May 2009

 Good Practice Note:  Asbestos: Occupational and Community Health Issues

1.  Summary

 The purpose of this Good Practice Note is to increase the awareness of the health risks related to occupational asbestos exposure, provide a list of resources on international good practices available to minimize these risks, and present an overview of some of the available product alternatives on the market. The need to address asbestos-containing materials (ACM) as a hazard is no longer under debate but a widely accepted fact.

Practices regarding asbestos that are normally considered acceptable by the World Bank Group (WBG) in projects supported through its lending or other instruments are addressed in the WBG’s General Environmental, Health and Safety (EHS) Guidelines.[1]  This Good Practice Note provide background and context for the guidance in the WBG EHS Guidelines.

Good practice is to minimize the health risks associated with ACM by avoiding their use in new construction and renovation, and, if installed asbestos-containing materials are encountered, by using internationally recognized standards and best practices (such as those presented in Appendix 3) to mitigate their impact.  In all cases, the Bank expects borrowers and other clients of World Bank funding to use alternative materials wherever feasible.

ACM should be avoided in new construction, including construction for disaster relief. In reconstruction, demolition, and removal of damaged infrastructure, asbestos hazards should be identified and a risk management plan adopted that includes disposal techniques and end-of-life sites.

Asbestos is a group of naturally occurring fibrous silicate minerals. It was once used widely in the production of many industrial and household products because of its useful properties, including fire retardation, electrical and thermal insulation, chemical and thermal stability, and high tensile strength. Today, however, asbestos is recognized as a cause of various diseases and cancers and is considered a health hazard if inhaled.[2] The ILO estimates that over the last several decades 100,000 deaths globally have been due to asbestos exposure,[3] and the WHO states that 90,000 people die a year globally because of occupational asbestos exposure.[4]

Over 90% of asbestos[5] fiber produced today is chrysotile, which is used in asbestos-cement (A-C) construction materials: A-C flat and corrugated sheet, A-C pipe, and A-C water storage tanks.  Other products still being manufactured with asbestos content include vehicle brake and clutch pads, roofing, and gaskets. Though today asbestos is hardly used in construction materials other than asbestos-cement products, it is still found in older buildings in the form of friable surfacing materials, thermal system insulation, non-friable flooring materials, and other applications. The maintenance and removal of these materials warrant special attention.

Because the health risks associated with exposure to asbestos area now widely recognized, global health and worker organizations, research institutes, and some governments have enacted bans on the commercial use of asbestos (see Box 1), and they urge the enforcement of national standards to protect the health of workers, their families, and communities exposed to asbestos through an International Convention.[6]

Box 1. Bans on the Use of Asbestos and Asbestos Products

 A global ban on commercial use of asbestos has been urged by the Building and Wood Workers Federation (IFBWW), the International Metalworker’s Federation, the International Trade Union Confederation, the government of France, and the distinguished scientific group Collegium Ramazzini. All member states of the European Union and over 40 countries worldwide (see Appendix 1) have banned all forms of asbestos, including chrysotile.[7]  In June 2006, the General Conference of the ILO adopted a resolution to “promote the elimination of all forms of asbestos and asbestos-containing materials.”

Landrigan PJ, Soffritti M. “Collegium Ramazzini Call for an International Ban on Asbestos.” Am. J. Ind. Med. 47: 471-474 (2005).

• The International Ban Asbestos Secretariat keeps track of national asbestos bans. http://bassecretariat.org./lka_alpha_asb_ban_280704.php
• General Conference of the International Labor Organization, “Resolution Concerning Asbestos,” Provisional Record, International Labor Conference, Ninety-fifth Session, Geneva, 2006, Item 299, pp. 20/47-48.
• World Health Organization: http://www.who.int/occupational_health/publications/asbestosrelateddiseases.pdf

Health hazards from breathing asbestos dust include asbestosis, a lung carring disease, and various forms of cancer (including lung cancer and mesothelioma of the pleura and peritoneum).[8]  These diseases usually arise decades after the onset of asbestos exposure. Mesothelioma, a signal tumor for asbestos exposure, occurs among workers’ family members from dust on the workers’ clothes and among neighbors of asbestos air pollution point sources.[9] Some experimental animal studies show that high inhalation exposures to all forms of asbestos for only hours can cause cancer.[10] Very high levels of airborne asbestos have been recorded where power tools are used to cut A-C products and grind brake shoes. For chrysotile asbestos, the most common variety, there is no threshold (non-zero) of exposure that has been shown to be free from carcinogenic risks. Construction materials are of particular concern, because of the large number of workers in construction trades, the difficulty of instituting control measures, and the continuing threat posed by in-place materials that eventually require alterations, repair, and disposal.[11] Renovations and repairs in buildings containing A-C materials can also endanger building occupants.  In addition to the problems from products made with commercial asbestos, asbestos also occurs as a contaminant in some deposits of stone, talc, vermiculite, iron ore, and other minerals. This can create health hazards for workers and residents at the site of excavation and in some cases in the manufacture and use of consumer products the materials are used to make. While asbestos is a known carcinogen when inhaled, it is not known to be carcinogenic when ingested, as through drinking water,[12] although pipe standards have been issued for asbestos-cement pipes conducting “aggressive” water.[13]

From the industrial hygiene viewpoint, asbestos creates a chain of exposure from the time it is mined until it returns to the earth at landfill or unauthorized disposal site. At each link in the chain, occupational and community exposures coexist. Workers in the mines are exposed to the fibers while extracting the ore; their families breathe fibers brought home on work clothes; workers in the mills and factories process the fiber and manufacture products with it; and their families are also secondarily exposed. Communities around the mines, mills, and factories are contaminated with their wastes; children play on tailings piles and in contaminated schoolyards; transportation of fiber and products contaminates roads and rights-of-way.[14] Tradesmen who install, repair and remove ACM are exposed in the course of their work, as are bystanders in the absence of proper controls. Disposal of asbestos wastes from any step in this sequence not only exposes the workers handling the wastes but also local residents when fibers become airborne because of insufficient covering and erosion control. Finally, in the absence of measures to remove ACM from the waste stream and dispose of them properly, the cycle is often repeated when discarded material is scavenged and reused.

There is evidence that, after a decline in the 1990s, the use of asbestos fiber is increasing globally. A recent study[16] shows that a 59% increase in metric tons was consumed in 12 countries from 2000 to 2004.

The International Labor Organization (ILO) established an Asbestos Convention (C162) in 1986 to promote national laws and regulations for the “prevention and control of, and protection of workers against, health hazards due to occupational exposure to asbestos.”[17] The convention outlines aspects of best practice: Scope and Definitions, General Principles, Protective and Preventive Measures, Surveillance of the Working Environment, and Workers’ Health. As of March 4, 2008, 31 countries had ratified the Convention;[18] 17 of them have banned asbestos.

Some of the ILO asbestos convention requirements:

• work clothing to be provided by employers; 
• double changing rooms and wash facilities to prevent dust from going home on street clothes; 
• training of workers about the health hazards to themselves and their families;
• periodic medical examinations of workers,
• periodic air monitoring of the work environment, with records retained for 30 years; 
• development of a work plan prior to demolition work, to protect workers and provide for proper waste disposal; and
• protection from “retaliatory and disciplinary measures” of workers who remove themselves from work that they are justified in believing presents a serious danger to health.   

Standard considerations for working with and procuring ACM are common to most projects. An overview of some basic ones is provided in Appendix 5.

Standards and regulations for work involving ACM have been published by nongovernmental organizations and government agencies. Appendix 3 provides a listing of some resources, including international organizations (e.g., WHO, ISO, ASTM) and national governments (e.g., UK, US, Canada, South Africa). The resources range from manuals to individual standards and cover a variety of work guidelines, including surveys, identification, inspection, maintenance, renovation, repair, removal, and disposal.  Some of the key issues discussed in these standards and regulations are as follows

• The scale of occupational hazards. The health risk is not simply a function of the properties of the ACM, but also reflects the type of work being done and the controls used. Although A-C products, for example, may seem to intrinsically present less of a risk than fire-proofing, air monitoring has shown that cutting dry A-C sheet with a power saw can release far greater amounts of airborne fibers than scraping wet, saturated fireproofing off a beam. The relationship between the nature of A-C products, the work being done and the controls used to control the release of fibers and debris is important (as discussed in ASTM E2394 and HSG189/2[19]).
• Controlling exposure to airborne fibers. Because asbestos fibers are primarily an inhalation hazard, the basic purpose of the regulations and standards is to control the concentration of asbestos fibers in the air inhaled by workers or others. Concentration limits have been set by regulations in numerous countries for workers whose duties involve contact with ACM; however, they do not purport to totally eliminate the risk of asbestos disease, but only to reduce it. Exposure limits for individuals other than workers, including occupants of buildings and facilities and the community, are lower than those for workers in deference to the very young and old as well as the physically compromised.
• Measuring exposure to airborne fibers. Compliance with exposure limits is demonstrated by air sampling in workers’ breathing zone or in the space occupied by the affected individuals, with analysis of the sample by optical or electron microscopy, as explained in Appendix 3. Abatement protocols determine whether a building can be reoccupied after asbestos abatement.
• Proper disposal. Proper disposal of ACM is important not only to protect the community and environment but also to prevent scavenging and reuse of removed material. ACM should be transported in leak-tight containers to a secure landfill operated in a manner that precludes air and water contamination that could result from ruptured containers. Similar requirements apply to remediation of sites such as mines, mills, and factories where asbestos fiber was processed and products manufactured. (See EPA NESHAP regulations, Appendix 3.)
• Transboundary movement of waste. Waste asbestos (dust and fibers) is considered a hazardous waste under the Basel Convention on the Control of Transboundary Movements of Hazardous Wastes and their Disposal. The Basel Convention imposes use of a prior informed consent procedure for movement of such wastes across international borders. Shipments made without consent are illegal. Parties have to ensure that hazardous waste is disposed of in an environmentally sound manner (ESM. Strong controls have to be applied from the moment of generation, to its storage, transport, treatment, reuse, recycling, recovery and final disposal[20]
• Identifying asbestos products. A-C products include flat panels, corrugated panels used for roofing, water storage tanks, and pressure, water, and sewer pipes. In some countries asbestos may still be used in making wallboard, heat-resistant gloves and clothes for industrial use, and brake and clutch friction elements and gaskets used in vehicles.[21] Thermal insulation containing asbestos and sprayed asbestos for insulation and acoustic damping were widely used through the 1970s and should be looked for in any project involving boilers and insulated pipes. Insulation dating from before 1980 should be presumed to contain asbestos unless analyzed and found not to. The microscopic methodology for analyzing bulk samples for the presence of asbestos is widely available in industrialized countries and is not expensive; it is less available in developing countries. In a developing country samples may have to be mailed out for testing; alternatively, training may be available for a laboratory in the country.
• Training. It is impossible to overemphasize the importance of training for working with ACM in any capacity-whether it involves inspections, maintenance, removal, or laboratory analysis. The duration of the training as well as the course content depends on the type of work the individual will be doing. Quality control and proficiency testing for laboratories and individual analysts are also important.

Safer substitutes for asbestos products of all kinds are increasingly available (see Appendix 4).  These include fiber-cement products using combinations of local vegetable fibers and synthetic fibers, as well as other products that serve the same purposes.[22]  The WHO is actively involved in evaluating alternatives.[23]

Fiber-cement roof panels using polyvinyl alcohol (PVA) or polypropylene combined with cellulose now cost 10-15% more to manufacture than A-C sheets.  Polypropylene-cellulose-cement roofing, a new product, is made at a cost of about 12 percent more than A-C roofing and has superior impact resistance. The non-asbestos fiber-cement panels are lighter, less brittle, and have improved nailability over A-C.  The increase in the overall cost of building construction that such products represent is to some degree offset by the obviation of special hygiene measures installation/maintenance/renovation, the lack of a continuing hazard to building workers and occupants, and reduced costs of waste removal and disposal. Micro concrete tiles are cheaper than A-C to produce, and can be made in a basic workshop near the building site with locally available small contractors and materials, lowering transport costs.  Compared with A-C pipes, iron pipes can be transported and installed with less difficulty and breakage, take greater compression loading and last longer. 

The WBG EHS Guidelines are technical reference documents with general and industry-specific examples of Good International Industry Practice (GIIP).[24] When one or more members of the WBG are involved in a project, the EHS Guidelines are applied as required by their respective policies and standards.

The WBG’s EHS Guidelines[25] specify that the use of ACM should be avoided in new buildings and construction or as a new material in remodeling or renovation activities.  Existing facilities with ACM should develop an asbestos management plan that clearly identifies the locations where the ACM is present, its condition (e.g., whether it is in friable form or has the potential to release fibers), procedures for monitoring its condition, procedures to access the locations where ACM is present to avoid damage, and training of staff who can potentially come into contact with the material to avoid damage and prevent exposure.  The plan should be made available to all persons involved in operations and maintenance activities.  Repair or removal and disposal of existing ACM in buildings should be performed only by specially trained personnel[26] following host country requirements or, if the country does not have its own requirements, internationally recognized procedures.[27] Decommissioning sites may also pose a risk of exposure to asbestos that should be prevented by using specially trained personnel to identify and carefully remove asbestos insulation and structural building elements before dismantling or demolition.

1. Argentina
2. Australia
3. Austria
4. Belgium
5. Bulgaria
6. Chile
7. Cyprus
8. Czech Republic
9. Denmark
10. Egypt
11. Estonia

• 12. Finland
• 13. France

1. Gabon
2. Germany
3. Greece
4. Honduras
5. Hungary
6. Iceland
7. Ireland
8. Italy
9. Japan
10. Jordan
11. Kuwait
12. Latvia
13. Lithuania
14. Luxembourg
15. Malta

• 29. Netherlands

1. Norway
2. Poland
3. Portugal
4. Republic of Korea
5. Romania
6. Saudi Arabia
7. Seychelles
8. Slovakia
9. Slovenia
10.  South Africa
11. Spain
12. Sweden
13. Switzerland
14. United Kingdom
15. Uruguay

NOTE: this listing is not meant to be all-inclusive, but is a sample of available information.

Appendix 4. Some Alternatives to Asbestos-Containing Products

Appendix 5.  Considerations for Working with Asbestos Materials in Existing Structures

 A. Evaluation of alternatives

1.  Determine if the project could include the installation, replacement, maintenance or demolition of:

• Roofing, siding, ducts or wallboard
• Thermal insulation on pipes, boilers, and ducts
• Plaster or fireproofing
• Resilient flooring materials
• Other potentially asbestos-containing materials

2.  If the use of asbestos-containing materials (ACM) has been anticipated for new construction or renovation, provide information about alternative non-asbestos materials and their availability. For new construction, determine the expected difference for the entire project-on initial and operating costs, employment, quality, expected service life, and other factors-using alternatives to ACM (including consideration of the need for imported raw materials).

3.  In many cases, it can be presumed that ACM are part of the existing infrastructure that must be disturbed.  If there is a need to analyze samples of existing material to see if it contains asbestos, provide information on how and where can that be arranged.

4. Once the presence of ACM in the existing infrastructure has been presumed or confirmed and their disturbance is shown to be unavoidable, incorporate the following requirements in tenders for construction work in compliance with applicable laws and regulations.

B. Understanding the regulatory framework

1.  Review the host country laws and regulations and the international obligations it may have entered into (e.g., ILO, Basel conventions) for controlling worker and environmental exposure to asbestos in construction work and waste disposal where ACM are present. Determine how the qualifications of contractors and workers who maintain and remove ACM are established, measured, and enforced.

2. Determine whether licensing and permitting of the work by authorities is required.

3. Review how removed ACM are to be disposed of to minimize the potential for pollution, scavenging, and reuse.

4. Incorporate the following requirements in tenders involving removal, repair, and disposal of ACM.

C. Considerations and possible operational requirements related to works involving asbestos

1. Contractor qualification

• Require that contractors demonstrate having experience and capability to observe international good practice standards with asbestos, including training of workers and supervisors, possession of (or means of access to) adequate equipment and supplies for the scope of envisioned works, and a record of compliance with regulations on previous work.

2. Related to the technical requirements for the works

• Require that the removal, repair, and disposal of ACM shall be carried out in a way that minimizes worker and community asbestos exposure, and require the selected contractor to develop and submit a plan, subject to the engineer’s acceptance, before doing so.
• Describe the work in detail in plans and specifications prepared for the specific site and project, including but not limited to the following:

–     Containment of interior areas where removal will occur in a negative pressure enclosure;
–     Protection of walls, floors, and other surfaces with plastic sheeting;
–     Construction of decontamination facilities for workers and equipment;
–     Removing the ACM using wet methods, and promptly placing the material in impermeable containers;
–     Final clean-up with special vacuums and dismantling of the enclosure and decontamination facilities;
–     Disposal of the removed ACM and contaminated materials in an approved landfill;[29]
–     Inspection and air monitoring as the work progresses, as well as final air sampling for clearance, by an entity independent of the contractor removing the ACM.

• Other requirements for specific types of ACM, configurations and characteristics of buildings or facilities, and other factors affecting the work shall be enumerated in the plans and specifications. Applicable regulations and consensus standards shall be specifically enumerated.

3. Related to the contract clauses[30]

• Require that the selected contractor provide adequate protection to its personnel handling asbestos, including respirators and disposable clothing.
• Require that the selected contractor notifies the relevant authorities of the removal and disposal according to applicable regulations as indicated in the technical requirements and cooperates fully with representatives of the relevant agency during all inspections and inquiries.

4.  Related to training and capacity building

• Determine whether specialist industrial hygiene expertise should be hired to assure that local contractors learn about and apply proper protective measures in work with ACM in existing structures.

World Bank:  Operations Policy and Country Services

[2] http://www.who.int/occupational_health/publications/draft.WHO.policy.paper.on.asbestos.related.diseases.pdf.  See also Stayner L, et al., “Exposure-Response Analysis of Risk of Respiratory Disease Associated with Occupational Exposure to Chrysotile Asbestos.” Occupational Environmental  Medicine. 54: 646-652 (1997).

[3] http://www.ilo.org/wow/Articles/lang–en/WCMS_081341

[4] http://www.who.int/occupational_health/publications/asbestosrelateddiseases.pdf

[5] Asbestos defined in Castleman, B. Asbestos: Medical and Legal Aspects 5^th Ed. New York: Aspen, 2005, 894 pp. 

[6] ILO Asbestos Convention No. 162, (see http:www.ilo.org/ilolex or http://www.itcilo.it/actrav/osh_es/m%F3dulos/legis/c162.htm)

[7] http://www.who.int/occupational_health/publications/asbestosrelateddiseases.pdf.  Directive 2003/18/EC of the European Council and Parliament amending Council Directive 83/477/EEC,  and Directive  99/77/EEC

[8] http://www.euro.who.int/document/aiq/6_2_asbestos.pdf

[9] “Asbestos.” World Health Organization IARC Monographs on the Evaluation of Carcinogenic Risks to Humans/ Overall Evaluations of Carcinogenicity: An Updating of IARC Monographs 1 to 42,  Suppl. 7.  Lyon: International Agency for Research on Cancer, 1987, pp. 106-116. 

[10] Wagner JC, Berry G, Skidmore JW, Timbrell V.  “The Effects of the Inhalation of Asbestos in Rats.”  Br. J. Cancer 29: 252-269 (1974).

[11] International Program on Chemical Safety, “Conclusions and Recommendations for Protection of Human Health,” Chrysotile Asbestos, Environmental Health Criteria 203.  Geneva: World Health Organization, 1998, p. 144.

[12] http://whqlibdoc.who.int/hq/2000/a68673_guidelines_3.pdf

[13] http://whqlibdoc.who.int/hq/2000/a68673_tech_aspects_4.pdf

[14] Jones, Robert  “Living in the Shadow of the Asbestos Hills (The Need for Risk Based Cleanup Strategies for Environmental Asbestos Contamination in South Africa).” Environmental Exposure, Crisis Preparedness and Risk Communication, Global Asbestos Congress, Tokyo, Japan, November 19 – 21, 2004. http://park3.wakwak.com/~gac2004/en/index_abstract_e.html.  See also Oberta, AF “Case Study: An Asbestos Cement Plant in Israel — Contamination, Clean-up and Dismantling.” Hellenic Asbestos Conference, Athens, Greece, October 29 – 31, 2002.  http://www.ibas.btinternet.co.uk/Frames/f_lka_hellen_asb_conf_rep.htm

[15] Boer, A.M., L.A. Daal, J.L.A. de Groot, J.G. Cuperus “The Combination of the Mechanical Separator and the Extraction Cleaner Can Process the Complete Asbestos-containing Waste-stream and Make it Suitable for Reuse.” European Conference on Asbestos Risks and Management, Rome, Italy, December 4 -6, 2006. http://venus.unive.it/fall/menu/Boer.pdf

[16] R. Virta, US Geological Survey, 2007.

[17] www.ilo.org/ilolex

[18] http://www.ilo.org/ilolex/english/convdisp1.htm

[19] See Appendix 3.

[20] See Basel Convention Secretariat http://www.basel.int/

[21] In 2004, Russia, China, India, Kazakhstan, Thailand, and Ukraine together accounted for about three-quarters of world asbestos consumption. Other major consumers of asbestos are Iran, Brazil, Vietnam, and Indonesia.

[22] 7.  The U.K. Health and Safety Executive commissioned a report that concluded that the main replacement fibrous materials for asbestos in fiber-cement products and brakes are less hazardous than chrysotile asbestos.  See Harrison PTC, et al. “Comparative Hazards of Chrysotile Asbestos and Its Substitutes: A European Perspective.”  Envir. Health Persp. 107: 607-611 (1999).  http://www.ehponline.org/members/1999/107p607-611harrison/harrison-full.html  

[23] http://www.who.int/ipcs/assessment/asbestos/en/

[24] Defined as the exercise of professional skill, diligence, prudence, and foresight that would be reasonably expected from skilled and experienced professionals engaged in the same type of undertaking under the same or similar circumstances globally. The circumstances that skilled and experienced professionals may find when evaluating the range of pollution prevention and control techniques available to a project may include, but are not limited to, varying levels of environmental degradation and environmental assimilative capacity as well as varying levels of financial and technical feasibility

[25] http://www.ifc.org/ifcext/enviro.nsf/AttachmentsByTitle/gui_EHSGuidelines2007_GeneralEHS/$FILE/Final+-+General+EHS+Guidelines.pdf  (pp. 71, 91, 94)

[26] Training of specialized personnel and the maintenance and removal methods applied should be equivalent to those required under applicable regulations in the United States and Europe (examples of North American training standards are available at: http://www.osha.gov/SLTC/asbestos/training.html)

[27] Examples include the ASTM International E1368 – Standard Practice for Visual Inspection of Asbestos Abatement Projects; E2356 – Standard Practice for Comprehensive Building Asbestos Surveys; and E2394 – Standard Practice for Maintenance, Renovation and Repair of Installed Asbestos Cement Products.

[28] http://www.ifc.org/ifcext/enviro.nsf/AttachmentsByTitle/gui_EHSGuidelines2007_GeneralEHS/$FILE/Final+-+General+EHS+Guidelines.pdf  (pp. 71, 91, 94)

[29] Alternative guidance for circumstances where approved landfills are not available for disposal of hazardous substances, such as asbestos, guidance is provided in the EHS General Guideline, reference above as well as in the Guideline on Waste Management Facilities. http://www.ifc.org/ifcext/sustainability.nsf/AttachmentsByTitle/gui_EHSGuidelines2007_WasteManagement/$FILE/Final+-+Waste+Management+Facilities.pdf

[30] Standard contract clauses for asbestos work exist but are too extensive for this short note. To view an example, the U.S. National Institute of Building Sciences “Asbestos Abatement and Management in Buildings: Model Guide Specification” has a complete set – in copyright form – and the clauses and instructions for using them fill a two-inch binder.