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Mesothelioma Lawyer: Known in Europe by about 1900. In the 1920s, asbestosis was described in the medical literature. By then its associated mortality had become so pronounced that the British government ordered an inquiry and in 1930 introduced government safety measures and workman?s compensation. In the 1930s, the first medical reports appeared in the US and the UI< that suggested a link between asbestosis and lung cancer. Because the latter disease was not so prevalent in the 1930s, it was easier for physicians to ?see? the connection. The most sophisticated understanding of the asbestos lung cancer problem developed in Germany and in the UK. Germany made asbestos-related lung cancer a compensable disease in 1943; and although Britain did not follow this lead, data accumulated by the Factory Inspectorate provided compelling evidence by the late 1940s that asbestos could cause lung cancer. By the mid-1950s~when the first epidemiological study of lung cancer in asbestos workers was published? no one could doubt the connection.
By then, the first mesotheliomas amongst asbestos workers had been described. It was such a rare and unusual tumor that the link with asbestos was even easier to see: ?Few [medical] authors ever expressed doubt about the relationship between malignant mesotheliomas and asbestos exposure, and by 1953, the issue seemed to be fairly well resolved. However, mesothelioma excited little interest, because it was still a rare disease. That situation changed dramatically in the late 1950s, when a team of South African pathologists uncovered a mesothelioma ?epidemic? around the asbestos mines in Cape Province. The research, published in 1960, connected asbestos with mesothelioma and also sug?gested that non-occupational (i.e. neighborhood/environmental) exposure might cause the disease. In 1964, a major American study of insulation workers gave worldwide publicity to the dangers of asbestos and the widespread nature of the risk.
The development of ARDs can best be viewed as a series of waves: 1930s (asbestosis); 1940s (asbestos-related lung cancer); and 1960s (mesothelioma). Besides the impact on individuals, each wave had a characteristic impact as it rippled through the industrial and socio?political systems in various countries. The impact of the final wave (the result of three ARDs combined) has been the most profound?making the period after 1960 of great significance. Until then, asbestos was virtually unknown to the wider public as a health hazard. But since the 1960s, the incidence of ARDs in many countries has increased dramatically, making the final wave of ARDs a tsunami of occupational and environmental disease. Mesothelioma, in particular, is an increasing problem worldwide. At the start of the twentieth century, the disease was extremely rare, with perhaps an annual incidence of no more than one or two cases per million. However, that incidence has risen to over forty per million in some countries (while in some of the worst-affected regions around shipyards and asbestos factories the incidence can be as much as eighty- five per million). At Prieska, a blue asbestos producing center in South Africa, between 8 per cent and 15 per cent of people born in the 1940s has died (or will die) of mesothelioma.
Mesothelioma has achieved parity with other male cancers and is now roughly as common as cancers of the liver, bone, and bladder, especially in Europe and Australia. The disease is increasingly seen as an epidemic in the developed world and as a legacy of asbestos use that continued far too long. Because of the long incubation period between first expo?sure and the onset of disease, that legacy is only now being realized. It is disturbing that in some developed countries asbestos mortality is yet to peak and for the thousands of individuals with asbestos fibers in their lungs no help can be offered. In these countries, mesotheliomas may continue to appear until at least the middle of the present century. Meanwhile in the developing world, the asbestos problem is only now emerging.
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Mesothelioma Lawyer: Snapshots can be provided from epidemiological surveys and by look?ing at the situation in individual countries. In the US, one study in 2004 claimed that 10,000 Americans die each year of ARDs?a rate approaching thirty deaths per day. Asbestos in the US thus kills thousands more people than skin cancer each year, and nearly the number that are slain with firearms. The epidemic is national in scope, affecting every state. In Canada, the home of supposedly ?safe? white asbestos, 343 persons died from mesothelioma in 2003?a 17 per cent increase from only four years previously. In the UK, about 4,000 individuals die each year from asbestos?more than ten times the number of workers killed in industrial accidents. In Britain, the number of mesotheliomas has increased 40 per cent in the last eight years (to 2,037 in 2005). But this percentage rise is not unusual in industrialized countries. Every day in France, accidents kill on average two people, while asbestos kills eight. Japan?s mesothelioma rate has almost doubled: from about 500 in 1995 to 953 in 2004. Australia (which has the highest reported incidence of mesothelioma in the world) saw the disease jump 60 per cent between 1995 and 2003 (to about 700 cases). But Germany, with about 900 cases in 2004 also saw a rise of 80 per cent since the mid-1990s.
No one knows the final global death toll, but the International Labor Organization (ILO) and the World Health Organization (WHO) have recently stated that asbestos kills at least 90,000 workers worldwide each year at present. According to one report, the asbestos cancer epidemic could take at least five million (and possibly as many as ten million) lives before asbestos is banned worldwide and exposures cease. Of course, one might argue that the chances of anyone contracting an ARD?especially a person born today?are slight. It is also true that other threats to health are equally, if not more, pressing: for example, HIV has already killed some twenty-five million, and tobacco kills nearly five million each year. On the other hand, no other industrial agent?not lead, not benzene, not vinyl-chloride, not chromium?even approaches the burden of disease that asbestos has caused worldwide. Moreover, it is the tragedy of asbestos that so much of this illness and death could?as we shall show?have been avoided.
Not surprisingly, asbestos has been widely discussed and publicized since the 1960s. Following the discovery of the link between asbestos and mesothelioma, the mineral has been the subject of innumerable television and radio broadcasts. At the scientific level, an explosion in medical research has occurred that, according to Pub Med (the National Library of Medicine?s online catalog in the US), has produced over 9,000 pub?lications since 1960 alone?a tally that is certainly an underestimate. Social scientists, journalists, and historians have been busy, too. Absolved the American asbestos companies of conspiracy against the public interest, and placed the blame for litigation on journalists and on opportunistic lawyers. In Britain, the asbestos industry?s apologist has been Peter Bartrip, whose authorized histories of the British and American asbestos industries have depicted the leading companies as blameless and traduced by historians with an aversion to capitalism. In the face of these attempts to revise the consensus, we have felt that the experience of asbestos and the lessons it teaches needed restating.
The opportunity to write a fresh study was facilitated by new documents and the availability of more detailed information. Asbestos had been one of the most inscrutable industries, until the tidal wave of litigation after the 1970s cracked its carapace of secrecy. In the US, legal discovery has been used to dramatic effect, bringing into the public domain a vast quantity of documents that were never intended for public scrutiny. Because the litigation has not stopped?indeed it has increased?the steady flow of incriminating documents has shown no slackening. Shortly after we completed our books, a treasure trove of unpublished asbestos documentation was generously donated to us by an American physician, Dr David Egilman. In addition to this material, much of which we had never seen, we found ourselves reading an endless stream of company correspondence, published government reports, epidemiological studies, think-tank analyses, and new historical articles.
However, the catalyst that pushed us towards writing this book was not new documentation, the industry?s apologists, or gaps in the his?toriography. Instead, it was the need to explain one of the industry?s greatest paradoxes?one of which most people remain unaware. The full extent of this paradox was revealed with the publication of a time-series, which synthesized all the available data on asbestos production (and use) worldwide between 1900 and 2003. This pioneering survey, which was unavailable for our previous work, was compiled by Robert Virta of the US Geological Survey. We examined this windfall with considerable interest, especially Virta?s tabulation of world production data. We did not regard the list of tonnage figures as particularly noteworthy.
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Mesothelioma Lawyer: To be sure, the mineral was associated with serious and debilitating industrial diseases: however, this was never serious enough to threaten the multinational asbestos companies. Society uses dangerous materials whenever the benefits apparently outweigh the risks. However, the publicity about mesothelioma in 1960 should have marked a sea- change. After all, mesothelioma demonstrated that occupational and environmental exposure to even relatively low doses of asbestos could be fatal. In other words, compelling scientific reasons existed for asbestos use to be severely restricted or perhaps even banned. This was particularly so, because during the 1960s and 1970s substitute materials were increasingly available for many asbestos products. Indeed, some have pointed out that many of these substitutes?such as fiberglass?had been available throughout the twentieth century. They did not cause fibrosis of the lungs and were not associated with mesothelioma or lung cancer. In short, one might have expected world asbestos production to decline rapidly after 1960.
What accounts for such a severe dislocation between medical knowl?edge and economic development? This burgeoning use of asbestos after 1960 has not escaped everyone?s attention and Virta comments on it himself. He offers an explanation that is couched entirely in technolog?ical imperatives and medical uncertainties. Virta says that there was a ?lack of knowledge about the risks posed by exposure to high levels of airborne asbestos dust?, and claims that the ?asbestos health issue did not arise until long after asbestos had been used by society for a long period of time?. However, this is hardly convincing and is the kind of apologia that has always been offered by industry or government (or their supporters).
We believe that the reasons for this dislocation must be looked for elsewhere: first, in the history of asbestos before 1960, but particularly in events thereafter when the asbestos industry reacted to mesothelioma. That reaction was not simply dictated by a lack of knowledge or a failure to find adequate substitutes, but was often driven by purely political and commercial considerations. The argument that is advanced in this book is that asbestos has proved so enduring, because the industry was able to mount a successful defense strategy for the mineral?one that still operates in some parts of the world. Central to this strategy was a policy of concealment and, at times, misinformation that often amounted to a conspiracy to continue selling asbestos fiber irrespective of the health risks. We unravel that conspiracy to highlight how the industry censored scientific research; used reputable scientists to elide the health hazards and nurture scientific uncertainty; denied basic compensation (and some?times human rights) to victims; and colluded with governments and scientific bodies.
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Mesothelioma Lawyer: The leading British asbestos manufacturer T&N was founded in 1878 in Rochdale, near Manchester, by Samuel Turner. The company, which had its origins in the Lancashire cotton industry, was much larger than its competitors British Belting & Asbestos and the Cape Asbestos Company. By the 1920s, T&N accounted for nearly half of UK asbestos manufacture and its Rochdale factory was the world?s largest asbestos textile plant. T&N was the only company of comparable size and influence to Johns- Manville and, like its US competitor, T&N relied upon vertical integration to guarantee a supply of cheap fiber. It operated mines in Quebec and southern Africa.
The asbestos industry was too large and diverse to characterize easily. There was more than one type of fiber, and there were several asbestos markets. The longest fibers were used in textiles, woven brake linings, clutch pads, and marine insulation. Shorter fibers were combined with cement to make prefabricated wall panels, corrugated roof sections, and waters pipes or mixed with vinyl and asphalt to manufacture tiles. Asbestos was also a common filler to bolster cements, putties, and paints. Fiber quality was as important as type. Normally, if a pure chrysotile blend was used in cement sheets or pipes, the final product was likely to warp. To overcome that problem, manufacturers used a mixture of crocidolite and chrysotile. That was necessary with all white asbestos except for the fiber from Havelock mine in Swaziland, Cassiar in British Colombia, and from Shabanie and Gaths mines in Southern Rhodesia.
The widespread use of asbestos in commercial, industrial, and domestic settings and the mobility of fiber through the cycles of mining, transport, and manufacture meant that during the second half of the twentieth century almost every citizen in the US or Western Europe was exposed in some way or other to airborne fiber. That is surprising, as the fire-resistant properties of asbestos are not unique, and when the mineral first appeared on the world market in the 1880s, there were already other products which could serve the same purpose. Mineral wool was first manufactured in the 1840s for thermal insulation and rock wool was available before the end of the nineteenth century. In cement manufacture asbestos was merely a reinforcing agent which could have been replaced with any number of substitutes. The major appeal of asbestos to manufacturers lay in its low cost and that in turn derived from the conditions under which it was mined.
The US Industry was structured around the specializations of paper, cement, asbestos magnesia, textiles, and brake linings. That diversity was repeated within each of those five divisions. Asbestos paper, for exam?ple, included all types of paper, millboard, pipe covering, cell pipe, and insulating cement. The bigger companies, such as Johns- Manville, Philip Carey, and Raybestos-Manhattan operated factories that straddled all five divisions. They also made non-asbestos products. Raybestos-Manhattan (later Raymark), for example, was a leading manufacturer of bowling balls. The industry?s diversity was reflected in its workforce and, besides the men and women who worked in factories, large numbers of jobbers, dealers, and contractors came into daily contact with the mineral. Prior to the Second World War, more than 10 per cent of the US asbestos workforce was female and the tendency to pay women less than men was consistent with wider market conventions.
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Mesothelioma Lawyer: The manufacture of asbestos products required heavy machinery for carding, picking, spinning, and mixing and in each phase of the pro?duction process workers faced some risk of traumatic injury. All asbestos manufacture shared another common denominator?high levels of dust. This was a particular problem in asbestos textile plants where raw asbestos was blended manually. It was then disintegrated or beaten by hand to open up the fibers. During carding, asbestos was fed over rotating cylin?ders then transferred to spinning frames, which twisted and spun the fiber into yarn. The looms were poorly ventilated and mill workers were often knee-deep in dust. The fiber was screened on open trays and the residue cleared into settling chambers which were cleaned manually at the end of each week. Suppressing dust at carding machines was difficult. Carding material is easily disturbed by exhaust fans, which can damage the quality of the final product. To maintain the integrity of the asbestos-cotton mix requires still air. In British and US factories the only concessions to safety were some basic ventilation and the use of respirators for the cleaning of the dust-settling chambers.
Nothing illustrates better the versatility of asbestos than the shipbuild?ing industry. The introduction of steamships in the latter half of the nine?teenth century created a need for packing and insulation to make engines more efficient. In addition to running turbines, the steam generated by boilers was piped throughout ships for heating, cooking, and washing. Before the introduction of asbestos, such pipes were often uncovered. The resulting high temperatures from radiant heat could make work condi?tions below decks intolerable. Serious accidents were common on rolling ships as sailors were thrown against hot pipes. Amosite and crocidolite were light- and heat-resistant, and by the 1920s asbestos cladding had become a standard feature on ships. The new insulation was so popular that anyone employed in a shipyard or who worked on a ship after 1930 was exposed to asbestos.
Asbestos imports into Scottish docks came directly from South Africa and the biggest shipyards had their own sheds where fiber was unpacked and prepared by hand. During construction the trades within a ship?s hull included joiners, shipwrights, plumbers, electricians, smiths, and boiler makers. Laggers were mostly employed by outside contractors and in general they were not covered by shipyard regulations. Asbestos was sprayed onto bulkheads and deckheads and moulded sections made from almost pure amosite were used to insulate pipes and machin?ery and to fireproof living quarters. Heavy asbestos blankets covered boilers and steam lines were lagged with asbestos paste In addition to the normal vibration which broke down insulation, constant refittings released dust into confined spaces. Ventilation systems circu?lated the dust, thereby contaminating sleeping quarters, messes, and lounges.
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