1. INTRODUCTION
1.4. Asbestos as a health hazard
Asbestos was widely used in Finland as well as around the world because it is an extremely versatile mineral fiber; it is flexible and yet strong, it does not conduct heat or electricity well, it has high absorbency, high mechanical stability, and it is resistant to acids and bases.18 Asbestos was used in many forms; spray, mass, mixed with cement, and sheets. The usage of asbestos was, for example as spray in the fire protection, thermal insulation, and insulation of the ventilation ducts. It was widely used in all the residential buildings and factories in pipes, facades, floors, walls, and insulator in boilers. The abundant utilization of asbestos in construction is still today seen as substantial asbestos removal in private homes, apartment buildings and other buildings.19
However, it is dangerous for health. In Finland, the government started to restrict the usage of asbestos in the 1960s to the halfway of the 1970s and in the 1990s asbestos was not used in the building. The workers were exposed to asbestos dust in all stages of work from mining to shoveling processed asbestos into fabric sacks. People who are working with asbestos are
16 Savon Sanomat, 10th of May in 1996: Myydään vapaa-ajan kiinteistö Tuusniemen kunnassa
17 Pekkinen 2000, p. 77
18 Ross et al. 2008, p. 27
19 Työterveyslaitos 2016, p. 3-14
in danger because it is not possible to remove microscopic asbestos particles from lungs as particles emanates through the nose and larynx and part of the particles attach to slime walls of bronchus. A portion of the particles moves to the digestion system causing similar irritation as in lungs. Lastly, some particles are transmitted in the tissues of lungs causing the loss of resilience of tissues that is necessary for lungs.20
The cumulative factors increase the risk of lung cancer that is already high when exposed to asbestos. It is consistent because asbestosis and its development is identified to require substantial exposure. The more the workers exposed to asbestos, the more the risk of lung cancer increases. 21 For example, smoking increases the risk of lung cancer significantly; the risk of getting lung cancer multiplies if a person is smoking tobacco and exposed to asbestos.22 Among the group that worked in Paakkila, 81% of men were smoking whereas 14% of the female workers smoked. Also, not all the people who worked in Paakkila had the same exposure to asbestos because of different duties such as sprayers exposure more than for instance the truck drivers. Based on the research by Kokki et al. work-related exposure appears to be the main cause of risk of lung cancer among residents living close to the asbestos mine of Paakkila. 23 Therefore, it is possible that smoking has had impact on men’s health in Paakkila and the cumulative impact of smoking with the asbestos exposure increased the amount of diseases.
The most common asbestos disease is the pleural plaque that is not causing the insufficiency of lungs and are not precursors of cancer. Even a relative exposure to asbestos can cause the asbestos particles to emanate into lungs but these can be seen with an x-ray after decades after exposure. Abundant exposure to asbestos dust for years to decades may cause scar formation in lung tissues i.e. asbestosis. The most fatal deceases caused by asbestos are the lung cancer, carcinoma of the larynx, and pleura cancer. There is no safe threshold for carcinogenic exposure and the risk of cancer increases as exposure increases. Characteristic of diseases caused by asbestos is that time delay after being exposed can be long; at least 10 years but usually 20-40 years, or, even longer.24
20 Vikström 1993, p. 13-14
21 Nynäs 2017 p. 34
22 Työterveyslaitos 2016, p. 10
23 Kokki et al. 2001 p. 319
24 Työterveyslaitos 2016, p, 9-10
According to Ringo, professionals have known in the middle 1980s the dangerousness of asbestos for human health. Before this asbestos was not generally viewed as a hazard, even though during the 1960s it was known that it is not good for health. In those days, the safety textbooks featured incomplete information about asbestos in the workplace. After the dangerousness of asbestos was broadly known many former employees started legal actions against companies claiming that companies should have known that it can cause diseases and there was not sufficient protection in the workplace.25
To give perspective how common asbestos related diseases were, and still are, I will be presenting the study by the Finnish Institute of Occupational Health that analyses possible cases of work-related diseases from 2005 to 2014. It is a part of occupational risk professions that has been registered into the work-related disease register. Based on the study, mesothelioma was the third most common confirmed occupational disease and asbestos with noise are still the most significant cause of the occupational diseases. People of the working age were confirmed with 238 cases of occupational cancer; hence it is still a topical issue.
Most of the occupational cancers are caused by asbestos. Among the people past 65 years, asbestos pleural plaque disease is the most common disease whereas asbestosis, mesothelioma and lung cancer are also at the top of the list.26
The same problems have been seen internationally around the world over the increase of diseases caused by asbestos is seen around the world. Good example is Japan. Asbestos was vital for the defence industry of Japan during the Second World War. At the same time external import from abroad became impossible, which lead to the situation where they had to utilize their own deposits. After the war had ended the impacts on asbestos mine workers’
health became known when numerous people died from diseases caused by asbestos.
However, the connection between asbestos and deaths was not seen in the beginning because only a few deaths were found to be caused by asbestos although the truth was different.
Later, the increased amount of deaths awaked to study the health impacts of asbestos and the causal connection between asbestos and the asbestos workers’ diseases and deaths were found. It might be that the increased amount of deaths forced the state authorities to start actions.27
25 Ringo 2004, p. 51-52, 55
26 Työterveyslaitos 2019, p. 3-7, 156
27 Morinaga – Shinohara 2001, p. 55-56, 59
In Japan, former employees were eligible for seeking compensation for the diseases caused by asbestos. However, it was the year 2006 when the amount of compensations increased because of the media encouraged the families and support groups and started information campaigns to alert and educate the people. This caused that the matter became political because government authorities overlooked the advises of experts. However, in 2005 a new asbestos compensation framework was established. Eventually, asbestos as a risk for health was recognized by Japanese government authorities in 2005.28
The dangers of asbestos started to emerge in the USA and Great Britain during the 1920s and 1930s when the asbestos workers started to seek compensation for their diseases and injuries. At the same time, the asbestos as a health risk was recognized in the Journal of the American Medical Association, which was the biggest medical organization in the USA.
The British and American journals found out in their studies that asbestos is connected to lung cancer and asbestosis. The international organization ILO published at the same time their study were dangers are noted and demanded that asbestos should be controlled by regulation.
Nevertheless, the evidence and regulation did not meet because of the strong lobbying by the asbestos industry. It was found in the 1970 that it is not only the workers, but also the people who live in the mining area that can get diseases caused by asbestos. Finally, the Occupational Safety and Health Act of 1970 in the USA was the most significant impulse to prevent diseases caused by asbestos.29 The government of the USA banned first in 1973 the materials that contain asbestos spraying30, the bans were extended to involve all spray materials in 1978, in 1975 EPA banned the use of asbestos in construction31, in 1977 it was banned in fireplaces and wall compounds32, in 1989 there was a ban for the new use of asbestos33, and finally in 1990 a ban for spray-on materials that contain more than 1% of asbestos in construction34.
28 Morinaga – Shinohara 2001, p. 66-68, 72
29 Lemen – Landrigan 2017, p. 2-7
30 National Emission Standards for Hazardous air Pollutants
31 National Emission Standards for Hazardous Air Pollutants
32 Consumer Product Safety Commission
33 Toxic Substances Control Act
34 National Emission Standards for Hazardous Air Pollutants