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PNEUMOCONIOSIS IN CHINA-

ADVANCES

IN PREVENTION AND CONTROL

Dehong Li, M.D.National Institute of Occupational Health

and Poison Control, Chinese CDC

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OUTLINE OF THE PRESENTATION

●●●● POLICY AND STATEGIES

●●●● LEGISLATIONS AND HEALTH STANDARDS

●●●● TECHNICAL MEASURES-EIGHT CHINESE CHARACTER GUIDELINE

●●●● ACHIEVEMENTS

●●●● CURRENT SITUATION

●●●● PROBLEMS

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POLICY FOR PREVENTION AND CONTROL OF PNEUMOCONIOSES●●●● Mobilizing the whole society to participate●●●● Developing and perfecting the legal system

of occupational health●●●● Development of science and technology●●●● prevention first●●●● Readjustment of the industrial structure●●●● Strengthening the comprehensive

administration and management

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TECHNICAL STRATEGIES FOR ELIMINATION OF PNEUMOCONIOSES

●●●● Engineering prevention as the first-Primary

prevention

●●●● Technical innovation for dust control

●●●● Looking for substitute of high free silica

●●●● Strengthening personal protection

●●●● Health surveillance for workers exposed to dust

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THE MAIN ACTIVITIES●●●● Government activities-Legislation●●●● Enterprises activities-A campaign of technical

innovation-eight character guideline-Engineering prevention

●●●● Occupational health professional activities

★★★★Development of health standards for workplaces

★★★★ Epidemiological study to clarify the situation

★★★★ Occupational health services-monitoring of

workplaces and health surveillance

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ISSUED LEGAL DOCUMENTS CONCERNING PNEUMOCONIOSIS

CONTROL (1)

●●●● The Decision on Prevention of Hazards of Silica Dustin Factories and Mines in May, 1956;

●●●● The Technical Measures for Prevention of Silica Dust Hazards in Mines in March, 1958;

●●●● The Measures for Tuberculosis Control in Workers with Silica Dust Exposure in March 1958;

●●●● The Implementing Measures of Medical Prevention forWorkers Exposed to Silica Dust Operation in July 1963;

●●●● The Provision for Pneumoconiosis Control issuedby the State Council in December 1987;

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ISSUED LEGAL DOCUMENTS CONCERNING PNEUMOCONIOSES

CONTROL (2)

●●●●The list of Occupational Diseases and the Provision on Management of Occupational Disease Patients issued jointly by the Ministries of Health, Labor, Finance and General Union of China in 1987

●●●● The Measures of Diagnosis and Management of Occupational Diseases issued by the Ministry of Health in 1980s.

●●●● The National Law on Prevention and Control ofOccupational Diseases implemented, May 2002

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CONTENTS OF THE NATIONAL LAW OF PREVENTION AND CONTROL OF

OCCUPATIONAL DISEASES●●●● ChapterⅠⅠⅠⅠ General Provisions

●●●● ChapterⅡⅡⅡⅡ Prevention at An Earlier Stage

●●●● ChapterⅢⅢⅢⅢ Protection and Management in the Process of

Work

●●●● ChapterⅣⅣⅣⅣ Diagnosis of Occupational Diseases and Security

of Patients with Occupational Diseases

●●●● ChapterⅤⅤⅤⅤ Supervision and Inspection

●●●● ChapterⅥⅥⅥⅥ Legal Liabilities

●●●● ChapterⅦⅦⅦⅦ Supplementary Provisions

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DEVELOPMENT OF HEALTH STANDARD

●●●● Up to now there are 376 items of health standards at workplaces, of which 47 are related to dusts. These are mainly the standards of maximum allowable concentration, and technical standards for dust measures.

●●●● The first diagnostic criteria for pneumoconioseswere developed in 1957 and it was revised consequently in 1963, 1986, and 1999.

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OCCUPATIONAL EXPOSURE LIMITS FOR

DUSTS ( GBZ 2-2002) Categories of dusts Concentration of silica

(%) TWA

（total dust）

( mg/m3)

TWA of respiratory dusts ( mg/m3)

Silicon dust Coal dust Cement dust Welding dust Talcum dust Aluminum oxide Graphite dust Carbon black dust silicon carbide dust Mica dust Asbestos dust

50-80 >80 10-50 <10 <10 <10 <10

0.7 0.5 1.0 4 4 4 3 4 4 4 8 2 0.8f/ml

0.3 0.2 0.7 2.5 1.5 1 2 4 1.5

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“ EIGHT -CHARACTER GUIDELINE ” FOR DUST CONTROL- AS PRIMARY

PREVENTION

1de� watering for wet operation ( shui-水水水水)

� ventilation to discharge dusts (Fen-风风风风)

� airtight operation to seal dusts off (mi-密密密密)

� technical innovation and reform, (ge-革革革革)

� personal protection ( hu-护护护护) � Training and education in knowledge of health

and safety (xuan-宣宣宣宣) � maintenance and management of dust

preventing facilities ( bao-保保保保)

� supervision and monitoring (cha-查查查查).

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ACHIEVENMENTS AFTER THE ADOPTION OF COMPREHENSIVE DUST CONTROL

MEASURES

●●●● About 70% workplaces compliance with the health standard in state-owner enterprises

●●●● Dust concentration were extremely decreased1118mg/m3 ~ 1.93mg/ m3 1957-- 1967 in Yaogangxian

●●●● No case of silicosis occurred after wet operation since 1963 in Dongfen mine

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latency of working period for occurrence of silicosis and CWP

0

5

10

15

20

25

30

1955 1960 1965 1970 1975 1980 1985

Years

Silicosis

CWP

Silicosis 9 26 CWP 16 25

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Age of occurrence of silicosis and CWP

0000

10101010

20202020

30303030

40404040

50505050

60606060

1955195519551955 1960196019601960 1965196519651965 1970197019701970 1975197519751975 1980198019801980 1985198519851985

silicosissilicosissilicosissilicosis

CWPCWPCWPCWP

Si 35 50CWP 40 50

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Age of death for silicosis and CWP patients with calendar

0000

10101010

20202020

30303030

40404040

50505050

60606060

70707070

1955195519551955 1960196019601960 1965196519651965 1970197019701970 1975197519751975 1980198019801980 1985198519851985

silicosissilicosissilicosissilicosis

CWPCWPCWPCWP

Si 37 60CWP45 62

230000

5 0 0 05 0 0 05 0 0 05 0 0 0

1 0 0 0 01 0 0 0 01 0 0 0 01 0 0 0 0

1 5 0 0 01 5 0 0 01 5 0 0 01 5 0 0 0

2 0 0 0 02 0 0 0 02 0 0 0 02 0 0 0 0

2 5 0 0 02 5 0 0 02 5 0 0 02 5 0 0 0

1 9 9 11 9 9 11 9 9 11 9 9 1 1 9 9 21 9 9 21 9 9 21 9 9 2 1 9 9 31 9 9 31 9 9 31 9 9 3 1 9 9 41 9 9 41 9 9 41 9 9 4 1 9 9 51 9 9 51 9 9 51 9 9 5 1 9 9 61 9 9 61 9 9 61 9 9 6 1 9 9 71 9 9 71 9 9 71 9 9 7 1 9 9 81 9 9 81 9 9 81 9 9 8 1 9 9 91 9 9 91 9 9 91 9 9 9 2 0 0 02 0 0 02 0 0 02 0 0 0 2 0 0 12 0 0 12 0 0 12 0 0 1 2 0 0 22 0 0 22 0 0 22 0 0 2

尘肺

职业病总数

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MEDICAL SCREENING AND HEALTH SURVEILLANCE

as secondary prevention

Medical screening examination started in 1951 and hasbecome a routine work in the country. According toan analysis of data in recent years, the annual rate of medical screening covered about 30% of workers exposed to dust, and newly detected cases of pneumoconiosis are 10-15 thousand every year.

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CURRENT SITUATION OF PNEUMOCONIOSIS

IN CHINA

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NUMBER OF CASES WITH PNEUMOXONIOSES BY THE END OF

2003

Cumulative cases 588741

Death cases 141024

Fatality 23.9%

Prevalence cases 446347

New cases/2002 12248

Case died/each year 3000- 5000

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Number of cases different pneumoconiosis

• Silicosis 48.3%

• CWP 39.6%

• Others 12.1%

88%

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NUMBER OF CASES IN INDUSTRIES

• Metallurgical 12.4%

• Non-ferrous metallurgical 10.3%

• Coal & coke 54.5%

• Building materials 3.5%

• Machinery 3.4%

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Number of cases with pneumoconiosis in industries

MetallurgicalMetallurgicalMetallurgicalMetallurgical

Non - f e r r o u sNon - f e r r o u sNon - f e r r o u sNon - f e r r o u s

CoalCoalCoalCoal

Building Building Building Building

MachineryMachineryMachineryMachinery

OthersOthersOthersOthers

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THE KEY PROBLEMS FOR ELIMINATION OF PNEUMOCONIOSIS

●●●● Negligence of the occupational hazard control in Economic development

●●●● Changes of economic and industrial structures

●●●● Growing of SSEs, private enterprises and migrantworkers rapidly

●●●● Low education levels leading to unawareness and Lack of knowledge in protection

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HIGHLIGHTS FOR PNEUMOCONIOSIS ELIMINATION

●●●● Put the priority in prevention and control of pneumoconiosis as the policy of OH

●●●● Enforce the inspection and management ●●●● Pre-evaluation on occupational hazards as

primary prevention ●●●● Strengthening OHS, specially for SSEs and

migrant workers-Risk assessment, Health surveillance, Health education & promotion

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OUR RESPONSIBILITY ON ELIMINATION OF PNEUMOCONIOSES

It is our responsibility to respond to ILO/WHO International Program on Global Elimination of Silicosis.

A long way to go for the goal

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