Kind words for a killer

In 2005, at the age of 65, Narayan Mehra was diagnosed with tuberculosis and asbestosis, a chronic inflammatory medical condition that affects the lungs, causes shortness of breath, and puts a person at risk of cancer. Mehra had worked 22 years in a power plant in Ahmedabad. It took him another three years, in 2008, to get a written assurance of Rs 80,000 as compensation from his employer. He is yet to receive the money. Raghunath K Manvar of the Occupational Health and Safety Organisation, which fights for the workers’ rights to a safe working environment, visits the power plant’s office every day to help Narayan collect the promised sum. “They keep delaying, giving some excuse or the other,” says Raghunath.

Asbestos is a known industrial hazard. Its ill-effects on health are well-documented and its use is banned in many countries (such as the European Union, Chile, Iceland, Saudi Arabia, Brazil). For one thing, it has been identified as a cancer-causing agent. The Asbestos Cement Product Manufacturers Association argues that the use of chrysotile variety of asbestos under “controlled conditions is safe for workers, environment and the general public”. However, former scientific adviser to the European Commission Barry Castleman, in a 2003 paper, writes that “controlled use” of this substance has been discredited worldwide. The same year, Union minister Sushma Swaraj said in the Rajya Sabha, “Studies by the National Institute of Occupational Health, Ahmedabad, have shown that long-term exposure to any type of asbestos can lead to asbestosis, lung cancer and mesothelioma.”

However, in India, asbestos is still widely used (in 2006 the country imported 3,06,000 tonnes). Against this backdrop, the NIOH’s latest study on the hazards of using chrysotile asbestos gains significance. The draft report obtained early this year comprises a survey of six sites where asbestos is used. It concluded that the fibre levels in all the workplaces studied were below national and international standards and workers from five of the sites were “found to be in a good state of health”.

This study has been partly funded by the asbestos industry itself. A letter dated April 24, 2006, from the under secretary in the department of chemicals and petrochemicals, ministry of chemicals and fertilisers, to the director of NIOH reads: “The government will contribute Rs 43.66 lakh, while the Asbestos Cement Product Manufacturers Association would contribute Rs 16 lakh towards the total cost of the study.”

How objective can such a study be? Occupational health experts and others have serious concerns over its status.

Dr V Murlidhar, an occupational health specialist who has worked with the United Nations, says the draft does not quote NIOH’s own study on asbestosis among workers. The 2005 study by S K Dave and W S Beckett concludes that asbestos-related diseases are expected among workers exposed to asbestos while mining, milling and manufacturing as well as in those with secondary exposures to materials containing asbestos.

Benedetto Terracini, retired professor of cancer epidemiology at the University of Torino (Italy), asks: “On what basis do the authors state that ‘… the possibility of safe use of chrysotile asbestos … happens to be an unresolved issue’? Many asbestos experts would not endorse such a statement.” He says that the referred literature also does not mention relevant findings such as the consistent evidence that all forms of asbestos are carcinogenic for laboratory animals. More than 30 years ago, he writes, all types of asbestos were classified as carcinogenic to man by the International Agency for Research on Cancer.

Murlidhar, whose earlier study, ironically, was quoted by the NIOH report, says the numbers of Indian workers affected by asbestosis are less than the international norm because sick workers mostly leave the factory. Castleman wondered why some firms that participated in the study sent in people who had worked less than 20 years. In one firm, the mean age of selected workers is 30, with a mean-job duration of five years. “Not a chance of finding disease in this study,” he says.

Even when the study was proposed there were objections from experts. They advised the government against such a study. They also criticised the method used in the first of the series of studies, conducted in Kolkata.

Dr Murlidhar had written to the Union minister for chemicals and fertilisers that the proposed study would never find a place in a peer-reviewed journal. “If the work cannot have any chance of publication in any peer-reviewed journal, it is meaningless and trash.” He did not receive any reply.

Dr V Ramana Dhara, adjunct professor at the Morehouse School of Medicine and Rollins School of Public Health of Emory University, USA, wrote to the minister that, “No details of where the studies are to be conducted, exposure assessment, sampling methodology, and investigational methods are provided in the proposal.” Neither the proposed NIOH study nor the Kolkata study addresses the issue of lung cancer. He was clear that Indian workers were being needlessly exposed to asbestos. The only prudent solution was to ban its production and use. Dr Ramana never received a reply to his letter.

However, the National Institute of Occupational Health is unimpressed by the contrarian notes. Senior research officer Dr R R Tiwari, who worked on the report, says the institute stands by it. “We conducted a scientific study and whatever we have to say is in that report.” According to him, the report has been sent to the ministry of chemicals and fertilisers. He refused to comment further.

While the debate rages, industry workers continue to face the risk of disease and worse.

July 26 2008

Asha Menon

The New Indian Express