Lung cancer is one of the world’s most common cancers, with a devastatingly poor prognosis – only one in five people live longer than five years after diagnosis. Many well known risk factors are modifiable, including passive exposure to tobacco smoke, biomass fuels, diesel exhaust, radon, asbestos and other environmental and workplace carcinogens (FIRS). Yet despite knowledge of the risks of these environmental carcinogens, people around the world are continually placed at risk through exposure to them. Asbestos is one such threat to health, linked to several forms of cancer, including mesothelioma, as well as to a variety of chronic lung conditions.

On World Lung Cancer Day, Emily Walsh looks at the impact of asbestos on lives and explores what needs to be done to alleviate the avoidable risk to life and health. 

"Asbestos exposure robbed me of my left lung and the entire first year of my daughter's life while I endured surgery, debilitating chemo and radiation. My daughter didn't deserve to have a sick mom. Asbestos did that to my family." Heather Von St. James

While mesothelioma is often referred to as an “old man’s disease” because of its association with the construction industry and its long latency period, Heather Von St James is proof this is not always the case. Diagnosed with malignant pleural mesothelioma when she was 36, just three months after the birth of her daughter, Heather was given 15 months to live unless she pursued aggressive treatment for her cancer. The diagnosis led her halfway across the country to receive care from a doctor specialising in the disease, undergoing invasive surgery, chemotherapy, and radiation for several months.

Asbestos – what is it & how does it cause such widespread harm?

Despite decades of research confirming the negative impact asbestos has on health, exposure remains a recognisable problem in today’s world. With the links between noncommunicable diseases (NCDs) and environmental risk factors becoming increasingly clear, known carcinogens like asbestos should be proactively ruled out to limit their harmful effects and make a substantial dent in preventable NCD mortality. 

Once commonly mined and included in manufactured products because of its resistance to fire and heat, asbestos was used widely use across construction industries. It became clear that continual exposure to asbestos led to life-threatening diseases. When asbestos fibers are released into the air they can be breathed in or ingested, leading to irritation and scarring of the lungs, sometimes developing into cancer. Initially, few protective measures were taken when working with the toxin, allowing for continued inhalation and exposure over long periods of time. Decades later, when an alarming number of construction and military service members developed similar respiratory health conditions, connections were drawn to asbestos.

Regulations commensurate to risk and harm

Knowledge of the life-threatening risks of asbestos triggered precautions and regulations on its handling and use. The United States made moves to regulate the amount of asbestos used in certain products during the late 1970s, while the EU banned all forms of asbestos use in 2005.

The impact of asbestos on health felt by the United States and European Union in the mid-twentieth century is now being mirrored across Asia in countries like China, Russia, and India, where manufacturing continues to be a booming industry, disturbingly growing in popularity among developing countries due to its cost-efficiency and abundance. As the world leader in asbestos production, Russia mines upwards of 600,000 tons of the carcinogenic mineral each year. 

Today asbestos is banned in nearly 60 countries. Even where regulations are in place, asbestos exposure continues to be an issue, especially in occupational settings. 125 million people around the world continue to be exposed to asbestos in the workplace alone. Many measures intended to protect against asbestos help to limit exposure, but they neglect asbestos – which is not biodegradable - already found in older structures and materials. Asbestos is still often inhaled when people unwittingly come into contact with the toxin in older buildings or by encountering airborne fibers spread throughout the environment. The highest rates of exposure to asbestos fibers through inhalation are commonly in male dominated, labor intensive industries. In fact, asbestos is the leading cause of occupational cancer in the United States, with rising rates of environmental exposure to the toxin. 

A survivor’s message: it’s time to ban asbestos use & take measures to prevent exposure

“Asbestos is still legal in the U.S. and more than 15,000 deaths occur each year due to asbestos exposure. It is time we followed the lead of those 50+ countries that have banned its use and have programs in place to prevent exposure.”

More than twelve years after her diagnosis, Heather has defied the odds, dedicating her life to raising awareness about mesothelioma and the dangers of asbestos use. Her story is not only defined by her survivorship but also her advocacy, and she uses her voice to speak for the thousands of mesothelioma patients who do not have the chance. Stories like Heather’s provide hope and act as a call to arms to phase out harmful substances like these that impact real lives every day. 

A toxic legacy for governments to redress

Asbestos, once a highly valued construction material has a very dark side, and has left a toxic mark on the world through various forms of NCDs. The world, and people like Heather, will continue to endure the immense costs to health and lives of asbestos’ use until all asbestos-containing products are ruled out and carefully disposed of. To control the damage done by the carcinogenic mineral, several worldwide organisations have launched initiatives aimed at ending asbestos exposure once and for all. In a global proposal from the World Health Assembly, WHO has been charged with creating policies and plans to prevent NCDs, including those derived from asbestos exposure, by 2020. With no safe amount of exposure to asbestos, it is up to governments to enact policies which ensure the risk of asbestos exposure and associated life-threatening diseases like mesothelioma subside.

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