Canada's asbestos legacy at home and abroad

Do patterns of past asbestos use and production reflect current geographic variations of cancer risk?: mesothelioma in Ontario and British Columbia, Canada

PURPOSE

Canada was a major global asbestos producer and consumer. Geographic patterns of Canadian asbestos use and mesothelioma, a highly fatal cancer linked to asbestos exposure, have not been previously reported. This study summarized key trends in mesothelioma incidence by geography and time in two Canadian provinces, Ontario and British Columbia (BC), and explored how past workforce characteristics and geographic trends in asbestos production and use may shape variations in regional rates of mesothelioma.

METHODS

We report trends in mesothelioma incidence (1993-2016) for Ontario and British Columbia using population-based incidence data that were age-standardized to the 2011 Canadian population. Historical records of asbestos production and use were analyzed to geo-locate industrial point sources of asbestos in Ontario and BC. The prevalence of occupations in regions with the highest and lowest rates of mesothelioma in Ontario and BC were calculated using labor force statistics from the 1981 Canadian Census.

RESULTS

Regional mesothelioma rates varied in both provinces over time; more census divisions in both Ontario and BC registered mesothelioma rates in the highest quintile of incidences during the period 2009 to 2016 than in any prior period examined. Certain occupations such as construction trades workers were more likely to be overrepresented in regions with high mesothelioma rates.

CONCLUSION

This work explored how studying asbestos exposure and mesothelioma incidence at small-scale geographies could direct cancer surveillance and research to more targeted areas. Findings indicated that regional variations in mesothelioma could signal important differences in past occupational and potentially environmental exposures.

Storylines of research on resource extraction and health in Canada: A modified metanarrative synthesis

Patterns of research on resource extraction's health effects display problematic gaps and underlying assumptions, indicating a need to situate health knowledge production in the context of disciplinary, corporate and neocolonial influences and structures. This paper reports on a modified metanarrative synthesis of 'storylines' of research on resource extraction and health in the Canadian context. Peer-reviewed articles on mining or petroleum extraction and health published between 2000 and 2018 and dealing with Canadian populations or policies (n = 87) were identified through a systematic literature search. Coding identified main disciplinary traditions, methodologies and approaches for judging high-quality research. Underlying assumptions were analyzed in terms of models of health and well-being; resource extraction's political economic drivers; and representations of Indigenous peoples, territories and concerns. Findings included a preponderance of occupational and environmental health studies; frequent presentation of resource extraction without political economic antecedents, and as a major contributor to Canadian society; sustainable development aspirations to mitigate health impacts through voluntary private-sector governance activities; representations of Indigenous peoples and concerns ranging from complete absence to engagement with legacies of historical trauma and environmental dispossession; and indictment of corporate (especially asbestos industry) and government malfeasance in a subset of studies. Canada's world-leading mining sector, petroleum reserves and population health traditions, coupled with colonial legacies in both domestic and overseas mining and petroleum development, make these insights relevant to broader efforts for health equity in relation to resource extraction. They suggest a need for strengthened application of the precautionary principle in relation to resource extraction; nuanced attention to corporate influences on the production of health science; more profound challenges to dominant economic development models; and extension of well-intentioned efforts of researchers and policymakers working within flawed institutions.

If it bleeds, it leads: the construction of workplace injury in Canadian newspapers, 2009-2014

BACKGROUND

Public perceptions of workplace injuries are shaped by media reports, but the accuracy of such reports is unknown.

OBJECTIVES

This study identifies differences between workers' compensation claims data and newspaper reports of workplace injuries in Canadian newspapers and media sources.

METHODS

This study applies quantitative content analysis to 245 Canadian English-language newspaper articles from 2009 to 2014. Workers' compensation claims data is drawn from the Association of Workers' Compensation Boards of Canada.

RESULTS

Newspapers dramatically overreport fatalities, injuries to men, injuries in the construction and mining/quarrying/oil industries, injuries stemming from contact with objects/equipment and fires/explosions, and acute physical injuries such as burns, fractures, intracranial injuries, and traumatic injuries. Newspaper reporters tend to rely upon government, police/firefighter, and employer accounts, rarely recounting the perspectives of workers.

CONCLUSION

Newspapers overreported fatalities, injuries to men, and injuries in the construction and mining/quarrying/oil industries. This results in a misleading picture of occupational injuries in Canada.

Exploring the usefulness of occupational exposure registries for surveillance: the case of the Ontario Asbestos Workers Registry (1986-2012)

Objective:

The ongoing presence of asbestos in products used across workplaces in Canada reinforces the importance of occupational exposure surveillance. This study evaluates the usefulness of the Ontario Asbestos Workers Registry.

Methods:

The study includes 30,829 workers aged 15 to 80 years. Researchers reported on the data quality and analyzed the proportions of workers exposed by industry, and standardized rates by geographic areas and over time.

Results:

The incidence of exposure started to decrease around 1990; but about 2000 workers were still exposed annually until 2006. Results showed large geographical disparities. Unexpectedly, workers from industries other than construction reported exposure.

Conclusions:

The Ontario Asbestos Workers Registry is a useful but challenging source of information for the surveillance of asbestos exposure in Ontario. The registry could benefit from well-defined surveillance objectives, a clear exposure definition, systematic enforcement, regular data analyses, and results dissemination.

The case for a global ban on asbestos

BACKGROUND

All forms of asbestos are now banned in 52 countries. Safer products have replaced many materials that once were made with it. Nonetheless, many countries still use, import, and export asbestos and asbestos-containing products, and in those that have banned other forms of asbestos, the so-called "controlled use" of chrysotile asbestos is often exempted from the ban. In fact, chrysotile has accounted for > 95% of all the asbestos used globally.

OBJECTIVE

We examined and evaluated the literature used to support the exemption of chrysotile asbestos from the ban and how its exemption reflects the political and economic influence of the asbestos mining and manufacturing industry.

DISCUSSION

All forms of asbestos, including chrysotile, are proven human carcinogens. All forms cause malignant mesothelioma and lung and laryngeal cancers, and may cause ovarian, gastrointestinal, and other cancers. No exposure to asbestos is without risk. Illnesses and deaths from asbestos exposure are entirely preventable.

CONCLUSIONS

All countries of the world have an obligation to their citizens to join in the international endeavor to ban the mining, manufacture, and use of all forms of asbestos. An international ban is urgently needed. There is no medical or scientific basis to exempt chrysotile from the worldwide ban of asbestos.

Under-reporting of compensable mesothelioma in Alberta

BACKGROUND

When combined with a history of occupational asbestos exposure, mesothelioma is often presumed work-related. In Canada, workers diagnosed with mesothelioma caused by occupational asbestos exposure are often eligible for compensation under provincial workers' compensation boards. Although occupational asbestos exposure causes the majority of mesothelioma, Canadian research suggests less than half of workers actually apply for compensation. Alberta's mandatory reporting requirements may produce higher filing rates but this is currently unknown. This study evaluates Alberta's mesothelioma filing and compensation rates.

METHODS

Demographic information on all mesothelioma patients diagnosed between 1980 and 2004 were extracted from the Alberta Cancer Board's Cancer Registry and linked to Workers' Compensation Board of Alberta claims data.

RESULTS

Alberta recorded a total of 568 histologically confirmed mesothelioma cases between 1980 and 2004. Forty-two percent of cases filed a claim; 83% of filed claims were accepted for compensation.

CONCLUSIONS

Patient under-reporting of compensable mesothelioma is a problem and raises larger questions regarding under-reporting of other asbestos-related cancers in Alberta. Strategies should focus on increasing filing rates where appropriate.

International jurisprudence on trade and environmental health: one step forward, two steps back?

Since the creation of the World Trade Organization (WTO), there has been considerable debate regarding the impact of its rules on public health. By contrast, the role of the WTO dispute settlement mechanism has received little attention, even though the bodies responsible for settling disputes are the ultimate interpreters of WTO rules and agreements. To date, three WTO disputes that relate to occupational and/or environmental health have been fully litigated. A review of the decisions and reasoning in these cases indicates that WTO jurisprudence is evolving, as Panels and the Appellate Body try--with varying degrees of success--to balance countries' rights and obligations under international trade agreements with their right to protect occupational and environmental health. Disputes between nations can have an impact beyond the parties concerned, and raise questions about the relationship between trade agreements and other international agreements, especially multilateral environmental agreements (MEAs).