[Health surveillance of workers exposed to asbestos: an example of cooperation between the occupational prevention system and the national health system].
The Ministry of Health and Consumer Affairs and the Autonomous Governments of Spain have designed and agreed by consensus with the sanitary professionals and major employer's organizations and Unions a Integral Health Surveillance Programme of asbestos-exposed workers, in order to assure appropriate, uniform and harmonized action throughout the national territory with relation to these workers.


METHODS
This initiative started from the Occupational Health Working group of the Interterritorial Council, with inputs from the Asbestos Working Group of the National Occupational Safety and Health Commission. It was agreed with occupational medicine and infirmary professionals and was approved by the Health and Labour authorities. The program is organised in seven main activities.
two years after the Programme approval a total of 5778 workers are included in the Registry of asbestos-exposed workers. 208 workers have COPD, 198 benign pleural disease, 8 lung cancer, 10 mesothelioma and 7 workers have other cancers possibly related to asbestos (gastric, larynx and colon cancer).


CONCLUSIONS
the agreement and participation reached in this Programme allow achieving much higher coverage of occupational prevention policies than those obtained with a mere law approval, as we could see during the second year of implementation of the Programme in which the number of attended workers has doubled.
García Gómez
M
M
Area de Salud Laboral, Dirección General de Salud Pública, Ministerio de Sanidad y Consumo. mgarciag@msc.es
Artieda Pellejero
L
L
Esteban Buedo
V
V
Guzmán Fernández
A
A
Camino Durán
F
F
Martínez Castillo
A
A
Lezzáun Goñi
M
M
Gallo Fernández
M
M
González García
I
I
Martínez Arguisuelas
N
N
Elvira Espinosa
M
M
Sánchez de Navas
A Montilla
AM
Zimmermann Verdejo
M
M
Campos Acedo
R
R
Galván Olivares
F
F
Castañeda López
R
R
Estaún Blasco
E
E
Castell Salvá
R
R
Martínez-Portillo
L Miralles
LM
Rubio Sanz
A
A
Unamuno Achúcarro
A
A
Fernández Fernández
I
I
Lama Herrera
C
C
Mayoral Cortés
J M
JM
D001195:Asbestosis / Q000453:epidemiology / Q000517:prevention & control*; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D006801:Humans; D016273:Occupational Exposure; D009786:Occupational Health Services / Q000592:standards; D011159:Population Surveillance / Q000379:methods; D011314:Preventive Health Services / Q000592:standards; D012308:Risk Management