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Cablegate: Economic Growth Trumps Public Health: Vietnamese Roofing

VZCZCXRO3008
RR RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0046/01 0160106
ZNR UUUUU ZZH
R 160106Z JAN 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 6999
INFO RUEHHM/AMCONSUL HO CHI MINH 4150
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 7010
RUEHMO/AMEMBASSY MOSCOW 0751
RUEHOT/AMEMBASSY OTTAWA 0511
RUCPDOC/DEPT OF COMMERCE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHC/DEPT OF INTERIOR WASHINGTON DC
RUEAWJA/DEPT OF JUSTICE WASHINGTON DC
RUEHC/DEPT OF LABOR WASHINGTON DC
RHMFIUU/HQ EPA WASHINGTON DC

UNCLAS SECTION 01 OF 04 HANOI 000046

SIPDIS

SENSITIVE
SIPDIS

BANGKOK FOR REO WALLER AND RDM/A (OCARDUNER/CBOWES)
CDC ATLANTA FOR COGH (SBLOUNT/KMCCALL) and NIOSH
(JHOWARD/GWAGNER/MSWEENEY)
COMMERCE FOR 4430/MAC/AP/OPB/HPPHO
HHS/OSSI/DSI PASS TO OGHA (WSTIEGER/LVALDEZ/CHICKEY) AND
FIC/NIH (RGLASS)

E.O. 12958: N/A
TAGS: SENV TBIO ECON SOCI VM
SUBJECT: ECONOMIC GROWTH TRUMPS PUBLIC HEALTH: VIETNAMESE ROOFING
TILE WORKERS EXPOSED TO ASBESTOS

REF: 07 Ho Chi Minh City 1276

HANOI 00000046 001.2 OF 004


1. (U) Summary. Vietnam increasingly relies on asbestos in its
construction sector, despite the internationally recognized harmful
health impacts from asbestos exposure. In the absence of effective
worker safety provisions, many workers in Vietnam's growing number
of asbestos-cement processing facilities will suffer debilitating
diseases from handling asbestos over the ensuing decades. End
Summary.

Vietnam Construction Sector Relies on Asbestos...
--------------------------------------------- ----

2. (U) To support the rapid development of its construction sector,
Vietnam has increasingly turned to asbestos for low-cost, durable
roofing material and now has one of the world's highest per capita
consumption rates. Vietnam does not produce asbestos, instead
relying on imports of the raw material to meet domestic demand. In
2005 (the last year for which complete statistics are available),
Vietnam imported over 74,000 tons, largely from Russia, China, and
Canada. The GVN has officially licensed 35 factories to produce
asbestos-cement roofing tiles, though labor protection authorities
believe at least fifteen other non-permitted factories have recently
opened to take advantage of the growing market for the product and
simple manufacturing technology. In 2005, permit-holding facilities
produced over 66 million square meters of asbestos-cement materials,
almost all for domestic consumption, at a value of over USD 40
million.

3. (SBU) Asbestos-cement producers directly employ over ten thousand
workers and provide indirect employment to many thousands more.
According to Dr. Pham Van Hai of the National Institute of Labor
Protection (NILP), cheap, durable asbestos-cement roofing tiles ease
the development of rural areas and coastal zones that face heavy
storms, high heat and other harsh environmental conditions. Dr.
Nguyen Ba Toai of Hanoi University of Civil Engineering, told
Embassy Department of Health and Human Services (HHS) Officer that
asbestos-cement roof materials reduce housing costs and play an
important role in GVN poverty reduction programs, under which the
GVN often provides asbestos-cement roofing tiles free of charge to
replace fire-prone native roofing materials.

...Leading to Severe Health Effects
-----------------------------------

4. (U) International health experts list asbestos as a carcinogen in
humans and state that it may cause severe impacts to exposed
Vietnamese workers, including lung cancer, malignant mesothelioma,
asbestosis, and other serious diseases. Since the Vietnamese
asbestos-cement roofing sector developed in the mid-1990s and
diseases from asbestos exposure often exhibit a latency period of
twenty or more years, there would be little specific impact on
Vietnamese workers currently. Indeed, Vietnam has few reported
cases of asbestos-related diseases, with only four "official"
confirmed cases of asbestosis and no cases of mesothelioma or lung
cancer among asbestos-cement roofing tile workers. However, in
addition to the lag time between exposure and disease, the lack of
capacity for occupational disease checks, the lack of a national
disease surveillance program, and low cooperation from
asbestos-cement manufacturers probably leads to substantial
under-reporting.

5. (U) A 2006 National Profile on Occupational Safety and Health in
Vietnam (NPOSH) report noted that occupational disease cases
generally are likely to be at least eight times higher than reported
and recent medical examinations of workers in several
asbestos-cement plans found that 88 percent reported health problems
ranging from breathing difficulties to chronic nasal inflammation.
Furthermore, smoking substantially aggravates the impacts of
asbestos exposure. As about 55 percent of Vietnamese males over the
age of 15 years smoke, the combined health effects of smoking and
asbestos-exposure over time probably will be severe. (Note: At some

HANOI 00000046 002.2 OF 004


point, Vietnamese consumers also will suffer health effects due to
asbestos exposure as current asbestos-containing materials
deteriorate, are repaired or are recycled).

Poor Health Controls at Production Facilities
---------------------------------------------

6. (U) Vietnamese asbestos-cement roofing tile factories lack
adequate engineering controls or ventilation systems and become
contaminated with asbestos dust, leading to worker exposures far
above Vietnamese or international standards. World Health
Organization experts who have visited numerous asbestos using
factories note poor worker protection with no personal protective
devices or masks and NILP surveys have found workers handling
asbestos with bare hands. Few workers or managers know of
asbestos-related health risks or means to limit them. Even at
permitted facilities, processing equipment and broken storage bags
leak asbestos into the air. Warning labels often are in Russian or
English -- unintelligible to most workers and supervisors.

Past GVN Attempts to Ban/Control Asbestos Have Failed
--------------------------------------------- --------

7. (U) As early as 2001, the GVN moved to limit asbestos, as part of
a Prime Ministerial Decision (115/2001/QD-TTG) to develop a master
plan for the construction industry through 2010 that would have
modified legislation to require the roofing industry to use
alternative materials, control the number of existing
asbestos-roofing factories, forbid the construction of new asbestos
roofing factories, and finally eliminate asbestos in the production
of roofing tile by 2004. The Decision also addressed environmental
air control, air monitoring, health examinations of asbestos
workers, personal protective equipment, training on occupational
safety and health, and inspections.

8. (U) However, the GVN never fully enforced this Decision, instead
revising it through a subsequent Decision (133/2004/QD-TTG), issued
on July 20, 2004, which banned the use of amosite and amphibole
asbestos in production of roofing tile and required existing roofing
tile facilities to obey all health and environmental protection
requirements. Again, enforcement was weak. On September 6, 2006,
the Ministry of Construction issued a decision to ban importation of
amphibole asbestos but continued to allow the import of chrysotile
asbestos. However, these measures contain more bark than bite.
Amphibole asbestos makes up less than one percent of current world
production (Note: chrysotile or "white asbestos," which Vietnamese
legislation does not ban and which international health experts also
believe to be dangerous enough to justify a ban, makes up 99 percent
of world production).

Initial Steps to Find Substitutes, Mitigate Impacts
--------------------------------------------- ------

9. (U) At this time, the GVN has begun to investigate the use of
asbestos substitutes, such as polyvinyl alcohol (PVA) cellulose
cement materials, although commercial production might be several
years away. Several issues stand in the way: substitute products
are perceived by the Vietnamese to be more expensive and less
durable; and hence may explain why there are only two companies in
Vietnam currently that manufacture with substitutes. The GVN also
has taken initial steps to mitigate the health impacts of asbestos,
including listing asbestosis as a recognized occupational disease,
entitling affected workers to compensation. The Ministries of
Health, Labor, War Invalids, and Social Affairs, and Construction,
along with labor unions have been tasked with increasing supervision
of the asbestos sector to ensure compliance with occupational safety
and health regulations Similarly, Vietnamese law requires all
asbestos factories to organize worker safety training courses for
all employees and include environmental control systems as part of
modernization plans.

Lack of Capacity Hinders Efforts

HANOI 00000046 003.2 OF 004


--------------------------------

10. (SBU) However, as with many worker safety issues (reftel)
Vietnamese attempts to limit the health effects of asbestos seem
doomed to fail due to lack of manufacturing and technical capacity,
weak political will, and limited funding and investment.
Additionally, and despite declarations from international health
experts to the contrary, some Vietnamese public health experts
believe that chysotile asbestos is less harmful than the
already-banned amosite asbestos and have been hesitant to support
restrictions on this affordable and useful substance. Existing
safety and health standards are inadequate to protect worker health
and few companies follow even these minimal standards. GVN
authorities rarely inspect asbestos production facilities. NILP,
part of Vietnam General Confederation Labor (VGCL) and the most
senior institution representing workers' rights in Vietnam, must
receive permission from asbestos-cement roofing tiles prior to
conducting site visits. Unlike many developed nations, Vietnam has
no national disease surveillance program to monitor and track
asbestos workers -- critical as most asbestos-related diseases do
not develop for ten to forty years after exposure -- though the WHO
plans to fund the Ministry of Health to develop such a program in
2008. Vietnam also has no standards for health exams for these
workers, who rarely receive medical checks. Those that do display
work-related illnesses typically are moved to other areas in the
factories.

As Does Fear of Economic Impacts
--------------------------------

11. (SBU) GVN officials fear that a ban or significant restriction
on asbestos could cost thousands of jobs as the country attempts to
move to alternate production and would send many poorly educated and
low-skilled workers looking for employment, while removing a
low-cost source of construction materials. Though there is some
debate on this point, many Vietnamese involved with the issue
believe that conversion to cost-effective substitutes for
asbestos-cement roofing materials is not feasible in the short term.
We could not determine if any external marketing pressure by
asbestos suppliers is being applied in Vietnam, as has been reported
in other countries. Vietnamese decision makers also tend to
discount the economic impacts of asbestos exposure, since serious
future health costs will not accrue for many years. In the face of
more immediate economic considerations, many GVN officials are
loathe to take the issue on publicly, instead hoping to quietly move
for better protections and seeking voluntary cooperation from
businesses, instead of popularizing the issue.

Comment
-------

9. (SBU) As Vietnam continues to expand economically, its
policy-makers will need to address the public health and
environmental impacts of such rapid growth. To date, the GVN claims
promoting better health is a national priority, but typically
sacrifices physical well-being if it compromises production. The
asbestos-cement roofing sector is a case in point and illustrates an
insufficient approach to both health policy development and
integration with economic policy. The GVN realizes that prolonged
exposure to asbestos will cause workers to suffer a variety of
diseases. However, those impacts probably are years down the road.
The need for economic growth, on the other hand, is current and
ever-present. In such cases, short-term economic concerns trump
long-term public welfare needs.

MICHALAK


6


HANOI 00000046 004.2 OF 004

1

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