Health problems
Left-sided mesothelioma : CT chest
Amosite and crocidolite are the most hazardous of the asbestos minerals because of their long persistence in the lungs of exposed people. Tremolite often contaminates chrysotile asbestos, thus creating an additional hazard. Chrysotile asbestos, like all other forms of asbestos, has produced tumors in animals. Mesotheliomas have been observed in people who were occupationally exposed to chrysotile, family members of the occupationally exposed, and residents who lived close to asbestos factories and mines.
Asbestos exposure becomes a health concern when high concentrations of asbestos fibers are inhaled over a long time period. People who become ill from inhaling asbestos are often those who are exposed on a day-to-day basis in a job where they worked directly with the material. As a person's exposure to fibers increases, because of being exposed to higher concentrations of fibers and/or by being exposed for a longer time, then that person's risk of disease also increases. Disease is very unlikely to result from a single, high-level exposure, or from a short period of exposure to lower levels.
Other asbestos-related diseases
Asbestos warts: caused when the sharp fibers lodge in the skin and are overgrown causing benign callus-like growths.
Pleural plaques: discrete fibrous or partially calcified thickened area which can be seen on X-rays of individuals exposed to asbestos. Although pleural plaques are themselves asymptomatic, in some patients this develops into pleural thickening.
Diffuse pleural thickening: similar to above and can sometimes be associated with asbestosis. Usually no symptoms shown but if exposure is extensive, it can cause lung impairment.
Asbestos as a contaminant
Asbestos fibers (SEM micrograph)
Most respirable asbestos fibers are invisible to the unaided human eye because their size is about 3.0–20.0 µm long and can be as thin as 0.01 µm. Human hair ranges in size from 17 to 181 µm in width.[26] Fibers ultimately form because when these minerals originally cooled and crystallized, they formed by the polymeric molecules lining up parallel with each other and forming oriented crystal lattices. These crystals thus have three cleavage planes, just as other minerals and gemstones have. But in their case, there are two cleavage planes that are much weaker than the third direction. When sufficient force is applied, they tend to break along their weakest directions, resulting in a linear fragmentation pattern and hence a fibrous form. This fracture process can keep occurring and one larger asbestos fiber can ultimately become the source of hundreds of much thinner and smaller fibers.
As asbestos fibers get smaller and lighter, they more easily become airborne and human respiratory exposures can result. Fibers will eventually settle but may be re-suspended by air currents or other movement.
Friability of a product containing asbestos means that it is so soft and weak in structure that it can be broken with simple finger crushing pressure. Friable materials are of the most initial concern because of their ease of damage. The forces or conditions of usage that come into intimate contact with most non-friable materials containing asbestos are substantially higher than finger pressure.
Environmental asbestos
Asbestos can be found naturally in the air outdoors and in some drinkable water, including water from natural sources. Studies have shown that members of the general (non-occupationally exposed) population have tens of thousands to hundreds of thousands of asbestos fibers in each gram of dry lung tissue, which translates into millions of fibers and tens of thousands of asbestos bodies in every person's lungs.
Asbestos from natural geologic deposits is known as "Naturally Occurring Asbestos" (NOA). Health risks associated with exposure to NOA are not yet fully understood, and current US federal regulations do not address exposure from NOA. Many populated areas are in proximity to shallow, natural deposits which occur in 50 of 58 California counties and in 19 other U.S. states. In one study, data was collected from 3,000 mesothelioma patients in California and 890 men with prostate cancer, a malignancy not known to be related to asbestos. The study found a correlation between the incidence of mesotheliomas and the distance a patient lived from known deposits of rock likely to include asbestos; the correlation was not present when the incidence of prostate cancer was compared with the same distances. According to the study, risk of mesothelioma declined by 6 percent for every 10 kilometers that an individual had lived away from a likely asbestos source.
Portions of El Dorado County, California are known to contain natural asbestos formations near the surface. The USGS studied amphiboles in rock and soil in the area in response to an EPA sampling study and subsequent criticism of the EPA study. The study found that many amphibole particles in the area meet the counting rule criteria used by the EPA for chemical and morphological limits, but do not meet morphological requirements for commercial-grade-asbestos. The executive summary pointed out that even particles that do not meet requirements for commercial-grade-asbestos may be a health threat and suggested a collaborative research effort to assess health risks associated with "Naturally Occurring Asbestos."
Large portions of Fairfax County, Virginia were also found to be underlain with tremolite. The county monitored air quality at construction sites, controlled soil taken from affected areas, and required freshly developed sites to lay 6 inches (150 mm) of clean, stable material over the ground.
For environmental samples, one must normally resort to electron microscopy for positive identification. Today, gravimetric and PCM/PLM techniques are employed. However, the latter techniques cannot readily identify the smallest, most hazardous, fibers, because they are limited to PM10 particulate size evaluation, which completely ignores ultrafine particles (UFPs).
History of health concerns and regulation
Before 1900
By the first century AD, Greeks and Romans had already observed, at least in passing, that slaves involved in the weaving of asbestos cloth were afflicted with a sickness of the lungs.
Early concern in the modern era on the health effects of asbestos exposure can be found in several sources. Among the earliest were reports in Britain. The annual reports of the Chief Inspector of Factories reported as early as 1898 that asbestos had "easily demonstrated" health risks.
At about the same time, what was probably the first study of mortality among asbestos workers was reported in France. While the study describes the cause of death as chalicosis, a generalized pneumoconiosis, the circumstances of the employment of the fifty workers whose death prompted the study suggest that the root cause was asbestos or mixed asbestos-cotton dust exposure.
1900s—1910s
Micrograph demonstrating asbestosis of the lung (ferruginous bodies). H&E stain.
Further awareness of asbestos-related diseases can be found in the early 1900s, when London doctor H. Montague Murray conducted a post mortem exam on a young asbestos factory worker who died in 1899. Dr. Murray gave testimony on this death in connection with an industrial disease compensation hearing. The post-mortem confirmed the presence of asbestos in the lung tissue, prompting Dr. Murray to express as an expert opinion his belief that the inhalation of asbestos dust had at least contributed to, if not actually caused, the death of the worker.
The record in the United States was similar. Early observations were largely anecdotal in nature and did not definitively link the occupation with the disease, followed by more compelling and larger studies that strengthened the association. One such study, published in 1918, noted:
All of these processes unquestionably involve a considerable dust hazard, but the hygienic aspects of the industry have not been reported upon. It may be said, in conclusion, that in the practice of American and Canadian life insurance companies, asbestos workers are generally declined on account of the assumed health-injurious conditions of the industry.
1920s—1930s
Widespread recognition of the occupational risks of asbestos in Britain was reported in 1924 by a Dr. Cooke, a pathologist, who introduced a case description of a 33-year-old female asbestos worker, Nellie Kershaw, with the following: "Medical men in areas where asbestos is manufactured have long suspected the dust to be the cause of chronic bronchitis and fibrosis..."[38] Dr. Cooke then went on to report on a case in 1927 involving a 33-year-old male worker who was the only survivor out of ten workers in an asbestos carding room. In the report he named the disease "asbestosis".
Dr. Cooke's second case report was followed, in the late 1920s, by a large public health investigation (now known as the Merewether report after one of its two authors) that examined some 360 asbestos-textile workers (reported to be about 15% of the total comparable employment in Britain at the time) and found that about a quarter of them suffered from pulmonary fibrosis. This investigation resulted in improved regulation of the manufacturing of asbestos-containing products in the early 1930s. Regulations included industrial hygiene standards, medical examinations, and inclusion of the asbestos industry into the British Workers' Compensation Act.
The first known U.S. workers' compensation claim for asbestos disease was in 1927. In 1930, the first reported autopsy of an asbestosis sufferer was conducted in the United states and later presented by a doctor at the Mayo Clinic, although in this case the exposure involved mining activities somewhere in South America.
In 1930, the major asbestos company Johns-Manville produced a report, for internal company use only, about medical reports of asbestos worker fatalities. In 1932, A letter from U.S. Bureau of Mines to asbestos manufacturer Eagle-Picher stated, in relevant part, "It is now known that asbestos dust is one of the most dangerous dusts to which man is exposed."
In 1933, Metropolitan Life Insurance Co. doctors found that 29% of workers in a Johns-Manville plant had asbestosis. Likewise, in 1933, Johns-Manville officials settled lawsuits by 11 employees with asbestosis on the condition that the employees' lawyer agree to never again "directly or indirectly participate in the bringing of new actions against the Corporation." In 1934, officials of two large asbestos companies, Johns-Manville and Raybestos-Manhattan, edited an article about the diseases of asbestos workers written by a Metropolitan Life Insurance Company doctor. The changes downplayed the danger of asbestos dust. In 1935, officials of Johns-Manville and Raybestos-Manhattan instructed the editor of Asbestos magazine to publish nothing about asbestosis. In 1936, a group of asbestos companies agreed to sponsor research on the health effects of asbestos dust, but required that the companies maintain complete control over the disclosure of the results.
1940s
In 1942, an internal Owens-Corning corporate memo referred to "medical literature on asbestosis… scores of publications in which the lung and skin hazards of asbestos are discussed." Testimony given in a federal court in 1984 by Charles H. Roemer, formerly an employee of Unarco, described a meeting in the early 1940s between Unarco officials, J-M President Lewis H. Brown and J-M attorney Vandiver Brown. Roemer stated, "I’ll never forget, I turned to Mr. Brown, one of the Browns made this crack (that Unarco managers were a bunch of fools for notifying employees who had asbestosis), and I said, ‘Mr. Brown, do you mean to tell me you would let them work until they dropped dead?’ He said, ‘Yes. We save a lot of money that way.'" [46] In 1944, a Metropolitan Life Insurance Company report found 42 cases of asbestosis among 195 asbestos miners.
1950s
In 1951, asbestos companies removed all references to cancer before allowing publication of research they sponsored. In 1952, Dr. Kenneth Smith, Johns-Manville medical director, recommended (unsuccessfully) that warning labels be attached to products containing asbestos. Later, Smith testified: "It was a business decision as far as I could understand… the corporation is in business to provide jobs for people and make money for stockholders and they had to take into consideration the effects of everything they did and if the application of a caution label identifying a product as hazardous would cut into sales, there would be serious financial implications."
In 1953, National Gypsum's safety director wrote to the Indiana Division of Industrial Hygiene, recommending that acoustic plaster mixers wear respirators "because of the asbestos used in the product." Another company official noted that the letter was "full of dynamite" and urged that it be retrieved before reaching its destination. A memo in the files noted that the company "succeeded in stopping" the letter, which "will be modified."
1960s—1980s
Through the 1970s, asbestos was used to fireproof roofing and flooring, for heat insulation, and for a variety of other purposes. The material was used in fire-check partitioning and doors on North Sea Oil Production Platforms and Rigs.
Modern regulation
United States
In 1989 the United States Environmental Protection Agency (EPA) issued the Asbestos Ban and Phase Out Rule which was subsequently overturned in the case of Corrosion Proof Fittings v. EPA, 947 F.2d 1201 (5th Cir. 1991). This ruling leaves many consumer products that can still legally contain trace amounts of asbestos. For a clarification of products which legally contain asbestos, read the EPA's clarification statement.
The EPA has proposed a concentration limit of seven million fibers per liter of drinking water for long fibers (lengths greater than or equal to 5 µm). The Occupational Safety and Health Administration (OSHA), has set limits of 100,000 fibers with lengths greater than or equal to 5 µm per cubic meter of workplace air for eight-hour shifts and 40-hour work weeks.
New Zealand
In 1984, the import of raw amphibole (blue and brown) asbestos into New Zealand was banned. In 2002 the import of chrysotile (white) asbestos was banned.
Australia
A complete ban on asbestos-containing material in Australia was introduced in 1991 although some building materials in storage were still being used in the years that followed. Queensland began regulation of asbestos removal and disposal in 2005. Handlers of asbestos materials must have a B-Class license for bonded asbestos and an A-Class license for friable asbestos.
The town of Wittenoom, in Western Australia was built around a (blue) asbestos mine. The town has since been closed, and is contaminated. However one couple remains there, refusing to leave the area and refusing to believe in current medical advice. Conversely, the town of Asbestos, in Quebec, which remains the world's largest open pit asbestos mine, retains a significant population, albeit one that aged as a result of the failure of Magnola, a multi-million dollar plant designed to extract magnesium from asbestos tailings.
