As the number of fibers absorbed by the body increases and the amount of damage grows, disease symptoms can begin to show up.  As more fibers are ingested, the damage increases and the symptoms worsen.

The most common and most dangerous method for asbestos to enter the body is breathing asbestos dust. To reach the point when adverse health effects become noticeable requires long-term exposure to low levels of asbestos dust, or shorter-term exposure to higher concentrations of dust. Although swallowing asbestos can also lead to asbestos-related diseases, most measures of exposure are based on counting the number of fibers floating in the air. 

Exposure Limits

Shortly after its formation in 1971, the Occupational Safety and Health Administration (OSHA) established a personal exposure limit (PEL) for asbestos in the workplace.  The first PEL was based on an average count of 12 fibers per cubic centimeter of air (12 f/cc) over an eight hour period.  By the end of 1971, this limit was reduced to 5 f/cc over an  eight hour period with a maximum peak exposure not to exceed 10 f/cc.

Today the PEL is as low as 0.1 f/cc average over 8 hours with a peak exposure limit of 1 f/cc in a thirty minute period.

OSHA Regulations

If airborne asbestos in the workplace exceeds the exposure limits, a number of OSHA rules and regulations go into effect.  OSHA’s asbestos regulations affect four worker groups:

• Construction workers
• Shipyard workers
• Workers in the brake and clutch industries
• General workplace (all other workers)

Though the precise rules vary, the general intent of OSHA regulations is to:

• Modify materials and work processes to reduce the creation of airborne asbestos fibers
• Enclose work areas and provide ventilation to capture and limit the spread of asbestos dust
• Educate workers on the dangers of asbestos and how to protect themselves
• Provide protective clothing and respirators to workers, as well as decontamination facilities
• Monitor employee health on a regular basis

Compliance

As a practical matter, OSHA regulations are not evenly enforced across all industries. For example, an auto mechanic using compressed air to blow dust off a break drum can send up a cloud of asbestos fibers worn off of the brake lining – very likely exceeding the exposure limits.  Yet auto repair shops seldom make any effort to control this type of exposure.

Remodeling contractors can also easily turn a blind eye to asbestos materials being removed from buildings they’re working on.  Long-time employees can be endangered when this becomes a “way of business.”

In other industries, compliance may vary depending on a company’s size or profitability.  Workers who should be covered by workplace safety standards can be knowingly or unknowingly exposed to high levels of asbestos with increased risk for asbestos-related diseases. One study indicated that auto mechanics as a group have a 30 times greater incidence of mesothelioma than the general population having no asbestos exposure.

Risky Jobs

It’s estimated that 1.3 million workers are involved in occupations with potential exposure to asbestos dust. Some of these occupations are listed below.  As a general rule, workers in these occupations prior to the 1990s have a much greater risk for asbestos-related diseases than workers in these trades in the past two decades.  Nonetheless, the risk for these occupations is many times higher than the general population. Moreover, symptoms will not generally appear until 10 to 40 years after initial exposure.

Although the risk is higher, the number of workers who will ultimately be diagnosed with an asbestos-related disease is still a small percentage of the total number of workers. 

• Aircraft mechanics
• Asbestos abatement workers
• Asbestos mixers
• Auto mechanics
• Boilermakers
• Brake mechanics
• Bricklayers
• Building maintenance workers
• Carpenters
• Cement finishers
• Construction laborers
• Crane operators
• Demolition workers
• Drywall tapers
• Electricians
• Flooring installers
• Foundry workers
• Heavy equipment mechanics
• Insulators
• Lathers
• Longshoremen
• Machinists
• Masonry workers
• Merchant marine seaman
• Millwrights
• Navy yard workers
• Painters
• Paper mill workers
• Pipefitters
• Plant maintenance workers
• Plasterers
• Plumbers
• Railroad workers
• Roofers
• Sailors
• Sheetmetal workers
• Ship builders
• Ship fitters
• Ship scrapers
• Steamfitters
• Steelworkers
• Welders

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• Asbestos is fireproof, and provides excellent insulation against heat and sound.
• It’s also an electrical insulator, is resistant to chemicals, and has high tensile strength.
• Asbestos can be woven like cloth or mixed with other materials and molded into shapes.

What asbestos products might I find in my home?

The unique properties of asbestos can’t be duplicated by any other commonly available material. Therefore, asbestos found its way into such common building products as:

Pipe insulation. At one time, asbestos coatings or blankets were used on hot water or steam pipes, or heater exhaust vents for heat insulation.

Furnaces. Asbestos was once used for gaskets on oil- and coal-fired furnaces, and as heat insulation in a variety of home heating units.

Fireproofing. The walls and floors around wood burning stoves were sometimes protected with panels made of asbestos paper, fiberboard or cement.

Shingles. Popular because they were fireproof, asbestos cement shingles were used on roofs and as siding.

Wall and ceiling insulation.  Before its use was discontinued in the 1950s, many types of wall and ceiling insulation contained asbestos.

Wall patching materials. Until banned in 1977, compounds for covering joints in wallboard or making repairs to walls and ceilings, and even some textured paints sometimes contained asbestos.

Acoustic insulation.  Spray-on materials such as those used for pop-corn ceilings sometimes contained asbestos.

Flooring.  Many types of vinyl asbestos, rubber, and asphalt floor tiles, as well as the backing on vinyl sheet flooring had asbestos added to make them stronger and longer wearing. Asbestos was also added to flooring adhesives.

Miscellaneous household products.  Fireproof gloves or pads used for ironing boards or stovetops were often woven from asbestos.  Fake embers for gas fireplaces were once made of asbestos, and hand-held hair dryers typically contained asbestos insulation inside them until banned by the Consumer Product Safety Commission in 1979.

What are the risks to my family and me?

The good news is that in the majority of cases, simply having these materials in your home presents no health risk whatsoever.

• Asbestos is a health risk only after prolonged and/or heavy exposure to airborne fibers. Isolated, incidental, short-term  exposure is not sufficient to cause any noticeable health effect.
• The majority of the asbestos products found in older homes are intact and not releasing asbestos fibers into the air.

What do I do about asbestos in my home?

Unless the product is labeled, you won’t know for certain if it contains asbestos.  But in most cases, you won’t need to know with certainty what products in your home actually contain asbestos. 

• If you think it might contain asbestos, assume it does.
• If the material is intact and not deteriorating so as to potentially release fibers, it is not a risk.
• Avoid handling, sawing, cutting, drilling, or otherwise disturbing the material so as not to release fibers into the air.

If disturbing materials that may potentially contain asbestos is unavoidable, or if the material is deteriorating, contact a licensed contractor who is certified to perform asbestos inspections to determine your best course of action.

A certified contractor can:

• Safely take material samples for laboratory testing
• Advise whether the material can be safely encapsulated to avoid the hazards associated with removal
• Remove the material in a safe and approved manner if removal is necessary.

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Asbestos laws, both federal and state, are intended to protect people from exposure to dangerous levels of asbestos fibers in the air. In the federal government, the primary regulating agencies are:

• Environmental Protection Agency (EPA)
• Consumer Product Safety Commission (CSPC)
• Occupation Health and Safety Administration (OSHA)

Many states impose additional worker health and safety regulations, and rigorously regulate the construction industry regarding disturbance and removal of asbestos-containing materials in existing residential and commercial buildings.

The 1970s

By 1970, the connection between asbestos and lung damage had been clearly established. But there were no federal agencies with clear authority to do anything about it until Richard Nixon created the Environmental Protection Agency by Executive Order in 1970. The Environmental Protection Agency fired the first shot in the battle against asbestos by declaring it a toxic substance in 1971.

Also in 1971, Congress authorized the creation of the Occupational Health and Safety Administration which lost no time imposing workplace limits on exposure to airborne asbestos fibers in the same year (along with 400 other hazardous substances). The permissible amount of airborne asbestos in the workplace was lowered in 1972, and lowered again in 1976.

In 1973, the EPA issued the first restrictions on asbestos use by banning spray-on fire coatings or building insulation when either contained more than 1% asbestos.

Additional regulations in 1975 banned installing wet-applied and molded asbestos pipe insulation, and molded asbestos insulation blocks in boilers and hot water tanks.

In 1978, the ban on asbestos-containing spray-on coatings was extended to “decorative” uses.  But eventually, the ban against spray application was modified to allow spray-on uses if no fibers were released into the air in the process, and the resulting product was coated with a resin-like material to prevent release of asbestos fibers.

As increasing media coverage fanned the public’s concern over asbestos, the Consumer Product Safety Commission (CSPC) entered the regulatory fray in 1978 by banning asbestos-containing drywall patching compounds, and “emberizing” compounds used on fake fireplace logs. In 1979, CSPC further banned hand-held hair dryers containing asbestos insulation, though it was criticized by manufacturers for creating unwarranted alarm and an unnecessary recall.

The 1980s

In the 1980s, the much-smaller Consumer Product Safety Commission backed away from continuing aggressive examination of asbestos-laden products, ceding the effort to the much-larger EPA, particularly after the EPA announced in 1979 it would use the Toxic Substances Control Act of 1976 to further regulate asbestos.

Thus, it was the EPA and OSHA that led the fight to regulate asbestos throughout the ’80s.  And a fight it was going to be because asbestos was an essential component in more than 3,000 industrial and building products.

OSHA Makes Headway

In the case of OSHA, they held extensive rulemaking meetings and listened to arguments pro and con from hundreds of industry and union representatives. In 1986, OSHA finally adopted revised workplace exposure standards applying to workers in general and other rules specifically for construction workers.  These standards defined the substances covered to include minerals related to asbestos, but not technically asbestos.

The new OSHA standards were quickly challenged in court by several unions and industry groups. By 1988, the Court had upheld the majority of the OSHA regulations but sent several matters back for reconsideration. The back and forth between the Court and OSHA over these issues continued into the 1990s.

EPA Makes News

The 1980s saw several successes for the EPA on the asbestos hazard front.

First was the Asbestos in Schools Identification and Notification Rule (ASINR) set down in 1982 requiring all public and private elementary and secondary schools in the U.S. to identify any friable asbestos-containing materials existing in their buildings  (Friable means “easily crumbled or reduced to powder.”) The rule requires that schools also:

• Maintain a record of their findings
• Notify employees of the location of friable asbestos
• Provide employees with instructions on reducing exposure to asbestos
• Notify parents or the parent teacher association if friable asbestos is found

By 1984, these mandatory inspections resulted in estimates of 34,800 schools containing friable asbestos, potentially exposing 1.4 million school workers and 15 million students. This led to President Reagan signing the Asbestos School Hazard Abatement Act of 1984 authorizing $600 million in asbestos cleanup loans and grants to poor schools with significant asbestos problems.

AHERA

Possibly one of the most significant asbestos regulations to come out of the 1980s was the Asbestos Hazard Emergency Response Act (AHERA) of 1986.  Ostensibly, AHERA’s purpose was to ensure “appropriate response actions” by schools to the presence of asbestos hazards discovered under the ASINR.  But the law didn’t stop at mandating procedures for school cleanups. It also included provisions related to:

• Creating accreditation programs for inspectors and asbestos abatement contractors
• Accrediting laboratories for analyzing sample materials for asbestos
• Studying the availability of liability insurance for schools and contractors
• Creating an asbestos inspection program for public buildings

Asbestos Ban and Phaseout Rule of 1989

After ten years of studies, many millions of dollars spent, and interminable meetings, testimony and hearings, EPA finally adopted the “Asbestos Ban and Phaseout Rule” of 1989. The ban designed to be implemented in phases over many years applied to the manufacture, import, processing and distribution of as much as 94% of all asbestos-containing products. So sweeping was the ban that it galvanized manufacturers and industry organizations in opposition, and a lawsuit was quickly filed. 

The 1990s

The seeming successes of the 80s were quickly met by the setbacks of the 90s. The EPA’s asbestos ban was overturned by the Court in 1991 on the basis that EPA had not met the legal requirement for constructing the “least burdensome alternative” for regulating the risk of asbestos exposure.  The verdict was not appealed.

On the plus side, however, the Asbestos School Hazard Abatement Reauthorization Act of 1992 (ASHARA) not only continued the AHERA asbestos abatement programs for schools, it also extended them to public and commercial buildings.

Despite minor legal disputes over workplace rules, OSHA continued refining regulations for workplace exposure to asbestos.  General rules applicable to all workers and the specific regulations governing construction workers were extended in special regulations to similarly cover shipyard workers and those in the asbestos brake-lining industry.

Meanwhile, the Consumer Product Safety Commission continued to be conspicuously absent.  Its most recent previous recall had been in 1983 for a paper-maché modeling compound used in school art projects that had not been manufactured since 1975. It’s next asbestos-related press release didn’t come until 2000 when it declared chalk for chalkboards and drawing did not contain asbestos, while some colors of crayons produced by three different manufacturers contained “scientifically insignificant” levels of asbestos posing no risk to children.  Nonetheless, the crayon manufacturers agreed to reformulate the crayons to eliminate any traces of asbestos.

Regulations Today

In current law, a limited number of specifically named asbestos-containing products are no longer permitted to be manufactured or commercially imported into the United States.  Most of these laws do not apply to importation of asbestos-containing products for private use. 

Still, asbestos has such unique properties for which there are no commercially reasonable substitutes, it continues to be important in the manufacture of many present day products.  In use, these products encapsulate the asbestos in ways designed to reduce the risk for them giving off airborne fibers.  The creation of new products containing asbestos, however, is effectively prohibited.

Despite the continued existence of asbestos-containing products, workplace exposure to asbestos fibers is heavily regulated and when the rules and regulations are followed, the health risks are far lower than ever in history.

The most significant remaining risk is to occupants of older homes who may be unwittingly disturbing asbestos-containing construction materials in their home, and releasing asbestos fibers into the air.  A one-time occurrence is not likely to result in enough exposure to cause any health problems, but continuing exposure over months or years could set them up for unexplained health problems many years from now.

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In all cases, these membranes consist of two thin layers. The inner layer is wrapped closely around the organ it surrounds, and the outer layer provides a larger sac inside which the organs can move. To make it easier for organs to move freely, the area between the two layers is filled with a lubricating fluid.

Approximately 70% of mesothelioma tumors are found in the pleura, while approximately 20% are in the peritoneum and 10% in the pericardium. In exceptionally rare cases, a tumor may occur in an extension of the peritoneum surrounding the testes, called the tunica vaginalis.

How Pleural Mesothelioma Occurs

Asbestos is a naturally occurring mineral made up of needle-like fibers. Mining or manufacturing processes frequently release tiny fragments of these fibers into the air as dust where they can be inhaled. 

Because the asbestos dust particles are so fine, they escape many of the body’s defense mechanisms designed to keep foreign materials out of the lungs.  Defenses such as hair and moisture in the nose, cilia (fine, hair-like structures in the bronchial tubes that trap and move foreign materials upward), and the involuntary cough response all fail to keep the asbestos fibers out.

Ultimately, the fine fibers make their way into the lungs’ tiny air sacs (alveoli) where blood cells give off carbon dioxide and absorb oxygen from the air.  Being very small and very hard, a fiber can puncture the alveoli’s exceptionally thin cell walls and trigger the body’s immune system response. 

Macrophages, the immune system cells designed to surround and digest invaders, have no effect on the asbestos mineral fibers.  Worse, in an attempt to destroy the asbestos, the macrophages themselves are destroyed, which releases their specialized toxins and further damages the alveoli. This process leads to the disease known as asbestosis.

Over a span of decades, constant movement can cause the sharp asbestos fibers to penetrate completely through the alveoli into the mesothelium surrounding the lungs (the pleura). The damage the fibers cause to the mesothelial cells disrupts normal cell reproduction and can cause malignant cells to form. When malignant cells begin reproducing, they eventually create a cancer tumor. The degree to which the tumor spreads within the mesothelium or spreads to other organs varies from individual to individual.

Causes of Pericardial and Peritoneal Mesothelioma

The relationship between breathing asbestos fibers and damage to the tissues in and surrounding the lungs is easy to understand. The process by which asbestos fibers are transported to the tissue surrounding the heart or the abdomen is much less clear. 

It’s thought that some instances of these less common mesotheliomas are the result of asbestos fibers working their way from the lungs to other locations in the body, perhaps being carried in the bloodstream. Another theory is that swallowing the fibers may result in some of them penetrating the stomach or intestines.

Probability of Mesothelioma from Asbestos Exposure

Of the millions of people exposed to asbestos dust in the work place before asbestos became intensely regulated, only a small percentage have developed or are expected to develop mesothelioma.  This is possibly a testament to the resilience of the body to resist disease processes.  Nonetheless, the odds of developing the disease are much higher for people with heavy exposure than for the general population.  The heavier and more prolonged the exposure, the higher the risk.

From 2,000 to 3,000 new cases are diagnosed each year, representing approximately 1 in every 50,000 adults.

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Asbestos actually describes a group of six silicate-based minerals that can be separated into fibers.

• Chrysotile asbestos (white asbestos)
• Amosite asbestos (brown asbestos)
• Crocidolite asbestos (blue asbestos)
• Tremolite asbestos
• Anthophylite asbestos
• Actinolite asbestos

Chrysotile asbestos is in the serpentine family of asbestos because its fibers are curly. The other types of asbestos belong to the amphibole family and have straight, needle-like fibers. Breathing asbestos fibers can cause the lung disease asbestosis and the cancer mesothelioma.

Asbestos became a popular industrial material because its fibers are flexible enough to be woven like cotton (particularly chrysotile asbestos). Moreover, because it’s a mineral, it has many unique properties.

• Fire resistant
• Thermal insulator
• Resistant to chemicals
• Electrical insulator
• Sound insulator
• High tensile strength

History of Asbestos Use

Archeological evidence indicates humans have recognized asbestos’ unique qualities for at least 3,000 years. The ancient Greeks used asbestos in clothing and as wicks for temple lamps. The name “asbestos” is actually derived from the Greek words for “not extinguishable” because of its flame resistance. In Roman times, asbestos was also popular in tablecloths. They were thrown into the fire after a meal, and emerged clean and unharmed.

Though usage declined during the Dark Ages, asbestos flourished again in the Industrial Revolution, becoming popular as insulation in ovens and steam engines. Because of increasing demand, the first commercial mine opened in Quebec in 1879. Eventually, asbestos mines also appeared in Russia, Australia,] and South Africa.

In the U.S., the expanding railroads drove the growth in asbestos use as insulation in steam locomotives. By the early 1900s, asbestos was being used in thousands of other products from hot plates and automobile brake pads to building materials and fireproof coatings.

Link to Lung Disease

The ancient Greeks and Romans both observed an increased occurrence of lung sickness among the slaves who wore asbestos clothing or worked in asbestos mines. The Roman Pliny the Elder counseled against purchasing slaves who had worked in the asbestos mines because of their tendency to die young. To protect the miners, he recommended they use a bladder skin to cover their mouth and nose to protect them from breathing the asbestos dust.

Even though asbestos use began growing tremendously in the mid 1800s, it wasn’t until the late 1800s that physicians began once again drawing the link between asbestos and lung disease that Pliny the Elder had noted 18 centuries earlier. The first record of the new association is in the 1897 report of a Viennese doctor who linked emaciation and lung disease among asbestos weavers directly to inhaling asbestos dust. In 1898 and 1899, several British factory inspectors began noting the danger of asbestos dust to workers and the need to improve working conditions.

Actual proof of a link didn’t occur until 1906, however, when a British doctor presented an autopsy report revealing a fatal pulmonary fibrosis in the lungs of an asbestos worker. The disease itself, “asbestosis,” was not named until 1928 when Dr. Cooke described it as an irreversible and progressive condition caused by inhaling asbestos fibers. By 1935, physicians also began observing higher incidences of lung cancer among asbestos workers.

Asbestos Regulation

Evidence of the dangers of inhaling asbestos grew steadily in the mid 1900s but powerful industrial and economic interests resisted regulation as long as possible. By the early 1970s however, mounting publicity resulted in the first regulations of asbestos in the U.S. by the Occupational Health and Safety Administration (OSHA) and the Environmental Protection Agency (EPA).

Today, the use of asbestos is severely regulated in over 50 countries. Some have banned asbestos entirely, but in some cases the bans apply only to the new manufacture or import of asbestos-containing products and not to products already in use.

Risks

Because workplace exposure to asbestos is so heavily regulated, modern workers have little risk of asbestos exposure except in case of an accident or a violation of workplace safety rules. Those exposed to asbestos in the workplace before extensive regulations were in place, however, may yet be at risk for developing serious lung conditions such as asbestosis or mesothelioma.  For mesothelioma in particular, symptoms don’t appear until ten to forty years following initial exposure.

Despite the current U.S. phase out of asbestos products, older homes may still contain original materials made from asbestos. Solid asbestos poses no danger unless it is sufficiently disturbed so that the mineral fibers are released into the air. Therefore, people should exercise caution when remodeling or disturbing building materials that may contain asbestos.

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A naturally occurring fibrous mineral, asbestos was once used in a wide variety of industrial products and building materials. Workers in industries with heavy asbestos exposure have been at the greatest risk for developing asbestosis later in life. It can take more than ten years for disease symptoms to appear.

Disease Process

Asbestos fibers are very thin and needle-like. When asbestos is handled or processed, tiny bits of these fibers break off and float in the air as dust where they can be breathed into the lungs.

In the lungs, the fibers work their way into the alveoli – the small air sacs where the blood absorbs oxygen through very thin cell walls. When an asbestos fiber becomes lodged in the alveoli and penetrates its cell wall, the body’s immune system launches an attack on the foreign matter.

Macrophages, tiny cells designed to surround and digest invading bacteria, try to consume the fiber. But because the mineral fiber is too large and chemical resistant, the macrophage self-destructs and its digestive compounds are released into the alveoli, permanently damaging it. As more and more alveoli are damaged in this process, lung function begins to decrease and symptoms appear.

Symptoms of Asbestosis

When exposure to asbestos stops, progression of the disease also stops. Persons whose exposure was limited may suffer few noticeable symptoms from the minimal damage caused by the fibers. Others may experience a progression of the following symptoms based on the severity of lung scarring.

• Shortness of breath during physical activity (in the early stages)
• Shortness of breath at rest (in the advanced stages)
• A persistent, dry cough
• Tightness in the chest
• Chest pain

Some sufferers may also exhibit clubbing of the fingers. This condition, caused by a lack of oxygen in the blood, causes the flesh under the fingernail to thicken, resulting in a nail that curves downward in an inverted spoon-shape.

Diagnosis

Asbestosis symptoms can be very similar to the symptoms of other lung diseases. An accurate diagnosis usually depends on a reported exposure to asbestos.

On examination with a stethoscope, the asbestosis patient’s lungs typically produce a dry, crackling sound. X-rays or CT scans can show scar tissue and plaques revealing the extent of the lung damage. The doctor may also order pulmonary function testing (breathing tests) to determine how severely normal physical activity is affected.

Asbestosis Treatment

Stopping all exposure to asbestos is the first imperative. The disease does not progress once exposure ends. Then the primary aim of treatment is to aid breathing and prevent respiratory infections.

For smokers, quitting smoking is also important for two reasons. The first is that smoking inflicts continuing damage on lungs that are already compromised, leading to increasingly severe breathing problems sooner. Second, studies have shown that smokers who have been exposed to asbestos are many more times likely to develop lung cancer than other smokers.

Flu vaccinations are recommended, as well as prompt treatment for cold, flu, or other respiratory conditions.

Depending on the severity of the condition, the doctor may also prescribe various medications to improve breathing. In the most advanced cases, supplemental oxygen may be necessary.

In some cases, after doing their damage to the alveoli, the asbestos fibers can continue working their way through the lungs into the lining around the lungs. This may cause fluid build-up around the lungs, causing pain and difficulty breathing. It may be necessary to remove the fluid using a needle in a procedure called thoracentesis.

A few of the severest cases have required lung transplants.

Complications of Asbestosis

• High Blood Pressure. Scar tissue in the lungs can lead to high blood pressure in the pulmonary arteries (pulmonary hypertension), which in turn can lead to heart damage. Hypertension is treated with blood pressure lowering and blood thinning medications.
• Lung Cancer. Asbestosis sufferers – most especially those who smoke – are at risk for also developing lung cancer.
• Mesothelioma. Prolonged exposure to asbestos also puts asbestosis sufferers at risk for developing mesothelioma – an asbestos-caused cancer of the lining surrounding the lungs, heart, or abdominal organs. Mesothelioma may develop many years after the symptoms of asbestosis appear.

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