活動紀錄

2005年6月，日本機械設備領導品牌「久保田」公司被媒體揭發，在過去十年間，有超過五十名前員工死於罕見的致命癌症「間皮瘤」，該疾病已知與石綿暴露有密切相關。後續報導更揭露工廠周遭居民，也有多人因間皮瘤過世。久保田事件引發社會震撼，並迅速發展成全國性的職災與公害疾病訴訟運動。日本政府不得不修訂法規，積極面對石綿疾病受害者的補償與救濟問題，並著手處理環境的石綿暴露問題。反觀台灣，早期石綿工廠遍佈，包括製造業、營造業、裝潢業、造船業與拆船業，過去均曾有相當高濃度的石綿粉塵暴露，但政府不僅未正視石綿疾病受害者的困境，對於至今仍無所不在的石綿暴露，也無積極對策。

石綿疾病個案增加，已是不爭的事實

石綿會導致石綿肺症，也是間皮瘤、肺癌與其他癌症的重要致病因素。目前全球已有超過50個國家全面禁用石綿，但台灣仍允許部分產業繼續使用，而周遭的亞洲國家包括中國、泰國、越南、印度等國，仍持續大量使用。世界衛生組織的報告即指出，石綿危害已是亞洲地區的重大公衛問題。

工業先進國家雖已全面禁用石綿，但由於暴露至疾病發生的潛伏期高達數十年，因此至今石綿疾病仍不斷出現。以日本為例，戰後快速工業化時期大量使用石綿，導致間皮瘤死亡個案在過去20年來成長三倍，光在去年一年間（2015）即有1500人因間皮瘤死亡。

台灣近年來已有不少臨床醫學報告，指出石綿疾病快速增加；國內學者也已出版多篇流行病學研究，指出石綿暴露嚴重的產業，包括拆船業勞工，罹患石綿疾病的風險高於一般民眾。國家衛生研究院李俊賢醫師研究團隊分析台灣癌症登記資料庫，更發現台灣的惡性胸膜間皮瘤發生率逐年增加。因石綿暴露而引起的其他疾病，包括石綿肺症、肺癌、喉癌與其他癌症，預期將相當可觀。

日本的石綿訴訟、補償與公害救濟

日本民間組織「全國勞動安全衛生中心聯絡會議」事務局長古谷杉郎、「間皮瘤、石綿疾病患者與其家屬協會」事務局長澤田慎一郎，以及「大阪石綿律師辯護團」團長村松昭夫共同發表的聲明指出，根絕石綿疾病的最好方法，是全面禁用石綿，但這只是第一步。更重要的是，需積極落實「無石綿環境」。

對於石綿疾病的受害者而言，由於勞災補償與公害救濟機制的限制，司法制度是實現正義的另一手段。以石綿紡織產業為發源地的大阪泉南地區，石綿疾病患者及其家屬，以國家沒有適當監管與管理，導致石綿危害的擴大，集體對國家提起了訴訟。「泉南訴訟」自2006年提出，歷經八年，最高法院在2014年10月9日做出裁決，確定了國家有其損害賠償的責任。此外，全國各地從事建築工作而罹患石綿疾病的勞動者與其家屬，也對國家與石綿建材製造商追究責任。在東京、福岡、大阪、京都等四個地方法院的判決，皆判決國家應負責任。在京都地方法院的判決中，部分石綿建材製造商也被認定須為石綿受害者的損害承擔責任。為了讓未提起訴訟的受害者也能獲得補償，民間團體正在研究特別基金的設置。

從石綿危害，檢視台灣職業安全健康制度問題

台灣職業安全健康連線已訪談數位罹患間皮瘤或石綿相關疾病的工作者，發現罹病者大多有明顯的石綿職業暴露史，但他們卻不清楚石綿的危害。此外，因為目前職災補償制度的問題叢生，導致石綿疾病難以被認定為職業病。大多數罹病者除了健保提供的醫療服務，未獲得任何補償。

面對當前的石綿疾病風暴，日本與歐美等工業先進國家已紛紛提出因應之道：對於受害者，建立合理的補償與醫療照顧機制；對於高暴露族群，建立健康檢查追蹤機制；對於目前仍存在於環境中的石綿危害，包括既有建築物中的石綿瓦、石綿板、石綿管以及廢棄物，建立監測、標示與管理機制。反觀台灣，政府並未重視工業化過程對勞動者帶來健康傷害。在目前混亂的職災補償制度之中，職業病患者難以獲得合理正義的補償。在危害暴露的管理上，台灣不僅尚未禁用石綿，更任由含石綿物質充斥環境，任由無數建築、裝潢、拆除業工作者甚至一般民眾，繼續陷於罹病風險。我們呼籲政府應儘快採取以下行動：

預防暴露：儘速全面禁用石綿、盤點並標示現存之石綿暴露、提供石綿作業工作者個人防護設備、落實石綿廢棄物管理、加強進口貨品查驗。

健康追蹤：辦理高暴露族群的定期健康檢查、清查建置曾有暴露史之勞工名單，並於轉職或退休後仍持續健康追蹤、建立全國惡性間皮瘤及石綿相關疾病的登記通報機制。

補償救濟：檢討現行職災保險制度，包括擴大涵蓋人口、提高給付額度、簡化認定程序、針對環境暴露者，建立合理的公害救濟機制。

教育宣導：充分告知石綿的健康危害、暴露資訊及預防暴露方式，並宣導職業傷病通報認定與補償制度的重要性。

記者會出席人員： 

黃怡翎           台灣職業安全健康連線執行長 

李俊賢           國家衛生研究院國家環境醫學研究所醫師 

澤田慎一郎    間皮瘤、石綿疾病患者與其家屬之協會事務局長 

古谷杉郎       石綿對策全國連絡會事務局長 

村松昭夫       大阪石綿律師辯護團團長、律師 

彭保羅           中央研究院社會學研究所副研究員 

林宜平           陽明大學科技與社會研究所副教授兼所長 

鄭雅文           台灣職業安全健康連線理事長/台大健康政策與管理研究所教授

Toward an asbestos-free environment,

Japan has progressed but Taiwan still lags far behind

Taiwan Occupational Safety and Health Link

In June of 2005, the media disclosed that over the past 10 years, more than 50 former workers of the Kanzaki factory of the Kubota Corporation, a leading machinery manufacturer in Japan, had died from mesothelioma. It is a rare type of cancer and is caused almost exclusively by asbestos exposure. Subsequent reports further revealed that some residents in the neighboring area also died from the disease. These events shocked the society, leading to a nationwide social movement up until today demanding for fair compensation to workers and residents succumbed to asbestos related diseases. In response the government of Japan amended compensation regulations and took measures to control asbestos hazards in the environment.  In Taiwan, occupational asbestos exposure was also severe in the past. Workers in manufacturing factories, construction and renovation sites as well as shipbuilding and ship-breaking industries were exposed to high levels of asbestos. Until now, asbestos-containing materials are still ubiquitous in our living environment.  However, in contrast to Japan's development, Taiwan's government has turned a blind eye to the hardships encountered by patients with asbestos-related diseases, and has done little, if any, actions to control asbestos exposures.

Epidemic of asbestos-related diseases is an undeniable fact

Asbestos is known to cause a variety of diseases, including asbestosis, mesothelioma, lung cancer and other malignant cancers. More than 50 countries have banned asbestos in all types, but asbestos is still allowed in some manufacturing factories in Taiwan. It is even more troublesome that many Asian countries including China, Thailand, Vietnam and India are still consuming asbestos on a large scale. The World Health Organization has asserted that asbestos related diseases represent a rising epidemic especially in Asia.

In almost all economically advanced countries, asbestos had been banned many years ago. However, due to a long disease latency, the number of asbestos-related diseases continues to rise.  As shown in Japan, high asbestos consumption in the past has contributed to the rising trend of mesothelioma deaths. Over the past 20 years, the number of mesothelioma deaths has grown by 3-fold, accounting for 1500 deaths in year 2015 alone.

Clinical case reports published by Taiwanese researchers have indicated that asbestos-related diseases are also on a rise in Taiwan.  Epidemiologic studies from Taiwan have found that workers previously exposed to asbestos exposure, including shipyard workers, were at substantially higher risks for asbestos-related diseases than the general population. to the workers who exposed asbestos in shipbuilding and ship-breaking industry.  Dr. Lee Jyuhn-Hsiarn, a researcher and physician of the National Health Research Institutes of Taiwan, analyzed data from the Taiwan Cancer Registry and found that the incidence rate of mesothelioma has increased steadily over years. Based on Taiwan's asbestos consumption data in the past, we expect to observe more and more asbestos-related diseases.

Asbestos litigation, compensation and relief act in Japan

Mr. Sugio Furuya, the Secretary General of the Japan Occupational Safety and Health Resource Center (JOSHRC), Mr. Shinichiro Sawada, the Secretary General of the Japan  Association of Mesothelioma and Asbestos Related Disease Victims and their Families, and Mr. Muramatsu, an attorney at law and the leader of the Osaka Asbestos Litigation Team, issued a statement together, which stated that the best way to eradicate asbestos related diseases is to ban asbestos, but it is only the first step. The next step should be the removal of asbestos from our living environment.

As to victims succumbed to asbestos related diseases, the judicial system is an alternative to realize fair compensation, beside the worker’s compensation system and the relief scheme. Asbestos victims and their families in Sennan area, the birthplace of Japan’s asbestos textile industry, filed a class lawsuit in 2006 against the government, accusing that the government had failed to supervise enterprises and implement necessary regulations. After 8 years of legal process, the Supreme Court issued its final decision on October 9, 2014, asserting that the Japan government was liable for the damages suffered by asbestos victims.  Moreover, construction workers suffer from asbestos diseases and their families also filed lawsuits against the governments and producers of asbestos containing building materials. Similar lawsuits have been filed nationwide, and the district courts of Tokyo, Fukuoka, Osaka and Kyoto had all determined that the governments were liable. The court of Kyoto further determined that building material manufacturers were also responsible for the health damages. Activists in Japan have have proposed to establish a special fund to help other asbestos victims who did not file lawsuits.

Examining Taiwan's occupational safety and health systems

Taiwan Occupational Safety and Health Link, a NGO dedicated to promoting workers' health, has interviewed several workers with mesothelioma or other asbestos-related diseases. We found that most of these workers had clear occupational history of asbestos exposure, but few of them were aware of asbestos risks. Furthermore, very few of them were eligible for workers' compensation, due to many barriers existing in current workers' compensation systems. 

In response to asbestos epidemics, Japan and many western countries have taken several policy actions, including the establishment of reporting mechanisms for asbestos related diseases, provision of health care for the victims, provision of regular health checkups for high exposure groups, setting up monitoring and management mechanisms of asbestos-containing materials and wastes. In contrast, the government of Taiwan has long been negligent in overlooking workers' health problems caused by industrial hazards. Under current workers' compensation systems, workers suffering from occupational diseases can hardly obtain fair compensation. While asbestos is still allowed and no effective environmental control strategies are implemented, numerous workers in construction, renovation, demolition, waste removal industries and even the general public are all under the health threats of asbestos. We urge the government to take immediate actions as following:  

Prevent exposure  The government should impose a complete ban on asbestos, check and label existing asbestos exposure, provide workers with proper personal protective equipments, manage asbestos wastes and strengthen the inspection of imported goods.

Health surveillance  The government should establish regular health check mechanism for high exposure groups, make list of high exposure workers and provide health checkups even after job changes or retirement, and establish a national registration and notification mechanism for mesothelioma and asbestos-related diseases.

Compensation and relief  Major reforms of the workers' compensation system are urgently needed, including a full coverage of all employees, more comprehensive scope and increased levels of benefits and simplification of application procedure.  A relief system should also be established for disease victims due to environment asbestos exposure.

Health education  The government should inform the public of the health risks of asbestos, exposure control methods as well as the purpose and importance of workers' compensation for occupational diseases.