Monday, March 4, 2013

A Deadly White Powder

Harry would arrive home from work covered in white powder.  He'd shed his clothes in the back hall, his wife dutifully shaking them out before putting them in the laundry.  Little did they know they were both being exposed to a deadly dose of asbestos.

At the shipyards, Harry was a boilermaker.  Large bags of asbestos would be carried down into the ships being refitted for service in WWII.  The bags would be dumped into open barrels and water added to make an asbestos paste.  There was little or no outside ventilation so asbestos particles clouded the air.  The ship's pipes and boilers were wrapped and coated with asbestos, a great fire retardant but unrecognized environmental hazard.

In 1964, I heard a talk in New York by Dr. Irving Selikoff.  He had made the link between asbestos exposure and lung disease in his patients from the shipyards.  Selikoff went on to do ground breaking research.  From him I learned about mesothelioma, asbestosis and asbestos related lung cancer.  Interestingly, all of us who are city dwellers appear to have asbestos fibers in our lungs.  Asbestos is basically indestructible.  When inhaled it can migrate to the outer reaches of our lungs causing a low grade inflammatory process.  A marker of prior asbestos exposure is thickening of the outer lining of the lung (the pleura) visible on a chest X-Ray or CT scan.  This change might take 20 or 30 years to develop and doesn't cause a problem per se. 

Harry's wife did show thickening of the pleura but never had symptoms or problems with it - except the worry that she was at an increased risk for lung cancer or cancer of the pleura (mesothelioma).  Harry and many other shipyard workers weren't so fortunate.  Harry, a non-smoker, began having a cough and chest pains in his 60's, long after his initial asbestos exposure.  An evaluation revealed fluid around the left lung and marked irregular thickening of the pleura.  Despite all attempts at treatment, Harry passed away from the pleural cancer, mesothelioma.

Many of Harry's co-workers were smokers.  Almost half of them developed lung cancer.  There's a multiplying effect on cancer causation between asbestos and tobacco exposure.  Some other co-workers developed a diffuse scarring of the lung (pulmonary fibrosis) or a mesothelioma.

In the early 1970's I wrote to one of the asbestos manufacturers complaining about their advertisement stating that "with asbestos your life is safer".  The letter I got back was quite hostile and defensive.  It took time and litigation to achieve improved occupational safety measures.

It's interesting there are still law firms trolling for patients with asbestos related diseases, but most of the heavy asbestos exposures from mining and the shipyards are, thankfully, a thing of the past.

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