National Institute for Occupational Health, National Health Laboratory Service, Johannesburg, South Africa.
Glob Health Action. 2013 Jan 24;6:19410. doi: 10.3402/gha.v6i0.19410.
Environmentally acquired asbestos-related diseases (ARDs) are of concern globally. In South Africa, there is widespread contamination of the environment due to historical asbestos mining operations that were poorly regulated. Although the law makes provision for the compensation of occupationally acquired ARDs, compensation for environmentally acquired ARDs is only available through the Asbestos Relief Trust (ART) and Kgalagadi Relief Trust, both of which are administered by the ART. This study assessed ARDs and compensation outcomes of environmental claims submitted to the Trusts.
The personal details, medical diagnoses, and exposure information of all environmental claims considered by the Trusts from their inception in 2003 to April 2010 were used to calculate the numbers and proportions of ARDs and compensation awards.
There were 146 environmental claimants of whom 35 (23.9%) had fibrotic pleural disease, 1 (0.7%) had lung cancer, and 77 (52.7%) had malignant mesothelioma. 53 (36.3%) claimants were compensated: 20 with fibrotic pleural disease and 33 with mesothelioma. Of the 93 (63.7%) claimants who were not compensated, 33 had no ARDs, 18 had fibrotic pleural disease, 1 had lung cancer, and 44 had mesothelioma. In addition to having ARDs, those that were compensated had qualifying domestic (33; 62.2%) or neighbourhood (20; 37.8%) exposures to asbestos. Most of the claimants who were not compensated had ARDs but their exposures did not meet the Trusts' exposure criteria.
This study demonstrates the environmental impact of asbestos mining on the burden of ARDs. Mesothelioma was the most common disease diagnosed, but most cases were not compensated. This highlights that there is little redress for individuals with environmentally acquired ARDs in South Africa. To stop this ARD epidemic, there is a need for the rehabilitation of abandoned asbestos mines and the environment. These issues may not be unique to South Africa as many countries continue to mine and use asbestos.
环境获得性石棉相关疾病（ARDs）在全球范围内引起关注。在南非，由于历史上石棉开采作业监管不善，环境受到广泛污染。尽管法律规定对职业性获得的 ARDs 进行赔偿，但环境获得性 ARDs 的赔偿只能通过石棉救济信托基金（ART）和卡加拉迪救济信托基金获得，这两个信托基金均由 ART 管理。本研究评估了信托基金受理的环境索赔的 ARD 情况和赔偿结果。
从信托基金 2003 年成立到 2010 年 4 月受理的所有环境索赔中，使用个人详细信息、医学诊断和暴露信息，计算 ARD 和赔偿裁决的数量和比例。
共有 146 名环境索赔人，其中 35 人（23.9%）患有纤维性胸膜疾病，1 人（0.7%）患有肺癌，77 人（52.7%）患有恶性间皮瘤。53 人（36.3%）获得了赔偿：20 人患有纤维性胸膜疾病，33 人患有间皮瘤。在未获得赔偿的 93 名（63.7%）索赔人中，33 人无 ARD，18 人患有纤维性胸膜疾病，1 人患有肺癌，44 人患有间皮瘤。除了患有 ARD 外，获得赔偿的人还存在符合国内（33 人；62.2%）或邻里（20 人；37.8%）暴露标准的石棉暴露。大多数未获得赔偿的索赔人患有 ARD，但他们的暴露情况不符合信托基金的暴露标准。
本研究表明，石棉开采对 ARD 负担产生了环境影响。间皮瘤是诊断出的最常见疾病，但大多数病例未得到赔偿。这表明南非环境获得性 ARD 患者几乎没有得到补救。为了阻止这种 ARD 流行，需要对废弃的石棉矿和环境进行修复。由于许多国家继续开采和使用石棉，这些问题可能不仅在南非存在。
