Commentary on Notification and Recordkeeping of Occupational Mesothelioma in India

TL;DR

India's laws require reporting occupational mesothelioma, but no cases have been officially reported, despite evidence of the disease in medical literature.

Contribution

Highlights the discrepancy between legal reporting requirements and actual notifications for occupational mesothelioma in India.

Findings

No mesothelioma cases were reported under the Mines Act from 2004 to 2024.

Only one occupational cancer case was reported under the Factories Act in one state.

Medical literature shows many mesothelioma cases in India, indicating underreporting.

Abstract

In India, some occupational diseases are notifiable under the Mines Act, 1952, and the Factories Act, 1948. Mesothelioma, primarily attributable to asbestos exposure, has been listed specifically as one of the notifiable diseases under the Mines Act, 1952, and is notifiable under the category of occupational cancer in the Factories Act, 1948. The total number of cases of mesothelioma notified to the Directorate General of Mines Safety under the mining safety law was zero from 2004 to 2024. Similarly, under the factory safety law, only one case of occupational cancer was notified in one state, in a country of 28 states and 8 union territories (mesothelioma being listed under occupational cancer and not a separate entry under the factories law). This is in sharp contrast to the medical literature, where a large number of cases have been published by researchers and doctors from Indian hospitals. The absence of notified disease may not automatically mean the absence of disease. Further, a parallel National Cancer Registry Program, which is not only for occupational cancers, but which may overlap with occupational cases, covers only 16% of the country's population. With clear lack of notification of cases and underreporting of occupational mesothelioma, and cancer not being declared as universally notifiable at the national level, disease surveillance in India may need to be invigorated so that easily preventable disease is reduced, load on the already strained healthcare infrastructure is decreased, and overall national medical costs are reduced in the future.