Slow transition from use of asbestos raises concern as cancer cases rise

By DANN OKOTH

NAIROBI, KENYA: Kenya spends nearly 10 per cent of its health budget to treat asbestos-related cancers as experts warn the slow transition from the product could be more costly for the country.

The National Environmental Management Authority (Nema) says the government needs to step up efforts to replace asbestos on all institutional rooftops to avert widespread environmental pollution and health risks.

“The cost of environmental damage caused by asbestos pollution, including asbestos-related cancers, which are a lot more difficult to treat, is higher than what we would spend to replace the roofs,” says Izaak Elmi, chief research officer at Nema. “The cost of treating asbestos-related cancer is very high and could top 10 per cent of the country’s total health budget,” he added.

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In the 2013/2014 fiscal year, the government allocated Sh34.7 billion to the health sector. This means Sh3.4 billion would be spent treating asbestos-related cancers. But the figure could be higher given the difficulty in determining the actual number of such cases in the country.

paints

Although the government banned the use of asbestos in 2006, nearly all government institutions, including educational facilities and residential estates built in the 1950s and 1960s, still have asbestos roofs.

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But the brown cement-like material is believed to be dangerous to human health. Ageing roofs have exacerbated concerns of an outbreak of asbestos pollution. Asbestos is also often used in motor vehicle clutch or brake pads and some types of paints.

In some residential estates in Nairobi, residents even collect rainwater from asbestos rooftops oblivious to the potential risks. A walk through old Nairobi estates like Bahati, Kimathi and Ofafa Jericho reveals houses with asbestos roofs. Beneath the roofs are huge black plastic tanks used to collect rainwater.

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“Whenever it rains, we collect the rainwater, which saves us when taps run dry,” says Josephine Murambi, a resident of Jericho.

Murambi, who has lived in the same house for nearly 50 years since independence, and is currently raising her grandchildren in the same house, is unaware of the dangers of asbestos.

“I did not know about the dangers until you told me,” she says. “As you can see, we repaired the roof ourselves a few years back,” she added pointing to a section of the roof patched with iron sheets.

Besides personal health, asbestos has a negative impact on the environment. A study presented in 2006 at the International Conference on Health, Environment and Justice found that asbestos dust can easily travel through the air into the water supply. It can also settle on the surface of the soil instead of getting absorbed into the ground, which means that it can still get picked up by wind and inhaled into the lungs.

The study found that countries with a history of production and consumption of asbestos showed a high incidence of asbestos-related diseases and pronounced levels of asbestos particles in the environment.

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This shows that asbestos can pose a significant risk even after it has been banned in the countries featured in the study.

According to Dr Tom Kambeche, a leading public health consultant in Nairobi, Kenya may not have the capacity to diagnose asbestosis or asbestos poisoning.

“Asbestosis is difficult to diagnose because it’s linked to chest and breathing problems that may have many different causes. It would be quite difficult to isolate asbestos poisoning as the cause of chest conditions,” he says.

“Asbestosis is associated with poisoning caused by a group of minerals that are microscopic – they cannot be seen by the naked eye,” he adds.

“It causes inflammation of lungs that may lead to a cough. It may also cause mesothelioma, which is a cancer of the lungs. Usually a computer tomography (commonly called CT scan) would be done to rule out other causes of disease and zero-in on asbestos poisoning.”

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lung tissue

A doctor would normally check the pulmonary system to ascertain lung function. But even then he would need a history of exposure before he can consider possible effects. Although asbestos poisoning happens, it is rare and long term. It may occur in communities where asbestos mining is done.

“There may not be many cases in Kenya, but that could be a reflection of the difficulty in diagnosing asbestosis, rather than actual absence of the condition. The Occupational Safety Centre located in Nairobi’s Industrial Area may have statistics on asbestosis since it is mainly an occupational hazard,” says Kambeche.

Other studies have shown that asbestosis occurs from breathing in asbestos fibres. Breathing in the fibres can cause scar tissue (fibrosis) to form inside the lung. Scarred lung tissue does not expand and contract normally.

How severe the disease is depends on how long one was exposed to asbestos and the amount one breathed in. Often, people do not notice symptoms for 20 years or more after exposure to asbestos.

Asbestos fibres were commonly used in construction before 1975. Asbestos exposure occurred in asbestos mining and milling, construction, fireproofing, and other industries. Families of asbestos workers can also be exposed from particles brought home on the worker’s clothing.

lack of awareness

In Europe, the ban took effect in 2005. Directive 1999/77/EC of the European Union bans all types of utilisation of asbestos from January 1, 2005. In addition, the 2003/18/EC directive bans the extraction of asbestos and the manufacture and processing of asbestos products.

It says: “Hereby, the exposure of the primary users of the asbestos-containing products and materials to asbestos is stopped. However, the problem of exposure to asbestos in the course of removal, demolition, servicing and maintenance activities comes to the forefront.”

In Kenya, the risk of asbestos poisoning is exacerbated by the lack of technical expertise to safely dispose of the material. Also, there are several safety regulations to be considered while handling asbestos, which many people in Kenya do not follow due to ignorance.

“Kenya does not have a comprehensive solid waste management system despite the existence of the solid waste management regulation of 2006, which incorporates Environment Impact Assessment and Audit Regulations, 2003,” observes Elmi.

The result is that asbestos waste is being dumped everywhere, including at the massive Dandora dumpsite where thousands of scavengers – including children – rummage through the lethal dust.

Rules put in place by Nema require that any organisation or individual who would want to dismantle or handle damaged asbestos must have been trained. They must also have protective gear, including masks, special gloves aprons and gumboots.

The safest way to dispose of asbestos, according to Nema regulations, is to bury it in the ground and encase it with cement. The requirements include digging a cubicle trench in the ground, cementing the cubicle walls and putting the asbestos inside, then spraying the asbestos with cement before sealing the trench.

This is to prevent the asbestos from seeping into the ground and contaminating the soil and possibly water aquifers. However, the transfer of this technical knowledge to the 47 counties has been hampered by lack of preparedness and awareness campaign fatigue among officials.

technical people

“As it is, the county governments have only started employing and they lack enough technical people to handle such matters. The sad reality is that asbestos will remain in environment for quite some time, with possible damning consequences,” Elmi says.

He says there is an urgent need to train customs officials manning Kenya’s ports of entry to be able to detect asbestos. This is to prevent asbestos waste from outside getting into the country.

The need for training is all the more urgent after customs officials recently intercepted a shipment from Europe containing asbestos waste at the port of Mombasa.

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