Asbestos Waiting Timebome to Explode

What is Asbestos ?
Asbestos is fibrous form of naturally found minerals. There are several types of asbestos but most commonly used are crysotile, crocidolite and amosite asbestos that have different colors and physical appearances but very similar characteristics and effects. Due to its chemical and physical stability asbestos has been widely used until recent in most of European countries as heat and thermal insulation materials and is still wide spread.

Why it is Dangerous?
Asbestos fibers are dangerous when they are dispersed in air and could be inhaled. Asbestos are recognized as class 1 carcinogen (its cancer causing ability is scientifically proven). When encountering the lungs asbestos fibers could cause diseases like asbestos (scarring of the lung tissue), lung cancer and mesothelioma (cancer of the pleura). It is estimated that asbestos is responsible for more than 70,000 death across global annually. There is a clear scientific consensus internationally that asbestos, in all its forms, and even at low doses, is a proven human carcinogen.

Asbestos Ban

For well over a century asbestos was one of the material most widely used in industries as diverse as construction, road building, engineering or shipbuilding. Its fire resistant property caused it to be used on a massive scale, with manufacture and use peaking in the 1970. workers exposed to asbestos are not only those employed in the industries which mine, prepare, process and use the product but also those in jobs where they are likely to handle materials that contain asbestos – construction and civil engineering workers, garage mechanics, plumber, for example.

The well know carcinogen has killed hundreds of thousands of people. For most of the illnesses it causes, especially mesothelioma, there is still no effective medical treatment. Asbestos may have seemed an economically profitable commodity throughout the 20th century, but in addition to this devastating cost in human lives, it is now proving very costly in term of compensatory payouts to its victims which is costing the governments in the Western world and in Japan Billions of dollars.

There is no such thing as “Good” asbestos. All form of asbestos are harm full.

World production reached its highest level in 1975 at over 5 million tones. It is still around 2 million tones a year now, most of the asbestos produced (more than 90%) being chrysotile. The most important areas of asbestos use have traditionally been, and in many countries still are, in the manufacture of asbestos cement, sprayed coat for fire protection, asbestos cement pipes, industrial and domestic floor covering, brake lining and clutch assembly in the automotive industry and in form of paints, coating and fillers.

In some industrialized countries the manufacture and use of asbestos and its derivates in now prohibited, or at least their use is extremely limited. But people are still exposed, and will continue to be exposed for many years to come, both at work and in the home, because asbestos –containing materials are still in place in existing structure. Those at risk are predominantly specialists working in demolition, asbestos removal and maintenance (in other words, those concerned with all types of construction finishes and fittings).

In most countries, however asbestos is not banned. So high exposures to asbestos fiber dust continue, putting a lot of people at huge risk. And many of these countries not only adults but also young adolescents and even children are already heavily exposed in a range of working environment, increasing their risk of developing an asbestos –related illness and of developing it earlier.

HEALTH EFFECTS OF ASBESTOS

Mechanisms of action

Asbestos fibres break down into fibrils and are inhaled in the form of very fine dust that penetrates deep into the lungs. The longer and thinner these fibrs are, the harder it is for the body to eliminate them. The body’s defence mechanisms cannot cope, and the physico-chemical properties of the fibres trapped within the respiratory system mean that they cannot be broken down and destroyed. They then very gradually cause inflammation and then fibrosis of the lung tissue (asbestosis) or the membrane-the pleura-which covers the lungs and may cause a variety of pleural conditions. On contact with the lining of the bronchi they can interface with cell division and, after a lengthy latency period, cause cancerous changes leading to a lung tumour. The risk is exacerbated if there is simultaneous exposure to other carcinogenic agents. Certain fibres may migrate outside the pleural cavity, where they evoke localized fibrosis (pleural plaques) or cancer of the pleura (mesothelioma).

The most dangerous fibres are those which are long (more than 5 μm) and thin (less than 3 μm), with a length –to-diameter ratio greater than 3:1. However, whilst the likelihood of developing an illness depends very largely on the size and natural of the asbestos fibres, and thus varies according to the type of asbestos concerned…


Non-malignant respiratory diseases caused by asbestos

Pulmonary fibrosis (asbestosis)

The disease is triggered by heavy exposure to asbestos fibres, over a variable length of time. The latency period between exposure and the onset of disease is usually 10 to 20 years or more, and the higher the exposure, the shorter the latency period will be. The symptom of asnestosis is breathlessness, which may progress to respiratory and cardiac insuffiency. There is no specific treatment, apart from alleviation of the symptoms. Patients with asbestosis are at higher risk than others of developing lung cancer, and that risk is significantly higher if they smoke.

Benign pleural conditions

Asbestos fibres migrate very readily from the lung to the pleura, where they cause a range of lesions: pleural plaques, pleurisy, diffuse pleural fibrosis. Pleural plaques are areas of fibrosis, with pleural thickening and sometimes calcification. Unlike asbestosis, these benign pleural plaques do not in general cause problems. They are usually identified on a chest X-ray. Regarded as a , marker’ of asbestos exposure, they are not a predictor of mesothelioma.



Asbestos-related cancers
Lung Cancer

High and protracted exposure to asbestos fibres increases the risk of developing bronchopulmonary cancer, even where these is no asbestosis. There is clearly a dose-effect relationship here, but the threshold for cancer induction cannot be identified. Exposure to other carcinogens, especially tobacco smoke, exacerbates the risk. At the same level of exposure, the risk to smokers is ten times that of non-smokers. Latency periods between exposure to asbestos and the onset of pathological symptoms are on average 15-20 years, and may be as long as 30 years. The disease and its progression have no specificity compared with other cancers of the lung. The same applies to the options for treating it, which vary depending on the nature of the tumour, its stage and site. Whilst the prognosis is still often very poor, lung cancer can be cured, especially if it is diagnosed early.

Pleural mesothelioma

Mesothelioma is a primitive cancer of the pleura (and very rarely of the peritoneum and pericardium). This particularly malignant tumour is highly specific for exposure to asbestos. Onset typically follows a latency period of 20-40 years. Unlike lung cancer it may be triggered by even very low-level and brief exposures. There is no link to smoking. Chest pain, cough and breathlessness are the principal symptoms. The prognosis for this cancer is very poor and no treatment has yet proved effective, though therapeutic are ongoing.

Other cancers

Scientific writing has looked at other cancer sites for a possible link with asbestos exposure:

•Throat cancer, recognized as an occupational disease in some European countries;
•Digestive cancers;
•Urogenital cancers.

Medical Surveillance

Although most asbestos-related illnesses are hard to treat and that for most of them there is no cure, it is important that they are detected as early as possible both from a social and medical point of view.

Medical surveillance of all exposed workers is imperative and monitoring must continue even a after exposure has ceased, in view of the lengthy latency periods for these diseases (up to 30 or even 40 years).


Monitoring must ideally be organized using a standardized procedure, in such a way that everyone can have access to it, even when he or she stops work or moves to a new employer. It must on no account entail a loss of earnings and it must be provided free of charge to the individuals concerned. Persons exposed must be informed that they need to be monitored.

Medical surveillance entails check-ups, with an analysis of the person’s occupational and medical history, respiratory function tests and a chest X-ray. These check-ups are usually offered every one to three years. Lung tumours can be detected earlier using a scanner, if this chest imaging equipment is available, and in some cases this extends the patient’s expected life expectancy. But scans involve a higher level of radiation exposure that conventional radiology. So when deciding what kinds of radiological investigations to perform, besides the technical means that are available, the physician needs to take due account of the risk factors of age, latency period, duration or level of exposure, smoking habit and the expected social and medical benefits.

The cost of asbestos-related diseases

Compensation

Systems of insurance in the world vary very widely, and this has a bearing on the level of costs which the patient is able to recover.

In principle there are three basic possibilities

1)The Worker bears the cost himself.
2)The cost is borne by the employer. He is responsible for the illness because he caused the worker to be exposed to asbestos. In some European countries a state or private-sector insurance scheme covers these costs for the employer.
3)The state is responsible for compensation.

Compensation covers the medical costs of these illnesses, which can be extremely high, plus financial compensation for loss of income and/or benefits for the person’s dependants of (s)he should die.

The scale of this reimbursement and its economic impact depend both on the quantities of asbestos used in a given country and above all on the social security provisions in place for workers. It should be noted however that disparities remain when it comes to certain types of illness (e.g. mesothelioma, asbestos – included lung cancers and asbestosis) being recognized as occupational diseases.

The costs of compensation may be so high that they produce a serious imbalance in some countries’ systems of compensation for occupational diseases, force the state to pay financial compensation or cause some companies to go bankrupt.By making future generations bear the responsibility for compensating victims and the financial burden of looking after them.

In Germany, for example, the total cost of meeting victims’ medical expenses and paying financial compensation to victims and their dependants has already reached € 290 million. In order to deal with this problem the French Government has had to put in a place a specific structure- in the Netherlands they have done something similar- which is publicly funded out of the social security and the national budget, to reimburse victims and to meet the cost of early retirement by victims or persons formerly employed in establishments on record as having used asbestos.

Liability

In many countries workers who contract asbestos-related illnesses have the right to sue their employers for costs and compensation. In some specific cases these compensation claims can be for enormous sums and may place the very survival of the company in doubt. In the USA, 2,000 companies are currently the target of compensation claims.

Against this background groupings have been formed to organize victims’ bids for compensation, uphold their interests, and in particular to improve the pay-out they are likely to get. Very often these groups advise victims to bring personal lawsuits against their employer on the grounds that he failed to take appropriate protective measures, even though the risk was known and such measures were required under national law. These lawsuits have become commonplace and the victims usually win, obtaining financial compensation from the company.

Cases are also increasingly brought against the state, which is accused of being too slow to introduce laws to safeguard the health of workers or the general public against asbestos, even though the risks were known to be serious and were confirmed by international health organizations.

Asbestos in place: managing the risks

Regardless of any decision to ban asbestos, throught needs to be given to asbestos-containing materials which are already in place. Working with these materials or removing them creates risks which have to be properly managed.

The risks here are risks to public health, and their scale and urgency are directly proportional to the volume and age of the materials in place. Removal and disposal of asbestos also means risks to the persons carrying out these operations and potentially for persons in the victinity of anything should go wrong.

What kind of measures are needed, and how urgently, depends on how extersively fibres are being released into the air, their initial form (bonded or friable) and the condition of the materials concerned, which must be inspected regularly.

These last two options are temporary solutions, however, only possible when the level of risk permits. They take account of the constraints imposed by the need to dispose of large quantities of hazardous materials (often tens of millions of tones), the time available to do it and the cost of doing it.


Removal of asbestos in place
Asbestos removal requires rigorous technical procedures. It is physically hard work, not to say exhausting. Friable asbestos is so hazardous that specific methods have to be used to remove it or to manage the risk, sustainable and without exposing people afresh, that fibres may be released from asbestos which remains in place. For this reason there are contractors who specialize in asbestos removal, a task which must only be undertaken by highly speacialized technical personnel.

There are relatively few of these and they constitute a high-risk group. The ready propensity of the fibres to disperse in the air means that the work area has to be kept totally segregated (sealed to exclude the finest dust and maintained at negative pressure (rigorously airtight) and workers shall wear protective equipment (rigorously airtight overall, respirators).

These removal operations generate waste which is almost always heavy and bulky, and thus hazardous on that count too. It needs to be safely and durably airtight-packaged. Precautions are needed when this waste is handled, transported, destroyed or permanently disposed of a dedicated landfill sites.

To ensure that persons carrying out asbestos removal operations are protected, the work must not be done in an hoc manner. There must at the very least be specific instructions, sealed bags, also specifically for asbestos waste, and disposal sites must be demarcated and secured at all times.

Maintenance Work

Many types of work may bring workers into contact with asbestos. Many of these will entail construction finished and fittings. Contractors have to assess whether premises they will work in contain asbestos and inform workers of the risks in their work zone. Safety and health measures must be taken accordingly.

The need for a ban

Every country in the world has to deal with this global scourge, and none can plead ignorance of it. And yet only forty countries have so far banned asbestos or are about to ban it.

Better understanding of the health risks, especially in the industrialized countries, had led to a decline in world consumption of asbestos during the 1980s and 1990s. But in the last few years consumption has begun to rise again. This may be due in particular to the fact that countries experiencing rapid growth are expanding their economies by strengthening their asbestos mining or processing industries and finding new markets.

Arguments against a ban

The arguments put forward against a ban on asbestos are essentially economy. They range from job losses to the cost of using substitute products. One argument used against a ban on all types of asbestos is that chrysotile (white asbestos) is supposedly less dangerous, less carcinogenic, than the other types, despite tha fact that the scientific world is unanimous that a distinction in favour of chrysotile should no longer longer be made.

According to the WHO no threshold has been identified below which asbestos dust does not constitute a cancer risk.

Arguments in favour of a comprehensive ban

These arguments are based primarily on health and humanitarian considerations. They point out that over the longer term asbestos-related disease and mortality have declined (see chapter 2). They are economic too, emphasizing the devastating consequences of the cost of these illnesses (see chapters 2 and 3). Predictions of asbestos-related morbidity and mortality in the decades ahead may sometimes be polemical, but they show clearly that the resulting cost is guaranteed to rise dramatically and that future generations will have difficulty meeting it.

A few Figures:
In Japan, asbestos has so for cost up to 27 billion yen. It is predicted that Japanese deaths from malignant mesothelioma will be 49 times higher during the next 40 years than in the 1990s. Latest statistics of the UK government revealed that every year 3 500 persons die from past exposure to asbestos. Currently, there are 10,000 asbestos-related deaths every year in the US. In Pakistan, between 1995-2003, 601 cases of mesothelioma were diagnosed only in the North West Frontier Province.
Epidemiologists predict that by 2023, more than 45,000 Australians will have died from asbestos malignancies (mesothelioma and asbestos-related lung cancer).Although the use of asbestos was banned in Sweden 30 Years ago, asbestos-related diseases kill currently 2 to 3 times as many workers as fatal occupational accidents.

Experience shows very clearly that the longer we procrastinate, the worse the result will be. It is now an acknowledged fact that asbestos is truly a time bomb waiting to explode.

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