Literature Review
On December 6, 2008, the editorial entitled Asbestos-related Disease a Preventable Burden was published in The Lancet.1 Reviewing recent judicial developments in the UK, the editorial points out that the UK asbestos epidemic is likely to be replicated in developing countries where asbestos is still widely used. It singles out Canada as the only high-income country that still mines asbestos (in the form of chrysotile), and it is the second largest exporter of the toxin in the world (after Russia). It is categorical in its support of WHO guidelines and states that the only way to eliminate asbestos-related disease is to stop the use of all types of asbestos, all over the world.
Mesothelioma in a Worker Who Spun Chrysotile Asbestos at Home During Childhood, a paper published online on January 13, 2009, leaves little room for doubt about the consequences of human exposure to chrysotile in China; the authors conclude that:
Chrysotile with little contamination of tremolite can lead to early development of malignant mesothelioma when heavily exposed from childhood at a company residence with household exposure. There can be several mechanisms for tremolite to remain in the lung tissue, far exceeding chrysotile in number.2
The focus of this paper was the fatal effects of such exposure on a 35-year-old man who had not only worked in an asbestos textile factory in Chongqing but had also been brought up in an environment heavily contaminated with chrysotile asbestos. As a child he had lived in a housing complex run by the asbestos company for which his father worked; from 14 to 17 years of age, he had helped his father by manually spinning asbestos thread brought into the home:
The work was performed in a room of his house 10m2 in size, with windows kept closed to shield from the wind and with no respiratory protection. Even today in the plant, the only respiratory protective device used is a thin cloth mask.
He died of malignant mesothelioma at the age of 37 in Chongqing Medical University Hospital.
It is of interest to note that although the chrysotile he was exposed to whilst working for 4 years at the asbestos textile factory in Chongqing contained less than 0.001% tremolite and other forms of amphiboles: the vast majority of the fibers found in the lung tissue of a biopsy sample was tremolite (even though) the proportion of tremolite detected in the work environment was far less (1%, or less) than that of chrysotile. In addition, even less tremolite was observed in the raw asbestos material The authors state that the prevention of asbestos-related disease among chrysotile-exposed workers requires reduction of exposure to commercial chrysotile.
On January 18, 2009, a photo-essay entitled In Pictures: The Victims of Asbestos was published in the newspaper Scotland on Sunday.3 Having begun the article with a snapshot of the work done by Clydeside Action on Asbestos, a grassroots group based in Glasgow which was established 23 years ago, Journalist Peter Ross put the Scottish asbestos tragedy into a wider context:
asbestos is a global problem. It continues to be used widely as a building material in poorer countries and, according to the World Health Organization, it kills at least 90,000 people each year. Some sense of this can be seen in the work of the award-winning photographer Louie Palu who has journeyed from his native Canada to India, England and Scotland, taking stark black-and-white pictures of sufferers. 'No one deserves to die because they go to work and breathe a dust that gives them a death sentence,' says Palu
'There seems to be no worldwide outrage because it is a silent killer,' he (Palu) says. 'I sometimes imagine that if all the asbestos victims died at once on the streets, people would then grasp that something has to be done.'
The photographs taken by Palu which are at the end of the article graphically illustrate the devastating effect asbestos exposure has had on individuals and the pervasiveness of the contamination which exists in both developed and developing countries
February 4, 2009
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1 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(08)61821-8/fulltext
2 Yano E, Wang ZM, Wang XR, et al. Mesothelioma in a Worker Who Spun Chrysotile Asbestos at Home During Childhood. Published online on January 13, 2009. American Journal of Industrial Medicine.
http://www3.interscience.wiley.com/journal/121631869/abstract
3 Ross P. In Pictures: The Victims of Asbestos. Scotland on Sunday. January 18, 2009. http://scotlandonsunday.scotsman.com/spectrum/In-pictures-The-victims-of.4884891.jp