12 March 2018

Health challenge from asbestos is still with us

Clinical Public Health Respiratory

Fifteen years after Australia imposed a complete ban on asbestos, researchers say the risk of exposure to the potentially deadly respirable fibres remains a significant public-health challenge.

The incidence of deadly mesothelioma is only now believed to be topping out at about 700 diagnoses a year, reflecting the long latency period and Australia’s past avid production and consumption of asbestos products.

“We had an asbestos ban in 2003. But many people were exposed before that time and people are continuing to be exposed,” epidemiologist Matthew Soeberg, of the Asbestos Disease Research Institute (ADRI), said.

“This is not an issue that is going to go away overnight. We are starting to see a peak, but about 700 people are still being diagnosed with mesothelioma every year. That is not an insignificant amount.”

Deaths from all asbestos-related conditions related to occupational exposure in Australia were estimated at 4048 in 2016, according to a recent ADRI report.

Three quarters of those deaths were from lung cancer.  Of the remainder, 19% died from malignant mesothelioma, usually within nine to 12 months of diagnosis, and the remaining 6% died from larynx cancer, ovarian cancer or asbestosis.

Occupational exposure remained a danger, especially for workers such as plumbers and electricians, Dr Soeberg said.

“There is still a lot of asbestos in Australian buildings, homes and infrastructure. People digging up roads and pipes are at risk. Constant vigilance is required,” he said.

Currently, the highest risk of non-occupational exposure is associated with people renovating or living in renovated properties that were built before the 1990s.

“In people who have been exposed outside of workplaces, there is a 50-50 split between men and women,” Dr Soeberg said, noting more research was needed in this area.

Data collected by the Australian Mesothelioma Register over seven years to 2017  listed 113 men and 119 women with non-occupational exposure. In a further 50 people, there was no evidence of occupational or non-occupational exposure.

In NSW and the ACT, authorities are still dealing with the remediation nightmare of the Mr Fluffy scandal, in which crushed asbestos was installed as ceiling insulation in thousands of homes.

Simply removing the loose-fill insulation did not remove the risk; whole properties have had to be destroyed and demolitions are continuing in a program costing billions.

Dr Soeberg said countries, including China, Russia and Kazakhstan continued to make asbestos products, exporting to unrestricted markets such as Vietnam and Fiji.

“I think that’s an important role for Australia, not just our institute, to tell the stories about the devastating impact of asbestos use and how the legacy continues to live on, ” he said.

Historically, the highest exposures are thought to have occurred in the shipyard, insulation and asbestos manufacturing industries.

But import and export trade in asbestos and asbestos products spread exposure and sickness in groups such as dock workers.

The ADRI report, published in the International Journal of Environmental Research and Public Health, says Australia’s asbestos use peaked in the 1970s.

But right up until the 2003 ban was imposed, chrysotile (white asbestos) continued to be used in friction products, sealing gaskets and adhesives.

“Many asbestos-containing products and materials remain in situ in  Australia’s residential and non-residential buildings, as well as water and sewerage piping,” the report says.