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News

The Killer Within

[ The University of Melbourne Voice Vol. 3, No. 2  12 May - 9 June 2008 ]

Australia and UK have the highest rate of asbestos-related cancer deaths in the world.

One in 10 retired carpenters in Australia and the UK will die of asbestos related cancers according to visiting cancer expert Professor Julian Peto, Head of the Cancer Research UK Epidemiology and Genetics Group, London School of Hygiene and Tropical Medicine.

Using World Health Organization mortality statistics Professor Peto reveals that Australia and UK have the highest rate of asbestos-related cancer deaths in the world.

He says the mesothelioma rate is increasing everywhere. Rising trends show the death-rate in men who are now 40 will be 100 times higher by age 80. This is the basis for Professor Peto’s predictions of world-wide death-rates over the next 40 years.

Professor Peto delivered his warning in a Miegunyah public lecture for the Faculty of Medicine Dentistry and Health Sciences at the University of Melbourne last month (22 April).

Professor Peto says that although it may be thought that asbestos-related deaths are a thing of the bad old past, 500 men and 100 women now develop mesothelioma every year in Australia. As people who were born before1950 age, these predictions suggest that the epidemic will worsen for 15 years, with 900 deaths a year at the peak.

There have already been about 10 000 mesotheliomas in Australia since records began in the early 1980s, and Professor Peto predicts that 25 000 Australians will die from mesothelioma over the next 40 years.

Asbestos comes in three main types, the commonest of which is white (chrysotile), but most mesotheliomas have been caused by blue (crocidolite) or brown (amosite), says Professor Peto.

Blue asbestos use had virtually ceased by 1970 following the closure of the Wittenoom mine in Western Australia, but cement board containing brown asbestos was used until the 1980s.

Professor Peto believes that exposure to white asbestos is less dangerous because the fibres disappear from the lung after you stop exposure, just as the lung cancer risk is lower if you stop smoking. But blue and brown asbestos stay in the lung, so the exposure continues for the rest of your life.

Countries that used less blue or brown asbestos have much lower mesothelioma rates. Imports of brown asbestos reveal Australia’s and UK’s reliance on the material, with more than 10 000 tonnes per year coming into Australia at the peak in the 1970s.

The US was also a big user of asbestos, but used much less brown asbestos than Australia and the UK, and its rates of mesothelioma are now much lower. “Our rates are at epidemic proportions. In men in their 50s, the mesothelioma death-rate in Australia and UK is now five times the rate in the US,” Professor Peto says.

The main cause of the continuing epidemic was the post-war building boom in Australia.

“The hazards in manufacturing, lagging and shipbuilding were recognised, but the much larger workforce in construction went on being heavily exposed with no effective regulation at all. Australian builders, particularly carpenters, often had to cut asbestos cement board with power tools, which caused very high dust levels,” Professor Peto says.

He says that asbestos use eventually ended because of a huge scare in the 1980s about the risk to the general population from asbestos in buildings rather than concern at the much greater risk to building workers who installed it.

What concerns Professor Peto is why the dangers of brown asbestos were overlooked for so long. Questions that remain unanswered for him include: What caused the industry to reduce amosite use long before it was regulated more strictly? And why did James Hardie’s medical officer then publish an article in 1980 saying that amosite was no more dangerous than chrysotile?

“The dangers of blue asbestos had been accepted in the 1960s, but there was a tragic alliance between people trying to defend the asbestos industry by arguing that brown asbestos was no more dangerous that white asbestos, and those who were campaigning for all asbestos to be banned, who minimised differences between fibre types under the slogan ‘one fibre can kill’.

“If they had campaigned for brown asbestos to be abolished immediately at the same time as blue asbestos, its use would have been stopped 15 years earlier.”



Professor Julian Peto is a University of Melbourne 2008 Meigunyah Distinguished Visiting Fellow.



LEFT BREATHLESS

Professor Peto and colleagues also studied the lifetime occupational histories of 600 mesothelioma patients and 1400 controls in the UK, the world’s biggest study of its kind. Findings include:

The largest risk is now to construction workers, particularly carpenters, plumbers and electricians, rather than the high-risk jobs in asbestos manufacture, lagging and shipyards where the risk was first recognised.

About one in 10 carpenters born before 1950 will die of asbestos related cancers (1 in 15 from mesothelioma plus many from lung cancer).

Rates have also increased in women, although at a much lower level. Some were exposed domestically through a husband or father, but this cannot explain all of the increase. This suggests an environmental risk, although it is not clear whether this is due to widespread asbestos pollution in cities or to occasional or local exposures in particular circumstances.

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