Global Asbestos Congress 2004 is underway in Tokyo, Japan. This is a three-day conference which began on 19th November 2004. Deliberations are on to ensure early global ban on all forms of asbestos.

The Congress brings together some 420 researchers, civic group representatives and relatives of people who have asbestos-related diseases from more than 36 countries to discuss problems caused by asbestos and their possible solutions. The conference was organized by Japanese civic groups and researchers.

The Opening Ceremony began with introductions from Yoko Tomiyama and Sugio Furuya moderating the session of speakers like Yuji Furukawa, Ministry of Health, Labour and Welfare (MHLW), Japan, Isao Noda, Tokyo Metropolitan Government, Japan, Mitsuko Horiuchi, ILO Office in Japan
Seiko Hayashi, Japan Trade Union Confederation (JTUC-RENGO), Japan, Fiona Murie, International Federation of Building and Wood Workers (IFBWW), Switzerland, Laurie Kazan-Allen, International Ban Asbestos Secretariat (IBAS), U.K. and Yoshiomi Temmyo, GAC2004 Organizing Committee, Japan

The First Plenary Session on Global Health Impact of Asbestos called for urgent action with
Kazutaka Kogi and Laurie Kazan-Allen as chairs.

Setting the agenda,speaking about "The WTO Trade Dispute's Impact on Global Efforts to Ban Asbestos" Barry Castleman, Environmental Consultant from US how the establishment of the WTO in 1995 created a forum on the global stage where national asbestos bans could not only be challenged individually but collectively.

Recalling the event of Canada, the world's leading exporter of asbestos fiber, descison to risk taking a case to this "world court of trade" as national bans on asbestos proliferated across Europe and were proposed in Asian and South American countries, he said, though WTO must have seemed an ideal forum, where trade was the predominant priority, there were also considerable risks for Canada and what remained of the asbestos industry at the turn of the century.

The WTO's decision that asbestos bans did not violate international trade agreements, that they were fully justified on public health grounds, was a green light for asbestos ban efforts around the world and has now led to bans in a growing number of countries in all parts of the world.

He briefly narrated an epic story of a public health struggle that has come to involve a virtual network of people all over the world and stands as a model for these times. His analysis of the global struggle in which activists, scientists, unionists, and public health workers defeated attempts by asbestos interests to manipulate U. N. organizations. He presented the journey from Seattle to Geneva to the Third World to create the frame in which the issue stands at present.

Speaking as the second speaker Claudio Bianchi, Tommaso Bianchi, Center for the Study of Environmental Cancer - Italian League against Cancer, Monfalcone, Italy gave an overview
of the Geography of mesothelioma. He said, the principal feature in mesothelioma geography is the lack of data. Reliable figures on the incidence/mortality of/from mesothelioma are available for about 15% only of the world population. In particular, mesothelioma epidemiology is scarcely known for a majority of the big asbestos producers/consumers countries.

Where data are available, marked variations in incidence are observed. During the last decades mesothelioma incidence showed a progressive increase in various industrialized countries, reaching the highest values in Australia, Belgium, and the UK. In such countries annual crude incidence rates are around 30 cases per million. At the other extreme, crude incidence rates of 0.6 and 0.7 cases per million are reported respectively from Tunisia and Morocco. Japan showed a tremendous rise in mortality from mesothelioma during the last few years.

In all the countries a high ratio pleura/peritoneum is generally observed. Incidence is markedly higher among men than among women, and it varies substantially from one occupational category to another. Some occupational groups (for instance maritime trades, non asbestos textile industries) have only recently been recognized as categories at risk for mesothelioma.

At national level, wide variations are obser ved among the different areas. The above characteristics may largely be explained by differences in the asbestos use. The latency periods (time intervals between first exposure to asbestos and diagnosis of mesothelioma) are considerably longer than previously reported and currently appreciated. In large series mean latency periods were around 50 years.

He warned, an inverse relationship between intensity of exposure to asbestos and duration of latency period has been observed. Predictions on the future trend of mesothelioma epidemic should take into account the fact that generally latency periods are longer than 20-30 years. The mesothelioma wave consequent on the very high world asbestos consumption occurred in 1970s has yet to be seen, Bianchi concluded.

Epidemic of Asbestos-Related Diseases is a reality. Takehiko Murayama, Division of Multidisciplinary Studies, School of Science and Engineering, Waseda University, Japan presented this reality to the Congress.

In Japan, the consumption of asbestos, which is almost equal to the amount of asbestos imported due to negligible mining capacity, was minimal before World War II. It increased dramatically during the post-war "catch-up" period, reaching a peak level of 350,000 tons per year (t/yr) in the first half of the 1970s. Since then, it fluctuated around 250,000 - 300,000 t/yr until 1990, at which time a rapid decrease began. The most recent figure is 43,318 tons in the year 2002.

In 2003, the Japanese government began amending the related laws and regulations to prohibit in principle all asbestos use. The bulk of demand for asbestos came from the manufacture of asbestos cement sheet. Given the fact that use of asbestos continued over such a long period, concern regarding the risk of mesothelioma is well justified. The available statistics since 1995 show a growing number of mesothelioma deaths and has raised considerable concern among the public.

The trend has also prompted the government to revise the compensation criteria for mesothelioma as an occupational disease. Hence the prediction of the future trend of this disease has important implications from both the public health and occupational health standpoint.

According to a prediction by age-cohort model, the total number of deaths in the 40 years between 2000 and 2039 reaches about 103,000, and the predicted number (43,900) in the ten years between 2030 and 2039 would be 21.4 times the observed number (2,051) in the ten years between 1990 and 1999.

Another result based on a model using dose-response relationship shows that deaths induced by environmental exposure may occupy about ten percent of total number of deaths, informed Murayama.

The Burden of Asbestos-Related Diseases in South Africa and the Struggle for Reparation was also presented.

Asbestos mining in South Africa started around 1895 and continued until 2001. The shrinking international asbestos market resulted in decline in production from 1978 onwards. The National Union of Mineworkers (NUM), concerned about high levels of exposure and disease, organized for audits of surveillance programmes at various asbestos mines.

Screenings involved review of occupational and medical histories, chest radiographs and spirometry. Chest radiographs were read using the standardised International Labour Organisation (ILO) classification for pneumoconiosis. Lung function tests were interpreted using the American Thoracic Society (ATS) criteria.

Records of more than two thousand workers in crocidolite, amosite and chrysotile mines were reviewed over an 8 year period. Prevalence of asbestos-related disease (ARD) amongst retrenched workers ranged from 21-39% (crocidolite mines); 26-36% (chrysotile mines) and 37% in one amosite mine.

Workers were also exposed to asbestos in the transport, construction, asbestos-cement, motor, energy, textile and waste-disposal industries.

In addition, community members have been exposed to asbestos because of the extensive contamination of the environment. Given the epidemic proportions of ARD among exposed workers and surrounding communities, the Parliamentary Asbestos Summit was convened under the auspices of the Department of Environment and Tourism (DEAT) in the National Parliament of South Africa (1998).

All major role-players were involved, and practical recommendations were made to address the asbestos epidemic. The DEAT recently announced in Parliament that asbestos use will be prohibited and will be phased out over three to five years for products where no current alternatives are available.

Trade Union and civil society organization as well as litigation have been important in attempts to address the asbestos legacy of injustice, poverty, inequality and disease burden left by apartheid.

The Indian presenter informed the Congress of absence of central mesothelioma registry, shortage of trained pathologists to correctly identify the disorder, lack of occupational safety and health arrangements specially for industrial hygiene assessment of exposure. It seems India has a long way to go before asbestos is banned in India. Application of precautionary principle, and placing a ban on all forms of asbestos use as practiced in Australia and Europe, may offer protection to millions at work and in community in India.

The Global Asbestos Congress would conclude its sessions on 21 November 2004.