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December 19, 2018

Asbestos revealed as Canada’s top cause of workplace death

Asbestos exposure is the single largest on-the-job killer in Canada, accounting for more than a third of total workplace death claims approved last year and nearly a third since 1996, new national data obtained by The Globe and Mail show. The 368 death claims last year alone represent a higher number than fatalities from highway accidents, fires and chemical exposures combined.

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Since 1996, almost 5,000 approved death claims stem from asbestos exposure, making it by far the top source of workplace death in Canada.

The numbers come as the federal government – long a supporter of the asbestos industry – continues to allow the import of asbestos-containing products such as pipes and brake pads. A Globe and Mail investigation earlier this year detailed how Ottawa has failed to caution its citizens about the impact that even low levels of asbestos can have on human health. Canada’s government does not clearly state that all forms of asbestos are known human carcinogens. Dozens of other countries including Australia, Britain, Japan and Sweden have banned asbestos.

Canada was one of the world’s largest exporters of asbestos for decades, until 2011, when the last mine in Quebec closed. The mineral’s legacy remains, as it was widely used in everything from attic insulation to modelling clay in schools and car parts and in a variety of construction materials such as cement, tiles and shingles. Health experts warn long latency periods mean deaths from asbestos will climb further.

“The indications are that we can expect an increase [in asbestos-related diseases] to continue for at least another decade or so. And that’s assuming we as a nation ban it now. If we don’t do that, we can expect it to continue to rise indefinitely, but perhaps at a lower rate,” said Colin Soskolne, an Edmonton-based professor emeritus at the University of Alberta.

In Australia, which banned asbestos in 2003, asbestos-related diseases continue to climb. The “responsible public-health action would be to ban the use of asbestos in Canada and other countries and replace it with substitutes,” said Dr. Soskolne, who is also chair of the International Joint Policy Committee of the Societies of Epidemiology, adding that there is “no demonstrated safe way to use it in Canada.”

Asbestos-related diseases have a long latency period of typically 20 to 40 years. Many victims die of mesothelioma, an aggressive form of cancer caused almost exclusively by exposure to asbestos, and asbestosis, a fibrosis of the lungs.

The data come from the Association of Workers’ Compensation Boards of Canada and is typically updated every fall. For 2013, the most recent year for which annual data are available, it shows the single greatest cause of death was mesothelioma, with 193 fatalities. Asbestosis was a factor in 82 deaths.

“There’s some misconception that we banned it – and we haven’t,” said Jim Brophy, former director of the Occupational Health Clinic for Ontario Workers in both Windsor and Sarnia. Canada now has “an enormous public-health tragedy, disaster on our hands.”

All commercial forms of asbestos including chrysotile, the type formerly mined and most commonly used in Canada, are classified as carcinogenic by the International Agency for Research on Cancer. Its evidence shows there is no “safe” form of asbestos nor a threshold that it considers safe.

The agency’s position is at odds with Health Canada, whose website continues to play down the risks of asbestos exposure. It never clearly states that all forms of asbestos cause cancer, but rather that chrysotile asbestos is “less potent” than other forms and that there “is no significant health risk” if the fibres are enclosed or tightly bound.

“Asbestos poses potential health risks only when fibres are present in the air people breathe,” Health Canada says. The problem is there’s no way of ensuring that all products are always bound or enclosed. Brake pads wear down; renos stir up dust while pipes and tiles get sawed.

Britain’s national regulator for workplace health and safety informs its citizens that asbestos causes about 5,000 deaths per year – but there is no comparable information on Health Canada’s site. Health Canada told The Globe and Mail it has no plans to update its website, last revised in 2012.

And while the World Health Organization bluntly says “all types of asbestos cause lung cancer, mesothelioma, cancer of the larynx and ovary, and asbestosis,” Health Canada still says asbestos fibres “can potentially” cause asbestosis, mesothelioma and lung cancer “when inhaled in significant quantities.” The potential link between exposure to asbestos and other types of cancers “is less clear,” it adds.

The workers’ compensation numbers don’t fully capture the total number of fatalities in Canada as not everyone is covered by workers’ comp and not every claim is successful. Separate Statistics Canada data show almost 4,000 people died of mesothelioma alone in the decade to 2011.

Heidi von Palleske says the numbers also don’t capture wives and children who have been affected. She calls herself an asbestos orphan – her father died in 2007, with asbestosis and lung and prostate cancer. He was a former worker at a plant run by Johns Manville, which made asbestos-fibre products. Her mother, who shook out and washed her husband’s clothes for years, died of mesothelioma in 2011 and Ms. von Palleske’s sister and brother have since been diagnosed with pleural plaque (a calcification of the lungs).

“It’s inexcusable,” said Ms. von Palleske. She wants to see a ban and better supports for families affected by workplace exposure.

Miners were among the first to be affected, but the range of occupations with workers exposed has expanded in recent decades.

About 152,000 workers in Canada are currently exposed to asbestos, according to Carex Canada, a research project funded by the Canadian Partnership Against Cancer. The five largest groups are specialty-trade contractors, building construction, auto repairs and maintenance, ship and boat building and remediation and waste management.

Number of workplace fatalities in Canada

From approved workers’ compensation claims, 1996-2013

  • Asbestos
  • Other causes of workplace death

THE GLOBE AND MAIL

»

SOURCE:

AWCBC

Year,1,2,3,4,5,6,7,8,9,10
'96,43,46,13,54,19,21,50,25,11,69
'97,128,79,25,7,30,19,34,35,21,43
'98,121,65,24,28,29,23,20,17,12,31
'99,173,28,30,16,21,23,19,17,17,17
'00,151,31,28,59,25,23,30,21,19,19
'01,186,31,35,37,30,32,25,14,18,22
'02,226,21,32,38,24,35,17,24,24,23
'03,259,27,32,42,33,30,22,27,22,13
'04,286,34,37,8,38,26,19,30,20,7
'05,344,37,28,52,26,32,14,30,18,11
'06,306,22,38,36,34,29,19,25,16,7
'07,335,36,29,57,29,22,17,26,21,11
'08,349,28,39,4,25,26,20,24,21,13
'09,392,14,25,18,18,13,23,16,21,6
'10,407,27,31,10,14,21,23,25,23,3
'11,378,30,27,5,7,27,24,20,22,7
'12,407,51,30,15,22,20,31,16,19,8
'13,368,32,19,9,21,12,20,22,20,8

Credit – 

Asbestos revealed as Canada’s top cause of workplace death

Rust-Oleum Maker to Pay $797.5 Million to Asbestos Trust

RPM International Inc. (RPM), the maker of
Rust-Oleum and other specialty paints, agreed to pay $797.5
million to settle asbestos-related claims faced by its bankrupt
Bondex and Specialty Products units, less than the $1.17 billion
a judge said they may have owed.

The money will be paid over four years into a trust to
benefit personal-injury claimants, the Medina, Ohio-based
holding company
said today in a statement. Related documents
weren’t immediately posted with U.S. Bankruptcy Court in
Wilmington, Delaware.

Companies used asbestos in insulation and fireproofing
materials. It can reach deep into a victim’s lungs and may cause
cancer and other diseases. Bankrupt companies are able to win
immunity from future asbestos lawsuits by setting up trusts to
cover asbestos-related costs.

The settlement would be part of a reorganization plan for
Bondex and Specialty Products. The settlement and the plan must
be approved by the federal judge overseeing the bankruptcy.

The units sought court protection from creditors in May
2010, estimating asbestos liabilities of less than $400 million
at the time from more than 10,000 lawsuits. Three years later,
U.S. Bankruptcy Judge Judith K. Fitzgerald said claims from
current and future victims of asbestos poisoning may reach $1.17
billion.

“We have been able to reach a settlement on acceptable
terms,” Frank Sullivan, RPM’s chairman and chief executive
officer, said in the statement.

Natalie Ramsey, an attorney for asbestos victims, confirmed
that they had reached an agreement in principle with the
company.

The bankruptcy case is In re Specialty Products Holdings
Corp., 10-bk-11780, U.S. Bankruptcy Court, District of Delaware
(Wilmington).

To contact the reporters on this story:
Phil Milford in Wilmington, Delaware at
pmilford@bloomberg.net;
Steven Church in Wilmington, Delaware at
schurch3@bloomberg.net

To contact the editors responsible for this story:
Andrew Dunn at
adunn8@bloomberg.net;
Michael Hytha at
mhytha@bloomberg.net
Joe Schneider

Read this article:  

Rust-Oleum Maker to Pay $797.5 Million to Asbestos Trust

Pipes with asbestos still used in new buildings

Pipes containing asbestos are being installed in new condominiums, hospitals and high-rises in Canada, despite widespread health concerns that have led many countries to ban its use.

The new installations come as cities across the country are spending millions of dollars to manage and remove asbestos materials from public buildings such as schools, community centres, courts and medical facilities.

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Unlike most other developed countries, Canada has never banned the use of asbestos and continues to import and export asbestos-containing materials, such as pipes and tiles, The Globe and Mail has reported.

Asbestos-cement pipes are allowed in both Canada and the United States, though there are regulations about how to cut and dispose of them. It is unclear how many asbestos-cement pipes are being installed in Toronto and other cities, and there appear to be no central records of where asbestos is being used. Once the products are imported into Canada, it’s difficult to pinpoint where it actually gets sold. A key concern is that many workers, tenants and owners may not know asbestos materials are in their buildings, raising the risk of accidental exposures particularly in the event of a fire, or as the materials start to deteriorate.

The World Health Organization has declared all forms of asbestos carcinogenic and recommends its use be eliminated. In Canada, asbestos has become the top on-the-job killer, causing diseases such as mesothelioma and asbestosis. Evidence has found even low levels of exposure raise the risk of cancer.

The distributor of some of the pipes is Portneuf, Que.-based Tuyaux Logard Inc., whose owner said Toronto is a key market for the company.

All of Logard’s pipes contain asbestos. They are imported from other countries including Mexico, while Logard cuts and distributes them to contractors in Canada. The company, which employs about 25 people, wouldn’t disclose its revenue or volumes imported for competitive reasons. But Statistics Canada trade data show Canada imported about $2.2-million in asbestos-containing pipes, tiles, sheets, panels and tubes from 2010 to 2013.

Logard also supplies contractors through Ontario and Quebec, and on occasion, the Maritimes, the company’s owner Louis Beauregard says.

Another recent customer was the McGill University Health Centre, he said, a billion-dollar-plus, Montreal mega-hospital which was built by SNC-Lavalin. SNC-Lavalin said in an e-mail the pipes are used in stormwater drainage and noted the only risk with this type of pipe is “when it is being cut upon installation,” a risk that is regulated by the province . “There are no risks associated with this type of piping once installation is completed,” the company said.

Logard is not the only supplier of asbestos-cement pipes in Ontario. Brampton-based Crowle Fittings and Supplies distributes them through the Greater Toronto Area as well (imported from Mexico) and says a “good majority” of the high-rise buildings going up in Toronto are using them, in parking garages or running up to the roof.

Some provinces have boosted restrictions on asbestos, which has curtailed use. In British Columbia, “tightened current regulations have generally stopped the current use of asbestos-cement pipes,” said Al Johnson, vice-president of prevention services at WorkSafeBC. The issue of safe use has surfaced at Ontario’s Ministry of Labour. The ministry said in an e-mail that it has encountered cases of employers or contractors who are not following the rules, noting that in those cases a provincial inspector can stop the job. “It is always a concern for the Ministry of Labour when asbestos is being installed or removed in a workplace,” the ministry said.

The Globe and Mail visited a dozen construction sites in Toronto, Markham and Vaughan, from luxury condos to commercial offices. Asbestos-cement pipes were being installed in at least eight of the sites, principally for drainage. The pipes were stamped with the word “asbestos” on them.

The concern, people in the industry say, is that proper procedures are not always followed and that the fibres could become airborne, endangering both workers on the site and future occupants in buildings.

Tom Kelly, president of Inscan Kaefer Inc., an insulation and asbestos abatement company, says it’s incongruous he’s being asked to remove precisely the same types of pipes that are now being newly installed.

“The regulations are largely geared to removing it,” Mr. Kelly said. “We weren’t anticipating that new piles of this stuff would be installed.”

Mr. Kelly is concerned that a lack of awareness among workers will lead to inadvertent exposures during installations. He also has specific concerns: that the improper use of a handsaw or power saw could generate dust; that, even if a site is wet, fibres could become airborne as it dries; that waste or cut-off pieces of pipe are not being disposed of properly; and that workers may be cutting and working with parts of pipes that don’t have the asbestos stamp on them.

Follow on Twitter: @taviagrant

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Pipes with asbestos still used in new buildings

Your asbestos-related questions answered

The Globe’s weekend piece about asbestos and the dangers of exposure generated many letters, e-mails, phone calls and online comments. Some readers shared stories of losing family members to asbestos-related diseases, having difficulty navigating the workers’ compensation system and being exposed to asbestos in their own workplaces and homes.


No safe use: The Canadian asbestos epidemic that Ottawa is ignoring

Canada’s embrace of the “miracle mineral” has seeded an epidemic of cancers. Yet many Canadians are still exposed to asbestos every day. Don’t look to Ottawa for help — it’s still defending an industry that, like its victims, is wasting away. Read the full story, then share your thoughts in the comments.

More Related to this Story

Other readers had questions. Here are some answers.

I have a family member who has an asbestos-related disease. Where can I go for more information and advice?

Mesothelioma is the leading cause of work-related deaths in Canada, as measured by accepted workers’ comp claims. Yet relatively little is known about this form of cancer, which has sometimes been misdiagnosed as lung cancer. For those seeking to know more, visit the Canadian Mesothelioma Foundation website. It’s important to know there are new treatment options that can prolong peoples’ lives.

Other illnesses from asbestos exposure include other types of cancer such as lung cancer, along with asbestosis. More information can be found at the Asbestos Disease Awareness Organization, an advocacy and education group which is based in the U.S., but also works in Canada.

In Canada, Princess Margaret Cancer Care offers an early detection program and has a new treatment that extends the lives of mesothelioma patients.

More reading material can be found in the links at the end of this story.

I’m worried I may have been exposed in past years. What can I do?

It’s important to know the World Health Organization and other medical experts say there is no safe level or threshold, so even shorter-term exposure to can raise the risk of getting sick. And the odds also increase, exponentially, if someone is also a smoker – so one of the best things one can do to reduce risk is stop smoking.

But there’s also important context – many people have been exposed and never gotten sick. Mesothelioma cases – while rising – are still relatively rare with nowhere near the number of cases as, say, breast cancer. Some workers have toiled for years in clouds of asbestos dust, and haven’t gotten sick. It seems hard to predict who gets affected and who doesn’t.

If people are showing no symptoms, they can stick with their routine annual checkup with their family doctor.  Those who are higher risk — such as people who have pleural plaque or with known past asbestos exposure — could consider screening programs (Princess Margaret runs one).

If symptoms appear, such as shortness of breath, coughs or pain in the chest wall, patients should be seen by a doctor, who may refer them to a thoracic surgeon.

I’d thought Canada had long banned asbestos products. Is it true they’re still being used?

Asbestos was an ingredient in thousands of products in previous decades, from modelling clay to insulation.

Canada now has stricter regulations about asbestos use than in years past – but this country never banned imports or exports. Asbestos has long been used in building materials such as roof shingles, floor tiles, insulation and textured coating on ceilings. To see more examples of where it might be in the home, check out WorkSafeBC’s photos and this week’s Globe Now video.

Asbestos products continue to flow into Canada, in the form of pipes and tiles, replacement brake pads and linings, friction materials, fibre jointing and even clothing (typically used in protective gear such as firefighters’ suits).  A sample list of suspected asbestos-containing materials can be found here and here (these are U.S. sites) as well as here (a U.K. site). An Ontario list can be found here.

(We couldn’t find a full list of brand names of products that contain asbestos, but some lawyers who represent victims with mesothelioma do have catalogues).

How prevalent is asbestos in our homes, schools, hospitals and work spaces?

Short answer – we don’t know. We do know it was a common building material in Canada and in many developed nations right up until the 1990s (and in some cases, is still being used), so construction workers, contractors and do-it-yourself renovators should get materials tested by a reputable, independent lab and taking proper precautions. WorkSafeBC has advice for workers and homeowners on its site.

Saskatchewan is getting a better grasp of the presence of asbestos. The province has established a mandatory registry to alert staff and workers of where asbestos exists in public buildings. 

How can I get compensation if I have an asbestos-related disease stemming from workplace exposure?

Workers’ comp is a government-run system of no-fault compensation in Canada (where workers, in turn, give up their right to sue their employer for an injury).  Each province has its own system, such as this in Ontario and this in Alberta. Each site has information for workers looking to make a claim. An overview of workers’ comp in Canada can be found here. As our weekend story explained, the workers comp data does not give a complete picture because claims are often not filed or are unsuccessful.

All the provinces and territories (except Quebec) have a free worker advisor service to help people navigate the system. Contact information for these services (including Office of the Worker Adviser) is available here. Many workers will also be able to get help from their unions.

In some provinces, there are legal clinics which may handle workers’ compensation. In Ontario, for example, the two main ones are Injured Workers’ Consultants and Industrial Accident Victims’ Group of Ontario. There are also private bar lawyers and paralegals who represent the victims and families on a fee-for-service basis.

Is the Globe planning more coverage of Canada’s asbestos issue?

Yes. We’re looking at how asbestos products are currently being used and other follow-up ideas over the coming weeks and months. Suggestions and feedback welcome: tgrant@globeandmail.com

Follow on Twitter: @taviagrant

Jump to original – 

Your asbestos-related questions answered

Government silent as questions mount about asbestos danger

The federal Conservative government is refusing to join the rest of the developed world in declaring that there are no safe uses for asbestos, even though the material is the top workplace killer in Canada and deaths from exposure are expected to rise.

While such countries as Australia, Japan, Sweden and Britain have imposed a ban on the flame-retardant mineral once widely employed in construction and still used in other applications including brake pads, Canada continues to allow asbestos to be both imported and exported.


No safe use: The Canadian asbestos epidemic that Ottawa is ignoring

Canada’s embrace of the “miracle mineral” has seeded an epidemic of cancers. Yet many Canadians are still exposed to asbestos every day. Don’t look to Ottawa for help — it’s still defending an industry that, like its victims, is wasting away. Read the full story, then share your thoughts in the comments.

More Related to this Story

The government would not respond directly on Tuesday to a question from the opposition about why the policy has not changed despite overwhelming evidence of the health risks.

A Globe and Mail report on Saturday said the federal government has dragged its feet in protecting this country’s citizens from asbestos’s deadly effects, and that more than 1,200 successful claims for fatality benefits were made in Canada between 2007 and 2012.

Health Canada’s website plays down the causal relationship between asbestos and some types of cancer, while asserting that it is a problem only when its fibres become airborne and “significant quantities” are inhaled.

Pat Martin, a New Democrat MP who worked in asbestos mines when he was young and has been campaigning to have the substance banned in Canada since he was elected 17 years ago, demanded to know why the government is not wavering from its position.

Mr. Martin rose during the daily Question Period in the House of Commons to ask how Labour Minister Kellie Leitch, a medical doctor who has received many letters from people who have lost family members to asbestos-related diseases, could “in all good conscience defend her government’s reprehensible policy on asbestos?”

Ms. Leitch did not respond.

In her place, Natural Resources Minister Greg Rickford told the House that the government will not oppose the listing of chrysotile under the Rotterdam Convention, a United Nations-sponsored treaty that requires the exporters of hazardous substances to disclose the risks.

Between 2006 and 2011, Canada was the only developed nation to object to bringing asbestos under the control of that agreement. It withdrew that objection in 2012, a year after both of Quebec’s asbestos mines were shut down.

Mr. Rickford went on to say the government’s 2013 action plan supports the economic diversification efforts of the Quebec communities of Thetford Mines and Asbestos where asbestos was mined.

“Resource management is the responsibility of the province,” he said.

Repeated questions about the government’s position that were directed this week to Health Minister Rona Ambrose have gone unanswered. Ms. Ambrose’s spokeswoman said Mr. Rickford’s reply to Mr. Martin in the House of Commons was all the government had to say about the matter.

Last month, Health Canada told The Globe in an e-mail that the information on its website “remains accurate,” and that the government has “consistently acted to protect Canadians from the health risks of asbestos.”

Mr. Martin said he was heartened by the interest in the issue that has been fostered by the newspaper’s investigation, and he believes the government is leaving itself vulnerable to criticism, both foreign and domestic, by refusing to alter its stance.

“They are increasingly marginalized among the international trading partners and they are sort of the last man standing in terms of developed nations still supporting and advocating asbestos,” Mr. Martin said. “At least we have guilted them into not actively sabotaging the Rotterdam Convention, which sadly can be seen as great progress.”

With a report from Tavia Grant

Follow on Twitter: @glorgal

Link to article:

Government silent as questions mount about asbestos danger

Assembly passes asbestos lawsuits bill

MADISON, Wis. (AP) – A bill opponents say would deny justice to people exposed to asbestos has passed the Wisconsin Assembly.

Veterans are among the most vocal opponents of the measure passed on a party line 55-38 vote Thursday. The bill now heads to Gov. Scott Walker.

The heavily lobbied proposal would require plaintiffs who have suffered from asbestos exposure to reveal how many businesses their attorneys plan to sue. They would also have to go after money from an asbestos trust before they could sue for more in court.

Proponents argue it is needed to prevent filing multiple claims against both trust funds set up to pay victims of asbestos exposure as well as individual businesses.

Democrats argue the changes would make it more difficult for people harmed by asbestos to collect damages.

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

See more here: 

Assembly passes asbestos lawsuits bill

Willow Grove businessman charged with illegal asbestos removal

David Mermelstein, 53, of Elkins Park, was indicted Aug. 27 following a grand jury investigation on five counts of illegal removal of asbestos, according to the U.S. Attorney’s Office in Philadelphia.

In April 2001, Mermelstein, who owns a business in Willow Grove, purchased a large, old furniture warehouse in Northeast Philadelphia, which he operated under the name of Red, White and Black Furniture, at 10175 Northeast Ave., according to the indictment. Insulated pipes that ran throughout the building were covered with insulation made of or containing asbestos, it says.

The indictment alleges that from September 2009 through April, 2010, after learning the cost of proper asbestos removal, Mermelstein hired day laborers instead of licensed asbestos contractors to remove asbestos from the commercial property. Mermelstein directed the removal of asbestos by these laborers without telling them they were removing asbestos and without proper safety equipment and “in a manner that did not comply with asbestos work practice standards” required by federal law, the indictment says.

If convicted, Mermelstein faces a maximum possible sentence of 25 years imprisonment and a fine of $1.25 million.

The case was investigated by the Environmental Protection Agency and the City of Philadelphia’s Air Management Services. It is being prosecuted by Assistant U.S. Attorney Virgil B. Walker and Special Assistant U.S. Attorney Patricia Miller.

David Mermelstein, 53, of Elkins Park, was indicted Aug. 27 following a grand jury investigation on five counts of illegal removal of asbestos, according to the U.S. Attorney’s Office in Philadelphia.

In April 2001, Mermelstein, who owns a business in Willow Grove, purchased a large, old furniture warehouse in Northeast Philadelphia, which he operated under the name of Red, White and Black Furniture, at 10175 Northeast Ave., according to the indictment. Insulated pipes that ran throughout the building were covered with insulation made of or containing asbestos, it says.

The indictment alleges that from September 2009 through April, 2010, after learning the cost of proper asbestos removal, Mermelstein hired day laborers instead of licensed asbestos contractors to remove asbestos from the commercial property. Mermelstein directed the removal of asbestos by these laborers without telling them they were removing asbestos and without proper safety equipment and “in a manner that did not comply with asbestos work practice standards” required by federal law, the indictment says.

If convicted, Mermelstein faces a maximum possible sentence of 25 years imprisonment and a fine of $1.25 million.

The case was investigated by the Environmental Protection Agency and the City of Philadelphia’s Air Management Services. It is being prosecuted by Assistant U.S. Attorney Virgil B. Walker and Special Assistant U.S. Attorney Patricia Miller.

View original article:

Willow Grove businessman charged with illegal asbestos removal

Asbestos exposure, asbestosis, and smoking combined greatly increase lung cancer risk

Apr. 12, 2013 — The chances of developing lung cancer associated with asbestos exposure, asbestosis and smoking are dramatically increased when these three risk factors are combined, and quitting smoking significantly reduces the risk of developing lung cancer after long-term asbestos exposure, according to a new study.

“The interactions between asbestos exposure, asbestosis and smoking, and their influence on lung cancer risk are incompletely understood,” said lead author Steven B. Markowitz, MD DrPH, professor of occupational and environmental medicine at the School of Earth & Environmental Sciences at Queens College in New York. “In our study of a large cohort of asbestos-exposed insulators and more than 50,000 non-exposed controls, we found that each individual risk factor was associated with increased risk of developing lung cancer, while the combination of two risk factors further increased the risk and the combination of all three risk factors increased the risk of developing lung cancer almost 37-fold.”

The findings were published online ahead of print publication in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

The study included 2,377 long-term North American insulators and 54,243 male blue collar workers with no history of exposure to asbestos from the Cancer Prevention Study II. Causes of death were determined from the National Death Index.

Among non-smokers, asbestos exposure increased the rate of dying from lung cancer 5.2-fold, while the combination of smoking and asbestos exposure increased the death rate more than 28-fold. Asbestosis increased the risk of developing lung cancer among asbestos-exposed subjects in both smokers and non-smokers, with the death rate from lung cancer increasing 36.8-fold among asbestos-exposed smokers with asbestosis.

Among insulators who quit smoking, lung cancer morality dropped in the 10 years following smoking cessation from 177 deaths per 10,000 among current smokers to 90 per 10,000 among those who quit. Lung cancer rates among insulators who had stopped smoking more than 30 years earlier were similar to those among insulators who had never smoked.

There were a few limitations to the study, including the fact that smoking status and asbestosis were evaluated only once and that some members of the control group could have been exposed to relatively brief periods of asbestos.

“Our study provides strong evidence that asbestos exposure causes lung cancer through multiple mechanisms,” said Dr. Markowitz. “Importantly, we also show that quitting smoking greatly reduces the increased lung cancer risk seen in this population.”

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Asbestos exposure, asbestosis, and smoking combined greatly increase lung cancer risk