Air Date: Week of May 21, 1999
The carcinogen asbestos has been banned in the U.S. for decades; but as John Rudolph reports, deaths from the hazardous building material are likely to continue as cures remain illusive. Advances in gene therapy and laser treatments offer patients some hope.
CURWOOD: It's Living on Earth. I'm Steve Curwood. The Federal Government banned asbestos as a building material in the United States a decade ago, but health problems still remain. People exposed to what was once called the miracle building material are still battling disease. Each year, as many as 3,000 people in the United States die from mesothelioma, a deadly cancer caused by breathing in tiny asbestos fibers. Even though there are strict laws designed to protect people from asbestos exposure, medical researchers believe that waves of asbestos-related deaths will continue well into the 21st century. John Rudolph reports on the reasons for the ongoing threat.
RUDOLPH: In a sterile white room at the hospital of the University of Pennsylvania, 67-year-old Don Hardy lies on a metal table. Overhead a CAT scan machine takes X-rays of Hardy's lungs and abdomen, as a mechanical voice coaches him to regulate his breathing.
VOICE: Breathe in. Hold your breath.
RUDOLPH: Hardy figures he's had this test performed about 20 times over the past 4 years.
HARDY: I was doing it on a monthly basis, then on a 2-month basis. And now it's been probably averaging about every 3 months.
RUDOLPH: Plus there have been countless chest X-rays, blood tests, and other medical procedures. All part of Don Hardy's battle against mesothelioma, a particularly dangerous type of cancer that surrounds the lungs with a thin, sheet-like tumor. Each time Hardy enters the hospital for a test, the same thoughts go through his mind.
HARDY: Hopefully the pictures come out well, and also that the results are good. But I'm thankful that they have the equipment to do this.
RUDOLPH: For 35 years Don Hardy worked in construction, first as an asbestos installer in factories and power plants, and later, after asbestos was banned as a building material, as an asbestos remover. Often, he was surrounded by clouds of asbestos dust. Unlike most of his coworkers, Hardy wore a homemade mask on the job because breathing the dust gave him headaches. But he says he had no idea of the cancer risk he faced from inhaling the tiny asbestos fibers.
HARDY: Not until the banning of the product came out in the 70s was any of us really aware of the hazard that it caused. I enjoyed the work. In fact asbestos cement was a great product to work with. You'd mix a slurry of that and it made your hands so soft and smooth. People, you know, that were exposed to it in our line of work early on never had a problem. We used to mix it with the bare hand because it was great, it was a great product.
RUDOLPH: It wasn't until 1994 that Hardy was told he had what some workers call "the big M." Mesothelioma, the disease that almost no one survives. Most people don't live more than 18 months after being diagnosed.
HARDY: The disease has been traumatic for everyone it's been kind of, you know, connected with it. You're always constantly reminded that it's not, you know, there's something wrong. It becomes a drain, and people have to be strong to, you know, to survive that. I know in my own case, my family is constantly worrying.
(Hospital machinery. Woman: "You just have surgery?")
RUDOLPH: At the hospital at the University of Pennsylvania in Philadelphia, doctors see a steady stream of patients with mesothelioma and other diseases caused by asbestos. These patients hope not to join the estimated 171,000 American workers who have died from asbestos-related cancer over the past 30 years. Nearly 19 million American workers were exposed to high levels of asbestos during World War II and the postwar building boom. Asbestos is a naturally-occurring mineral. It's fireproof, easy to apply, and virtually indestructible. Before it was banned, asbestos was used in huge quantities, mainly as an insulating material in buildings, in ships, and in many manufactured products. Researchers predict that the first years of the next century will see tens of thousands of mesothelioma deaths in the US. Even higher death rates are forecast for Europe, as well as many developing countries where asbestos is still mined and used as a building material. Dr. Daniel Sterman is a mesothelioma researcher at the University of Pennsylvania.
STERMAN: Even if we, no one else in America was exposed to asbestos again, starting tomorrow, we would still have a marked increase in the number of cases over the next 10 to 15 years.
RUDOLPH: But why is this hazardous material still causing so many deaths? One reason is that diseases caused by asbestos usually don't occur until 20 or 30 years after a person is exposed. The microscopic fibers stay inside the body forever, causing slow changes over time. The 1960s and 70s saw the first major wave of mesotheliomas in the US. The victims were mainly shipyard workers exposed to asbestos during the massive shipbuilding effort of the second World War. The second mesothelioma wave includes factory employees and construction workers like Don Hardy, who worked with asbestos in the 1950s and 60s. Dr. Steven Levin is an authority on occupational safety and health at New York's Mt. Sinai Hospital.
LEVIN: There was a huge wave of construction of schools, office buildings, other kinds of structures. And often by building code, those buildings had to have in them asbestos insulation, called for by code. The workers who installed those materials had very significant exposures, and that gave rise to much of the mesothelioma cases that we've seen, really, in the 1980s and continues through the current time.
RUDOLPH: And will there be a third wave of mesotheliomas? Definitely, says Dr. Levin. He says those at high risk include workers involved in removing old asbestos from buildings.
NASSRY: Okay. In New York, in order to do asbestos abatement, the first step is to construct worker decontamination chamber. What you're seeing is the skeleton, the structure of worker decontamination chamber. We're going to walk through this chamber right now...
RUDOLPH: At the Big Apple Occupational Safety Corporation in New York City, instructor Enayat Nassry trains a group of construction workers in the legally required methods for handling asbestos that's being torn out of a building.
NASSRY: So we try to control the dust. For centuries nations controlled the dust with spraying some water, so that's what we are doing. It's also required by the Federal and State and city government. And then all this waste...
RUDOLPH: Asbestos removal, or abatement, as it's called, is a multi-billion- dollar industry. New York City alone has dozens of asbestos abatement companies. Today's regulations contrast sharply with practices that were common years ago. Masks and protective clothing are required. Areas where asbestos is being removed must be sealed in plastic, and workers are required to shower each time they leave a contaminated site. New York City's Commissioner of Environmental Protection, Joel Miele, contends that the risk of asbestos exposure is now virtually nil.
MIELE: Clearly, the exposure of not any workman but people in the nearby area has been reduced to the point where I believe that the risk is absolutely minimal.
RUDOLPH: But while the threat has been reduced, Commissioner Miele admits his department lacks the resources to inspect many asbestos removal jobs. In fact, he says, 70% of the smaller asbestos removal projects in the city are never seen by a government inspector. In the view of Dr. Steven Levin, the lack of government oversight in New York and around the country creates a serious health threat for asbestos workers.
LEVIN: It is possible technically to protect them very well. And at times those removal workers are protected very well; they're not always protected very well. But the issue is not whether we know how to do it technically, but do we have the political will, and are we willing to devote the resources to making sure that those people are not placed at risk?
RUDOLPH: Equally pressing is the need to find a cure for mesothelioma. The usual cancer therapies, radiation, surgery, and chemotherapy, can't stop the disease. So far, victories have been rare, but they have occurred, and Don Hardy is one of them. Hardy has undergone 2 highly experimental treatments. The first, gene therapy, attempted to genetically alter the cancer cells in Hardy's body to make them appear as though they were infected with a virus. Hardy was then given an antiviral drug to hopefully kill the genetically- changed cells. In the second experiment, doctors used a laser to burn away the tumor around Hardy's lungs. A few hours after his latest CAT scan, Hardy's doctor, Joseph Fridberg, has good news. The X-ray shows the tumor has all but vanished.
FRIDBERG: So really, whatever it is is completely stable. We'll take it. I mean, this is -- it would be extremely uncharacteristic of mesothelioma to just --
HARDY:-- Lie back like that --
FRIDBERG: -- and not do anything.
HARDY: That's great news for me.
FRIEDBERG: It is -- controls --
HARDY: You know, my family's anxiously waiting for what kind of results did you get today? So I'll relay that to them.
FRIDBERG: All good news.
HARDY: It's worth a trip down in that traffic. (Fridberg laughs)
RUDOLPH: Unfortunately, Don Hardy's case is an exception. The majority of people who've undergone experimental mesothelioma treatments at the University of Pennsylvania have died. But Don Hardy has beaten the odds, surviving more than 3 years longer than most people diagnosed with the disease. No one can say, however, if a treatment will be discovered in time to save other workers already exposed to high levels of asbestos, and facing the threat of mesothelioma in the coming decades. For Living on Earth, this is John Rudolph.
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