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, ''Jgii'A&D MOLECULES
Transcript //42-!-
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THE CASE AGAINST THE MAGIC MINERAL, PART I
American Chemical Society Nev.'S Service 1155 Sixteenth Street, N.W Washington, D.C. 2003o
RE. 7- 3337
RECiV^
MAY.-8197C
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.NARRATOR:
-The American Chemical Society presents...MSN...AND,..MOLECULES,..the story of chemical research. This is Stuart Finley. This week, the first of two reports on THE CASE AGAINST THE MAGIC MINERAL,
NARRATOR:
Every occupation has its obvious drawbacks with 'which we can usually . cope. But for many of the men who mine and work-with asbestos--a mineral famous for its ability to stand up to fire--the hazard has not only been invisible, it has also been deadly. In the past two decades the evidence has mounted that asbestos is a potent cause of cancer, and that it is the major cause of what was at one time a rare form of cancer. Since the Greeks--who noticed that slaves working with asbestos had long troubles--people have accepted the idea that years of exposure of asbestos can scar the lungs. The definite link with cancer was not made until this century, and it has only become clear since the 1950-'s of just how pcworfiil that link is. part of the evidence was supplied in 155^- when Itr. Irving J. Selikoff, now professor of environemtnal medicine at the Mt. Sinai School of Medicine, decided.to keep track of what happened to eighteen asbestos workers who had been forced to leave the industry because of a'factory closing..
SELIKOFF:
Of the eighteen men, twelve are now dead. T.y died primarily of two. things; first scarred lungs, in other words.what we call asbestosis, a oust disease of the lung due to asbestos; or of several forms of
cancer. Why people who breathe in asbestos have a much greater risk of dying of cancer, we do not know. The first case of a man dying of cancer of the lungs, who also had asbestosis, was only reported in. 1935* Numerous reports since then have confirmed this original report.' Other cancers, including a very peculiar one called mesothelioma, are now also reported in very much greater incidence among people who regularly work with asbestos. Why these tumors appear, we do not know.
NARRATOR:
''
Mesothelioma is a cancer of the tissue, or membrane, that lines the lungs and abdomen. It Is a cancer so rare--perhaps one case in ten thousand--that few physicians ever see a case. But the incidence of it as well as more better known cancers, such as lung cancer, a apparently being raised by asbestos.
SELIKOFF:
Incidentally, one thing is very Interesting about these tumors. They dc not appear the moment an individual begins to work with asbestos. They generally don't appear until more than twenty, twentyfive, or thirty years have passed since the onset of employment with
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the material. Nov; we understand the problem, however, and now, therefore, * cone to a tine when we should do something about it.
NARRATOR:
Doing something about asbestos should be in many ways a sinplier job than dealing with some of the otner hazards to health.. .cigarette smoking, air pollution, to name two. The sources of asbestos are limited--Canada.and the Soviet Union supply most of it. The asbestos industry is relatveley small, so modifying it won't shake the economy. But one of the difficulties in dealing with asbestos is that although we're surrounded by the stuff, it's rarely seen. It lines the brakes of our cars; most of the materials used to.constuuct our homes and offices contain asbestos. It's in textiles, plastics, and cables. There are an estimated three thousand different industrial uses for asbestos in the United States alone. It is light weight but strong, and it won't decay. It resists most chemicals. It's such an ideal material, that it's been called the magic mineral, which incidentally, wa;-.; the title of a recent report on asbestos in The New Yorker Magazine But while asbestos may be magical, it is not a mineral, but father a group of minerals with unusual properties in common.
SLLIZOFif;
proof; and so forth. Therefore,. they are very useful ior rainfore reinforcement --being very strong. It's very useful for insulation, very useful as a filler--an loner filler--in many materials and indeed it is a wonderful material. It Is wonderful in .Industry; it is not so wonderful in the human lung.
NARRATOR:
The studies ot Dr. Selikoff.and others In many countries made it appear that people directly exposed to asbestos for a long period of time were likely to develop scarred lungs, and, if they lived long enough, various forms of cancer. But still the evidence was on shaky ground, based on.a farily small sample of people,and limited to those who had direct and long-terra exposure to asbestos. That picture changed in 1964 when Dr. Selikoff and his Kt. Sinai colleagues, along with Dr. Cuyler Ham ond of the American Cancer Society, reported on the fate of six hundred and thirty-two men who were members of the insulators workers Union in New York City. These were men who installed asbestos containing insulation; they didn't make it. They had been members of the union since 1942. Dr. Selikoff and his colleagues knew their ages, they knew the years of exposure to asbestos insulation, and they kr.evt how many should die of any particudar disease.
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SELIKOFF:
We calculate that the six hundred and thirty -two men, given their
ages and given the years in which they were living, there should have
been two hundred and three deaths among them. There were too hundred
-and' fifty-five. In other words, approximately fifty more men died
than would have been expected in a group of six hundred and thirty-
two men of the same age over the sarnie period of time. When we looked
at the causes of death, we found the reasons for this excess
mortality. There should have been six or seven deaths due fo cancer
of the lung; there were forty-five. There should have been nine or
-ten deaths due to cancer of the stomach,or cancer of the colon; and
there were twenty-nine. There should, by the way, have been no
deaths due to mesothelioma-; and there were four.
/
"NARRATOR:
........
-
ThaT'Ttuby^oTXh^irTsuIabTon 'workers, which made the lethal risks of
their occupations so obvious, covered a twenty year period from
'19^2 to 1962.
'
SELIKOFF:
-.
Since then the results have been equally bad. For example, in the
last one hundred and twenty deaths, there should have been no deaths
due to mesotheliomas,which is very rare; and there were fourteen.
There should have been two or three deaths due to cancer of the lung
among the surviving men; and there were twent5'-seven. So that the
-results indicate that working with asbestos, as a member of the
Insulation Workers Union in the New York area during these last
twenty-six years, has' significantly increased the risk of dying of
;very serious diseases.
--
"NARRATOR:------------""----------------------*-------------------- ----------- ------------------- -- ..." - -
This study by Dr. Selikoff and his col!eagurss--now a classic in -environmental medicine--removed any doubt about the terrible penalties .that could be paid for a lifetime of exposure of asbestos. But even -more disturbing evidence began to accumulate--evidence that suggested that even indirect exposure to asbestos might lead ot mesothelioma, the cancer now condidered a marker disease of asbestos. And other clues came suggesting that even a brief exposure, a matter .of weeks instead of the decades associated with lung scarring and cancer, could result in mesothelioma twenty or thirty years later. The evidence of the hazards of indirect exposure to asbestos came in part from Dr. Mureil Newhouse, an epidemiologist working in London.
SELIKOFF:
.
She has found, for example, in studying seventy-six mesothiliomas at one hospital--the London Hospital--that, as expected, thirty-one occurred in asbestos workers--people who had in one trade or another worked with asbestos. Of the forty-five who had no history of working with asbestos, nine occurred in people who simply lived in a household of an asbestos worker, and who were presumabley exposed to
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the fibers brought home on the work, clothes. .And of the thirty-six who neither worked with asbestos, nor lived in a household of an asbestos worker, eleven simply lived within a half mile of an asbestos plant. This raises the very serious question: whether a neighborhood exposure, or exposure within households, or indirect occupational exposure carries a risk similar to that of the individual working regularly with asbestos, although, perhaps to a lesser degree. The exact degree to which that risk occurs is what we must find out. If it's very small, there's no qreat problem; if it's very large, then the proglem is multiplied a great deal.
BARRATOR:
-The evidence that even fairly brief exposure of high levels of asbestos can bring on mesothelioma, cancer of the membranes that-line the -lungs-and abdomen, has been gathered in bits and snatches, really more anecdotal than scientific. Nevertheless, Dr. Selikoff and his colleagues are seriously worried about the stories they hear. For i7i.ste.nce, there was the case of a patriotic young woman.
Ibis
it young woman--at the time a student at uellesley--who, in
response to patriotic appeals, worked during her summer vacation in
194b in one of f>,o shipyards in Boston for six weeks doing insulation
work ebon:, dost--.c-ysr eye'ort?. Shy breathed in signif5cans amounts of
asbesoGv during these 3Lr. week.a . The fact that during oho next
fcwar-.ty*fyss.rs. she dich-rt have additional expof 1.vo to eccesuos does
not mean thud the fibers that ch& inhaled, during those six weeks
were not exposing her lung coils to the effaces.ef asbestos.
NARRATOR;-
The young woman.died of mesothelioma in the mid-sixties, roughly
thirty years after a one-time exposure to asbestos. /BEAT) By now .the obvious question looms. Uhat of us, the people who have never worked with asbestos, have never known an asbestos 'worker, have never lived near a plant using asbestos, but do live in'cities with buildings and cars that contain thi-s magic mineral? Has asbestos found its way to the lungs of the general population? For a long time, many thought not. .But they've changed their minds.
SELIKOFF:
In 1963 a sort of mild bombshell was exploded in our part of the scientific world by Professor John Thompson of Capetown. He published
a paper then in which he stated that he had examined five hundred
consecutive autopsies of adults in Capetown. Using a very simple
technicue--namely, making a smear of tissue fluid squeezed from the
incised lung base and examining this fluid microscopically--he was
able to demonstrate what are called asbestos bodies in twenty-five
percent of all the people who came to autopsy at the University
Hospital at Capetown at that time.
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NARRATOR: . . j
In other words, one quarter of random selection of bodies had asbestos bodies in their lungs. Asbestos bodies are asbestos fibers coated with an iron-rich material, giving them a yellowish-brown appearance. Since the Capetown studies, the picture has become even more gloomy.
SSLIKOFF:
From twenty-five to fifty percent of all people who are examined in post-mortems in such cities as Montreal, London, Milan, Belfast, Miami, Pittsburgh, and so forth have these asbestos bodies in their lungs. In New York City, we are examining three thousand consecutive autopsies in three of our hospitals--Elmhurst General Hospital, the Bronx Veterans Administration Hospital, and Mt. Sinai Hospital. And we have found that fifty percent of all the people whose lungs we've examined have those asoestos bodies or the structures which appear to --be asbestos bodies in their lungs. Nevertheless, the numbers are very smaller than the numbers that we find In the lungs of peoole who regularly work with asbestos. Therefore, we muse assume that the exposure of people in the general population is very much less at this time than the exposure surfered by asbestos workers. We do not know at this time, therefore, whether the haalth effects that might be associated with these much.fewer fibers will be.anything like the health effects suffcreed by asbestos workers.
As I said earlier, the asbestos problem is unusual in that its sources are limited, its uses known, and its effects documented. It is a problem with sollutions.
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MSN AND MOLECULES
transcript #42fj
THE CASE AGAINST THE MAGIC MINERAL, PART II
American Chemical Society
Nevis service
1155 Sixteenth Street, N.W.
Washington, D.C, 20036
737-3337
'
NARRATOR:
~
the American Chemical Society presents...MEN.,.AND...MOLECULES...the story of chemical research. This is Stuart Finley. This vieek, the
second of two reports concerning THE CASS AGAINST THE MAGIC MINERAL.
Dr. Irving , . Selikoff radiates the confidence.of a natural optimist A wearer of bow ties, with a liking for people and conversation, who app oaches a task with gusto and zeal, it's obvious that Dr. Selikoff prefers to look at the bright side of things. In a way, that1s fortune te considering the problems associated with asbestos--the magic mineral_p_rselikoff is Professor of Environmental Medicine at the _ iit. Sinai School of Medicine in New York City. As you heart! last week, he and other researchers in the United States, England, and South
Africa"have'proven that those who had mined and worked with asbestos in the past are dying, at significantly high rates, of various cancers, including lung cancer, and a rare form of cancer called mesothelioma.
Mesothelioma, a cancer of the tissue or membrane that lines the lungs
and the abdomen, usually occurs in only one in ten thousand people, but has become all too common among people who've been exposed to high levels of asbestos. But what really worries Dr. Selikoff, and
others, -is that not only asbestos workers get mesothelioma, now considered a marker disease for asbestos, but their families may also gem it. people who lived near an asbestos plant or mine have also
gotten it. Even people regularly exposed at work for a few weeks to asbestos fibers may develop mesothelioma twenty-five or thirty years-.,. ,
later--the time it seems to take between expsoure and diagnosis. In addition, autopsies done at random on the lungs of people in many of 'the world's major cities have turned up asbestos bodies...iron coated
asbestos fibers in twnety-five to fifty percent of the cases. But there were two questions we left unanswered last week: what is the danger of.asbestos to the general population, the people v?ho don't work with asbestos at all; and how long has. this population been exposed to asbesto:
SELfKGFF
Ee don't know. I suspect that it's relatively recent. The raason for this suspicion is as follows: there wasn't very much asbestos in use until relatively recently. For example, only fifty thousand tons per year were produced in the world around 1900. In 1930 the annual world, production was five hundred thousand tens per year. We are producing much more asbestos now with the growth of our industry, the growth of- our population, and the recognition of the excellent and Industrial qualities of this mineral fiber. Therefore, we can almost assume that inhalation, or the potential for Inhalation, is a relatively recent event. Since the diseases associated with inhalation of asbestos don't appear for twenty to thirty or more years, any health effect associated with asbestos, wbuch is now being inhaled, will not be
observed until around 1990 or the year 2000. I don't want^tp observe
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SSLIKOPP: (cont'd)
these effects then, which is the reason for my concern that we prevent inhalation at this time.
NARRATOR:
purfcunately, asbestos, as we emphasized last yeek, is a problem with practical solutions. Its sources, uses, and effects are all known. Some of those solutions are already in effect, others being planned. We* 11 get to those in a moment, but first a word about the asbestos workers. What's being lone to protect them against the magic mineral that is killing them? Unfortunately, for many of these workers-- such as many of the members of the insulation Workers union with which Dr. Selikoff viorked--litt3.e can be done. They've already had decades of exposure to asbestos, making it statistically certain that some of them, with time, will die of lung cancer and mesotheliomaA gloomy thought...
SSLIKOPP:
fas, this is a gloomy thought. But these are very unusual men--the
insulation workers in New York and New Jersey. They are the old kind
of self-reliant sturdy craftsmen. They are an intelligent--highly
intelligent--group. These are independent individuals, as are many
craftsmen in the construction trades. And, when faced with this
problem, they have not sat wringing their hands, but have determined
zo do something abqyt it. And much of the vigor and energy with which
this problem is now being attacked has been due to the good activity
of this group of workmen.; that is, the union to which this group of
workmen belong--the Insulation Workers Union.
*
NARRATOR:
Already a simple way has been found to cut down the rate of lung cancer among asbestos workers. That was to tell them to stop smoking. The Justification for that was a study Dr. Selikoff did with. Dr. Cuyler Hammond of the American Cancer Society, who, more than any other man, gathered the statistical evidence that cigarette smoking was a cause of lung cancer in the general population. Drs. Selikoff and Hammond studied the histories of eighty-seven asbestos workers who never smoked, and two hundred and eighty-three who did.
SSLIKOPP:
.
Of the eighty-seven men who didn't smoke cigarettes, we didn't expect any to die of lung cancer, because people -who don't smoke cigarettes by and large don't die of lung cancer, although a few do. That has been our experience among the asbestos workers as well. We have yet co see in New York City a death due to lung cancer in an asbestos woncer wnc riidnrt. smoke cigarettes. ~Qn the other hand, of the two hundred ar.d eighty-three men who had a history of cigarette smoking, v.-e should have expected, as cigarette smokers, two or three deaths due to lung aancer. There have been twenty- seven. This indicates
that there is some combined multiple effect between asbestos and lung
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SELIKOFF: (Cont'd)
cancer. Dr. Hammond has calculated that an asbestos worker who smokes cigarettes has ninety-two times the risk or" dying of lung cancer as compared with a person who neither works with asbestos, nor smokes cigarettes, therefore, i asbestos workers will stop smoking cigarettes^ and-many-have, we can prohably eliminate a large part of -., the risk of lung cancer among them.
NARRATOR:
.
Unfortunately, at this point, there is no simple way to reduce the -
other possible result of working with asbestos--the appearance,
twenty-five to thirty years after the fact, of mesothelioma, the
cancer of lung and abdominal tissue,that is now a fatal and virtually
incurable disease.
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SSLIKOFF:
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........."
T/je have observed mesothelioma among asbestos workers who do not smoke cigarettes. Therefore, a second approach is necessary: the approach of sharply decreasing the exposure to asbestos. Now, most of these men began work, and were exposed to asbestos, at a time when- the risk was not known. Therefore, precautions were either minimal or non existent. We now know these risks, and, therefore, it is important for us to design measures, knowing these risks, to eliminate them.
NARRATOR:
There are many ways to start, as Dr. Selikoff pointed out to us. Government has to set some sort of standards. Scientists have to come up with the proper information needed to set those standards. And the men working with asbestos, through their unions, have to help themselves. And the unions, as you've already heard, have made a. start toward solving the asbestos problem.
SSLIKOFF:
..............
labor unions, indeed, in the last several years, have almost led the "way in demonstration of social responsibility. For example, at the
present time, the only large-scale industrial hygiene program in the asbestos industry and the construction trades has been designed and had been worked out by the labor unions involved. This is a remarkable thing. It is remarkable that one of the building and construction uraae unions have actually gotten together all their people and each member of this union is contributing ten dollars per year out of his own pocket to work out an industrial hygiene program to solve the
problems within this industry. This effort on the part of labor has attracted.the additional support of some segments of this industry.
For example, the Johns Manville, Corporation is cooperating fully in this support of the development of this program in this one asbestos industry. Of course, there are other asbestos industries in which such programs have not corae about.
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"NARRATOR:'
r?he major'approach in the construction trades, which use asbestos in ^tremendous quantities, has been .to try to contain the stuff so that ^.asbestos fibers don't get into the lungs of asbestos workers, their, 'families, or the general population. But that approach, simple as it Isourids, has its complexities.
- SELIKOFP:
*.
Recognition of such complexity is essential to any efforts to manage 'the problem. Only simplistic approaches are invalid. There are really .'many aspects in. the use of asbestos in the construction trades. For ^example, asbestos cement is still used. It is mixed with water to 2make.the final finished product by simply dumping a fifty pound bag 'on this feathery, powdery cement into a large tub and adding the water.
-Uhen-this is done, a cloud os asbestos-containing dust is produced. -`b'e've simply worked out methods of mixing the material within a ..container so that no dust is created. Secondly, asbestos containing materials are cut and divided by power swws. It is simple and logical bto enclose these operations ana to put appropriate exhaust systems on ..these power saws so that the dust created doesn't enter the general ia'irstream. Anti-dust materials, or dust suppressors, can be added to .one materials used during the manufacturing process. This is now .'being done. Appropriate attentiaon can. be paid to solid-waste disposal. This was-not even looked at until now simply because, by and large, it was not realized that this was a significant risk. Yet, 'it is perhaps one of the most important sources for this dust.
:Many different measure will be needed; no one single measure will
"be adequate. 3uc all.of these measures are certainly within the .capabilities of our technology at this time. What is needed is the nerve to co it, the will to do it, the desire to do it. Unfortunately, 1..such...ner.ve,. ana such .will, .and such desire cannot come about ---------.automatically, and requires the interest and the consideration of many 'diverse groups in the community,.including industry, labor,government, and. other social groups such as scientists, academic groups, and so forth.
NARRATOR;
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This has been the last of two reports on THE CASS AGAINST THE MAGIC MINERAL, featuring Dr. Irving J. Selikoff, Professor of Environmental Medicine and Chief of the Division of Environmental Medicine at the Mt. Sinai school of Medicine in New York City.
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