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Asbestosis and general health among migrant shipbreakers from northern Bangladesh Courtice, Midori Nakano


In Bangladesh, shipbreaking is often carried out by internal migrant workers from the impoverished northern regions. Ships can contain hazardous substances such as polychlorinated biphenyls, heavy metals and asbestos, which are all recognized carcinogens. Work is done by hand, without heavy equipment, adequate training or protection, and with high potential for exposures. This pilot study examined asbestosis and non asbestos-related respiratory symptoms among these migrant workers. Shipbreakers were recruited from their home communities in northern Bangladesh. They were interviewed in Bangla, and received anteroposterior chest x-rays and physical exams. Information was collected on: a) respiratory symptoms using validated questions from the American Thoracic Society, b) work history and past occupational exposures, c) clinical history, d) attitudes around occupational health and safety, e) and knowledge of the potential heath risks and fate of asbestos. Chest x-rays were read by a B-reader for asbestosis diagnosis. One hundred and four male shipbreakers were recruited with average age 40 years and 2.5 years education. On average they had nine years shipbreaking experience and 17 years since first year of employment on the yards. Radiographic results indicated a six percent prevalence of asbestosis, and results from the interviews indicated a thirteen percent and eight percent prevalence of work-related cough and phlegm, and work-related shortness of breath, respectively. The prevalence of asbestosis appears lower than seen in previous studies of shipbuilders and ship-repairers. However, beach-based shipbreakers (steel plate loaders and cable-pullers) were overrepresented in comparison to ship-based (cutters and fitters) workers. This, and the small sample size, inclusion criteria, and a possibly exaggerated healthy worker effect, could have resulted in an underestimate of prevalence. Ships typical of those being dismantled contain several tons of asbestos; there is a need for improvements in exposure control, including educating the shipbreakers about asbestos and where it is found. Future research should focus on subjects who have worked closer to the source of exposure, as well as better characterizing the exposure and learning about the fate of the asbestos after it leaves the yards.

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