Asbestos kills, that's for sure

The World Health Organization & Thai doctors know it, but the public health ministry seems more interested in serving business interests.

Protective suits used to protect workers from breathing dangerous cancer-causing asbestos particles (Source: Wikipedia)

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EDITORIAL

Asbestos kills, that's for sure

26 Apr 2013

Asbestos particles that can cause so many deadly diseases when inhaled (Source: Wikipedia)

The Public Health Ministry under the leadership of Minister Pradit Sintanawarong is never short of controversies. Amid a severe shortage of physicians in rural areas, Dr Pradit issued a policy to cut their hardship allowances.

Effective treatment requires physicians to spend time with patients to gather details of their symptoms and personal backgrounds so they can make an accurate diagnosis. Yet the minister imposed a pay-for-performance system that rewards physicians on the quantity of tasks performed and requires doctors to document each and every task, which turns hospitals into factory assembly lines and a hell of paperwork.

His policy has triggered fierce protests from rural doctors. They accuse him of trying to demoralise and directly force them to work for private hospitals in the city under the government's medical hub policy push.

They also view the ministry's move to vilify the Government Pharmaceutical Organisation and its focus on generic drug production as a move to serve big pharma. The minister's effort to weaken the National Health Security Office (NHSO) is also seen as a bid to control the NHSO's huge budget for health care.

Roofing made from asbestos typically found in Thailand (Source: Wikipedia)

The latest incident that has further shaken public confidence in the ministry is its refusal to recognise that asbestos, a known human carcinogen used in construction materials, is dangerous to health.

Deputy secretary-general Charnwit Tharathep last week said there is not enough medical evidence to support the view that asbestos poses a health danger. His statement flies in the face of the asbestos ban imposed by the World Health Organisation (WHO) and more than 50 countries.

The powerful asbestos lobby has been trying to mislead the public into believing that chrysotile, a type of asbestos that is used in Thailand, is safe. This is not true, says the WHO; all forms of asbestos are carcinogenic to humans and may cause mesothelioma and cancer of the lung, larynx and ovaries as well as difficulty in breathing and severe coughing.

In 2010, the National Economic and Social Development Board (NESDB) proposed a ban on asbestos. The cabinet approved it in 2011. With the Industry and Public Health ministries insisting on more and more studies, the ban has been delayed for two years now.

A CT scan of Mesothelioma, responsible for many deaths from asbestos exposure (Source: Wikipedia)

Thailand is the world's second biggest importer of asbestos, mainly from Russia and Canada.

Asbestos is used heavily in the construction industry for insulating materials and floor covering. It is also used for brake linings, clutch assemblies and heat-resistant household appliances such as toasters, irons and ovens.

It becomes a serious health hazard when people inhale its very fine durable fibres that damage their lungs. Workers at asbestos plants, construction and demolition sites, and consumers are exposed to the health risks. The WHO says there are 125 million of them around the world and more than 107,000 people die each year from asbestos-related diseases resulting from occupational exposure.

Yet the ministry still refuses to recognise asbestos health dangers. Meanwhile, the NESDB says low figures for asbestos-related diseases here result from poor reporting and diagnosis in the healthcare system itself.

Public confidence in the ministry is now at its lowest. To restore credibility, it must prove it is not serving business interests as alleged. It could start by accepting asbestos as a heath hazard, which has long been acknowledged worldwide.

(Source: Bangkok Post, EDITORIAL, Asbestos kills, that's for sure, 26 Apr 2013, link


Asbestos Public Health Hazard Vocabulary

asbestos - "minerals used commercially for their desirable physical properties. The prolonged inhalation of asbestos fibers can cause serious illnesses including malignant lung cancer, mesothelioma, and asbestosis ... The European Union has banned all use of asbestos and extraction, manufacture and processing of asbestos products.Asbestos became increasingly popular among manufacturers and builders .... because of its sound absorption, average tensile strength, its resistance to fire, heat, electrical and chemical damage, and affordability. It was used in such applications as electrical insulation for hotplate wiring and in building insulation. When asbestos is used for its resistance to fire or heat, the fibers are often mixed with cement (resulting in fiber cement) or woven into fabric or mats" (See Wikipedia & asbestos related diseases)

asbestos kills, that's for sure

asbestos removal -
the costly process of removing asbestos from buildings, requires workers wear special suits and masks (See Wikipedia)

asbestos lawsuits -
"asbestos litigation is the longest, most expensive mass tort in U.S. history.... Analysts have estimated that the total costs of asbestos litigation in the USA alone is over $250 billion (See Wikipedia & asbestos and the law around the world)

chrysotile - "used more than any other type of asbestos and accounts for about 95% of the asbestos found in buildings in America. ... Its most common use has been in corrugated asbestos cement roof sheets typically used for outbuildings, warehouses and garages. It may also be found in sheets or panels used for ceilings and sometimes for walls and floors. Chrysotile has been a component in joint compound and some plasters. Numerous other items have been made containing chrysotile, including brake linings, fire barriers in fuseboxes, pipe insulation, floor tiles, and rope seals for boilers (See Wikipedia & pronunciation)

chrysotile, a type of asbestos that is used in Thailand

mesothelioma - an aggressive and incurable tumour that is difficult to detect and diagnose caused by asbestos that arises in the lining of the abdominal cavity (See Wikipedia & pronunciation)

Public Health Ministry

leadership

never short of -
meaning opposite: has a lot of 
controversies -
things that cause disagreements and arguments between people
never short of controversies

The Public Health Ministry under the leadership of Minister Pradit Sintanawarong is never short of controversies.

severe - very serious and worrying ที่รุนแรง ที่น่าเป็นห่วง
shortage - when there is not enough of something การขาดแคลน
a severe shortage

rural - in the countryside (farms, forests), not the city ในชนบท, บ้านนอก
rural areas

physicians - medical doctors
a severe shortage of physicians in rural areas

issued - made available ออกใหม่
policy - a set of plans or action agreed on by a government, political party, business, or other group; a plan of action to guide decisions and achieve outcomes นโยบาย (See Wikipedia)
issued a policy

hardship - when life is difficult and unpleasant (usually due to a lack of money)
allowances - money given to people to help them pay for the things they need
hardship allowances

Dr Pradit issued a policy to cut their hardship allowances.

treatment - medical treatment; the process of providing medical care การรักษา
effective treatment - medical treatment that works, that cures disease and makes a person healthy again

symptoms - the things that show that a person has a disease
personal backgrounds

accurate - correct, exact and without any mistakes ถูกต้อง, แม่นยำ
diagnosis - when a doctor makes a judgement about what disease a patient has
accurate diagnosis

Effective treatment requires physicians to spend time with patients to gather details of their symptoms and personal backgrounds so they can make an accurate diagnosis.

performance - how well or badly something works (or whether an investment provides a reasonable return)
a pay-for-performance system

impose - force people to use something or follow some rule
imposed a pay-for-performance system

rewards - things you get for doing something good or great like winning a competition รางวัล
task - a piece of work that someone does หน้าที่ something that you have to do หน้าที่; ภารกิจ
rewards physicians on the quantity of tasks performed

document each task -
write down on paper or on a computer (a record of the things that you do)
requires doctors to document each and every task

assembly lines - the many steps of producing a product in a factory (each worker doing one step in production) แนวประกอบชิ้นส่วนของเครื่องในโรงงาน, สายประกอบ
turns hospitals into factory assembly lines

hell - the place where some people are believed to go after death to be punished forever for the bad things they have done during their lives นรก
paperwork - the routine part of a job of filling in forms, faxing, photocopying, filing, writing emails and reports งานเอกสาร
a hell of paperwork

Yet the minister imposed a pay-for-performance system that rewards physicians on the quantity of tasks performed and requires doctors to document each and every task, which turns hospitals into factory assembly lines and a hell of paperwork.

trigger - cause
fierce - very intense and very aggressive
protests - meetings, sometimes forceful or violent, or public statements by people who strongly disagree with something ชุมนุมประท้วง
trigger fierce protests

His policy has triggered fierce protests from rural doctors.

accuse -
to say that someone has done something bad and wrong
demoralise - making a person so they don't want to try hard and work hard anymore
They accuse him of trying to demoralise them

private hospitals - hospitals owned by companies, not the government (so they only have to treat rich people)

force them to work for private hospitals in the city

hub
- the central or main part of something where there is most activity จุดศูนย์กลาง
medical hub policy push
the government's medical hub policy push - the policy to promote medical tourism, foreigners coming to Thailand  to get treated in expensive private hospitals which attract many doctors because they pay better 

They accuse him of trying to demoralise and directly force them to work for private hospitals in the city under the government's medical hub policy push.

Government Pharmaceutical Organisation (GPO) -
the government run company that makes cheap drugs for government hospitals and clinics (including the important and cheap AIDs drugs that even the poorest have access to)

big pharma - the big profit-making international drug companies

generic drug - a version of a drug that is cheaper than the brand offered by a big pharnmaceutical company
generic drug production

focus - the main thing it is concerned with ให้ความสำคัญ
the focus of the GPO on generic drug production
a move to serve big pharma.

vilify - say bad things about someone, give them a bad name

They also view the ministry's move to vilify the Government Pharmaceutical Organisation and its focus on generic drug production as a move to serve big pharma.

National Health Security Office (NHSO) - the government agency that oversees and manages the universal 30 baht healthcare scheme

effort - an attempt to do something ความพยายาม
effort to weaken the National Health Security Office (NHSO)

bid - an attempt to do something ความพยายาม
budget - the amounts of money that an organisation has available to spend on different things during a period งบประมาณ (See Wikipedia)
a bid to control the NHSO's huge budget for health care

The minister's effort to weaken the National Health Security Office (NHSO) is also seen as a bid to control the NHSO's huge budget for health care.

incident - an unpleasant event
the latest incident

confidence - the quality of being certain; feel sure about something ความมั่นใจ ความเชื่อมั่น
public confidence
shaken confidence - make people less confident, make them believe in it less

ministry - a government department dealing with an area of activity กระทรวง
further shaken public confidence in the ministry

recognise - to officially agree that something exists เป็นที่ยอมรับโดยทั่วกัน
refusal to recognise that
refusal to recognise that asbestos is dangerous to health

carcinogen - a chemical that causes cancer
a human carcinogen - a chemical that causes cancer in people
a known human carcinogen - a carginogen that scientists have identified already through their research

construction - the work of building or making something, especially buildings, bridges, etc. การก่อสร้าง
construction materials
a known human carcinogen
used in construction materials

The latest incident that has further shaken public confidence in the ministry is its refusal to recognise that asbestos, a known human carcinogen used in construction materials, is dangerous to health.

evidence - information that shows that something actually did happen or actually is true หลักฐาน
support - help สนับสนุน
there is not enough medical evidence to support the view that

asbestos poses a health danger

flies in the face of - is not what you would expect, is not reasonable

ban - an official statement ordering people not to do something ห้าม การห้าม ห้ามอย่างเป็นทางการ  การประกาศห้าม
the asbestos ban imposed by the World Health Organisation (WHO) and more than 50 countries

Deputy secretary-general Charnwit Tharathep last week said there is not enough medical evidence to support the view that asbestos poses a health danger. His statement flies in the face of the asbestos ban imposed by the World Health Organisation (WHO) and more than 50 countries.

lobby -
people hired by companies to influence what politicians do
the powerful asbestos lobby

mislead - make people belief something that is not true
mislead the public
mislead the public into believing that asbestos is safe

coughing - the action of forcing air up through your throat with a sudden noise, especially when you have a cold
severe coughing

lung - one of the two organs in your chest that fill with air when you breathe ปอด
larynx - voice box กล่องเสียง

all forms of asbestos are carcinogenic to humans and may cause mesothelioma and cancer of the lung, larynx and ovaries
difficulty in breathing and severe coughing

The powerful asbestos lobby has been trying to mislead the public into believing that chrysotile, a type of asbestos that is used in Thailand, is safe. This is not true, says the WHO; all forms of asbestos are carcinogenic to humans and may cause mesothelioma and cancer of the lung, larynx and ovaries as well as difficulty in breathing and severe coughing.

propose - suggest (but not yet chosen or decided upon)
propose a ban on asbestos

In 2010, the National Economic and Social Development Board (NESDB) proposed a ban on asbestos. The cabinet approved it in 2011.

insisting
- keeping saying very firmly that something is true or that something must be done, even when other people will not believe you ยืนกราน
insisting on more and more studies

With the Industry and Public Health ministries insisting on more and more studies, the ban has been delayed for two years now.

insulating - protecting the inside from the outside (usually from outside heat) การป้องกัน (ความร้อน)
insulating materials

brake linings
clutch assemblies

resistant - not harmed or affected by something
heat-resistant

heat-resistant household appliances 

Asbestos is used heavily in the construction industry for insulating materials and floor covering. It is also used for brake linings, clutch assemblies and heat-resistant household appliances such as toasters, irons and ovens.

hazard - something that is dangerous and likely to cause damage สิ่งที่เป็นอันตราย
a health hazard  
a serious health hazard

fine - very small
durable - able to stay in good condition for a long time ทนทาน
fine durable fibres

lungs - the organs in your chest that fill with air when you breathe ปอด
damage lungs

inhale - to breathe in สูดลมหายใจ
inhale its very fine durable fibres that damage lungs

plants - factories
asbestos plants

demolition - complete destruction การรื้อถอน, การทำลาย
demolition sites

Workers at asbestos plants, construction and demolition sites

exposed - openly affected by and not protected from ได้รับ ในที่นี้หมายถึง สูดควันบุหรี่ ได้รับ ได้สัมผัส (แดด หรือสารพิษ เป็นต้น)

consumers
- people who buy things (individuals and families)
consumers are exposed to the health risks.
more than 107,000 people die each year from asbestos-related diseases resulting from occupational exposure

It becomes a serious health hazard when people inhale its very fine durable fibres that damage their lungs. Workers at asbestos plants, construction and demolition sites, and consumers are exposed to the health risks. The WHO says there are 125 million of them around the world and more than 107,000 people die each year from asbestos-related diseases resulting from occupational exposure.

figures - statistics, numbers describing the economy
low figures for asbestos-related diseases

reporting
diagnosis

poor reporting and diagnosis

healthcare - the treatment and prevention of diseases and other medical problems
healthcare system 
poor reporting and diagnosis in the healthcare system 

Yet the ministry still refuses to recognise asbestos health dangers. Meanwhile, the NESDB says low figures for asbestos-related diseases here result from poor reporting and diagnosis in the healthcare system itself.

credibility - believability, when many people believe that what you say is true; the degree to which something can be believed or trusted ความน่าเชื่อถือ,ความน่าไว้วางใจ

restore - to cause a particular situation to exist again, especially a good one ฟื้นฟูสภาพ
restore credibility

interests - people who gain or lose depending on how events turn out business interests
business interests

serving business interests - working for companies, not the public who they were voted into office to serve
alleged - claimed to be true although not yet proven ที่ถูกกล่าวหา

Public confidence in the ministry is now at its lowest. To restore credibility, it must prove it is not serving business interests as alleged. It could start by accepting asbestos as a heath hazard, which has long been acknowledged worldwide.

About the author

columnist
Writer: Jon Fernquest
Position: Online Writer