Perhaps one of the most interesting presentations at the recent Asbestos Awareness Day Conference in Detroit, at least to me, was that of Rebecca J. W. Cline, PhD, a senior scientist in Communication and Behavioral Oncology for the Karmanos Cancer Institute and Associate Professor of Family Medicine at Wayne State University.

Dr. Cline recently conducted a community-based focus group investigation in Libby, Montana, on psychosocial issues related to vermiculite/asbestos exposure. She also is currently leading a related population-based survey investigating that community.

She describes asbestos related disease as a “slow-motion technological disaster,” in which community and social responses have a great deal to do with how people fare, mentally and socially.

The basic definition of a technological disaster is a “catastrophic event caused by humans that results in the toxic contamination of the environment.” This includes asbestos contamination, as in Libby, resulting from decades of vermiculite mining, hence “slow moving,” as well as things like oil spills, which can devastate an area fairly quickly.

Libby is the epicenter of what Dr. Cline calls “the worst environmental disaster in the United States,” with multiple generations affected. She examined in particular how stigma associated with asbestos disease can have an impact on what people do.

Dr. Cline said there are two possible responses to technological disaster – the emergence of an altruistic community, or a community in conflict. The latter, she said, is common where there is human culpability, and it was the result in Libby.

The Libby study, conducted in 2006, included focus groups and some individual interviews with adults who lived and worked in the Libby area for at least the past five years. Interview subjects included people with connections to the mine, people with no connections to the mine, people affected by asbestos disease personally, people with family affected by the disease, and people with no disease in family or person.

She found that people fell into three categories – early believers, those who immediately understood the connection of vermiculite to what was happening to the town; late believers, those who initially resisted the idea that the mine made people sick; and those in denial or conflicted, who still did not or would not believe the mine was responsible.

Dr. Cline found that there was a great deal of stigma attached to asbestos-related disease, which created a barrier to social support. People with mesothelioma or other asbestos-related diseases were often afraid to talk about it, she said, even to close friends.

She said that the stigma came from a variety of sources. Conflicts included concerns about the economic disaster that the loss of the mine signified for the town, for which it was the main industry and source of jobs and security. People feared that if the mine were blamed for illness and deaths in the community there would be a decline in property values, loss of jobs, and a lost way of life.

As a part or a result of that, conflict also grew from a concern about what was the truth. There was a suspicion among neighbors that people claiming illnesses were phony, money-grubbing, greedy or opportunistic, making up illnesses to get a part of a financial settlement from the mining company.

People suffering from asbestos disease personally or within their family were afraid to talk about it out of fear that they would be ostracized and shunned by their neighbors and their community.

Dr. Cline told the story of two women, best friends for years, who bumped into each other in the Center for Asbestos Related Disease, which had been established in Libby to test, diagnose and treat patients. “What are you doing here?” one whispered. “I have the asbestos,” the other whispered back. “Me too,” came the whispered response. Best friends, but afraid at the core to admit to having asbestos disease.

On top of this, people who are ill or whose family members are ill fear the health and medical disaster itself, which was already upon them. They said they felt a lack of hope for survival, not just for themselves or their immediate family, but for generations.

Some of those in denial, or conflicted, still refuse to be tested for asbestos disease. They don’t want to know, Dr. Cline says, or they do not believe the mine could harm them.

There appears to be one universal in Libby.

“Across the groups, people felt like the community as a whole had been stigmatized, that everyone ‘knew about Libby’ and it had been given a bad reputation,” Dr. Cline said.

In addition to the physical toll, the mental toll of asbestos disease in Libby has been incalculable, she said.

SOURCE: myMeso › The mental toll of mesothelioma

News24.com reported, in a story compiled by the South African Press Association, that trade union Solidarity expressed its support for the ban, and called on the government to also amend its asbestos dumping requirements or find alternative options.

The union also said that South Africa “could have followed the example of the rest of the western world and enforced this prohibition years ago,” according to the news story.

A related story published by TransWorldNews on Monday, April 7, stated that “in newly published documents by the Department of Environmental Affairs and Tourism [in South Africa], specific regulations have been introduced upon the use, manufacturing, import, and export of asbestos and asbestos containing materials.”

The report says that while some asbestos containing products, such as existing concrete shingles and ceilings, will not be immediately eradicated, the regulations call for the “phasing out” of such materials.

While the move toward this asbestos ban in South Africa is a positive step, it may be too little too late, according to Robert Jones, an environmental researcher with Rhodes University, who recently completed a study of several areas closest to now-closed asbestos mining sites in South Africa. Jones was a speaker at the recent Asbestos Awareness Day Conference in Detroit, Mich.

“South Africa is blessed with mineral resources – gold, diamonds, platinum,” he said. “And also cursed with mineral resources – asbestos.”

Between 1893-2001, South Africa mined all three types of commercial asbestos and was among the world’s leaders in asbestos mining and use.

Jones surveyed several communities within 2-5 km of the country’s largest asbestos mining sites, encompassing an area of approximately 7,000 square kilometers at each site. Assessment teams were made up of local people in the affected communities, and they targeted areas most suspect for contamination. Teams physically sampled soil and building materials from the locations.

While acknowledging that samples all came from high-risk areas where contamination was expected, the results were still staggering.

75-85% of homes surveyed are contaminated.

47-59% of schools are contaminated

53% of roads are contaminated

In many cases, the soil is blue with visible asbestos dust and clumps of asbestos fibers and minerals. Sports fields and schools are built on contaminated ground, and people build homes with mud bricks made from asbestos-contaminated soil. Some of the population has 24/7 exposure to contaminated soil. The ground is dry, and homeowners sweep bare ground into clouds of dust.

Jones likens the potential future of some of these areas of South Africa to “Libby (Montana) times forty.”

SOURCE: myMeso › South Africa is ‘Libby x 40′

The article starts from the viewpoint of economics, exploring the rising costs of asbestos insurance claims, but goes on to talk with several people who were featured speakers at the recent Asbestos Awareness Day Conference, held in Detroit, touching on the human issue and the projected cost in human life.

There is some valuable statistical information in this article.

Take a look – it’s worth reading!

It’s a real shame that the issue of asbestos awareness doesn’t seem to be getting much attention in the media outside of Michigan, where the conference was held. I’d like to see some national news outlets pick up on this!

SOURCE: myMeso › Excellent story on asbestos cost, impact

SOURCE: myMeso › Canada blocks asbestos ban

The conference was held at the Barbara Ann Karmanos Cancer Institute, which is the location of the National Center for Vermiculite and Asbestos-Related Cancers, co-directed by Dr. Michael Harbut and Dr. John Ruckdeschel, both of whom spoke at the ADAO conference.

While it might seem obvious, Dr. Harbut said, a key to diagnosing and treating asbestos disease is an emphasis on a medical approach.

Dr. Harbut explained that the Karmanos program “approaches asbestos disease from a purely medical standpoint, which includes taking into account any risk factors, employing state-of-the-art scanning equipment and a multidisciplinary, research-driven approach to early detection and treatment. This includes consideration of non-mailgnant or sub-clinical asbestos disease.

“Diseases that are ‘not hurting you yet,’” he said.

Focus areas at the National Center for Vermiculite and Asbestos-Related Cancers include the establishment of a schema for high resolution CT (HRCT) classification, measurement of pleural plaque volume, examination of psycho-social aspects of asbestos disease, testing new treatments including osteopontin and SMRP, and compiling a comprehensive database of disease, diagnosis and treatment.

The Center encourages anyone at risk from asbestos exposure to seek testing for early detection.

Dr. Ruckdeschel said barriers to successful asbestos disease treatment include a sense of nihilism in the medical community, the idea of giving up on the patient when mesothelioma is diagnosed due to its traditionally high mortality rate. There is a sense of providing only “quick fix” supportive care, he said.

Other challenges include a lack of treatment centers with a documented track record, lack of large standardized treatment trials, and a paucity of research investment, Dr. Ruckdeschel said.

The Center predicts an epidemic of vermiculite and asbestos-related cancers in the near future, as the latency period of asbestos disease exposure is reached, and as asbestos exposure spreads around the world, particularly in third-world countries.

“One life lost to asbestos disease is tragic. Hundreds of thousands of lives lost is unconscionable,” Dr. Ruckdeschel said.

For more information, visit the Karmanos Cancer Institute online or call 1-800-KARMANOS.

SOURCE: myMeso › Karmanos tackles looming asbestos epidemic

Following is a story that appeared in the Detroit Free Press about the remembrance service, and the mission of asbestos awareness. I will post some stories and images from the conference this week, but I wanted to share this excellent report.

By Amber Hunt, Free Press Staff Writer

For Andrew Manuel, it began with back pain.

But the seemingly benign symptom turned out to be something far more sinister, and within two years, the married father of three shed 65 pounds, underwent surgery to have a lung removed and endured chemotherapy and radiation to no avail.

At 42, he was dead. The killer: mesothelioma, a cancer linked to asbestos.

“When I heard the diagnosis, I said, ‘Meso-what?’ ” said Manuel’s wife, Latanyta Manuel, 45, on Sunday. “All I heard was ‘lung cancer,’ and I said, ‘No, that’s not possible.’ My husband never smoked or drank, but they said this cancer is about asbestos.”

On Sunday, a group of people affected by the deadly disease, which they refer to as “meso” for simplicity’s sake, gathered at the Marriott in downtown Detroit’s Renaissance Center for a remembrance brunch.

The event was sponsored by California-based Asbestos Disease Awareness Organization and the Karmanos Cancer Institute in Michigan.

Some, such as Manuel, had lost loved ones. Others have been diagnosed with the deadly disease themselves.

They gather annually, they said, to support each other and to spread the word about asbestos-related diseases, including lung cancer and asbestosis.

Asbestos is a fiber that for decades was routinely used for fireproofing and insulation.

While the U.S. government has limited its use, asbestos still can be found in many products, including some stuccos, vinyl flooring and even theater curtains, according to the Asbestos Resource Center.

“Asbestos is still being imported. It’s still being put in products,” said Michelle Zigielbaum, whose husband, Paul, has been diagnosed with peritoneal mesothelioma.

By the time he was diagnosed, his stomach was so full of fluid and tumors that “I looked like a pregnant woman,” Paul Zigielbaum said.

The Asbestos Disease Awareness Organization recently conducted a study that tested 250 products off store shelves for asbestos content. A first lab found that 18 of the products contained asbestos.

A second lab confirmed that eight of the products had asbestos, while a third confirmed that five products — including a child’s toy — contained asbestos.

Those gathered Sunday said they and their loved ones got sick in different ways.

Andrew Manuel’s father worked in a pipeline, bringing asbestos back into the home. Paul Zigielbaum said he believes he was exposed secondhand, too, but said he also believes that contact with everyday products contributed.

All blamed aggressive asbestos lobbyists as the reason the United States hasn’t banned the substance altogether.

“It’s disturbing to see how companies and politicians try to cover it up,” said Dwayne Manuel, Andrew Manuel’s 26-year-old son. “This is a preventable disease.”

Latanyta Manuel said she just wants to honor her husband’s wishes and spread awareness about the disease.

“Once it erupts, it just kind of takes over,” she said. “People need to know.”

Contact AMBER HUNT at 586-826-7267 or alhunt@freepress.com.

SOURCE: myMeso › Conference educates about asbestos