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Who is at risk of developing mesothelioma and is the lung cancer moving on to a different type of victim?

05 October 2015

What was once the horrific reserve of a generation of industrial workers and users of asbestos in the workplace, the incidence of mesothelioma is moving on to an unsuspecting generation of sufferers who have been exposed to low levels of asbestos, including in the asbestos industry, teachers, pupils, caretakers and DIY enthusiasts.

Mesothelioma is a dreadful terminal lung cancer caused by exposure to asbestos dust and fibres. The cancer usually develops in the lining of the lungs between 10 and 50 years after exposure. There is no cure and treatments are limited, although research and access to clinical trials are improving survival times.

Laggers and asbestos factory workers

The cancer has devastated a generation of hard working asbestos industrial workers who inhaled high doses of the deadly dust and fibres every working day. Decades later, often as these workers started retirement, mesothelioma took hold and cut short their lives.

shutterstock_209016844 webThe construction industry

A second demographic of mesothelioma sufferers emerged soon after the epidemic  within the building trade. Asbestos materials (such as asbestos board, lagging and tiles) were used throughout construction as fire proofing and insulation – and where existing asbestos has to be removed. The introduction of power saws and drills increased the risk of high exposure as asbestos dust and fibres were scattered into the air.

The use of asbestos in construction was very widespread, and is still found within buildings today. People in building professions are still at risk of being exposed and developing mesothelioma. For example plumbers, joiners, electricians, demolition workers, painters and decorators, engineers, dockworkers, welders and shop fitters.  The Health and Safety Executive continues to highlight the dangers of asbestos for tradespeople with coordinated campaigns.

Neighbourhood, shakedown and secondary exposure

Another group found to be at a high risk of developing mesothelioma were those who lived near or passed by asbestos factories, such as the notorious Cape Factory in East London. Dust from the factory spewed on to the streets from giant fans, leaving wisps of asbestos fibres to settle. The nearby residents remember that it looked like Christmas and children used to pick up the ‘snow’ to throw at each other.

Shakedown or secondary exposure mesothelioma claims also began to surface from the 1970s. These were cases where a loved-one had work clothes contaminated with asbestos washed or shaken out at home, and where workers came into contact with family members, for example when cuddling small children, whilst still dressed in dusty overalls.

shutterstock_116832280 smlThere is no threshold dose of asbestos below which there is no risk

At the moment more than 2,500 people a year are dying from mesothelioma and the Health & Safety Executive predicts that the death rate will peak in 2020, but mesothelioma is unlikely to disappear. More than 53,000 British people will die from mesothelioma between 2013 and 2037, according to the Department of Work and Pensions, and we are still ignorant of the full extent of the terrible asbestos legacy.  As the number of skilled and semi-skilled manual workers exposed between the 1950s and 1990s plateaus, a new wave of sufferers is emerging in increasing numbers.

Mesothelioma is unlike other asbestos-related lung diseases (such as asbestosis, pleural thickening and asbestos-related lung cancer) because it does not require high and regular exposure to the deadly dust and fibres for the cancer to develop. It is legally and medically accepted that very low exposure could potentially lead to a person developing the aggressive lung cancer.

Dr Robin Rudd, a leading medical expert on asbestos disease, said: “Mesothelioma is a rare tumour in persons who have not been exposed to asbestos… [It] can occur after low level asbestos exposure and there is no threshold dose of asbestos below which there is no risk.”

Bob Clark, a Factory Inspector from 1976 to 1990 who has written more than 1,700 expert reports on asbestos, says: “It seems to me that some individuals are more susceptible than others, and developing mesothelioma after sustaining seemingly very low exposures to asbestos fibres.

“I can recall preparing a report in connection with a claim that concerned the domestic exposure of two boys who both contracted mesothelioma as a result of inhaling asbestos fibres that originated from their father’s woolly jumper that he wore at work. Conversely, I find it astonishing that a few laggers, who must have sustained massive asbestos exposures over years, do not contract mesothelioma.”

A new wave of sufferers

Asbestos is still found in many buildings constructed before 2000 and because some people are more susceptible to mesothelioma after inhaling just a few asbestos fibres, there is a new wave of sufferers who develop the cancer after low dose exposure. These victims are not the industrial and construction workers of the 50s, 60s, 70s and 80s, but office, retail and classroom based professionals.

Teachers and pupils

The most high profile example are teachers. Between 1980 and 1985 there were 15 mesothelioma deaths among school teachers – just three per year. In 2012 alone, there were 22. And a growing number of legal cases now involve people who believe they – or their relatives – were exposed to asbestos as pupils.

More than 75% of school buildings contain asbestos. According to a report from the all-party parliamentary group on occupational health and safety, the issue is a ‘time-bomb in our schools’. Almost all the 14,000 schools built between 1945 and 1975 contain asbestos alongside any that were refurbished during that period.Classroom-004

While asbestos does not pose a serious risk if enclosed and well managed, the report says materials such as asbestos lagging, sprayed asbestos and asbestos insulating board can release dangerous fibres and are present in our schools. The all-party group quotes a report from the Medical Research Council, which estimates that even when a school building containing asbestos is in good condition, fibre levels are between 5 and 500 times those found outdoors.

The DIY boom

From the 1990s there has been a boom in DIY as post-war homes have been renovated by an enthusiastic public fuelled by home improvement television programmes. Right up to the year 2000, asbestos was being used in the construction of homes. Its insulation and fire proof properties mean that the mineral was used in everything from Artex ceilings and Marley floor tiles through to boiler jackets, electrical boxes, radiator covers, roofs, stoves and heaters. There is no way of knowing yet whether mesothelioma will develop in a generation of DIY enthusiasts ignorant of the presence of asbestos in UK housing.

In the past mesothelioma has been thought of as a cancer that affects mostly the elderly, so it is often forgotten and attracts very little media interest and research funding. Attitudes are changing as the media warns of its presence in schools and while teachers and former pupils make the headlines after developing mesothelioma at a younger age. The message is that the deadly mineral is still in many buildings and you may be at risk of developing mesothelioma if you disturb asbestos materials. Be safe and be vigilant to the presence of asbestos in every job that you do at work and in the home.

Further reading:

HSE – Are you a member of the public?

HSE – Where can you find asbestos?

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