Author: Nancy Meredith
OSHA Sampling Shows Asbestos Air Measures Above Permissible Limits
An analysis of air sampling data in four industries shows breathable asbestos levels well above limits set by the Occupational Safety and Health Administration (OSHA).
OSHA established in the late 1980s a permissible workplace exposure limit of 0.2 fibers per cubic centimeter of air (0.2 f/cc), averaged over an eight-hour work shift. It also set a short-term limit of one asbestos fiber per cubic centimeter of air (1 f/cc) averaged over a 30 minute sampling period.
But according to an analysis of OSHA air sampling data collected over the period 1984-2011, personal air samples frequently exceeded OSHA exposure limits for four asbestos-using industries, with some measurements reaching as high as 175 f/cc.
“Asbestos compliance sampling data associated with the construction, automotive repair, manufacturing, and chemical/petroleum/rubber industries included measurements in excess of 10 f/cc, and were above the permissible exposure limit from 2001 to 2011,” writes lead researcher Dr. Dallas M. Cowan in a study published in Regulatory Toxicology and Pharmacology.
http://www.sciencedirect.com/science/article/pii/S0273230015001014
Airborne asbestos fibers result from raw asbestos used in manufacturing and the handling of asbestos products, which remain legal in the United States despite the dangers of asbestos exposure being established in scientific literature by the 1960s. Asbestos fibers in any amount can cause mesothelioma and other diseases, even with only one exposure incident.
Asbestos-containing products such as cement sheet, roofing products, and automotive components continue to be manufactured, imported, processed, and distributed in the United States. The Environmental Working Group (EWG) reports that over the last decade alone, more than 8 million pounds of raw asbestos have entered U.S. ports in addition to hundreds of shipments of asbestos-containing products. A recent EWG analysis puts the number of annual U.S. asbestos deaths at 12,000-15,000.
Construction workers can encounter asbestos while installing new products or while working on buildings with existing asbestos products. Automotive repair workers create asbestos dust when working on vehicle brakes, transmission components, and engines. Manufacturing workers who make products with raw asbestos are also at risk of exposure, while workers in the chemical/petroleum/rubber industries come into contact with asbestos-insulated machinery, asbestos gaskets, asbestos construction materials, and other asbestos products.
Complete Ban on Asbestos Needed
The Cowan report doesn’t contain all bad news. It also notes “historically decreasing trends in the consumption of asbestos,” declining mesothelioma incidence rates, and declines in airborne asbestos concentrations in some industries over the past 30 years.
Short of a complete asbestos ban, however, asbestos products will continue to put thousands of American lives per year at risk. Creating an asbestos-free future means acting now, since mesothelioma can take 15 to 50 years or more to develop following exposure to asbestos. Currently two competing bills—one that calls for an outright asbestos ban and another that does not and is generally viewed as more pro-chemical industry—are facing off in Congress.
Workers who believe they’re being exposed to asbestos can report the alleged violation to OSHA, which has the authority to impose monetary penalties on companies that expose workers to asbestos and other workplace hazards. Workers who are diagnosed with an asbestos disease may wish to assess their legal options.
“Analysis of workplace compliance measurements of asbestos by the U.S. Occupational Safety and Health Administration (1984-2011)” can be read in full on ScienceDirect.
http://www.sciencedirect.com/science/article/pii/S0273230015001014
“Laboratory in a Patient” Could Allow Simultaneous Testing of Multiple Mesothelioma Drugs
Personalized cancer therapy allows doctors to target treatment to a patient’s unique mesothelioma characteristics. Oncologists can personalize and adjust care based on the efficacy of a treatment for the patient. However, determining the right treatment or how well a drug is working can take time, leaving the patient with precious little time if the drug is not effective at fighting off the deadly cancer.
Now, researchers at MIT, Beth Israel Medical Center and Fred Hutchinson Cancer Research Center and Presage Biosciences in Seattle have found a way to determine whether a patient’s tumor will be sensitive to a sampling of cancer drugs through an “implantable device” that can return nearly immediate results. The “laboratory in a patient” can contain samples of multiple drugs and simultaneously expose the tumors to all the drugs at once to assess the impact on the cancer, allowing the doctor to find the optimal drug for the patient.
In an April 22 article in MedlinePlus, researchers report two separate tools have been developed that can quickly detect whether a patient will respond to a treatment. With this approach, no biopsies are needed, several drugs are tested at once, and the patient is not exposed to side effects.
“Different patients can respond completely differently to the same drug,” said the lead author of one of the studies, Oliver Jonas, a post-doctoral associate in the Robert Langer Lab at the Massachusetts Institute of Technology’s Institute for Integrative Cancer Research. “So you have to test therapies sequentially. And it can take several weeks to many months to see the effect of a single therapy,” Jonas said.
“So the motivation of this whole study was to find ways to identify the optimal therapy in a patient before a treatment decision is actually made,” Jonas said.
Mesothelioma, often called asbestos cancer as the signature cancer of the mineral, is highly aggressive, with no known cure. Most often, the cancer resists the selected treatment, leaving the oncologist scrambling to find another option that may prove effective. Unfortunately, this gives the mesothelioma time to grow and divide, impacting the patient’s survival.
One device, that can hold 16 different cancer drugs, according to MedlinePlus, was tested on mice using melanoma, prostate and breast cancer tumors. The results showed “a reliable and accurate way to predict each drug’s effectiveness.” However, Jonas warned that the test comprised a mere millionth of a full dose, although he added, that the amount “correlated strongly” with the impact of a full dose used in treatment.
Personalized care targeted to a patient’s unique mesothelioma characteristics optimizes the potential for success of the treatment and offers treatment options that may not otherwise have been considered. The use of this device could allow oncologists to personalize treatment to each patient’s reaction to the therapies.
The second device, from the Seattle team, is a handheld microinjection device designed to test up to eight drug samples in tumors located near the surface of the skin, such as skin cancer, breast cancer, and lymphoma. Initial tests have been conducted in four humans with no serious side effects.
The researchers concluded, “Because these effects are crucial to predicting drug response, we envision that these devices will help identify optimal drug therapy before systemic treatment is initiated and could improve drug response prediction beyond the biomarkers and in vitro and ex vivo studies used today.”
Dr. Peter Kozuch, associate professor of medicine, hematology and medical oncology at Beth Israel Medical Center in New York City, adds that more research must be done, and they must see the same benefits and results in people as they have seen in the lab.
“The field of oncology is increasingly trying to become more precise,” said Dr. Kozuch. “But this is brand new technology, ” he cautions, “And unfortunately there is simply no shortcut to clinical development.”
Findings from both studies were published online April 22 in Science Translational Medicine (http://stm.sciencemag.org/content/7/284/284ra57).
See Mouse Models That Mimic Human Tumor Growth Could Lead to New Approach to Personalized Mesothelioma Care for a study where researchers tested parallel tumor progression in patients suffering from the disease in an animal laboratory mice.
Know more about Mesothelioma and how you can deal with it.
EWG Analysis: Asbestos Kills 12,000-15,000 Americans per Year
A new analysis by the Environmental Working Group (EWG) finds that asbestos kills significantly more Americans each year than previously estimated—and the actual asbestos death toll may be much higher.
Using data from the Centers for Disease Control and Prevention (CDC) database, EWG calculated that from 1993 to 2013, 189,000 to 221,000 people (12,000 to 15,000 per year) died from mesothelioma, lung cancer, and asbestosis in the United States.
EWG says that public records of U.S. asbestos-related deaths are imprecise, however, and that their estimate is conservative.
“As shocking as these figures are, they may be too low,” said epidemiologist and former assistant Surgeon General Dr. Richard Lemen in a press release from EWG Action Fund.
http://www.prweb.com/recentnews
“The report did not estimate deaths from the other-asbestos-related diseases. Furthermore, some studies suggest even higher lung cancer rates in asbestos-exposed workers,” said Lemen.
According to EWG, 39,870 American died from mesothelioma, an incurable cancer caused exclusively by asbestos exposure, from 1999 to 2013. Over the same period, EWG estimates that 20,317 Americans died from asbestosis, a type of lung scarring caused by asbestos fibers, while as many as 159,480 died from asbestos-related lung cancer.
In addition to deaths from these causes, it is believed that asbestos exposure can also cause cancers of the larynx, pharynx, stomach, colon, ovaries, and rectum. An older study by EWG that includes asbestos-related gastrointestinal cancer puts the number of annual U.S. asbestos deaths at around 10,000.
U.S. asbestos use peaked in the 1970s and the carcinogenic mineral fiber is no longer mined in this country, but it continues to be imported and used in a wide range of products. An EWG analysis of U.S. port records indicates that at least 8 million pounds of raw asbestos have arrived here since 2006.
EWG’s figures indicate that there was no apparent decline in asbestos deaths from 1999 to 2013. There were 2,481 mesothelioma deaths in 1999 compared to 2,686 in 2013 and a high of 2,874 in 2012. Asbestosis deaths were virtually identical in 1999 and 2013 (1,258 vs. 1,229). Both EWG’s lower and higher estimate of lung cancer deaths show increases from 1999 to 2013.
This can be attributed to the long latency period of many asbestos diseases. Mesothelioma, for example, can take 15-50 years or more to develop from the time of initial asbestos exposure.
Given the lag between asbestos exposure and disease onset, asbestos disease rates will likely remain high for years to come. One expert estimates that within the next three decades 300,000 Americans will die from asbestos.
“The only way to see the numbers of asbestos-related fatalities significantly decline among Americans is for our elected leaders to adopt an outright ban on the deadly substance,” said Sonya Lunder, author of the EWG report, “Asbestos kills 12,000-15,000 people per year in the U.S.”
Proposed Legislation Would Allow Veteran Access to Non-VA Centers for Specialty Care
Veterans with mesothelioma who receive health benefits through the U.S. Department of Veterans Affairs (VA) are free to receive health care at any VA facility nationwide, providing them with access to mesothelioma specialty services that aren’t available at their local VA hospital.
But this can involve lengthy travel and time spent away from home, conditions that are far from comfortable for patients with painful and incurable cancer.
Fortunately, a rule change to the Veterans Access, Choice, and Accountability Act of 2014 (Choice Act) could allow veterans to seek mesothelioma care outside of the VA network and closer to home.
The Choice Act was President Obama’s and Congress’s response to a scandal that broke last year over long wait time and systemic mismanagement within the VA health system. One of its major provisions is the Veterans Choice Program, which provides veterans access to private health care facilities if they cannot receive an appointment with the VA within 30 days or live more than 40 miles from a VA health facility.
As it was originally worded, the Choice Program allowed veterans access to private (non-VA) local health care if they lived more than 40 miles from a VA health facility “as the crow flies.” A rule change in April changed the mile requirement from a straight line measure to actual driving distance, an update that VA Secretary Bob McDonald said, “will allow more veterans to access care when and where they want it.”
But some critics say that the Choice Program still doesn’t go far enough because it fails to account for veterans who live within 40 miles of a VA facility but need care beyond what that facility offers.
For example, the MilitaryTimes cites the case of Mark Gendron, an Air Force veteran who lives within 40 miles of a VA clinic with basic services, but not the specialty psychiatric services he needs for his post-traumatic stress disorder. Gendron lives 70 miles from the nearest VA psychiatrist and isn’t eligible to be seen by a non-VA specialist due to his proximity to a VA clinic.
“I just want the care I need,” Gendron told MilitaryTimes. “I shouldn’t have to deal with this.”
A similar situation exists for mesothelioma patients. There are only a handful of VA centers nationwide with the expertise needed to treat veterans suffering from mesothelioma and other asbestos diseases. Research suggests mesothelioma patients have better outcomes at facilities with greater expertise in treating the rare cancer. Even hospitals with excellent oncology programs may not be well-suited to treat mesothelioma, a cancer that disproportionately affects Navy and other veterans, who make up around 30 percent of all cases.
If pending Congressional legislation becomes law, however, patients who live farther than 40 miles from a mesothelioma clinic may be able see a mesothelioma specialist closer to home.
According to The Hill, companion bills authored by Sen. Jerry Moran (R-Kan.) and Rep. Markwayne Mullin (R-Okla.) address the plight of veterans who don’t live close to a VA facility that offers the care they need.
“Our legislation calls on the VA to use its authority to provide veterans access to non-VA health care when the nearest VA medical facility within 40 miles drive time from a veteran’s home does not offer the care sought by the veteran,” write the congressmen in an op-ed.
The full text of the House and Senate bills can be read here and here.
For more information on the Veterans Choice Program, visit the VA website.
https://www.va.gov/opa/choiceact/
Sources”
- MilitaryTimes
https://www.militarytimes.com/story/military/benefits/veterans/2015/04/24/veterans-choice-40-miles/26295537/ - op-ed
https://thehill.com/opinion/op-ed/241458-va-choice-program-must-work-better-for-our-veterans - better outcomes
https://onlinelibrary.wiley.com/doi/10.1111/codi.12975/abstract
Italian Study: Mesothelioma Cases Concentrated Near Asbestos-Using Industries
Italian researchers looked at the geographic distribution of malignant mesothelioma cases and found that they tend to be clustered around cement manufacturing, shipbuilding, and other industrial facilities.
A team lead by Marisa Corfiata analyzed 15,322 incident cases of malignant mesothelioma from the period 1993 to 2008 recorded by the Italian national mesothelioma registry. Subjects were interviewed and asbestos exposure—the only known cause of mesothelioma—was defined for 11,852 of 15,322 cases. Cases were then then mapped and geographic clusters identified for the Northwest, Northeast, Centre, and South & Islands regions of Italy. Finally, case clusters were identified according to one of three asbestos exposure modalities: environmental, familial, and occupational.
According to the researchers, the main sources of mesotheliomas are cement manufacturing plants and shipyards, while several case clusters were also found in the vicinity of asbestos textile facilities.
“The largest [malignant mesothelioma] clusters, per number of cases or municipalities included were found, indeed, where the biggest asbestos cement plants or shipyard facilities were located,” writes Corfiata. “Overall, it should be noted that an asbestos cement industry, an asbestos textile industry or a harbor industrial area inclusive of shipyards partially contribute to exposure of MM cases in about 75% of the clusters identified.”
Diving deeper into the numbers, the researchers note that the high number of mesothelioma cases among women in the largest asbestos-cement industry clusters may be attributable to familial exposure, or so-called “take home” exposure, which occurs when one family member brings home asbestos fibers on their body or clothing and exposes other family members. For the shipyard clusters, mesothelioma is mainly associated with naval construction and/or repair activities.
The researchers also note a number of other industrial asbestos exposure sources, including steel manufacturing plants, metal product manufacturing, oil refineries, chemical facilities, power plants, railway carriage construction and maintenance, the automotive industry, glass industry, and food processing. These are many of the same industries that have historically in the United States produced occupational asbestos exposure.
But unlike the United States, Italy has enacted a national asbestos ban. The study points out that Italian asbestos consumption peaked later in Italy than in the U.S., and, given the 35-40 year latency period of mesothelioma, “a high number of cases is still expected in Italy in the next few decades.”
Mesothelioma incidence is thought to have already peaked in the United States, but as long as the use of asbestos products remains legal in this country, the carcinogenic mineral fiber continues to pose a threat to public health. Each year in the U.S. approximately 3,000 people are diagnosed with mesothelioma, while 10,000 total death are attributed to asbestos.
You can read the full text of the Italian report “Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry” at BMC Cancer.
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