The Multinational Monitor

The following are excerpts from an interview with Barry Castleman that appeared in the September 2000 issue of Multinational Monitor. Mr. Castleman is the author of Asbestos: Medical and Legal Aspects, which is the standard reference for understanding the history of asbestos-caused diseases.

(April 2002)

MM: What are the health effects of exposure to asbestos?

Castleman:The main hazards of asbestos are attributed to the inhalation of the dust created in the manipulation and manufacture of these products. Very fine, respirable particles were first identified about 100 years ago as the cause of a lung-scarring disease called asbestosis. In the 1930s, it began to be recognized that people with this condition also had more than their expected share of lung cancer. By 1943, lung cancer was included among the list of compensable occupational diseases for asbestos workers in Nazi Germany. This gives an idea of how long it has been known that asbestos is a cancer-causing agent. Other cancers have since been attributed to asbestos, the most worrisome being a very rare form of cancer called mesothelioma of the pleura and peritoneum, which are, respectively, the thin membranes enclosing the chest cavity and the abdominal cavity. Cancers of the pleura and peritoneum are rare in the general population but quite frequent in asbestos-exposed people. It was the presence of these very rare tumors, which are now thought of as signal tumors for asbestos exposure, that made it possible to see that the mortal hazards of asbestos were clearly going beyond the factory gate into the houses of asbestos workers and the neighbors of the asbestos factory. This was confirmed by statistical studies in the mid-1960s.

MM: How much exposure is required for these health effects to occur?

Castleman:It’s generally accepted by medical authorities around the world that no level of asbestos exposure can be considered safe, and that the more exposure one has, the greater the risk. The incapacity of the lungs caused by asbestosis is the result of a multitude of insults to the lung from individual fibers. Cancer is different in that the emergence of a cancer can actually occur from as little as one asbestos fiber interacting with the cell of the lungs or another cell in the body in such a way as to start the chain of events that creates a self-reproducing malignant cell.

MM: How many workers exposed to asbestos end up with asbestos-related disease?

Castleman:There are different studies that have been done on different cohorts, or groups of people exposed to asbestos. The most extensively studied cohort was the people involved in insulation work. Beginning in the 1960s, studies on the population of insulation workers – pipe coverers were the most heavily exposed group, but they worked alongside electricians, plumbers, pipe-fitters, carpenters and other kinds of construction trades in shipyards and other construction sites – showed that about 40 percent of them were dying from occupational cancer and asbestosis. If they were still alive 30 years after starting the trade, almost all of the workers in the trade had lung scarring from asbestos.

MM: What did the industry do with the information it had on the harms of asbestos exposure?

Castleman:

Asbestos, the industry trade magazine, was starting to cover some of these events as developments of common interest to companies in the asbestos industry, whose advertisements filled the magazine. This stopped in March 1930, the last issue of Asbestos magazine for about 40 years to mention that asbestos might be dangerous to your health. The correspondence that’s been unearthed indicates that the companies were directing the trade magazine not to say anything about the hazards of asbestos. The evident reason was that they were being sued in various parts of the country – New Jersey, Illinois and other states. The last thing the companies wanted brought in as evidence while they were denying that there was any hazard were issues of the trade magazine with articles about asbestosis on one page and their advertisements on another.

MM: How did awareness of the harms of asbestos end up spreading among the public?

Castleman:

The most amazing thing was there could be this substantial body of medical and scientific knowledge published in the medical literature and in safety publications, trade magazines, insurance publications and even general encyclopedias, and yet workers on the front lines of the risk were not made aware of it for decades. The unions were minimally funded for health and safety activities, and the companies weren’t telling them about it. The companies were doing what they could to minimize regulations or any kind of public announcement of the hazards. In the 1930s, when the public health service came to do surveys in North Carolina, they were sternly admonished to not stir up any kind of damage suits by telling the workers that they were examining how dangerous asbestos was. The companies were certainly not putting any kind of warning labels on their products until the 1960s, after the mortality studies were published in the Journal of the American Medical Association in 1964. Within months of those studies, some of the companies started to put mild warning labels on their cartons of insulation products. Even then they weren’t putting warnings on sacks of pure asbestos being shipped from the mines in Canada and Southern Africa.

MM: What broke things open?

Castleman:The publication of those studies and the willingness of the doctor who conducted them – Dr. Irving Selikoff in New York – to publicize the results. Selikoff was assisted in his research by the insulation workers union locals in New York and New Jersey. They gave him their death cards. By using these cards, he was able to track down the death certificates of the individuals in the union who had joined or been members since the beginning of 1942. He followed them up through 1962. So there was a minimum of 20 years of follow-up for all the people in the study. He found that 255 of the 632 men had died. He recorded staggering excesses of cause-specific death rates, of lung cancer, mesothelioma, other cancers and asbestosis. Selikoff had an extraordinary personality. He was willing to talk to the media about these things. He understood that was part of what it was going to take to turn the situation around. Ultimately, along with Selikoff’s efforts, it took the environmental movement and the creation of the Environmental Protection Agency and the Occupation Safety and Health Administration – agencies where occupational and environmental health professionals could have a job and not be working for big business. This broke open the conspiracy of silence and started getting this information into the public domain. This came at a time, the 1970s, when the media were much more receptive to stories about environmental health, occupational hazards and the unsavory role of business.

For the full story go to Multinational Monitor

See also: The deadly truth about asbestos — A brief chronology of what the owners and managers of asbestos companies knew, and when they knew it by the New York Committee for Occupational Safety and Health.