Distribution of Asbestos Enterprises and Asbestosis Cases - China, 1997-2019

Our plain-English summary of Distribution of Asbestos Enterprises and Asbestosis Cases - China, 1997-2019, by M. Chen, H. Wang, J. Zhang, et al (China CDC Weekly, 2020).

The study

• Authors: M. Chen, H. Wang, J. Zhang, C. Yu, W. Liu, Y. Xu
• Journal: China CDC Weekly
• Published: 2020;2(18):305-309
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

What Is Already Known On This Topic?: Asbestos is classified as a Class I Carcinogen by the International Agency for Research on Cancer (IARC) because exposure causes mesothelioma and lung cancer in addition to asbestosis and plaques. So far, asbestos has been banned in 67 countries, but chrysotile, a commonly encountered form of asbestos, is still widely used in China and most developing countries. Most asbestos-caused cancers are not reported, recorded, and compensated in many countries.

What Is Added By This Report?: Enterprises manufacturing asbestos products have been migrating from economically developed Eastern China to relatively underdeveloped central and western regions between 2010 and 2019. Asbestosis cases reported in Tianjin, Beijing, Shandong, Xinjiang, Gansu, Qinghai, and Sichuan accounted for a large proportion of the total cases in China, which was inconsistent with the distribution of asbestos-related enterprises (AREs). The reported asbestosis cases versus total pneumoconiosis cases declined from 2.81% to 0.39% from 2006-2017, and this proportion reached 0.69% in 2018.

What Are The Implications For Public Health Practice?: Robust occupational and environmental health assessments and reporting are needed to define the epidemiology of asbestos-related lung diseases, and management of using asbestos and existing products containing asbestos need strengthening and follow-up. Enterprises should be encouraged to use safer substitutes and gradually ban asbestos materials in China.

Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2020.

In plain English

This descriptive study used data from China's occupational disease reporting system and its industry-commerce registration system. The authors counted asbestos-related enterprises in mainland China: 1,611 in 2010, with 188,739 employees, and 1,936 in 2019. The share of these enterprises located in Eastern China fell from 78.4% to 58.1%, while the share in Western China rose from 8.0% to 24.6%. A total of 3,831 asbestosis cases were reported between 1997 and 2018. Reported cases fell from 294 in 1998 to 89 in 2017. Asbestosis fell from 3.55% of all reported pneumoconiosis cases in 1998 to 0.39% in 2017, and was 0.69% in 2018. Where cases were reported did not match where the enterprises were. Hebei had the most enterprises in both years but only 26 reported cases in 1997 to 2018. Tianjin had 67 enterprises across the two years and 1,362 cases. The authors concluded that many asbestosis patients may not have been found. They had no asbestos exposure information and could not evaluate the reported cases in each region for authenticity, completeness or precision, which may affect their regional distribution.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive analysis of national registry data: occupational disease reports and business registrations
• Who was studied: Asbestos-related enterprises registered in mainland China: 1,611 (with 188,739 employees) in 2010 and 1,936 in 2019. Also the 3,831 asbestosis cases reported in China between 1997 and 2018.
• Exposure: No measured exposure. Enterprises were included if their registered business involved asbestos raw materials (mining, trading, making primary products) or asbestos products such as vinyl asbestos tiles, asbestos cement, roofing felt, adhesives, sealants, cloth and coatings.
• Main results:
  • In 2010 the asbestos-related enterprises had 188,739 employees in total, an average of 117 per enterprise.
  • Eastern China had 1,263 enterprises (78.4%) in 2010 and 1,125 (58.1%) in 2019. Western China had 129 (8.0%) in 2010 and 477 (24.6%) in 2019 (table totals).
  • Compared with 2010, the number of enterprises in Eastern China fell by 10.9% in 2019 and the number in Western China rose by 269.8%.
  • Of the 3,831 reported asbestosis cases, 1,470 were reported in 1997 to 2007 and 2,361 in 2008 to 2018 (an increase of 60.6%).
  • Cases reported in Tianjin, Beijing, Shandong, Xinjiang, Gansu, Qinghai, Sichuan, Zhejiang and Jiangsu made up 90.7% of the total.
  • Reported asbestosis cases showed a downward trend from 1998 to 2017, from 294 to 89 cases.
  • Asbestosis as a percentage of all reported pneumoconiosis cases fell from 3.55% in 1998 to 0.39% in 2017 (from 2.81% in 2006), and was 0.69% in 2018.
  • Hebei had the most enterprises in 2010 (348 of 1,611) and 2019 (470 of 1,936), but only 26 asbestosis cases were reported there from 1997 to 2018.
  • Tianjin had 67 enterprises across 2010 and 2019 (67 of 3,547), but 1,362 asbestosis cases were reported there.
  • No asbestosis cases were reported in Guizhou, Hainan or Tibet.
• The authors' conclusion: The authors concluded that there may be a large number of asbestosis patients who have not been found, and that the harm is seriously underestimated.
• Limitations the authors state:
  • The authors could not provide information on asbestos exposure.
  • The authors could not evaluate the reported asbestosis cases in different regions for authenticity, completeness or precision. They state that this may affect the regional distribution of reported cases.
  • The number of employees in the enterprises was missing for 2019.

Topics

Medical terms in this study, explained in our Lexicon: IARC, Mesothelioma, Lung Cancer, Chrysotile, Pneumoconiosis, Epidemiology.

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