As a malignant tumor associated with asbestos, this long latent period disease,
mesothelioma, is not easy to diagnosis. It had been reported since 1960 and the short
survival time between 7-13 months after diagnosis. Therefore, prevention and early
diagnosis are much more important. Today it is also found that daily exposure to asbestos
products, such as Erionite, are also at risk for the disease. It is estimated that the number
of people with malignant mesothelioma worldwide would peaked up from 2015 to 2020.
Therefore, the purpose of this study was found out the international experience and
policies by using literature review to find out the relevant experience and policies of
various countries as a reference for government administration. In addition, we would
like to do the epidemiological mornintoring for mesothelioma for preventing and treating
work. This research would provide the information about the usage of health insurance,
co-disease before the mesothelioma diagnosis and geographical exposure factors.
　　All workers employed in asbestos-related factories and registered by the Bureau of
Labour Insurance and Taiwan National Health Insurance between 1979 and 2014.
Incidence and prevalence of mesothelioma and lung cancer were obtained from the
datasets combined with Taiwan Cancer Registry. SIRs were calculated based on
comparison with the incidence rate of the general population of Taiwan and adjusted for
age, calendar period, sex. The usage of health insurance produced for exam the co-exited
disease and medical fees. Cox regression had used for identified the risk different
between the workers in asbestos factories or not.
　　Overall, of the 770 patients diagnosed as mesothelioma, the average duration of
exposure in different occupation was 14.4 years. The diagnostic age was between 44-72
and most of them had been found this disease after the year 2000. Most of them had been
work in manufacture. The incidence of mesothelioma in towns near the asbestos-related
institutions is higher than that in other areas. In addition, patients with mesothelioma
whose asbestos exposed work period longer were close to the higher urbanization area.
　　The suggestions submitted by this study included as following. 1. The construction
industry, cutting, shaping and finishing of stone industry, and brake manufacturing
industry are high risk group of asbestos exposure. We recommended that the handbook
for prevention and control of asbestos edited by Institute of Labor, Occupational Safety
and Health (ILOSH) should be used as the safety and health education for workers in
these three industries. 2. Since the current labor insurance information does not have the
job title. Furthermore, the difficulties for exposure history and exposure level recalled by
workwers. The occupational physicians can not detect occupational diseases for lack of
exposure evidence and without clear relationship between diseases and work. This study
suggests adding a job title field to the labor insurance information as an important
reference for the identification of occupational diseases. 3. Referring to the German
occupational disaster insurance agency's practice, we recommend to establish a work card
for workers exposed to asbestos to fully grasp the work history for workers exposed
asbestos, as an important basis for the identification and compensation of occupational
diseases. 4. As the current asbestos related occupational diseases certification guidelines
lack of risk screening for occupational disease identification, so that the detection rate for
occupational disease was low. We recommended that asbestos related occupational
diseases certification guidelines to add the risk screening, if there is related respiratory
diseases, chest (rib) membrane inflammation, essential hypertension, bronchitis,
bronchiolitis, and comorbidities that invade the respiratory system and other chest
diseases, and when medical expenses increase rapidly within one year, as long as there is
a history of asbestos exposure.