Tamura Akihiko, Member of Board of Directors of Min-Iren,
Secretary, Survey and Research Team on Multiple Asbestos-Related Facilities

Since the “Kubota Shock” of June 2005, asbestos has been receiving increasing attention in Japan. Health hazards have been found not only in manufacturing plants of asbestos-related products, but in more extensive areas, including shipbuilding, automobile manufacturing, locomotive manufacturing and dismantlement, harbor loading and unloading and construction-related facilities. And it was found that local residents living in the surrounding areas of these facilities, as well as workers there, have also been affected. At present, those victims are bringing their cases into court to question the responsibility for the damage and demand compensation. They include the Osaka Sennan Area Asbestos State Compensation Case, the Tokyo Metropolitan Construction Asbestos Case that try to hold major building material manufacturers and the government to account.

Min-Iren’s research draws attention of academic societies

Since the problems arose, Min-Iren has conducted counseling meetings at different places to turn up health damages related to asbestos. It also held “Schaukasten seminars” for Min-Iren medical doctors to improve their image diagnostic technology.

Further, in order to elucidate academically the situation of health damage, in 2008, Min-Iren established the Min-Iren Survey and Research Team on Multiple Asbestos-Related Facilities made up of 14 medical doctors, which launched a study on the effects of asbestos among lung cancer patients.

In 2008, 66,849 people died from lung cancer, the largest number among all cancer deaths in Japan, and the number is increasing. However, compared with the cases of mesothelioma (a kind of cancer developing on pleura), which is unique to the people exposed to asbestos, there has been only a low recognition on the relation of asbestos with lung cancer cases even among people in medical practices. Lung cancers are often attributed to patients’ smoking habits, and other possible contributing factors have not been sufficiently examined. The Research Team held image-reading sessions to decipher the chest X-ray and chest CT scanning images of lung cancer patients, and studied the patients’ employment histories and the ratio of pleural plaques development which is often regarded as the “index of asbestos exposure”.

Last year, the interim report of the study was presented before the Japan Society for Occupational Health, the Japanese Respiratory Society and the Japanese Society for Social Medicine, and attracted a great deal of attention from participants. The report covered 471 primary (not metastatic) lung cancer patients, whose diagnoses were confirmed during 2006-2007. Among 339 male and 132 female patients, 12.3%, 1 out of 8, were confirmed to have pleural plaques by their chest CTs. Pleural plaques were found especially among those who had experienced the jobs in which they had presumably been exposed to asbestos, such as construction or civil engineering works (40.0% each), or metallic material manufacturing (30.8%).

These image-reading sessions were held in 6 places in Japan, and at present, the team is compiling its final report after studying 900 patients. The final result, roughly the same content of the interim report, will again be presented before academic conferences.

Each image-reading session lasted for two days from morning to evening, covering the images of 140-180 patients, attended by a group of doctors. Though getting their eyes strained and suffering from backaches by the end of the day, in addition to the team member doctors, 50 other doctors and doctors-in-training from different parts of the country took part in the sessions. This study contributed greatly to training groups of Min-Iren doctors who can cope with the problems of asbestos damage, which are likely to continue for the coming decades.

Min-Iren’s Request to Patients and Affiliated Organizations

Min-Iren is calling on patients and members of Min-Iren affiliated organizations the following three points:

1. Tell the history of your employment and residence: When you visit a hospital/clinic, please tell the history of your employment and residential areas to doctors or medical staffs. In this study on multiple facilities, 1 out of 8 patients was found to have been affected by asbestos. But the employment and residence history was entered on the medical chart of only two-thirds of those patients. The patients yourselves should help medical experts to learn about the disease by telling them your job history.
2. Expand counseling activities: Let us support the victims inviting them to Min-Iren’s counseling places. Asbestos has caused extensive health damage and many of the victims are still left with no relief measures. If you know someone diagnosed with not only mesothelioma, but also with lung cancer, interstitial pneumonia or pneumonocirrhosis, listen to their problems and consult with our hospitals or clinics.
3. Importance of regular health check-ups and health management: Characteristics of asbestos include high cancer-causing property and the long incubation period. So those who had been exposed to asbestos in the past need to manage their health carefully by having regular medical check-ups and quitting smoking.

The government has set up a system of issuing an asbestos health-check card to former workers of asbestos-related industries, with which they can undergo free medical check-ups twice a year. Those who have experienced any works related to asbestos should make use of this system, which will be made available by checking with prefectural labor bureaus or labor inspection offices.

There are still shortcomings, however, with this health-check card system, such as (a) Small number of cards issued; (b) Few medical institutions designated by labor bureaus for health-checkups; (c) The system does not cover independent carpenters, those who carry on business on their own or local citizens who have lived in the neighborhood of asbestos-related facilities.

In 2011, the “New Relief Scheme” law for asbestos victims is due to be revised. We call for a nation-wide people’s movement to achieve a total-relief for the victims and the establishment of their health-care management system.

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A Quite Rare Survey in the World

Suganuma Narufumi

Professor of Kochi University, who took part in the survey as an advising doctor

There have been many researches and studies about the effect of asbestos on the groups of people who have high probability of having been exposed to asbestos (workers in asbestos mines, textile plants or construction sites, etc.) in different parts of the world. What is rare in our study was that all lung cancer patients were targeted, irrespective of their employment histories.

Thanks to dedicated staffs of Min-Iren working on occupational disease issues, many doctors and personnel in radiotherapy helped us with collecting cases. The ability of image diagnostic technology of the doctors in the team improved each time we had the image-reading session.

In Min-Iren, there are many doctors who are considerate of and sympathetic towards patients’ feelings. I hope they will keep such a posture and continue to work for the patients.