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Report on the activities of the Centre for the 2004–2010 period | Environmental asbestos exposure and asbestos pollution in Poland | The "Amiantus" Project | Occupational exposure, medical care | Asbestos-related occupational diseases

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The „AMIANTUS” programme of prophylactic medical examinations of the former asbestos workers in:
NEONILA SZESZENIA-DĄBROWSKA, BEATA ŚWIŚTKOWSKA, ZUZANNA SZUBERT, URSZULA WILCZYŃSKA, ASBESTOS IN POLAND: OCCUPATIONAL HEALTH PROBLEMS. Int. J. Occup. Med. Environ.l Health 2011;24(2):142–152

Subject to special protection are the former workers of all asbestos-processing plants in Poland listed in the Act on the Ban of Use of Asbestos-Containing Products of 19th June 1997. The Act specifies the following rights of the workers employed in these factories: free access to periodical medical examinations, free access to medications used to manage asbestos-induced diseases, once a year referral to a health-resort and exemption from treatment charges. The funds necessary to cover the costs incurred by these activities are allocated in the state budget.
To facilitate implementation of the Asbestos Ban Act, the Ministry of Health has launched the AMIANTUS Programme of prophylactic examinations designated for former workers of asbestos processing plants. As envisaged in the Programme, each person who had been employed under conditions of occupational exposure in these plants was provided with a medical check-up book. The book contains information about the work post, the level and duration of exposure and the consecutive prophylactic examinations.

In view of the fact that the asbestos-processing plants were scattered all over Poland, the medical examinations for asbestos workers involve many different health care units. Thus, it was necessary to coordinate the examinations conducted by several dozen physicians from 13 occupational health care units.
The main tasks of the coordination of the Programme are as follows:
− to implement a uniform methodology of medical examinations;
− to ensure training and consultations;
− to monitor respiratory effects of exposure in workers occupationally exposed to asbestos dust;
− to keep a central register of workers exposed to asbestos;
− to manage database of results of  prophylactic examinations.
The strategy of prophylactic examinations for asbestos workers has been developed by the Nofer Institute of Occupational Medicine in Łódź which also supervises the examinations of former workers of asbestos processing plants.

For the purposes of the AMIANTUS Programme, a unified procedure for large-scale prophylactic examinations has been adopted, and standardized forms to document medical records that would cover exposure assessment, as well as the principles of collecting occupational exposure data, have been prepared. All health centres performing the examinations follow the provisions of the 1997 Helsinki Criteria for diagnosis and attribution in asbestos-related diseases – for clinical, radiological, spirometric, histological diagnoses and exposure assessment .
The Programme tasks completed in 2000–2010 have made it possible to develop a database containing medical data on 6 853 asbestos workers. The data derive from 18 955 medical examinations performed in the course of the programme. Asbestosis was diagnosed in 1476 cases, i.e. 21.5% of the examined workers, lung cancer in 68 cases and mesothelioma in 40 cases.

Among the workers formerly exposed to asbestos dust who are subject to prophylactic examinations, a continuous year-to-year growth was noted in the proportion of pathological findings in radiological examinations (pleural alterations and parenchymal opacities). Also the number of patients with diagnosed asbestosis was found to increase from 7% in 2000 to 26% in 2010.This considerable increase is largely due to a better asbestos-related disease detectability achieved by virtue of the implemented Programme.

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