title: Evaluation of the national health surveillance program of workers previously exposed to asbestos in Spain (2008).
abstract: OBJECTIVE
  Although asbestos was banned in Spain in 2001, monitoring the health of previously-exposed workers is required. In 2002 the Ministry of Health and the autonomous regions of Spain planned a health surveillance program for workers exposed to asbestos (Programa de Vigilancia de la Salud de los Trabajadores Expuestos al Amianto [PIVISTEA]) with employers' organizations, trade unions and scientific societies. The aim of this study was to evaluate the PIVISTEA to improve its effectiveness.
  
  
  METHODS
  A questionnaire with indicators for the year 2008 was sent to Spain's 17 autonomous regions, as well as to the autonomous cities of Ceuta and Melilla. The results were analyzed by evaluating the compliance of each program with the activities established by the PIVISTEA.
  
  
  RESULTS
  In December 2008, a total of 22,158 workers from 14 autonomous regions and 306 companies were included in the program. The program had been started in 88% of the regions but surveillance activities remained scarce in 24%. Fifty-seven percent of the autonomous regions (69% of the total number of workers) provided the information requested. Seven autonomous regions provided data on the relationship between the diseases found and asbestos exposure. Only 5% of these diseases entitled affected individuals to receive compensation for occupational diseases.
  
  
  CONCLUSIONS
  The health surveillance of workers previously exposed to asbestos in Spain, as well as medical-legal recognition of diseases caused by exposure at work, remain in adequate. Although the trend is positive, the effectiveness of many regional programs is limited, and inter-regional inequalities among affected workers have been detected.
authors.affiliation: Área de Salud Laboral, SGSAySL, Dirección General de Salud Pública y Sanidad Exterior, Ministerio de Sanidad, Política Social e Igualdad, Madrid, España. mgarciag@mspsi.es
authors.forename: Montserrat García
authors.initials: MG
authors.lastname: Gómez
authors.forename: Rosario
authors.initials: R
authors.lastname: Castañeda
authors.forename: Vega García
authors.initials: VG
authors.lastname: López
authors.forename: Manuel Martínez
authors.initials: MM
authors.lastname: Vidal
authors.forename: Vicent
authors.initials: V
authors.lastname: Villanueva
authors.forename: Mercedes Elvira
authors.initials: ME
authors.lastname: Espinosa
mesh_terms: D001194:Asbestos / Q000009:adverse effects*; D006801:Humans; D009313:National Health Programs; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D011159:Population Surveillance; D015397:Program Evaluation; D013030:Spain; D011795:Surveys and Questionnaires
chemical_list: D001194:Asbestos