Cairo – The symptoms of the illness of Am Salama, 56, a worker in a ceramics factory in Suez, started with coughing and breathing difficulties when exerting the slightest effort.
These problems intensified until he was no longer able to work after 20 years on this job.
At the health insurance office inside the factory he follows the expressions on the doctor’s face as the latter informs him that he had silica dust on his lungs. He wasn’t reassured by what he heard so he decided to consult another physician at a private hospital in Suez. After going through tests and x-rays the doctor informed him that he had lung cancer. He recalls his journey with the illness after being diagnosed with Silicosis , a chronic lung disease caused by breathing tiny bits of silica dust.
He talks about his colleagues who suffer from different chest and lung ailments because of exposure to products in the trade, including the crushing and grinding process, which emits poisonous gasses that settle into the workers’ lungs and could cause cancer.
Violations carried out by owners of the country’s ceramics factories threaten the lives of 40,000 labourers working in this sector who are exposed to crystalline silica. Their ailments range from asthma and tuberculosis to silicosis and lung cancer. Medical insurance staff do not carry out routine tests on the workers as stipulated by the Social Insurance Law.
To investigate these concerns we delved into the world of the ceramics factories: 31 such establishments with a $5.1 billion investment (chart no.2). The investigation reveals tricks of the trade employed by owners of these factories to get out of having to provide occupational safety and heath tools such as masks to protect their labourers from the deadly silica dust which is emitted during production (chart no. 1). They also do not follow the procedures put in place by the Ministry of Labour and its relevant institutions, in an attempt at saving money to make more profit. Thus, many owners take advantage of the weakness of the Egyptian punitive measures which forces them to pay fines of no less than one thousand Egyptian pounds and no more than 10 thousand, or serve a jail term of three months, or both if the law is violated.
There is no monitoring process to enforce the law and to shut down any violating factory. This works in favour of the owners at the expense of the labourers.
“Sayed” – who refuses to give his full name to avoid losing his job, has been working for eight years in the production of tiles which involves grinding raw products and drying them. He earns a monthly salary of 700 Egyptian pounds – 500 pounds less than the minimum monthly wage. Two years ago he started feeling a shortness of breath with chronic coughing when working.
He was informed by the doctor that he was in the early stages of Silicosis. He was warned that if he did not pay attention, this would develop into lung cancer.
Dr. Mustapha Shawki, the respiratory diseases specialist at the Demerdash Hospital, confirms that both “Sayed” and “Am Salama” suffer from silicosis. There are three types of silicosis, the most common of which is chronic silicosis. It usually occurs after 10 or more years of exposure to crystalline silica at low levels. The second and third types are accelerated and acute silicosis, and the latter can be fatal within months. The intensity and duration of exposure to this dust in addition to the genetic makeup of the worker are key factors in determining the speed at which silicosis spreads.
Instead of undergoing routine tests, workers only visit doctors when symptoms take hold. By then, the disease has entered a dangerous phase.
Silica Dust is the culprit
“It’s the fault of the silica dust sir, it’s going to bring our end”, Ali B, a chemist at one of the biggest ceramic factories in Egypt, told this reporter. “The factories do not provide us with masks and the state knows this”. The main components of the manufacturing of ceramics are sand, feldspar, black mud, white mud, Kaolin and Talc, in addition to other substances used in products like Sodium Hydroxide, Sodium Silicate, Calcium Carbonate and others. The grinding and crushing process emits the silica dust, which causes chest ailments, silicosis and lung cancer.
“Dr. Shawki” says silica dust does not only cause silicosis. It can lead to tuberculosis since it penetrates into certain cells within the immune system that protect the human body from such a disease and destroys them.
I accompanied “Abdul Razak” and “Sayed” who work in two of the six factories at the 10th of Ramadan district to carry out chest x-rays. We received results in the form of digital imaging from the laboratory. “Abdul Razak” was confirmed with tuberculosis and “Sayed” with silicosis. A questionnaire I distributed to 78 workers at two factories showed that workers do not undergo routine tests and some of them have never seen a mask.
The survey showed the following: all workers had signed contracts and all underwent medical check-ups prior to the commencement of work. These included chest and lung examinations as well as x-rays. They were carried out by the state-run medical insurance authority. All the workers agreed that their factories did not have agreements with outside medical centres but had an in-house physician who took care of the labourers and examined them when required to verify if they needed medical leave.
95% of the workers said they did not find that the state run medical insurance authority was providing them with suitable treatment to their illnesses despite the fact the companies were deducting 5% of their monthly wages for such insurance.
The Social Insurance Law stipulates that labourers should undergo medical examinations three times a year by the authority but not all workers get this. Some said that they had not had any chest or lung examinations since starting their jobs. They said they did not know that that they should have routine tests performed by the medical insurance authority.
41% of the workers succumbed to various illnesses after starting to work. 80% said they are certain that their illnesses were work related: 20% not knowing the reason and 90% confirming that they had chest and lung complaints.
As to whether the factories provided occupational safety and health tools, almost 77% said that that the factories provided some but not all. 23% said that none were being provided. All the workers confirmed that the factory administration did not provide the new masks with filters attached to protect them from dust emitted during production. In the areas left for other notes, most of the surveyed workers left comments to the effect that their rights were being violated, business owners did not really care and the state was not paying attention.
The National Centre for Studies on Occupational Safety and Health is a government institution that sets routine tests and specifications for industrial establishments. It is concerned with all aspects of occupational health, safety and environmental protection.
Dr. Mageda Salam, head of the administration for work environment research at the national centre for safety studies said the most recent field study carried out nationally was by the centre on deadly dust and the ceramics factories was published in 2000. It had the following heading:“Evaluating the Exposure to Dust in the Ceramics Industry and How to Control It.”
Dr. Mageda adds that this comprehensive study has been updated annually since 1999 and the results do not vary, because factory owners do not comply with the recommendations provided.
We obtained a copy of this study, which looks at the comparison of free silica particles in scattered dust to which the workers are exposed. Results showed rates much higher than is permissible, some reaching dangerous levels.
The study included weight analysis of 200 dust samples, scattered and inhaled inside the ceramics factories and took 20 chemical samples to determine the rate of free silica in various industrial stages.
It concluded that the concentration of inhaled dust reached its limit when measuring the weight of the tile contents, standing at 6,667 mg/m3 compared with the permissible exposure level of 68,0 mg/m3. This means that the worker is being exposed to 900 times more than what is safe. Free silica tests in the dust indicated very high levels ranging between 11% to more than 60% of the dust.
We also obtained a report that was issued in 2013 by the same centre showing final results for personal inhalable dust concentrations in the field in some of the largest ceramics and porcelain factories in Egypt.
Measurements were made by placing a “dust mask” on the chest of the labourer, which he would carry during the eight hours of his shift (the amount of time he is supposed to work as per Egyptian Labour Law regulations). This mask would gather the dust in the surrounding air. Measurements were taken in different areas of the factory where dust can be found and the results showed the following: Presses that pressed raw products – 9,1 mg/m3, Dryers – 7,3 mg/m3, Skirting Presses – 3,2 mg/m3, Mills – 6,33 mg/m3. All these results were much higher than the permissible level which is 8,0 mg/m3.
(The milligram is the unit of measure for dust and refers to the mg of polluted dust per cubic metre of air).
Results for the glaze lines also came in at 2,2 mg/m3 which are higher than the permissible rate of 1,2 mg/m3. However, the permissible rates do differ for glaze lines as per location in accordance with the free silica rate in the dust.
Dr. Mageda Salam explains all this by saying that the permissible limit with regard to dust concentration differs and varies according to the rate of silica in the dust. “We arrive at the correct amount by carrying out a simple digital equation using the numbers achieved from the measurements so that we can secure the permissible rate, which differs from one area to the next”.
The ceramics factories in Egypt – according to the studies carried out by the centre – she says, are witnessing a dangerous increase in dust concentrations because they do not adhere to the geometric and health guidelines that should be followed. These guidelines are set by the Occupational Safety and Health Department at the Ministry of Labour in line with Labour Law No.12/2003. Article 208 in the law states: “The establishment and its subsidiaries shall provide all forms of occupational health and safety measures and provide a hazard free work environment.”
Meanwhile Article 210 of the same law stipulates: “The establishment and its subsidiaries shall carry out all preventative measures to protect the labourer from contracting any bacteria, viruses, fungi, parasites and biological hazards should the type of work carried out put him in the danger of contracting them.”
Fuad Sa’ad, director of the Egyptian Organization for Occupational Safety and Health says all factories should provide their workers with the following: a pair of gloves, a helmet, overalls, a suitable mask, goggles, earplugs, safety gear and a pair of glasses,” to meet requirements of occupational health and safety tools.
There are five types of masks used by labourer in dusty conditions inside a factory varies depending on the concentrations of dust. If the concentration is less or equal to 500 micrograms the mask has to have a filtration system that purifies the air and be equipped with a good quality inhaler. If the concentration is 1250 micrograms or less, the mask needs to be attached to a helmet and provide a constant flow. If the concentration level is 2500 or less the mask has to cover the whole face and be equipped with a good quality inhaler. In cases where the concentration is 50000 or less the mask has to purify the air and half of it needs to work with a pressure pump if required. However if the concentration levels are less or equal to 100000 micrograms the mask has to cover the whole face and be equipped with a pressure pump to be used when necessary.
Dr. Mageda says masks provide good protection from the dust. Failure to provide workers with proper masks amount to a crime that should not be accepted. In its supervisory capacity the state simply informs the factory that it has violated the permissible dust levels!
This reporter showed the results of his work and the outcome of the questionnaire to Dr. Maged Srour, Deputy Labour Minister in charge of monitoring the safety of the workforce and work environment. He said: “the job of the administrative bureaus is to routinely carry out measurements and tests of the levels of dust and if we arrive at the conclusion that levels had been in violation of permissible rates we inform the factories so that they respect the guidelines.
They also inspect whether or not factories are providing protective gear to the workers. The insist that all safety equipment should be effective and that factories use a good ventilation system that follows proper geometric guidelines.
When we informed Dr. Srour that the workers were neither provided with proper clothing and safety equipment or were undergoing routine checks, he refused to accept this conclusion. He said that the administrative bureaus were carrying out their jobs. He rejected the labourers’ complaints as well as my findings.
Factory owners are willing to pay the 10,000 pounds in fines rather than adhere to the guidelines!
Mageda Barakat, the chief researcher at the Department of Occupational Safety and Health says: if we come across any establishment in violation we provide it with a three-month notice to rectify the matter. If they ask for an extension they are provided with an additional three months, and the report is withheld if they comply. “In the case of non-compliance we enforce punitive measures and send the report to the courts to set the punishment as per the guidelines of the law, which is a fine not less than 1,000 Egyptian Pounds and not more than 10,000 or a three-month prison term or both.
But Fuad Sa’ad says that the weakness of the legal system allows the factory owner to completely overlook the reports filed by the monitoring authority and its punitive measures.
According to Mageda Barakat the factory owners would rather pay the fines on an annual basis not exceeding 10,000 than providing workers with millions of pounds worth of protective gear to adhere to the safety guidelines.
The medical insurance run by the Ministry of Health has to carry out examinations of the workers and treat them according to the law. But this does not take place.
The Labour Law also stipulates that this department has to carry out inspections and examinations of workers in every city and governorate to ensure they are within safety levels, and to determine the levels of contamination for industrial areas. The law lists 48 illnesses and the relevant routine examination and attaches this to the Social Insurance Law No.79/1975. Silicosis is one of the illnesses listed in chart no. 1.
This means that work related illnesses have been defined as illnesses that the labourer contracts as result of working in a certain environment or due to unhealthy factors that are part of the job.
Fuad Sa’ad, director of the Egyptian Occupational Safety and Health Organization says the government medical insurance has to examine the workers three times per year as is stipulated by the law. If during these examination it is found that a worker has developed a work related illness, immediate treatment has to be provided and he should receive compensation for the days of work he has missed and until he recovers. A salary is to be provided in the case he is unable to continue work.
But all of these guidelines are not implemented though both the employer and the worker pay a monthly fee that goes to the medical insurance fund to cover the above mentioned situations.
Dr. Ali Higazi, director of the Medical Insurance Authority declined to provide any information on why his department was not taking care of the sick workers. And he refused to provide statistics for the number of ceramics factory workers who are suffering from silicosis. He cited the “country’s situation” and “directives from higher authorities” as reasons that prevent him from giving this data or commenting on the situation.
The situation is further exacerbated by dust emitted from the ceramics factories into the air covering an area of 5 kilometres around the factories, according to the director of the Atmospheric Research Department at the National Centre for Research. This air is inhaled by residents of the area. According to the law, the Ministry of Environment should take care of that and can even take legal action against violators in line with Environment law No.4/1994. The ministry, too, refused to comment on our findings and to provide us with any reports other than the annual environment report confirming the spread of the silica dust in Egypt.
The findings of the 2011 Annual Report on the Environment in Egypt and published in 2012 – the most recent report issued by the ministry to date:
Inhalable particles are one of six main pollutants affecting human health and the surrounding environment in Egypt. These are “Sulphur Dioxide”, “Nitrogen Dioxide”, “Carbon Monoxide”, “Ozone Gas”, “Lead” and finally “Inhalable Particles”. The ministry aims to combat the sources of these pollutants and to diminish them by using all possible scientific techniques until they reach acceptable healthy levels as designated by the World Health Organization.
The report also states: the ministry has measured the inhalable particles in the atmosphere with a radius of less than 5,2 microns. “A micron is the unit of measurement used to measure inhalable particles in the atmosphere,” and it is the deadliest of pollutants because it contains free silica.
The current law does not set a limit for the worst and deadliest of these air pollutants.
This section of the report revealed a dangerous professional intransigence since the permissible limit is 50 micrograms/m3 – that is one cubic metre of air does not contain more than 50 micrograms, which is a measuring unit for inhalable particles – as per the World Health Organization. However Law No. 4/1994 which is adhered to by the ministry states that no more than 5,2 microns of inhalable particles should be present.
The report indicates that such a limit was “suggested” whereas until now the existing law does not include a set limit to this the deadliest of air pollutants in the world, an indication of negligence and nonchalance.
Another alarming finding in this report is that the annual average for 2011 is 74 micrograms/m3, almost a 50% increase than the limit allowed by the World Health Organization.
How do we restrict the dangers of inhaling silica?
The American National Institute for Occupational Safety and Health (NIOSH) has shown in several studies that the best way to overcome silicosis is not to be exposed to silica dust. As this is impossible, attempts were made to lower the instances of exposure through all possible means. Some countries have succeeded in lowering the rate of injury to one sixth per year by adopting a number of strict geometric and environmental procedures, most of which have been approved by the Egyptian National Centre for Occupational Safety and Health.
The procedures are:
– Isolating storage areas from work locations.
– Using wind protection measures such as wind barriers and industrial barriers.
– Using closed equipment to carry raw dry products such as carriers and closed spiral containers.
– Using dust extraction equipment and bag filters especially in dry loading and unloading areas as well as cutting locations.
– Limiting the air leakage through routine maintenance
– Maintaining a negative pressure level in the closed circuits used for providing materials and removing dust from extracted air.
– Using equipment to isolate moist dust to treat the emissions during the drying process as well as during the application of glass. Using filters to isolate the dust during the application of glass.
“Am Salama” and many others did not see any of these precautions being taken and they couldn’t do anything other than await their fate and hope that the laws will be changed to charge violators who have cause their illnesses.
What is Silica? What effect does it have on the human body?
Dr. Ragai’ Al-Tahlawi, professor in mining at the Faculty of Engineering at Asyut University and the former president of the university, he says silica is crystalized free silica or SIO2. It is one of the most common ores in the earth’s crust. It is found in sand and in a number of rocks. It is light in weight and remains in the atmosphere for long periods of time and is inhaled by humans.
Silica dust is created through the process of crushing and grinding rocks and sand as well as concrete and some metals in mines and quarries or glass and ceramics factories. Inhaling this dust is very dangerous with the smallest particles of less than 5,2 microns of dust causing the most risk to health
Dr. Hasan Yassir Ibrahim, head of the Atmospheric Research Department at the National Centre says: the dust emitted during the production of ceramics contains free silica, which is very dangerous and can cause huge damage. One particle of free silica, if inhaled into the lungs, is enough to destroy them and lead to silicosis, which is a dangerous illness resulting from this exposure.
The Ceramics Industry in Egypt
The ceramics industry is one of Egypt’s largest. Data from the Ministry of Industry and Foreign Trade and the Ministry of Investment shows that investment in this industry stands at $5.1 billion.
According to statistics from the Federation of Egyptian Industries, there are 31 ceramics factories in the country, in 12 industrial areas in 8 different governorates. They are distributed as follows:
Six factories in the 10th of Ramadan area, 5 in October 6th, 3 in Suez, 5 in Alamiriya and Burj Al Arab in Alexandria, 4 in Kweisna and Sadat in Al Monofiya, 3 in Koum Oshaym in Al Fayoum, 3 in Koum Abu Radi in Bani Sweif and 2 in Al Qalyoubiya in Abu Za’abal and Al Abour.
Almost 50,000 workers are employed in these factories according to figures provided by the Egyptian Ministries of Labour.
This investigation was completed with support from Arab Reporters for Investigative Journalism (ARIJ).