Ep 118 Asbestos: Corruption and cancer and corporate greed, oh my!
An entire generation probably first learned the word “mesothelioma” and its link to asbestos from those ubiquitous commercials in the 1990s and 2000s. You know the one: “if you or a loved one has been diagnosed with mesothelioma you may be entitled to financial compensation.” These commercials made it seem like mesothelioma suddenly came out of nowhere. Was this a newly discovered disease? Wasn’t asbestos banned? How did asbestos cause mesothelioma? Heck, what even was asbestos? By seeking to answer all those questions and more, this episode picks up where those commercials left off. We detail how teeny tiny asbestos fibers can wreak immense devastation, untangle the long human history of asbestos products, and assess the current status of this fibrous mineral, which is disappointingly far from banned worldwide. No story of asbestos would be complete without a spotlight on the town of Libby, Montana, where brave crusaders continue to fight against a company whose callous negligence led to injury, death, and widespread environmental contamination. Tune in to find out where salamanders, The Wizard of Oz, Charlemagne, and The River Wild fit into the story of asbestos.
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2023-05-30
98 min
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00:00:00 Speaker 1: In early nineteen ninety six, Les had a cough that he just couldn't shake. He didn't think much of it. It had been a hard cold winter and he just figured he had a touch of bronchitis. But Gayla Benefield wasn't so sure. She suggested that Less go over to see doctor Whitehouse in Spokane. White House had already treated several people from Libby. Finally, as much to get Gaila off his back as anything, Less made an appointment, and he and Rita got into their eighty nine Dodge and took the five hour drive over to Spokane one spring day in nineteen ninety six. Les was a little embarrassed about the whole thing. When he got there, he told the nurse, I don't feel sick. Alan Whitehouse put him at ease right away. He looked over Less's information and said, so you're from LIBBYA. Yes, Well, I've got a pretty good idea why you're here. You do yep, take your shirt off. We're going to do a chest X ray in a breathing test. About forty five minutes later, white House came back into the room and leaned on the examining table and said, well, you've got active asbestosis, no hemming and hauling les recalled the doctor telling him he had between five and ten years to live. Less was stunned. He really didn't know what asbestosis was, but he knew he didn't feel bad enough to be dying. He hadn't worked at that mine for thirty five years. How do you comprehend something like that? He took the inhaler and walked out to the front desk and said, send me a bill, and he and Rita got in the car and started home. And he didn't say anything at all until they had gotten almost halfway home. He pulled over to the side of the road and stopped the car and shook his head. What's the matter, Narita said, By god, you know, I believe I just got a death sentence. 00:02:39 Speaker 2: Wow. 00:02:41 Speaker 1: Yeah, so that really sad. Snippet of a story, really just a tiny little piece, is adapted from a book called An Air That Kills by Andrew Schneider and David McCumber, and Less in the story is a real person. His name was Less Scram's dad, and he was an outspoken activist and advocate for everyone affected by asbestos related diseases. And he died on January twenty first, two thousand and seven, at his home in Libby, Montana from mezzothelioma. And you'll hear more about Libby Montana later on in the episode. 00:03:19 Speaker 2: Oh, I'm sure we will. Wow. 00:03:23 Speaker 1: Yeah, I know. Hi. I'm Aaron Welsh. 00:03:28 Speaker 2: And I'm Aaron Alman Updike. 00:03:30 Speaker 1: And this is this podcast will Kill You. 00:03:33 Speaker 2: And today we're talking about asbestos. 00:03:36 Speaker 1: Yeah. This is a topic that we've been wanting to do for a while, but I feel like we've been intimidated by just how much there is to cover and wanting to do it justice, which is impossible to do. 00:03:49 Speaker 2: Really is Yep. 00:03:51 Speaker 3: Yeah, We're gonna fall short in some regards, but we're gonna learn a lot together today. 00:03:56 Speaker 1: Yeah. Yeah, it's gonna be a very interesting episode. I'm really looking forward to understanding what the heck asbestos does to your body because I really don't know. 00:04:05 Speaker 3: Ooh, and I really want to understand the history because I feel like it is going to be massive and a lot of drama. 00:04:13 Speaker 1: Infuriating. Yeah, really soul crushing for sure. 00:04:18 Speaker 3: Well, Well, on that note, on those happy notes, yeah, shall we is it quarantine? 00:04:25 Speaker 1: Ey time? 00:04:26 Speaker 2: It definitely is? 00:04:27 Speaker 1: What are we drinking this week. 00:04:29 Speaker 2: This week, we're drinking Unquenchable. 00:04:33 Speaker 1: Yeah, we're calling it unquenchable because asbestos means unquenchable in Greek. It's like one of the words that lent its meaning to asbestos. 00:04:43 Speaker 2: Love that, Yeah, And what is in unquenchable, Well, we. 00:04:48 Speaker 1: Wanted to do something that resembled asbestos fibers, and I think the closest thing was cotton candy. 00:04:55 Speaker 2: Cotton candy, you'll never look at it the same. 00:04:57 Speaker 1: No, And it's cotton candy plus seco and raspberry and some lime juice. 00:05:03 Speaker 3: And yeah, it's surprisingly tasty for cotton candy containing drink. 00:05:10 Speaker 1: Yeah, I think that is an accurate and accurate representation of my feelings about this drink. 00:05:18 Speaker 3: We will post the full recipe for that quarantini as well as our non alcoholic plusy Brita on our website This podcast will kill You dot Com and our social media channels. 00:05:27 Speaker 1: We certainly will. On our website, you can find all sorts of things, such as transcripts for each and every one of our episodes. You can find links to bookshop dot org and Goodreads list. You can find links to our music by Bloodmobile to Patreon to merch to probably other things that are out there. Check it out. There's a lot to discover. This podcast will kill you. 00:05:50 Speaker 2: Dot Com loved it beautifully down rude. Any other business that we must urgently attend to, I. 00:05:58 Speaker 1: Really don't think so. I think the most urgent business is to get straight into the meat of this episode. So please, after this break, can you tell me about the biology of asbestos? 00:06:09 Speaker 2: Sure you can try. 00:06:37 Speaker 3: In literally the very first lines of the very first paper that I opened about asbestos, I learned things that I didn't know. So I was starting from a place of knowing absolutely nothing clearly about asbestos, because, as it turns out, asbestos is not one thing that. 00:07:00 Speaker 1: Was news to me as well as to me it's an industry term. 00:07:05 Speaker 3: Right, So I understood asbestos from a public health perspective prior to this exclusively and from a public health perspective, I understood asbestos as like a fibrous material that was used a lot in construction that when inhaled, can cause disease. And that's not entirely wrong, but as we'll see, it's not the. 00:07:27 Speaker 2: Whole story right. 00:07:30 Speaker 3: Historically, and this is not I think stepping on your toes because it's just a very brief introiler. 00:07:37 Speaker 2: But historically asbestos has. 00:07:39 Speaker 3: Been used for so many different things, and I know aarin you're gonna get into that in more detail. 00:07:46 Speaker 1: It's absurd how many things I. 00:07:49 Speaker 2: The wicked which is broom? Did you know that? I did know that covering playgrounds instead of grass? 00:07:56 Speaker 1: Uh huh. 00:07:58 Speaker 3: It's incredibly heat resistant and fire resistant and resistant to corrosion. So it was used for fireproof suits, piping, insulation, housing, insulation, roofing, flooring, cement, brake pads, like literally everything. 00:08:13 Speaker 1: Except for the fact that I think was is not the appropriate tense. It's correct. Still is used in a very disturbing number of things, very very in the US and around the world, although many countries have banned it. But that's getting way ahead of ourselves. 00:08:29 Speaker 2: Yeah, we'll get there eventually. But it's not one fibrous thing. So what is it? At its core? 00:08:40 Speaker 3: Asbestos is a mineral compound or multiple types of mineral compounds that are made of silicon and oxygen that naturally form into fibers like fibrous substance kind of looks like cotton candy. Six of these specific minerals are grouped together under this umbrella of asbestos, and they are in many countries either banned now or at least highly regulated. However, there exist hundreds of other minerals that also naturally exist in a very similar fibrous state, and in many cases have also been shown to be carcinogenic to one degree or another, but are not regulated as asbestos because they, at least historically haven't had a large amount of commercial usage. And like you mentioned, aaron asbestos is really a commercial or a regulatory definition. One example of this is aaronite, I think that's how you pronounce it, which is also a fibrous mineral and is a known and recognized human carcinogen, but it is not regulated in the same way as asbestos. It is not considered under this asbestos umbrella. However, mineralogically, it's a very similar compound. 00:10:07 Speaker 1: That's interesting in terms of regulation and protection and what determines safe levels of exposure, which is already a total mess, or at least historically has been such an infuriating mess where it's like, oh, we don't want to use this new high powered microscope because that'll find more asbestos than we thought was there using our outdated thirty year old techniques. Anyway, I love. 00:10:35 Speaker 2: That we're already getting a glimpse into the history. 00:10:38 Speaker 1: I don't even talk about the whole, like protocols for assessing asbestos exposure, but it is like a part of it that is oough anyway, sorry. 00:10:48 Speaker 3: But in general, what we call asbestos can be broken down into two subgroups. There is serpentine asbestos, which includes chrysotile, and that is is by far the most widely used form of asbestos. This form of asbestos. 00:11:06 Speaker 2: Makes these longer, curly. 00:11:08 Speaker 3: Fibers that are very very versatile in their uses. If you look at them under like a scanning electron microscope, they look like these long curly tubes that if you cut them in cross section kind of roll up like a scroll. 00:11:22 Speaker 2: Almost. 00:11:22 Speaker 1: Yeah. 00:11:23 Speaker 3: And then there's a grouping of amphibole asbestos, which includes five different forms actinolite, tremolite, anthrophilite, crocodilite, and amocite. And apologies if I pronounced any of those incorrectly, but all of these fibers tend to be more straight and brittle and are usually described as kind of needle like. They're still used a lot in commercial situations, but definitely less than chrysatile. 00:11:51 Speaker 2: But the thing is. 00:11:52 Speaker 3: That even within these two kind of broad mineralogic classifications serpentine and amphibles, these kind of mineralogic classifications, there are a lot of other fibrous materials that are not regulated as asbestos even within those two categories. So it's a lot and I find it very interesting. 00:12:16 Speaker 1: Yeah, yep. 00:12:18 Speaker 3: The major determinants of the toxicity of any of these forms of asbestos is the fiber dimension itself, like how wide, how long. 00:12:30 Speaker 2: Et cetera. 00:12:32 Speaker 3: And the bio persistence how long do these fibers just hang out, either in the environment or in our lungs, which we'll get to, and then of course dose and duration and things like that. In general, the amphable types of asbestos have been shown to be more pathogenic and more carcinogenic than the crysotiles. However, those are used much more frequently. Right, And don't get me wrong, all forms of asbestos, as well as many other similar mineral compounds, are pacinogenic and carcinogenic. Right, So anyone who says they're not is not telling the truth. 00:13:13 Speaker 2: Okay, I can tell by your face that we'll get there. 00:13:18 Speaker 3: We will, so let's talk about what the actual health effects of asbestos are, shall we? At its core, the reason or the mechanism by which asbestos causes disease is that we inhale these teeny tiny little fibers into our lungs. These fibers, even though when you have a big clump it might look like cotton candy, the actual individual fibers themselves are like microns or tenths of microns long. We're talking very very small, invisible to the naked eye. When you breathe them in. We're inhaling them into our lungs, and then they simply stay there. Some like the chrysotile, are longer, so they might get stuck and places in our lungs that are a little bit higher up, or we might even maybe sometimes be able to breathe some back out. But many, including the very short or needle like varieties, can penetrate very deeply into our lungs and then stay there. So that's part of why the pathogenicity is the actual biopersistence. How deep are these getting into our lungs, which the fiber length and size is going to play into and then how long do they stay there? 00:14:42 Speaker 1: Okay, so when you say how long do they stay there? Does our immune system play a role at all in breaking them down or isolating them or anything like that, or do they just stay there forever. 00:14:54 Speaker 2: Yeah, that's a great question. 00:14:56 Speaker 3: Our immune system plays a really big role, but as we'll see, it's largely just in causing inflammation from these just staying there. 00:15:06 Speaker 1: Okay, So it's like I know there's something there, but I can't do anything about it, and I'm angry and inflamed. 00:15:13 Speaker 3: One thing that can happen is our immune system can form these what are called asbestos bodies, where macrophasas and things kind of try to. 00:15:21 Speaker 2: Wall off these little asbestos fibers. But again, that can just be a nitis for more chronic inflammation. 00:15:28 Speaker 3: Okay, So let's get into the different types of diseases that we see with asbestos. Because spoilers, if you didn't realize this, it's not just one. Asbestos can cause two different classifications of diseases, cancers and non cancers, and these are not mutually exclusive, and many times the non cancerous form of asbestos can develop into cancer later in life. But in terms of the non cancerous disease, the major one that we see with asbestos is called asbestosis, pretty aptly named, and this comes from usually long standing. 00:16:09 Speaker 2: Exposure to asbestos. 00:16:11 Speaker 3: I really tried to get a handle on quantifying this, like how much asbestos do you really need to be exposed to? I could not get a good answer for this. 00:16:22 Speaker 1: Sarin, I'm not surprised. 00:16:24 Speaker 3: Really, Yeah, I'm not either once I really started thinking about it. 00:16:27 Speaker 1: But it just was. 00:16:29 Speaker 2: Disappointing. I think. 00:16:31 Speaker 1: So, if you couldn't get info on how much asbestos causes asbestosis, what are the diagnostic criteria for asbestosis? 00:16:42 Speaker 3: Yeah, let's talk about what it actually looks like, shall we Yeah, So, asbestosis looks and is really very similar to a pretty generic disease called interstitial pulmonary fibrosis. This is a lot of inflammation in the life ungs, a lot of scarring, and this type of scarring happens kind of in between areas in our lungs, like in between the alveoli and in between places where your oxygen is supposed to be diffusing into. 00:17:16 Speaker 2: Your blood stream. 00:17:17 Speaker 3: So what this results in is decreased capacity for diffusion. You can't get air to actually cross from the lungs into the bloodstream, So this is what is called a restrictive lung disease. It's the opposite of what we were talking about with bronchiolitis, which is obstructive right where you can get air in, but you can't get it out. Here your air is not getting in as well, or at least it's not diffusing the way that it. 00:17:46 Speaker 2: Is supposed to. 00:17:47 Speaker 3: Okay, So people have shortness of breath, often a pretty dry cough. On an X ray or a CT scan, you can often see this pattern called honeycombing, because the spaces between you know, little air sacs and things get thickened, so you can see those scarred inflamed areas more prominently. Gotcha, none of this is specific to asbestos or asbestosis. But so you asked, how do you actually then make this diagnosis? It would be seeing all of these symptoms and then asking have you ever worked around asbestos? Have you ever had any exposure to asbestos that you know of, and someone who had that history, you might think this could be caused by asbestos. And then if you were to do a biopsy, you would actually be able to see the asbestos fibers existing still in the lungs and asbestos bodies like I mentioned in addition to all of these inflammatory changes. 00:18:46 Speaker 1: Okay, how often is that biopsy done and how is the treatment different if it's asbestosis versus another cause of this pulmonary fibers. 00:19:00 Speaker 2: Great question. 00:19:02 Speaker 3: So the biopsy can be done via like a levage, so you don't have to necessarily puncture lung tissue, It doesn't have to go from the outside. You can do it through a bronchoscopy where you're putting like a tube down into the lungs, looking there and then putting fluid in and kind of washing the area. And we do that for a lot of different things. But so you would be able to see asbestos fibers and asbestos bodies in that what's called a bronchio alveolar levage. And you could potentially take additional biopsies too if you needed to. In terms of treatment, it doesn't differ than any other treatment for inner social pulmonary fibrosis or a lot of other kinds of restrictive lung disease. Really, and that is that we don't have very. 00:19:48 Speaker 2: Good treatment for it. 00:19:49 Speaker 3: Yeah, okay, yeah, yeah, So that is the kind of non cancerous major non cancerous disease that we see with asbestos asbestosis. But of course asbestos is a known carcinogen, carcinogen being substances that are known to cause cancer. And the biggest buzzword which you heard in our first hand account and most people probably associate with asbestos, is mesothelioma. Do you remember Aaron the like legal company infomercials about mesothelioma. Oh yeah, I feel like I don't see those anymore, which is interesting. 00:20:30 Speaker 1: I feel like I just watched TV on subscription services, so that's maybe part of it for me. 00:20:36 Speaker 3: I just pay for the cheap ones where I still have ads on my. 00:20:40 Speaker 2: On my WHU who. 00:20:43 Speaker 3: But yeah, the reason that this association is so strong in so many of our brains is because the vast, vast majority of all cases of mesothelioma are caused by asbestos. In fact, one of the papers that I read said that the only other generally recognized causes of mesothelioma are arianite exposure, which again that's a very similar compound. 00:21:11 Speaker 1: But as best as adjacent. 00:21:13 Speaker 3: Exactly, and that's from like endemic exposure in places where that's naturally occurring. Okay, ionizing radiation when people were exposed to very specific types of contrast and chest injuries. 00:21:28 Speaker 2: Huh, So without asbestos. 00:21:31 Speaker 3: Mesothelioma would be an incredibly rare cancer. But what actually is it? 00:21:36 Speaker 1: What is this? 00:21:37 Speaker 3: Yeah? Yeah, mesothelioma is a cancer of linings. It is a cancer of the lining of our lungs called the pleura, or the lining of our abdomen called the peritoneum, or in some rare cases, lining of our heart or the lining of the testes which is called the tunic of vaginalis. So it's a cancer of the thorrosa. That's a word that we actually just talked about in our loopus episode, specifically within our soirosa. There are cells in this lining that are called mesothelial cells, and so cancers are usually very boring and called after the type of cell that they come from. So that's what a mesothelioma is. The mesothelial cells in our crosa are pleura our peritoneum. They're what make our insides slippery and allow them to move well across each other. The cirrosa lines both, for example, our lungs and our chest wall and allows your lung to move freely against the chest wall without any irritation, inflammation, et cetera. So that that is what a mesothelioma is. It's a cancer of the lining of something, and most often our lungs. 00:22:57 Speaker 1: Okay, in the cases of asbestos associated mesothelioma, it is tends to be the plura. 00:23:05 Speaker 3: Very often it's the pleura. It certainly can be the peritoneum as well, because while inhalation is the most common root of exposure, you can also be exposed via water, You can be exposed via soil, and so this isn't something that's limited to our lungs, right, Okay, But mesothelioma is a generic term. That could mean mesothelioma of the pleura of the lungs or of the peritoneum of your abdomen, right, So it's kind of a little bit more generic than just lungs. Yeah, So what we see with mesothelioma of the plura of the lungs is that people are going to present with a lot of difficulty breathing, as you can imagine a lot of chest pain, especially pain with deep inhalation, or chest pain that gets worse with inhalation, and when you look at imaging like an X ray or a c you see a lot of fluid built up around the lungs. This is called a plural effusion if instead of being in the lungs it's the peritoneum the abdomen, you see similar things just in the abdomen abdominal pain. Your abdomen is a lot more elastic than your chest wall, so you might see a lot of distension of the abdomen because of this fluid, and we call fluid in the abdomen acides. And then depending on how bad it gets or how much tumor burden there is, you can end up with compression of things like bowels that could lead to a bowel obstruction. And because this is a cancer, this is tumor that we're talking about, but it's developing on this structure that's very thin and kind of vast, right like it lines the entirety of our chest wall or the entirety of our abdomen. The amount of spread and invasion that we tend to see with mesothelioma by the time someone is symptomatic and therefore diagnosed, is really extensive. 00:25:11 Speaker 1: How does asbestos exposure lead to mesothelioma. 00:25:16 Speaker 3: Excellent question. That that's the key question, isn't this as per usual. Part of my answer is going to be that we don't fully know. Of course it has to be, has to be, but we do have kind of a lot of ideas. These are fibers that are penetrating our lungs and causing a lot of irritation. 00:25:41 Speaker 2: They're causing a lot of inflammation, so. 00:25:45 Speaker 3: We know that this can lead to things like asbestosis, like we're already talked about. That's just sort of inflammation and irritation. Part of this inflammation itself can put you at risk for cancers right of various forms. But in the case of asbestos, it also seems to have specific carcinogenic properties as well, and these are actually more varied than you might think. One thing that asbestos fibers actually seem to do is disrupt the mitotic spindles of cells, like physically break the mitotic spindles which are necessary for the process of mitosis or cell division. So it's thought that this physical disruption can result in chromosomal damage during mitosis while our cells are trying to replicate. 00:26:37 Speaker 1: Okay, so it's just like putting a wrench in the whole cell replication process. 00:26:42 Speaker 3: That's one of the ways. Yeah, asbestos also seems to induce a lot of reactive oxygen species formation that additionally can cause further DNA damage, which can then put you at risk for cancers. We also see in general dysregulated cell growth because of disruption of growth factor genes. So there's a lot of kind of more specific cancer causing genetic changes that we see after exposure to asbestos that we still don't fully understand, gotcha. One thing that's interesting is that mesothelioma's specifically, especially in the lungs, tend to occur first on what's called the parietal surface, that's the body surface of that lining, rather than the lung surface of that lining, since again there's like two of this linings, so it's thought that it's the asbestos fibers literally sticking out of the lung and scraping along that body wall side that's causing that repeated inflammation and those other changes. 00:27:51 Speaker 2: That we talked about. 00:27:52 Speaker 1: Oh my god, that is horrifing. 00:27:54 Speaker 3: I know, I know, and mesothelioma is a horrible cancer. Median survival has been and continues to be nine to twelve months after diagnosis. 00:28:07 Speaker 2: Wow. But that's not all, because it never is. 00:28:14 Speaker 3: Because while we may associate asbestos with mesothelioma in our mind, asbestos also can cause and does cause, any and every other type of lung cancer as well. This means squamous cell, lung cancer, adnocarcinoma, large cell, small cell, as well as laryngeal cancer, ovarian cancer. Possibly increases your risk of colorectal cancer and other cancers. In fact, it's estimated that asbestos exposure causes six times more lung cancer as in other types of lung cancer than it does mesothelioma. 00:28:54 Speaker 1: Huh. 00:28:55 Speaker 3: And it's also estimated that lung cancer deaths are likely twice as great as mesas ethelioma deaths in relation to asbestos exposure, specifically because even though mesothelioma is horrific, it still remains very rare, thankfully. 00:29:09 Speaker 1: Okay, are there associations with certain types of asbestos and certain outcomes of asbestosis or certain types of lung cancers versus mesothelioma stuff like that. 00:29:21 Speaker 2: It's a really good question. 00:29:22 Speaker 3: I found a paper that I'll link to that tried to really quantify cancer risks for both lung cancers and mesothelioma by like fiber size, and the truth is that we just don't We just don't have enough data to actually like the end result of that was that, no, not really. What it showed was that the chrysotile forms, which again are more common, do seem to be slightly less carcinogenic than the other like amphable forms, but both of them are associated with significantly increased risks of mesothelioma and other lung cancers. Gotcha, Okay, Yeah, And there are a lot of different ways aside from just fiber size that people have tried to kind of really quantify the risk of asbestos exposure or the risks of various cancers after exposure. But there isn't an easy, clear, single answer. Like I mentioned, it depends on fiber type, it depends on the persistence and the size, but it also depends on dose, on duration, and then individual factors as well, things like smoke or tobacco exposure at the same time or in the same person even further increases the risk of cancers because of additional damage to the lungs. 00:30:45 Speaker 2: And then we all have our. 00:30:46 Speaker 3: Own individual baseline cancer risk or genetic cancer risk that plays into this as well. There are papers that have numbers that exist, but they're not really great and I don't think that they provide all that much context. 00:31:00 Speaker 1: Yeah. 00:31:01 Speaker 3: The other thing about lung cancer and especially mesothelioma is that the latent period is incredibly long after exposure. 00:31:11 Speaker 1: Why is it so long or is it just that we are not good at picking up one to one causes of cancers and other types of exposures. I guess does that make sense? 00:31:23 Speaker 3: Like is this abnormally long or do we just not know the exposure for other cancers right to know the latency period. That's a really good question. Yeah, that's a really good question. I don't have a good answer to that. So I don't know if it is abnormally long or if it's just that that we know this, we know this latency period. That's I hadn't thought about that. Actually, I don't have an answer. It's a really good question, but it is about thirty to forty years or more. By the way, for anyone wondering how long long is, it's so long. It's very long, which means that we are certainly not out of the woods in terms of new diagnosis of asbestos related diseases, even though efforts have been made to reduce asbestos exposures. So yeah, that's I mean, that's asbestos. 00:32:17 Speaker 1: Maybe this is a question more for current events, But are there any medications or therapies that can reduce the damage caused by or reduce the asbestos burden in people's bodies who have been exposed? 00:32:34 Speaker 3: Not that I was able to find or read about. Okay, yeah, yeah, it's a bummer. 00:32:40 Speaker 1: How do you know if you've been exposed to asbestos? If you don't know? Right? Like, are there tests that can show before you develop asbestosis or before you develop one of these lung cancers into a biopsy? Are there screenings that can say, yes, you have asbestos in your lungs and you know or is it just that you're seeking answers to a health problem that you've observed. 00:33:03 Speaker 3: All of us have been exposed to asbestos. All of us likely have asbestos in our lungs, like to one degree or another. Because asbestos is and has been so common, there are not screening protocols that are universal. Some countries have some screening guidelines in place for specific occupations, and things like that, if you've had very high levels of exposure to asbestos because of your occupational exposure. But none of that has been very well studied, and so it's not very well kind of flushed out. There's a lot of interest in this, especially because in recent years we do have guidelines for general lung cancer screening as it relates to tobacco smoking. We know that screening for lung cancer in people who have a history of a long term smoke exposure can reduce mortality because we can catch cancers earlier. Right, that's the point of screening. That data doesn't exist yet for asbestos. Could it in the future maybe, but it doesn't right now. 00:34:20 Speaker 1: Okay, yeah, okay, So we may not have good numbers on how many asbestos fibers of this type or that type will cause cancer or asbestosis or whatever. But I feel like for a really long time it was like, oh, you have to be an employee at an asbestos mine for thirty five years in order to get any one of these things, and that's the only time that you're really at risk. But that is not the case. 00:34:50 Speaker 3: It's definitely not the case. Like I said, there's going to be a lot of individual variation in this, but because we have all been in exposed to asbestos, and some people to greater degree than others, in theory, any exposure to asbestos can put you at risk for mesothelioma and other cancers. Some papers tried to put an estimate, not necessarily on exposure, but just on the amount of asbestos, say remaining in your lungs and the increased risk of cancer. And what they estimated was, for example, a twofold increase in risk of lung cancer. If you were to do one of those levages of the lungs and find between five to fifteen asbestos bodies, that's that inflammatory reaction per milli liter of fluid. And that's a relatively low number, but that's kind of at least the number that this paper sided. 00:35:53 Speaker 1: Okay, Yeah, it's just hard to get. 00:35:56 Speaker 2: A real sense of it. Yeah, and it is. 00:36:00 Speaker 3: It is going to vary so much person to person because not everyone who has worked even in say asbestos minds, or worked with asbestos for their entire life is going to develop cancer. And then there are people who have been exposed maybe to just asbestos that was in their home that they didn't even know about and then end up with mesotheliama or lung cancer as a. 00:36:22 Speaker 2: Result of it. 00:36:23 Speaker 1: Yeah. 00:36:24 Speaker 3: So yeah, that's asbestos in a nutshell, small one. Ah yeah, Aaron, I cannot wait to hear everything about how we came to find this what do you call it? 00:36:44 Speaker 2: Mineral? 00:36:44 Speaker 3: I guess these minerals, these commercial designation minerals, How we decided to start using them in all of these different ways, how we decided this wasn't a great idea. 00:36:58 Speaker 2: I want to know all of it. 00:36:59 Speaker 1: Yeah, there is a lot to this story, and so let's just jump to it right after this break. Like I said, the history of asbestos is unsurprisingly huge. It spans thousands of years, encompasses the entire globe. Whole books have been written about the legal aspects of asbestos litigation or moments in asbestos history, not to mention the health effects of asbestos and how we learned about them. So having to distill this entire history down into like an hour and a half hour whatever podcast, it's a little daunting because I know that I won't be able to do this entire story. Justice and justice is certainly deserved, especially for those who have suffered and continue to suffer from the corporate negligence that makes up a horrifyingly large portion of the history of asbestos. So what I'm going to do in the history section is present the history of asbestos in basically two parts. The first as a little tour not comprehensive by any means, through the ancient history of asbestos up until about like the nineteen thirties nineteen forties or so, which is when the health effects really began to be widely recognized. In the second part, I want to take a closter look at why asbestos has earned this notoriety as an industrial killer by taking us through the story of Libby, Montana, which is often described as one of the worst environmental disasters in the history of the United States. 00:39:18 Speaker 2: Have we talked about Libby, Montana in other episodes? 00:39:22 Speaker 1: I don't think so. So we've talked about in our arsenic episode. I think we made reference to the anacondamine which is in Montana, and then of course in Rocky Mountain Spotted Fever, we talked a lot about the Bitterroot Valley, But I don't think we've talked about Libby, Montana. 00:39:40 Speaker 3: I don't know why it sounds familiar like, I definitely don't know anything about Montana. 00:39:45 Speaker 1: I think you know more than you think. 00:39:47 Speaker 3: Nope, bless well, and you think by the end of this history section you'll know more. 00:39:54 Speaker 1: How about that? But let's start back at the beginning, back to when humans first began using asbestos, which turns out to be a lot longer ago than I realized. There is evidence of asbestos used in pottery in parts of Africa and in Finland dating back four thousand years wow. And homes in eastern Finland from this time were found to contain asbestos packed into the crevices between logs, presumably for insulation. 00:40:26 Speaker 2: Wow. 00:40:28 Speaker 1: In ancient Rome, the wicks in the lamps used by the Vestal Virgins were made of asbestos so that they would burn forever as long as there was oil in the lamp. 00:40:39 Speaker 2: Oh, my gosh, because it's fire retarded. 00:40:41 Speaker 1: Uh huh what that's so cool? Isn't that cool? And like we said at the very beginning of the episode, the word asbesos comes from the Greek meaning unquenchable or inextinguishable. The Vestal virgins, by the way, which like, I've heard about them, but I don't know. I didn't know what they were. They were called that because they were priestesses of Vesta, the Roman goddess of the hearth, and so the constantly burning flame was especially symbolic for like this ever burning hearth flame fire. 00:41:14 Speaker 3: I can't tell you how much I now want an asbesta scandal. 00:41:19 Speaker 1: I don't think that's a great idea. 00:41:20 Speaker 2: It's not. But doesn't it sound cool? 00:41:23 Speaker 1: I mean, asbestos seemed to hold such like magical power for so much of history, and I can I can see it. It is like an incredibly impressive mineral. 00:41:36 Speaker 2: It is. Yeah. 00:41:37 Speaker 1: Yeah. Charlemagne, who lived in the eighth and ninth centuries, allegedly had a tablecloth woven with asbestos and he would use it as like a party trick to spill wine or meat, sauce or I don't know, beats on it, and then you would toss it into the fire to clean it, and he would just then pull it out unscathed. 00:42:01 Speaker 2: Okay, that's a cool party trick. 00:42:04 Speaker 1: Very cool party trick. Yep. There are also references to asbestos napkins that could be similarly cleansed by fire, which hints at another earlier name for asbestos, amiantus, meaning undefiled. 00:42:18 Speaker 2: Wow. 00:42:20 Speaker 1: The uses of asbestos from ancient times through the seventeen hundreds range from like the sort of useful such as in body armor, fireproof coats, shirts, gloves, sleeve ruffles. I love that because like, sleeve ruffles must have been so prone to getting catching on. 00:42:37 Speaker 3: Fire fire, Like, we can't get rid of the ruffle, we have to get fireproof. 00:42:42 Speaker 1: Yeah, thinking outside the box. And also my favorite is burial shrouds so that the ashes could be kept separate. Wow. But then there were the more inventive but not necessarily practical uses such as the quote unquote Book of Eternity, which was a book that people wanted to make whose pages were made of asbestos so couldn't be destroyed by fire. Okay, to things that were purely just for show, like Benjamin Franklin's purse made of his bestus fiber, which you can see if you go to the Natural History Museum in London. 00:43:23 Speaker 2: Wow. 00:43:24 Speaker 1: And I've seen a picture of it, and it is I have to say, it is a hideous little thing. Like it it's not it's not good looking, right. And there was something about, oh, we didn't want to burn a hole in his pocket with the money, so he like wanted to save money as something to that effect. This is ridiculous, Yeah, super ridiculous. But throughout history asbestos maintained global popularity with minds all over the world. Despite this global popularity and the existence of minds everywhere, there seems to have been a bit of confusion over where asbestos came from, and somehow people either forgot that it came from rocks or the alternative explanation was just too good. It was just too magical and too fun, which was that asbestos grew as hair on fire resistant salamanders. 00:44:25 Speaker 2: Like in Frozen Too. 00:44:28 Speaker 1: Is there a fire resistant salamander. 00:44:29 Speaker 3: Yeah, there's a little salamander who like his butt. He goes boof and then he catches on fire and then runs around and says seated too many times. 00:44:36 Speaker 1: It's exactly that. That's amazing because I had no idea, but apparently salamander's had this reputation for being fireproof. H The etymology of salamander is not fully resolved, but it may come from the Persian meaning fire within, or from the old French legendary fiery beast. Oh my god, it's fascinating, and so the idea behind this or at least. One of the proposed ideas as to why it has his reputation is that some species live in damp logs, and so if you toss that log onto a fire, it may burn for a bit before it gets too hot in the salamander, but then run out and it's like, whoa, this thing just came from the fire. It's fireproof, got it? 00:45:20 Speaker 2: Oh cool? 00:45:21 Speaker 1: I mean maybe who knows, but yeah, this was a very common myth, not just the fire resistant salamander, but that hair grew on these fires in salamanders, and that's where asbestos came from. 00:45:35 Speaker 2: That's so interesting because like it's just you just mine it. 00:45:38 Speaker 1: Do you just mine it? I don't, I don't know, but as. 00:45:41 Speaker 2: This one was clearly mining it way back then. 00:45:43 Speaker 1: I think it's just like it is a more fun It is a more fun explanation. People called asbestos salamander wool or salamander cotton for okay, a long time. And yeah, people did try to dispel this myth, such as Marco Polo, who around thirteen hundred wrote about in Asbesto's Mind that he saw quote towards the northern boundary of this province is a mountain with a vein from which is produced salamander. You must understand that this is not a beast, as is commonly asserted, but its real nature is such as I will now describe. It is a well known fact that by nature, no beast or other animal can live in fire. And so he's calling as Best's salamander, which kind of is also confusing, right, But he's like, no, that it's not an animal. It is a thing that you find in the mountain. 00:46:39 Speaker 3: Right, it's in this rock. It's just a thing in the rocks. You can take it out of the rocks. It's not alive, yeah, yeah. 00:46:45 Speaker 1: And then he goes on to explain the mining process and how you turn it into fibers, and how you can burn those fibers and it comes out unscathed or whatever. And then he concludes with quote, the account I have given you of the salamander is the truth, and all the accounts that are put about are lies and fables. Strong words end. But even after this, even after these strong words by Marco Polo, the nature of asbestos remained a mystery until about the sixteen hundreds, and the salamander imagery was linked with asbestos for quite some time. Later on, certain asbestos processing companies used it on their logos, and I'll try to find one to post on social media. Oh interesting, anyway, the seventeen hundreds and the eighteen hundreds really saw a huge increase in the popularity of asbestos, again, with applications ranging from the ridiculous, like the so called human salamanders who dressed in asbestos clothes and roasted steaks by hand and did other types of tricks like that while standing in a fire. I don't know how that would have worked. I don't I'm not convinced that it did. 00:48:00 Speaker 2: You would still get really. 00:48:02 Speaker 1: Hot, I don't. Humanity, well, you know things that people were writing about in the seventeen hundreds. 00:48:10 Speaker 2: Yeah, you know. 00:48:10 Speaker 1: Don't believe everything you read period, especially from the seventeen hundreds. Just kidding. But then there were more practical inventions. One of the earliest successful asbestos businesses was founded by Giovanni Aldini, nephew of Luigi Galvani. If you remember from Our Electricity, Yeah, exactly, he did the frog leg experiments? 00:48:38 Speaker 3: Was he the one who did the frog leg and then came to the exact wrong conclusion? 00:48:42 Speaker 1: Aaron that was oh sorry, two years ago, I have no idea A year ago. It's impossible to say anyways, movie always Aldini made fireproof apparel specifically for firefighters. Just kind of a cool idea, if only he knew. Not long after, fireproof theater curtains came onto the market and were credited with saving like quite a few lives. But asbestos really started its upward climb in the Industrial Revolution. Used in steam engines, in roofing material combined with cement to make fireproof ships, and electrical panels, in vinyl asbestos tile brake linings, insulating material, the possibilities seemed truly endless, and most scholars point towards the eighteen sixties and the eighteen seventies as the beginning of the modern asbestos industry. As more and more products began to include asbestos, and as demand for those products grew, asbestos mines and processing facilities kept popping up to provide all the asbestos the world market wanted. People loved asbestos. The nineteen thirty nine World's Fair featured a booth just overflowing a guess had asbestos everywhere, like actual asbestos, and a giant asbestos man. It seemed like a magical substance, there was no end to how it could be used, and over the first half of the nineteen hundreds or so, it found its way not just in construction or insulating materials like asphalt, paint, plastics, plasters, clays, fireproofing materials, clutch facings. It was especially important during World War One and World War Two, but it also began to make an appearance more and more in everyday life to the everyday consumer. Let me just list a few of these items here, dear as a filtering agent for wine, beer, gin, pharmaceutical products. Asbestos was even used as a cigarette filter during the nineteen fifties. 00:50:56 Speaker 2: I read that one and I went ooh. 00:50:58 Speaker 1: Ooh, I oh, yeah in the nineteen fifties, which like we already knew, yeah that it was no good gas mask filters, sewing threads, surgical threads, surgical dressings, blankets, mail bags, ironing boards, toasters, play sand, fake snow, toothpaste, baby powders. All in all around three thousand to four thousand commercial products. So you mentioned the Wicked Witch of the West's broom. It wasn't just the Wicked Witch's broom. It was also the fake snow used in the movie likely asbestos. Whoa and the use of asbestos and the Wizard of Oz that was hardly a one off. Next time you watch It's a Wonderful Life, or actually many Christmas movies from that era, keep in mind that the fake snow swirling around every one on set was often a form of asbestos. 00:52:04 Speaker 3: That is, I have to say, it's just so interesting that something and I think this goes back to the fact that like, asbestos is not one thing, right, but that something with one name can be so many different things. 00:52:24 Speaker 1: Yeah, right, right, And so that is something that like I didn't mention at the top of this history, but I am lumping asbestos all together. 00:52:33 Speaker 2: Right, I mean that's how it is lumped. 00:52:35 Speaker 1: It is how it is lumped. Yeah. Yeah, And in that regard, it makes sense that it was used in thousands of commercial products and had so many different uses and yeah, and so given that it was so widely used from the fake snow to toothpaste to filtering agents, you know, surely no and suspected that it could be bad for you because how could it still be used, I mean to such a degree. 00:53:06 Speaker 3: I've heard too many of your history sections too, think that that's true for a second. 00:53:11 Speaker 1: You know, I'm just trying to make everyone just that much more cynical or realistic, is how I like to look at it. Yeah. No, So all of these products, or at least many of these products were produced up through the nineteen well, I mean today still, but I mean like the heyday was probably the nineteen forties, nineteen fifties, somewhere around there at the latest. By the eighteen nineties is when people had started to recognize that exposure to asbestos, especially in occupational settings, could lead to diseases of the lungs. 00:53:53 Speaker 2: WHOA, that is not a good look. 00:53:57 Speaker 1: No, I mean far from it. In eighteen ninety eight, the Lady Inspector of Factories in Great Britain, which like, I want to know more about that entire title and that entire role and Everythingay we know, right, a future episode anyway, the Lady Inspector noted that disease seemed to be higher among asbestos textile workers, and the following year, a physician named doctor Montague Murray treated a person who had quote an unusual fibrosis of the lungs. He didn't report on the case until seven years later, during a meeting on compensation for industrial Diseases when the patient that he had treated talked about how he was the only one still alive of the ten that had worked with asbestos fibers. Oh, all the others had died by the age of thirty. The committee, upon hearing this story did not recommend compensation because they couldn't rule out tuberculosis, which was very prevalent at that time and may have obscured the link between asbestos and health issues more broadly speaking, especially lung diseases. But still still Yeah, about twenty years later, so we're talking in the nineteen twenties or so. The word asbestosis, coined by Thomas Oliver, first appears in a series of medical papers examining the occupational exposure to asbestos, and this increased attention, along with the case of pulmonary fibrosis and a Glasgow asbestos worker, prompted a medical examiner named Edward Merriweather to see, quote whether the occurrence of this disease and an asbestos worker was merely a coincidence or evidence of a definite health risk in the asbestos industry. Quote I'll give you one guess as to what he found. 00:55:55 Speaker 2: I can guess correctly. 00:55:57 Speaker 1: Yeah, yep. He found a quote definite occupational risk among asbestos workers as a class end quote, with disability and death as possible and indeed likely outcomes from fibrosis of the lungs. This was in nineteen twenty nine. 00:56:18 Speaker 2: Oh dear. 00:56:20 Speaker 1: As a reminder, the Wizard of Oz was released in nineteen thirty nine, and asbestos production in the United States peaked in nineteen seventy two. 00:56:34 Speaker 3: Oh I laughed, because otherwise you just cry. 00:56:40 Speaker 1: Yeah. Yeah, that year, seven hundred and seventy five thousand tons of asbestos were produced in the US alone, in the US alone. Yeah, that is its stomach turning. It honestly is like, yeah. 00:56:55 Speaker 3: But that is I mean, I knew that there was going to be I knew this was going to be bad, but that, I mean. 00:57:02 Speaker 1: That alone, it gets so much worse, Oh dear, Because we're going to do like case study style. 00:57:08 Speaker 2: Oh no, yeah, okay. 00:57:09 Speaker 1: Okay, Before we get there, let's head back to the nineteen thirties, when evidence for the harmful nature of asbestos continued to mount. So this guy Merriwether his findings did lead to some industry change, because he especially noted that dust seemed to be a huge part of the problem. So he was like, either minimize dust or minimize your exposure to it and you reduce disease development. And in the places that took him up on this, which was actually like a large part of the industry in Britain, this did lead to a decrease in pulmonary asbestosis cases delayed, of course because of the length of onset, but this was specific to Britain. This didn't happen in the US because in the US similar safety measures had not been widely adopted and would remain patchy at best, or more like lip service than actually protective. Even after asbestos was shown to be associated first with lung cancer, so it was suspected to be associated with lung cancer in the nineteen thirties and nineteen forties, and then shown definitively in the mid nineteen fifties, and then that strong link with mesothelioma was shown in the nineteen sixties. 00:58:27 Speaker 2: I yeah, I'm not going to have any words for a lot of this. 00:58:30 Speaker 1: It's just so United States m HM. And alongside the discovery of the link between mesothelioma and asbestos came the observation that it wasn't just workers exposed to large amounts of asbestos day after day for years on end, who were getting sick and who were dying, but anyone who used asbestos products or lived near asbestos factories. In the nineteen sixties or so, the great love Affair with asbestos, at least for the general public, was over, as television and newspaper reports highlighted the health risks of the substance, and faced with this backlash, the asbestos industry reacted by revisiting safety regulations, implementing new ones sure, and funding studies that would conclude that, whoh, this amount of dust is perfectly safe. Oh well, this form of asbestos is perfectly safe. 00:59:32 Speaker 2: Those are the ones, those are the ones. 00:59:34 Speaker 1: Those drive me, oh upp a wall. This playground full of asbestos rocks is perfectly safe. And gee, asbestos is simply the greatest. And you should just trust us on this one, because we've done a lot of research, and why would we lie to you, even if we're worried about our business failing. The callous deceit exhibited by the asbestos industry goes way beyond negligence. And there are one thousand and one stories that show this. But I'm just gonna briefly go through one, and that is the story of Libby, Montana, Okay. 01:00:15 Speaker 2: Ready for it. 01:00:17 Speaker 1: Libby is a small town population two thousand and seven hundred and seventy five as of twenty twenty. 01:00:25 Speaker 2: Various wild town. 01:00:27 Speaker 1: Yeah, and it's located way up in the far northwest corner of the state of Montana, Okay. It's surrounded by gorgeous natural beauty, snow capped mountains, lush forests, the Roaring Cooten Eye River. Have you seen the incredible movie The River Wild? Nope, the rafting movie with Meryl Streep and Kevin Bacon from the nineties. No, but now I must oh fantastic. I mean, I haven't watched it in like twenty years. But part of it, for all you listeners who may have seen it, part of it was filmed nearby Libby, Montana. Libby is, also, like I said, the site of what has been called one of the greatest environmental disasters in US history. According to a twenty sixteen study, six hundred and ninety four Libby residents have died of asbestos related diseases since nineteen seventy nine. And that's in a town of twenty seven hundred and twenty five Yeah. 01:01:26 Speaker 2: Oh my goodness. 01:01:29 Speaker 1: Uh huh, and that number, which is likely an underestimate to begin with, will continue to grow. Oh my gosh, what happened in Libby isn't a case of whoopsie, we had no idea Asbesis was so bad for you. So sorry, It's not our fault. It is a case of deliberate concealment of a company making decision after decision after decision to ide information from people, to continue to knowingly expose them too deadly substances, and to try to avoid any responsibility for doing so, all in the name of profit. I'm getting worked up. Okay, there is so so much more to the story that I'm going to go into right now, and I encourage everyone listening to follow up to get the full picture. I used a few sources for this that I'll post on our website, but mostly I took from a book called An Air That Kills by Andrew Schneider and David McCumber, who are two journalists that played a big role in exposing the Libby scandal, and it's a great source for more details on this, but I'll do the best I can right now, the is best. The situation in Libby, which had been known to residents and lived by residents for decades, started to gain national recognition in the fall of nineteen ninety nine when an article about it was published in a Seattle newspaper. When the EPA got wind of this article and these outrageous, these seemingly outrageous claims that it made, they were incredulous. First of all, if there were this many cases of asbestos related disease and deaths at the time it was reported as one hundred and ninety eight deaths in this one tiny town, the EPA would have known about it. Secondly, the article was claiming that it wasn't just the miners that were getting sick and dying of exposure to asbestos. It was also their families, their spouses and children, as well as other members of the community who didn't have any direct connection to the mine. This had to be sensationalist journalism. But to find out just how much misreporting was going on, the EPA had to investigate the situation for themselves over the next couple of years. What they ended up finding was that not only were the reported numbers accurate, but if anything, the article barely scratched the surface of the horrific situation that had unfolded over the previous decades in Libby. Wow. The story begins really in the nineteen twenties, when a man named Edgar Alley established a mind to produce a substance called vermiculite, which, when heated, expands greatly, making it useful in many different products as insulation for buildings, in concrete, in packaging to protect what you're shipping, in soil to keep it errated. The possibilities seemed endless. At one point, I think it was around nineteen sixty I read that there were even experiments in Libby to see whether vermiculite could be added to animal feed or loaves of bread. What uh huh. Turns out that the bread rose faster and got moldy more slowly. So sometimes it's like you don't need to do something just because you can. 01:05:00 Speaker 2: That's they didn't stop to think if they should. 01:05:03 Speaker 3: Yeah, exactly, okay, yeah. 01:05:08 Speaker 1: Oh my gosh. Yeah. The vermiculite deposit in Libby was one of the largest ever discovered, And to give you some idea of just how huge Libby produced up to eighty percent of the entire world's supply of vermiculite between the nineteen twenties and nineteen ninety when the mine closed. Whoa, whoa uh huh. Now, on its own, vermiculite is non toxic. But in Libby vermiculite sold under the name zonolite, was not on its own. The vermiculite there was contaminated with a form of asbestos called tremolite or tremolite, actinolite or Libby amphable asbestos. So, like you said, Aaron, it was one of the more shorter, spikier fibers that are highly pathogenic and highly carcinogenic. And when asbestos was found to co occur with this vermiculite, it was called quote one of the largest deposits of asbestos ever uncovered. 01:06:16 Speaker 2: Oh dear. 01:06:17 Speaker 1: If we revisit the timeline of when asbestos related disease was first recognized, it shows us that by this time, so by the time that asbestos had been recognized to be present in this vermiculite, the occupational hazards of asbestos were well known, and the evidence would just continue to pile up over the years and the asbestos industry was more than ready to deal with these findings by trying to keep anyone from knowing about them. Of course, starting in the nineteen thirties, there was an industry wide push to prevent any negative press about asbestos by funding experiments on the condition that these companies maintain in complete control over the reporting of the fines, by ordering trade magazines like Asbestos Magazine. It was a real thing not to write anything about the health risks of asbestos, by making it a policy to not tell employees that they were working with a deadly substance. For instance, the president of Johns Manville, which was a major player in asbestos products, said that managers at another asbestos company were quote a bunch of fools for notifying employees who had asbestosis end quote. 01:07:39 Speaker 2: Hmm. 01:07:39 Speaker 1: And when one of those managers replied, quote, do you mean to tell me you would let them work until they dropped dead end quote, the president of John's Manvil allegedly said, quote, yes, we'd save a lot of money that way. End quote. It's like cartoonish, How a villainous, how evil these people were. 01:08:07 Speaker 3: It's I really just have It was such a hard time relating like, how do you do that? 01:08:16 Speaker 1: How do people do that? Are you a human right? You have no no moral compass whatsoever. 01:08:22 Speaker 2: I mean wow. 01:08:25 Speaker 1: Any mention of the word cancer was dropped from any official documentation, and even providing respirators or protective clothing to employees working with the stuff was a huge no no, because it suggested that, hey, you should protect yourself against this stuff. This dust could be dangerous, and they didn't want to make any suggestion to that effect. And there was no question whatsoever that the dust was dangerous, especially in Libby. A state inspection of the Libby mine in nineteen fifty six when it was still the Zonolite company, showed that these bestest content in the dust at the mine and mill ranged from eight percent to twelve percent, which is. 01:09:07 Speaker 3: Huge, like eight to twelve percent of the air of the dust had and it was a very incredibly dusty place. 01:09:16 Speaker 1: Yeah, eight to twelve percent was asbestos. So the inspector recommended, of course, that improvements be made to reduce the overall dust levels as well as exposure to the dust, by changing stuff like the ventilating systems and providing PPE. And he concluded his report warning that the disease would likely occur in employees who had continued exposure. Pretty clear message, right, yeah, do this or your employees will get sick and die. But when he came back a couple of years later, nothing had been done. And when he came back a couple of years later after that, having made again those same recommendations, things still hadn't changed. Thing. The concentration of asbestos in the dust was even higher. How could the company simply ignore these reports if they're being done by a state inspector. 01:10:10 Speaker 3: Because there's absolutely no enforcement policies. Welcome to America, yep. 01:10:15 Speaker 1: Not only that, there was an agreement between the mine and the state of Montana. The inspectors were only allowed to access the site to perform these inspections on the condition that the reports be kept confidential to mine management. Only A huh. Not only did Zono Light know about the dangerous levels of dust in the mine, they also had proof that they themselves gathered that asbestos exposure was actually causing disease in mine employees. In the late nineteen fifties, mine Mann had X ray screenings done of the entire workforce, and the resulting report by doctors showed that eighty two workers out of the one hundred and thirty screened had signs of lung disease. Not one of them was informed. 01:11:17 Speaker 2: I'm sorry, I. 01:11:21 Speaker 3: Okay, okay, I'm going to go into work. I'm gonna get an X ray. 01:11:28 Speaker 2: Why. I don't know. 01:11:30 Speaker 3: They're not gonna tell me. No one's gonna tell me the answer. But turns out all of you have asbestosis. Yeah, except they weren't told that. 01:11:37 Speaker 1: They were just like, hey, free x ray screenings, Hey, free physicals. We're gonna do this every year and collect this long term data set. 01:11:44 Speaker 2: We're not going to tell you about it. 01:11:45 Speaker 1: I'm not going to tell you, not gonna tell everyone and hope this never gets out. Yeah yeah, yeah, yeah yeah yea yea uh huh uh huh. Yep. None of the workers were told, and nor were they told when the company w R. Grace purchased zon A Light in nineteen sixty three and took over mining operations. 01:12:04 Speaker 3: W R. 01:12:05 Speaker 1: Grace was fully aware of the asbestos content in the dust and the asbestos related disease becoming more and more common in mind employees, but like Zono Light, they choose to do nothing or worse than nothing. What could be worse than nothing? I'll tell you. When Grace's corporate safety chief Peter Caustick was informed of these X ray reports that had been done, he suggested that those with the most severe disease be reassigned to less dusty, less dirty jobs. Quote. If we minimize their exposure to dust, chances are we may be able to keep them on the job until they retire, thus precluding the high cost of total disability. 01:12:49 Speaker 2: Yep, yep, yep, yep. Plus. 01:12:51 Speaker 3: Also, now let's bring in a whole bunch of new people who have had less exposure and expose them to the high levels of dust. 01:12:58 Speaker 1: Let's not do anything about the It's like, let's calculate how we can maximize disease and death in these people, but also use them until the end of their lives like parasites. Yeah, yep. Eventually some ppe was offered, but it was more lip service than anything, since it got incredibly clogged with dust basically right away, and people just wore them around their necks and it was just like I can't breathe that, Like there's no I have to clean it all the time, and I'm getting it. Yeah, it's hard to imagine how this could get even worse or more evil, But it does. And I'm sorry that I keep saying this, but it just it just happens. Because W. R. Grace also had evidence that as best as dust from the mine found its way into the town itself detectable quote in downtown Libby on many dry days end quote. According to an internal memo, how much dust are we talking? In nineteen six quote, twenty four thousand pounds of dust a day were expelled from the large stack on the dry mill. The dust was about twenty percent asbestos and had tested as high as forty percent end quote. Ah. And the production of asbestos would continue to increase in later years, doubling even at some points. The asbestos contamination in homes, in laundry, hung out to dry in soil, and some of the most contaminated places were the little league fields and playgrounds, where vermiculite tainted with asbestos was spread intentionally. There are pictures of piles, huge piles of dust and children playing in them. It is heartbreaking and horrifying. It was on the clothes of miners who came home from work not told that they were coated in a deadly substance as they hugged their children and spouse. Entire families in Libby developed asbestos related disease from this constant exposure, and wr GRACE continued to secretly monitor lung disease in their workers, with a confidential report in nineteen sixty nine concluding that quote, although seventeen percent of our one to five year service group have or our suspect of lung disease, there is a marked rise forty five percent beginning with the eleventh year of service, climbing to ninety two percent in the twenty one to twenty five year service group. That report ended with this ridiculous understatement quote this suggests that chances of getting lung disease increase as years of exposure increase. End quote. It's more like a guarantee than it is suggestive of a relationship Like what okay? Where was the US government in all of this? That's too big of a story for me to even go into. But not doing anything anything to protect employees, only to protect and bending to the will of industry. OSHA, the Occupational Safety and Health Administration, was created in nineteen seventy one in large part due to occupational exposure to asbestos and the incredible work done by asbestos researcher Irving Selikoff. So why had an OSHA or the EPA or NIOSH looked into the mounting cases of asbestos related disease and death in Libby. Well they actually had in nineteen eighty, with reports on the mine showing that levels of asbestos exposure were one hundred times what OSHA then deemed to be saved. Now guidelines are even more stringent, and that workers were at risk of developing severe asbestos related disease. Not only that, but that the quote unquote common knowledge that disease could only happen after prolonged exposure that was wrong. The report from nineteen eighty read quote mesothelioma, a marker disease for asbestos exposure, has occurred in persons with exposures as brief as one or two days, and in persons with exposures as low as those found in the homes of asbestos workers, and in the neighborhoods around asbestos minds, asbestos product factories, and shipyards end quote. Despite this, despite these reports, nothing seemed to be done about it. When investigators from the EPA began their investigation of Libby in nineteen ninety nine, two thousand and two thousand and one, they came across these reports showing that they were covering the same exact ground that other people at this organization had done before. Yet for some reason, those nineteen eighty reports were not followed up. Why what was that reason? It's unclear. There is some speculation that politics played a role. Wr Grace's CEO was super tight with Reagan, who was president at the time that the decision to follow up would have been made. And under Reagan, the Grace Commission was established to find ways to cut funding for the EPA, and so the Grace Commission ended up suggesting a whole bunch of decisions for the EPA. And you know, I will say that it seems unclear what those recommendations were or what those decisions were, but I don't think it's super far fetched to imagine that they might have gone something like nothing to see here. Libby's fine. It's one of those things where a lot of people work at the EPA, work at OSHA, work at NIOSH because they're passionate about protecting people, protecting the environment, but their hands are often tied by whatever administration is currently making decisions, and those decisions can often be guided by industry interests rather than human interests, because there's money in industry interests, but there's not in human the everyday person. 01:19:38 Speaker 2: Yeah, it is. 01:19:39 Speaker 3: It's really it's a really depressing kind of tightrope balance thing to think about when you when you when you start looking at cases like this, right, it's just it's a it's really depressing. 01:19:55 Speaker 1: Yeah. And even though nothing was done about those reports from Libby from nineteen eighty, there were still these passionate people in the EPA and elsewhere fighting for the ban of asbestos products, and in nineteen eighty nine, the EPA did enact such a ban on the quote, manufacture, processing, and selling of almost all products containing asbestos end quote, I mean. And that was a huge triumph that got national attention. What didn't get as much attention was when the ban was overturned within just a couple. 01:20:34 Speaker 2: Of years nineteen ninety one, nineteen. 01:20:36 Speaker 1: Ninety one, Yeah, yeah, yep. And I feel like many people might be surprised to learn that asbestos is far from band in the US, and that the US still imports and uses literal tons of asbestos every year, and it's been an ongoing battle, and in fact, the Trump administry actively fought against regulating asbestos, and Trump himself claimed that asbestos was quote unquote one hundred percent safe and that anti asbestos movements were a conspiracy by the mob. Anyway, it's just another demonstration of something we're always saying on a podcast, which is that public health and politics are heavily intertwined. You can't separate them by the mob, Aaron, I know, I mean, like it's absurd. The vermiculite asbestos mine in Libby closed in nineteen ninety, but the damage was far from over. The lag time between exposure and disease was one component, but another was the enormous contamination that Grace left behind. Starting in the late nineteen nineties and early two thousand's, former employees of the WR Grace mine in Libby and family of those employees successfully sued the company to cover their mounting healthcare costs, and the company was ordered to clean up the asbestos contamination at the site of the mine, but the company fought everything tooth and nail, including hiding funds and declaring bankruptcy so they wouldn't have to pay out or clean up classic. Yeah, and if it weren't for the amazing efforts by activists such as GAYLEA. Benefield, they may have gotten away with it. In the early two thousands, Libby was declared a Superfund site to help prioritize its decontamination, and in two thousand and nine, for the first time in the agency's history, the EPA declared a public health emergency in the town to help provide healthcare assistance. It's a victory for those who have fought so long and so hard to hold W. R. Grace accountable for their actions that resulted in so many lives ruined, lives ended far too soon and too painfully. But these activists, they never should have had to fight that hard and for that long. WR. Grace knew what they were doing, and they knew the harm that it would cause, and they sacrificed the people of Libby, Montana anyway in the name of corporate profits. Unfortunately, the story of Libby, Montana is still unfolding as the diagnoses and deaths continue, and it's not limited to that small corner of the state. As bestus contaminated vermiculate from Libby was shipped around the world without a warning label because, as they acknowledged, a warning label would lead to substantial sales losses, so we better not. It was shipped to at least seven hundred and fifty locations in North America and to countries such as Japan, Australia, New Zealand, England, Ireland, France, Germany, Venezuela, and Saudi Arabia. As best as containing zonolite was used in insulation for millions of homes in the US, and in the nineteen seventies, fireproofing using asbestos and vermiculite was sprayed on tons of buildings and skyscrapers, including the World Trade Center. There's an ad from nineteen eighty one for asbestos fireproofing showing the twin Towers with the line quote, when life depends on it, you use asbestos. 01:24:20 Speaker 3: I saw in one of the papers that I read they were mentioning detecting, like how high the levels got of asbestos in the air in New York after the collapse of the World Trade Center. 01:24:33 Speaker 1: Yeah yeah one EPA chemist who tested the dust after the World Trade Center found that quote. The concentrations of asbestos in settled dusts inside homes in Libby is comparable to the settled dust inside the buildings in Lower Manhattan. But the message was let's get Wall Street back up and running, Come on back, We got to do this once again. Profit corporate profit is more important than human lives and health. There is no telling how many people around the world have gotten sick or have died from exposure to Libby asbestos, and wr Grace is certainly not alone in putting profits before the health of their employees, not in terms of asbestos or tons of other toxic substances. And this, honestly, this could be an entire podcast where we talk about corporate negligence and how so many companies don't care about their workers and continually expose them to things. And you could just do a whole series on asbestos because there are so many more stories out there. But the story of Libby and of asbestos overall is still unfolding. It's still happening as we speak. And so now I'll hand it over to you, Aaron, to bring us up to speed a bit on the current asbestos situation, which is I know, a tall order. 01:25:54 Speaker 2: Yeah, I will try my best. Right after this break. 01:26:23 Speaker 3: As of twenty sixteen, which is the most recent numbers that I found. Sixty seven countries around the globe have banned all forms of asbestos. As you mentioned, Aaron, and because many of our listeners are US based, as are we, the United States is not one of those. The partial ban on manufacture, import, processing, distribution of some asbestos products that was enacted in nineteen eighty nine was overturned in nineteen ninety one, and since then, from what I can tell, all we have in the United States are some cobbled together state, federal, and local laws that have varying degrees of regulation on asbestos. And that's that's kind of it. From what I could gather. Twenty nineteen was the first time, at least recently, that the EPA has proposed further restrictions. In twenty twenty two, they proposed a further ban on the use of chrisotile asbestos for all ongoing uses. Again, this is the most common form of asbestos, and as of March twenty twenty three, which is when not only we're recording, but also most recently that the EPA has updated this website, this ban, which would be pretty comprehensive, is still just a proposed ban. As far as I can tell, it's still open for public comment, and it's not like it has not been enacted at this point. 01:28:01 Speaker 1: Okay. 01:28:03 Speaker 3: In contrast, everywhere in the EU, all of the EU member states banned all types of asbestos as of two thousand and five, and many of them had banned it earlier than that. So the World Health Organization unsurprisingly has a very big push effort desire to reduce or eliminate asbestos related diseases. That's kind of the angle with which the World Health Organization, of course, is going to come at it. But we have such a long. 01:28:39 Speaker 2: Way to go. 01:28:40 Speaker 3: Yeah. According to the World Health Organization, one hundred and twenty five million people worldwide are exposed to asbestos at their workplace, and they estimate that fully half one half of all occupytational cancer deaths are attributable to asbestos. And on top of that, several thousand deaths annually are attributable to household asbestos exposure. 01:29:14 Speaker 1: That's a lot yep. 01:29:17 Speaker 3: Most estimates that I saw from as recently as twenty fourteen and twenty sixteen are that we still consume between one point three and two million tons of asbestos around the world every year, and for comparison at the peak in like the I think it was the nineteen seventies of overall global consumption, our peak was about five million tons annually. 01:29:45 Speaker 1: Oh my god, it's like barely dropped. 01:29:48 Speaker 2: Right, that's one hand. 01:29:50 Speaker 3: I was like, well, it's dropped, but not that much, like one point three to five. 01:29:56 Speaker 2: Like gosh, I would have hoped it'd be better than that. 01:30:00 Speaker 1: I mean, yeah, but as long as someone is making money off of producing asbestos, it's. 01:30:08 Speaker 2: I know, I know, I know. 01:30:13 Speaker 3: In terms of additional numbers on how many people are affected by this, it's estimated that if we look just at asbestosis, so not even accounting for cancer related deaths, twenty seventeen, it was estimated that over three thousand people died from asbestosis worldwide. Mesothelioma. It's a little bit hard to get total numbers on, but in the US between nineteen ninety nine and twenty eighteen, there were almost fifty thousand new cases of mesothelioma of all types of mesothelioma that were diagnosed, and again, almost all of these are as a result of asbestos exposure. And then when we look at lung cancer, because again, asbestos is causing more lung cancer than it is mesicili almost specifically, lung cancer is in some countries the leading cause of cancer related deaths in almost all countries, one of the top causes of cancer deaths as well as a top cause of overall mortality worldwide, with over two million cases diagnosed every year, And we really don't understand how much of that lung cancer burden is attributable to asbestos exposure. We really don't have a handle on those numbers because lung cancer is so multifactorial, right, And I think that part of what really irked me in my I mean, you explained a lot of things that were like really infuriating Aaron about this story of asbestos. But I think, especially when it comes to mesothelioma and the way that we view it in relation to asbestos, or the way that we view asbestos in relation to disease, is that a lot of papers, when they're talking about the burden of asbestos and the costs of asbestos, focus on the economic burden as it relates to compensation for exposure. So an article from the New England Journal of Medicine from two thousand and five predicted the total economic burden of malignant mesothelioma as it relates to compensation for asbestos exposure is up to two hundred billion dollars in the United States and eighty billion dollars for Europe. And like, just even using that as a metric, it just tells you. 01:32:52 Speaker 2: How incredibly. 01:32:56 Speaker 3: Corrupt the system was and remain in terms of the amount of negligence. Yes, for workers and humans who are just exposed to asbestos, even outside of an occupational setting, right, it's depressing. 01:33:15 Speaker 1: Yeah, that is a really interesting framing. I know that we we often have a little bit of a uh I don't really like that when things are talked about in terms of the economic burden, but this seems especially not representative of the problem of asbestos. I don't know, I'm trying to articulate how I feel about it, but it's it's not. 01:33:37 Speaker 3: Because it's not even just the direct like healthcare related costs right of a disease. We're talking about, you know, compensation for known exposures that were in fact negligent or or worse than negligent. 01:33:51 Speaker 2: And then it's of course. 01:33:53 Speaker 3: We always overlook the personal burdens, right the people who are living with this, or who are living having known that they've been exposed, and what does that mean because we don't know what does that mean if you were exposed and for how much of your life and to what degree? And we don't necessarily have screening protocols in place. So it's yeah, it's really tragic. 01:34:20 Speaker 2: I think. 01:34:20 Speaker 1: Yeah, like in Libby, people who have been diagnosed with an asbestos related disease and are wondering if their children who played on these baseball fields, who played in these dust piles of asbestos, like are they going to get diagnosed? And a lot of them have been. 01:34:38 Speaker 2: Right, and how long do you wait? What do you check for? And yeah? 01:34:44 Speaker 3: Yeah, So in terms of where do we kind of go from here, I don't have a great conclusion. Unsurprisingly, there's a very big push from a lot of organizations, both GLOW and locally in various countries to further regulate or ban in fact all forms of asbestos on a global scale. I will also say that there is a lot more that needs to be done to understand the actual mechanisms of carcinogenesis, both for mesothelioma specifically, but also for all the other types of cancers that asbestos can cause. And then I also will say that I do have a paper if people are interested in where we stand with the treatment of mesothelioma specifically, because that is also a pretty depressing state of affairs. I mentioned that the median survival after diagnosis with mesothelioma is nine to twelve months. That hasn't changed, and so there's I think a lot to be done as well in terms of treatment for mesothelioma, because again, this isn't something that has is going anywhere anytime soon. Yeah, so that is kind of where we stand with and asbestos related cancers today. 01:36:04 Speaker 1: Okay, yep, yep, sourcess. 01:36:10 Speaker 3: I don't know. 01:36:10 Speaker 1: I don't know what else to say, honestly. Yeah. I have many sources for this. I'll shout out again the book and Air That Kills if you want to read more about libby Montana, and for the history of asbestos overall, I have a lot, but I'll shout out one by Tweedale from two thousand and two titled Asbestos and It's Lethal Legacy. 01:36:35 Speaker 3: I also had a little lot of papers for this. One one of my favorites actually was a report by the International Agency for Research on Cancer from twenty twelve that is very long and includes a lot of things other than asbestos, but they had a whole section on asbestos that I found really helpful, as well as a Lancer article from two thousand and five that was specifically titled Malignant Mesothelioma that was specific to mesothelioma. There are, honestly, so so many more though, for any deep dives that you want on any specific aspect of asbestos or cancer or mesothelioma or the current status. So we will post all of our sources for this episode and every one of our episodes on our website. This podcast will kill you dot com. 01:37:27 Speaker 1: We certainly will. A big thank you to Bloodmobile for providing the music for this episode and all of our episodes. 01:37:34 Speaker 3: And a big thank you to Leana Squilacci are wonderful mixologist. 01:37:40 Speaker 2: For these episodes. Can you say that mixologists? Is that right? 01:37:43 Speaker 1: Sure? Is that drinks? 01:37:45 Speaker 2: I don't know. 01:37:46 Speaker 1: I think it could be widely applied, however you want to use it for found mixologists. There we go, and thank you to exactly right. 01:37:56 Speaker 3: And thank you to you wonderful listeners. We really appreciate you listening. Hope that you enjoyed this episode. 01:38:03 Speaker 1: Yeah, it feels weird sometimes to say enjoyed this episode, but I hope that you learned something this episode. 01:38:09 Speaker 2: We hope that you feel as infuriated as we do. 01:38:11 Speaker 1: Yeah, and as always, a huge thank you to our wonderful, generous patrons. Seriously, you are amazing. Thank you, We love you, We love you. Okay, Well, until next time, wash your hands, you filthy animals.
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