Document nkbdeDyDzx60vgJ11KaKOBk1a

FILE NAME: Abex (ABX) DATE: 1977 May DOC#: ABX105 DOCUMENT DESCRIPTION: AIA Critique of Mrs. Nancy Tait's Asbestos Kills-New Facts Pamphlet c asbestos information ccmmiae ASBESTOS K X L L S H E W FACTS7 COMMENTARY on Mrs Nancy Talt's pamphlet Hay,1977 GENERAL . . Mrs Nancy Tait's now pamphlet .covers a vide field and its contents need to he evaluated hy people vhose professional knowledge covers medicine (including medical care, diagnosis and treatment), pathology, epidemiology, statisticscommunity health, waste disposal, industrial hygiene and legal compensation. . To deal vith al.1. these facets of the asbeatos/health. problem is ambitious ond understandably difficult within the compass of a short pamphlot, and it is equally difficult for a brief commentary to discuss the subject in depth or to deal with every single error. Ve do not comment on the slurs which the pamphlet casts, unnecessarily, on the professional reputation of individual doctors. There are however several points on which obvious comment can be made immediately and vith * reasonable brevity for the benefit of readers who are not in a position to verify references for themselves, Page 1 . "A spokesman for the Asbestos Information Committee reported, at an Industrv-Government Conference in Washington'in September. 1976"', . No spokesman for the Asbestos Information Committee reported at this Washington conference. Mr A A Cross addressed it in his role (at that time) of Chairman, Standing Committee, International Asbestos Information Conference. . _ Chrvsotilo a carcinogen The abstract of Professor Corbett McDonald's latest.presentation "Mesothelioma and Asbestos - Fibre Type" concludes that "the fisk of mesothelioma after orocidolite exposure would appear to be at least 50 times greater than that associated with chrysotil `production. "This does not mean that mesothelioma cannot be cause by chrysotlle, but it does mean that chrysotile is probably only likely to be a cause of mesothelioma where exposure has been particularly heavy or where a man is exceptionally susceptible. (Nobody in. the UK has ever claimed that "chrysotile is safe1]. Enormous efforts are made to minimise exposure to it, in view of its known associations with all three asbestos-related diseases. Page ii DHSS Cancer Epidemiology and Clinical Trial Unit The American National Institute of Occupational Safety and Healt (NIOSH) vhatevor it may have published, could not possibly have the results of the Trials Unit study because this has not yet been completed. The most that has reliably appeared is the evidence of Mr Julian Peto, published to the Advisory Committee SCF-ALLF-06580 on Asbestos, and made available to that Committee ca'l6th June, 1-977 a month after Mrs Talt's pamphlet vent to press. yaga 111 ' It is not true to say that "crocidolite- vas not used" in the production of asbestos textiles at Turner it Hawaii, Rochdale. Considerable amounts of crocidolite (blue) vere used before 1951, and it vas encountered in the cheese winding and plaiting sections of the factory up to 1969- "Excesa deatb3 from circulatory disease" Mrs Tait has omitted the comment by the authors (Knox, Holmes, . Sir Richard Boll and Hill) in relation to such deaths in vorkers exposed since 1993, that"it seems probable that this is a chance finding of no medical importance*. She has also omitted their comment on the excess of other cancers that "the small excess of ..deaths due to other neoplasms is not statistically significant". "Women, one of them a non-smoker, had died from lung cancer" A reader could be forgiven for thinking that quite a number of women had died from lung cancer. In fact two vomen vere reported, one a -smoker,- one a non-smoker. . Mrs Tait has also omitted the quite important conclusion of the authors that "among men'and women who have worked in the scheduled areas only slnoe 1933 the observed mortality from all causes is close to-.the expected (79 against 81.05)" .vyo hov learn that instead of 1 in IOO being slightly affected. . -- br.-J.97t 1 in 10 had died from respiratory disease". . " Mrs Talt's comment has no bearing on the adequacy of the standard. The British Occupational Hygiene Society reoommended a 2 f/mX ` .standard on the basis that this would reduce the risk of encountering the first clinical signs of asbestosis, after $0 yearB continuous exposure to 1 in IOO. The group of workers studied have largely been exposed to appreciably higher exposures than.2 f/ml. However, in a small sub-group vhich has been exposed for the first time -since 1951 at -dust levels kaovn to have Tjeen in. the region of 2 f/ml, there have been no cases of .any. .aisbestoo disease whatever. . Page iv . .'"Another company vhich claimed a trouble-free record had not '."boon in existence for the length of time which normally elapses between exposure to asbestos and development of disease. On averoge this is 25 years for lung cancer; 35 years for mesothelioma", The faotory described was the Rhoose factory of TAG Construction Materials Ltd, which has been operated by that company for U2 years. "Professor Sir Richard Doll of the EHSS Cancer Eoidemiolorv Unit at Oxford hag published foraiu <iulv in America) that, because jt is an extremely dim^tfous material which other intm-inl s c.-m rcnlnc. we ourlit to ban the use of asbestos". On 17th May 1977 Sir Richard Ball wrote the following letter to Br Valter Smithort J H M 0858.3 3 .:- . !:v ' . - . t ' . I j "Xvaa moat distressed to see tho statement attributed to me in the report of the meeting of the Nev York Academy of Science. Xt certainly ia not my viev that the use of asbestos should be banned. Xt is, however, ray viev that the use of crocidolite should be banned. Please feel free to use thia statement In .any vay you vant". . . * * Comnmnitr Concern * - ' ' j xhe views- of Dr Robert Murray axe quoted as if he vas opposed to the opening of a nev brake lining factory at Ovens, near Cork. Hia actual assessment appeared in the Irish Times on 17th May, in the folloving termst 1*. : ... -.One international medioal expert brought to Cork by the . - .. . - . ID A . literally staked his professional reputation on the .-.i .....;; ..belief that neither the factory nor the dump vill cause r-xi. .-.cancer or other diseases among vorkers or the communities -- .living around them. 'There is no medical reason vhy this . plant should not go ahead,' Dr Robert Murray told tho ' . ___ county council meeting". . O i` _ . Pa*e vfi . "The 500.000 needed for the AIC's advertising campaign vas . passed in ten minutes of discussion" ' "" V : To o *aggregate of discussions by Board members of member companies- of the AIC amounted to many hours, and individual " Board members came to the relevant AIC committee meeting vitb ' a clear idea of their companies'views. These vere -unanimous, ..--*7'- '-- rthat--the only method of securing a platform for a balanced --- ---- -- presentation of tho issues at stake vas to take paid ','.* * ` advertising" space, since -the industry's vievs vere not ' receiving more than cursory editorial notice in the media at - the time (late spring anti sarly summer 1976). The Advertising Standards Authority The' ASA did net criticise the AIC advertisement "as being complacent about the latent dangers and oversimplifying the 'health hazards of asbestos and as giving information vhich is premature and unsubstantiable" Nowhere in their ruling did the ASA use the vords *complacent", "premature" or "unsubstantiable". They sold "The advertisement did not, in the Authority's viev, make adequately clear that there exists -l-'o-- Substantial difference of medical opinion about the extent -- of--the-cuxxent and future risks related to asbestos. In A-- consequence,there vas a degree of over-simplification vhich* J. night have had tho effect of obscuring some of the uncertainties 4n the medical assessments of* the hazards." . . . . . ng CD CD -------- CO- Annual Report of H M Chief Insuector of factories,197 "h-f/ml - tvjce the official Hygiene Standard". ------ 5 ---- In-197U-tho_official hygiene standard of 2 f/ml vas not a ceiling X but a target tovards vhich industry vas expected to aim. The prac- of the factory Inspectorate,as set out in its Technical Data Note ** *-- "- . vas* to take no action if a ten--minute sample showed asbestos dust : levels to fce below 2 f/ml and to ask for improvements if the leva.' vno botvoon 2 and 12 f/ml. It is only in tho past fov months ;*.V-v.--""'V"' that To clinical Data Note 13 has beon supersedod bv llveieno Note 1 j i =f. - ..vhich demands (a) the lovest level reasonably practicable (b) a ..ceiling of 2 f/rai when averaged over h hours and (o) a ceiling 'for a 10 minute sample of 12 f/ml. The*1975 Industry and Services Report of the Health and Safety . Executive, vhich Mrs Tait has not quoted, reports as follows on the industry's achievements two years ago: -- . * . "Of a total of 675 representative personal samples taken in the. workers' breathing zone over a h hour period, 955$ were . . belov the current hygiene standard of 2 f/ml- and 99? were - below k f/ml, A further 280 representative personal samples taken at 18 faatories vhich do not have facilities for undertaking their own. medical surveillance of employees ... _revealed 90?^ belov 2 f/ml and S6^i. belov i* f/ml". \l ri\i:r I-PagOj ix .OH'O'f/mi "represents 9.600.000 fibres breathed in-a dav and is twice the level which the TOC recommends should aoolv in industry for all tvneo of asbestos". Most of the fibres breathed in are also breathed out or dealt i . with by the body's rejeotlon mechanism. Pago x ' a -- * \* -''STor-every fibre counted, Ti* ' '-tncdhfi-ted fibres". there are between . 100 and 1000 smaller 1--The-fibres that are counted ore those that arb biologically - significant (i.e, fibres more then 5 microns long and less than ``3 microns in diameter).. A ' ** e;-*- ^ VV Page xi XARC Statement of scone of problem related to asbestos exposure --The--paragraph quoted from an International Agency for Research or '-Cancer-publication does not appear in the main body of the report --and-is in fact prefaced with the following qualification:- ""Tfab-'prosent Working Group, convened to evaluate asbestos, ri efelt-'tbat in view of tho importance of this substance, this .tr* srv-*. *-"7*-monograph should also present a quantitative evaluation of --r the future scope of the problem in terms of society as a r ' w h o l e S u c h forecasts are dependent on several variables 0858s: U3 -r.:iofiich"cannot be predioted with certainty. Without implying ' CO disagreement with the views of the Working Group, -the in Director of the XARC haa requested that this section - oo . o appear as an Appendix to the main text of the monograph. ' ------ X . .* JTV : 27th June 1977 -7 *' -* ..J f.. :i --- ' The Asbestos Information Committee supported by BBA Group ltd Cape Industries Ltd . Eteralt Bid.Products L . Turner & Revall Ltd, a other British asbestos companies, ' y T v * . Further Information contact - 11 Old Burlington Street, '... . . i ; ... . XONDON V1X 1LA, (01 09 0573) . I I i A ASBESTOS KILLS I NEW FACTS 1977 * < . .. j- ij by I NANCY TAIT Churchill fellow i97 I JHM 08565 I I ` 0330 i I I I  ' asbestos In d u stry, w hich led to the appointm ent, by the Quebec Provincial Govern m ent, o f the 'C o rn iti <?tude su r la salubrit dam l'in d u strie de f*am iante' o f which Judge. Beaudry w as'president - The Incidence o f asbestos disease b under-recorded . The stu d y a t the mines and m ills in Th atfo rd , Quebec Province, 3 j Im portant be* . cause exposure was o n ly to ch ryso tile, yet 687 o r 60% o f 1101 w orkers were found to have abnormal X-rays. 49% o f non-smokers and 46% o f those w ho had worked where dust counts were low est, as In open pits above ground, were also found to be affected. 63J>% of sm okers and 76% of those w orking In very dusty conditions had abnormal - r X-rays. A m o rtality study reported excess deaths from lung cancer. 585 o f 714 workers - found in 1974 to be affected , had not been advised o f th eir condition by the mines c lin ic doctor. O r Paul C artie r. . : r-- D r C artie r, who resigned in 1974, had also been the governm ent inspector fo r th area fo r a num ber o f years. He has published th at he 'considers th at asbestosis can be tolerated quire w ell fo r many years' and the'problem w ill rem ain unnecessarily serious fo r many years to com e if a 'too scie n tific m edical concept' is accepted. Others share h is. view s. Professor P .C . Elm es. D irecto r o f the M edical Research'C ouncil Pneumocon iosis U n it, Penarth, w rote in 1976, 'A s It Is unusual a t the present tim e to detect asbestosis in w orkers under the age o f 5 0 , It Is evident th at asbestosis m ay coincide w ith other d isab ilities leading to the necessity fo r lig h t w o rk and retirem ent at the age o f say 60. U fe m ay n o t be appreciably shortened and death from unrelated disease is common*. I deplore such callous Indifference to the suffering caused by asbestos. The M ount S in ai stud y at Thatford w hich proves conclusively that chrysotile b dangerous, has n o t been publicised in th is co u n try. In reply to a Parliam entary Question, the Chairm an o f the Health and Safety Com m ission has stated th at a.physician from o u r Em ploym ent M edical A d viso ry Service attended the clin ica l exam ination a t the Thatfo rd Mines in 1974 but made no report on the v is it 4 . Although it Is argued that chrysotile cannot penetrate to the pleura to cause m esotheliom a, French.researchers -investigating .cases o f m esotheliom a have-identified i fib rils o f ch ryso tile in pleural plaques and near the surface o f the lung 5 . Mesothelioma i has been diagnosed amongst ch rysotila m iners and th eir fam ilies, yet it is s till claim ed th at the health records o f the Canadian chrysotile-m iners show that chrysotile is safe. DHSS C ancer Epidem iology and C lin ical Trials U n it Fu rth er evidence o f the dangers o f chrysotile b provided by studies8* 7 carried out at T u rn er and N ew ell. Rochdale, by the D H SS Cancer Epidem iology and C linical T ria ls U n it at O xfo rd U niversity. Parliam entary Questions have been unable to obtain details o f these stu d ies4 . However, the Am erican N ational In stitu te o f Occupational Safety & Health (N IO SH ) quotes these studies as reporting an increased risk of JHM 08568 r /-- - t - . J?i !- i v i I; -; i ' :: ili developing lung cancer (1 .8 times the expected) among those firs t entering scheduled areas between 1933 end 1950, and an excess o f deaths from lung cancer (1 .9 tim es the expected) among those who started w o rt a fte r 1950. when new dust control measures had been Introduced and conditions were m uch less d u sty. M ost w orkers were em ployed in the production o f textiles fo r w hich cro d d o lite was n o t used. . O r o f these studies has- been referred to in- a paper by a m em ber o f the O xfo rd . teem (again obtainable o n ly in A m erica), w h ich reports th a t 1 In 10 o f 678 m en, who worked o n ly in conditions covered by the Asbestos Regulations 1931, had, by 1974, died fro m lung cancer, mesothelioma and asbestos . 17 of- these deaths had oecured by 1968, as had excess deaths from d ra ila ta ry disease and from other cancers: cancer o f stom ach, co lon , gall-bladder and prostate. W om en, one o f them a non-sm oker, had died fro m lung cancer. The researchers K n o x, Holm es, O oll and H ill com m ent th at the wom an's deaths were unexpected' *ln view o f the ra rity o f th e disease in wom en in the co untry es a w hole' 8 , Paym ents by the com pany (1 a w eek to w idow s) were made as 'an ex-gratia allowance subject to review a t an y tim e and its continuance fo r a sp ecific period cannot be guaranteed'. Relatives w ere n o t to ld th at it had been accepted th at em ploym ent had contributed to death. ... T w o members o f this team , D r*. K nox and Holm es, gave the Standards Com m ittee o f the B ritish Occupational Hygiene So ciety the inform ation on w hich o u r Hygiene Standard o f 2 fibres per cubic centim etre Is based and from w h ich the Com m ittee concluded th at If men worked fo r 50 years in conditions w hich allow ed 2 fibres o f ch ryso tile pec cubic centim etre of a ir U .e. 2 m illio n 'fib re s breathed in an ho u rl less, than 1 m an in 100 would be affected and he w ould show o n ly the very earliest signs o f the effects o f asbestos on the lung 9 . The Com m ittee described th is data as scan ty: no data on cancer was considered although O r*. K n o x and Holm es knew It was available. We now learn th at, instead o f 1 In 100 being slig h tly affected , by 1974, 1 in 10 hod died fro m respiratory disease. ` T h e Standards Com m ittee reported th at inhaled ch ryso tile fib rils dissolved slo w ly from th e lungs, yet failed to investigate the process and the effects this dissolved asbestos m ight have. However, recent research In A m erica and France s w hich was no t restricted to investigation o f the lungs, as happens so often in th is co u n try, has ident ifie d -fib rils o f chrysotile,-visible o nly when an electron m icroscope is used, w hich have m igrated through human tissue to all organs o f the body. In d u strial disease statistics ' T h is w ork has especial significance fo r those seeking to explain the excess deaths from a ll cancers which a rt reported by studies o f asbestos and therm al insulation w o rkers. Deaths from these cancers do not appear in sta tistics as deaths from ind ustrial disease, because only asbestoses and mesothelioma are 'prescribed . Lung cancer in the U K q u alifies fo r DHSS benefit only if asbestosfs is also diagnosed. The T U C has recommended that both lung cancer and cancer o f the la ry n x should be listed as JHM 08 S69 Vi W atts disposal ,. ' When the-usa o f asbestos it discontinued,.w orm w ill till be a problem . So il cover ing old dumps In the U K has been found to.have eroded, exposing blue asbestos which rem ains uncovered w hile companies and lo cal au tho rities argue at to who should meet the co st o f m aking them safe. In C o rk, follow ing protests by residents. In d u ttry has offered to m ake Its waste asbestos in to cem ent p ellets before it is dum ped, b u t the com m unity feels strongly that the proposed site, near a school, is unsuitable fo r waste asbestos even In th is form and th at tinea experts canno t assure us that there is a level o f exposure to asbestos dust w hich is free o f ris k , factories and dumps should not operate where hom es, schools, shops o r farm s m ay be a ffe cte d .* . Para-occupational exposure ' * . The experts who reported to the Com m ission o f the European Com m unities on tho. Public Health R isks o f Exposure to A sbestos, decided th at. T h e re are no t suf fic ie n t data to estim ate the size o f the population a t risk* fro m para-occupational or dom estic exposure They report O r. Holm es' claim th a t 'Exp e rie n ce from the- Rochdale asbestos Industry U K does not reveal any Increased prevalence o f diseases In relatives; In th is case however rather strict hygiene measure* are being taken : w orkers are not allowed to take w orking clothes hom e; laundering is perform ed w ith in the facto ry'.16. In fa ct the com pany provides and launders o n ly a loose coat-type overall fo r the m ajo rity o f w o rkers; even head-covering is o ptio n al. Asbestos fibres leave the facto ry in h air and clothing and w ill continue to do so u n til showers and a com plete change o f clothing and shoes b provided fo r a ll w orkers. N o m o rtality stu d y o f the com m unity a* a whole has been made. In h is report to the Standards Com m ittee, O r Holmes referred to Rochdale as a 'conurbation w ith a high prevalence o f ch ro n ic bro nchitis' and described two w orkers as 'm embers o f a local large b ro n ch itic fa m ily ',6 In another tow n, although a w o rker was found at post m ortem , to have evidence o f exposure to asbestos, the dependants were refused pension on the grounds that he was treated as b ro nchitic, not asbestotic, during life . In o th er esses, a diagnosis o f asbestosis o r mesothelioma has been contested u n til confirm ed by post m ortem . O nly recently have General Practitioners become aw are th at in d ustrial diseases m ay affect the com m unity. Many report "that th eir interest Is-resented .by Em ploym ent M edical Advisers and com pany doctors. Dom estic exposure ,, ' W hile some sections of in d ustry rd ll try to claim th at there is no risk to the general pu b lic from asbestos, others adm it th at the risks e xist, but claim that they can be reduced to an acceptable level. D uring 1976, reports have reached me o f an asbestos ironstand given to a baby as a plaything , asbestos paper used as pellets by schoolboys, a to y cupboard lined w ith asbestos and children playing on asbestos dumps or near W a tt water from asbestos factories and Industrial laundries anfars the public sewerage system. Sludge is spread an farmland. - v i workm en cutting asbestos m atarais. Such exposures would n o t be remembered if disease developed In 40 years tim e. T o pro tect the com m unity the controls w ould have to be as rigid as those designed to ensure the safa use o f radio-active m aterial. Such measures are n o t practicable In homes, shops, o ffice s, schools and hospitals, where asbestos is frequently handled carelessly whan repairs to existing asbestos become necessary o r when new asbestos is fitte d to meet the requirem ents o f the fire regulations. In d u rtry .ln A m erica has reported th at the dust taken home in a w orker's d o d ies is a perm anent cancer risk to the fa m ily and th at, once in the home, asbestos im pregnates carpets and fu rn itu re and is recirculated in the breathing tone by any m ovem ent, p articu larly by vacuum cleaning *7 . Those who claim th at controls can make the use o f asbestos safe, cannot be aw are th at, although legislation exists In the U K to prevent such practices, m any reports reach me o f contractors cutting asbestos In occupied premises and leaving unsealed surfaces, dust and debris, which m ust Impregnate the home. The risk w ill spread across Europa if the European Com m unity Introduces Fire Regulations sim ilar to those w h ich created the problem In the U K . The A dviso ry Com m ittee on Asbestos No attem pt Has yet-been made to deal e ffe ctive ly w ith the problem In the U K where m any s till claim th at 'ch ryso tila is safa' and where the A d viso ry Committee on Asbestos has issued an in terim statem ent w h ich has only recommended th a t fu rth er research is necessary and th a t exposure to a ll form s o f asbestos dust should be reduced to die minim um reasonably p racticab leta . T h is has pleased the Asbestos Inform ation Com m ittee. __ Tha Asbestos Inform ation Com m ittee Th is Com m ittee w responsible fo r some o f th e m ajor problem s arising from the use o f asbestos which face governm ent, w orkers and the com m unity. The 500,000 needed fo r th eir 1976 advertising campaign was passed in ten m inutes o f discussion although, in 1975, th eir expenditure on advertising in the U K was cu t back from 55,000 to 50,000 1. One o f th eir fu ll page pres* advertisements was criticised by the A dvertising Standards A u th o rity as being com placent about the laten t dangers and oversim plifying the health hazards of asbestos and as giving inform * ation w hich is prem ature and unsubstantiable. The A u th o rity also criticised the .Advertisem ent because it did not m ake it d e a r that the Asbestos Inform ation Com m ittee was set up b y, and is funded b y, a consortium o f asbestos m anufacturers, but im plied th at the A IC was connected w ith the Governm ent's Asbestos A dvisory Com m ittee and obtained its advice from o fficia l governm ent sources. T h a t advertisem ent w ill n o t appear again. . ' Asbestos K ilts As part o f th eir cam paign. tha A IC produced a com m entary on Asbestos K ilts. It ,$ 8 0 JHA/l 08573 i i i I v iii - . " .; contains untrue statements such as 'cases are registered (b y Pneum oconiosis Boards) so lely on the Identification o f d isa b ility due to observed fib ro sis'. T h e Industry was . helpful to M rs T a it a t the tim e o f her husband's death' and 'M rs T a ft's source fo r this statem ent Is an allegation In a television program m e'. J' Although much o f the com m entary Is concerned w ith trivia l details o n ly, the f la t page shows d e a rly the attitude o f ind ustry to safety m easures and co ntro l. Ignoring the o ffid a l Health & Safety"Executive Hygiene Standards to w hich I referred : and which state th at occupational exposure to ch ryso tile dust should not exceed 2 f/m l when measurements are averaged over a'4 ho ur perio d, o r 12 f/m l when measured over any 10 m inute period, the A IC im plies that m uch higher dust counts are accepted ^ o ffic ia lly , by daim ing: " r.r Since th e 0O H S Standard'w as not a "2 fibre" standard b u t a " 100 fib re year per j..: m illilitre " standard the allowable co ncen tratio n 'fo r anyone w ith 25 years contin- . uous exposure would be 4 f/m i. and w ith o n ly 10 y e a n continuous exposure, 10 ;i. f/m L' The BO H S only advised the D ept, of Em ploym ent, it did n o t set the standards. _. The A IC claim s ` a w orking atmosphere w hich Is adequate In relation to asbestosis ta regarded as adequate In relation to lung cancer also' as If th is were the o ffid a l opinion, although both the BO H S and the H ealth and S afety Execu tive have published th at the num erical relationship between asbestos and cancer risk not known. . Asbestos K ills quotes from the Annual R ep o rt 1974 o f HM C h ie f Inspector o f Facto ries, th at 97 o f 400 sam ples were found to be above the Hygiene Standard of 2 f/m l. The A IC claim s th at th is Is 'a typical piece o f m isrepresentation 'because 6 5 . above 2 f/m l, were not above 4 f/m l' - twice the o ffid a l Hygiene Standard. W ould a m otorist's plea th at he had no t disregarded a speed lim it o f 3 0 m ph, because he was travelling a t less than 60 m ph, be accepted? * ` " T h e Asbestosis Research C ouncil Asbestos related diseases A guide fo r die Genera/ Practfdoner by D r Sm lther of Cape Asbestos, states that it Is published by the Asbestos Inform ation Com m ittee, t -supported -by 8 8 A .G roup -Ltd.. Cape. Industries L td . T u rn e r & N ew all Ltd and other B ritish Asbestos Companies and also by the Asbestosis Research C o u n d l. i l Com pletely Independent-research Is rarely possible. The in d u stry, w hich in flu ences research by com m issioning Its own studies, by financing the Asbestosis Research Council and by grants to the W orld Health O rganisation and International Agency fo r Research on Cancer, also controls inform ation w h ich researchen need, such as medical records and dust counts. . The presentation o f inform ation m ay be unconsciously Influenced by prejudice or m ay be deliberately slanted. Sum m aries can be so b rief as to be m isleading. S*r* ** <y ** , \ Gow Jl UH iiv>* 08574 r-X'ir Ingested asbestos ' D r Sm lther, w riting In Woman's O w n, claim ed that the asbestos In all the beer consum ed in this co u n try in a year, w ould fill o n ly a sm all cup. Ha did not m ention that In A sbestos --its special attributes and uses. the A lC has published that chrysotile fib ril* are so fine th at less than 1 gram , (1 /30 ounce) w ould reach 477,680 m iles to the moon an d .b a ck, w h ich distance represent* 385 m illio n m illio n fibres o f e site thought to be capable o f causing cancer. . ... Asbestos occurs w id ely In food, d rin k and drugs; it has been used fo r w ater and sewage pipes and to cover reservoirs and to lag tanks. Industry Is anxious to deny th at Ingested asbestos is dangerous. However, the IA R C has quoted recently ` Epidem iolog ical studies have co n sisten tly shown an excess risk o f o ther cancers, especially o f the gastro In testin al tra c t, follow ing exposure to m ixed fib re s . . . How ever, such risks have been less than th at fo r lung ca n ce r,. . . increased exposure to inhaled asbestos particles leads to increased digestive system cancer'. (1 0 0 ,0 0 0 colestom ies are recorded In the U K and the figure is increasing by 6 ,0 0 0 a year) ` Sm oking has n o t been found to be associated w ith an increased risk o f m esotheliom as o r cancers o f the stom ach, colon and rectum , w hich o ccu r w ith equal frequency among sm oking and non-smoking asbestos w o rk e rs'19. ' . Measurements o f asbestos dust concentrations The practice o f referring to fibres per cu b ic centim etre o f a ir, rather than to the num ber o f fibres In the to tal volum e o f a ir breathed, also encourages under-estim ation o f the ris k . O r Sm ither claim s th at 0 .4 0 fibres per .c o n stitu te a negligible risk , b u t., th is represents 9 ,6 0 0 ,0 0 0 fibres breathed in . a day and is tw ice the level w hich the T U C recom m ends should ap p ly in in d u stry, fo r all types o f asbestos. When reporting as ranging between 0.01 and 0 .1 3 f/cc, the fibres produced by a toaster, a haird ryer, an ironing board, a co o ker o r a radiant rin g . D r .Sm ithef did not make it clear th at each measurem ent was o n ly o f the co n trib ution w hich that single appliance made at that tim e to the general revel o f asbestos In the home nor did he make It clear th at the measurements he reported had been adjusted by subtracting background measure ments fro m his resu lts. Such scie n tific exercises bear little relationship to the experience o f an in d ivid u al who m ust breathe the asbestos w hich has accum ulated In the home from ail sources. G overnm ent Departm ents daim that dom estic appliances and oven gloves. Iro n stands, co o ker braids and sim m ering m ats, need to be replaced only when damaged o r frayed , b u t It is during-the'procew o f wear th at fibres are rubbed onto do th in g o r released In to the room , to co lle ct there perm anently, as do the fibres taken hom e on a w o rker's clothes, as in d u stry has re p o rted .17 "The m ethod o f counting asbestos fibres w hich is cu rren tly in use. Is recognised to be inadequate. When a num ber o f laboratories are asked to assess the same filte r, it is usual fo r d ifferen t counts to be reported by each laboratory and even by Individuals In a Jingle labo rato ry. O n ly a sm alj proportion o f the fibres present can be distinguished . j h ,A 08575 . ,, ft. -d J =.Tot'ZtZT'ZZilZ H '. '* - r s f i s s s S A - r J f f i S i ' S : asbestos carcinogenic. A fib re ^ * f flb^ ( l6ngof than 2 m ic ro , ha damaged call M m ic ro ) may W f * `f ^ , ! ^ X | r * t i W m ay be triggered. V e r , S X S t i f S i ' S S 3 * . Ptoura by panelrating to the alveolar area, o f the lung; others m ay m igrate. ' . F - * 1 * S 2 ? .t S recommended fo r w e w ith the Hygiene not counted. Fo r every fib re counted, end 1 .8 m icro n , in diam eter, even if seen, are ^ w o n t e d , fo r every there are between 100 anti 1000 .m a ile r, uncounted fib re*. - Labelling T h e A tC baa publicised tb 'n< l^ rY ^ ^ r ^ ^ r t a l l Y ^ e ^ v ^ ^ ^ i n g u nn designed to affo rd protection. ^ readily available'; the volun- la b e l, and le afle ts, announced ,n " V * im ports o f products containing In cfu rtry '. concern A nother daim w hich tha A IC has publldsed w id aly is : . Sadly. e a tin g pensation to them * exposed w ork*. m ~>r. ih , t heloed by good medical care and fa ir com- S J w i J S n t y the asbestos in d ustry h a. " * of pounds have been 'paid both in direct SL32. *. <^ ,0Ye to,i9hw"" Com pensation ' I f m illions o f pound, have been paid in m a rt be affected than tiv lu .t^ w i l adm it. nn f industrial d ila t e , the O H SS Newell paid widows 1 a week n 187& W d J # jiftg(e paym ent 0 f up to adds S5p a week to the norm al widow s pen* now ,,creased from 1 to 8 a 3 0 0. Follow ing m uch p u b licity. T u n * r& N ( 0< O irectou.* week its 'E x G ratia A llo w an ce Paid dunng dependa,, ts fin d that the The OHSS has not increased its pay d fro fn |tat8 benefits. Few can them- S T S o T n . r t K 'S <* 'i.'fr.Hli * ,,,w ,MU- 1"rtta' 08576 advice w hich a u n t support a claim . Em ploysrs do not hava these disadvantages when contesting claim s. . , ` M edical car' , ... 'G o o d m edical ca rs' can deal o n ly w ith sym ptom s; there is no treatm ent o r cure. T h e ' International Agency fo r Research on Cancer at Lyo n has w ritten T h e only w ay ` 'to fig h t cancer deaths,related to asbestos Is to elim inate exposure to asbestos.' T h is can o n ly be done by lim itin g the use o f asbestos to situatio ns in w hich it can be to tally enclosed o r to w hich o n ly those provided w ith fu ll protective clothing are allowed access. Show ers and a com plete change o f clothing before leaving the w ork place, are e s s e n tia l.. Diagnosis A n EM I Scanner, w hich i i said to diagnose asbestasls a t a much earlier stage than is possible by other m ethods, is available to those livin g in the M anchester area. A Safety Representative, M r R Jackson has succeeded in obtaining sim ilar facilities in the Hum berside Area and, because o f the high Incidence o f asbestos disease amongst Therm al Insulation W orkers, he recommends th at they should press every Area Health A u th o rity to In stall th is equipm ent. Treatm ent .. In A m erica, a research programme at M ount S in a i, to And an effective treatm ent and m eans o f early diagnosis fo r mesothe.lioma, has been funded by an in itia l donation o f 300;000 from Johns-M enville and the international Association of Heat & Frost In su lato rs and Asbestos W orkers. Professor S e lik o ff has predicted 7 0 ,0 0 0 cases of m esotheliom a amongst A m erican asbestos w orkers during d ie n e xt 4 0 yeers. In the U K D r. M uriel Newhousa estim ated th at 7%-11% o f w orkers em ployed at an asbestos fa cto ry , now closed, w ould die o f m esotheliom a. Inadequate control The IA R C has published th at, 'In spite o f the fact th at the hazards from exposure to asbestos dust had been clearly defined by M erewedier and Price in tha U K (as early as 1930] . . . in su fficien t action was taken. . . . B y the tim e the cancer potential had been recognised and defined (1935-60) asbestos had permeated much o f modem in d ustry, and. indeed, modem so c ie ty ,, . , in circum stances that we now understand are inadequate fo r the co n tro l o f occupational disease, including cancer. A s a re su lt we are'n o w faced w ith a double dilem m a, o f how to deal w ith the consequences of previous inattention and erro r. In'term s of human disease, and o f how to avoid further exposure which could produce disease in the fu tu re .. . In m any studies o f groups o f asbestos w orkers, fo r exam ple, approxim ately 20% o f ail deaths are the resu lt o f lung cancer, three-quarters of w hich are attributable to th eir w o rk w ith asbestos*.,3 Should .--Tfdeo J HM 0857! estim ate prove accurate, some 200,000 deaths from lung cancer and 50,000 deaths from m esotheliom a era forecast fa r US and these take no account o f deaths w hich w ill arise fro m future exposures. ` Y e t any attem pt to deal w ith the e ffe c tj.o f the problem on people, rather than on sta tistics. Is attacked by ind ustry as 'em otive'. Despite rising p ro fits. Industry claim s th at It cannot affo rd to Introduce m ore effective m ethods o f dust co ntro l and threatens w orkers w ith unem ploym ent . ` It Is understandable `that w orkers and unions Involved In the m anufacture of asbestos should faar the th reat o f unem ploym ent, but every w o rker em ployed in the production o f asbestos puts a t risk hundreds o f o thers. F o r brake-linings, the figures, are given as 135 a t risk from servicing and repair w o rk , fo r every 1 paid to produce them . In ad ditio n, there ls: the risk to the general p u b lic from asbestos dust which accum ulates in the environm ent, when released b y an y o f Its 3 ,0 0 0 uses. Industry should be prepared to contribute to the co st o f putting its house in order. A con stru ctive approach such as the T U C proposals fo r licensing o f the therm al insulation in d ustry and Its programme fo r a change to alternative m aterials,' is possible. Redund ancies can be avoided; the Introduction o f new processes and new m aterials could create em ploym ent. 8 rltish R a il are enforcing a Hygiene Standard o f 0 .0 5 fibres cc . w hen stripping cro d d o lite from existing ro llin g sto ck. T h e P o rt O ffice has adopted the T U C recommended standard o f 0 .2 fibres cc fo r a ll existing asbestos. Both use altern atives fo r new w o rk. Such measures w ill be effe ctive if applied rig id ly throughout Industry and the com m unity. _ Help needed The num ber o f people suffering as a re su lt o f past m istakes Is increasing and there is an urgent need for an organisation to help those w ho develop asbestos disease and th eir dependants by providing sym pathetic advice and Info rm atio n on treatm ent, nursing care, benefits and com pensation. A ctio n Is also needed to counteract the m isleading Inform ation published by the Asbestos Inform ation Com m ittee and to ensure th a t the risks are understood and safety regulations adequately enforced. I have w ritten m ainly about the situation in the U K . b u t m y visits to Europe and correspondence from the rest o f the w o rld, show tills to be a problem w hich needs to be tackled Intern ation ally. Th e .H ealth & Sa'fety Execu tive is extending Its w o rk in in d ustry In the U K , but its powers and resources are lim ited . Those whose lives are affected by the in d u stry, th at is those who use asbestos, th eir fam ilies and neighbours (in fa ct every in d ividual in the com m unity) should be heard and there should be research to ensure th eir safety In the future and to alleviate the su fferin g o f the victim s of past neglect. I hope that plans fo r a T ru st in the U K w ill m ature in the near future and that the 08578 . : zx^ tU M 'u riU iM i >' "--- ? `r '~ rr r ^ .......... rfl European Foundation fo r the Im provem ent o f W orking & liv in g Conditions, w hich has In vited me to 'su b m it m y proposals fo r dealing w ith the problem , w ill extend the w ork to Europe. . A levy on im ports o f raw fibre and products containing asbestos would make sub stitu ts m aterials more com petitive and could be used to finance the change to altern ative m aterials and the w o rk w hich needs to be done fo r those who develop asbestos d lse a sa . : I I I ! t REFERENCES . Rem arks o f A le x A Cross. Chairman, Standing Com m ittee, International Asbestos Inform ation Conference a t Asbestos Inform ation A ssociation Third Annual In du stry-- Governm ent Conference. Septem ber 8-9,1976. . 2 . Rapport du Com itt ftude su r la sa lu britdans tln rh n trla de l'am iante, 4 volum es; 8 docum ents published by L 'E d ite u r O fficie l du Quebec, Service de la Reprographie, Dcem bre 1976. ' 3 . Tmoignage du D octeur W Nicholson -- Lo rs d'une Audience Publique de C ES!A , 2 7 February 1976. M ontreal, 1976. 4 . Hansard, House o f Lords O fficia l R ep o rt, 1 M arch 1977 C o l 611*614, and 14 March 1977 C ol 1440-1442. ' 5 . fte-exam ination'snd Update of in form ation on th e Health'E ffe cts o f Occupational Exposures to Asbestos, U S Departm ent o f H ealth, Education and W elfare, Pub lic' Health S ervice. Centre fo r Disease C o n tro l, N ational In stitu te fo r O ccupational Safety and H ealth(D ec 1 9 7 6; in press). . .. 6 . Peto J-. 'T h e Establishm ent o f Ind ustrial Hygiene Standards; A n exam ple'. Envir onmental H ealth: Quantitative M ethods, S IA M --S IM S , Philadelphia, 1977, pp 99-109. 7 . Howard S .. Kim ben L . X `, Lew insohn H . C ., Peto X and D o ll R ., `A m ortality study among w orkers in an English asbestos factory* {in press). 8 . K n o x X F .. Holmes S .. O oll R .. and H ill I. D .. 'M o rtality from lung cancer and" o ther causes among w orkers in an asbestos te xtile facto ry*, B rit J . Industr. Med. 25. 1968. pp 293-303. I M JHM OS570 S . a r id * O ccupational' Hygieni Standards fo r Chrysotil Asbestos Oust*. A nn. O ccup. H yg. 11. iS b o . PP t a 'In d u stry th a t takes great care is fighting fo r s u rv w a l, Tha Tim es. 31 M arch . 11. Bugler J .. 'S o ciety at w o rk : A sbestos* and after*. N ew S o ciety. 27 January 1977. 12. TU C Evidence to the A dvisory Cm m im e on A sbestos. (December 1 9 7 a 13. OoU R .. 'D iscussion Papes'. Annals o f the New Y o rk Academ y o f Sciences 246, 197S. pp 320-321. .. s rs ' N ational In stitu te fo r O ccupational Safety and H ealth . A p ril 1976. IS . The Irish Tim es. 21 February 1977. - SSSS.S European Communities. Directorate General Sfo r Social TA ffairs, S fieaim an ;r Directorate, Pergam on Press, 1977. 17. Comments o f JohnoM annHo C(" f ^ r o iT u - T . 0 .~ . Cricrudo. 1 9 ,6 . ,9 . H e rid , ,d S r i . C o m m u n e health hazards and precautions: an mtenm -statem ent o y me . Asbestos, HM SO , 1977. 1 9 . Evaluation o f the Carcinogenic R isk o f Chem icals to M an: Asbestos (IA R C VrtlltM 1 4\. 1977. / w ould lik e to thank the Winston Churchill M em orial T ru st which has *> !o v*d TM ,, ^ Z f io U t Z eon* e o tu e n n 'A fte ito i K ill, em f eom yon. * ,, has riven me Inform ation and encouragement Nancy Tait M ay 1977. JHJVl 08580 80