Chrysotile asbestos has been imported into Indonesia and processed in numerous factories since 1950. Despite many years of asbestos exposures, no claim of occupational asbestos-related disease has been recognised and compensated by the National Labour Insurance program.Methods
An employee from an asbestos gland packing factory was selected to undergo an examination in accordance with the seven step process required for occupational disease diagnosis set by the Indonesian Ministry of Health (Regulation #56, 2016) and criteria set by the American Thoracic Society The employee was interviewed and underwent a physical exam, ILO standard chest radiography, spirometry, and high-resolution CT (HRCT) imaging.Result
The employee had over 23 years of occupational asbestos exposure and presented with chronic non-productive cough, exhaustion, low body weight, and intermittent chest pain. The ILO standard radiograph and HRCT were consistent with asbestosis and the spirometry test showed a mild restrictive ventilator defect. The case was reported to the district Ministry of Manpower and compensation of 74 million rupiah (USD 5000) was awarded by the National Labour Insurance Program in late 2016. This amount was calculated based on the percentage of physical disability and the base salary of the worker.Discussion
This is the first case of asbestos-related disease to receive compensation from the Indonesian government. It is important because asbestos hazards are relatively unknown by both the public and workers in Indonesia. Finding more asbestos-related disease cases is an urgent concern, especially among exposed employees. Furthermore, given that many asbestosis cases progress to lung cancers, the amount of compensation solely from the asbestosis disability appears inadequate. It is suggested that the Indonesian Manpower Ministry review the compensation system to include follow-up and screening for malignancies, their treatment, and related disabilities.