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What is asbestos?
Asbestos is the name given to a group of
minerals that occur naturally in the
environment as bundles of fibers and can be
separated into thin, durable threads. These
fibers are resistant to heat, fire, and
chemicals and do not conduct electricity.
For these reasons, asbestos has been widely
used in many industries.
There are two subgroups of asbestos:
chrysotile, which has curly fibers and is in
the serpentine family of minerals; and
amphibole asbestos, which has straight,
needle-like fibers and includes actinolite,
tremolite, anthophyllite, crocidolite, and
amosite asbestos. Chrysotile asbestos is the
form that has been used predominantly in
commercial applications worldwide (1,
2).
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How is asbestos used?
Asbestos was mined and used commercially
in North America beginning in the late
1800s. Its use increased greatly during
World War II (3,
4). Since then, asbestos
has been used in many industries. For
example, the building and construction
industry has used it for strengthening
cement and plastics as well as for
insulation, roofing, fireproofing, and sound
absorption. The shipbuilding industry has
used asbestos to insulate boilers,
steampipes, and hot water pipes. The
automotive industry uses asbestos in vehicle
brakeshoes and clutch pads. Asbestos has
also been used in ceiling and floor tile;
paints, coatings, and adhesives; and
plastics. In addition, asbestos has been
found in vermiculite-containing consumer
garden products and some talc-containing
crayons.
In the late 1970s, the U.S. Consumer
Product Safety Commission (CPSC) banned the
use of asbestos in wallboard patching
compounds and gas fireplaces because the
asbestos fibers in these products could be
released into the environment during use.
Additionally, in 1979, manufacturers of
electric hairdryers voluntarily stopped
using asbestos in their products. In 1989,
the U.S. Environmental Protection Agency
(EPA) banned all new uses of asbestos; uses
established prior to 1989 are still allowed.
The EPA also established regulations that
require school systems to inspect for
damaged asbestos and to eliminate or reduce
the exposure to occupants by removing the
asbestos or encasing it (2).
In June 2000, the CPSC concluded that the
risk of children’s exposure to asbestos
fibers in crayons was extremely low (1).
However, the U.S. manufacturers of these
crayons agreed to eliminate talc from their
products. In August 2000, the EPA responded
to reports it received about the adverse
human health effects associated with
exposure to asbestos-contaminated
vermiculite by conducting a series of tests
to evaluate the extent of the risk. The EPA
investigation concluded that the potential
exposure to asbestos from some vermiculite
products poses only a minimal health risk to
consumers. The EPA recommended that
consumers reduce the low risk associated
with the occasional use of vermiculite
during gardening activities by limiting the
amount of dust produced during use.
Specifically, the EPA suggested that
consumers use vermiculite outdoors or in a
well-ventilated area; keep vermiculite damp
while using it; avoid bringing dust from
vermiculite use into the home on clothing;
and use premixed potting soil, which is less
likely to generate dust.
The regulations described above and other
actions, coupled with widespread public
concern about the health hazards of
asbestos, have resulted in a significant
annual decline in U.S. use of asbestos.
Domestic consumption of asbestos amounted to
about 803,000 metric tons in 1973, but it
had dropped to about 2,400 metric tons by
2005 (3, 5).
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What are the health hazards of exposure
to asbestos?
People may be exposed to asbestos in
their workplace, their communities, or their
homes. If products containing asbestos are
disturbed, tiny asbestos fibers are released
into the air. When asbestos fibers are
breathed in, they may get trapped in the
lungs and remain there for a long time. Over
time, these fibers can accumulate and cause
scarring and
inflammation, which can affect breathing
and lead to serious health problems (6).
Asbestos has been classified as a known
human
carcinogen (a substance that causes
cancer) by the U.S. Department of Health and
Human Services, the EPA, and the
International Agency for Research on Cancer
(2, 3,
7, 8).
Studies have shown that exposure to asbestos
may increase the risk of lung cancer and
mesothelioma (a relatively rare cancer of
the thin
membranes that line the chest and
abdomen). Although rare, mesothelioma is
the most common form of cancer associated
with asbestos exposure. In addition to lung
cancer and mesothelioma, some studies have
suggested an association between asbestos
exposure and
gastrointestinal and
colorectal cancers, as well as an
elevated risk for cancers of the
throat,
kidney,
esophagus, and
gallbladder (3,
4). However, the evidence
is inconclusive.
Asbestos exposure may also increase the
risk of asbestosis (a
chronic lung disease that can cause
shortness of breath, coughing, and permanent
lung damage) and other nonmalignant lung and
pleural disorders, including pleural plaques
(changes in the membrane surrounding the
lung), pleural thickening, and
pleural effusions (abnormal
collections of
fluid between the thin layers of
tissue lining the lung and the wall of
the chest cavity). Although pleural plaques
are not precursors to lung cancer, evidence
suggests that people with pleural disease
caused by asbestos exposure may be at
increased risk for lung cancer (9).
-
Who is at risk for an asbestos-related
disease?
Everyone is exposed to asbestos at some
time during their life. Low levels of
asbestos are present in the air, water, and
soil. However, most people do not become ill
from their exposure. People who become ill
from asbestos are usually those who are
exposed to it on a regular basis, most often
in a job where they work directly with the
material or through substantial
environmental contact.
Since the early 1940s, millions of
American workers have been exposed to
asbestos. Health hazards from asbestos
fibers have been recognized in workers
exposed in shipbuilding trades, asbestos
mining and milling, manufacturing of
asbestos textiles and other asbestos
products, insulation work in the
construction and building trades, and a
variety of other trades. Demolition workers,
drywall removers, asbestos removal workers,
firefighters, and automobile workers also
may be exposed to asbestos fibers. However,
recent studies do not support an increased
risk of lung cancer or mesothelioma among
automobile mechanics exposed to asbestos
through brake repair (10).
As a result of Government regulations and
improved work practices, today’s workers
(those without previous exposure) are likely
to face smaller risks than did those exposed
in the past.
Those involved in the rescue, recovery,
and cleanup at the site of the September 11,
2001, attacks on the World Trade Center
(WTC) in New York City are another group at
risk of developing an asbestos-related
disease. Because asbestos was used in the
construction of the North Tower of the WTC,
when the building was attacked, hundreds of
tons of asbestos were released into the
atmosphere. Those at greatest risk include
firefighters, police officers, paramedics,
construction workers, and volunteers who
worked in the rubble at Ground Zero. Others
at risk include residents in close proximity
to the WTC towers and those who attended
schools nearby. These populations will need
to be followed to determine the long-term
health consequences of their exposure (11).
One study found that nearly 70 percent of
WTC rescue and recovery workers suffered new
or worsened respiratory symptoms while
performing work at the WTC site. The study
describes the results of the WTC Worker and
Volunteer Medical Screening Program, which
was established to identify and characterize
possible WTC-related health effects in
responders. The study found that about 28
percent of those tested had abnormal lung
function tests, and 61 percent of those
without previous health problems developed
respiratory symptoms (12).
However, it is important to note that these
symptoms may be related to exposure to
debris components other than asbestos.
Although it is clear that health risks
from asbestos exposure increase with heavier
exposure and longer exposure time,
investigators have found asbestos-related
diseases in individuals with only brief
exposures. Generally, those who develop
asbestos-related diseases show no signs of
illness for a long time after their first
exposure. It can take from 10 to 40 years or
more for symptoms of an asbestos-related
condition to appear (2).
There is some evidence that family
members of workers heavily exposed to
asbestos face an increased risk of
developing mesothelioma. This risk is
thought to result from exposure to asbestos
fibers brought into the home on the shoes,
clothing, skin, and hair of workers. To
decrease these exposures, Federal law
regulates work practices to limit the
possibility of asbestos being brought home
in this way. Some employees may be required
to shower and change their clothes before
they leave work, store their street clothes
in a separate area of the workplace, or wash
their work clothes at home separately from
other clothes (2).
Cases of mesothelioma have also been seen
in individuals without occupational
exposure, but who live close to asbestos
mines or have been exposed to fibers carried
home by family members working with asbestos
(6).
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What factors affect the risk of
developing an asbestos-related disease?
Several factors can help to determine how
asbestos exposure affects an individual,
including (2,
6):
-
Dose (how much asbestos an
individual was exposed to).
-
Duration (how long an individual was
exposed).
-
Size, shape, and chemical makeup of
asbestos fibers.
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Source of exposure.
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Individual
risk factors, such as smoking and
pre-existing lung disease.
Although all forms of asbestos are
considered hazardous, different types of
asbestos fibers may be associated with
different health risks. For example, results
of several studies suggest that amphibole
forms of asbestos may be more harmful than
chrysotile, particularly for mesothelioma
risk, because they tend to stay in the lungs
for a longer period of time (1,
2). All common commercial
types of asbestos have been associated with
lung cancer (13).
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How does smoking affect risk?
Many studies have shown that the
combination of smoking and asbestos exposure
is particularly hazardous. Smokers who are
also exposed to asbestos have a risk of
developing lung cancer that is greater than
the individual risks from asbestos and
smoking added together (3,
6). There is evidence that
quitting smoking will reduce the risk of
lung cancer among asbestos-exposed workers (4).
Smoking combined with asbestos exposure does
not appear to increase the risk of
mesothelioma (9). However,
people who were exposed to asbestos on the
job at any time during their life or who
suspect they may have been exposed should
not smoke.
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How are asbestos-related diseases
detected?
Individuals who have been exposed (or
suspect they have been exposed) to asbestos
fibers on the job, through the environment,
or at home via a family contact should
inform their doctor of their exposure
history, whether or not they experience any
symptoms. The symptoms of asbestos-related
diseases may not become apparent for many
decades after exposure. It is particularly
important to check with a doctor if any of
the following symptoms develop (6):
-
Shortness of breath, wheezing, or
hoarseness.
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A persistent cough that gets worse
over time.
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Blood in the
sputum (fluid) coughed up from the
lungs.
-
Pain or tightening in the chest.
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Difficulty swallowing.
-
Swelling of the neck or face.
-
Loss of appetite.
-
Weight loss.
-
Fatigue or
anemia.
A thorough
physical examination, including a
chest x-ray and lung function tests, may
be recommended. The chest x–ray is currently
the most common tool used to detect
asbestos-related diseases. However, it is
important to note that chest x-rays cannot
detect asbestos fibers in the lungs, but
they can help identify any early signs of
lung disease resulting from asbestos
exposure (2).
Studies have shown that
computed tomography (CT) (a series of
detailed pictures of areas inside the body
taken from different angles; the pictures
are created by a computer linked to an x-ray
machine) may be more effective than
conventional chest x-rays at detecting
asbestos-related lung abnormalities in
individuals who have been exposed to
asbestos (14).
A lung
biopsy, which detects
microscopic asbestos fibers in pieces of
lung tissue removed by
surgery, is the most reliable test to
confirm the presence of asbestos-related
abnormalities. A
bronchoscopy is a less invasive test
than a biopsy and detects asbestos fibers in
material that is rinsed out of the lungs. It
is important to note that these tests cannot
determine how much asbestos an individual
may have been exposed to or whether disease
will develop (14).
Asbestos fibers can also be detected in
urine,
mucus, or feces, but these tests are not
reliable for determining how much asbestos
may be in an individual’s lungs (2).
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How can workers protect themselves from
asbestos exposure?
The Occupational Safety and Health
Administration (OSHA) is a component of the
U.S. Department of Labor (DOL) and is the
Federal agency responsible for health and
safety regulations in maritime,
construction, manufacturing, and service
workplaces. OSHA established regulations
dealing with asbestos exposure on the job,
specifically construction work, shipyards,
and general industry, that employers are
required to follow. In addition, the Mine
Safety and Health Administration (MSHA),
another component of the DOL, enforces
regulations related to mine safety. Workers
should use all protective equipment provided
by their employers and follow recommended
work practices and safety procedures. For
example, National Institute for Occupational
Safety and Health (NIOSH)-approved
respirators that fit properly should be worn
by workers when required.
Workers who are concerned about asbestos
exposure in the workplace should discuss the
situation with other employees, their
employee health and safety representative,
and their employers. If necessary, OSHA can
provide more information or make an
inspection. Regional offices of OSHA are
listed in the "United States Government"
section of a telephone directory’s blue
pages (under "Department of Labor").
Regional offices can also be found at
http://www.osha.gov/html/RAmap.html on
the Internet.
More information about asbestos is
available on the OSHA Asbestos Web page,
which has links to information about
asbestos in the workplace, including what
OSHA standards apply, the hazards of
asbestos, evaluating asbestos exposure, and
controls used to protect workers. This page
is available at
http://www.osha.gov/SLTC/asbestos/index.html
on the Internet. OSHA’s national office can
be contacted at:
|
Organization: |
Office of Public Affairs
Occupational Safety and Health
Administration
U.S. Department of Labor |
|
Address: |
Room
N–3649
200 Constitution Avenue, NW.
Washington, DC 20210 |
|
Telephone: |
202–693–1999
1–800–321–6742 (1–800–321–OSHA)
|
|
TTY
(for deaf or hard of hearing
callers): |
1–877–889–5627 |
|
Internet Web site: |
http://www.osha.gov/as/opa/worker/index.html
(workers’ page) |
Mine workers can contact MSHA at:
The National Institute for Occupational
Safety and Health (NIOSH), part of the
Centers for Disease Control and Prevention,
is another Federal agency that is concerned
with asbestos exposure in the workplace.
NIOSH conducts asbestos-related research,
evaluates work sites for possible health
hazards, and makes exposure control
recommendations. In addition, NIOSH
distributes publications on the health
effects of asbestos exposure and can suggest
additional sources of information. NIOSH can
be contacted at:
|
Organization: |
Education
and Information Division
Information Resources Branch
National Institute for Occupational
Safety and Health |
|
Address: |
Robert A. Taft
Laboratories
4676 Columbia Parkway
Cincinnati, OH 45226 |
|
Telephone: |
1–800–356–4674
(1–800–35–NIOSH) |
|
E-mail: |
eidtechinfo@cdc.gov |
|
Internet Web site: |
http://www.cdc.gov/niosh |
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What programs are available to help
individuals with asbestos-related diseases?
Some people with asbestos-related illness
may be eligible for Medicare coverage.
Information about benefits is available from
Medicare’s Regional Offices, located in 10
major cities across the United States and
serving specific geographic areas. The
Regional Offices serve as the agency’s
initial point of contact for beneficiaries,
health care providers, state and local
governments, and the general public. Contact
information for each Regional Office can be
found at
http://www.cms.hhs.gov/RegionalOffices
on the Internet. General information about
Medicare is available by calling toll-free
1–800–633–4227 (1–800–MEDICARE) or visiting
http://www.medicare.gov on the Internet.
People with occupational asbestos-related
diseases also may qualify for financial
help, including medical payments, under
state workers’ compensation laws. Because
eligibility requirements vary from state to
state, workers employed by private companies
or by state and local government agencies
should contact their state workers’
compensation board. Contact information for
state workers’ compensation officials may be
found in the blue pages of a local telephone
directory or at
http://www.dol.gov/esa/regs/compliance/owcp/wc.htm
on the Internet.
If exposure occurred during employment
with a Federal agency, medical expenses and
other compensation may be covered by the
Federal Employees’ Compensation Program,
which is administered by the DOL, Employment
Standards Administration’s Office of
Workers’ Compensation Programs. This program
provides workers’ compensation benefits to
Federal (civilian) employees for
employment-related injuries and diseases.
Benefits include wage replacement, payment
for medical care, and, where necessary,
medical and vocational
rehabilitation assistance in returning
to work. Benefits may also be provided to
dependents if the injury or disease causes
the employee’s death. The program has 12
district offices nationwide.
In addition, the Longshore and Harbor
Workers’ Compensation Program provides
benefits to longshoremen, harbor workers,
other maritime workers, and other classes of
private industry workers who are injured
during the course of employment or suffer
from diseases caused or worsened by
conditions of employment. Information about
eligibility and how to file a claim for
benefits under either of these programs is
available from:
|
Organization: |
Office of
Workers’ Compensation Programs
Employment Standards Administration
U.S. Department of Labor |
|
Address: |
Frances Perkins
Building
200 Constitution Avenue, NW.
Washington, DC 20210 |
|
Telephone: |
1–866–692–7487
(1–866–OWCPIVR)
202–693–0040
(Federal Employees’ Compensation
Program)
202–693–0038
(Longshore and Harbor Workers’
Compensation Program) |
|
E-mail: |
OWCP-Public@dol.gov |
|
Internet Web site: |
http://www.dol.gov/esa/owcp_org.htm |
Eligible veterans may receive health care
at a Department of Veterans Affairs (VA)
Medical Center for an asbestos-related
disease. Veterans can receive treatment for
service-connected and nonservice-connected
medical conditions. Information about
eligibility and benefits is available from
the VA Health Benefits Service Center at
1–877–222–8387 (1–877–222–VETS) or on the VA
Web site at
http://www1.va.gov/health on the
Internet.
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Is there legislation to help victims of
asbestos-related health diseases?
No Federal legislation has been enacted
yet to compensate victims of
asbestos-related diseases or to protect
people from asbestos exposure. However, in
2005, the Fairness in Asbestos Injury
Resolution (FAIR) Act (Senate bill 852) was
introduced into Congress (15).
This bill would create a national trust fund
to compensate victims suffering from
asbestos-related diseases. The proposed
trust fund would be administered by the DOL,
outside of the courts, through a claims
process whereby all those with certain
medical symptoms and evidence of
asbestos-related disease would be
compensated. Funding for the trust would
come from insurance companies and companies
that mined, manufactured, and sold asbestos
or asbestos products. Under the bill,
individuals affected by asbestos exposure
would no longer be able to pursue awards for
damages in any Federal or state court.
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What other organizations offer
information related to asbestos exposure?
The organizations listed below can
provide more information about asbestos
exposure.
The Agency for Toxic Substances
and Disease Registry (ATSDR) is the
principal Federal agency responsible for
evaluating the human health effects of
exposure to hazardous substances. The agency
works in close collaboration with local,
state, and other Federal agencies, with
tribal governments, and with communities and
local health care providers to help prevent
or reduce harmful human health effects from
exposure to hazardous substances. The ATSDR
provides information about asbestos and
where to find occupational and environmental
health clinics. The ATSDR can be contacted
at:
|
Organization: |
Agency for
Toxic Substances and Disease
Registry |
|
Address: |
1825 Century
Boulevard
Atlanta, GA 30345 |
|
Telephone: |
1–800–232–4636 (1–800–CDC–INFO)
|
|
TTY: |
1-888-232-6348 |
|
E-mail: |
cdcinfo@cdc.gov |
|
Internet Web site: |
http://www.atsdr.cdc.gov
|
The U.S. Environmental Protection
Agency (EPA) regulates the general
public’s exposure to asbestos in buildings,
drinking water, and the environment. The EPA
offers a Toxic Substances Control Act (TSCA)
Hotline and an Asbestos Ombudsman. The TSCA
Hotline provides technical assistance and
information about asbestos programs
implemented under the TSCA, which include
the Asbestos School Hazard Abatement Act and
the Asbestos Hazard Emergency Response Act.
The Asbestos Ombudsman focuses on asbestos
in schools and handles questions and
complaints. Both the TSCA Hotline and the
Asbestos Ombudsman can provide publications
on a number of topics, particularly on
controlling asbestos exposure in schools and
other buildings. The Ombudsman operates a
toll-free hotline for small businesses,
trade associations, and others seeking free,
confidential help.
The EPA Web site includes a list of EPA
regional and state asbestos contacts at
http://www.epa.gov/asbestos/pubs/regioncontact.html
on the Internet. In addition, EPA’s Asbestos
and Vermiculite home page provides
information about asbestos and its health
effects and links to asbestos resources,
including suggestions for homeowners who
suspect asbestos in their homes, and laws
and regulations applicable to asbestos. This
page can be found at
http://www.epa.gov/asbestos/ on the
Internet. Questions may be directed to:
|
Organization: |
U.S.
Environmental Protection Agency
EPA West Building
National Program Chemicals Division
|
|
Address: |
Mail Code 7404T
1200 Pennsylvania Avenue, NW.
Washington, DC 20460 |
|
TSCA
Hotline: |
202–554–1404 |
|
TTY:
|
202–554–0551 |
|
Asbestos Ombudsman: |
1–800–368–5888 |
|
E-mail: |
tsca-hotline@epa.gov
|
|
Internet Web site: |
http://www.epa.gov/asbestos/
|
Another EPA resource that may be of
interest is the brochure titled Current
Best Practices for Preventing Asbestos
Exposure Among Brake and Clutch Repair
Workers. Released in April 2007, this
brochure includes work practices for both
automotive professionals and home mechanics
that may be used to avoid asbestos exposure.
It also summarizes existing OSHA regulatory
requirements for professional auto
mechanics. The brochure supersedes the EPA’s
existing Guidance for Preventing
Asbestos Disease Among Auto Mechanics,
which is known as the "Gold Book." The
brochure can be found at
http://www.epa.gov/asbestos/pubs/brakesbrochure.html
on the Internet.
The U.S. Consumer Product Safety
Commission (CPSC) is responsible
for protecting the public from unreasonable
risks of serious injury or death from more
than 15,000 types of consumer products,
including asbestos, under the agency’s
jurisdiction. The CPSC maintains a toll-free
24-hour hotline where callers can obtain
product safety and other agency information
and report unsafe products. In addition,
CPSC publications provide guidelines for
repairing and removing asbestos, and general
information about asbestos in the home. CPSC
can be contacted at:
|
Organization: |
Office of
Information and Public Affairs
U.S. Consumer Product Safety
Commission |
|
Address: |
4330 East West
Highway
Bethesda, MD 20814 |
|
Telephone: |
1–800–638–2772 |
|
TTY
(for deaf or hard of hearing
callers): |
1–800–638–8270 |
|
E-mail: |
info@cpsc.gov |
|
Internet Web site: |
http://www.cpsc.gov |
Individuals can also contact their local
or state health department with questions or
concerns about asbestos.
Information about cancer is available by
calling the
National Cancer Institute’s (NCI)
Cancer Information Service (CIS) at
1–800–4–CANCER (1–800–422–6237) or by
visiting the NCI’s Web site at
http://www.cancer.gov on the Internet.
The NCI is a component of the
National Institutes of Health.
Information about quitting smoking,
including smoking cessation counseling, is
available by calling the NCI’s Smoking
Quitline toll-free at 1–800–44U–QUIT
(1–800–448–7848) or visiting the NCI’s
smoking cessation Web site at
http://www.smokefree.gov on the
Internet.
