An Approach to Overcome the Limitations of Surveillance of Asbestos Related Diseases in Low- and Middle-Income Countries: What We Learned from the Sibaté Study in Colombia

• Published in: Annals of global health 2023-01, Vol.89 (1), p.64-64
• Main Authors: Ramos-Bonilla, Juan Pablo, Giraldo, Margarita, Marsili, Daniela, Pasetto, Roberto, Terracini, Benedetto, Mazzeo, Agata, Magnani, Corrado, Comba, Pietro, Lysaniuk, Benjamin, Cely-García, María Fernanda, Ascoli, Valeria
• Format: Article
• Language: English
• Subjects: Asbestos; Asbestos industry; asbestos-cement-facility; cluster; Clusters; colombia; Consortia; Epidemiology; Ethics; Exposure; Focus groups; Humanities and Social Sciences; Information sources; Information systems; Informed consent; Interviews; Low income groups; Lung cancer; Medical records; Medical research; Mesothelioma; Mortality; non-occupational-exposure; Original Research; Public health; research-protocol; sibaté; surveillance; Surveillance systems
• ISSN: 2214-9996; 2214-9996
• DOI: 10.5334/aogh.4166

Introduction: The asbestos industry began its operations in Colombia in 1942 with the establishment of an asbestos-cement facility in Sibaté, located in the Department of Cundinamarca. Despite extensive asbestos use and production in Colombia, the country lacks a reliable epidemiological surveillance system to monitor the health effects of asbestos exposure. The Colombian health information system, known as SISPRO, did not report mesothelioma cases diagnosed in the municipality, posing a significant challenge in understanding the health impacts of asbestos exposure on the population of Sibaté.Methods: To address this issue, an active surveillance strategy was implemented in Sibaté. This strategy involved conducting door-to-door health and socioeconomic structured interviews to identify Asbestos-Related Diseases (ARDs). Validation strategies included a thorough review of medical records by a panel of physicians, and the findings were communicated to local, regional, and national authorities, as well as the general population.Results: The active surveillance strategy successfully identified a mesothelioma cluster in Sibaté, revealing the inadequacy of the existing health information system in monitoring asbestos-related diseases. The discovery of this cluster underscores the critical importance of implementing active surveillance strategies in Colombia, where governmental institutions and resources are often limited.Conclusion: The findings of this study emphasize the urgent need for Colombia to establish a reliable epidemiological surveillance system for asbestos-related diseases (ARDs). Active surveillance strategies can play a crucial role in identifying mesothelioma clusters and enhancing our understanding of the health effects of asbestos exposure in low- and middle-income countries.