Health: Sound management of industrial chemicals in Bhutan is necessary to protect people from cancer, according to a report on preventive interventions for priority carcinogens in Bhutan 2016.

Priority industrial chemicals such as asbestos, benzene, formaldehyde and diesel engine exhaust commonly used in the country are known human carcinogens (cancer causing), the report states. These chemicals are classified as Group I carcinogenic chemicals to humans by the International Agency for Research on Cancer.

The report was shared yesterday at a high-level advocacy meeting on carcinogenic chemicals and human health. Preventing cancer from unsafe use of carcinogenic chemicals at work and home was the highlight of the meeting attended by parliamentarians and officials from various government agencies.

Use of priority industrial chemicals

According to the report, asbestos and asbestos containing material in various forms are used for construction and insulation of buildings while other fabricated asbestos like ropes, woven fabric, clothing, headgear, and footwear, among others, are used mainly as insulators against heat exposure from furnaces in the ferro-alloy industries.

Benzene in its pure form is used primarily in the printing industry and a substantial amount benzene containing products like gasoline, organic composite solvents, paints and varnish remover are imported.

Similarly, formaldehyde is used in large quantities for manufacturing particle boards and furniture while kerosene stoves and firewood used for heating are important sources of formaldehyde.

The significant rise in the import of diesel fuel over the years is also seen as an equal threat.

Threat

The Bhutan Cancer Report 2015 shows an increase in annual incidence of cancer cases from 31/100,000 in 2008 to 86/100,000 population in 2014 highlighting a possible link between industrial exposure and air pollution given the increasing number of vehicles in the country and increasing cancer incidence.

According to the report on preventive interventions for priority carcinogens, implementing preventive interventions for priority carcinogens will enable Bhutan to concentrate on measures that can produce tangible results of priority importance. This was also important with industrialisation and considering the latency period between exposure and the development of cancer and the challenges to ensure accurate diagnosis and reporting of cases.

Health minister Tandin Wangchuk said that cancer is a leading cause of death all over the world and Bhutan is no exception.

Lyonpo said that the increasing incidence of cancer in recent years resulted in substantial deaths, disabilities and economic loss. “The Human Carcinogenic Report also suspects link between industrial exposure from air pollutants and increasing cancer incidence,” Lyonpo said.

In addition, a study carried out in 2012 indicated a high quantity import of industrial carcinogens like asbestos, formaldehyde, benzene, and petrol in Bhutan. There was no information with regards to the extent of occupational exposure to these carcinogens. Therefore, an exposure assessment of identified human carcinogenic chemicals was carried out by the health ministry in collaboration with the labour ministry in selected workplaces in Pasakha, Tala, and Phuentsholing through this project.

“The result of some chemical analysis were found to be alarming as it exceeds the acceptable limit set by the international standard and labour ministry,” Lyonpo said. “The result clearly shows that the relevant agencies need to come together with sound strategies and appropriate measures to make our workplace safer.”

Recommendations 

The report suggested key recommendations both at a national and enterprise level. At a national level, addressing capacity building of relevant ministries is a priority.

The report states that exposure to carcinogenic chemicals in the workplace maybe widespread but most enterprises lack basic capacities to recognise and control hazards. “There is a need to augment human resources and laboratory capacities for workplace monitoring,” it states.

Routine capacity building exercises for broad categories of occupational health and safety professionals working in industry as well as in the labour inspectorate and relevant government agencies were found necessary. Besides, arrangements for periodic medical examinations should be reviewed, among others.

Pre-employment medical examinations should aim to detect medical conditions, which could make the workers vulnerable to specific chemical hazards, states the report. Periodic medical examinations should include hazard-specific medical tests. A concerted advocacy campaign was also found necessary besides improvements in basic industrial hygiene resulting in significant improvements in workplace conditions through additional investments and infrastructure.

Some of the recommendations made at an enterprise level are greater attention required on the storage, handling and disposal of hazardous chemicals, standard operating procedures and greater attention given to basic industrial hygiene activities such as the clean up of spills, handling work uniforms and cleaning of equipment and provision of basic housekeeping measures, and separate dining area and hygiene facilities.

Requirement of proper implementation of occupational health and safety at work regulations with priority to control of exposures at source rather than on relying on personal protective equipment and conducting mock drills as per statutes requirements are other recommendations at an enterprise level.

Meanwhile, the report on preventive interventions for priority carcinogens in Bhutan 2016 is part of the project funded from the Strategic Approach to International Chemicals Management (SAICM) through the Quick Start Programme (QSP) of the United Nations Environment Programme. The QSP programme is designed to assist governments in identifying their capacity building needs to manage chemicals soundly.

Speaking at the meeting, WHO’s representative Dr Ornella Lincetto said that exposure to chemicals are a critical part of environmental exposures and at the same time a double-edged sword.  While chemicals are useful for economic development and used in many areas, she said chemicals also cause adverse health effects if not properly used.

“Exposure to various chemicals occurs every day and through multiple routes such as food, air, skin contact and from mother to unborn child,” Dr Ornella Lincetto said. “With increasing industries, agricultural activities, and commerce, chemicals production and use continues to increase and so it is in Bhutan.”

The National Environmental Commission and health ministry undertook the project in collaboration with the World Health Organisation country office.

Kinga Dema