Asbestos: Socio-legal and Scientific Controversies and Unsound Science in the Context of the Worldwide Asbestos Tragedy – Lessons to be Learned^[*]

Abstract

Eight to fifteen per cent of lung cancer cases and nearly all mesothelioma cases are caused by asbestos. Problems in compensation issues ensue from strict legal requirements for eligibility and regulations of the statutory accident insurance institution pertaining to eligibility for occupational disease benefits. The latter include the unscientific requirement for set numbers of asbestos bodies or fibers to be found in lung tissue in order to “prove” disease causation if lung specimen are available. Although the validity of such evidence has been discredited by independent scientists, it is still used as evidence by an influential US pathology department. Frequently, epidemiological evidence regarding causal relationships and exposure histories is also often being ignored by insurance-affiliated medical experts.

Similar misleading arguments are currently being used in newly industrialized countries where white asbestos – which is carcinogenic and fibrogenic like other asbestos types – is efficiently promoted as being less harmful. As a result, asbestos use is increasing in some of these countries. Behind the worldwide asbestos tragedy, a well-designed strategy orchestrated by certain transnational or multinational industrial interest groups can be perceived.

Beyond the asbestos tragedy their covert plan is motivated by economic interests and discounts the ensuing damage to health and the impact of the diseases they create on public health systems.

Zusammenfassung

8 – 15 % aller Lungenkrebsfälle und nahezu alle Mesotheliome sind asbestbedingt.

Probleme der Berufskrankheiten-Entschädigung ergeben sich aufgrund der teils vom Verordnungsgeber, teils von der Arbeitgeber-Haftversicherung, d. h. den Berufsgenossenschaften, vorgegebenen hohen Hürden der Beweisanforderung. Von letzteren ist besonders die wissenschaftlich widerlegte Forderung des Nachweises einer bestimmten Zahl von Asbestkörpern bzw. -fasern im Lungengewebe relevant. Sie hat sich auch bei einem einflussreichen Pathologieinstitut in den USA etabliert. Dabei wird den sich aus epidemiologischen Studien ergebenden Wahrscheinlichkeiten für den Ursachenzusammenhang jegliche Bedeutung abgesprochen.

Entsprechend negierende Argumentationen finden sich aktuell in Schwellenländern. Dort wird Weißasbest, der wie andere Asbestarten kanzerogen und fibrogen ist, derart effizient propagiert, dass die Verbrauchsmengen z. T. wieder ansteigen.

Über die weltweite Asbest-Tragödie hinaus ist von Bedeutung, dass, zumeist geschickt verdeckt, letztendlich in vergleichbarer Weise bestimmte transnational oder global agierende industrielle Interessengruppen ihre wirtschaftlichen Interessen ähnlich rigoros auf Kosten des Gesundheitsrisikos der Allgemeinheit verfolgen.

^* Dedicated to Univ.-Prof. em. Dr. med. Hans-Joachim Woitowitz on the occasion of his 80th birthday.

• References

• 1 Gesundheitsberichterstattung des Bundes. Beiträge zur Gesundheitsberichterstattung des Bundes Krebs in Deutschland 2009/2010. 2013 9. http://www.rki.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/kid_2013/krebs_in_deutschland_2013.pdf?__blob=publicationFile
• 2 Sicherheit und Gesundheit bei der Arbeit 2013. Unfallbericht Arbeit. 2014 http://www.baua.de/de/Informationen-fuer-die-Praxis/Statistiken/Berufskrankheiten/Berufskrankheiten.html
• 3 WHO. Elimination of asbestos related diseases. WHO Fact Sheet N°343. 2010 http://www.who.int/occupational_health/publications/asbestosrelateddisease/en/
• 4 Baur X. Asbest: Kampf um effektiven Arbeitsschutz, das Asbestverwendungsverbot und Kompensation der Opfer. Zentralblatt für Arbeitsmedizin, Arbeitsschutz und Ergonomie 2015;
• 5 Schönberger A, Mehrtens G, Valentin H. Arbeitsunfall und Berufskrankheit. 8. Aufl. Berlin: E. Schmidt-Verlag; 2009
• 6 Schönberger A, Mehrtens G, Valentin H. Arbeitsunfall und Berufskrankheit. Berlin: E. Schmidt Verlag; 1998
• 7 (DGUV), D.G.U.e.V. Empfehlung für die Begutachtung asbestbedingter Berufskrankheiten – Falkensteiner Empfehlung. Berlin; 2012. (ISBN online: 978-3-883-875-8)
• 8 Baur X et al. [Diagnostics and expert opinion of asbestos-induced occupational diseases]. Pneumologie 2011; 65: e1-47
• 9 The Court Of Common Pleas, C.D.T.S.O.O. County of Cuyahoga Case No. 793085 Plaintiffs, -v- Ammco Tools, Inc., et al., Defendants. Transcript of proceedings. 18. 04. 2014.
• 10 Roggli VL. Asbestos bodies and nonasbestos ferruginous bodies. Pathology of asbestos-associated diseases. New York: Springer-Verlag; 2004
• 11 Roggli VL et al. Pathology of asbestosis- An update of the diagnostic criteria: Report of the asbestosis committee of the college of american pathologists and pulmonary pathology society. Arch Pathol Lab Med 2010; 134: 462-480
• 12 Craighead JEA, Churg A, Green FH et al. The pathology of asbestos-associated diseases of the lung and pleural cavities: diagnostic criteria and proposed grading scheme. Report of the Pneumoconiosis Committee of the College of American Pathologists and the National Institute for Occupational Safety and Health. Arch Pathol Lab Med 1982; 106: 544-596
• 13 Hammar SP. Controversies and uncertainties concerning the pathologic features and pathologic diagnosis of asbestosis. Semin Diagn Pathol 1992; 9: 102-109
• 14 Hammar SP, Abraham JL. Commentary on pathologic diagnosis of asbestosis and critique of the 2010 Asbestosis Committee of the College of American Pathologists (CAP) and Pulmonary Pathology Societyʼs (PPS) update on the diagnostic criteria for pathologic asbestosis. Am J Ind Med 2015; http://onlinelibrary.wiley.com/doi/10.1002/ajim.22512/abstract;jsessionid=AA3A590BDA0B1B0F394799A229C9A9A0.f02t02 58: 1034-1038
• 15 Rodelsperger K et al. Inorganic fibres in the lung tissue of Hungarian and German lung cancer patients. Int Arch Occup Environ Health 2001; 74: 133-138
• 16 Woitowitz H-J et al. Biomonitoring nach Asbestfaserstaub-Einwirkung: Lichtmikroskopie versus Elektronenmikroskopie. Arbeitsmed. Sozialmed. Präventivmed 1991; 26: 219-224
• 17 Egilman D. Fiber types, asbestos potency, and environmental causation: a peer review of published work and legal and regulatory scientific testimony. Int J Occup Environ Health 2009; 15: 202-228
• 18 Abraham JL. Analysis of fibrous and non-fibrous particles. Environmental and occupational medicine. 4. th edition. New York: Lippincott Williams and Wilkins; 2006
• 19 Warnock ML, Isenberg W. Asbestos burden and the pathology of lung cancer. Chest 1986; 89: 20-26
• 20 Davis JM. The pathology of asbestos related disease. Thorax 1984; 39: 801-808
• 21 Davis JM et al. Inhalation and injection studies in rats using dust samples from chrysotile asbestos prepared by a wet dispersion process. Br J Exp Pathol 1986; 67: 113-129
• 22 Wagner JC, Berry G, Pooley FD. Mesotheliomas and asbestos type in asbestos textile workers: a study of lung contents. Br Med J (Clin Res ed.) 1982; 285: 603-606
• 23 Wagner JC, Pooley FD. Mineral fibres and mesothelioma. Thorax 1986; 41: 161-166
• 24 Pott F. Neoplastic findings in experimental asbestos studies and conclusions for fiber carcinogenesis in humans. Ann N Y Acad Sci 1991; 643: 205-218
• 25 Pott F. Asbestos use and carcinogenicity in Germany and a comparison with animal studies. Ann Occup Hyg 1994; 38: 589-600
• 26 Gylseth B et al. Analysis of asbestos fibers and asbestos bodies in tissue samples from human lung. An international interlaboratory trial. Scand J Work Environ Health 1985; 11: 107-110
• 27 Dodson RF et al. A comparison of the ferruginous body and uncoated fiber content in the lungs of former asbestos workers. Am Rev Respir Dis 1985; 132: 143-147
• 28 Lemen RA. Chrysotile asbestos and mesothelioma. Environ Health Perspect 2010; 118: A282
• 29 Collegium Ramazzini. Collequium Ramazzini Perspectives on the 2014 Helsinki consensus report on asbestos. 2015
• 30 Craighead JE, Gibbs AR. Mineralogy of asbestos. Asbestos and its diseases. New York: Oxford University Press; 2008
• 31 Churg A. Non-neoplastic disease caused by asbestos. Pathology of occupational lung disease. 2. nd edition. Baltimore: Williams & Williams; 1998
• 32 Heitz P. Neue Definitionen der Minimalasbestose. Dtsch Ärztebl 1997; 64: A975
• 33 Wolff H et al. Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations. Scand J Work Environ Health 2015; 41: 5-15
• 34 Abraham JL, Burnett BR, Hunt A. Development and use of a pneumoconiosis database of human pulmonary inorganic particulate burden in over 400 lungs. Scanning Microscopy 1991; 5: 95-108
• 35 Dodson RF et al. Characteristics of asbestos concentration in lung as compared to asbestos concentration in various levels of lymph nodes that collect drainage from the lung. Ultrastruct Pathol 2007; 31: 95-133
• 36 Dodson RF et al. Analysis of asbestos fiber burden in lung tissue from mesothelioma patients. Ultrastruct Pathol 1997; 21: 321-336
• 37 FIOH. Helsinki Criteria Update 2014 Asbestos. Asbestosis, and Cancer. 2014 http://www.euro.who.int/en/health-topics/environment-and-health/occupational-health/publications/2013/the-human-and-financial-burden-of-asbestos-in-the-who-european-region
• 38 Raghu G et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 2011; 183: 788-824
• 39 WHO. The human and financial burden of Asbestos in the WHO European region. 2013 http://www.euro.who.int/en/health-topics/environment-and-health/occupational-health/publications/2013/the-human-and-financial-burden-of-asbestos-in-the-who-european-region
• 40 Wang X et al. Cancer mortality in Chinese chrysotile asbestos miners: exposure-response relationships. PLoS One 2013; 8: e71899
• 41 Camargo MC et al. Occupational exposure to asbestos and ovarian cancer: a meta-analysis. Environ Health Perspect 2011; 119: 1211-1217
• 42 Wilken D et al. Lung function in asbestos-exposed workers, a systematic review and meta-analysis. J Occup Med Toxicol 2011; 6: 21
• 43 Delpierre S et al. High prevalence of reversible airway obstruction in asbestos-exposed workers. Arch Environ Health 2002; 57: 441-445
• 44 La Vecchia C, Boffetta P. Role of stopping exposure and recent exposure to asbestos in the risk of mesothelioma. Eur J Cancer Prev 2012; 21: 227-230
• 45 Terracini B et al. A critique to a review on the relationship between asbestos exposure and the risk of mesothelioma. Eur J Cancer Prev 2014; 23: 492-494
• 46 Mirabelli D, Zugna D. Comment on 'The latency period of mesothelioma among a cohort of British asbestos workers (1978 – 2005). Br J Cancer 2014; 111: 1675
• 47 Egilman DS, Billings MA. Abuse of epidemiology: automobile manufacturers manufacture a defense to asbestos liability. Int J Occup Environ Health 2005; 11: 360-371
• 48 McDonald JC et al. The relationship between asbestosis and bronchial cancer. Chest 1980; 78: 380-381
• 49 Stayner L et al. Exposure-response analysis of risk of respiratory disease associated with occupational exposure to chrysotile asbestos. Occup Environ Med 1997; 54: 646-652
• 50 Gustavsson P et al. Low-dose exposure to asbestos and lung cancer: dose-response relations and interaction with smoking in a population-based case-referent study in Stockholm, Sweden. Am J Epidemiol 2002; 155: 1016-1022
• 51 Hein MJ et al. Follow-up study of chrysotile textile workers: cohort mortality and exposure-response. Occup Environ Med 2007; 64: 616-625
• 52 Vainio H. Epidemics of asbestos-related diseases -- something old, something new. Scand J Work Environ Health 2015; 41: 1-4
• 53 Baur X et al. Do advers health effects of chrysotile and amphibole asbestos differ?. Pneumologie 2012; 66: 497-506
• 54 Egilman DS, Bird T, Lee C. MetLife and its corporate allies: dust diseases and the manipulation of science. Int J Occup Environ Health 2013; 19: 287-303
• 55 Elsner G. Konstitution und Krankheit: Der Arbeitsmediziner Helmut Valentin (1919 – 2008) und die Erlanger Schule. Hamburg: VSA; 2011
• 56 Egilman D, Bird T, Lee C. Dust diseases and the legacy of corporate manipulation of science and law. Occup Environ Health 2014; 20: 115-125
• 57 International Agency for Research on Cancer. M.W.G. Asbestos (chrysotile, amosite, crocidolite, tremolite, actinolite, and anthophyllite). IARC Monographs on the Evaluation of Carcinogenic Risks to Humans 100C. 2012
• 58 Baur X et al. How conflicted authors undermine the World Health Organization (WHO) campaign to stop all use of asbestos: spotlight on studies showing that chrysotile is carcinogenic and facilitates other non-cancer asbestos-related diseases. Int J Occup Environ Health 2015; 37: 176-179
• 59 Baur X et al. Ethics, morality, and conflicting interests: how questionable professional integrity in some scientists supports global corporate influence in public health. Int J Occup Environ Health 2015; 37: 172-175