744 Asbestos related occupational diseases – legislative changes and incidence differences in croatia

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Abstract

Introduction

The aim of this study was to identify differences in the occurrence of asbestos-related occupational diseases in relation to the changes in Croatian legislation regarding health protection, surveillance and compensation entitlement due to occupational exposure to asbestos. Aforementioned changes occurred in the period between 2007 and 2008 and are considered as a significant step forward in registering asbestos-related occupational diseases.

Methods

Annual epidemiological and demographic data on newly diagnosed patients with asbestos related diseases have been retrieved from Register of Asbestos Related Occupational Diseases of the Croatian Institute for Health Protection and Safety at Work for the period between 2009 and 2016. Annual Croatian Health Service Yearbooks of the Croatian National Institute for Public Health have been used for obtaining data between 2000 and 2008. Descriptive statistical analysis has been performed.

Results

Between 2009 and 2016 1356 asbestos-related occupational diseases have been diagnosed with peak occurrence in 2011, following: 52% pleural plaques with asbestosis (n=705), 22.27% pleural plaques (n=302), 20.13% pulmonary asbestosis (n=273), 4.28% mesothelioma (n=58) and 1.33% other respiratory malignant neoplasms (n=18). Between 2000 and 2008 104 asbestos-related occupational diseases have been reported (nearly 13 times less compared to the post-legislative period).

Discussion

Changes in legislation have, undoubtedly, led to significant differences in the occurrence of occupational asbestos-related diseases. Reasons for such differences might be partially due to workers’ inclination to compensation and indemnification after being diagnosed with occupational disease. However, a relatively late onset of a complete ban of asbestos-engaged work in Croatia is also considered to be a major contributing factor for present results. Considering relatively late peak of occurrence in 2011, it is fair to assume that a significant number of asbestos-related diseases are yet to be reported. Hence, a further need for continuous health surveillance of workers exposed to asbestos cannot be accentuated enough.

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