When you can't breathe

....nothing else matters.

Asbestos Notes: From the literature.

A paper by the late and very much missed Dr Yossi Berger, AWU National OHS Officer at the time of writing.

1. Some Basics 
2. Buildings
3. Risk, bystander, short term and low level exposure
4. Some medical research information
5. Schools
6. Industry
7. Some legal and regulatory issues
8. References

Asbestos

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Serpentine (curly fibres) Amphibole (Needle like fibres)

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Chrysotile (white)                                                                           ¦

Crocidolite (blue) Amosite (brown) Tremolite Actinolite Anthophyllite

1. Some Basics

The two major classes of asbestos fibres are called serpentine and amphibole (see diagram above).

The three most commonly used types of asbestos fibres are chrysotile (95% of all usage), crocidolite and amosite.

1 mg (milligram=one thousandth of a gram) of chrysotile (pronounced, cry-so-tile) contains 13 billion fibres of 75 micron length, (a human hair is about 40 micron thick).

1 mg of crocidolite (cro-sido-lite, to rhyme with bite) contains 8 million fibres.

An asbestos fibre about the diameter of a human hair is actually a bundle of nearly 2 million fibrils that can fit on a pin head. An inch cube contains 15 million miles of fibres.

During the twentieth century sufficient asbestos cement pipe was used in the US to circle the earth eight times and still run to the moon and back.

An exposure limit of 1 f/cc (one fibre per cubic centimetre, which is the same as one fibre per millilitre of air, f/ml) is equivalent to one million fibres per cubic metre of air. In the course of an eight hour day a worker will breathe at least five cubic metres of air.

In 2006 world production of asbestos was –

• Russia 925,000 tons
• Kazakhstan 355,000
• China 350,000
• Canada 243,000
• Brazil 236,000
• Zimbabwe 100,000 Columbia 60,000
  
   
  Total world production: 2,300,000 tons.

It has been reported that there are in the order of 3000 uses for asbestos.

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2: Buildings

An estimated half a million public and commercial buildings in the US contain friable (aged, dry, soft and easily crumbled and therefore dangerous) asbestos containing materials (ACMs). A total estimate has never been made in Australia.

In the mid 1980s the US EPA estimated that 20% of all public buildings in the US contained some type of ACBMs (Asbestos Containing Building Materials) that was friable.

All ACMs will eventually become friable. Asbestos cement materials were made in Australia from 1917 to the mid-1980s so even the very youngest asbestos cement roof has been subjected to over twenty years of weathering, heat, cold, rain, hail and winds. ( also see Attachment 1).

Once airborne, there are no means of making an asbestos fibre safe.

As buildings with ACMs continue to age and deteriorate, risks are increasing for those involved in repair, renovation and demolition. This is a relatively newly recognised at risk group in Australia.

New York City estimated that 68% of all its buildings contained asbestos and that 81% of that asbestos was in such poor condition that it was a public health risk.

In Australia masonry material from demolished buildings is recycled. Only very obvious bits of ACMs are removed. This means that in Australia industry is recycling and returning (selling) asbestos fibres back into the community as a small proportion (unintended but known) of fill such as in various grades of gravel. No estimate has been made of the total quantity so 'recycled', but the total amount of gravel produced around the country every year would be in the millions of tons. (Asbestos in recycled materials is regulated in Victoria)

Inspections in many industries across Australia demonstrate that a great deal of ACBMs are damaged, there are few practical workplace asbestos registers (usually in the biggest workplaces, and generally they don't help anyway) very few regulators' inspections are related to asbestos and extremely few impose total removal.

There is no doubt that workers are therefore breathing more asbestos fibres, not less .

There is no doubt that many DIY builders are breathing more asbestos fibres, not less .

In the wide distribution of AC sheet in houses throughout Australia, or throughout industry, its low income families and workers who were most exposed.

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3: Risk, bystander, short term and low level exposure

In – 

• 1938 R.H. Turner from the UK ACMs manufacturing company Turner & Newall said: 'All asbestos fibre dust, whether it arises in a factory or elsewhere, is a danger to lungs'.  
• In 1961 D.W. Hills from Turner & Newall said: 'the only really safe number of [asbestos] fibres in the works atmosphere is nil'. 
• Dr Hilton C. Lewinsohn, a physician at Turner & Newall, wrote in appx. 1965 "….no [asbestos] dose, no matter how small, can at present be assumed to be safe".
  
  That's from within industry.

Australia was no different. In 1966 Ted Pysden from James Hardie said a newspaper article about asbestos was –

'merely one of many reports of world studies which have been conducted since 1935 when the association between exposure to dust and carcinoma of the lung, mesothelioma of the pleura, tumour of the bladder and uterus and other fatal complaints was first recognised … The only preventive action is to eliminate the presence of dust.'

All forms of asbestos can cause all the asbestos-related diseases. Some of these diseases are always fatal, there is no cure.

Simply because it was the most used chrysotile will kill through cancer three times more people than will die from mesothelioma.

Both human and animal data demonstrate that chrysotile is as potent a carcinogen to the lung as any other variety of asbestos.

In 1987, an IARC (International Agency for Research on Cancer - WHO) working group underlined that chrysotile induced lung cancer and pulmonary mesothelioma, and that there was no safe level. These are also the official positions of the US EPA and NIOSH. In 2000 WTO confirmed the carcinogenic risk of chrysotile fibres.

Short and low level exposure can be enough to cause asbestos-related disease.

Most scientists now accept that low-dose exposure in the home or in the general environment can, in certain circumstances, carry a measurable risk of malignant pleural mesothelioma.

In the Netherlands five mesothelioma cases have been identified among women without occupational or household exposure to asbestos. Some had lived during childhood along contaminated roads close to factories manufacturing ACMs.

Studies from France, Netherlands, Italy, South Africa and Australia suggest that mesothelioma can result from a single day's exposure.

There are reports that some individuals have developed mesothelioma after less than a day's exposure to asbestos.

Not every asbestos fibre in the lung will cause cancer, nor every time someone is exposed to high levels of asbestos, even for extended periods, will they contract an asbestos-related disease.

While not every single asbestos fibre kills, no single fibre is 'innocent'. Every fibre must be viewed as guilty until proven otherwise. Whilst the scientific jury is still out and workers and the community are repeatedly exposed extreme and extended caution is warranted.

On a battlefield not every single bullet kills, but every one just may and certainly is capable.

The fewer fibres are present in a person's breathing space the smaller the risk (likelihood) of suffering a 'hit', that is, contracting an asbestos-related disease. Back to the battle field, one experiencing 100 bullets per hour is less likely to harm a soldier than one with 1,000,000 bullets in the same period of time.

Asbestos is not essential for modern living. This is where the notion of risk (and risk assessments) vs. benefit is utilised by industry and governments, (also see Attachment 2).

If 'risk' is understood as meaning 'the likelihood of something happening', as expressed by a number, with the low numbers representing 'low risk', then the notion is one of chance and probability.

So who decides what's safe enough, and thereby condemns a calculable number of (generally not well-informed and consenting) people to tortuous death – as in the case of mesothelioma?

Experts agree there is no known safe level for asbestos fibres, but various institutions and instrumentalities talk about a low level (a certain number of fibres in the air) being 'safe'. Effectively this is either an absurdity, or –

A new and more cynical notion is meant, 'safe enough' .

By keeping certain information about asbestos away from the community and workers (or by using different emphases e.g. 'safe enough' vs. 'no safe level') industry and governments, (who are responsible for the creation and/or tolerance of hazards) manufacture a confused understanding ripe for the (ab)use of the notion of risk.

It should also be noted that what is to be chosen as an acceptable number of fatalities and disease per year is not a 'scientific' issue. It can only be decided by a socio-political process based on uncertainty and some values.

That is, a 1 chance in 100,000 people getting mesothelioma can mean my lifetime partner tortured to death. Is this scientifically acceptable?

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4: Some medical research information

Asbestos leads to the most serious category of occupational diseases. These diseases are not obscure workplace hazards linked to a fading industrial past, they are a current hazard which in some cases is getting worse.

Studies linking asbestos to disease began in the early 1900s.

Aside from the well known asbestos related diseases there have been reports of stomach, colo-rectal, larynx, pharynx, kidneys and oesophagus cancers.

Pleural disease is progressive, it is not benign, whether pleural plaque or pleural thickening.

Occupational exposure in schools and in place ( in situ ) can cause asbestos-related disease.

No other industrial agent, not lead, not benzene, not vinyl-chloride, not chromium even approaches the burden of disease that asbestos has caused world wide, and will get worse.

1898 - 1964:

• 1898 - Factory inspectors in the UK identify the 'evil effects' of asbestos and the 'easily demonstrated' danger to workers' health.
• 1899 – Asbestos worker admitted to a London hospital, suffering from pulmonary fibrosis. He dies the following year.
• 1924 – In Britain the first inquest on an asbestos worker leads to the first medical description of asbestosis.
• 1927 - Dr William Cooke coined the term pulmonary asbestosis.
• 1929 – In Britain a man living near an ACMs manufacturing company who had never worked at the plant had asbestos in his lungs. The firm's dust extraction system blew the asbestos fibres into the atmosphere outside the factory.
• 1931 - British government introduces dust control regulations in the asbestos industry.
• 1933 – First reported case of asbestosis in Australia in a mill hand in NSW.
• 1935 - Asbestosis and lung cancer cases appear in the medical literature in the US and Britain. A pathologist suggests to British government medical officers that the diseases might be linked.
• 1938 - German pathologist declares for the first time that lung cancer is an occupational disease of asbestos workers. In Britain, the government notes a significant rise in lung cancers in asbestosis cases.
• 1943 – German government recognises asbestos-induced lung cancer as a compensable occupational disease. One German pathologist links asbestos with rare pleural cancers.
• 1947 - British government statistics note a high percentage of asbestosis cases with lung (including pleural) cancers.
• 1955 - First epidemiological study of a group of British asbestos workers confirms a lung cancer risk.
• 1960 - Landmark study published by South African researchers shows a linkage between mesothelioma and both occupational and non-occupational exposure to asbestos.
• 1962 – First published case of mesothelioma in Australia in a worker from Wittenoom.
• 1964 – Catastrophic cancer mortality demonstrated among American insulation workers and publicised at a conference in New York.

"By the mid-1950s – when the first epidemiological study of lung cancer in asbestos workers was published – no one could doubt the connection", (Sir Richard Doll, 1955).

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5: Schools

The boom in use of asbestos in schools coincided with the baby boom.

In the three decades after 1945, Australia was the highest per capita user of asbestos in the world.

In 1991 US experts and government institutions projected that by 2020 approximately 1000 cases of mesothelioma will occur among persons in the US exposed to asbestos in school buildings as school children.

It is reported that 13 US teachers have contracted mesothelioma and were exposed to asbestos in schools.

The use of asbestos in schools generally occurred 1950s-1970s, at least two decades after the dangers of asbestos were well known.

In 1980 the US EPA stated that 8500 schools contained friable asbestos, placing three million pupils at risk, aside from the staff.

Of all people at risk (possible exposure) children have the most time for diseases to develop.

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6: Industry

As medical information about the dangers of asbestos was increasing so was production.

During the 1950s and 1960s the asbestos industry was at its most expansive and most profitable.

1900-2004 world production was approximately 182 million tonnes. Of this total 143 million tonnes were produced after 1960.

Therefore, nearly 80% of world asbestos production in the twentieth century was produced after the world learned that asbestos could cause mesothelioma. By then the link to asbestosis and lung cancer was well known.

"…….asbestos has proved so enduring, because the industry was able to mount a successful defence strategy for the mineral – one that still operates in some parts of the world. Central to this strategy was a policy of concealment and, at times, misinformation that often amounted to a conspiracy to continue selling asbestos fibre irrespective of the health risks. …….the industry censored scientific research; used reputable scientists to elide the health hazards and nurture uncertainty; denied basic compensation (and some times human rights) to victims; and colluded with governments and scientific bodies." (McCulloch & Tweedale, p14.)

In trying to explain the asbestos tragedy industry has blamed –

* Imperfections in medical knowledge.
* The incompetence of regulatory authorities.
* The physiology of the victims.

In doing this industry deliberately manufactured uncertainty and generated a social construction of ignorance. They well understood that science alone is not enough to achieve change.

As an example: industry argues that chrysotile (in mixed quality ACBMs) is safe, but shouldn't be removed because that makes it unsafe. That's absurd and feeds on manufactured uncertainty.

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7: Some legal and regulatory issues

In 1918 Prudential Life Insurance ceased issuing policies on the life of asbestos workers in Canada.

As a product, asbestos fibres are inherently unsafe. They are 'defective' products and have been recognised as such in the law.

Since 1980 eighty asbestos companies have filed for bankruptcy protection in the US.

There are 600,000 law suits and claims in the US by asbestos victims.

Between 1984 and 1986 President Reagan had signed an Abatement Act and the Asbestos Hazard Emergency Response Act.

The aim was to inspect school properties for friable asbestos and introduce management plans for problem areas with the option to remove ('abate') asbestos if it was judged a health hazard.

On 1 January 2005, all forms of asbestos were banned in the EU. By November 2005 some 40 countries banned it.

Some References

McCulloch, J. & Tweedale, G. Defending The Indefensible: The Global Asbestos Industry and its Fight for Survival , Oxford University Press, Oxford, U.K., 2008.

Castleman, B. Asbestos: Medical and Legal Aspects /5th Ed. 2005

Dodson, R.F. & Hammar, S.P. Asbestos: Risk Assessment, Epidemiology and Health Effects , 2006.

Bowker, M. Fatal Deception – The Untold story of Asbestos , 2003.

Tweedale, G. Magic Mineral To Killer Dust , 2000.

Landgrin, P.J. & Kazemi, H. The Third Wave of Asbestos Disease: Exposure to Asbestos in Place , 1991.

Benarde, M.A. Asbestos: The Hazardous Fiber , 1990.

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1. A great deal of ACMs are present throughout Australia. Most of them are building materials for cladding (AC sheet) in factories, contoured sheet cladding for housing and huge amounts of corrugated AC roofing.
2. ACM also occurs in roof shingles, in sheets used for fencing, roof guttering, down pipes, water delivery, flower pots and tubs, sculptures, many public structures and many homes and schools.
3. I have inspected a home where most of these ACMs where present at the one time.
4. Where such material cannot and will not release any asbestos fibres, and a permanent, reliable and verified inspection protocol is in place to make sure of such ongoing protective conditions no harm can result.
5. However, in practice (and particularly in industry) this is a very rare circumstance. The following are some possible assaults on such ACMs that increase the risk of release asbestos fibres:
   
   a) Weathering and/or corrosion.
   b) Vibration.
   c) Breakage, splitting and perforation.
   d) Machining with power tools.
   e) Polishing.
   f) Renovation.
   g) Demolition.
6. Following an examination of the formal literature on weathering of ACBMs and fibre release, and after some discussions with specialists in the area the Australian government (ASCC) reached the following conclusions in a 2008 report ( A Literature Review of Australian and Overseas Studies on the Release of Airborne Asbestos Fibres from Building materials as a result of Weathering and/or Corrosion ):
   
   
   • The studies and reports reviewed agree that such release is exceedingly small from non friable ACBMs as a result of weathering and/or corrosion.
   • Such releases can be reasonably well measured.
   • Overall, friable materials are more hazardous.
   • Proper risk assessments should be done on a case-by- case basis by experienced people with specialist knowledge.
7. This report did not address 6 of the 7 possible assaults on ACBMs listed above (point 5), whilst acknowledging that the amount of ACBMs in the community may be very high.
8. I found the comment about health risks (p8) misleading, though not incorrect:
   
   "The carcinogenic potential of asbestos fibres is well recognised and has been known for some time. Some of the earliest publications of occupational asbestosis include a 1934 report in the medical journal The Lancet. It was more formally listed in the first Annual Report on carcinogens in 1980 under the category "Known to be a human carcinogen".
9. Compare that to points 21, 22, 50, 51, 70 and 74 above. This quote, (point 8 above) illustrates how false implications can be generated about a current day hazard.
10. The report makes the point that highest concentrations were found where human activity and similar forces were the greatest, (p13).
11. On p9 – "Consequently, it may be most appropriate in the absence of more definitive information to assume that there is no safe – or threshold – dose of chrysotile and other forms of asbestos fibres".
12. On p15 a Table is provided summarising various fibre concentrations associated with ACBMs found and reported in the literature. The lowset is 0.00015 and the highest is 0.034 f/ml. That is a range of fibres potentially inhaled by someone in those environments in an eight hour day of 750-170,000 fibres. How does that range relate to point 11 above – 'No safe dose'?
13. And how does that stand in view of the fact that on a weekly basis I see damaged ACBMs in workplaces around Australia?
14. Frequently that's despite the fact that warning signs are up (as some were at the Cement Australia site at Railton in recent times despite the obvious presence of very poor and damaged material), and some form of poorly maintained and poorly inspected register is in place?

1. No, it's not. This has been tried before and hasn't worked.   The basic premise is morally reprehensible.  That is, "Can we keep this ACM in place for a longer period of time?"  This creates a 'time bomb' for the next generation.
2. I have now seen that generation born and start work in conditions that are definitely exposing them to more asbestos fibres.    
3. Workplace registers are generally not working (and are mainly non-existent), but even if they were in place they too often wouldn't help.
4. Supervision of the condition of ACMs isn't occurring in most workplaces or is very superficial and flippant.
5. Inspections aren't working. 
6. Put bluntly:  People are being killed and many are continuously placed at mortal risk. bluntly:  people are being killed and many are continuously placed at mortal risk. >
7. It should be very carefully noted that Cement Australia at Railton has taken the AWU's advice recently to accelerate a total removal program on their site without any risk assessments designed to keep the ACBMs in place.   
8. Anyone who has inspected ACMs and ACBMs, particularly throughout industry, will know that all such materials deteriorate over time. That means that a growing number of people will be exposed to more asbestos fibres. 
9. A risk assessment approach will condemn more people to such exposure. In practice ACMs and ACBMs are never safe.  Consider the thousands of people exposed to enormous amounts of such airborne fibres after the 9/11 destruction of the twin towers in New York.   
10. However, genuine and experienced assessment of risk as a preliminary to decisions about  timely prioritised removal is inevitable.  But the underlying assumption must be different: removal vs. retention.

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Last amended May 2015

Important Asbestos in the workplace Information