How can workers protect themselves from asbestos exposure?

The Occupational Safety and Health Administration (OSHA) is a component of the U.S. Department of Labor (DOL) and is the Federal agency responsible for health and safety regulations in maritime, construction, manufacturing, and service workplaces. OSHA established regulations dealing with asbestos exposure on the job, specifically construction work, shipyards, and general industry, that employers are required to follow. In addition, the Mine Safety and Health Administration (MSHA), another component of the DOL, enforces regulations related to mine safety. Workers should use all protective equipment provided by their employers and follow recommended work practices and safety procedures. For example, National Institute for Occupational Safety and Health (NIOSH)-approved respirators that fit properly should be worn by workers when required.
Workers who are concerned about asbestos exposure in the workplace should discuss the situation with other employees, their employee health and safety representative, and their employers. If necessary, OSHA can provide more information or make an inspection.

What are the health hazards of exposure to asbestos?

People may be exposed to asbestos in their workplace, their communities, or their homes. If products containing asbestos are disturbed, tiny asbestos fibers are released into the air. When asbestos fibers are breathed in, they may get trapped in the lungs and remain there for a long time. Over time, these fibers can accumulate and cause scarring and inflammation, which can affect breathing and lead to serious health problems.
Asbestos has been classified as a known human carcinogen (a substance that causes cancer) by the U.S. Department of Health and Human Services, the EPA, and the International Agency for Research on Cancer. Studies have shown that exposure to asbestos may increase the risk of lung cancer and mesothelioma (a relatively rare cancer of the thin membranes that line the chest and abdomen. Although rare, mesothelioma is the most common form of cancer associated with asbestos exposure. In addition to lung cancer and mesothelioma, some studies have suggested an association between asbestos exposure and gastrointestinal and colorectal cancers, as well as an elevated risk for cancers of the throat, kidney, esopaghus, and gallbladder. However, the evidence is inconclusive.
Asbestos exposure may also increase the risk of asbestosis (a chronic lung disease that can cause shortness of breath, coughing, and permanent lung damage) and other nonmalignant lung and pleural disorders, including pleural plaques (changes in the membrane surrounding the lung), pleural thickening, and pleural effusions (abnormal collections of fluid between the thin layers of tissue lining the lung and the wall of the chest cavity). Although pleural plaques are not precursors to lung cancer, evidence suggests that people with pleural disease caused by asbestos exposure may be at increased risk for lung cancer.

How is Asbestos Used

Asbestos was mined and used commercially in North America beginning in the late 1800s. Its use increased greatly during World War II. Since then, asbestos has been used in many industries. For example, the building and construction industry has used it for strengthening cement and plastics as well as for insulation, roofing, fireproofing, and sound absorption. The shipbuilding industry has used asbestos to insulate boilers, steampipes, and hot water pipes. The automotive industry uses asbestos in vehicle brakeshoes and clutch pads. Asbestos has also been used in ceiling and floor tile; paints, coatings, and adhesives; and plastics. In addition, asbestos has been found in vermiculite-containing consumer garden products and some talc-containing crayons.
In the late 1970s, the U.S. Consumer Product Safety Commission (CPSC) banned the use of asbestos in wallboard patching compounds and gas fireplaces because the asbestos fibers in these products could be released into the environment during use. Additionally, in 1979, manufacturers of electric hairdryers voluntarily stopped using asbestos in their products. In 1989, the U.S. Environmental Protection Agency (EPA) banned all new uses of asbestos; uses established prior to 1989 are still allowed. The EPA also established regulations that require school systems to inspect for damaged asbestos and to eliminate or reduce the exposure to occupants by removing the asbestos or encasing it.
In June 2000, the CPSC concluded that the risk of children’s exposure to asbestos fibers in crayons was extremely low (1). However, the U.S. manufacturers of these crayons agreed to eliminate talc from their products. In August 2000, the EPA responded to reports it received about the adverse human health effects associated with exposure to asbestos-contaminated vermiculite by conducting a series of tests to evaluate the extent of the risk. The EPA investigation concluded that the potential exposure to asbestos from some vermiculite products poses only a minimal health risk to consumers. The EPA recommended that consumers reduce the low risk associated with the occasional use of vermiculite during gardening activities by limiting the amount of dust produced during use. Specifically, the EPA suggested that consumers use vermiculite outdoors or in a well-ventilated area; keep vermiculite damp while using it; avoid bringing dust from vermiculite use into the home on clothing; and use premixed potting soil, which is less likely to generate dust.
The regulations described above and other actions, coupled with widespread public concern about the health hazards of asbestos, have resulted in a significant annual decline in U.S. use of asbestos. Domestic consumption of asbestos amounted to about 803,000 metric tons in 1973, but it had dropped to about 2,400 metric tons by 2005.

What is Asbestos

Asbestos is the name given to a group of minerals that occur naturally in the environment as bundles of fibers and can be separated into thin, durable threads. These fibers are resistant to heat, fire, and chemicals and do not conduct electricity. For these reasons, asbestos has been widely used in many industries.
There are two subgroups of asbestos: chrysotile, which has curly fibers and is in the serpentine family of minerals; and amphibole asbestos, which has straight, needle-like fibers and includes actinolite, tremolite, anthophyllite, crocidolite, and amosite asbestos. Chrysotile asbestos is the form that has been used predominantly in commercial applications worldwide.

Legal History

The first lawsuit against asbestos manufacturers was brought in 1929. The parties settled that lawsuit, and as part of the agreement, the attorneys agreed not to pursue further cases. It was not until 1960 that an article published by Wagner et al first officially established mesothelioma as a disease arising from exposure to crocidolite asbestos.The article referred to over 30 case studies of people who had suffered from mesothelioma in South Africa. Some exposures were transient and some were mine workers. In 1962 McNulty reported the first diagnosed case of malignant mesothelioma in an Australian asbestos worker.The worker had worked in the mill at the asbestos mine in Wittenoom from 1948 to 1950.
In the town of Wittenoom, asbestos-containing mine waste was used to cover schoolyards and playgrounds. In 1965 an article in the British Journal of Industrial Medicine established that people who lived in the neighbourhoods of asbestos factories and mines, but did not work in them, had contracted mesothelioma.
Despite proof that the dust associated with asbestos mining and milling causes asbestos related disease, mining began at Wittenoom in 1943 and continued until 1966. In 1974 the first public warnings of the dangers of blue asbestos were published in a cover story called "Is this Killer in Your Home?" in Australia's Bulletin magazine. In 1978 the Western Australian Government decided to phase out the town of Wittenoom, following the publication of a Health Dept. booklet, "The Health Hazard at Wittenoom", containing the results of air sampling and an appraisal of worldwide medical information.
By 1979 the first writs for negligence related to Wittenoom were issued against CSR and its subsidiary ABA, and the Asbestos Diseases Society was formed to represent the Wittenoom victims.

Legal Issues

The first lawsuits against asbestos manufacturers were in 1929. Since then, many lawsuits have been filed against asbestos manufacturers and employers, for neglecting to implement safety measures after the links between asbestos, asbestosis, and mesothelioma became known (some reports seem to place this as early as 1898). The liability resulting from the sheer number of lawsuits and people affected has reached billions of dollars.The amounts and method of allocating compensation have been the source of many court cases, and government attempts at resolution of existing and future cases.

Notable People that have lived for sometime with Mesothelioma

Although life expectancy with this disease is typically limited, there are notable survivors. In July 1982, Stephen Jay Gould was diagnosed with peritoneal mesothelioma. After his diagnosis, Gould wrote the "The Median Isn't the Message". for Discover magazine, in which he argued that statistics such as median survival are just useful abstractions, not destiny. Gould lived for another twenty years eventually succumbing to metastatic adenocarcinoma of the lung, not mesothelioma.
Author Paul Kraus was diagnosed with mesothelioma in June 1997 following an umbilical hernia operation. His prognosis was "a few months." He continues to survive using a variety of integrative and complimentary modalities and has written a book about his experience.

Notable People who Died from Mesothelioma

Mesothelioma, though rare, has had a number of notable patients. Australian anti-racism activist Bob Bellear died in 2005. British science fiction writer Michael G. Cooney, responsible for nearly 100 works also died in 2005. American film and television actor Paul Gleason, perhaps best known for his portrayal of Principal Richard Vernon in the 1985 film The Breakfast Club, died in 2006. Mickie Most, an English record producer, died of mesothelioma in 2003. Paul Rudolph, an American architect known for his cubist building designs, died in 1997.
Bernie Banton was an Australian workers' rights activist, who fought a long battle for compensation from James Hardie after he contracted mesothelioma after working for that company. He claimed James Hardie knew of the dangers of asbestos before he began work with the substance making insulation for power stations. Mesothelioma eventually took his life along with his brothers and hundreds of James Hardie workers. James Hardie made an undisclosed settlement with Banton only when his mesothelioma had reached its final stages and he was expected to have no more than 48hrs to live. Australian Prime Minister-elect Kevin Rudd mentioned Banton's extended struggle in his acceptance speech after winning the 2007 Australian Federal Election.
Steve McQueen was diagnosed with peritoneal mesothelioma on December 22, 1979. He was not offered surgery or chemotherapy because doctors felt the cancer was too advanced. McQueen sought alternative treatments from clinics in Mexico. He died of a heart attack on November 7, 1980, in Juárez, Mexico, following cancer surgery. He may have been exposed to asbestos while serving with the U.S. Marines as a young adult—asbestos was then commonly used to insulate ships' piping—or because of its use as an insulating material in car racing suits.(It is also reported that he worked in a shipyard during World War II, where he might have been exposed to asbestos.
United States Congressman Bruce Vento died of mesothelioma in 2000. The Bruce Vento Hopebuilder is awarded yearly by his wife at the MARF Symposium to persons or organizations who have done the most to support mesothelioma research and advocacy.
After a long period of untreated illness and pain, rock and roll musician and songwriter Warren Zevon was diagnosed with inoperable mesothelioma in the fall of 2002. Refusing treatments he believed might incapacitate him, Zevon focused his energies on recording his final album The Wind including the song "Keep Me in Your Heart," which speaks of his failing breath. Zevon died at his home in Los Angeles, California, on September 7, 2003.
Christie Hennessy, the influential Irish singer-songwriter, died of mesothelioma in 2007, and had stridently refused to accept the prognosis in the weeks before his death.His mesothelioma has been attributed to his younger years spent working on building sites in London.
Bob Miner, one of the founders of Software Development Labs, the forerunner of Oracle Corporation died of mesothelioma in 1994.

Phase IV

Phase IV mesothelioma clinical trials study a drug that has already been approved by the Food and Drug Administration. Drug companies often sponsor these trials to study even more uses of drugs already available.

Phase III

In Phase III mesothelioma clinical trials, the new cancer treatment is generally compared to a standard existing treatment. Patients are usually randomly assigned (that is, a process similar to flipping a coin is used to determine which treatment the patient receives) to receive either a standard treatment or the new treatment. During the trial, patients may or may not be told which treatment they are getting but are told what to expect and what to watch for. Occasionally, even the doctor will not know which treatment each patient is getting so that he or she can remain unbiased about how the disease is responding to the treatment. (This is uncommon in cancer clinical trials). Phase III studies are designed to ensure that any side effects that patients experience are identified treated according to local standards of care.

Phase II

In Phase II mesothelioma clinical trials, the mesothelioma drug is studies in a larger group. The primary purpose of these studies is to see how well the drug or treatment shrinks tumors in patients with specific types of cancer. The investigator will watch closely for side effects and will also watch how the disease responds to the treatment.

Phase I

In Phase I mesothelioma clinical trials, doctors are primarily studying the safety of giving mesothelioma drugs to humans, while also looking for the best way to give a medication (for example, as a pill, an injection, or an infusion). They will usually study how the mesothelioma drug is eliminated from the body in humans. Also, doctors are trying to find the right doses for further testing. They carefully watch for any side effects. Phase I study drugs are usually given to small groups of humans. During this phase, for drugs used to treat mesothelioma cancer, investigators may be able to find out which tumors a treatment works best in.

Mesothelioma clinical trials follow a plan of very strict scientific guidelines, which is called a protocol.

The protocol explains everything that will happen in the study. It must be approved by review boards made up of health care professionals and other qualified people before the study can enroll patients.

When a potential mesothelioma drug is first identified, preclinical studies, which are conducted in a laboratory setting, help to find out whether the drug is safe to test in humans. During this stage, the drug is usually studied in animals to answer questions about how a drug works and how the body changes and disposes of it. Humans do not participate in preclinical studies. There are four possible phases of cancer clinical trials in humans, each designed to answer different questions about the treatment being studies.

Mesothelioma tend to grow and spread in unusual ways compared to other tumors.

Rather than forming a "lump", mesothelioma tends to extent from the pleural lining to press against the lung or abdominal organs. It also grows along the pleural lining, eventually forming a hard casing around the lung and making it difficult for patients to take a deep breath. Mesothelioma generally does not spread widely to other organs but, rather, tends to extensively involve the chest and lungs or abdominal cavity before spreading to other distant organs, late in the course of the disease.

If the disease is detected early, when only limited growth on the pleural lining has occurred (stage I), the tumor is considered potentially curable and an attempt can be made to surgically remove the entire tumor. Usually, however, the tumor is detected later, when it more extensively involves the pleural lining and has possibly invaded surrounding normal structures. In these advanced stages (stages II, III and IV), the cancer significantly impacts the quality of life.

The most common place for mesothelioma to develop

The most common place for mesothelioma to develop is in the mesothelial membrane, also called the pleural lining, surrounding the lungs. About two thirds of all mesothelioma cases develop in the pleural mesothelium or lung lining. Pleural mesothelioma is also known as cancer of the lung lining. The remaining cases, about one third, develop in the peritoneal mesothelium in the abdomen (peritoneal mesothelioma). Rarely, mesothlioma occurs in other mesothelial tissue, such as around the heart or in the reproductive organs (pericardial mesothelioma).

Mesothelioma is a very rare form of lung cancer that arises in the mesothelium.

The mesothelium is made up of parietal and visceral membranes, thin layers of tissue, which surround organs and body cavities, such as the lungs or abdomen. The visceral membrane immediately surrounds the organ, and the parietal membrane is a sac covering the visceral membrane. The visceral and parietal membranes that make up the mesothelium. This fluid helps organs move easily among surrounding structures. In the case of the lung, it helps reduce friction between the lung and chest wall during normal breathing as the lung expands.

The mesothelioma is referred to by different names, depending on what part of the body it is found in. In the abdomen, it is called the peritoneum, in the lungs, the pleura, and in the heart, the pericardium. These correspond to peritoneum mesothelioma (cancer of the abdomen/stomach), pleural mesothelioma (cancer of the lung lining) and pericarium mesothelioma.