Globalization and the Transfer of Hazardous Industry: Asbestos in

Globalization and the Transfer of
Hazardous Industry:
Asbestos in Mexico, 1979–2000
GUADALUPE AGUILAR-MADRID, MSC, CUAUHTÉMOC A. JUÁREZ-PÉREZ, MSC,
STEVEN MARKOWITZ, PHD, MAURICIO HERNÁNDEZ-ÁVILA, MD, SC,
FRANCISCO RAÚL SÁNCHEZ ROMÁN, MSC, JUAN HUMBERTO VÁZQUEZ GRAMEIX, MSC
This study quantified asbestos use in Mexico in the past
decade and evaluated available data on mortality due to
malignant mesothelioma in Mexico between 1979 and
2000. Mortality data were analyzed from secondary databases of the Mexican Social Security System and the
Ministry of Health. Data on the import and export of
asbestos in Mexico were obtained from the Ministry of
Trade and Industrial Development of Mexico. Deaths
due to pleural mesothelioma significantly increased in
this period. Although the import of asbestos declined,
the number of Mexican products that contain asbestos
tripled. Export of Mexican asbestos-containing products to Central America grew rapidly in the last ten years
of the study. Mexico continues the appreciable use of
asbestos and has experienced a significant increase in
the occurrence of the sentinel asbestos-related disease,
malignant mesothelioma. Given the many limitations to
the control of hazardous work exposures in Mexico, a
ban on asbestos is advocated as the most feasible means
of limiting an epidemic of asbestos-related disease. Key
words: mortality; pleural mesothelioma; asbestos;
imports; exports; Mexico.
I N T J O C C U P E N V I R O N H E A LT H 2 0 0 3 ; 9 : 2 7 2 – 2 7 9
Received from Coordinación de Salud en el Trabajo, Instituto
Mexicano del Seguro Social, Centro Médico Nacional. Distrito
Federal, México (GA-M, CAJ-P, FRSR); the Center for the Biology of Natural Systems, Queens College, City University of New
York, and Mount Sinai School of Medicine, New York, New York
(GA-M; SM); Centro de Investigación en Salud Poblacional,
Instituto Nacional de Salud Pública, Cuernavaca, Morelos,
México (MH-A); and Dirección de Informática y Geografía
Médica. Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México (JHVG). Supported by the Foundation MacArthur,
and in part by the Fogarty International Center of the U.S.
National Institutes of Health, through the Mount Sinai/Queens
College International Training Irving Selikoff Fellowship Program in Environmental and Occupational Health (Grant No.TW
00640-07) of the Mount Sinai School of Medicine and Queens
College, City University of New York.
Address correspondence and reprint requests to: Guadalupe
Aguilar Madrid, Instituto Mexicano del Seguro Social. Área de
Calificación y Evaluación de Enfermedades de Trabajo, Centro
Médico Nacional Siglo XXI, Av. Cuauhtémoc 330, Col. Doctores,
Distrito Federal, CP 62508, México; telephone: (52)55 5627 69 00,
ext. 1875; fax: (55) 55 38-8145; e-mail: <[email protected].
apc.org>.
272
T
he causal association between exposures to all
types of asbestos and the subsequent development of pleural mesothelioma, asbestosis, and
lung cancer has been well-documented.1 In 1986,
asbestos was declared a human carcinogen by the Environmental Protection Agency of the United States and
the International Agency for Research on Cancer of
the World Health Organization.2,3 The common historic and continued use of asbestos in different countries suggests that large numbers of workers and the
general population have been and continue to be
exposed to asbestos, often without their full knowledge.
Globalization has had important consequences for
the dissemination of the hazards of asbestos exposure
throughout the globe. The commercial strategy of
multinational asbestos industries has depended on the
opening of markets within the global economy framework, business liberalization, changes in investment
policies, the introduction of new technologies and
chemical substances, and the establishment of free
trade agreements. The prerogative of free trade has prevailed over human, environmental, and labor rights.
This globalization process has been further accompanied by the transfer of hazardous industries, such as the
manufacture of asbestos products, from developed
countries (i.e., Canada, the United States, the European
Union and Japan) to the developing countries of Latin
America, Asia, and Africa,4 including Mexico.
In Mexico, the key factors that have allowed the
export of risk by multi-national companies to Mexico
are:
greater legal flexibility in labor and environmental
concerns;
cheap Mexican labor;
fiscal incentives for multinational companies;
political control in union organizations;
lack of updated legislation in health, safety, and
hygiene matters;
deficient governmental surveillance of compliance
with the existing laws, regulations, and standards:
lack of information about health risks of asbestos to
workers and neighborhood residents;
lack of professionals in the fields of environmental
and occupational health;
economic crises and unemployment in developing
countries; and
stricter environmental and occupational regulating
controls in developed countries as well as the
increase in legal demands of workers and populations affected in those countries.
The transfer of hazardous industries such as asbestos
production to Mexico is generally believed to have an
important impact on the health of workers and the
general population, but, in fact, this has been little
studied in Mexico.
Mexico lacks asbestos mines and, therefore, has
depended on import of the raw material from other
countries such as Canada. Examples of companies that
have set up business in Mexico are subsidiaries of Eternit
(Switzerland), and Eureka, Johns Mansville and Textiles
Americanos de Asbestos (United States). The United
States closed asbestos plants in the United States in the
mid 1970s due to regulation and tort litigation. These
companies then moved their businesses to other countries, including Mexico. Thus, the resources of underdeveloped countries have contributed to the growth of
multinational corporations, especially through the availability of cheap labor, low-cost raw materials, and a regulation- and litigation-free atmosphere. In addition, in
spite of the progress in the development of “clean” technologies, transnational companies often transfer “older”
and obselete, and therefore less protective, technologies
to economically less developed countries.
The development of asbestos-using industries in
Mexico began in the 1930s, when Techo Eterno
Eureka, S.A. de C.V, an asbestos cement company,
opened a plant in Mexico City. Thereafter, the proliferation of companies manufacturing asbestos products
was gradual, until it accelerated in the 1970s due to a
significant migration of American and European companies in response to increased regulation of asbestos
in developed countries. The total quantity of asbestos
imports through 1997 in Mexico is not known.
The goal of this report is to describe the use of
asbestos in Mexico and the trend in mortality from
pleural mesothelioma in the Mexican population
during the period 1979–2000.
METHODS
To determine the mortality due to pleural mesothelioma in Mexico, we obtained information from secondary data sources that reported deaths based on
death certificates. The following sources were used: the
National Institute of Statistics, Geography and Informatics (INEGI); the Mexican Institute of Social Security
(IMSS); the Institute of Social Security Services for State
Workers (ISSSTE); the Ministry of Health (SSA); the
Naval Hospital; the medical departments of Petróleos
Mexicanos, the Army, and numerous private hospitals.
VOL 9/NO 3, JUL/SEP 2003
The underlying causes of death on death certificates
were coded according to the 9th and 10th revisions of
the International Classification of Disease of the World
Health Organization. The death certificates contain the
following information: gender, age, date of death, cause
of death, date of birth, place of residence, occupation,
place of death, and type of health insurance. This
information was validated by comparing the underlying
causes of death that were recorded in the INEGI and
SSA records in order to verify the concordance between
them. In addition, we analyzed IMSS records of occupational diseases that occurred among insured workers
and that were generated by health services at the respective work places between 1992 and 2002.
To determine the use of asbestos in Mexico, we
obtained data on imports and exports of asbestos in
Mexico from 1992 to 2000 from the Ministry of Trade
and Industrial Development (SECOFI).5 Data prior to
1992 were not available. The information from SECOFI
was validated through use of specific customs codes for
asbestos.
RESULTS
Imports and Exports of Asbestos
According to SECOFI data and reports of asbestos
industrial facilities,5 the asbestos industry, which has
begun in Mexico in 1932, accelerated in the metropolitan area of Mexico City in the 1970s (Table 1). By
TABLE 1. Chronology of Asbestos Industry in Mexico*
Company
Techo Eterno Eureka,
S. A. de C.V.
Asbestos de Mexico,
S. A. de C.V.
Mexalit, S.A. (División
Centro)
Eureka del Norte,
S. A. de C.V.
Asbestos del Noroeste,
S. A. de C.V
Mexalit, S.A.
(División Norte)
Eureka de Occidente,
S. A de C.V.
Mexalit, S.A.
(División Occidente)
Asbestolit de
Guadalajara, S. A.
Asbestos de Hidalgo,
S. A.
Asbestolit del Sureste,
S. A.
Mexalit, S.A.
(División Sureste)
Location
Year
Established
Mexico City
1932
State of Mexico
1943
State of Mexico
1952
Nuevo León
1956
Sonora
1956
Chihuahua
1960
Jalisco
1960
Jalisco
1960
Jalisco
1976
Hidalgo
1977
Tabasco
1977
Tabasco
1979
*Source: Asociación Mexicana de Fabricantes de productos de Asbestos—Cemento, A. C. 1985.3
Asbestos in Mexico
•
273
TABLE 2. Source Countries for Asbestos Imports and Their Costs to Mexico, 1992 and 2000
1992*
______________________________________
Total Cost
Cost/kg
Tons (%)
(US$ in millions)
(US$)
Canada
Switzerland
Brazil
Zimbabwe
TOTAL
2000*
______________________________________
Total Cost
Cost/kg
Tons (%) (US $ in millions)
(US$)
10. 5 (30)
6 3 (18)
2 .5 (7)
2 .4 (7)
5.3
4.5
1.8
2.4
0.51
0.71
0.72
0.98
17.8 (68)
0
7.8 (30)
3.0 (1.1)
8.3
—
4.2
1.9
0.46
—
0.54
0.64
35.3 (100)
21.2
0.60
26.1 (100)
12.8
0.48
*Mean values. Source: SECOFI, 2001.
1986, there were 97 asbestos industries in this zone,
mostly in Mexico City (92 in Mexico City and five in the
State of Mexico). Automotive products was the principal asbestos-using industry (61 facilities), followed by
the asbestos cement industry (30 plants).6,7 After the
Mexican economic crisis of 1994, the number of small
asbestos-using companies diminished. By 2001, there
were 1,881 companies in Mexico importing different
forms of asbestos: 263 facilities (13.9%) made prefabricated construction materials, including tiles, 45 facilities (2.3%) made brake pads, and 38 (2%) used it as
fiber or rock.5
According to SECOFI data,5 Mexico imported raw
asbestos from 19 countries in 1992, which dropped to
six in 2000. In 2000, two countries dominated: Canada,
which doubled its sales in tons of asbestos and
increased its share of Mexican asbestos imports from
30% to 68% between 1992 and 2000; and Brazil, which
tripled its sales of asbestos to Mexico and raised its
share from 7% to 30% during the same period (Table
2). Overall, imports of asbestos in Mexico decreased
from 35.3 tons to 26.1 tons of asbestos between 1992
and 2000. Thus, between 1992 and 2000, asbestos
imports decreased, both in tonnage and in the number
of exporting countries.
Comparison of average imports in 1992 and 2000
shows increases from 3.20 to 4.35 tons per year per
country. The cost of a kilogram of asbestos dropped
from $0.51 to $0.46 during the same period. Despite
the drop in imported asbestos, total and average
exports increased (Table 3).
In 1992, 96% of asbestos products manufactured in
Mexico were exported to the United States. By 2000,
however, this percentage had decreased to 58%. By
contrast, El Salvador, which purchased only 0.04% of
Mexican asbestos exports in 1992, had increased its
share to 22.6% by 2000 (Table 4).
In 2001, 29 of the 1,881 asbestos-using companies
were located in the Valley of Mexico (which includes
Mexico City and State of Mexico), employing approximately 5,000 workers.5 Half (47%) of these facilities
produced brake linings, and an additional fourth
(21%) made gaskets. Other products included waterproofing materials (14%) and water tanks and sheets
(7%). Approximately 50% of these asbestos-using
industries were located near residential areas with a
high population density within a 2-km radius (Figure
1). Social security records for 2001 indicated that there
were 15 asbestos cement industries that insured their
workers and that employed approximately 7,200 persons in 2001. This employed population is in addition
to the 5,000 workers5 cited above. Thus, it appears that
no fewer than 12,000 workers were employed in
asbestos-using companies in Mexico City in 2000.8
Employment data relating to the asbestos industry
from earlier decades are not available.
MESOTHELIOMA AND ASBESTOSIS IN
MÉXICO
During the 22-year period, 1979 to 2000, there were
793 deaths from malignant mesothelioma of the pleura
TABLE 3. Total and Average Asbestos Imports and Exports and Their Costs in Mexico, 1992 and 2000
1992
___________________________________
Amount/Year
Cost US $
2000
___________________________________
Amount/Year
Cost US $
Imports
Average
Total
3,209,143 tons
35,300,576 tons
1,928,794
21,216,739*
4,350,306 tons
26,101,840 tons†
2,128,935
12,773,616
Exports
Average
Total
112,674 units‡
20,619,497 units
189,562
34,689,914
201,151 units
67,184,516 units
309,896
104,745,041
*The unit cost of 1 kg of asbestos was 0.60 US $.
†The unit cost of 1 kg of asbestos was 0.48 US $.
‡Units per year.
Source: Secofi, 2000.
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INT J OCCUP ENVIRON HEALTH
TABLE 4. Volumes and Costs of Exports of Mexican Asbestos-containing Products to Principal Importing Countries,
1992 and 2000
Country*
1992
___________________________________
Units/Year
Cost
No. (%)
(US $)
2000
___________________________________
Units/Year
Cost
No. (%)
(US $)
USA
Canada
El Salvador
Honduras
Guatemala
Nicaragua
Costa Rica
Cuba
Germany
Chile
Belize
19,845,793
1,160
83,815
15,297
134,759
1,217
3,185
39,387
211,568
6,064
37,000
39,286,492
1,116,497
15,318,194
4,006,296
2,271,365
2,093,497
1,019,705
537,540
374,991
172,631
91,486
TOTAL
(96)
(0.005)
(0.04)
(0.07)
(0.6)
(0.005)
(0.01)
(0.2)
(1)
(0.03)
(0.1)
20,619,497
30,714,631
10,755
192,815
118,203
417,801
20,601
58,627
302,854
609,141
103,976
89,181
34,689,914
(58)
(1.65)
(22.6)
(5.9)
(3.3)
(3.1)
(1.5)
(0.8)
(0.5)
(0.2)
(0.1)
83,714,631
1,257,899
4,544,194
2,115,557
2,179,359
911,648
1,921,527
900,684
1,035,725
572,734
169,391
67,619,497
104,745,041
*Total countries: 183.
Source: Secofi, 2001.
in Mexico. None of these deaths was recognized as
occupational disease, according to records of Social
Security.9 Of those who died, 62% (491) were male and
38% (302) were female. The mean age was 60.7 years
(SD = 16 years), with a range of 1 to 105 years; 81 cases,
or 10%, were less than 40 years of age, and 92, or
11.6%, were 80 years old or older. Analysis of the deaths
by age shows that 31.9% (252) occurred between the
ages of 40 and 59 years (Table 5 and Figure 3). There
was no significant difference between the mean ages of
males and females. Of the cases for whom the sources
of medical care were known, 50.4% (316) received
health care as part of the Mexican social security system
for private-sector workers (IMSS). Nearly 90% of the
people who died from mesothelioma had had no more
than some primary school education (Table 5).
From 1979 to 1997, there were 487 deaths from
malignant mesothelioma, or a mean of 25.6 deaths per
year, including means of 15 deaths among males and
ten in females. The gender ratio was 1.5:1. During the
period 1998–2000, there were 306 deaths from malignant mesothelioma of the pleura, or a mean of 102
cases per year. This represented a fourfold increase. In
the latter period, there were means of 64.7 and 37.3
deaths from malignant mesothelioma of the pleura
among males and females, respectively, with a resulting
ratio of 2:1 (Figure 2).
A third of the deaths from pleural mesothelioma
(256, or 32.3%) were recorded in the metropolitan area
of the Valley of Mexico; This coincides with the geographic location of greatest concentration of asbestos
industries in Mexico, and also the location of the most
important hospitals with the best technology for diagnosing cases of pleural mesothelioma (Figure 4).
Based on an analysis of the social security records
obtained from IMSS,9 there were 211 cases of asbestosis
recognized as an occupational disease between 1992
VOL 9/NO 3, JUL/SEP 2003
and 2000 in Mexico. Nearly all (202, or 95.7%) were
male workers, but nine (4.3%) were female workers.
The mean age at the time of diagnosis was 49 years (SD
= 5 years), with a range of 23–76 years. A recording
error caused a decrease in the number of cases of
asbestosis between 1998 and 2002, when many cases of
asbestosis were coded as pneumoconiosis rather than
asbestosis specifically (Figure 5). Of the cases of
asbestosis, 48.8% (103) were concentrated in the Valley
of Mexico.9
TABLE 5. Mortality Due to Pleural Mesothelioma by
Sociodemographic Variables, Mexico,1979–2000
Gender
Males
Females
Total
491
302
793
(62%)
(38%)
(100%)
Type of medical service
None
IMSS
ISSSTE
Pemex
159
316
52
12
(25.4%)
(50.4%)
(8.3%)
(2%)
Education
None
1st–4th grade primary
5th–6th grade primary
Junior high school
62
323
157
71
(9%)
(45%)
(22.3%)
(10%)
Age (years)
<14
15–19
20–29
30–39
40–49
50–59
60–69
70–79
>80
Total
12
—
18
51
97
155
206
159
92
790
(1.5%)
—
(2.3%)
(6.5%)
(12.3%)
(19.6%)
(26.1%)
(20.1%)
(11.6%)
(100.0%)
Source: INEGI. Ministry of Health,1979–2000.
Asbestos in Mexico
•
275
Figure 1—Asbestos industries in the Mexico City Metropolitan Area, 1999–2000. Source: Secofi, 2001.
DISCUSSION
Imports and exports of asbestos to and from Mexico
were dynamic in the ten years under study. Virtually all
asbestos used in Mexico is now imported from just two
countries, Canada and Brazil. By contrast, whereas the
United States used to be nearly the sole recipient of
asbestos-containing goods from Mexico, Central America now imports over a third of Mexico’s asbestos products. Even though the import of asbestos into Mexico
Figure 2—Pleural mesothelioma cases by
gender. Mexico, 1979–
2000. Source: INEGI,
2001 Ministry of Health,
1979– 2000.
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Aguilar-Madrid et al.
INT J OCCUP ENVIRON HEALTH
Figure 3—All deaths due to pleural mesothelioma by age group. Mexico, 1979–
2000. Source: Death certificates of INEGI
and Ministry of Health.
fell by 25% between 1992 and 2000, the number of
asbestos-containing units produced In Mexico more
than tripled in the same period.
These changes in Mexico have occurred in a context
of widespread restrictions on asbestos use and relaxation of trade barriers, especially in North America.
Asbestos import fell dramatically in Europe and the
United States in the 1980s as a consequence of stricter
regulation and accelerated litigation. In more recent
years, a number of countries have adopted a ban on
asbestos, including the European Union’s ban on the
use of all forms of asbestos, effective in 2005.10 In Latin
America, Chile11 and Argentina12,13 have banned the
use of asbestos.
The sense of urgency about asbestos control and
elimination has been substantiated by a growing literature documenting the overall burden of asbestosrelated diseases, especially malignant mesothelioma.
Figure 4—Cases of mortality due to pleural mesothelioma, Mexico, 1979–2000. Fuente: INEGI, 2001 Secretaría de
Salud,1979–2000.
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Asbestos in Mexico
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277
Figure 5—Cases of asbestosis in workers affiliated with Social Security, Mexico, 1992–
2002. Source: Statistics of Medical Informatics Coordination. CST. SUI-ST-5.IMSS. Mexico,
1992–2002. Note Fig.5: the percent of all
deaths from malignant mesothelioma of the
pleura.
Several studies show that mortality due to malignant
mesothelioma has increased rapidly among workers
exposed to asbestos in many countries, including
France, Italy, the United Kingdom, the United States,
Australia, Denmark, Canada, Sweden, Germany, and
China.14-17 According to Banaei et al., mortality due to
mesothelioma among French men aged between 50
and 79 years will continue to increase until it reaches a
annual peak ranging between 1,140 and 1,300 deaths
per year in the period 2030–2040. Thus, between 1997
and 2050, the total number of mesothelioma deaths in
France will increase from 44,480 to 57,020.19 In Finland, which banned the use of asbestos in 1976, there
was an average of 35 cases of mesothelioma in men in
1995, and this trend is expected to increase to 40–50
annual cases by 2010.18 Despite the more recent bans,
most developed countries are expected to experience
continued epidemics of asbestos-related diseases for
several decades.20,21
In response to these events, Canada, a leader in
asbestos exportation, has implemented a strategy to revitalize the industry of this raw material with the participation of state governments of Canada and Quebec and
the National Chambers of Fibrous Cement Industries in
Mexico (now grouped into the Asbestos Institute). Their
strategy has consisted of establishing their markets in
developing countries through the promotion of “the
safe and controlled use of asbestos.”22 Recently, this has
resulted in pressure on the governments of Chile and
Argentina, which banned the use of asbestos in 2001 and
2003, respectively, to reverse the bans.
There has been little study of asbestos-related diseases
in Mexico. In 1990, Gaviria et al. identified 52 cases of
malignant mesothelioma using pathologic anatomy
records of different hospitals of the national health institutes (IMSS and ISSSTE) during the period 1980–1985.6
The extent to which Mexican physicians failed to diagnose mesothelioma was not addressd. In 1986, Pérez L et
al. studied pulmonary function and chest x-rays of 23 of
400 workers at a Borg Warner subsidiary in Mexico,
which manufactured brake linings. The periods of exposure to asbestos in this group of workers ranged from
one to ten years.23 Two of the examined workers had
pleural thickening; 14 workers (60%) had obstructive
278
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Aguilar-Madrid et al.
abnormalities in respiratory function tests; in five cases,
the obstruction was in central airways; in three, a mixed
pattern was present (restrictive and obstructive); and
finally, six workers’ examination results were recognized
by the social security system as presenting evidence of
occupational diseases.23
Recent labor and community activities in Mexico
demonstrate that there is increased awareness of the
importance of asbestos exposure. In 1998, Mexican
workers who had been fired from the ITAPSA and
American Brakeblock companies of Mexico City, which
manufactured asbestos brake linings, brought an
action before the National Administrative Office
(NAO). This body was created in 1994 as a part of Parallel Agreements of the North American Free Trade
Agreement (NAFTA) signed between Mexico, Canada,
and the United States, in part to address issues involving occupational health and safety and the prevention
of occupational accidents and diseases. The lawsuit
described a series of violations, including the lack of
enforcement of safety and hygiene standards necessary
to prevent health risks due to the use of asbestos. The
NAO affirmed the claims and issued a summons to
Mexican labor authorities, though with little action
taken to date.24 In a second case, community residents
of the San Lucas quarter in Iztapalapa, Mexico City,
brought a lawsuit against American Roll, S.A. de C.V.
(ITAPASA S.A. de C. V.), a company manufacturing car
brake linings, to close its factory. The plant is located
within 300 meters of six schools and numerous housing
complexes housing at least 500 families. No action has
been taken by governmental authorities, and the facility remains open.
There are numerous limitations to our study. We
have not identified the reason for the precipitous
increase in mesothelioma deaths beginning in 1998.
The mortality statistics are fragmented in Mexico and
make the underestimate of mesothelioma deaths
highly probable. The failure of the Mexican health care
system to recognize occupational diseases, including
mesothelioma, as we demonstrated here, further
undermines the proper reporting of cases of even obvious occupational diseases. There is no effective public
health surveillance system in Mexico to monitor the
INT J OCCUP ENVIRON HEALTH
occurrences of occupational diseases and occupational
risks. These limitations impede the ability to fully characterize the risk and burden of disease for the best
known of all occupational hazards—asbestos.
The relatively recent introduction of asbestos in
Mexico suggests that Mexico is only now beginning to
experience asbestos-related disease. Given the very
long latency for asbestos-induced mesothelioma, the
incidence of this disease is likely to increase in coming
decades. Factors that are specific to, or more common
in, developing countries such as Mexico are likely to
intensify this epidemic. These include poor nutritional
levels associated with high rates of morbidity in workers, absence of a union organization, lack of governmental authorities’ awareness regarding contamination
and occupational health risks, lack of care and action
on the part of authorities, and lack of workers’ experience in this kind of industrial environment, as well as
the absence of occupational health services and qualified staff.
Given the many failures of the occupational health
system in Mexico, it is imperative for the Mexican government to ban the use of asbestos25,26 in order to limit
the future extent of asbestos-related disease and to protect the health of the Mexican population.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
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7. Asociación Mexicana de Productores y manufactureros de
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