職安議題

我們，身為世界各國的研究者、科學家、醫師、職業健康及石綿相關疾病的專家，共同與石綿受害者群體的代表和工會，聯合支持這封給您的公開信。我們對於亞洲許多國家仍持續使用白石綿的現況，表達誠摯而深沈的憂慮。儘管已有清楚且明確的證據指出，癌症和其他疾病的風險與持續使用石綿相關。

當您考慮貴國未來繼續使用石綿產品時，我們希望下列各點能喚起您的注意。

• 白石綿是現今石綿相關疾病在世界上的首要原因。白石綿，以及所有其他類型的石綿，無疑已知將會造成肺癌、間皮瘤、石綿肺症、喉癌和卵巢癌。國際癌症研究署（International Agency for Research on Cancer, IARC）已清楚且妥善記錄了白石綿與一系列癌症具有直接關連的國際證據[1]。
  
  
• 提倡繼續使用白石綿者聲稱白石綿纖維在體內14日內便會溶解，因而不會造成石綿疾病──這是完全錯誤的[2]。
  
  
• 提倡繼續使用白石綿者聲稱世界上還有80%的國家仍使用白石綿，這是錯誤的。世界上多數國家若非已正式禁止白石綿，就是不再將它用於製造業，這是因為它對勞工和社群帶來致命的癌症。2015年僅有87國報告曾使用石綿原料，且其中多數僅使用非常少量。聯合國195個會員國中，僅低於15%曾在2015年使用超過1,000噸白石綿。當年，世界上僅有七國使用超過5萬噸（即中國、印度、印尼、越南、烏茲別克斯坦、俄國和巴西）。亞洲是目前使用白石綿最後的主要區域，年度使用量超過全球的75%[3]。
  
  
• 國際勞工組織（ILO）全體會員國在2006年舉行的勞動會議（Labour Conference）聲明：未來不再使用石綿，是保護勞工免於石綿暴露及預防未來石綿相關疾病最有效的方法[4]。
  
  
• 世界衛生組織多次表示「根除石綿相關疾病最有效率的方式，是停止使用所有類型的石綿。」[5]
  
  
• 整條供應鍊都無法擔保任何石綿的「安全使用」方式。證據持續顯示：國家的石綿相關疾病負荷與該國的石綿使用量直接成正比。研究發現也支持，已工業化國家的高石綿相關疾病負荷可歸因於其數十年前的石綿使用，儘管過去曾有各種確保「安全使用」的嘗試[6]。
  
  
• 2017年出版的「全球疾病負荷」研究最近期的推估：2016年可歸因於石綿的全球死亡負荷為每年超過22.2萬人[7]。有證據指出即使是這個巨大而令人擔憂的數字，都還是低估。
  
  
• 含石綿產品的「低成本」特性，成為被引用為繼續使用石綿的論點，特別是為窮人提供廉價的住房材料。真要公平比較，聲稱的「低成本」並未考慮到未來石綿相關疾病罹患者的補償和健康照護成本、住在破損的有毒屋頂房子中的暴露風險，以及未來為移除與安全處理含石綿材料的建築和其他產品所衍生的成本。
  
  
• 含石綿產品有安全且經濟上可行的替代品，已用於亞洲和禁止石綿的所有國家[8]。
  
  
• 在亞洲發展無石綿科技，是在該區域產生在地工作和新綠能產業的機會。
  
  
• 許多已工業化國家已歷經社會大眾的不安和對政府的訴訟，這是由於政府未能即時地對石綿危害採取恰當的行動，而感覺到政府無能保護大眾健康。
  
  
• 世界衛生組織一份對所有禁止石綿國家的近期研究，並未發現對任何禁止石綿的國家造成GDP負面影響[9]。

為了在亞洲拯救生命、減少未來的石綿相關疾病負荷、支持永續經濟發展、避免不必要的社會不安，我們敦促政府立即行動，以迅速淘汰石綿用於建材，並禁止所有類型的石綿用於所有產品。

[1] http://monographs.iarc.fr/ENG/Classification/

[2]影片www.chrysotile-asia.com/+ Richard L. Kradin MD,  George Eng MD, | David C. Christiani MD 2017 ‘Diffuse peritoneal mesothelioma: A case series of 62 patients including paraoccupational exposures to chrysotile asbestos  +Leslie T Stayner, PhD, David A. Dankovic, PhD, and Richard A. Lemen, PhD 1996

Occupational Exposure to Chrysotile Asbestos and Cancer Risk: A Review of the Amphibole Hypothesis  + Suzuki Y¹, Kohyama N. Am J Ind Med. 1991;19(6):701-4.Translocation of inhaled asbestos fibers from the lung to other tissues. + Xiaorong Wang,1 Eiji Yano,2 Hong Qiu,1 Ignatius Yu,1 Midori N Courtice,1 L A Tse,1 Sihao Lin,1 Mianzhen Wang 2011 A 37-year observation of mortality in Chinese chrysotile asbestos workers

[3]USGS - Estimates Of Global Asbestos Production, Trade, & Consumption In 2015

[4]ILO Resolution on Asbestos 2006

[5]Chrysotile Asbestos 2014 WHO  http://www.who.int/ipcs/assessment/public_health/chemicals_phc

[6] https://www.ncbi.nlm.nih.gov/pubmed/17350453

[7]193,374: http://vizhub.healthdata.org/gbd-compare/

[8]Asbestos Economic Assessment of Bans and Declining Production and Consumption; Lucy P. Allen, Jorge Baez, Mary Elizabeth C. Stern and Frank George 201)

[9]同前註。

We, as researchers, scientists, doctors, specialists in occupational health and asbestos related diseases (ARDs) from around the world, in conjunction with representatives of asbestos victims’ groups and trade unions are supporting this open letter to you to express our sincere and deep concern over the continuing use of chrysotile asbestos in many countries in Asia. This is despite clear and unequivocal evidence of cancer and other disease risks associated with its continued use.  

We would like to bring the following to your attention, as you consider the future use of this product in your country.

• Chrysotile asbestos is the leading cause of asbestos related diseases in the world today. Chrysotile asbestos, along with all other types of asbestos, are without any doubt known to cause lung cancer, mesothelioma, asbestosis, laryngeal cancer and ovarian cancer.  Theinternationalevidenceonchrysotile’ s directlinktoa range of cancers is clear and well documented by the International Agency for Research on Cancer (IARC)[1].
  
  
• The claims from those that advocate the continued use of chrysotile asbestos that chrysotile fibers dissolve in the body in 14 days and therefore do not cause asbestos disease, are completely false[2].
  
  
• The claims from those that advocate continued use of chrysotile asbestos  that 80% of the world still use chrysotile asbestos is false. The majority of countries in the world either have formally banned chrysotile or no longer use it in manufacturing because of its deadly cancer legacy for workers and communities. Only 87 countries reported any consumption in 2015 of raw asbestos and most of these consumed very small amounts. Fewer than 15% of the 195 countries belonging to the UN used more than 1,000 tons of chrysotile asbestos in 2015. In that year, just seven countries in the world used more than 50,000 tons (i.e. China, India, Indonesia, Vietnam, Uzbekistan, Russia and Brazil). Asia is now the last major region consuming chrysotile asbestos, with more than 75% of the world’s annual consumption[3].
  
  
• The ILO Labour Conference of all member states in 2006, declared the elimination of the future use of asbestos as the most effective means to protect workers from asbestos exposure and to prevent future ARDs.[4]
  
  
• The WHO has repeatedly stated ‘the most efficient way to eliminate asbestos-related diseases is to stop using all types of asbestos’[5]
  
  
• There is no ‘safe use’ of asbestos that can be ensured across the supply chain. Evidence continues to show that national burdens of ARDs are directly proportionaltonationalconsumptionofasbestos.Thisissupported byfindingsthattheheavyburden of ARDs in industrialized countries is attributable to their consumption of asbestos several decadesearlier,despiteallattemptstoensurethe“safeuse”ofasbestos[6].
  
  
• The global burden of deaths attributable to asbestos has been estimated by Global Burden of Disease at over 222,000 persons annually[7] in its latest estimate for 2016 published 2017.  Evidence exists that even this large and alarming number is an underestimate.
  
  
• The “low cost” of asbestos-containing products is cited as an argument for continuing the use of asbestos, particularly in providing cheap housing material for the poor. The purported “low cost” to be a fair comparison, fails to consider the compensation and health care costs for future ARD sufferers, the exposure risks for those living in houses with degrading toxic roofing as well as the future costs of removing and safely disposing of asbestos-containing materials from buildings and other products.
  
  
• There are safe and economically viable substitutes for asbestos containing products, that are already used in Asia and all countries that have banned asbestos[8].
  
  
• Asbestos-free technologydevelopedin Asia,isanopportunity to generate localjobs and new greenerindustries intheregion.
  
  
• Several industrialized countries have experienced public unrest and litigation against Governments due to the Governments’ perceivedfailuretoprotectpublichealthby failing to act in a timely and appropriate manner on asbestos hazards.
  
  
• A rerecent WHO study[9] of all countries that have banned asbestos has found no negative effect on GDP of any country that has banned asbestos. 
  

To save lives, reduce the future burden of ARD’s,supportsustainable economicgrowthand avoid unnecessary social instabilityin Asia, we urge immediate action by governments to rapidly phase out the useofasbestos inconstructionmaterialsandban all types of asbestos in all products.

Please read the Open Letter carefully and email us with the following information if you agree to add your name being added to the Letter: 

• Your title
• Your organisation
• Your country
• Your email address (kept private)

This campaign for signatures will be open until 15 February 2018. All emails to be received by 5pm (AEDT) Thursday 15 February 2018.

Emails to be sent to openletter@apheda.org.au with a statement along the following lines: “I agree to sign on to the A-BAN Open Letter to Asian Governments and other Policymakers in regards to the Health Alert on Chrysotile Asbestos’”

Details of how to sign on to the letter are available at the following link http://apheda.org.au/asbestos-open-letter/

[1] http://monographs.iarc.fr/ENG/Classification/

[2] Video clip www.chrysotile-asia.com/+ Richard L. Kradin MD,  George Eng MD, | David C. Christiani MD 2017 ‘Diffuse peritoneal mesothelioma: A case series of 62 patients including paraoccupational exposures to chrysotile asbestos  +Leslie T Stayner, PhD, David A. Dankovic, PhD, and Richard A. Lemen, PhD 1996

Occupational Exposure to Chrysotile Asbestos and Cancer Risk: A Review of the Amphibole Hypothesis  + Suzuki Y¹, Kohyama N. Am J Ind Med. 1991;19(6):701-4.Translocation of inhaled asbestos fibers from the lung to other tissues. + Xiaorong Wang,1 Eiji Yano,2 Hong Qiu,1 Ignatius Yu,1 Midori N Courtice,1 L A Tse,1 Sihao Lin,1 Mianzhen Wang 2011 A 37-year observation of mortality in Chinese chrysotile asbestos workers

[3] USGS - Estimates Of Global Asbestos Production, Trade, & Consumption In 2015

[4] ILO Resolution on Asbestos 2006

[5]Chrysotile Asbestos 2014 WHO  http://www.who.int/ipcs/assessment/public_health/chemicals_phc

[6]https://www.ncbi.nlm.nih.gov/pubmed/17350453

[7] 193,374: http://vizhub.healthdata.org/gbd-compare/

[8] Asbestos Economic Assessment of Bans and Declining Production and Consumption; Lucy P. Allen, Jorge Baez, Mary Elizabeth C. Stern and Frank George 201) 

[9]Ibid