Book Review
Defending the Indefensible: The Global Asbestos Industry and its Fight for Survival
This aptly named book is written by historians with three previous books and many journal articles on the history of the asbestos industry between them. They begin by presenting the past century graph of world asbestos use.make the point that, despite all that was known about the lethality of asbestos by 1960, and with the publicity over mesothelioma triggered that year by Wagner's report, world asbestos use soared afterwards. Nearly 80 percent of all asbestos used in the 20th century was used after 1960. Fifty percent occurred after 1976. The authors conclude that the asbestos industry mounted an aggressive defense that was successful for many years and is still used in some countries. The defense is presented as a pattern of concealment and misinformation "that often amounted to a conspiracy to continue selling asbestos fibre irrespective of the health risks." This book is an effort to lay out this epic global history in less than 300 pages, on the theme of the asbestos industry's ruthless strategy.
The growth of asbestos use in construction materials and brake linings and the way these products were used by workers unaware of the deadly danger of dust all around them is vividly described. The grotesque exploitation of workers in the South African asbestos mines is described, based on research and interviews done by McCulloch (more fully described in his book, Asbestos Blues). The memos of company doctors describe terrible working conditions and asbestosis in the Canadian asbestos mines and French asbestos factories. In the meanwhile, the published medical recognition of asbestosis by the mid-1930s, then lung cancer, and in the early 1960s mesothelioma played out in the background, largely unknown to the workers.
Onto the scene came Dr. Irving Selikoff in the early 1960s, presenting the asbestos industry with an extraordinary challenge in the US. Selikoff was an epidemiologist doing research with the cooperation of the asbestos insulation workers' union, documenting the appalling mortality of these men and masterfully presenting it to scientists and the media. “For the industrialists, Selikoff was the physician from hell: they had no scientific studies to counter him and lacked his flair for publicity.” His story is told in considerable detail, first highlighted by a major medical conference he organized in New York in 1964. Much of the documentation, including repeated efforts to smear and discredit Selikoff, comes from company and trade association internal documents revealed in litigation, though additional insights are drawn from recent interviews with people who worked with Selikoff (1915-1992).
Industry created research organizations such as the Industrial Hygiene Foundation, which the asbestos manufacturers used for confidential surveys in the 1940s and skewed epidemiology in the 1950s. Then there were asbestos industry front groups, starting with the Asbestosis Research Council in the UK in 1957 and the Institute for Occupational and Environmental Health in Canada. These were by 1970 followed by more frankly named propaganda groups (Asbestos Information Committee in the UK, Asbestos Information Association in the US), guided by Hill & Knowlton public relations damage-control specialists who had learned their skills working for the tobacco industry. The techniques of these groups are described in some detail, along with their message (asbestos disease is rare, the public is not at risk, asbestos saves lives, proper controls have been implemented at great expense to the industry, only blue asbestos causes mesothelioma, asbestos in brake linings and cement sheets is “locked in”, etc.).
The 1970s brought the challenge of regulation of asbestos in industry and the environment, and publicity about asbestos as a public health hazard. The national asbestos trade associations defended the industry in the arenas of public relations and regulation. This included the endless wrangling about how much asbestos exposure was safe or acceptable, and how much risk was theoretically associated with long-term exposure to concentrations of asbestos on which there was and still is no epidemiology available. The Asbestos Information Association chief expressed satisfaction with the Nixon administration's acceptance of most of the industry's positions in issuing the workplace asbestos standard months before the 1972 presidential election. The US industry group later served as a gathering place for development of defense strategies as the deluge of lawsuits brought by asbestos victims started coming in. “The industry's overall strategy … was to shift the hidden costs of production onto labour or the state.”
The industry reacted to the challenge of mesothelioma, a signal tumor of asbestos exposure, with what is called the “chrysotile defense” or the “amphibole hypothesis”. Chrysotile, or white asbestos, has accounted for about 95% of all the asbestos ever used in industry. The other types of asbestos are called amphiboles by geologists. Simply put, the authors relate this defense as follows:
(W)hite asbestos is benign and the amphiboles alone are responsible for asbestos-related diseases, especially mesothelioma. Chrysotile, therefore, if it is handled in a “controlled” fashion can still be used and the world can continue to enjoy the material's prodigious benefits – especially in the developing world, where any health risks are outweighed by the flow of clean water through asbestos-cement pipes.
In Canada, the asbestos industry started to sponsor research at McGill University soon after Selikoff's conference in 1964. Doug Liddell, one of the Canadian Chrysotile School, editorialized in 1997 that chrysotile asbestos was “essentially innocuous, except possibly in textile manufacture.” The editorial whined that Selikoff and other doctors at the Mt. Sinai School of Medicine were motivated by “intense malice” in calling for control measures.
By then, the once-dominant US and UK asbestos multinationals were gone, but the government of Canada has continued to play a singularly “malevolent role in promoting asbestos use in the developing world.” This included such things as pressuring other countries to drop warning label requirements, using embassies to hold conferences promoting asbestos and dismissing health concerns, using influence at international U.N. organizations to downplay the risks of chrysotile asbestos, bringing a challenge at the World Trade Organization over the asbestos ban in France, and supporting the Asbestos Institute and consular officials to hold missions and workshops and lobby scientists, politicians, unionists, and journalists around the world.
Major distortions in the medical literature and suppression of industry studies are briefly described. The enlistment of famed epidemiologist, Sir Richard Doll, as a litigation consultant and defender of British asbestos interests was of critical importance. Similarly, the hiring by asbestos interests of physicians who had published reports damaging to the industry, including Christopher Wagner and Peter Elmes, was helpful in maintaining the chrysotile defense and defending damage suits. The industry's suppression of government research in South Africa, the one country where all three major types of asbestos were mined, is described in the decades following the discovery of mesothelioma cases linked to occupational and environmental asbestos exposure there in 1960. Virtually all government health research had to be approved by the asbestos industry, so there was practically none done. Even in the late 1980s, key government officials were harassed for trying to present and publish anything about the toll of asbestos in South Africa.
The authors describe how the experimental studies showed chrysotile to be as carcinogenic as the amphiboles. Most occupational exposure was to mixed fiber types, limiting the information available by fiber type. Products frequently were made with two types of commercially available asbestos, and factory workers could be exposed to multiple fiber types used in different products made in the same plant. The occurrence of mixed seams of amosite and crocidolite assured that amosite would often be contaminated with crocidolite. Tremolite and even crocidolite were shown to be present as contaminants in Canadian chrysotile. Blaming the contaminant tremolite did nothing to get the commercial chrysotile product off the hook as causing asbestos disease, as no practical and economic process exists that can separate the other fiber types from mined chrysotile. The US government has never adopted a different regulatory standard for different types of asbestos, though other countries have done so.
The “elephant of compensation” has always been the mortal threat to the asbestos industry, and the authors describe how that was well known to the industry and minimized since the 1920s. The explosion of personal injury suits for asbestos disease in the US starting in the 1970s is contrasted with the situation in Europe, Australia, and Japan, where few claims were prosecuted, Litigation in these countries came mainly in the 1990s and thereafter, and compensation was minimal. In European countries, state run insurance funds pay small amounts, and most mesothelioma cases identified by national authorities go uncompensated. Bystander and environmental cases are rarely compensated. In India and other countries in the developing world, mesothelioma is still not formally recognized as an occupational disease. Very rarely is lung cancer from asbestos compensated anywhere, and usually this is only in a few cases where the claimant also has asbestosis. Outside the US, pre-trial legal discovery is minimal to nonexistent, so it is still unknown what the asbestos companies in most countries knew and did about their awareness of the asbestos hazard to workers and customers.
The impoverishment of affected workers and their families eventually led to the formation of asbestos victims' groups starting in the UK and the US in the late 1970s. The authors list more than two dozen such groups around the world. The victims' groups have been instrumental in securing asbestos bans and getting compensation for asbestos victims in Australia, Brazil, Britain, Japan, and other countries.
Civil courts have awarded extra compensation for “contumelious disregard” in Australia, “inexcusable fault” in France, “moral damages” in Brazil, and willful, reckless disregard by companies ordered to pay punitive damages in the US. But there have been no criminal prosecutions of officials in the asbestos industry except a case in Italy. In many cases, the responsible individuals had died by the time evidence of their actions was revealed in litigation.
Civil suits began to succeed in the UK in the 1990s, and by 2000, the compensation battle was fully joined in the UK. Defendants and insurers spun off liabilities into shell companies that went bankrupt. One outrageous decision after another followed in the British courts, steadily reducing the compensation to asbestos victims. The most extreme of these was reversed by legislation after public outcry. It didn't seem that the courts had got it right to let all the defendant corporations off, because a mesothelioma victim could not scientifically establish which among multiple occupational asbestos exposures caused the cancer. On the other hand, the House of Lords ruled that South African asbestos victims could bring a class action in the UK against Cape Industries, a British corporation that had left only devastation in South Africa after leaving the country in 1979.
The appalling situation in Russia and Kazakhstan, leading asbestos mining and exporting countries, is rendered from the slim public record and Jock McCulloch's interviews in Kazakhstan. In major asbestos consuming countries such as Brazil and India, it is noted that the foreign multinational asbestos corporations are gone, replaced by national companies with close relations to the governments and little concern about public image.
Asbestos victims have their stories and voices in this account, quoted from legal depositions, company records, and proceedings of international conferences organized since 2000 by the International Ban Asbestos Secretariat and other groups.
The book closes with some hope on account of the efforts of the International Ban Asbestos Secretariat, activists, unionists, politicians, lawyers, journalists, and dedicated government workers, holding major conferences every year or two and starting and supporting social movements all over the world.
By necessity, statements are made that are elaborated upon and referenced in other sources, many of them articles written by the authors of this book. This is an authoritative examination of how it has come about that most of the world's people still live in countries where asbestos is carelessly used, and global asbestos use is holding steady or rising in the new century at around half the historic peak levels of consumption of the 1970s and 1980s.
