Asbestos Lung Cancer: Causes, Diagnosis & Treatment Other Criteria Helsinki Criteria The Helsinki Criteria were established in 1997 to help doctors determine if lung cancer and other pleural diseases are asbestos-related. If a person's lung cancer is diagnosed as asbestos-related, it must fit two criteria: The first addresses the latency period: Lung cancer must develop at least 10 years after initial exposure to asbestos. Asbestos-related lung cancer has a minimum latency period of 10 years. If a person is diagnosed within a decade of his or her first exposure to asbestos, the exposure is ruled out as a possible contributing factor. If a patient developed lung cancer 10 or more years after initial exposure, they fit the first criterion. To prove that asbestos contributed to the development of lung cancer, the patient must fit only one of the remaining Helsinki Criteria: Remaining criteria: Diagnosis of asbestosis. Higher than normal asbestos fibers in the lung tissue. The number of asbestos fibers is measured per gram of dry lung tissue and must coincide with the amount seen in asbestosis patients. The exact amount varies based on type and length of asbestos fibers. Higher than normal exposure to asbestos, measured in fibers per milliliter of air a year (fibers/mL-yr).

The patient must have been exposed to levels of airborne asbestos equal to 25 f/mL-yr. To reach this threshold in a one-year work period, the patient must have been exposed to a level of 25 f/mL. Such a high level is typically only found in asbestos manufacturing and asbestos insulation work. To reach 25 f/mL-yr in a five-year period, an individual must have been exposed to asbestos at a level of 5 f/mL. This level is typical of shipbuilding and construction work. In 2004, researchers reviewed new study results that had emerged since the Helsinki Criteria first were formed. Researchers concluded the 17-year-old criteria still held. But they amended the list to answer a common question. Researchers more closely considered the role of smoking in asbestos-related lung cancer, stating that a second cause of cancer complicates the issue. Most lung cancer cases are linked to smoking, and some are further linked to asbestos. The authors are careful to note the secondary attribution is difficult to determine. Because asbestos and smoking work together synergistically, researchers suggest it is especially difficult to distinguish smoking-related cases from those caused by both smoking and asbestos.

The Helsinki Criteria at work: Suppose a man is diagnosed with lung cancer and worked as a shipbuilder 30 years earlier for several years. The individual fits the first criterion: his first exposure to asbestos was more than 10 years before his diagnosis. He also fits one of the remaining criteria: his occupation exposed him to asbestos at a level of at least 25 f/mL-yr. Because of these two risk factors, doctors would conclude that asbestos caused or contributed to the man's lung cancer. Criticism of the Helsinki Criteria The main critique of the Helsinki Criteria is a result of contradictory hypotheses relating asbestos exposure to lung cancer. There are three distinct and conflicting hypotheses about asbestos exposure causing lung cancer: Asbestos exposure only increases the risk of lung cancer when it has caused asbestosis. Asbestos exposure increases the risk of lung cancer when it is enough to cause asbestosis, despite whether it actually led to an asbestosis diagnosis. This is the hypothesis favored by the Helsinki Criteria. Asbestos exposure always increases the risk of lung cancer, absent of any threshold needed for asbestosis.

The Helsinki Criteria specifically state that asbestosis is not necessary to prove a causal relationship, but that asbestosis must have been possible based on the amount of exposure. Researchers who disagree with this hypothesis disagree with the Helsinki Criteria. Proponents of the first hypothesis argue the criteria are too lenient, and supporters of the third hypothesis argue they are too strict. Despite some opposition, the Helsinki Criteria are an accepted standard throughout the world. Other Sets of Criteria to Determine Asbestos Association Countries struggling with asbestos-related health problems lay out their own versions of the Helsinki Criteria. Panels of experts worldwide typically accept the Helsinki Criteria as a valid set of guidelines and make minor changes specific to each country. The American Thoracic Society (ATS) lays out criteria to determine if a disease is caused by asbestos. The ATS states that, although its guidelines are outlined for nonmalignant diseases and not lung cancer, they coincide with the Helsinki Criteria. The AWARD (Adelaide Workshop on Asbestos-Related Diseases) Criteria, another set of widely recognized standards, was laid out in 2000 to determine the utility of the Helsinki Criteria in Australia. In making the AWARD Criteria, Australia's experts made minor alterations to reflect the specific types of asbestos found in the country.

Overall, the panel of experts deemed the Helsinki Criteria to be reasonable and applicable. Asbestos-Related Lung Cancer and Asbestosis: After much debate, the medical community now believes the presence of asbestosis is a reliable diagnostic marker that a patient has received enough asbestos exposure to develop lung cancer. Some studies claimed asbestosis must be present for lung cancer to be associated with asbestos, while others stated the two can exist independently. Asbestosis and lung cancer are commonly associated because the risk for both rises in a parallel manner as asbestos fibers accumulate in lung tissue. Evidence shows the level of exposure required to develop asbestosis and lung cancer is similar. Asbestos-Related Lung Cancer and Smoking Find a Top Mesothelioma Doctor Prognosis and Survival Rates The prognosis and survival rate for someone with lung cancer related to asbestos differs by type and subtype of the disease and also by the stage at which the cancer is found. Overall, the median survival for a limited stage small cell patient, with combination chemotherapy, is 16 to 22 months. For patients with extensive stage cancer, the median survival is nine to 11 months with the same treatment.

A 2008 review of medical literature found that adenocarcinoma is almost always associated with longer survival times. A 2011 study agreed with these findings, reporting that adenocarcinoma patients lived a median of 8.4 months while all other NSCLC patients lived a median of 8.1 months. While the difference is small, researchers believe it to be significant. Click here to learn more about asbestos lung cancer prognosis Types of Lung Cancer There are two primary forms of asbestos lung cancer: small cell lung cancer and non-small cell lung cancer. Non-small cell lung cancer is less aggressive and more common, accounting for at least 80 percent of all lung cancer cases. Small cell lung cancer makes up less than 20 percent of cases and is more difficult to treat. About 6 percent of small cell lung cancer patients live five years or longer, but early treatment can improve survival rates significantly. About 17 percent of non-small cell lung cancer patients live five years or longer, nearly three times the percentage for small cell lung cancer.

Small Cell Lung Cancer Better prognosis 17% Live 5 Years or Longer There are three primary subtypes of NSCLC distinguishable by the appearance and chemical makeup of their cells: Squamous cell (epidermoid) carcinoma - The most common variety of NSCLC, these cancers form in flat cells that line the inside airways of the lungs. About 25 to 30 percent of all lung cancers are squamous, and this is the most prevalent type of NSCLC among men. Adenocarcinoma - Forms in mucus-producing glandular tissues that line the outer parts of the lungs. It is more common in women than men and the predominant type of cancer among non-smokers. Large cell (undifferentiated) carcinoma - Appearing in any part of the lung, this type of cancer grows and spreads more rapidly than the other varieties of NSCLC. Accounting for 10 to 15 percent of lung cancers, large cell carcinoma appears to be decreasing in occurrence due to advances in diagnostic techniques. Additional Resources Asbestos as a cause of lung cancer Agent Orange Asbestos as a Cause of Lung Cancer While cigarette smoking is the most important risk factor for lung cancer, asbestos exposure is also an important factor.

Inhaled asbestos and smoking work together synergistically to cause lung cancer. The risk of lung cancer in a smoker that has been exposed to asbestos is higher than the risk of the two factors combined. Smokers and those exposed to asbestos each have about a 5 to 10-fold increased risk of developing lung cancer. However, people that were exposed to asbestos AND smoked, are 50 to 100 times more likely to develop lung cancer . Several factors influence the magnitude of the risk of asbestos-related lung cancer. The rate increases with: The amount and duration of exposure The amount of time that elapsed since exposure; peak rate of lung cancer is 30 years after asbestos exposure The age at exposure; exposure while young is worse than when older Tobacco smoking The type and size of asbestos fibers; long fibers are more likely to cause cancer than short fibers (short asbestos fibers are still dangerous) About one in seven people with asbestosis develop lung cancer. Asbestosis is a fibrotic lung disease caused by breathing asbestos fibers. Asbestosis is an independent risk factor for lung cancer; it increases lung cancer risk in the absence of other risk factors (like smoking).

It is estimated that there are over 100,000 people in the United States with asbestosis. Approximately 2,000 people die of asbestosis each year and an additional 2,000 to 3,200 people die of asbestos-related lung cancer. About Asbestos Asbestos is a group of minerals that exist in nature as fibers. In fact, asbestos is the smallest naturally-occurring fiber. Asbestos occurs in crystals of two major forms: serpentine (of which chrysotile fibers are the only major form) and amphibole. Chrysotile fibers are long, curly and easily bend while amphibole asbestos fibers are short, stiff and straight. The amphibole type of asbestos fibers is found in the soil of many countries, especially in Europe and northern Asia. Chrysotile fibers were the main asbestos fiber type used for commercial applications the United States, which amounts to approximately 95% of all commercial applications. The reason that asbestos was used so extensively over the last two centuries is that it highly resistant to damage from heat and corrosion. It is an excellent electrical insulator. Asbestos is quite durable but also flexible.

Moreover, asbestos is relatively inexpensive to obtain through mining. If asbestos was not associated with such horrible diseases as lung cancer, it was and would be an incredibly useful material. Uses of Asbestos Asbestos was used in thousands of different applications over the past decades — when a durable material was needed to stand up to repeated wear, electricity and high heat. Asbestos was commonly used in shipping materials, building materials and electrical products. It was used in various modes of transportation as well including airplanes, railroads/trains, ships and automobiles (especially in parts like brake pads, clutch linings and gaskets). When asbestos was commonly used, there were dozens of trades that included duties in which asbestos exposure was possible or likely. Obviously asbestos miners, those that transported asbestos and those that weaved asbestos fibers into fabrics had extremely high exposure rates. Workers that used asbestos for insulation or those who removed asbestos-containing insulation were greatly affected as well. Contractors, tradesman, and laborers that worked with asbestos also had high exposure rates. When asbestos is in its stable, undisturbed state, it is not hazardous to health. Unfortunately, working with the material in almost any way can disrupt the asbestos, causing fibers to become airborne.

When asbestos particles are dispersed, they are inhaled and become embedded in the lungs. Even moderate exposures to asbestos have been linked to serious diseases of the lung, including cancer. Many trades in which asbestos contact was limited or indirect are still associated with relatively high rates of lung cancer and other asbestos-related disease. Automobile mechanics, janitorial staff, factory workers, and demolition crews may have received a reasonably large exposure. In fact, the spouses of workers in high-exposure professions were sometimes exposed to disease-causing amounts of asbestos. They inhaled asbestos fibers from clothing and other items belonging to the directly exposed. We can help you figure out if you were exposed to asbestos. We have a database of products that employed asbestos over the years, and a list of workplaces and occupations where exposure was likely to occur. If you have lung cancer and were exposed to asbestos in the past, you may have a legal case. Contact us for more information . Asbestos and lung cancer Asbestos has been linked to a number of lung diseases including asbestosis, pleural plaques/effusions, and mesothelioma. Asbestos is also an important cause of small cell and non-small cell lung cancer.

There are a number of lines of evidence that asbestos is clearly linked to lung cancer including laboratory, epidemiological, and clinical research. Among medical professionals, asbestos is now universally accepted as a cause of lung cancer. DNA damage is the hallmark of the cancerous transformation of cells. Asbestos fibers have been shown to be able to kill cells, delete large stretches of DNA from a cell’s genome, and damage chromosomes (bundles of DNA that make up the genome). The silicate fiber may cause DNA damage through oxidative damage because antioxidants can reduce the damage in laboratory studies. Asbestos contributes to inflammation and fibrosis, which may exacerbate cancer formation/propagation . The clinical evidence linking asbestos to lung cancer dates back to at least the 1930s, though an association was theorized in the 1890s. The original epidemiological evidence began appearing in the scientific literature in the 1950s. It was found that asbestos textile workers in India were ten times more likely to develop lung cancer than matched controls. In the United States, the increased lung cancer risk in asbestos insulation workers was found to be sevenfold. It became clear that the risk of lung cancer increases in a dose-dependent fashion.

In other words, people with higher or longer exposure to asbestos fibers have a higher the risk of developing lung cancer. This is considered more or less definitive evidence of a causal link from an epidemiological perspective. Did you develop lung cancer because you were exposed to asbestos? If so, you may have a legal case against the asbestos manufacturers . Help for Veterans Who Were Exposed to Asbestos If you have been diagnosed with lung cancer and have been exposed to asbestos, then you may be entitled to additional compensation; call us toll-free at 1-800-258-1054 to determine your eligibility. Veterans with lung cancer also may be eligible for compensation in addition to what is available through the VA; again call us at 1-800-258-1054 for more information. If you have been diagnosed with lung cancer but are not sure about your asbestos exposure, consult our lung cancer exposure questionnaire. Asbestos Regulation In the United States, there are two main agencies that are tasked with the duty of making and enforcing regulations regarding asbestos. The federal agency that is responsible for regulating air pollutants is the Environmental Protection Agency (EPA). Under the Clean Air Act, the EPA must provide guidelines about emission rates.

The EPA is also responsible for regulations covering asbestos in schools. The other agency that is responsible for asbestos regulation is OSHA or the Occupational Safety and Health Administration. OSHA is responsible for protection and safety of workers. OSHA is concerned with the protection of workers that may have been/are exposed to asbestos in the course of their professional duties or in their work environment. There is important overlap and redundancy between the EPA and OSHA when it comes to asbestos regulation. The notion that asbestos was an important cause of human disease was suspected in the late 19th Century and documents show asbestos companies knew of the health hazards in the early and mid 20th Century; however, asbestos was not regulated to any significant degree in the United States until the 1970s. Originally the asbestos fiber exposure limits were set at 5 fibers per cubic centimeter in 1971. In 1994 this limit was revised to 0.1 asbestos fibers per cubic centimeter. In 1989, The EPA banned all new uses of asbestos in the United States. Since it is clear that the risk of asbestos-related diseases increases with increased exposure, the goal of asbestos disease prevention is to limit exposure.

Undisturbed asbestos is not dangerous; therefore it is often better to leave existing asbestos in place and prevent it from being disturbed rather than removing it. The risk to the asbestos workers and the resulting spread of the asbestos in the environment during removal may outweigh the risk of exposure from stable asbestos. The EPA and OSHA can be called upon to make case by case recommendations as to whether asbestos should be removed or secured. Read more about: Asbestos - National Cancer Institute Asbestos A garage built with asbestos-containing material What is asbestos? Asbestos is the name given to a group of naturally occurring fibrous minerals that are resistant to heat and corrosion. Because of these properties, asbestos has been used in commercial products such as insulation and fireproofing materials, automotive brakes, and wallboard materials. How are people exposed to asbestos? If products containing asbestos are disturbed, tiny asbestos fibers are released into the air. When asbestos fibers are breathed in, they may get trapped in the lungs and remain there for a long time. Over time, accumulated asbestos fibers can cause tissue inflammation and scarring, which can affect breathing and lead to serious health problems. Low levels of asbestos fibers are present in the air, water, and soil.

Most people, however, do not become ill from this type of exposure. People who become ill from asbestos usually have been exposed to it on a regular basis, most often in a job where they have worked directly with the material or through substantial environmental contact. Most heavy exposures to asbestos occurred in the past. The heaviest exposures today tend to occur in the construction industry and in ship repair, particularly during the removal of asbestos-containing materials due to renovation, repairs, or demolition. Workers may also be exposed during the manufacture of asbestos-containing products, such as textiles, friction products, insulation, and other building materials. Which cancers are associated with exposure to asbestos? Exposure to asbestos is associated with an increased risk of lung cancer and mesothelioma , which is a cancer of the thin membranes that line the chest and abdomen. Mesothelioma is the most common form of cancer associated with asbestos exposure, although the disease is relatively rare. What can be done to reduce the hazards of asbestos? The use of asbestos is now highly regulated in the United States. The Occupational Safety and Health Administration has issued standards for the construction industry, general industry, and shipyard employment sectors. How does smoking tobacco affect the risk of asbestos-associated cancers?

Many studies have shown that the combination of tobacco smoking and asbestos exposure is particularly hazardous. However, there is also evidence that quitting smoking reduces the risk of lung cancer among asbestos-exposed workers. Selected References National Institute for Occupational Safety and Health. Asbestos, NIOSH Pocket Guide to Chemical Hazards. Atlanta, GA: Centers for Disease Control and Prevention, 2010. Also available online . Last accessed December 16, 2014. National Toxicology Program. Asbestos, Report on Carcinogens, Thirteenth Edition. Triangle Park, NC: National Institute of Environmental Health and Safety, 2014. Also available online . Last accessed December 12, 2014. Related Resources Asbestos Cancer – Abramson Cancer Center Asbestos Cancer Asbestos Diseases Caused by Exposure to Asbestos Insulation Asbestos exposure may cause asbestos-related cancers including pleural mesothelioma and lung cancer . Pleural mesothelioma is commonly referred to as asbestos cancer. Asbestos is a group of naturally occurring fibrous minerals commonly used in building materials such as flooring, ceilings, roofing, automotive parts and other construction materials.

How Asbestos Causes Mesothelioma The only known cause of mesothelioma is asbestos exposure. When microscopic asbestos fibers are inhaled or ingested, they become embedded in the lining of primary organs such as the lungs, heart and abdomen known as the mesothelium. The mesothelium is a thin membrane of cells that produces a lubricating fluid on the surface of organs. Over time, asbestos causes inflammation and scar tissue to develop on the surface of the mesothelium that can lead to the development of tumors. Types of Asbestos Cancers and Diseases Asbestos is known to cause a multitude of health problems. Asbestos-related cancers and asbestos diseases include: Asbestosis Asbestos Exposure and Cancer Risk Fact Sheet - National Cancer Institute What other organizations offer information related to asbestos exposure? What is asbestos? Asbestos is the name given to a group of minerals that occur naturally in the environment as bundles of fibers that can be separated into thin, durable threads. These fibers are resistant to heat, fire, and chemicals and do not conduct electricity. For these reasons, asbestos has been used widely in many industries. Chemically, asbestos minerals are silicate compounds, meaning they contain atoms of silicon and oxygen in their molecular structure.

Asbestos minerals are divided into two major groups: Serpentine asbestos and amphibole asbestos. Serpentine asbestos includes the mineral chrysotile, which has long, curly fibers that can be woven. Chrysotile asbestos is the form that has been used most widely in commercial applications. Amphibole asbestos includes the minerals actinolite, tremolite, anthophyllite, crocidolite, and amosite. Amphibole asbestos has straight, needle-like fibers that are more brittle than those of serpentine asbestos and are more limited in their ability to be fabricated ( 1 , 2 ). How is asbestos used? Asbestos has been mined and used commercially in North America since the late 1800s. Its use increased greatly during World War II ( 3 , 4 ). Since then, asbestos has been used in many industries. For example, the building and construction industries have used it for strengthening cement and plastics as well as for insulation, roofing, fireproofing, and sound absorption. The shipbuilding industry has used asbestos to insulate boilers, steam pipes, and hot water pipes. The automotive industry uses asbestos in vehicle brake shoes and clutch pads.

Asbestos has also been used in ceiling and floor tiles; paints, coatings, and adhesives; and plastics. In addition, asbestos has been found in vermiculite-containing garden products and some talc-containing crayons. In the late 1970s, the U.S. Consumer Product Safety Commission (CPSC) banned the use of asbestos in wallboard patching compounds and gas fireplaces because the asbestos fibers in these products could be released into the environment during use. In addition, manufacturers of electric hairdryers voluntarily stopped using asbestos in their products in 1979. In 1989, the U.S. Environmental Protection Agency (EPA) banned all new uses of asbestos; however, uses developed before 1989 are still allowed. The EPA also established regulations that require school systems to inspect buildings for the presence of damaged asbestos and to eliminate or reduce asbestos exposure to occupants by removing the asbestos or encasing it ( 2 ). In June 2000, the CPSC concluded that the risk of children’s exposure to asbestos fibers in crayons was extremely low ( 1 ). However, U.S. manufacturers of these crayons agreed to eliminate talc from their products.

In August 2000, the EPA conducted a series of tests to evaluate the risk for consumers of adverse health effects associated with exposure to asbestos-contaminated vermiculite. The EPA concluded that exposure to asbestos from some vermiculite products poses only a minimal health risk. The EPA recommended that consumers reduce the low risk associated with the occasional use of vermiculite during gardening activities by limiting the amount of dust produced during vermiculite use. Specifically, the EPA suggested that consumers use vermiculite outdoors or in a well-ventilated area; keep vermiculite damp while using it; avoid bringing dust from vermiculite into the home on clothing; and use premixed potting soil, which is less likely to generate dust ( 2 ). The regulations described above and other actions, coupled with widespread public concern about the health hazards of asbestos, have resulted in a significant annual decline in the U.S. use of asbestos. Domestic consumption of asbestos amounted to about 803,000 metric tons in 1973, but it had dropped to about 2,400 metric tons by 2005 ( 3 , 5 ).

What are the health hazards of exposure to asbestos? People may be exposed to asbestos in their workplace, their communities, or their homes. If products containing asbestos are disturbed, tiny asbestos fibers are released into the air. When asbestos fibers are breathed in, they may get trapped in the lungs and remain there for a long time. Over time, these fibers can accumulate and cause scarring and inflammation , which can affect breathing and lead to serious health problems ( 6 ). Asbestos has been classified as a known human carcinogen (a substance that causes cancer) by the U.S. Department of Health and Human Services, the EPA, and the International Agency for Research on Cancer ( 2 , 3 , 7 , 8 ). Studies have shown that exposure to asbestos may increase the risk of lung cancer and mesothelioma (a relatively rare cancer of the thin membranes that line the chest and abdomen ). Although rare, mesothelioma is the most common form of cancer associated with asbestos exposure.

In addition to lung cancer and mesothelioma, some studies have suggested an association between asbestos exposure and gastrointestinal and colorectal cancers, as well as an elevated risk for cancers of the throat , kidney , esophagus , and gallbladder ( 3 , 4 ). However, the evidence is inconclusive. Asbestos exposure may also increase the risk of asbestosis (an inflammatory condition affecting the lungs that can cause shortness of breath, coughing, and permanent lung damage) and other nonmalignant lung and pleural disorders, including pleural plaques (changes in the membranes surrounding the lung), pleural thickening, and benign pleural effusions (abnormal collections of fluid between the thin layers of tissue lining the lungs and the wall of the chest cavity). Although pleural plaques are not precursors to lung cancer, evidence suggests that people with pleural disease caused by exposure to asbestos may be at increased risk for lung cancer ( 2 , 9 ). Who is at risk for an asbestos-related disease? Everyone is exposed to asbestos at some time during their life. Low levels of asbestos are present in the air, water, and soil. However, most people do not become ill from their exposure.

People who become ill from asbestos are usually those who are exposed to it on a regular basis, most often in a job where they work directly with the material or through substantial environmental contact. Since the early 1940s, millions of American workers have been exposed to asbestos. Health hazards from asbestos fibers have been recognized in workers exposed in the shipbuilding trades, asbestos mining and milling, manufacturing of asbestos textiles and other asbestos products, insulation work in the construction and building trades, and a variety of other trades. Demolition workers, drywall removers, asbestos removal workers, firefighters, and automobile workers also may be exposed to asbestos fibers. Studies evaluating the cancer risk experienced by automobile mechanics exposed to asbestos through brake repair are limited, but the overall evidence suggests there is no safe level of asbestos exposure ( 3 , 8 ). As a result of Government regulations and improved work practices, today’s workers (those without previous exposure) are likely to face smaller risks than did those exposed in the past. Individuals involved in the rescue, recovery, and cleanup at the site of the September 11, 2001, attacks on the World Trade Center (WTC) in New York City are another group at risk of developing an asbestos-related disease.

Because asbestos was used in the construction of the North Tower of the WTC, when the building was attacked, hundreds of tons of asbestos were released into the atmosphere. Those at greatest risk include firefighters, police officers, paramedics, construction workers, and volunteers who worked in the rubble at Ground Zero. Others at risk include residents in close proximity to the WTC towers and those who attended schools nearby. These individuals will need to be followed to determine the long-term health consequences of their exposure ( 10 ). One study found that nearly 70 percent of WTC rescue and recovery workers suffered new or worsened respiratory symptoms while performing work at the WTC site. The study describes the results of the WTC Worker and Volunteer Medical Screening Program, which was established to identify and characterize possible WTC-related health effects in responders. The study found that about 28 percent of those tested had abnormal lung function tests, and 61 percent of those without previous health problems developed respiratory symptoms ( 11 ). However, it is important to note that these symptoms may be related to exposure to debris components other than asbestos.

Although it is clear that the health risks from asbestos exposure increase with heavier exposure and longer exposure time, investigators have found asbestos-related diseases in individuals with only brief exposures. Generally, those who develop asbestos-related diseases show no signs of illness for a long time after their first exposure. It can take from 10 to 40 years or more for symptoms of an asbestos-related condition to appear ( 2 ). There is some evidence that family members of workers heavily exposed to asbestos face an increased risk of developing mesothelioma ( 6 ). This risk is thought to result from exposure to asbestos fibers brought into the home on the shoes, clothing, skin, and hair of workers. To decrease these exposures, Federal law regulates workplace practices to limit the possibility of asbestos being brought home in this way. Some employees may be required to shower and change their clothes before they leave work, store their street clothes in a separate area of the workplace, or wash their work clothes at home separately from other clothes ( 2 ). Cases of mesothelioma have also been seen in individuals without occupational asbestos exposure who live close to asbestos mines ( 6 ). What factors affect the risk of developing an asbestos-related disease?

Several factors can help to determine how asbestos exposure affects an individual, including ( 2 , 6 ): Dose (how much asbestos an individual was exposed to). Duration (how long an individual was exposed). Size, shape, and chemical makeup of the asbestos fibers. Source of the exposure. Individual risk factors , such as smoking and pre-existing lung disease. Although all forms of asbestos are considered hazardous, different types of asbestos fibers may be associated with different health risks. For example, the results of several studies suggest that amphibole forms of asbestos may be more harmful than chrysotile, particularly for mesothelioma risk, because they tend to stay in the lungs for a longer period of time ( 1 , 2 ). How does smoking affect risk? Many studies have shown that the combination of smoking and asbestos exposure is particularly hazardous. Smokers who are also exposed to asbestos have a risk of developing lung cancer that is greater than the individual risks from asbestos and smoking added together ( 3 , 6 ). There is evidence that quitting smoking will reduce the risk of lung cancer among asbestos-exposed workers ( 4 ). Smoking combined with asbestos exposure does not appear to increase the risk of mesothelioma ( 9 ).

However, people who were exposed to asbestos on the job at any time during their life or who suspect they may have been exposed should not smoke. How are asbestos-related diseases detected? Individuals who have been exposed (or suspect they have been exposed) to asbestos fibers on the job, through the environment, or at home via a family contact should inform their doctor about their exposure history and whether or not they experience any symptoms. The symptoms of asbestos-related diseases may not become apparent for many decades after the exposure. It is particularly important to check with a doctor if any of the following symptoms develop ( 6 ): Shortness of breath, wheezing, or hoarseness. A persistent cough that gets worse over time. Blood in the sputum (fluid) coughed up from the lungs. Pain or tightening in the chest. Difficulty swallowing. Swelling of the neck or face. Loss of appetite. Fatigue or anemia . A thorough physical examination , including a chest x-ray and lung function tests, may be recommended. The chest x-ray is currently the most common tool used to detect asbestos-related diseases.

However, it is important to note that chest x-rays cannot detect asbestos fibers in the lungs, but they can help identify any early signs of lung disease resulting from asbestos exposure ( 2 ). Studies have shown that computed tomography ( CT ) (a series of detailed pictures of areas inside the body taken from different angles; the pictures are created by a computer linked to an x-ray machine) may be more effective than conventional chest x-rays at detecting asbestos-related lung abnormalities in individuals who have been exposed to asbestos ( 12 ). A lung biopsy, which detects microscopic asbestos fibers in pieces of lung tissue removed by surgery , is the most reliable test to confirm the presence of asbestos-related abnormalities. A bronchoscopy is a less invasive test than a biopsy and detects asbestos fibers in material that is rinsed out of the lungs. It is important to note that these tests cannot determine how much asbestos an individual may have been exposed to or whether disease will develop ( 12 ). Asbestos fibers can also be detected in urine, mucus, or feces, but these tests are not reliable for determining how much asbestos may be in an individual’s lungs ( 2 ). How can workers protect themselves from asbestos exposure?

The Occupational Safety and Health Administration (OSHA) is a component of the U.S. Department of Labor (DOL) and is the Federal agency responsible for health and safety regulations in maritime, construction, manufacturing, and service workplaces. OSHA established regulations dealing with asbestos exposure on the job, specifically in construction work, shipyards, and general industry, that employers are required to follow. In addition, the Mine Safety and Health Administration (MSHA), another component of the DOL, enforces regulations related to mine safety. Workers should use all protective equipment provided by their employers and follow recommended workplace practices and safety procedures. For example, National Institute for Occupational Safety and Health (NIOSH)-approved respirators that fit properly should be worn by workers when required. Workers who are concerned about asbestos exposure in the workplace should discuss the situation with other employees, their employee health and safety representative, and their employers. If necessary, OSHA can provide more information or make an inspection. Regional offices of OSHA are listed in the “United States Government” section of a telephone directory’s blue pages (under “Department of Labor”). Information about regional offices can also be found on OSHA’s website .

More information about asbestos is available on OSHA’s Asbestos page, which has links to information about asbestos in the workplace, including what OSHA standards apply, the hazards of asbestos, evaluating asbestos exposure, and controls used to protect workers. OSHA’s national office can be contacted at: Office of Public Affairs Occupational Safety and Health Administration U.S. Department of Labor What programs are available to help individuals with asbestos-related diseases? Some people with asbestos-related illness may be eligible for Medicare coverage. Information about benefits is available from Medicare’s Regional Offices , located in 10 major cities across the United States and serving specific geographic areas. The Regional Offices serve as the agency’s initial point of contact for beneficiaries, health care providers, state and local governments, and the general public. General information about Medicare is available by calling toll-free 1–800–633–4227 (1–800–MEDICARE) or by visiting the Medicare website . People with occupational asbestos-related diseases also may qualify for financial help, including medical payments, under state workers’ compensation laws. Because eligibility requirements vary from state to state, workers employed by private companies or by state and local government agencies should contact their state workers’ compensation board.

Contact information for state workers’ compensation officials may be found in the blue pages of a local telephone directory or on the DOL website . If exposure occurred during employment with a Federal agency, medical expenses and other compensation may be covered by the Federal Employees’ Compensation Program, which is administered by the DOL, Employment Standards Administration’s Office of Workers’ Compensation Programs. This program provides workers’ compensation benefits to Federal (civilian) employees for employment-related injuries and diseases. Benefits include wage replacement, payment for medical care, and, where necessary, medical and vocational rehabilitation assistance in returning to work. Benefits may also be provided to dependents if the injury or disease causes the employee’s death. The program has 12 district offices nationwide. In addition, the Longshore and Harbor Workers’ Compensation Program provides benefits to longshoremen, harbor workers, other maritime workers, and other classes of private industry workers who are injured during the course of employment or suffer from diseases caused or worsened by conditions of employment.

Information about eligibility and how to file a claim for benefits under either of these programs is available from: Office of Workers’ Compensation Programs Employment Standards Administration 1–866–692–7487 (1–866–OWCPIVR) 202–693–0040 (Federal Employees’ Compensation Program) 202–693–0038 (Longshore and Harbor Workers’ Compensation Program) Eligible veterans may receive health care at a Department of Veterans Affairs (VA) Medical Center for an asbestos-related disease. Veterans can receive treatment for service-connected and nonservice-connected medical conditions. Information about eligibility and benefits is available from the VA Health Benefits Service Center at 1–877–222–8387 (1–877–222–VETS) or on the VA website . Is there Federal legislation to help victims of asbestos-related diseases? No Federal legislation has been enacted to compensate victims of asbestos-related diseases or to protect people from asbestos exposure. However, a bill called the Fairness in Asbestos Injury Resolution Act, or FAIR Act, has been introduced in Congress several times.

This bill would create a national trust fund to compensate victims suffering from asbestos-related diseases. The proposed trust fund would be administered by the DOL, outside of the courts, through a claims process in which all individuals with certain medical symptoms and evidence of asbestos-related disease would be compensated. Funding for the trust would come from insurance companies and companies that mined, manufactured, and sold asbestos or asbestos products. Under the bill, individuals affected by asbestos exposure would no longer be able to pursue awards for damages in any Federal or state court. What other organizations offer information related to asbestos exposure? The organizations listed below can provide more information about asbestos exposure. The Agency for Toxic Substances and Disease Registry (ATSDR) is the principal Federal agency responsible for evaluating the human health effects of exposure to hazardous substances. This agency works in close collaboration with local, state, and other Federal agencies, with tribal governments, and with communities and local health care providers to help prevent or reduce harmful human health effects from exposure to hazardous substances. The ATSDR provides information about asbestos and where to find occupational and environmental health clinics. The ATSDR can be contacted at: Agency for Toxic Substances and Disease Registry 4770 Buford Highway, NE.

1–800–232–4636 (1–800–CDC–INFO) 1–888–232–6348 (TTY) The U.S. Environmental Protection Agency (EPA) regulates the general public’s exposure to asbestos in buildings, drinking water, and the environment. The EPA offers a Toxic Substances Control Act (TSCA) Hotline and an Asbestos Ombudsman. The TSCA Hotline provides technical assistance and information about asbestos programs implemented under the TSCA, which include the Asbestos School Hazard Abatement Act and the Asbestos Hazard Emergency Response Act. The Asbestos Ombudsman focuses on asbestos in schools and handles questions and complaints. Both the TSCA Hotline and the Asbestos Ombudsman can provide publications on a number of topics, particularly on controlling asbestos exposure in schools and other buildings. The Ombudsman operates a toll-free hotline for small businesses, trade associations, and others seeking free, confidential help. The EPA website includes a list of EPA state asbestos contacts .

In addition, EPA’s Asbestos page provides links to information about asbestos and its health effects, including suggestions for homeowners who suspect asbestos in their homes, and laws and regulations applicable to asbestos. Questions may be directed to: U.S. Environmental Protection Agency Another EPA resource that may be of interest is the brochure titled Current Best Practices for Preventing Asbestos Exposure Among Brake and Clutch Repair Workers . Released in April 2007, this brochure includes work practices for both automotive professionals and home mechanics that may be used to avoid asbestos exposure. It also summarizes existing OSHA regulatory requirements for professional auto mechanics. The U.S. Consumer Product Safety Commission (CPSC) is responsible for protecting the public from unreasonable risks of serious injury or death from more than 15,000 types of consumer products, including asbestos, under the agency’s jurisdiction. The CPSC maintains a toll-free 24-hour hotline where callers can obtain product safety and other agency information and report unsafe products. In addition, CPSC publications provide guidelines for repairing and removing asbestos, and general information about asbestos in the home. CPSC can be contacted at: Office of Information and Public Affairs U.S.

Consumer Product Safety Commission 4330 East West Highway Types of Asbestos - Chyrsotile, Actinolite, Tremolite & More Types of Asbestos Get a Free Wristband Types of Asbestos Asbestos refers to six unique substances that belong to the serpentine and amphibole mineral families: chrysotile, amosite, crocidolite, tremolite, anthophyllite, and actinolite. These terms do not refer to mineral descriptions but to a broad term that refers to unique fibers. According to the Toxic Substances Control Act (TSCA), the asbestiform varieties of the following minerals are classified as asbestos. Chrysotile This is the most commonly used form of asbestos and can be found today in roofs, ceilings, walls and floors of homes and businesses. Chrysotile asbestos also was used in automobile brake linings, pipe insulation, gaskets and boiler seals. Although it is more prevalent, some studies show it takes more exposure to chrysotile than other types of asbestos to develop related diseases. Learn More About Chrysotile Asbestos Amosite This is known as brown asbestos, and it originates mostly in Africa.

It was used most frequently in cement sheet and pipe insulation. It can be found in insulating board (which contained up to 40 percent asbestos), ceiling tiles and in thermal insulation products. Like the other forms of amphibole asbestos, it has needle-like fibers. Learn More About Amosite Asbestos Crocidolite This is also called blue asbestos, and it has the least heat resistance. Mined mostly in South Africa, Bolivia and Australia, crocidolite was commonly used to insulate steam engines. It was also used in some spray-on coatings, pipe insulation and cement products. Learn More About Crocidolite Asbestos Tremolite This is not used commercially, but it can be found as a contaminant in chrysotile asbestos, vermiculite and talc powders. It was occasionally found as a contaminant in certain asbestos-containing insulation products, paints, sealants and roofing materials. Tremolite can be white, green, gray and even transparent. Learn More About Tremolite Asbestos Anthophyllite This type was mined primarily in Finland and displays a gray-brown color. It was not commercially used and was rather found as a contaminant. Anthophyllite was most commonly found in composite flooring.

Learn More About Anthophyllite Asbestos Actinolite This form of asbestos has a harsh texture and is not as flexible as the others. It is most often found in metamorphic rock. Actinolite was never used commercially, but it can be found as a contaminant in some asbestos products. Learn More About Actinolite Asbestos This classification was adopted by the U.S. Environmental Protection Agency (EPA) in 1976. The TSCA granted the EPA permission to regulate these six types of asbestos, and they have since been banned in 52 countries. However, hundreds of other asbestos-like minerals have since been recognized by the U.S. Bureau of Mines, yet they are not restricted or regulated. Erionite and taconite are two minerals that contain asbestiform fibers with the potential to cause serious health problems. Is All Asbestos Dangerous? While some types of asbestos may be more hazardous than others, all are dangerous. Leading health agencies, including the U.S. Department of Health and Human Services, the EPA and the International Agency for Research on Cancer, classify all types of asbestos as cancer-causing substances.

All of the identified forms of asbestos can cause asbestosis, malignant mesothelioma, lung cancer, ovarian cancer, laryngeal cancer and other serious diseases. Some agencies, such as the Health Protection Agency in the U.K., claim crocidolite (blue asbestos) and amosite (brown asbestos) are the most dangerous forms. The EPA has abandoned projects aiming to identify which asbestos fiber types are the most toxic, citing that the overall regulation of asbestos and asbestiform minerals is a more pressing priority. Get Your Free Asbestos Guide Get Your Free Asbestos Guide Serpentine Asbestos Chrysotile is the only type of asbestos that is from the serpentine family and is known as white asbestos. These fibers are curly and are comprised of sheets of crystals. Throughout industrial history, more than 95 percent of all asbestos used around the world was of the chrysotile variety. In many countries where other types of asbestos have been banned, the “controlled use” of chrysotile is still permitted. Despite the numerous studies that have proven chrysotile's carcinogenicity, this exemption is the result of a long lobbying history by those in the asbestos industry.

Chrysotile Asbestos Many studies have proven that exposure to chrysotile asbestos, commonly referred to as white asbestos, can cause a number of serious health conditions. While most commercial uses of asbestos in the United States have been of the chrysotile type, the use of this toxic mineral has declined significantly during the last few decades. Naturally occurring deposits of chrysotile are often accompanied by trace amounts of tremolite (amphibole) asbestos, which is considered more toxic than chrysotile. However, several reports have indicated that exposure to solely chrysotile asbestos fibers can occur and such exposure can be equally hazardous as exposure to amphibole asbestos types. Scientists from the National Institute for Occupational Safety and Health concluded that chrysotile asbestos should be treated with virtually the same level of concern as the amphibole forms of asbestos. Uses of Chrysotile Asbestos In comparison to amphiboles, chrysotile fibers are generally finer with high flexibility and good heat resistance. Known as the most common asbestos mineral, chrysotile accounts for about 90 to 95 percent of asbestos used in commercial applications in the United States.

This toxic mineral has been utilized in a number of products , including: Gaskets Roofing materials Amphibole Asbestos The other five types of asbestos are classified in the amphibole category. Amosite (brown asbestos) and crocidolite (blue asbestos) are considered the most commercially valuable types. Anthophyllite, tremolite and actinolite are the other non-commercial forms of amphibole asbestos. All amphibole fibers are straight and longer than chrysotile fibers, and studies suggest it may take less exposure to amphibole asbestos to cause mesothelioma than chrysotile asbestos. Amosite Asbestos According to the American Cancer Society, exposure to amosite asbestos creates a higher risk of cancer in comparison with other types of asbestos. Several asbestos studies suggest exposure to amosite can cause lung cancer, mesothelioma and asbestosis. In its natural state, amosite is known as the mineral grunerite. Commercially, grunerite is referred to as amosite or brown asbestos. Approximately 80,000 tons of amosite were mined in the Transvaal province of South Africa by 1970.

Uses of Amosite Asbestos Amosite asbestos offer good tensile strength and heat resistance. Commercial products that have been manufactured with amosite include: Cement sheets Fire protection Gaskets, lagging The U.S. Environmental Protection Agency has determined amosite to be the second most commonly used mineral type of asbestos in the United States. Crocidolite Asbestos Multiple asbestos studies suggest crocidolite may be responsible for more deaths than any other type of asbestos because its fibers are so thin — about the diameter of a strand of hair. When airborne, these fibers can be inhaled easily and become lodged in the lining of the lungs, more so than other forms of asbestos forms. Once inside the body, the fibers do not break down easily. This can lead to potentially life-threatening lung and abdominal conditions, including lung cancer, mesothelioma and asbestosis. These health risks are especially serious among crocidolite miners. An estimated 18 percent of crocidolite miners die from mesothelioma, research shows, and people living near crocidolite mines may also have increased risks for mesothelioma and other diseases. The existence of crocidolite asbestos was first established in the early 1800s in South Africa.

At the time, the mineral was known as "wooly stone," but interest in the naturally occurring mineral didn't take off until the 1880s, and large mining efforts of the material didn't begin until the early 1900s. Crocidolite is also known as "blue" asbestos. This form can be translucent or nearly opaque (which means light can't penetrate it). The most common mining sites for this type of asbestos were Bolivia, Australia and southern Africa. Today, crocidolite mining has virtually ceased because of both physical limitations and serious health risks. Crocidolite-containing materials are also more brittle than other amphibole asbestos products, meaning they break down sooner and can more readily lead to asbestos exposure. Crocidolite is categorized as an amphibole, which is usually a needle-like mineral that forms in crystal groupings, either as fibers or columns. Typically, crocidolite fibers can be curved or straight. While brittle, the fibers are flexible enough to bend beyond 90 degrees before breaking. Uses of Crocidolite Asbestos Like other types of asbestos, crocidolite was used to make a number of commercial and industrial products.

It did have a drawback that other asbestos types did not: It is less heat-resistant, making it less useful for industrial manufacturing. Some of the leading uses of crocidolite asbestos included: Ceiling tiles Thermal insulation (lagging and gaskets) Millboards (commercial ovens and steam pipes) What Is Asbestos? What Is Asbestos? Sounds dangerous, right? But what exactly is it? Unless you’ve been affected by this hazardous material -- or you know someone who has -- it’s probably not something you think about every day. Recommended Related to Lung Disease & Respiratory Health Lung Injuries A lung injury can occur in many ways. A car accident could cause a harmful blow and a punctured lung. Or lungs can become injured from inhaling harmful chemicals. A lung injury can even occur while being treated in the hospital for an infection or while on a ventilator. If you or someone you love has an injured lung, you may want to understand better how it occurred and what your health care providers are doing to help. Read the Lung Injuries article > > Asbestos is found in rocks and soil. These mineral fibers have worked well for manufacturers for many reasons. For starters, they’re flexible and resistant to heat, chemicals, and electricity.

That’s why they were widely used for years to make construction materials, automotive parts, and even textiles. Other items that may contain asbestos include: · Insulation in walls and attics · Vinyl tiles used for floors · Shingles · Blankets that protect hot water pipes · Fabrics that resist heat · Car brakes The fibers that form asbestos separate very easily into tiny pieces when they’re handled or damaged. They’re too small to see, but they’re easy to breathe in. They can build up in your lungs and cause health problems. What Health Problems Can Asbestos Cause? If you breathe in the fibers over long periods of time, you increase your risk for diseases like lung cancer , mesothelioma , and asbestosis. Smokers are even more affected. That’s because cigarette smoke irritates lung passages. This makes it harder for the lungs to remove asbestos fibers. Mesothelioma. If you’ve worked with the substance, shared a home with someone who has, or lived close to an asbestos mine, see your doctor if you have trouble breathing or believe it’s affected your health. He can do a chest X-ray or a pulmonary function test to see how much air your lungs can hold.

A CT scan or biopsy might help him determine whether you have mesothelioma. That’s a type of cancer that affects the lining that covers the lungs, chest or abdomen . An early warning sign is fluid buildup around the lungs. Other symptoms include pain around the rib cage, problems breathing, a cough , pain or lumps in the belly, fatigue , and constipation . People who have this kind of rare cancer were typically exposed to asbestos at work or lived with someone who was. It can take up to 20 years for symptoms to show up. Treatment may include surgery, radiation , or chemotherapy . Asbestos and lung cancer - NHS Choices Asbestos and lung cancer Women's health 60-plus As many as 20 tradespeople a week could be dying from asbestos damage to their lungs, the Health and Safety Executive (HSE) says. Even though asbestos is now banned, people working in the construction industries, maintenance or demolition could still come into contact with asbestos dust, putting their health in danger. Exposure to asbestos is a risk, whether tradespeople are working on domestic or industrial premises. The HSE estimates that tradespeople could encounter asbestos 100 times a year.

It has launched the "Beware Asbestos" campaign, which aims to stem the rising number of asbestos-related deaths. Diseases caused by contact with asbestos include mesothelioma (a type of cancer that affects the membrane around the lung) and asbestos-related lung cancer . Many asbestos-related deaths are among tradespeople, such as electricians, builders, plasterers and plumbers, or people working in construction industries like shipbuilding or insulation. The death rate among this group is increasing. It can take 20-50 years for mesothelioma to develop, so it is usually diagnosed when it is already at an advanced stage. People who worked in construction decades ago may still develop mesothelioma when they are much older. There is no link between mesothelioma and smoking, but smokers who have also been exposed to asbestos have a greater risk of lung cancer than smokers who haven’t. The asbestos risk According to the HSE, many workers, especially tradespeople, assume they're not at risk, because asbestos was banned many years ago. However, as asbestos remains in many buildings, it is still a risk to workers, even today.

Asbestos is likely to be present in any building constructed or refurbished before the year 2000. An estimated half a million buildings contain it. If a building containing asbestos is repaired or maintained and the asbestos fibres are disturbed – for instance, by drilling or cutting – they can easily be inhaled as a deadly dust. Opening a window or drinking a glass of water will not protect you against the dangers of asbestos. “We need to educate tradespeople about how asbestos and its dangers are relevant to them. We want them to change the way they work so that they don’t put their lives at risk,” says Steve Coldrick, director of the HSE’s Disease Reduction Programme. How to protect yourself from asbestos You can find out more on the HSE web pages on asbestos , where there is also a free asbestos web app to help tradespeople identify where they could come into contact with asbestos in their day-to-day work. HSE has the following advice to workers who may be exposed to asbestos: Avoid working with asbestos wherever possible. If you're not sure whether asbestos is present, don't start work. Your boss or the customer should tell you whether or not asbestos is present. You can't work with some kinds of asbestos, as they're too dangerous.

Don't work if the asbestos material present is a sprayed coating, board, or lagging on pipes and boilers. Only a licensed contractor should work on these. Where asbestos is present, you can only continue to work if you’ve had asbestos training and you're using the right equipment. To minimise asbestos dust, use hand tools instead of power tools, and keep materials damp, but not wet. Clean up as you go, using a special (class H) vacuum cleaner (not a brush). Double-bag asbestos waste and label the bags properly. When working with asbestos, always wear a proper mask. Ordinary dust masks are not effective. Mesothelioma: Tom's story Tom King, 64, developed mesothelioma after exposure to asbestos in his job as a carpenter. He renovated domestic houses, which involved knocking ceilings and walls down to convert houses into flats. He removed any asbestos found during the work and threw it into skips for removal. He had no training on how to handle it. “I wasn’t aware of the danger of asbestos,” says Tom.

“If I’d known about it, I would have put a mask on, or I would have refused to handle it.” After experiencing chest pains and breathlessness, he went to visit his doctor, who referred him for a chest X-ray and other lung tests. Tom was diagnosed with mesothelioma. There is no cure for this asbestos-related cancer. However, treatments including chemotherapy , radiotherapy and surgery can prolong life and improve symptoms. More info and support for people with mesothelioma You may be able to claim compensation if you have been diagnosed with mesothelioma. Macmillan Cancer Support has more information on financial help and compensation for people with mesothelioma . Mesothelioma UK offers information and support through their free helpline. Call 0800 169 2409 or email Mesothelioma UK . They also have information on legal issues and lists of support groups for people with asbestos-related diseases . Page last reviewed: 20/04/2015

Question: What type of insulation can cause lung cancer and mesothelioma?
Answer: Asbestos