Glimmers of Hope 2020
Developments this year have been unprecedented in living memory: lives lost, families decimated, health systems attacked and economies wrecked. There have been few communities which have been spared the devastation wrought by the coronavirus. Despite this bleak scenario, campaigners and groups working to support victims of asbestos-related diseases continued their efforts, recognizing that amongst those most vulnerable to Covid-19 were people whose lungs had been damaged by asbestos. This snapshot of some of the outstanding initiatives rolled out in 2020 is indicative of the long-term sustained efforts being made to address another global pandemic, one caused by exposures to asbestos, which is claiming up to 250,000 lives a year.
Accomplishments of asbestos victims in: Brazil, Japan, South Africa and UK
One of the highlights of the year was the expansion of a surveillance and treatment program for Brazilians at high risk of contracting asbestos-related diseases, a collaborative initiative of the Brazilian Association of the Asbestos-exposed (ABREA) and medical experts.1 Explaining the roll-out of the asbestos outreach clinic, Dr. Ubiratan de Paula Santos explained:
The impact of Covid-19 has highlighted the vulnerability of people with asbestos-related diseases. This knowledge has incentivized medical professionals to prioritize outreach work such as regular contact, at short intervals, with patients with diseases related to asbestos to assess those with possible symptoms of Covid-19, as well as provide guidance on vaccination against influenza and pneumonia.
Asbestos Outreach Clinic in São Paulo, Brazil on November 14, 2020 [photo courtesy of Alexandro Cristino Guimarães].
On December 16, 2020, it was confirmed that the President of ABREA Eliezer João de Souza had been diagnosed with the coronavirus; reports from São Paulo suggest that he is making a steady recovery.
In Japan, the Mesothelioma Peer Support Caravan a nationwide informal association run by asbestos cancer victims continued to organize weekly online meetings post-Covid. The group had been using computer technology as well as in-person meetings well before the pandemic to enable mesothelioma patients to provide support for one another despite the geographical distances between them. A report on the challenging reality of life for Japanese mesothelioma sufferers based on the Groups research was published this year based on interviews with 88 patients. Legal actions against the Japanese government and former manufacturers of building materials brought on behalf of more than a thousand asbestos-injured construction workers or surviving family members continued throughout 2020. To date there have 15 court judgments decisions (9 verdicts from 7 district courts and 6 from 3 high courts) with 14 plaintiffs victories. On December 14, 2020, a plaintiffs verdict which dismissed an appeal brought by the Government was issued by the Supreme Court for construction workers from Tokyo; the Court ordered the Japanese Government to pay US$ 22 million to 350 asbestos-injured construction workers or surviving family members as per a 2018 order by the Tokyo High Court.2 The new ruling which acknowledged the Governments responsibility for the illnesses of both employed and self-employed workers was the first to hold the Government responsible for asbestos injuries to construction workers. In light of the stress asbestos litigation places on injured claimants, support is growing for the establishment of an asbestos compensation scheme funded by the Japanese government and former asbestos manufacturers.
In South Africa, a victims group from the former asbestos mining town of Kuruman has been collaborating throughout the year with stakeholders in the Northern Cape, Lesotho and overseas to improve medical care, provide practical assistance and progress efforts to eradicate asbestos contamination of local schools.
Participants at asbestos diseases medical workshop at Henrietta Stockdale Nursing School, Kimberley, South Africa. February, 2020 [photo courtesy of Tracey Woods].
Unfortunately, plans were severely impacted by the pandemic but partnering organizations are hopeful that asbestos remediation of a Maipeing school will commence in 2021 and that the new equipment library for asbestos patients will be operational at the Robert Mangaliso Sobukwe Hospital in Kimberley in January.
Feedback from the Chair of the Asbestos Victims Support Groups Forum UK (the Forum) Joanne Carlin underlined the duality of efforts undertaken by UK support groups which included not only administrative work but also lobbying to protect the interests of asbestos victims:
While Forum members progressed their day-to-day work on behalf of individual asbestos victims, the Forum acted quickly at the beginning of lockdown to liaise with the Department of Work and Pensions to ensure benefits for mesothelioma and lung cancer patients continued to be processed effectively and efficiently, without the need for patients to have to post forms etc. Unfortunately, the processing of asbestosis and pleural thickening cases has been more of an up-hill struggle as face-to-face medicals ceased and no action was taken to progress claims. Thankfully, claims are now being processed after a 9-month campaign, during which Forum members wrote to MPs as well as ran a social media campaign whereby we sent posts at the same time every Friday to raise awareness. This has enabled Forum groups to establish or re-establish links with supportive MPs. Throughout the year, the Forum worked closely with the TUC, the All-Party Parliamentary Asbestos Sub-Group and various advisory and steering groups which are pushing ahead with mesothelioma research initiatives and campaigns to raise public awareness.3
Campaigns by ban asbestos campaigners in: Korea, Indonesia and Laos.
Reporting from South Korea, Dr. Domyung Paek one of the organizers of the Ban Asbestos Network of Korea (BANKO) said:
Here in Korea, we also felt the pressure of Covid-19, disrupting every aspect of our lives. Meeting in person has become almost impossible and that makes us hesitant even over hospital visits for routine care. Asbestosis sufferer Mr. Ji-yeol Chung, one of the Chairpersons of BANKO, was diagnosed with lung cancer last year. He had been treated with several rounds of chemotherapy, but recently the cancer has metastasized to his brain. It has been difficult for him and his family to visit hospitals freely due to Covid-19, and we hope that we can see him in person someday in the near future.
Despite the pandemic BANKO continued to monitor asbestos-related issues and recently discovered that some white cement products being used in Korea may contain up to 1% tremolite. We are pressing the Ministry of Environment to adopt a protocol setting the permissible level of such contamination at 0.1%. During 2020, the campaign by Mothers Concerned about Asbestos in Korean Schools highlighted dangerous loopholes in regulations for the asbestos removal industry and requested the National Board of Audit and Inspection conduct a review of industry practices. This request was accepted and we are optimistic that in 2021 standards for asbestos removal will be brought into line with the best practice for zero carcinogens.4
The work of the Vietnam Ban Asbestos Network (VBAN) was featured in a documentary shown this year on Vietnamese TV. The film won the National Film and Television Award for best documentary despite asbestos industry objections. Recognition of the asbestos hazard has grown throughout the year, helped by a national communication plan by the Governments Department for Ethnic Minorities dedicated to changing consumer behavior i.e. stopping consumers from buying asbestos products. Topical issues addressed in 2020 included the need for regulations on the safe disposal of asbestos waste, labelling of consumer products that contain asbestos and raising the hazardous chemical rating of chrysotile asbestos. In December, medical experts from 19 hospitals in 10 provinces attended a medical training course in Hanoi on asbestos-related diseases during which Associate Professor and Vice Director of Vietnam Health Environment Management Agency Luong Mai Anh highlighted the importance of protecting Vietnamese people from harmful exposures to asbestos and confirmed her support for banning the use of chrysotile asbestos in Vietnam.
Mdm. Luong Mai Anh giving the opening speech on December 11, 2020 in Hanoi, Vietnam [photo courtesy of Nguyen Xuan Lam, Australias Union Aid Abroad APHEDA].
Presentations during the Hanoi event also discussed the repercussions of environmental as well as occupational asbestos exposures, the capacity of Vietnamese health facilities to diagnose cases of asbestos-related cancer and the content of new guidelines for the diagnosis of asbestos-related lung disease.
Collaborative efforts by the Indonesian Ban Asbestos Network, Local Initiative OHS Network and Australias Union Aid Abroad (APHEDA)5 have seen great progress this year on regional asbestos bans, including asbestos prohibitions for post-disaster reconstruction in Central Sulawesi and for temporary shelters nationwide. In February, Bandung City Assembly extended its previous decision on banning asbestos-containing materials from use in new commercial buildings to use in all new residential buildings. This makes Bandung City the first in Indonesia to effectively ban asbestos from all new buildings.
In Laos, a campaign by the Lao Ban Asbestos Network, Lao Federation of Trade Unions (LFTU) and APHEDA has raised awareness of the asbestos hazard amongst workers, healthcare university students and vendors of roof sheeting products. The LFTU also conducted a survey of seven out of the countrys nine factories manufacturing asbestos-containing roof sheeting to quantify the numbers of workers at risk and the amount of asbestos being used. Production capacity of asbestos roof sheeting has reduced by almost 50% in recent years partly due to campaigns to raise awareness of the asbestos hazard.
Progress on Asbestos Research
Despite the devastating impact of the coronavirus epidemic in the UK,6 work by clinicians and researchers to improve treatment and diagnostic protocols for victims of asbestos-related diseases continued. A high point of the year was the opening of the Mesothelioma UK Research Center-Sheffield. The ultimate aim of the Center, the first of its kind in the UK, is to improve outcomes and better understand peoples experience of living with mesothelioma, the signature cancer caused by asbestos exposure. Broad-based support for Mesothelioma UK7 a national specialist resource center specifically for the asbestos-related cancer, mesothelioma has enabled the charity to expand its specialist nursing team to 30, with new posts set up this year in West Yorkshire, the East of England and Kent. Mesothelioma UKs partnerships with diverse charities, alliances, networks and organizations has been crucial in developing the provision of mesothelioma clinical nursing in Scotland and Wales and raising the profile of mesothelioma during 2020.
Meeting the challenges imposed by Covid-19 restrictions head-on, Mesothelioma UKs operational team adopted new technologies so that staff could continue to interact with patients albeit using telemedicine to conduct follow-up appointments and symptom management, as well as provide emotional support from afar. On this theme, Mesothelioma UK increased its use of videos for information and community building via social media channels. During the Spring lockdown, a weekly Facebook live question and answer session was implemented to provide information about shielding, attending hospital appointments and other areas of concern. Recorded interviews with key people across the mesothelioma community which were shared online proved very popular.
Since June 2020, research on asbestos-related diseases continued more or less unhindered in Western Australia due to the states low incidence of the virus. According to a colleague at the National Centre for Asbestos-Related Diseases (NCARD):
The upside of the lockdown prior to June was the opportunity to focus on submitting papers for publication, and we were especially pleased to have a paper published in The Lancet Oncology on the DREAM study.8 The much anticipated third phase clinical trial which combines chemotherapy and immunotherapy has had many delays for many reasons, but will be commencing early in the new year.9
In December 2020, NCARD marked a milestone anniversary of a remarkable research program undertaken in collaboration with members of the Asbestos Diseases Society of Australia (ADSA).10 Over three decades, the health of nearly 5,000 participants at high-risk of contracting asbestos-related diseases was monitored during annual check-ups. Amongst the procedures conducted were taking of blood samples, lung function tests and chest X-rays. Medical personnel also provided health advice and support for the patients who initially attended the Perth Chest Clinic but now visit the Department of Respiratory Medicine at Sir Charles Gairdner Hospital.11
30th Anniversary Celebration of Asbestos Review Program, formerly called the Vitamin A Program, in Perth, Australia [photo courtesy of Brian Cowie, Media Office, Sir Charles Gairdner Hospital].
Over on Australias East Coast, researchers at The Asbestos Diseases Research Institute (ADRI) continued exploring alternative biomarker and therapeutic options for diagnosing and treating patients with mesothelioma. In the clinical field, ADRI focused on translational research for improving the outcome of immunotherapy administered to mesothelioma patients. ADRIs support service provided face-to-face, telephone and online support groups, treatment and clinical trial updates and guidance to specialist support groups across the country. During the year, ADRIs Mesothelioma Support Coordinators worked with nearly 70 patients and their carers.12
Status Updates on Global Campaigns
Confirmation received in November 2020, that the Asian Development Bank was putting into action its pledge to ban asbestos in all its projects was very welcome. In a letter explaining the work to achieve this goal, an ADB representatives wrote that the bank was: taking several actions intended to limit the risks of asbestos exposure in our projects: we are now preparing an internal memorandum that recommends for future ADB projects to refrain from supporting the procurement of any products containing asbestos 13 Urging the Bank to prioritize the updating of its Safeguard Policy Statement in order to achieve a total asbestos ban, Kate Lee from Australia's Union Aid Abroad (APHEDA) said the ban could not come soon enough.
Throughout 2020, global efforts raised the profile of the harm posed by the asbestos contamination of talc-based cosmetics such as Johnson & Johnsons iconic baby powder. The companys decision to withdraw talc-based baby powder from sale in North America whilst continuing to promote it elsewhere was universally deplored.14 Articles in multiple languages serving populations in far-flung countries reported laboratory findings of asbestos contamination in a range of personal care and hygiene products. The hazard posed by the sale of Johnson & Johnsons baby powder brought together civil society groups representing ethnic minorities, consumer advocates, health and safety campaigners, asbestos victims, legal experts and others from scores of countries; the lobbying being done by the network which coalesced around this issue will continue into 2021.
If anything sums up this years hard-won victories it is the rechristening of the Quebec mining town from Asbestos to Val-des-Sources (Valley of Springs) as a result of a municipal poll held in October. On December 17, news was released that the name change had been approved by Quebecs Municipal Affairs Minister Andrée Laforest. According to a former Mayor of Asbestos Louise Moisan-Coulombe, the towns rebranding was symbolic as well as pragmatic:
Once upon a time, we were very proud of that name, but now its very difficult because asbestos means a fiber that people are afraid of... Every time you say, especially in the United States, that you are coming from Asbestos, or they read Asbestos on a package, they are always afraid that it will be poison.15
For decades the asbestos mine had provided employment for generations of workers; throughout that time, asbestos stakeholders suppressed information about the negative impact of occupational and environmental asbestos exposures and lobbied the provincial and federal governments to promote the industry at home and abroad. With the industrys demise, the air is clearing and even former asbestos vested interests are facing up to reality: there is no place in the 21st century for this industry of mass destruction.
December 22, 2020
1 Kazan-Allen, L. Brazilian Success: Pioneering Medical Program to Expand! October 21, 2020.
2 Court finalizes state payment to asbestos victims, December 16, 2020.
3 Email from Joanne Gordon. December 15, 2020.
4 Email from Dr. Domyung Paek. December 13, 2020.
6 Covid-19 situation updated for the EU/EEA and the UK, as of week 50, 2020. December 17, 2020.
According to this data, the UK has had Europes second highest number of coronavirus cases at 1,849,403 and second highest number of fatalities (64,170).
7 Mesothelioma UK. Accessed December 16, 2020.
8 Nowak, A, Lesterhuis, WJ, et al. Durvalumab with first-line chemotherapy in previously untreated malignant pleural mesothelioma (DREAM): a multicentre, single-arm, phase 2 trial with a safety run-in. September, 2020. https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30462-9/fulltext
9 National Centre for Asbestos-Related Diseases. Website accessed December 16, 2020,
10 Asbestos Review Program Marks 30th anniversary. December 15, 2020.
11 Asbestos Review Program. Accessed on December 16, 2020.
13 Kazan-Allen, L. Asian Development Bank Bans Asbestos! November 16, 2020.
14 Press Release. Death, Duplicity and Double Standards. May 25, 2020.http://ibasecretariat.org/press_rel_may_25_2020.pdf
Health Alert: Asbestos in Baby Powder. June 17, 2020.
Double Standards: Toxic Talc Banned at Home, On Sale Abroad. May 28, 2020.
Outrage over Toxic Global Strategy! June 18, 2020.
Johnson & Johnson: Its Profits, Our Lives! October 9, 2020.
White Powder, Black Lives. July 10, 2020.
15 Kazan-Allen, L. From Asbestos to Val-des-Sources. October 21, 2020.
Say goodbye Asbestos and hello to Val-des-Sources as Quebec okays name change. December 17, 2020.