Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region

Abstract

Asbestos-related diseases usually have a long latency since first exposure and this legitimates a health surveillance programme addressed to asbestos workers after the cessation of their occupational exposure. After a brief history of health surveillance initiatives performed in Italy as well as in other countries, we describe a regional programme for former asbestos-exposed workers, focusing on organizational features.A regional group of experts defined its operational and economical aspects. The Regional Council supported the whole programme, making it free of charge for all subjects who fulfil the predefined enrolment criteria (being resident in the region, being younger than 80 years old with cessation of occupational asbestos exposure within the last 30 years). The programme activities are classified in two levels: a first level for a basic health evaluation and a second level for in-depth analyses. In order to guarantee an homogeneous delivery in the whole region, the programme has to be performed by public health services with a quality control of activities. The involvement of specific public health services and the cooperation of social stakeholders are expected to play a major role in overcoming still open critical issues, such as the lack of programme existence awareness and adhesion, the correct stratification of subjects for the follow-up, and the real homogeneous delivery of the health surveillance in whole region.

Clinical investigation of former workers exposed to asbestos: the health surveillance experience of an Italian University Hospital

“…A limitation of our research experience is that we allowed voluntary access by workers already exposed, regardless of exposure quantification, and in any case, allowed access to subjects who had ceased exposure for over 30 years, even those over 75 years old. Despite this, our study shares the well-established aims of health surveillance, such as the recognition of previous exposure, counseling for ARDs and their diagnosis and treatment, the deepening of the causal link by starting the medico-legal insurance process, and providing information and support to mitigate and eliminate additional risks ( 21 ).…”

“…In Italy, from the post-war period until the 1992 ban on asbestos, asbestos was widely used in many production areas. As a result, thousands of workers were exposed, especially in the years between 1950 and 1980 ( 19 – 21 ). In particular, the production of asbestos in Italy at that time was nearly 3.5 million tons, with a production peak recorded between 1976 and 1980 ( 22 ).…”

Epidemiology of Asbestosis between 2010–2014 and 2015–2019 Periods in Colombia: Descriptive Study

“…Among the relevant results, an increase in the frequency by people attended by asbestosis was determined from one five-year period to another, with an increased risk in women, people aged 45 or over, and in populations located in the Andean and Caribbean regions. The increase in frequency between periods may be due to the accumulation of risk between five-year periods, the implementation or improvements in diagnostic processes and epidemiological surveillance, or cohort effects such as described in the Japanese population [29,30].…”

Lung Cancer Screening in Asbestos-Exposed Populations

“…Italy has had a national exposure surveillance system for occupational carcinogens, including asbestos, and regional activities that are dedicated to health screening of former asbestos-exposed workers for many years and has been guided in recent decades by national consensus conferences attended by relevant experts [ 62 , 63 , 64 ]. These programs have been sponsored by occupational health services connected to regional health service departments and utilize numerous cohort studies previously conducted among workforces of large asbestos-using facilities.…”