February 6, 2023, Asbestos (Amyant-Whıte Soıl) Awareness and Knowledge Level of the People of the Region After the Earthquakes Centered in Kahramanmaras

Asbestos Awareness and Knowledge Level of the People of the Region After February 6, 2023, Turkey-Centered Earthquake Debris

Thousands of aftershocks were recorded after the 7.7 and 7.6 magnitude earthquakes that occurred in Türkiye on February 6, 2023. As a result of these large earthquakes, it has been clearly seen that disasters pose significant risks to public health and the environment. The impact of asbestos (released by disaster debris and the subsequent demolition of heavily damaged buildings) on human health, will also be great in the coming years.

The aim of this study is to increase the knowledge levels and awareness of the participants about asbestos exposure from debris and demolition works in the provinces affected by the 6 February 2023 Kahramanmaraş-based earthquakes.

Method

This study is a cross-sectional, descriptive study. The population of 13.5 million living in the affected provinces after the February 6 Kahramanmaraş-based earthquakes was accepted as the study universe. For the research, approval was received from the Ethics Committee of Non-Interventional Clinical Research (2023/ 4865). Participants answered survey questions on a voluntary basis via Google survey with snowball sampling method. The collected data were summarized as median (minimum - maximum) and number (percentage). The suitability of the data to the normal distribution was tested by the Kolmogorov Smirnov test. The Mann Whitney-U test, Kruskall Wallis test, and Pearson Chi-Square test were used where appropriate. A value of P < 0.05 was considered statistically significant. SPSS (Statistical Package for the Social Sciences) 26.0 (IBM Corp., Armonk, New York, USA) program was used in the analysis. Ethical issues (including plagiarism, informed consent, misconduct, and data fabrication, as well as double publication and/ or submission, redundancy, etc.) have been completely checked by the authors.

Results

A total of 417 people participated in the study, of which 259 (62.11%) were female and 158 (37.89%) were male. The mean age of the participants was 38 ± 10 years. 190 (45.56%) were single and 227 (54.44%) were married. 231 (55.40%) of the participants had no children. A hundred and sixty-six participants (39.81%) were health workers, 47 (11.27%) were non-health workers, 68 (16.31%) were teachers, and 33 (7.91%) participants were students. Also, 28 (6.71%) were housewives, and 75 (17.99%) were from other occupational groups. Three hundred and twenty-nine (78.90%) people stated that they did not have a chronic disease that they were followed up for before the earthquake, and 32 (7.67%) people stated that they had a chronic disease that they were followed up for before the earthquake. Three hundred and forty-four (82.49%) people were caught in the earthquake in their own homes. The building where 16 (3.84%) people were at the time of the earthquake collapsed, and 2 (0.48%) people were trapped under debris. Sixty-one (14.63%) people participated in the search and rescue efforts and 272 (65.23%) people lived close to the debris area after the earthquake. While 104 (24.94%) participants were partially exposed to the debris dust released during the post-earthquake debris studies, 200(47.96%) participants were fully exposed. A total of 312 (74.82%) people did nothing to protect themselves from debris dust after the earthquake, while 105 (25.18%) people stated that they used masks.

The distribution of participants’ answers to questions about asbestos is shown in Table 1.

Table 1. Distribution of participants’ responses to asbestos-related questions

Those exposed to debris dust during post-earthquake debris studies were aware that the separation of asbestos-containing insulation materials from rubble and excavation during building demolition and renovations should not be done on site (P = 0.014) (Table 2).

Table 2. Evaluation of data according to exposure to debris dust generated during debris work after the earthquake

Discussion

Since the mid-1980s, the use of asbestos individually has been banned in the European Union and on January 1, 2005, the production and use of asbestos has been banned in all member states. In Turkey, the production and trade of asbestos and asbestos products is prohibited in accordance with the “Regulation on Health and Safety Measures in Work with Asbestos” published in January 25, 2013. ¹

In this study, it was observed that those who lived close to the debris area after the earthquake had no idea about the duration of the effect of asbestos (P = 0.023). It is known that it takes 20 - 50 years after inhalation for asbestos to cause benign or malignant disease. ² For this reason, it would be appropriate to take the necessary precautions during the acute period of exposure and to carry out public education both in print and visually.

Asbestos exposure can occur through occupational or environmental means. Although its use in the field of industry is not very high in Turkey, environmental asbestos exposure is an important public health problem. For many years, it has been used primarily in the countryside, in the insulation of the roofs of houses, in plaster and whitewash, and on walls; as a floor material for side streets, as an additive to the material from which pottery and pottery are made, as children’s powder, and as molasses soil. ^3,4

When an asbestos-used building is demolished near an area, asbestos fibers can enter the atmosphere. During earthquakes, the number of asbestos fibers in the air increases. During the demolition of a building that has been used for asbestos-containing material, people present may inhale asbestos fibers. After the February 6 earthquakes, many buildings deteriorated and were severely damaged in the affected areas. Between 1930 and 1980 (until the use of asbestos was banned), asbestos material was used in buildings. Therefore, asbestos dust and fibers would be released from the collapsed and damaged buildings slated for demolition. ⁵

It was observed that 65.23% of the participants lived close to the debris area after the earthquake, 24.94% were partially exposed to the debris dust during the debris works after the earthquake, and 47.96% were completely exposed. A total of 74.82% stated that they did nothing to protect themselves from debris dust after the earthquake. The low level of knowledge and awareness about asbestos can create deficiencies in taking protective measures. In the study conducted by Şenyiğit et al., the participants 173 (79.4%) stated that asbestos soil is not harmful to health. ⁶

Conclusion

These results showed that the people of the region did not have enough information about the harmful effects of asbestos on human health. Since the results of asbestos are seen after many years and the number of buildings to be demolished is very high, increasing asbestos awareness levels will be beneficial for public health. Doing more work to increase awareness on this issue, creating a public spot to raise public awareness, and providing education about asbestos will provide vital benefits in terms of public health.