Introduction

The two asbestos registers - the Disease Register and the Exposure Register - have been in existence since 1992. When established, they had the following objectives:

1. To raise awareness of asbestos-related disease nationally
2. To improve the radiological diagnosis of asbestos disease by using the ILO reference radiographs
3. To confirm that pleural plaques is a disease and not just a marker for asbestos exposure
4. To reinforce the importance of patient support groups.

The legacy of disease from working with and exposure to asbestos in New Zealand is continuing. Exposure is now largely confined to brake repairers, lino removers, demolition workers, carpenters, electrical, plumbing and building maintenance workers, and asbestos removal workers.

Worldwide, asbestos exposure still occurs at a high level and there are a number of lessons than can be learned as a result.

Firstly, there continues to be a general lack of awareness of the effects of inhaling dust at work, regardless of the type of dust. Secondly, too great an emphasis has been put on whether or not dust is a danger to health. Concepts that cement dust is safe and silica dust unsafe, or blue asbestos is worse than white asbestos have distracted governments from the real issue of dirty workplace air.

Today this is recognised as a major problem, both in terms of respiratory and general health. However, its solutions are not complex. They involve putting in place good general and local exhaust ventilation, and providing comfortable and effective respiratory protection. While that sounds relatively simple, there needs to be a desire for clean workplace air.

So where to from here for the Registers? With a gradual reduction in cigarette smoking among the working population, the impact of dirty workplace air on respiratory health is likely to become clearer with diseases such as welder's lung, asthma, and chronic obstructive pulmonary disease recognised more clearly for their relationship to work practices and procedures.

Dr W I Glass (Convenor)
Dr R Armstrong
Dr D Jones
Dr A Brant

National Asbestos Medical Panel
July 2009

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