Het ministerie van VROM heeft 47 miljoen euro ter beschikking gesteld voor de schoonmaak van ongeveer 1000 met asbest vervuilde locaties in het gebied rond de voormalige asbestfabrieken van Goor en Harderwijk. Bron: provincie Overijssel, juni 2005.
Alpha-TOS, een soort vitamine E, heeft in experimenten met muizen mesothelioomkankercellen gedood en de groei van tumoren tegengehouden, zegt de Australische celbioloog Dr. Neuzil. Hij hoopt dat het middel over ongeveer 2 jaar bij mensen kan worden getest.
Bron: The Courier Mail, Daily Telegraph, 23 mei 2005.
The Courier Mail (Queensland, Australia)
May 23, 2005 Monday
HEADLINE: Vitamin cancer treatment hope
BODY:
A VITAMIN E-related compound may kill deadly cancer cells caused by asbestos exposure, says an Australian cell biologist who has already established its success in trials using mice.
Gold Coast-based Griffith University researcher Jiri Neuzil said alpha-TOS, which is closely related to vitamin E, killed mesothelioma cancer cells in experiments with mice.
Most victims of mesothelioma, an aggressive cancer that destroys a protective membrane covering internal organs including the lungs, have inhaled asbestos particles.
Dr Neuzil said alpha-TOS also halted growth of mesothelioma tumours, for which there is currently no cure, under a five-year study involving researchers from Australia, Italy and the Czech Republic.
He said the compound had also showed hints of suppressing breast cancer, melanoma, lung cancer and colon cancer tumours in animal experiments. Dr Neuzil said alpha-TOS would ultimately be put to the test in human trials, which he hoped to begin within two years.
Alpha-TOS was selective because it pursued mesothelioma cancer cells but caused only minor damage, if any, to normal cells in mice, he said.
Dr Neuzil said he stumbled on the compound’s promising qualities “by mistake five years ago.
De longartsenwerkgroep mesotheliomen van de NVALT beoordeelt aanvragen van mesothelioompatiënten waarbij het moeilijk is om een pathologische beoordeling te geven. In de periode januari 2000 tot maart 2004 heeft de werkgroep 132 casussen beoordeeld die bij het IAS zijn aangemeld. Tweederde deel werd als passend bij de diagnose ´maligne pleuramesothelioom´ beoordeeld, eenderde als niet passend. In meer dan tweederde deel van de casussen oordeelden de drie onafhankelijke specialisten unaniem.
Bron: Baas, P. et al. (2005). Ned. Tijdschr. Geneesk. 149. 759-763.
Volgens chemicus de Jong en arts de Waard zijn asbestvezels in de grond ongevaarlijk. Asbestsanering van grond is dus overbodig en bovendien slecht voor het milieu. Machines die bij die sanering worden gebruikt veroorzaken namelijk vervuiling van de lucht met roet en stof.
Bron: Tubantia / Twentsche Courant, 11 mei 2005
In de West-australische plaats Wittenoom werd van 1943 tot 1966 het gevaarlijke blauwe asbest gewonnen (crocidoliet). In 2002 werden 1885 inwoners, waarvan 1042 (ex-)werknemers onderzocht op asbestose (stoflongen) en bepaalde vitamine-niveaus in het bloed (retinol, caroteen en vitamine E). De onderzoekers vonden een relatie tussen chronisch lagere vitamine-niveaus en een grotere kans om aan asbestose te overlijden. Van de onderzoeksgroep overleden 76 personen aan asbestose, een te kleine groep om causaliteit te kunnen bepalen. Meer onderzoek is nodig.
Bron: Alfonso, H.S. et al. (2005). Plasma Concentrations of Retinol, Carotene, and Vitamin E and Mortality in Subjects With Asbestosis in a Cohort Exposed to Crocidolite in Wittenoom, Western Australia. Journal of occupational and environmental medicine. vol. 47, afl. 6, pag. 573-579 (7)
Alfonso, Helman S.. Fritschi, Lin. de Klerk, Nicholas H.. Ambrosini, Gina. Beilby, John. Olsen, Nola. Musk, A William (2005). Plasma Concentrations of Retinol, Carotene, and Vitamin E and Mortality in Subjects With Asbestosis in a Cohort Exposed to Crocidolite in Wittenoom, Western Australia. Journal of occupational and environmental medicine. vol. 47, afl. 6, pag. 573-579 (7).
Abstract
Objective:We sought to examine the relationships between plasma concentrations of retinol, carotene, and vitamin E and mortality associated with asbestosis in people previously exposed to crocidolite.
Methods:Cox regression modeling was applied to examine these relationships at the first measurement of each vitamin, at the measurement at each visit, and with the rate of change of each vitamin during the follow-up.
Results:There were 76 deaths of people with asbestosis during the follow-up period and 1885 subjects censored. Mortality in subjects with asbestosis was inversely related to plasma levels of retinol and Vitamin E concentrations and to their rate of increase during the follow-up. Carotene concentrations at first visit were associated with lower mortality but not during the follow up period.
Conclusions:Chronically low levels of these vitamins are associated with an increased risk of dying with asbestosis.
Een medewerker van het ministerie van defensie is in zijn functie van scheepsmaker langdurig aan asbest blootgesteld geweest. Hij kreeg na een aantal jaren longkanker en vervolgens slokdarmkanker waaraan hij is overleden. De rechtbank oordeelt dat het ontstaan van de longcarcinoom voor 50% aan roken is toe te rekenen en voor 50% aan asbestblootstelling. De Centrale Raad van Beroep bevestigt het oordeel van de rechtbank dat het ministerie onrechtmatig heeft gehandeld door het langdurig blootstellen aan asbest van betrokkene.Hierdoor is het risico op longkanker aanzienlijk vergroot en uiteindelijk verwezenlijkt. Het rookgedrag van de medewerker kan niet gezien worden als opzet of bewuste roekeloosheid.
Bron: rechtspraak.nl, LJN: AT5582, 12 mei 2005.
Begin mei is de nieuwe algemene brochure ´Asbest en Gezondheidsschade´ uitgekomen. Deze brochure vervangt de gelijknamige versie 20030108 (met blauw/witte achtergrond). De brochure is bestemd voor patiënten met mesothelioom (longvlies-/buikvlieskanker) en wordt verspreid onder alle ziekenhuizen (longartsen en patiëntenvoorlichting), Integrale Kankercentra, patiëntenorganisaties, thuiszorgorganisaties en onze sociale partners (werkgevers-werknemersorganisaties, verzekeraars en de overheid) Wanneer u van deze kosteloze brochure exemplaren wilt bestellen, stuur dan een email aan het secretariaat (secrias@ser.nl).
Duizenden werknemers staan bij het verwijderen van asbest bloot aan `gigantische gezondheidsrisico`s`, omdat veel bedrijven de regels voor het verwijderen van de kankerverwekkende stof aan de laars lappen. Dat zegt Frans Leerkes van de Arbeidsinspectie in het Algemeen Dagblad van 9 april. Het AD komt met dit nieuws naar aanleiding van een uitzending van RTL nieuws, waarin vorige week onthuld werd dat zowel gespecialiseerde bedrijven als kleine aannemers de regels overtreden. Ook zouden malafide bedrijven op grote schaal illegaal asbest verwijderen.
Bron: NFK, 21 april 2005 / AD.
Meer http://www.kankerpatient.nl/default.asp?ref=http://www.kankerpatient.nl/template_6_0_content.asp
Asbest bestaat uit microscopisch kleine vezels. Er zijn verschillende soorten, onderverdeeld in serpentijnen en amfibolen. Serpentijnen hebben gekrulde vezels, de vezels van amfibolen hebben de vorm van staafjes en zijn gevaarlijker. Een groep ratten werd gedurende 5 dagen herhaaldelijk blootgesteld aan een groot aanta calidria chrysotiel vezels (serpentijn), een andere groep aan een aantal tremolietvezels (amfibool). Tot één jaar na de proef werd bij de ratten die aan chrysotiel waren blootgesteld geen ontstekingsreactie gezien. Dit in tegenstelling tot de aan tremoliet blootgestelde ratten die sterk reageerden, ondanks blootstelling aan 16 x minder vezels dan de aan chrysotiel blootgestelde ratten. Bernstein, D. et. al., (2005). Comparison of Calidria Chrysotile Asbestos to Pure Tremolite : Final Results of the Inhalation Biopersistence and Histopathology Examination Following Short-Term Exposure. Inhalation toxicology. vol. 17, afl. 9, pag. 427-450 (24).
Bernstein, David. Chevalier, Jörg. Smith, Paul (2005). Comparison of Calidria Chrysotile Asbestos to Pure Tremolite : Final Results of the Inhalation Biopersistence and Histopathology Examination Following Short-Term Exposure. Inhalation toxicology. vol. 17, afl. 9, pag. 427-450 (24).
Abstract:
Calidria chrysotile asbestos, which is a serpentine mineral, has been shown to be considerably less biopersistent than the durable amphibole mineral tremolite asbestos, which persists once deposited in the lung. The initial results of this inhalation biopersistence study in rats that demonstrates this difference were reported in Bernstein et al. (2003). This article presents the full results through 1 yr after cessation of the 5-day exposure. This study was based upon the recommendations of the European Commission (EC) Interim Protocol for the Inhalation Biopersistence of synthetic mineral fibers (Bernstein & Riego-Sintes, 1999). In addition, the histopathological response in the lung was evaluated following exposure. In order to quantify the dynamics and rate by which these fibers are removed from the lung, the biopersistence of a sample of commercial-grade chrysotile from the Coalinga mine in New Idria, CA, of the type Calidria RG144 and that of a long-fiber tremolite were studied. For synthetic vitreous fibers, the biopersistence of the fibers longer than 20 µm has been found to be directly related to their potential to cause disease. This study was designed to determine lung clearance (biopersistence) and the histopathological response. As the long fibers have been shown to have the greatest potential for pathogenicity, the aerosol generation technique was designed to maximize the number of long respirable fibers. The chrysotile samples were specifically chosen to have 200 fibers/cm 3 longer than 20 µm in length present in the exposure aerosol. These longer fibers were found to be largely composed of multiple shorter fibrils. The tremolite samples were chosen to have 100 fibers/cm 3 longer than 20 µm in length present in the exposure aerosol. Calidria chrysotile has been found to be one of the most rapidly cleared mineral fibers from the lung. The fibers longer than 20 µm in length are cleared with a half-time of 7 h. By 2 days postexposure all long fibers have dissolved/disintegrated into shorter pieces. The fibers between 5 and 20µm in length were cleared with a half-time of 7 days. This length range represents a transition zone between those fibers that can be fully phagocytosed and cleared as particles and the longer fibers that cannot be fully engulfed by the macrophage. The fibers/objects shorter than 5 µm in length were cleared with a half-time of 64 days, which is faster than that reported for insoluble nuisance dusts such as TiO 2 . By 12 months postexposure, 99.92% of all the remaining chrysotile was less than 5 µm in length. Following the 5 days of repeated exposure to more than 48,000 chrysotile fibers/cm 3 (190 fibers L > 20 µm), histopathological examination revealed no evidence of any inflammatory reaction either after the cessation of the last exposure or at any time during the subsequent 12-mo period. This is in marked contrast to the amphibole tremolite, which was also investigated using the same inhalation biopersistence protocol. The long tremolite fibers, once deposited in the lung, remain over the rat’s lifetime with essentially an infinite half-time. Even the shorter fibers, following early clearance, also remain with no dissolution or further removal. At 365 days postexposure, there was a mean lung burden was of 0.5 million fibers L > 20 µm and 7 million fibers 5-20 µm in length with a total mean lung burden of 19.6 million fibers. The tremolite exposed rats, even with exposure to 16 times fewer total fibers than chrysotile, showed a pronounced inflammatory response with the rapid development of granulomas as seen at day 1 postexposure, followed by the development of fibrosis characterized by collagen deposition within these granulomas and by 90 days even mild interstitial fibrosis. With the short exposure, this study was not designed specifically to evaluate pathological response. however, it is quite interesting that even so there was such a marked response with tremolite. These findings provide an important basis for substantiating both kinetically and pathologically the differences between chrysotile and the amphibole tremolite. As Calidria chrysotile has been certified to have no tremolite fiber, the results of the current study together with the results from toxicological and epidemiological studies indicate that this fiber is not associated with lung disease.
Dit artikel beschrijft hoe claims ten gevolge van blootstelling aan asbest in de VS tot een crisis in het juridische systeem hebben geleid. Bedrijven gaan failliet door: rechters die dubieus medisch bewijs van blootstelling aan asbest accepteren, door het grote aantal schadevergoedingen aan mensen die wel met asbest hebben gewerkt, maar niet ziek zijn. En door de hoge juridische kosten. De echt zieke slachtoffers zijn daarvan de dupe. Bron: Brickman, L. & Shapiro, H.D (2005). Asbestos kills. National Review, 31 januari, 39-41.
Asbestos kills
And more than just people: jobs, ethics, and elementary justice
L E S T E R B R I C K M A N & H A RV E Y D. S H A P I RO
IT�S become a familiar scenario across the U.S.: A jovial air pervades this parking lot adjacent to a union hall that belies the serious purpose that has brought together a group of middle-aged men. For much of the afternoon they�ve been sipping coffee and waiting their turn to enter the trailer parked at one end of the parking lot. The trailer contains X-ray equipment, and they�re about to have their lungs checked for asbestos-related diseases. They�re here in response to postcards saying things like, �You Might Have Million Dollar Lungs!�
They know they�re entering a lottery, one in which a tiny few may find they have cancer but many more will find themselves perfectly healthy yet entitled to receive checks from 20 or 30 different companies totaling as much as $60,000�of course, that�s after their lawyers have deducted their 40 percent cut. For decades, scenes like this have been played out in the parking lots of hundreds of union halls, motels, and strip malls across America. For most Americans, asbestos litigation, like asbestos itself, is now a dimly remembered artifact of an earlier age. But despite 30 years of sweeping efforts to remove every trace of asbestos from American life, more than 100,000 new claims of asbestos-related diseases were filed in 2003�the most ever in a single year. While there was a sharp fall-off in nonmalignant claims filed in 2004, many experts anticipate that hundreds of thousands of additional claims will yet be brought, joining the 850,000 that have already come forward.
GONE BUT NOT FORGOTTEN
After years of asbestos-removal programs, prominent medical researchers Kevin Browne, Edward A. Gaensler, and Andrew Churg have called asbestosis a �disappearing disease,� and a condition that is �exceedingly rare.� So how is it that thousands and thousands of claims continue to be filed? This is a question the new Congress is likely to be asking, because of the increased power of Republican critics of trial lawyers. Asbestos could become the poster child for tort reform. As one leading medical expert on asbestos-related diseases, Dr. James Crapo, has said, claimants are being compensated �for illnesses that, according to the clear weight of medical evidence, either are not caused by asbestos or do not result in a significant impairment�i.e., are not generally regarded by the medical profession as an illness.� Yet asbestos lawyers continue their vigorous pursuit of potential claimants�not just through labor unions, but also through radio and TV ads and the Internet. So far, employers and their insurers have paid out over $70 billion�with more than half of that sum going to those who have either no injury or no proof that asbestos caused their injury. (That, of course, leaves far less to be paid to those who are truly suffering as a result of terrible asbestos-related injuries.) An additional $150 billion is likely to be required before the asbestos gods have been satiated. So far, some 8,400 companies have been sued. more than 70 have filed for bankruptcy. as a result of this financial drain, an estimated 500,000 jobs have been eliminated or not created. For a millennium, asbestos was �the magic mineral� because of its resistance to heat. In World War II, it was declared a �strategic and critical material� because of its value as insulation. After 9/11, experts said the World Trade Center would have burned more slowly, perhaps permitting more people to survive, had its asbestos insulation not been removed. And the O-rings in the doomed Challenger spacecraft would not have failed had they continued to contain asbestos.
But exposure to asbestos can cause cancer or asbestosis, a scarring of lung tissue. Between 1960 and 2003, some 75,000 people died of mesothelioma (tumors of the lung), and another 35,000 are likely to succumb before 2050. Knowledge of the hazards of asbestos dates back a century, and documents from the 1930s and 1940s revealed that two leading asbestos manufacturers had conspired to conceal the serious health threat posed to their workers. During World War II, naval officials ignored the consequences to 4.5 million shipyard workers�a cover-up that reached the highest levels of government. In the 1960s, Dr. Irving Selikoff of the Mount Sinai School of Medicine published research showing alarming rates of lung cancer and asbestosis among insulation workers, and a series of New Yorker articles by Paul Brodeur in the early 1970s helped focus public attention on asbestos. As awareness of the dangers grew, there was a sweeping campaign to remove asbestos wherever it had been used. Meanwhile, the growing awareness of the risks�and the cover-up�led to a spate of lawsuits, beginning in 1973 when the Fifth Circuit Court of Appeals allowed workers injured by exposure to asbestos to file a product-liability suit (in which juries determine the size of the award) rather than a workers�-compensation case (in which claims are paid according to a formula).
Much of the initial litigation targeted the Johns Manville Corporation, which had long been the nation�s principal miner and fabricator of materials containing asbestos. In 1982, after some 16,000 suits were filed, Manville declared bankruptcy. It emerged from bankruptcy in 1988 under an innovative plan in which almost $2 billion of cash and most of the company�s stock were transferred to the Manville Personal Injury Trust, and all asbestos claims were to be directed to the Trust. Claimants who submitted only minimal proof of exposure to a Manville product and asserted that they had an asbestos-related medical condition were paid according to a schedule of benefits. This set off a feeding frenzy: The Manville Trust quickly became insolvent after distributing nearly $680 million, including approximately $266 million to plaintiffs� lawyers. After this second Manville bankruptcy,
lawyers turned their attention to smaller asbestos producers and to construction firms that used asbestos products. Several critical legal principles fanned the flames of litigation. The principle of joint and several liability meant that a worker could sue several dozen companies, and any one of them could end up being held responsible for 100 percent of the claim, no matter how minor its involvement. Another key principle involved insurance coverage. Asbestos-related diseases take years to manifest themselves, so which liability insurers should pay the claims? Should it be the insurers at the time when the worker was exposed? Or the insurers when the disease was found? Or the insurers in the intervening 15 to 40 years, when initial exposures were slowly injuring a worker�s lungs? In 1988, a court held that all three sets of insurers would be liable. Originally, most asbestos litigation involved seriously injured claimants�those stricken with mesothelioma, asbestosis, or lung cancer. But since the Manville Trust and insurance companies were paying claims without demanding much in the way of proof, plaintiffs� lawyers began to seek compensation based on decidedly modest evidence of injuries and product exposure. For example, they obtained statements from doctors that an individual�s lung conditions were �consistent with asbestosis��even though anything from old age and obesity to smoking can account for the same lung condition.
READING THE B-READERS
The asbestos lawyers have created an entrepreneurial model to seek out potential claimants and send them to screening enterprises. The X-rays taken by the screeners are then sent for analysis to �B-readers,� specialized radiologists retained by plaintiffs� lawyers. The comparative handful of B-readers regularly selected by plaintiffs� lawyers consistently diagnose 60 to 80 percent of those screened with mild asbestosis. But in a Johns Hopkins study, approximately 500 X-rays in which plaintiffs� lawyers� Breaders had found signs of asbestosis were reread by other radiologists who did not know who was hiring them. These B-readers found that, at most, 4.5 percent of the X-rays indicated lung conditions consistent with mild asbestosis. Only about 5 percent of potential B-readers are used by plaintiffs� lawyers, and they have earned substantial fees for their services.
They also seem to have made convenient shifts in their diagnoses. Until the mid-1990s, most asbestos claimants were diagnosed as having �pleural plaques,� which are deposits of collagen fibers on the lining of the lungs. This typically produces no symptoms and does not increase the likelihood of contracting an asbestos-related disease, so many states do not allow suits based on pleural plaques. (In states that do allow such suits, however, juries have awarded damages as high as $1 million.) After a putative mega-settlement of asbestos issues proposed in 1993 placed no value on future pleural-plaques claims, the doctors hired by plaintiffs� lawyers almost immediately stopped diagnosing the newly screened as having pleural plaques. instead they found mild asbestosis.
In another very suggestive shift, on several occasions in which companies were entering bankruptcy, and their ability to pay claims dwindling, a number of witnesses suddenly recalled that the products they had handled were from companies that had not filed for bankruptcy. For example, in a deposition taken in October 1981, when Johns Manville was the premier target for plaintiffs� attorneys, one long-time New York Shipyard employee estimated that Johns Manville had supplied between 75 and 80 percent of the products containing asbestos. But when another witness was deposed in December 1982�several months after the Manville bankruptcy�that figure had shrunk to 25 percent and other companies were implicated instead.
�PRE-PACKED��AND STACKED
Faced with this movable feast of claims, some 70 companies have followed Johns Manville into bankruptcy, with more to come. Many follow the Manville model and transfer assets to a trust which is to pay future claims. Thus, claimants need a viable company to emerge from bankruptcy and generate revenues for the trust. To help facilitate this, Congress in 1994 created statutory authority to channel all asbestos claims to these trusts, not to the companies. But one of the provisions of the legislation increased the proportion of tort claimants who had to agree before the �channeling� function of the trust could become effective. This created perverse incentives for lawyers to recruit more claimants�regardless of the merits of their claims�because that gave the lawyers more leverage over the bankruptcy process (not to mention additional legal fees).
Recently, companies facing insolvency because of asbestos claims have turned to �pre-packaged� bankruptcies in which attorneys for the asbestos claimants and the company agree on a plan of reorganization and then present it to the bankruptcy court for approval. In other settings, �pre-packs� can minimize litigation costs, expedite claims payments, and give the company a better chance of surviving. In an asbestos pre-pack, the company typically negotiates an agreement in which it settles a large number of pending asbestos cases for highly inflated values�to be paid by its insurance company�and in return, the plaintiffs� lawyers let the company retain a substantial portion of its assets when it emerges from bankruptcy.
Claimants whose lawyers are part of the pre-pack negotiations Legislation created perverse incentives for lawyers to recruit more claimants�regardless of the merits of their claims�because that gave the lawyers more leverage over the bankruptcy process.
often receive highly favorable treatment in pre-packs. In December, the Third Circuit Court of Appeals turned down the proposed settlement in the Combustion Engineering bankruptcy, in which a pool of unimpaired claimants was supposed to get 95 cents out of every dollar they would have received in a pre-bankruptcy payment�while real cancer victims would get what was left: about 20 cents for every dollar of a pre-bankruptcy settlement. Moreover, the lawyer for the claimants was to get a $20 million fee from the company for putting together this deal. After lower courts approved this plan, 291 cancer victims appealed to the Third Circuit, which found that it did not meet the standards of fair treatment for all creditors required in a bankruptcy proceeding. Most judges, however, have been content to approve whatever is negotiated in a pre-pack. There is little doubt that after 30 years of lawsuits, the biggest beneficiary of the asbestos mess has been the plaintiffs� bar�to the tune of $20 billion in fees so far, and counting. This has come at the expense of those who are seriously ill, as well as companies that had only a peripheral involvement in the asbestos industry. The process is also burdening the property and casualty insurance industry. The 205-year-old Providence Washington Insurance Co., once the third-oldest insurer in the U.S., succumbed to asbestos liability, as has the Kemper Insurance Co. No skin off your back? Insurers recoup their losses by raising their rates. Higher insurance costs will inevitably be reflected in higher product prices.
There have recently been some signs that the plaintiffs� bar has gone a step too far. The Ohio legislature passed a law limitingasbestos claims to persons who can demonstrate actual illness. Courts in Mississippi have demanded more rigorous proof of injury in asbestos cases. And the conflictsof interest of several advisers retained by one judge in several asbestos bankruptcies
led the Third Circuit Court of Appeals to the highly unusual step of removing that judge from presiding over these bankruptcies.
After resigning from the bench in response, that judge went to work for one of those advisers.
A CHANCE FOR FAIRNESS
Over the years, parties to the litigation have entered into periodic and always
unsuccessful negotiations to settle the whole asbestos issue once and for all.
Intermittent congressional efforts have
been equally inconclusive. Last year, for
example, the proposed Fairness in Asbestos
Injury Resolution Act (FAIR) would have
set up a $140 billion industry-funded trust
fund to pay off all asbestos claims, including
those of the non-sick, and put an end
to further litigation. But trial lawyers and
labor unions decided it wasn�t enough and
blocked the measure.
The November elections have not only
brought additional advocates of tort reform
Bron: Brickman, L. & Shapiro, H.D (2005). Asbestos kills. National Review, 31 januari, 39-41.
