Background on Asbestosby Laurence B. MolloyAsbestos is a major media watchword! Front page headlines chronicle every new encounter with the "deadly, cancer-causing scourge" in the American environment. One family in Florida abandoned their home and everything in it due to asbestos contamination in the house. Now they cannot sell the house; they cannot afford to remove the asbestos; and no contractor will tear it down.1 Everyone is familiar with the multiple news reports about asbestos spills in the street and the asbestos contamination that drove 240 families from their New York apartment building and drove the equity in these 240 apartments from an average $300,000.00 to zero.2 Over the last few years, newspaper headlines chronicle every new regulation, criminal indictment, environmental investigation, and product ban. The federal government enforces a dizzy array of regulations governing asbestos removal in schools, in product sales in the marketplace and worker protection everywhere else. For public and commercial spaces, local, state and city governments are passing laws governing asbestos removal and repair. Despite some press reports debunking the asbestos scare,3 prestigeous medical journals, such as the Mayo Clinic Health Letter4 and the New York Academy of Science5, emphatically declare the association between asbestos exposure and cancer. Asbestos is big money. Asbestos sales in the United States amount to hundreds of millions of dollars since the turn of the century. A study of the Baltimore investment Bank, Alex, Brown & Sons estimated that property owners would spend $100 billion for asbestos removal.6 In fact, asbestos manufacturers, besieged by product liability suits, have funded a nonprofit education institution called the Safe Buildings Alliance with enough money to propagandize the press into believing that asbestos is somehow less dangerous that epidemiologists contend. Is asbestos really dangerous? Are the press reports over-blown? Why the sudden discrepancy? This report is an attempt to clarify the asbestos issues and shed common sense on the topic. NATURE OF THE BEASTAsbestos has been known for its heat and fire resistance since the Roman era. It was used in ships to retard flames from cooking, blacksmithing, and from the dreded Greek fire during war. Concomitantly, the dangers of asbestos were also known. Pliny the Younger discussed asbestos and lung disease in miners in the first century, A.D.. Later, the British medical journal, Lancet, published findings that condemned asbestos as a modern scourge in 1919. Nevertheless, asbestos was a much prized material. Since the mineral breaks down into fibers, it can be woven like cloth to create a shield that is fire and heat impenetrable. Louis the IV, sun king of France, used an asbestos table cloth for banquets. He delighted in amazing his guests by throwing it into the fire, thereby cleaning the table cloth. Asbestos is a naturally occurring mineral. It is found in rock formations. The scientific name is fibrous magnesium silicate. There are two families - the serpentines and the amphiboles. There is much debate about the differing health effects of each family. (See Health Effects) In its natural state, asbestos rock is relatively harmless. However, asbestos is inherently different from all other rocks. When pulverized, ordinary silica rocks break down into smaller units that are basically round. Break a boulder and get rocks. Smash rocks and get pebbles. Pound pebbles and get grit. Grind grit and get powder. In other words, rocks are round and therefore fundamentally harmless. Not so, however, asbestos. Unlike rocks, asbestos comprises many fibers woven together like hemp rope. In nature, asbestos rock pulls apart into layers, like double-knit cloth. Pulverized layers of asbestos yield fibers, each one of which is composed of thousands of tiny fibers twisted together like hemp rope. When mechanically manipulated, these fibers break down into smaller and smaller fibers until it reaches a final and indestructible sub microscopic fibril. At this level, the long, thin and invisible asbestos fibril eaten or inhaled can kill. It causes cancer, mesothelioma, gastric tumors and an irreversible and fatal lung disorder called asbestosis.7 There is no known safe level of exposure to asbestos; theoretically, a single fibril can kill..6 It is important to note here that visible asbestos fibers are not harmful - even those fibers that are visible through light microscopy. Only those fibers detected by transmission electron microscopy (TEM) are dangerous. Such fibrils are so small that they are invisible to the human eye even with the highest powered optical magnification. Nevertheless, the government allows laboratories to "report" asbestos concentrations using polarized light (PLM) and phased contrast (PCM), both forms of optical light microscopy. The government theory is that if damaged asbestos is deteriorated beyond fibrous clumps to the fiber level, it is reasonable to assume that fibrils also exist. Therefore, the standard is adaptable, i.e., OSHA regulations allow 0.l fibers per cubic centimeter of air whether read by PLM or TEM. However, an air sample read by PLM indicating 0.1 fibers per cubic centimeters of air may actually contain as many as ten to a thousand times as many fibers when read by TEM. Practically, the hazard is a mechanical geometric phenomenon. Imagine a fiber that looks like a javelin in an electron microscope. A fibril is approximately one-half micron wide and approximately 10 microns long. (A micron is one millionth of a meter.) At that level, a lung cell compared to a javelin is about the size of an office desk, completely round, of course, with a nucleus in the center. When breathing, an adult may inhale thousands of fibers with each breath. For example, an adult breaths 10 liters (10,000 cubic centimeters) of air each minute. If the air contains the OSHA permissible level of asbestos fibers, only 0.1 fibers per cubic centimeter, then an adult breathes 1,000 asbestos fibers each minute. In an eight-hour day, an adult consequently breathes 480,000 asbestos fibers when the air is theoretically "clean" according to OSHA standards. When breathing, most asbestos fibers are caught in the throat or nose and stick to the mucous membrane. A few hundred reach the lung and are dispersed throughout the avioli. In an asbestos-saturated environment, lung cells are bombarded with reeling javelins hurtling through the air passages. Asbestos fibrils easily pass through human tissue. Nevertheless, most javelins are deflected or embedded in cellular tissue. A few, however, pierce lung cells. Most of these, however, simply pass thorough the lung cell sides like arrows through jellyfish. Eventually, however, an asbestos fibril pointed at just the right angle strikes a lung cell and pierces the nucleus - a javelin stuck in the desk chair. Whether asbestos embedded in a lung or lung wall cell actually causes cancer is debatable. However, it is known that the asbestos fiber acts as a transport for whatever toxin its host breathes. Consequently, breathing tobacco smoke with asbestos in the lungs increases lung cancer expectancy by 100 times the expectancy of ordinary smokers. Similarly, a person with asbestos is equally susceptible to vehicle fumes, ozone, pesticides, solvents, methylene chloride, or any form of air pollution. This is why cancer rates climb 100 fold for asbestos workers who smoke.8 The phenomenon is also the reason that some people get asbestos disease while others do not. It is simply a matter of chance. Some people are unlucky enough to receive a javelin immediately whereas others are never struck - like medieval foot soldiers besieging a castle.. Nevertheless, cancer, lung disease, and asbestosis rates go up in direct proportion to the amount of asbestos fibers one breathes. This is why air testing is an official although specious test for environmental safety. THE CAPRICE OF AIR TESTINGAlthough it seems only commonsense to believe that testing the air will determine safety, air testing is, in fact, a notoriously unreliable method of assessing risk. Part of the reason is that asbestos fibers behave like rocks, not like gas. Humidity, for example is insidious, it disperses evenly in a given amount of air through osmosis. Similarly, carbon monoxide is largely equally diluted thermodynamically in a given space. Asbestos, however, acts differently. Imagine, for example, asbestos pipe insulation on a pipe in the boiler room. A worker accidentally hammers the insulation and so releases a cloud of asbestos fibers. The smallest fibers, called fibrils, are invisible and incredibly light because they are hollow. In an absolutely still room, asbestos fibrils will remain airborne for 24 hours before settling to the floor. Being rocks, however, the fibers tend to stick together in a cloud aggregate. (Asbestos fibrils are rocks and therefore have gravity and attraction.) These post-impact clouds will slowly drift around the room like balloons, lifted and newly propelled by any small air currents. An asbestos air sampling technician slowly enters the room and sets up a pump near one wall at a very slow flow rate. The pump slowly pulls existing air so as not to disturb air currents. It is also significantly impeded by the nearby wall which restricts the volume of air tested. If humid conditions prevail, then the chance that such an air test will detect the aforementioned balloon of asbestos fibers is remote. If the test is conducted 24 hours after workers have left, then there is no chance that an air test will detect asbestos even though hazardous asbestos fibers are dispersed throughout the room on work surfaces.9 There is, consequently, ample opportunity for an air testing technician to manipulate air testing results. The regulations only require "aggressive" (using a leaf blower) testing after asbestos removal. Otherwise, an air technician may simply take a minimum volume of air at a minimum rate of air flow. (OSHA regulations do not specify aggressive monitoring; only "representative" monitoring.) Nothing prevents the technician from waiting until all the fibers have settled to the floor nor from humidifying the air to make the fibers heavy and sticky before air testing. It is axiomatic in the industry that unless clearance air monitoring is required, an air technician may ask his client what test results are needed before the technician begins testing. Actually, the only reliable method of air testing is final clearance monitoring as defined by the EPA. In this "aggressive" method, a leaf blower is used for ten minutes blowing against all room surfaces in order to churn all available fibers. At the same time, a 20-inch fan is placed in the center of the room in order to keep all available fibers equally dispersed in the room air. A pump placed 3 feet high in the center of the room takes a specific amount of air at a moderate flow rate for a given amount of time. The pump pulls a measured amount of room air through a specified high efficiency particulate action filter which suspends 99.9% of all asbestos fibers in the cellulose matrix. The filter is then dissolved in the laboratory and the number of suspended asbestos fibers are counted. The result should be no greater than 0.0l fibers per cubic centimeter of air, or 48,000 asbestos fibers breathed in 8-hour working day.10 It is important to note that the OSHA regulations for air testing, which require only 0.1 fibers per cubic centimeter for clean air, assume that no asbestos will be inhaled after work and that no worker stays in a facility longer than 8 hours. The word asbestos is an early Greek term which means invincible. Asbestos is the only substance on earth with its particular fire resistance and insulation properties. There is no substitute today. Consequently, asbestos was considered the "wonder" material until its effects on human health were accepted by the medical community due to Irving Selikoff's research in the 1960's. Because of its properties, asbestos was added to more than 4,000 different kinds of building materials until it was banned for construction use in 1975. Asbestos is still used extensively by the military today. For example, asbestos was added to insulation because it absolutely prevented heat leakage. Asbestos was added to surface treatments because it met fire codes and also because it provided extraordinary acoustical dampening. Asbestos was added to electrical wiring because it would not burn by electrical shorting; in fact United Laboratories required electrical equipment to contain asbestos in the 1950's in order to receive the UL approval seal. Asbestos was added to rubber stair treads because it reduced wear and increased tread life. Asbestos was added to caulk because it adhered better than other thickeners. In the first quarter of the 20th Century, asbestos was added to cement and plaster because horsehair became expensive and because it was an excellent matrix for masonry material. Asbestos was lawfully used for decorative surface treatments until 1978. In short, the asbestos beast became a very big beast indeed. It became in America a billion dollar industry and spawned a plague of lawsuits and counter suits. Today, asbestos is both legal and illegal - both a toxic tort and a business opportunity. Today, no law specifically prevents asbestos from deteriorating onto workers heads, but it is illegal to touch it unless federally certified. Anyone who paints an asbestos- containing pipe is technically violating the law. Asbestos laws may be both sensible and stupid. It is, for example, permitted to sell existing stocks of asbestos material, but it is illegal to manufacture asbestos building materials. Asbestos is banned in certain material uses but permitted in others, despite the evidence of grave health risk. Homeowners are permitted to remove asbestos and bury it in the basement, but once asbestos leaves the property, it becomes a class I toxic waste subject to an extensive array of rules and regulations for transport and disposal. Finally, the owner of asbestos is ultimately responsible for all asbestos liability and that liability passes from generation to generation unless the owner can get someone else to purchase it and become owner of his asbestos. This applies to asbestos already disposed in federally approved toxic waste dumps. Consequently, many homeowners remove asbestos personally and bury it in the basement. REGULATING THE BEASTRegulating asbestos as a toxic substance did not begin until 1970 when the federal government proscribed the import of foreign asbestos and prohibited domestic manufacture. In 1972, the federal government prohibited asbestos for a building insulation material but did not prohibit acoustical or decorative uses. Such uses were finally banned in 1978. Nevertheless, industrial asbestos use remained widespread, particularly for brake linings and for military installations. The Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA) are the principal federal agencies involved with asbestos in building regulations. EPA regulations focus on the application and removal of asbestos in buildings and structures, emissions of asbestos fibers during renovation, demolition and disposal of asbestos materials and protection of public sector workers involved in asbestos abatement and not covered by OSHA or an OSHA-approved state plan. NESHAP 11The Clean Air Act (CCA) requires the EPA to develop and enforce regulations to protect the general public from exposure to airborne contaminates that are known to be hazardous to human health. In accordance with Section 112 of the CCA, EPA established National Emissions Standards for hazardous Air Pollutants (NESHAP) to protect the public. Asbestos was one of the first hazardous air pollutants regulated under Section 112. On March 31, 1971, EPA identified asbestos as a hazardous pollutant, and on April 6, 1973, EPA first promulgated the Asbestos NESHAP in 40 CFR Part 61. NESHAP jurisdiction defines a "facility" as any institutional, commercial, public, industrial or residential structure, installation or building, any ship or waste disposal site. The definition excludes residential buildings having four or fewer dwelling units. The definition applies to all federal facilities. NESHAP rules concern the application, removal, and disposal of asbestos-containing material (ACM) by requiring notification procedures, removal specifications, emission controls, and disposal specifications. Advance notice to the EPA must be filed when a building is being demolished or if more than 260 linear feet of asbestos pipe covering or 160 square feet of surfacing material are disturbed during building renovation. NESHAP requires the owner to remove friable asbestos with wet method techniques. Dry removal requires prior approval from the EPA. There is no numerical standard for air emissions during removal other than the requirement that there be no visible emissions of asbestos during any part of a demolition or renovation. All ACM must be wet or mixed with water and sealed in leak-tight containers while wet. Containers must have OSHA-specified labels and must be disposed in an approved landfill. NESHAP does not require a building owner to remove damaged or deteriorating asbestos-containing material. NESHAP requires inspection of property only prior to renovation or demolition; otherwise there is no inspection requirement. Visible emissions include dry friable asbestos lying on the ground as well as visible dust or fibers. OSHAOSHA has regulated occupations asbestos exposure since 1971. The new OSHA rule governing exposure to asbestos (29 CFR 1910.1001 and 1926.58 was published in the Federal Register: 51 FR 22612-22790, June 20, 1986. The rule is divided into two sets of regulations - one covering construction industries and one covering general industries. Companies in construction industries engaged in building maintenance, repair, renovation (including remodeling and decoration), and demolition, or in asbestos control industries are all other industries where workers may be exposed to airborne asbestos. Both sets of regulations can apply to workers in a building with ACM. For example, both office workers and service personnel (custodians and maintenance staff) are covered by the general industry regulations, while the service workers are covered by the construction industry regulations when they perform maintenance, repair renovation or asbestos abatement tasks. Outside contractors (e.g. electricians, plumbers, carpenter, asbestos contractors) are covered by the construction regulations. Both sets of regulations establish exposure standards for airborne asbestos, as measured by phase contrast microscopy (PCM). Fiber concentrations above these standards trigger various worker protection and related requirements. If average airborne concentrations on an 8- hour time-weighted basis are above the 0.1 fibers per cubic centimeter (f/cc), employee information, notification, and training and medical surveillance programs must be initiated. The construction industry requirements for air monitoring are less flexible. Personal monitoring of workers must be performed unless there is historical data proving that similar tasks do not produce fiber release or that objective date shows that the ACM being handled or disturbed cannot cause exposure above 0.1 fibers per cubic centimeter. The rules implicitly require that daily air monitoring will be required for most maintenance, repair, renovation activities performed in the presence of asbestos material. OSHA regulations apply to all employers except public employers in states which have not assumed OSHA enforcement responsibility. An EPA rule (40 CFR Part 763.120) extends the OSHA exposure regulations to all municipal employees engaged in asbestos abatement activities and not otherwise covered by OSHA rules. The EPA rule does not apply to "construction activities other than asbestos abatement. OSHA regulations also require owners and managers with buildings known to contain asbestos to develop an Operations and Management (O&M) program in order to maintain the building environment free of asbestos contamination. The O&M program focuses on the activities of custodial and maintenance workers and service contractors. Special procedures for routine cleaning by custodial workers are designed to achieve the first program objective, removing asbestos fibers that may have been released previously from ACM. In order to achieve second programs objectives, minimize future release and distribution of fibers, special work practices are designed for maintenance workers. For example, a building containing vinyl asbestos floor tiles prohibits stripping tiles with metal abrasives in order to remove old wax. Response (emergency) actions for fiber release episodes are also specified. In general, the O&M plan requires owners to designate a program manager responsible for worker safety and emergency response. This manager should obtain training in developing and managing an asbestos control program, including training in abatement techniques. OSHA requires that essentially the same person be appointed to supervise major renovation, demolition and ACM removal projects. The asbestos program manager should have authority to direct the custodial and maintenance staffs and outside contractors. The O&M program is essentially a document that is a written plan for managing asbestos in place in the buildings under the manager's administration. This document must contain all records including the original asbestos inspection documents and documents of all changes to the asbestos including emergency responses and abatement. In addition, the O&M plan document must contain written records for any and all asbestos-related activities, including but not limited to routine maintenance and inspection, independent contractors changes such as plumbers on wrapped pipes or cable installers, as well as documentation of all responses and medical surveillance. OSHA also requires that the building owner maintain a program for informing building occupants and identifying the location of all asbestos material. OSHA standards state that the employer/building owner must develop a training program for all employees who are exposed to airborne concentrations of asbestos at or above the action level. This program must be provided to all current employees, to all new staff prior to or at the time of initial employment and the training must be repeated on a yearly basis thereafter. First, building occupants must be informed of any potential hazard in the building. Second, occupants who are informed and instructed about ACM are less likely to disturb the material and cause fibers to be released. Building occupants can be informed in at least three ways; by distributing notices, posting signs and/or holding awareness sessions. In addition, existing asbestos must be marked with caution signs stating that asbestos, a health hazard is present. The notification program should include information sessions which give occupants a chance to meet and ask questions of the O&M program manager.12 Building owners cannot cavalierly order asbestos removal or repair. Owners must provide an education program which must include the following information: Asbestos is present in the building. The type and location of the asbestos. The potential health effects of asbestos Plans to deal with the problem. Instructions to avoid disturbing the asbestos. Procedures to report any disturbances or damage to ACM. Additions sources of information. A record of all attendees to the program. It is unclear to what extent a building owner/employee must notify employees if airborne concentrations of asbestos fibers do not reach 0.1 fibers/cc. Vigorous air testing under ideal (not aggressive) conditions may obviate the owner's responsibility for full notification as described above. Nevertheless, notification and training for hazardous materials on site is an OSHA requirement. OSHA O&M requirements also go on to specify certain work practices and training requirements. Keeping track of changes to ACM is an essential element of any O&M program, including regular surveillance and analysis. OSHA provides more than two dozen suitable forms to fill out and include in the O&M document. The Switch to ManagementDuring the push to remove asbestos in public schools, the United State Environmental Protection Agency carefully monitored the results of on-going asbestos removal propelled by the AHERA mandate. EPA studies of air quality in public schools after asbestos removal, no matter how careful, concluded that asbestos removal is inherently dangerous. In a startling reversal of AHERA policy, the United States Environmental Protection Agency published in June 1990 standards for managing asbestos in buildings instead of removing the carcinogenic material. In fact, William Reilly, Chief EPA Administrator recently said, "It is the opinion of EPA professionals that very often the best thing to do about asbestos when you find it in your building is to manage it." EPA chief Reilly also said that most asbestos removal in this country is unnecessary and that asbestos removal is inherently dangerous because it often creates more air contamination than when left alone.11 Managing asbestos, according to the June 1990 EPA publication, means identifying a building's hot spots and training building personnel to work safely around the material when they do maintenance, repairs and remodeling. This approach is far less expensive than removal. EPA chief Reilly also said that, "most asbestos removal in this country is unnecessary and that asbestos removal is inherently dangerous because it often creates more air contamination than when left alone." Besides being safer, managing asbestos in place costs less. A rule of thumb is that asbestos removal costs $20 per square foot; establishing a management program costs $2 per square foot. Managing asbestos, however, can be troublesome, particularly if the airborne concentrations reach 0.1 fibers per cubic centimeter and the owner is required to implement an OSHA notification and education program. Record keeping is the most important, the most onerous and the most expensive requirement of asbestos management. Often, records become so voluminous and so cumbersome that the management program becomes mired in paper. HEALTH EFFECTSThe first known notice of disease from asbestos exposure came from Pliny the Younger in 68 AD who decried the enormous incidence of lung disease in asbestos mine workers. Afterwards, various alarms were published throughout history, including a detailed study summarized in the prestigious British medical journal, The Lancet, in 1919. However, the fact that there was and is no substitute for asbestos in building and ship- building may have prevented moves to banish the material - especially during and between the world wars. Asbestos exposure causes disease.At minimum, asbestos is responsible for three fatal diseases: asbestosis, an irreversible thickening of lung tissue which eventually suffocates the patient, mesothelioma, cancer of the lining of the lungs, and gastric tumors which are curable but often metastasize and result in death. In addition of fatal disease, epidemiologists world wide report that asbestos is associated with chronic lung disease and respiratory disfunction. In addition, asbestos may be associated with many other malignancies because of the fibril's ability to travel through body tissue. (See the following discussion on Collegium Ramazzini.) A latency factor is characteristic of all asbestos disease. Although malignancies and lung disfunction may appear 5 to 10 years after exposure, the onset of most disease occurs 10 to 20 years after the causative asbestos exposure. Some malignancies have appeared as many as 40 years after exposure. During the early 1980's, Dr. Irving Selikoff at Mr. Sinai Hospital proved the insidious carcinogenicity of asbestos fibers. His research data disclosed that asbestos has an inherent latency of ten to twenty years and that there is no known safe level. In part due to Dr. Selikoff's work, Congress passed in 1985 the Asbestos Hazard Emergency Response Act (AHERA) mandating the mapping, assessment, and abatement of all asbestos in all public elementary and secondary schools.12 The new AHERA act established a protocol and procedure for identifying, classifying, mapping, and abating asbestos-containing building materials in public schools. During the last four years, the federal government has forced school districts to comply. At this writing, approximately 90% of American school districts have complied with the mapping and reporting procedures. In conjunction with the Department of Education, the Environmental Protection Agency is establishing penalties and sanctions for the remaining school districts.15 Regarding asbestos removal, the handwriting is on the wall. In July, 1989, the U.S. Environmental Protection Agency issued a rule under the federal Toxic Substances Control Act banning the use of asbestos in any form. The ban, which took effect August 1990, prohibits all domestic asbestos use (except some military usage) spread over the next seven years. Congress clearly stated that asbestos is a toxic material.16 The ban, however, is now being challenged in federal court . In August 1989, the U.S. Environmental Protection Agency published a summary report, Comparing Risks and Setting Environmental Priorities.17 The EPA records that indoor air pollution, in part due to asbestos exposure, is the most severe environmental health risk in the United States. The air inside buildings is often 100 times as polluted as outdoor air. The EPA study clearly states that the health risk posed by exposure to indoor air pollutants is significantly greater than the risk of other environmental problems receiving the most public concern and government funding. Americans spend 93% of their time indoors. Because our buildings are now energy efficient, pollutants tend to bottle up inside. Consequently, Americans are exposed to more contaminates in higher concentrations for longer periods of time. The Debate Over RiskCiting a December 1988 Kennedy Center symposium (afterwards touted in the press as the "Harvard Conference"), the New York Times was mislead and even published an editorial, "The Good News About Asbestos."3 The editorial likened asbestos to water and minimized the public fear of contamination. The editorial based its assumptions on a report issued in August 1989 by the John F. Kennedy School of Government, Energy and Environmental Policy Center stating that the health risk of asbestos exposure in buildings is far less than other commonly experienced health risks, such as tobacco smoke and radon.18 The principal assertion was that chrysotile asbestos was not proven carcinogenic (no mesothelioma), Inasmuch as chrysotile comprised 80% to 90% of American asbestos, then the hazard did not exist. There was consequently widespread relief in the real estate industry and intense pressure on governments to drop proposed new laws mandating asbestos surveys in public buildings. The "Harvard Conference" finding were subsequently published with much fanfare in the January 1990 edition of Science magazine.6 Nevertheless, contemporary medical journals, such as the Mayo Clinic Health Newsletter, ignored the "Harvard" conference findings and puhlished balanced views on asbestos exposure.3 The Kennedy report, however, is vulnerable to allegations of bias. Four real estate groups, including the Safe Buildings Alliance, underwrote the study. The Safe Buildings Alliance is a nonprofit educational organization wholly funded by former manufacturers of asbestos products and the real estate industry. Further, the report concedes that asbestos is a carcinogen but distinguishes between types of asbestos forms. Amphibole fibers, according to the report, pose a much greater risk of mesothelioma than chrysotile fibers.19 Although amphibole fibers are less common than chrysotile, they do often occur in residential and commercial buildings. Given the public's right to choose risk, the need for surveys, therefore, is even greater. Noted epidemiologist, Dr. Irving Selikoff, immediately organized an open conference on the hazards of asbestos exposure. Unlike the "Harvard Symposium," the Collegium Ramazzini conference was open to all scientists and took place in June, 1990 in New York City. I was one of the participants at the Collegium Ramazzini conference The Collegium is an international academic body of 125 environmental and occupational health scientists in 30 countries headquartered in Bentivoglio, Italy. Three hundred and fifty scientists, government officials, lawyers, corporate and labor representatives attended this important conference devoted exclusively to asbestos disease. The conference was jointly sponsored by The Mt. Sinai Medical Center and Harvard Medical School. I attended the entire conference and noted the most important medical papers presented during the proceedings. I taped the proceedings and took extensive notes. As an overview, Dr. Philip Landrigan from Mt. Sinai Medical Center reported that it is now more than 90 years since British Medical studies reported that asbestos causes fatal disease. Twenty five years later in 1934, studies proved that asbestos was linked with cancer. In 1967, Dr. Irving Selikoff began a study of 17,800 workers who were then members of the insulators union. He followed their experience until December 1988. During this period, 4951 workers died when under normal circumstances 3453 would be expected to die. The major causes of death were lung cancer, pleural and peritoneal mesothelioma and gastrointestinal cancer, but a number of other excess cancers have been found to have occurred in addition to deaths: cancers of the mouth, tongue, throat, larynx, pancreas, kidney and gall bladder. His research data disclosed that asbestos has an inherent latency of ten to twenty years and that there is no known safe level of exposure.20 In 1986, the United States Environmental Protection Agency, Office of health and Environmental Assessment, published a research assessment of the health effects in a report, Airborne Asbestos Health Assessment Update, by William J. Nicholson. The summary states, "The evidence that asbestos is a human carcinogen is overwhelming. Studies on more than 30 cohorts of workers exposed to asbestos have demonstrated an elevated risk of cancer at the 5% level of significance. All four major commercial varieties have been linked to excess cancer and asbestosis. The question is not so much what disease, but how much disease."21 Asked to respond Dr. Selikoff estimated that, "asbestos exposure continues to present a significant cancer risk on the order of 10,000 deaths a year in the United States." During this presentation, Dr. Selikoff was asked directly, "Is there a level of asbestos exposure that is relatively safe? He answered, "Not really, but we at least know something of what an upper limit might be. It would be below that which exists in homes of asbestos workers." Subsequently, Dr. Lou Joubert, Epidemiological Research Associate, American Cancer Society, reported on a study begun in 1975 of a cohort of 878 wives and children of factory workers from a asbestos textile plant in New Jersey who were intermittently exposed to low levels of asbestos from the workers clothes. Dr. Joubert reported that as of 1990, 115, or 38% have died from asbestos-related cancer. According to American Cancer society death rates in the general population, only 22% would be expected to die of cancer. "Our concern is that we are finding a slight increase in the incidence of lung cancer in family members. These people were not exposed during work at a factory; the exposure came only from dust the worker brought home on clothing. Women washed their husband's clothes and the children came into contact with asbestos from hugging or simply being nearby."22 Commenting on this presentation during the conference, Dr. Selikoff stated, "Low levels of exposure, resulting in death, among household contacts of asbestos factory workers are a good predictor of what may still occur among workers and the public if stringent public health controls are not used." He added that the study on these families raised a serious observation that researchers could not yet explain, i.e., that there were seven deaths due to Hodgkin's lymphoma in the 115 family members who died. "It's extremely worrisome. This is an extraordinary number because we don't see deaths from this rather uncommon disease," he said. "I have analyzed the first 850 deaths among the factory workers and there was only one lymphoma. So the family members has 30 times as much lymphoma from low level asbestos exposure as the factory workers had, exposed to the same fiber in the same years in the same city at the same time."18 Two additional studies presented at the conference traced school custodians' asbestos exposure. Harvard's L. Christine Oliver discussed her study of Boston School custodians released earlier this year. Oliver reported that 33% of the 121 custodians studied showed asbestos- related X-ray changes. Similarly, Mt. Sinai's Dr. Stephen Levin examined 660 working New York school custodians from 1985 to 1987. Levin stated that two-thirds of the group he studied had begun work as custodians in other types of buildings 20 years before. Sixty-three percent had exposure outside of the school environment and of those, custodians with 35 or more years since onset of exposure had an X-ray abnormality rate of 39%.18 When the researchers look at the 247 custodians who had no history of previous exposure outside of the schools, a large percentage showed abnormalities in X-rays. Levin said, "For those who had only their exposure in the school environment, the fact that nearly half showed X-ray changes consistent with prior asbestos exposure is an important finding and has some real implications for concerns we have regarding exposures in buildings."18 At the end of the conference, Dr. Homayoun Kazemi of Harvard Medical School summed the overall findings in ten points. 1. Asbestos exposure is a problem at any level. 2. Asbestos is associated with many disorders and malignancies of the respiratory tract, and epidemiological data now available suggest that may other forms of cancer are associated with asbestos exposure. 3. All asbestos fibers are associated with disease, although biological behaviors differ from one fiber to the next. 4. New studies with new techniques show the presence of fibers in the lining of the chest wall and places outside the respiratory tract and in the lymph nodes. 5. More refined radiographic approaches are needed to diagnose the spread of the disease in the chest, not only cancer but also other lung abnormalities. 6. Abnormalities in lung function can be associated with low levels of exposure, and there can be significant airways obstruction. 7. Malignancies are related to all forms of asbestos fibers. 8. Using immunological and serological techniques, the scientific and medical community is not beginning to understand the mechanism of asbestos disease. 9. Asbestos-related disease is worldwide. 10. Custodians, building occupants, and others exposed to low levels of asbestos can develop disease.20 All available evidence indicates that asbestos exposure at any level is hazardous to health. Asbestos causes lung cancer, fatal asbestos, mesothelioma, emphysema and other lung diseases, plus gastric cancer from ingestion. There is strong evidence that many other cancers are associated with asbestos exposure. Low level exposure seems to cause disease in the same proportion as high level. Asbestos exposure is clearly synergistic with other hazardous substances, especially environmental tobacco smoke and volatile hydrocarbons such as those emitted from paints and cleaning solvents. General Industry AssessmentA study by the Baltimore investment bank, Alex, Brown & Sons estimated that government and commercial property owners would spend $100 billion for asbestos removal during the next 25 years. Although it is not known how much asbestos exists in the United States infrastructure, the construction industry installed more than 1.4 billion square feet of asbestos into buildings in the 1960's alone.4 Asbestos has been a commonly used building material since 1880. In 1989, the New York City Department of Environmental Protection presented the findings of a City Council commissioned study assessing the prevalence and condition of asbestos in all public and private City buildings. Based on an extensive analysis of 900 different buildings carefully selected for a statistically valid sampling, the study estimated that 68% of all buildings in New York contain asbestos and that 81% of the in-place asbestos was in poor to fair condition, thereby constituting a public health risk.23 The DEP study, "Final Report on the Assessment of the Public's Risk of Exposure to In-Place Asbestos", excluded the potential need for asbestos removal due to renovation, alteration or demolition. Nevertheless, the study estimated 385 million square feet of asbestos in New York City buildings. At the very least, this amount of asbestos must be removed before these buildings are demolished. Many New York City asbestos management firms believe that these figures are too conservative. INDUSTRY ETHICSThere are thousands of licensed asbestos contractors in the United States and tens of thousands of unlicensed removal firms. Many states do not require licensing for asbestos removal firms.. Although some of these companies are not active, many have a thriving business. Moreover, the present demand for asbestos removal is merely the tip of the iceberg since most real estate holding companies adopt a "wait and see" attitude toward asbestos despite their liability exposure. Except for public schools, no law mandates removal of in-place asbestos in any building regardless of its use or occupants. Removal costs are so high that owners are reluctant to contract for abatement until forced. Consequently, there is at this writing an artificially low and unrealistic amount of asbestos removal under contract. There are basically two types of asbestos removal firms: the sophisticated, professional companies, which tend to be large; and the poorly administered, "cowboy" operations which tend to be small. The former companies routinely realize large profits on even low bid jobs. The latter organizations realize similar profits but sometimes fail because they get sued, spend too much overhead, or simply waste funds on poor administration. However, the lack of financial backing is the chief cause of failure. In addition, the asbestos removal business tends to be seasonal because of the cost of removal during the winter, i.e., removal from active hot water and steam pipes is expensive. Many companies also depend on contracts with local education agencies wherein asbestos removal occurs during the summer. Spring is an off season for most asbestos companies. The asbestos business has become a billion dollar industry in a few years. Customarily, a client owning a building employs various auxiliary professional services during an asbestos removal project: Licensed investigators, Project managers, Asbestos contractors, Air clearance technicians, Waste haulers, Laboratory analysis, and Building maintenance training programs. In turn, all these auxiliary professionals employ asbestos training institutions and purchase asbestos equipment. Large environmental companies sometimes provide all these services in house, sometimes to a single client. Such practices are not recommended. In the event of an accident that results in litigation, the "fox and chicken" predicament is risky. Prudent building owners agree to use different professionals for asbestos management and asbestos removal. Otherwise, the fox watches the chickens and the farmer never knows how much of the flock remains and how many feathers were left during removal. Put simply, the client could be too easily betrayed and a jury too easily convinced of skullduggery. Given the benchmark price of $25 a foot for removal, there is enormous opportunity for profit. The costs for labor, worker protection and equipment, however, are high and the business is risky. Nevertheless, there is an incredible opportunity for enormous profits when the rules are ignored. Contractors can rip out large amounts of dry asbestos in small amounts of time. For this reason alone, asbestos removal is often not recommended. Building owners should always employ third party environmental managers to oversee asbestos removal. Many don't, scrimp on costs and risk their health. SummationNews coverage of asbestos in buildings has tended to cause an egregious misunderstanding of the issues surrounding this controversy. Some people believe that asbestos is a hoax perpetrated by the government. Some organizations supported by former asbestos manufacturing companies confuse the public with claims that only one kind of asbestos is really dangerous. The government has produced no clear statement for the real estate industry regarding what action insures property safety and the value. The facts are: Asbestos DiseaseAll available evidence indicates that asbestos exposure at any level is hazardous to health. Asbestos causes lung cancer, fatal asbestosis, mesothelioma, emphysema and other chronic lung diseases, plus gastric cancer from ingestion. There is strong evidence that many other cancers are associated with asbestos exposure. Low level exposure seems to cause disease in the same proportion as high level. Asbestos exposure is clearly synergistic with other hazardous substances, especially environmental tobacco smoke and volatile hydrocarbons such as those emitted from paints and cleaning solvents. All asbestos disease has a latency of 10 to 20 years after exposure. Government RegulationVirtually all applications of asbestos in public or work spaces are banned in the United States. In addition, all asbestos imports are prohibited. The government clearly regards asbestos as a hazardous substance. Although controversy exists over how deadly asbestos actually is and what method of asbestos removal is permitted, regulation and litigation of asbestos is growing, not shrinking. It is certain that asbestos in buildings will become more regulated and more expensive in the future, not overlooked or deregulated. The public that uses buildings will finally decide how to identify and abate the asbestos hazard. The public insists on the right to know about environmental hazards. The knowledge that children romp in basement playrooms on cracked vinyl asbestos floors beneath delaminating spray-on asbestos ceilings, that mothers spend hours in laundry rooms under flaking asbestos pipe wrapping, and that families buy groceries stored in contaminated stockrooms will ultimately fuel the trend toward fuller disclosure and better management. Regarding the asbestos problem, real estate professionals should stay calm and clinically detached. Manmade disasters, like asbestos, cause greater individual distress and social disruption than natural calamities, fire for example.24 On the other hand, asbestos management considers risks and applies ethical standards of conduct that protect building managers and owners from liability risks without economic consequences. The silver lining may be the government move toward property tax devaluation.25 Bibliography1 "In Finding Asbestos in Home, A family Loses All It Owns", Associated Press, The New York Times, New York, November 2,1988. 2 "In the Wake of Asbestos: Many Fears, No Answers", David E. Pitt, The New York Times, New York, August 28, 1989. 3 Editorial, The New York Times, September 23, 1989 4 "Asbestos: A Potentially Lethal Enviromental Hazard", Minnesota, May, 1990 5 The Third Wave of Asbestos Disease; Exposure to Asbestos in Place, Philip J. Landrigan & Homayoun Kazemi, editors, Mount Sinai School of Meidcine & Harvard Medical School, NY Academy of Sciences, New York, 1991 6 "Why Throw Money at Asbestos?", Louis S. Richman, Fortune Magazine, New York, June 6, 1988. 7 Final Report: Assessing Asbestos Exposure in Public Buildings, US Environmental Protection Agency, Washington D.C., 1988 8 "Findings Shed Light on Asbestos and Cancer", Harold M. Schmeck, Jr., The New York Times, October 18, New York, 1988. 9 Sampling and Evaluating Airborne Asbestos Dust (NIOSH 582) Robert Wood Johnson Medical School, University of Medicine and Dentistry, Universities Occupational Safety and Health Education Resource Center, April 1989 10 Guidance for Controlling Asbestos-Containing Materials in Buildings, US Environmental Protection Agency, Washington D.C. June 1985 11 A Guide To The Asbestos NESHAP, US Environmental Protection Agency, Washington D.C. November 1990 12 "New OSHA Asbestos Rules to Affect Building Owners," Jason Fry, Indoor Air Review, Washington, D.C. September 1994 13 Managing Asbestos in Place: A Building Owner's Guide to Operations and Maintenance Programs for Asbestos-Containing Materials, US Environmental Protection Agency, Washington, D.C. July 1990 14 "The Asbestos Mess," Joseph Hooper, The New York Times, November 25, 1990 15 Asbestos-In-Schools: A Guide to New Federal Requirement for Local Education Agencies, US Environmental Protection Agency, Washington, D.C. February 1988 16 Asbestos Ban and Phaseout Rule 40 CFR 763.160 to 763.179. Federal Register, July 12, 1989 17 Comparing Risks and Setting Environmental Priorities, US Environmental Protection Agency, Office of Policy Planning and Evaluation, Washington, D.C. August 1989. 18 "Summary of Symposium on Health Effects of Exposure to Asbestos in Buildings", Spengler, Ozkaynak, McCarthy & Lee, John F. Kennedy School of Government, Cambridge, August 1989. 19 Proceedings: Symposium on Health Aspects of Exposure to Asbestos in Buildings December 14-16, 1988, Harvard Uni- versity Energy and Environmental Policy Center, December 1989 20 The Third Wave of Asbestos Disease; Exposure to Asbestos in Place, Philip J. Landrigan, Homayoun Kazemi, Editors, The New York Academy of Sciences, New York, New York 1991 21 Airborne Asbestos Health Assessment Update, William J. Nicholson, U.S. Environmental Protection Agency, Office of Health and Environmental Assessment, Washington, D.C., June , 1986. 22 The Third Wave of Asbestos Disease: Asbestos in Place, William Hines, The Workplace Health Fund, Washington, D.C. 1991 23 Final Report on the Assessment of the Public's Risk of Exposure to In-Place Asbestos, City of New York Department of Environmental Protection, New York, December 1, 1988. 24 "Disasters, Natural & Otherwise", Psychology Today, New York April, 1988. 25 "Ruling on Asbestos: A Wider Tax Role", Iver Peterson, The New York Times, New York, February 17, 1991. Additional Biographical Material "EPA Reproposes MCLG for Asbestos in Drinking Water," Asbestos
Issues, '89, Mediacom, Inc., Ft. Collins, Colorado 1989. |