Phillip Adams of the ABC interviews the following about asbestos
issues.
Matt Peacock
ABC Journalist and Senior Reporter with the 7:30 Report.
Jock McCulloch
Professor of History at RMIT University.
Geoffrey Tweedale
Professor of History at the Manchester Metropolitan University
[Courtesy ABC]
1
Introduction
2 Legal
Obligations
3
Asbestos containing materials (ACM)
4 Damage
to Heath
5 Health
Risk Assessment
6
Labelling
7
Activities Involving Potential Exposure
8
Minimising Potential Exposure
1 INTRODUCTION
The aim of
asbestos awareness-training is to provide a basic understanding and
perspective of asbestos issues in the workplace. Education and
training is a fundamental part of the understanding and management
of all types of hazards in the workplace.
2
LEGAL OBLIGATIONS
•
All Australian workplaces are governed byAsbestoslegislation.
•
Victoria has the strictest Asbestos regulatory controls in
Australia.
•
WorkSafe licensed removal contractors must carry out the removal
and or handling of asbestos materials. (Except for limited removal
of non friable asbestos materials by un licensed
persons)
•
The management of asbestos materials in (Victorian) workplaces
and or the removal or handling of asbestos materials must comply
with the requirements of;
Victorian Occupational
Health and Safety Act 2004.
Victorian Occupational
Health & Safety Regulations 2007
WorkSafe Victoria Compliance
Code – Removing Asbestos in Workplaces 2008
WorkSafe Victoria Compliance
Code – Managing Asbestos in Workplaces 2008
Go to
Regs & Codes page for these documents.
3
ASBESTOS CONTAINING MATERIALS (ACM)
Asbestos is
a generic term for a group of naturally occurring silicate minerals
that are mined primarily in South Africa, Canada, and Russia.
Asbestos can appear in fibrous crystal form, and when milled,
separates into flexible fibres. There are three commercially grades
of asbestos.
•
Chrysotile is white asbestos with fine silky fibers.
It accounts for over 90 percent of the asbestos used in Australia
and is the least hazardous type. This fibre is the only one still
legally imported and used in Australia in the friction materials
industry. I.e brakes.
Commonly
found in, asbestos cement (AC) sheet and pipe, vinyl floor
tiles, sealants, braided rope seals, gaskets,
roofing felts, switchboards, brake linings, etc.
•
Amosite is brown asbestos and is used mostly in
thermal insulation materials. The second most hazardous type.
Commonly found in, limpet sprayed fire proofing, pipe & boiler
lagging, AC sheet and pipe, etc.
•
Crocidolite is blue asbestos and is the most
hazardous type.
Commonly
found in, limpet sprayed fire proofing, pipe & boiler
lagging, older AC sheet and pipe, etc.
Asbestos
fibres have the following characteristics:
Resistant
to heat, fire, bacteria and chemicals
Great
tensile strength and stiffness. Blue Asbestos has the tensile
strength of mild steel.
Excellent
electrical and thermal insulator
Acoustic
insulation
Resistant
to the effects of friction and wear
Bonding
reinforcing material
FRIABLE
ASBESTOS MATERIALS
An
important term used in describing the condition of asbestos is the
word "friable."
A material
is considered friable if it can be reduced to powder by hand
pressure when dry.
Friable examples include,
limpet (sprayedfire proofing / coatings,
thermal and acousticinsulation applications)
pipe and boiler lagging, etc.
Non
friable asbestos materials
typically include moulded pre formed products; cement sheet
roofing, walls, pipes, vinyl floor tiles, Zelemite tar boards,
sealants, tar membranes, etc.
Although
the use of asbestos in thermal, surfacing, and fire proofing
materials was banned in 1978, buildings constructed as late as 1990
have been found to contain asbestos building materials. Some
building materials found to contain asbestos include:
Acoustic
ceiling tiles
Asbestos
cement sheet and pipe and pre formed materials
Bituminous
roofing felts, Malthoid
Expansion
joint fillers
Fire stop
packing in wall penetrations
Gaskets
and packing, braided seals, ropes and sealants in plant
and equipment
Lift motor
brake linings, spark arrestors, electrical cable wrap
Limpet
acoustic sprayed ceiling finish
Limpet
fireproofing insulation for structural steel beams,
lintels, trussess, columns,
Millboard
and paper for lino backing, duct insultation, fire door
cores
Thermal
hot pipe and vessel lagging for boilers, headers,
calorifiers, pipework
Vermiculite / Monocote
finishes
Vinyl
floor tiles and lino backing (Millboard paper)
Zelemite
compressed tar electrical backing boardsand many
others.
4
DAMAGE TO HEALTH
Routes of
entry into the body
While
asbestos fibres may gain entry into the body through inhalation and
ingestion, by far the major route is inhalation. Asbestos fibres
have no odour, and are for the most part invisible to the naked
eye.
The
respiratory system includes the mouth, nose, wind pipe (trachea),
bronchi and lungs.
The lungs
contain air sacks called alveoli. The alveoli are the sites where
oxygen is absorbed into the blood and carbon dioxide is removed
from the blood. Your body's respiratory system has defence
mechanisms, which work to keep foreign particles from causing
damage. Studies indicate that these mechanisms are 95 to 98
percent effective.
Bodily
Defence mechanisms and their
functions are:
•
The mouth and nose filter out the larger fibres and
particles.
•
Coated bronchi filter out smaller fibres and particles.
•
Cilia, which are hair-like protrusions on cells lining the airways
(bronchial tree), move the fibres and particles up to the back of
the mouth where they are ingested or expelled.
The
smallest fibres and particles which are not previously trapped may
travel to the alveoli in the respiratory system. Here they may be
attacked by large cells, known as macrophages, which attempt to
digest them.
Most of the
available information about asbestos diseases comes from studying
workers in the various asbestos industries. The bulk of the data
comes from World War II shipbuilding activities and the asbestos
industries in Australia, United States and England. Exposure to
very high levels of airborne asbestos typical of the asbestos
workplace prior to 1972 has been linked with the following
diseases:
Asbestosis is a chronic
disease in which lungs become scarred (fibrosis) as a result of
a
biological
reaction to the inhalation of asbestos fibres. Scarring causes
thickening of the
walls of
the lungs and a reduction in the capacity for transfer of oxygen to
the bloodstream.
Asbestosis
usually results after exposure to high concentrations of fibres
over a long period of time. Symptoms usually occur 15 to 35 years
after the first exposure.
Mesothelioma is a cancer of the
covering of the lung or lining of the chest or abdominal
cavities.
It is the rarest form of the asbestos-related diseases. This
disease is always
rapidly
fatal, usually within a year after diagnosis. There is a direct
relationship between smoking and the risk of developing
Mesothelioma. The latency period is usually 25 to 30 years for
mesothelioma.
Lung
Cancer is now responsible for
roughly 50% of the deaths that occur from past asbestos
exposures.
Generally,
the earliest symptom is the development of a persistent cough or
chronic cough. Later symptoms include loss of appetite, weight
loss, pain and general weakness.
Other
cancers have been noted in a very few individuals who are
occupationally exposed to asbestos. These tumors are usually
cancers of the gastrointestinal tract.
Smoking
and Lung Cancer
The
combination of asbestos exposure and smoking greatly increases the
risk of developing lung cancer. Smoking with asbestos exposure does
not just double the risk, but multiplies it many times. Unprotected
Asbestos workers are approximately five times more likely to
develop lung cancer than the general population. Smokers are ten
times more likely to develop lung cancer than the general
population. A person who works with asbestos and also smokes is
likely to have an approximate 50 times greater risk of
contracting lung cancer.
5
HEALTH RISK ASSESSMENT
Some
biological and physical factors that influence the asbestos risks
to health include,
•
Friable asbestos materials are more hazardous than non friable
asbestos materials
E.g pipe / boiler lagging is more hazardous than AC
sheet, gaskets, seals, vinyl,
etc.
•
Whether the product is external or internal. Internal materials
generally provide more risk than external materials for the same
type and condition.
•
The proximity of the asbestos product to the unprotected
person.
•
The type of asbestos fibre. Crocidolite (blue) asbestos and
Amosite (brown asbestos) are more hazardous than Chrysotile (white)
asbestos.
•
Concentration in air of the fibre. 0.01 fibre per millilitre
of air is considered safe.
•
Synergistic effects. (cocktail effect, smoking
increases the risk)
•
Environmental conditions. Heat, cold, wind and
rain affect fibre release and spread.
6LABELLING
Regulation
4.3.27 (6) requires labelling of workplace asbestos containing
material (ACM).
Extract;
(6) In relation to asbestos
that is identified under
subregulation (1)(b), the employer must ensure
that—
(a) the presence and location of the asbestos are
clearly indicated; and
(b) if reasonably practicable, the indication is by
labelling.
However it
is our experience that the majority of workplaces have not carried
this out.
The
majority of buildings that contain asbestos materials have little
if any labelling indicating the presence of asbestos and therefore
suspect materials should be deemed asbestos containing unless
otherwise identified. Copy and paste theselabelsand apply to a
clean surface of the asbestos material (without disturbing it).
I.e use A4 sheet labels (4, 6, 8 labels to a sheet), adjust
graphic size to suit label.
7
ACTIVITIES INVOLVING POTENTIAL EXPOSURE
Any
disturbance to an asbestos product may cause an asbestos exposure
risk.
This
disturbance may be by mechanical, human or by environmental
means.
Some
non-friable materials may become friable if they are cut, drilled
or damaged by water. Friable materials are more likely to release
fibres into the air where they can be a source of
exposure.
The
presence of asbestos alone in a building does not mean that the
building occupants are necessarily AT RISK OF EXPOSURE. As long as
asbestos-containing materials remain in good condition and are not
disturbed exposure is unlikely.
Whendamage, building
maintenance, repair, renovation or other activities disturb ACM,
asbestos fibres can be released creating a potential hazard to
building occupants. Fibre release may occur in several
ways:
Fallout. Old and or
deteriorated materials release fibres more easily due to the damage
or destruction of the bonding agents used to hold the asbestos
product together. Fallout may result in fibres being deposited on
horizontal surfaces over time due to humidity, vibration product
expansion / contraction or general ageing.
Contact. Striking, cutting,
drilling, etc. will release bulk fibres into the
environment.
Air erosion
is also a form of contact and may release fibres to the environment
from damaged or exposed material.
Work
Practices. Sweeping, dusting or non
HEPA filtered vacuuming of settled dust may result in asbestos
fibres being re-suspended into the atmosphere.
8
MINIMIZING POTENTIAL EXPOSURE
Read the
asbestos audit report. (In Victoria its referred to as the Division
5 or 6 / Part 5 or 6
report)
Demolition
and Refurbishment work must have a Division 6 report prior to job
start.
ACM must be
removed and removal areas cleared prior to commencement of
demolition works.
Do not
drill, sand, grind or cut materials that may contain
ACM.
Clean-up of
asbestos containing materials should only be done using a High
Efficiency Particulate Air (HEPA) vacuum and or wet methods by
licensed persons
Become
familiar with the health hazards associated with ACM.
Be aware of
areas that could potentially contain ACM.
•
Assist in the prevention of activities which disturb the ACM, i.e.
usual demolition
•
Report any suspect materials prior to demolition.
Exposure to airborne particles is the greatest risk
When the asbestos fibres become airborne, people working with
asbestos may inhale particles, which remain in their lungs. Over
time, these particles can cause disease. A person's chance of
developing asbestos-related disease depends on how much asbestos
they were exposed to and for how long. Smoking increases the risk
of asbestos-related diseases. If you stop smoking, it will help
protect your health.
The
use of asbestos was probably at its highest in the mid to late 70s,
but asbestos cement products like asbestos flues and water pipes
were still being installed into the 1990s. Asbestos use in brake
linings and pads and clutch plates has only recently been phased
out.
People who were involved in the following industries in the past
were at greatest risk:
Mining,
milling and manufacture of asbestos products
Tradespeople
who installed these products such as laggers
Shipbuilding
Boiler
attendants, fitters
Railway
carriage construction
Office
and industrial building construction
Power
industries (i.e old SEC plants in the La Trobe Valley in
Victoria)
Wives
and children of the above and many other incidences
Workers
and families were at greatest risk
Workers involved in the mining, milling or manufacture of asbestos
(I.e Wittenoom) and in the construction, power (I.e SEC) and
shipbuilding industries have been exposed in the period before
stringent controls were enforced.
Families of asbestos workers may also have been exposed to asbestos
fibres brought home on workers' clothing.
Asbestos use in new products is now banned
Since 31 December 2003, asbestos and all products containing
asbestos have been banned Australia-wide. They cannot be imported,
stored, supplied, sold, installed, used or re-used.
This ban does not extend to existing use of asbestos-containing
products such as vinyl floor tiles and asbestos cement (AC) roofing
or sheeting. These products can be left in place until they need to
be replaced.
TheOccupationalHealth
& Safety (Asbestos) Regulations 2007, also specify that only
licensed asbestos removalists may remove fixed or installed
asbestos-containing material (except in certain limited
circumstances).
Transporting and disposal of asbestos
The transport and disposal of asbestos waste is controlled by the
Environment Protection Authority, which stipulates the safe
handling and disposal through specific licensing.
Asbestos and the building trades
Today, workers in the building trades - such as plumbers,
carpenters and electricians, especially those who are self-employed
- could be exposed to asbestos. This will happen if they work on
materials that contain asbestos in such a way that fibres are
released into the air: for example, when using power tools.
Asbestos that is not disturbed and the fibres of which remain
contained does not pose a risk for people using the building.
Asbestos in the home
Asbestos products are still commonly found in homes. They can be
harmful only if the asbestos fibres are released into the air and
breathed in. If building materials like asbestos cement sheeting
(used for walls and roofs) are in good condition, the asbestos
fibres are tightly bound and very few escape into the air. These
materials are very unlikely to cause health problems. Even if the
walls or roof are not in good condition, the number of fibres
released is very small.
Asbestos fibres are most likely to be released if
asbestos-containing material is disturbed: for example, during home
renovations that involve drilling, cutting, sawing or breaking of
the asbestos-containing material.
Ways to work safely with asbestos are outlined in Asbestos in
the home - see related articles below.
Where to get help
Your
local doctor -for
concerns about health
Local
council -for
enquiries or complaints regarding the removal or disposal of
asbestos in your neighbourhood
Department
of Human Services (Environmental Health Unit)- for
a copy of the booklet, Asbestos in the home. Tel. (03) 9637
4156 or website
WorkSafe
Victoria -for
information about asbestos in the workplace and licensed asbestos
removalists. Tel. (03) 9641 1555 or website
Environment
Protection Authority Victoria -for enquiries about correct
disposal of asbestos-containing materials. Tel (03) 9695
2722
>Contact
this office for a list of WorkSafe licensed asbestos
removalists.
Click
here for Asbestos
Labels & Signs (PDF file) Open file, copy and paste (click
camera icon) appropriate label to Word then print on labels sheet
or laminate single page.
For
outdoor applications use laminated labels or metal
signs.
Asbestos
is a mineral rock that is made up of masses of tiny fibres. For
many decades, asbestos was mined and widely used in building
materials and for insulation, fireproofing and sound
absorption.
Why is
asbestos dangerous?
When
asbestos is disturbed, it forms a dust made up of tiny fibres. This
can easily be breathed in and cause serious health problems,
notably:
The
health hazards of asbestos have become clear in recent decades and
its use is now restricted in Australia.
Who is
at risk?
Almost
everyone has been exposed to some asbestos fibres, but for most the
exposure and the risk are very small.
People who have been exposed to asbestos fibres in their jobs are
at greater risk. Such jobs include:
mining
or milling asbestos
manufacture
and repair of goods using raw asbestos fibres, such as brake
linings
use of
products containing asbestos, for instance in building and
construction, heating, shipyards, power stations, boiler making and
plumbing
alteration,
repair or demolition of buildings or other structures containing
asbestos.
It may
take up to 30 or 40 years after exposure for any disease caused by
asbestos to become evident. Most workers exposed to asbestos will
not develop an asbestos-related disease.
What
are the symptoms of asbestos-related disease?
If you
have been exposed to asbestos you should tell your doctor. He or
she will examine you and may refer you for tests, for example, a
chest x-ray
or lung function test. If you smoke, you should stop, since smoking
can greatly increase your chance of developing asbestos-related
lung cancer.
You should see your doctor if you experience any of the following
symptoms:
Pleural
plaque is not cancer,
and it does not cause cancer. It takes at least seven years to
develop after asbestos exposure. It is quite common, generally
causes no symptoms and generally requires no treatment. It may
cause a dull pain or, in rare cases, make you short of breath.
A plaque is a thickened patch, known as ‘fibrosis', on the pleura.
The pleura is the two layers of membrane that line the chest wall
and cover the lungs.
While pleural plaque shows that you may have been exposed to
asbestos, pleural thickening can also be caused by a lung
infection.
If you have pleural plaque, it is important that you stop smoking.
You need to see your doctor for regular check-ups and have a chest
x-ray every three to five years. You may also need to have a lung
function test.
Asbestosis
Asbestosis
is not cancer but is a serious disease. It takes 10 years or more
after asbestos exposure to develop. It causes scarring of the lungs
and may lead to disability or even death.
Asbestosis
is not cancer but is a serious disease. It takes 10 years or more
after asbestos exposure to develop. It causes scarring of the lungs
and may lead to disability or even death.
When
asbestos fibres stay deep in the lungs, scar tissue forms around
them, and this may grow over years. The scar tissue can be seen on
a chest x-ray. It stops oxygen moving into the bloodstream, so the
person with asbestosis feels out of breath. The doctor will also
hear ‘crackles' in your chest-a bit like the sound made by rubbing
hair between your fingers. These are signs of scar tissue in the
lungs.
Asbestosis
slowly progresses over time. Some treatments can help to improve
quality of life. Extra oxygen can help some people-you should
discuss this with your doctor.
Asbestosis
usually develops in asbestos workers who have had a lot of
exposure, so new cases in Australia are becoming uncommon. People
with asbestosis may also develop lung cancer.
Lung
cancer
Lung
cancer may not develop until decades or more after exposure, and is
much more likely to develop in smokers and people with
asbestosis.
If you
have been exposed to asbestos and you smoke, your risk of getting
lung cancer is very high-perhaps as much as 90 times that of
non-smokers who have not been exposed to asbestos. If you have been
exposed to asbestos, you can probably reduce your risk if you stop
smoking. The risk continues to fall the longer you don't
smoke.
Mesothelioma
This
is a cancer that is very strongly linked to asbestos exposure,
occurring more frequently in Australia than anywhere else in the
world. Mesotheliomas can take 30 or 40 years after exposure to
asbestos fibres to develop. The most common type starts in the
pleura
(the two layers of membrane that line the chest wall and cover the
lungs).
Mesothelioma
may occur in one or more places over the pleura. It forms growths
shaped like small pieces of cauliflower. They grow and spread
gradually to surrounding areas.
If
asbestos fibres are ‘breathed into' the stomach, they may also work
their way through the stomach wall and cause mesothelioma in the
lining of the abdomen
(peritoneum). Occasionally, mesothelioma arises in the membrane
around the heart or the reproductive organs.
Symptoms
of mesothelioma
The
cancer causes cells in the pleura to produce fluid, called a
pleural effusion. The fluid builds up between the two layers of
pleura and presses on the lungs. This causes shortness of breath
and a dry cough, and can also be painful. As the cancer progresses,
it can grow into the lung, lymph nodes, chest wall and
ribs.
Mesothelioma
in the peritoneum ('peritoneal mesothelioma') causes pain and a
swollen abdomen, sometimes with nausea
, vomiting, fever or bowel or urinary problems.
In
both types, other symptoms may appear later, including severe
weight loss, spitting up sputum or blood, difficulty swallowing and
a hoarse voice.
Treatment
for mesothelioma
There
is no proven cure for mesothelioma, but new research findings have
recently resulted in better symptom relief and longer survival. The
main aim of treatment is to keep quality of life as good as
possible for as long as possible.
Some
people's outlook is better than others, and occasionally doctors
from the larger cancer centres can recommend more effective
therapies that have tolerable side effects.
Your
decision about treatment will depend on how far your cancer has
progressed, what you prefer and what your doctor suggests. PET/CT
scans and specific blood tests may help to choose which treatment
option is suitable for individual patients.
All
treatments have good and bad points and risks, and you should talk
these over with your doctor. Opinions may vary between different
specialists, and some people will find it helpful to get a second
opinion from experts who treat larger numbers of mesothelioma
patients as part of a dedicated team at specialised cancer
centres.
Surgery
You
may be advised to have an operation known as ‘pleurectomy'. This is
a major operation. The operation itself carries a risk of
complications and death and cannot help everyone. For a few people,
however, it may be worthwhile. If the cancer is found when it is
still small, and you are otherwise fit, pleurectomy may help to
gain a few more months or, sometimes, some years of good quality
life.
Some
surgeons also use phototherapy with surgery.
This means that before the operation, a special substance is
injected in a vein. This gets taken up by cancer cells and shows up
under laser light. After removing the pleura, the surgeon uses a
laser light to find extra cancer cells around the outside of the
lungs, and destroys them with the laser. The downside of this
treatment is that you must stay away from sunlight for the next six
weeks.
The
surgeon may also suggest removing part or all of a lung, if the
cancer has spread into it. Sometimes lymph nodes inside the chest
are removed together with part of the diaphragm and any tumour
deposits growing through the ribs but involving only one side of
the chest, in an operation called an extrapleural
pneumonectomy.
If a
major operation is planned, the addition of chemotherapy and
radiotherapy should be considered to reduce the chances of the
cancer growing back.
Chemotherapy
Your
doctor may recommend chemotherapy
(treatment with drugs that kill cancer cells). This will usually be
recommended if other treatments are not suitable or the cancer has
regrown following other treatment. In many cases it may reduce the
size of the cancer, reduce its symptoms and improve quality of
life. In addition, chemotherapy has been shown to gain a few more
months of life. The more effective drugs that are now
available to mesothelioma patients include combinations of
pemetrexed (Alimta), cisplatin or carboplatin and
gemcitabine.
Controlling
the fluid build-up
Often
the first concern with mesothelioma is to prevent or control
pleural effusion-the build up of fluid around the lungs. The
surgeon can put an irritant like surgical talcum powder into the
pleural sac. The pleura becomes inflamed and the two layers stick
together. This leaves no space for fluid, so the cells stop
producing it. This is called pleurodesis. It is often done during
thoracoscopy, when the doctor is looking inside the chest with a
flexible instrument like a small telescope.
Pleurodesis does not work for everyone. Removing the pleura will
also control fluid build-up, but as discussed above, it is a major
operation.
Radiotherapy
Radiotherapy
(treatment with radiation, using x-rays) to small areas of the
chest can often help control pain and lumps that grow up from the
surgical scars. It has generally not been used to treat the whole
pleura because it would do too much damage to the lungs, heart and liver.
This damage can be reduced by delivering the radiotherapy after
most of the mesothelioma has been removed by major surgery.
Recently, new advanced methods of high dose radiotherapy using very
complex beam arrangements with state of the art radiotherapy
equipment ( known as IMRT - intensity-modulated radiotherapy) have
been adopted successfully in a few specialised centres.
Treatment
for peritoneal mesothelioma
If
mesothelioma is in the lining of the abdomen
- the peritoneum - surgery
can often help. It is not often possible to remove all the cancer,
but surgery may prolong life and can relieve symptoms such as bowel
obstruction and pain. Radiotherapy
and chemotherapy
may also be used.
Side
effects of treatment
In
radiotherapy, the x-rays
are carefully targeted to do as little damage as possible to normal
body tissues.
It may cause some side effects, but most go away after treatment
stops. They can include tiredness, reddened and peeling skin in the
treated area, nausea, vomiting and difficulty swallowing for a few
days or weeks. It can also cause permanent changes (‘fibrosis') in
the lung tissue. This is not usually a problem unless high doses of
radiotherapy are used to a large area.
The
side effects of chemotherapy
depend on the drugs used and can vary from person to person. The
side effects usually go away after treatment stops. Your doctor
will talk to you about the side effects you might expect, and how
to manage them. With surgery there may be a chest pain; this
usually goes away or greatly improves over weeks to
months.
Compensation
for asbestos-related disease
If you
developed lung disease after exposure to asbestos, you may be
entitled to seek compensation. Contact the Asbestos Disease Society
of Victoria or your solicitor for information.
