Asbestos: Left Behind and Still Deadly

2022-11-23

Investigations Our Investigations

New evidence shows that asbestos is killing even twice as many people as we previously thought it was. Disposing it is an uphill battle. What can we do about it?

For a moment we thought we found an ideal material – versatile, cheap and created by Mother Nature herself. Although it was known to mankind for thousands of years, it only really rose to fame in the last hundred years. A group of six minerals with a unique fibre structure was called asbestos and given the role of the building material for the XX century.

We knew it was harmful. English doctor Hubert Murray documented a death related to asbestos in 1906 (first factory producing eternit was built on Polish soil a year later). In the 60’s, we confirmed that inhaling unique microfibers causes mesothelioma. But we paid no mind. Instead, we made use of its incredible characteristics – resistance to extreme temperatures, tensility, resistance to abrasion and friction, acids and salts. Asbestos seemed indestructible so we used it to build ships and make brake pads, clutches, glues, insulations, gaskets, even clothes and stage curtains. Between 1970 and 1990, Poland imported (mainly from the USSR, Italy and Canada) 78 000 tons of it yearly. It is estimated that it was used in the production of roughly 3000 different products.

But asbestos made the biggest career in the construction industry. To this day, there are over 4400 km (that’s roughly a distance between Cracow and North Pole) of asbestos pipes still in use in Poland, and this carcinogenic mineral, literally, provides a roof over our heads. We named cement mixed with asbestos eternit, from Latin word aeternitas, and used it to produce roof tiles.

Few decades later, we realized that instead of eternal roofs we got an eternal problem. Asbestos started to kill.

Like we walked out of the mill

Poland banned the use of asbestos in 1997. The European Union did the same eight years later. Can we safely assume that the worst is now behind us? And can we assess how costly this asbestos revolution really was? This article is a part of an international investigation carried out simultaneously in nine European countries. Together with journalists from all over Europe we spend months documenting victim’s stories, the scale of this problem, strategies implemented by particular countries and new challenges. One thing is certain – asbestos is not the past. And it turns out to be much more dangerous than we thought.

 Experts confirm that the numbers of patients and deaths related to asbestos exposure are rising. Most endangered were people who worked with asbestos or lived in the vicinity of factories and facilities where it was processed. ‘The latency period for lung cancer or mesothelioma is 30 to 40 years’, says prof. Beata Świątkowska who runs Amiantus programme, providing health care for former factory workers exposed to asbestos.

That rise is plain to see when you check the statistics. 70 people died in Poland of mesothelioma in 2000. A decade later, 190 deaths were registered. In 2019 (newest data), the number rose to 295. And this happens all over Europe.

If Jesús Ropero Calcerrada from Beasáin knew that fibers with a diameter of 3 micrometers (μm) can penetrate lower respiratory tracts and, years later, cause cancer, he probably wouldn’t take that job. ‘Clouds of dust shrouded us with every strike of the hammer, but back then we knew nothing of asbestos’, recalls a 73-year old man in an interview with Spanish colleagues from Grupo Merca2. 35 years earlier, he removed asbestos from old train wagons. Neither he nor other workers had any protective gear. They were provided only with hammers and crowbars to yank asbestos slabs out.

Jesús Ropero Calcerrada with his wife. Source: B. Jimenez Tejero

Jesús belongs to a group of the most recognizable asbestos victims – retired men who worked in the dust for half of their lives. When I spoke to former factory workers and roofers in Poland, I’ve heard similar stories. ‘Sometimes, we looked like we walked out of the mill. That’s how much we were covered in dust’, said one of the retired roofers. Jesús got his medical diagnosis a year before an interview – cancer, pleural mesothelioma. Later, he was connected to an oxygen cylinderand morphine was administered to relieve his pain.

‘I have a wife. Look how beautiful she is. And seven grandchildren. Maybe they’ll get some compensation payment’, said Jesús with a hope in his voice. He tried to convince his former employer to pay for any damages.

Jesús Ropero Calcerrada died on 5th November, just two weeks after the interview. 

600 per day

How many similar stories are there? In 2004, the World Health Organization estimated that around 107 thousand people died from asbestos exposure each year. Unfortunately, current estimates show numbers over twice as high. 

I’ve mentioned mesothelioma several times for a good reason. This malignant cancer (only 40% of patients survives the first year) attacks membranes close to vital organs of the human body: heart, abdomen and, most often, lungs. Unlike other cancers, mesothelioma is, almost solely, caused by asbestos. That is why scientists use it as a most reliable source of data. If it wasn’t for eternit, this disease wouldn’t even exist. 

But it is not the only threat. In 2012, a group of scientists calculated that for every case of mesothelioma caused by exposure to chrysotile (the most common type of asbestos) there are 6,1 cases of lung cancer. Further studies, including ‘Global Asbestos Disaster’, confirmed those findings. Dr. Jukka Takala from Finland, one of the co-authors of that publication and former chairman of International Commission on Occupational Health, says: ‘Nearly all international experts now agree on an annual number of deaths of asbestos globally to be around 250.000’.

We have confirmed those numbers, using various sources. One of them was a database compiled by Institute of Health Metrics and Evaluation at the University of Washington in Seattle. The data are terrifying. In 2019 alone, almost 240 thousand people died from asbestos exposure. 90 730 cases were registered in the EU and UK.

Even the typically cautious World Health Organization, helped by the International Labour Organization, updated its estimates. End result? 209 481 deaths all around the world. Almost 600 per day. 

Programme

We’ve searched the University of Washington’s database for information regarding Poland. According to American scientists, asbestos caused 4043 deaths in 2019. These are estimates, of course, but based on years of independently carried research. The rule is simple. If we register 295 deaths caused by mesothelioma, and therefore by asbestos, it means there are several times more cases of trachea, lung and bronchia cancers stemming from contact with this carcinogenic mineral. 

The problem is, no one can confirm nor refute those estimates. For diagnosis and cancer treatment purposes the cause is irrelevant. Nobody is researching cases of exposure that happened over 40 years ago. Lung cancer is attributed almost solely to heavy smoking, but research proves that the risk grows dramatically (even 50 times) if the smoker inhaled both tarry substances and asbestos microfibers.

I browse through the Polish occupational disease registry, but the data it provides can’t be considered as reliable. In Poland, occupational disease is diagnosed on request filed by an employee, employer or physician. Many people who were exposed to asbestos years ago don’t link their disease with former work. Others simply forgo the inconvenient clerical procedure. Needless to say, only 23 cases of mesothelioma (out of 337 diagnosed) were qualified as occupational disease in 2019. But some regularity can be discerned – 69 percent of all cancer cases qualified as occupational diseases were caused by asbestos. In some years this percentage is even higher. Additionally, there were 31 cases of other ‘asbestos’ diseases of pleura and pericardium, and 114 cases of pneumoconiosis.

I try to concentrate on a smaller scale. When the Polish state closed 28 asbestos plants, it took care of all workers and created the Amiantus programme. For over 20 years, it has been administered by Nofer Institute of Occupational Medicine in Łódź.

‘During the last two decades we’ve examined over 8 thousand people, mainly men’, says Beata Świątkowska, programme’s coordinator. ‘Every fourth patient was diagnosed with a disease caused by asbestos. It shows how harmful this substance is’. 

Most former workers have asbestos pneumoconiosis but almost 200 have malignant cancer. Pulmonary shadows were detected in 65 percent of Amiantus’ patients.

We will secure the asbestos tomorrow

The fate of former eternit plant workers is only one part of the problem. The other is us – their clients. How endangered are we exactly? Answering this question is even harder than counting occupational diseases, but the Polish government decided that the problem is serious enough and needs to be handled. ‘Programme for Asbestos Abatement in Poland 2009-2032’ launched over a decade ago. Its guidelines are simple. First, all of the asbestos has to be catalogued. Second, people have to be encouraged to replace old eternit roofs, pipes and insulations with new ones. And finally, poisonous materials need to be collected free of charge, transported to disposal sites and buried deep underground. The bulk of the work is done by local governments (mainly municipalities) with partial funding from the Ministry of Economic Development and Technology, and National Fund for Environmental Protection and Water Management, and the aid of National Labour Inspectorate and private firms contracted by municipalities to catalogue and utilize asbestos.

The goal was clear – get rid of all asbestos by the year 2032. Poland was the first European country to take this matter so seriously. As it turned out, we were also the only ones to do so. Asbestos abatement programme was implemented only in the Flanders Region of Belgium. In 2013, we were even praised by the European Parliament whose members urged other countries to follow the example given by Poland. 

After 12 years it has become obvious the programme won’t work as planned. During that time, we’ve managed to remove only 17 percent of catalogued asbestos. The number will drop even more when we take into account that nearly half of the asbestos is still waiting to be catalogued. All experts (including programme’s authors) estimate that there are around 15 million tons of asbestos materials still being used in Poland. At this rate, we will get rid of them all after 121 years.

‘I wouldn’t be so optimistic’, says prof. Daniela Szymańska from the Faculty of Urban Studies and Regional Development at Nicolaus Copernicus University in Toruń. ‘Looking at the different rate of progress made by municipalities, I say 120 years may not be enough’. 

So, it’s not certain we will deal with asbestos before the onset of the XXIII century. Why does it take so long? The Supreme Audit Office (NIK) inspected the programme twice – in 2016 and 2022. In both cases conclusions were similar – programme never gained momentum because it lacked funds and legal authority. It is only a Council of Ministers resolution, not a parliamentary one, and many local governments implement it superficially. Out of 31 inspected bodies 16 neglected the obligatory asbestos cataloging, even in their own offices. In the last five years, no mayor or president filed a complaint to the police regarding the use of asbestos.

The programme is additionally hindered by its own absurdities. At its core lies the Asbestos Database. Here, the materials are catalogued and their removal is registered. But even after 12 years the database is far from being user-friendly. The interface is clunky, it’s easy to make mistakes. NIK inspection found incorrect data in databases of 18 (out of 23) municipalities.

Piles of eternit slabs lying by the national road no. 94. Source: Krzysztof Story

You don’t have to look far to see how asbestos removal really works. Carcinogenic material is ubiquitous in the Polish countryside. I leave Cracow and drive state road 94 to Olkusz. Funny thing, for the first time I see what my eyes have unknowingly ignored before. There are heaps of eternit slabs stacked up on pavements, driveways and backyards. Passing just two villages – Jerzmanowice and Biały Kościół – I count ten of such piles, one for every kilometer. I speak with the owners and listen to similar stories. They’ve renovated their roofs, stacked old asbestos on pallets, all according to regulations, then wrapped it in foil, notified municipalities and waited ever since. They have been waiting for three, six, even eighteen months. There are no deadlines, so municipalities schedule the removals as they please, usually when ‘orders’ start to pile up. Until then, broken eternit slabs lie on the pavements, while wind and rain tend to the foil. I’ve seen only one well secured pallet.

I stop by another one. Neighbors say that it has been standing there for over a year. One-meter-high heap of corrugated eternit is not secured at all. Foil scraps litter the yard. The owner lives in Germany, he rents his house to a family from Ukraine. His brother-in-law takes care of the tenants but he does not want to speak about discarded eternit. I smile at the Ukrainian couple and gently suggest they should buy some stretch foil and wrap the slabs. They promise they will do it tomorrow. 

For reassessment

But let’s not demonize those roadside heaps. After all, asbestos abatement programme progresses (albeit poorly) mostly thanks to their owners. Free of charge removal provided by municipalities is hardly any help because utilizing toxic slabs is roughly only 10 percent of all costs of replacing a roof. 

Lack of funding is the weakest point of the national strategy. Apart from the Swiss-Polish Cooperation Programme, available only in two Lesser Poland municipalities (Krzeszowice and Andrychów), and few programmes dedicated to farmers, no one is offering any support for roof or insulation replacements. The effects are obvious. People renovate only things they care about and have the money for. If some asbestos slabs end up on a landfill site, it can be viewed as a side-effect. People I’ve spoken to were really happy about their new roofs, but at the same time ignored the broken eternit on their sheds, closets and garages. ‘There will be time for that too’, they said.

But for our health time is crucial. Asbestos roof is perfectly safe… as long as it stays in good condition. When it starts to crack, crumble and fall apart, it needs to be removed as quickly as possible. In theory, every catalogued asbestos material should receive one of three ‘removal urgency’ levels. But in 2010 norms were loosened. And so, the roof of the County Office in Brzeziny, qualified initially for immediate refitting, was reevaluated as ‘for reassessment after 5 years’. Furthermore, the rules were a dead letter right from the start because there is no legal instrument that can force owners to prioritize renovation oftheir tool sheds instead of their own houses. 

Not only old men

Our investigation proves that despite its mistakes and failures Poland is one of European leaders when it comes to fighting asbestos. Authorities in many countries, for example Slovenia, Croatia and Spain, don’t even know how many toxic materials they have on their hands and have to rely on data provided by NGOs. The Government of Holland wanted to force the obligatory refitting of all eternit roofs (with o total area equal to 11 400 football fields) until 2024, but the Senate rejected that motion.

In Italy, estimates predict that asbestos abatement will be completed in 60 to 100 years. Ezio Bonnano, chairman of National Asbestos Observatory, claims there are still 40 million tons that need removal. ‘350 thousand students from 2400 schools are at risk’, he says. In the United Kingdom, 90 percent of public hospitals and 81 percent of schools were built with asbestos materials, but authorities still didn’t come up with a plan to remove the toxic substance. In many countries authorities consider taking more decisive steps. For example, Spain wants to catalogue its asbestos until April next year.

The only exception to this rule is Flanders, a region in Belgium, where 2,3 million tons of asbestos wait to be utilized. Not long ago, new law has been introduced which forbids owners to sell houses built before 2001 if they don’t receive an ‘asbestos-free’ certificate. In 10 years, having this document will be mandatory for everyone.

All those steps are taken because more and more data show that what was previously considered as a threat only to workers of a few dozen factories and plants evolved into a much bigger problem. Its symbol is Helen Bone, a 40-year old former nurse from Middlesbrough. She was diagnosed with mesothelioma a year ago. Bone never worked with asbestos and never inhaled clouds of asbestos dust. She simply spent most of her life in buildings with toxic materials – as student, patient and nurse.

Helen Bone, a nurse from the UK. She was diagnosed with mesothelioma a year ago. Source: Katharine Quarmby

‘I thought that it was an old men’s disease. But attending support groups meetings I see more and more sick women’, she says in an interview with Katharine Quarmby.. Bone’s story is one of many indications that environmental exposure to asbestos is becoming a serious problem. In Sweden, where asbestos use was banned in 1982, the number of mesothelioma cases is still on the rise. In Poland, 104 women were diagnosed with that cancer in 2019. The youngest one didn’t even turn 35.

OSH didn’t take

We will have to wrestle with asbestos for many decades to come. We won’t correct past mistakes, but during our investigation we’ve examined how we can avoid making similar ones in the future. We have to acknowledge that full scale asbestos abatement will happen regardless of plans, programmes and strategies. The reasons for it are climate change… and time.

One of the pillars of ‘Energy Policy of Poland until 2040’ is listed as energy efficiency. We are to reduce the use of electricity and fuel by 23 percent before 2030. Even farther reaching goals are set in the European Green Deal. And that means big overhauling, thermomodernization, and refitting buildings to a passive house concept. According to EU strategy called Renovation Wave, even up to 35 million buildings will require renovation or demolition. Many of those will have asbestos materials. Additional millions of square meter asbestos tiles will simply fall apart. And we have to think about providing safety to those who will utilize them now. 

Rafał from Sąspów, a village near Cracow, tells me how it is done according to current work standards. He refitted his asbestos roof 12 years ago, but after talking with some of the neighbours I am convinced that not much has changed since then.

‘This house remembers communist times so all eternit tiles were fastened with nails. Instead of shims, workers used old one zloty coins. They were easy to pierce and a lot cheaper than regular shims. The problem is, they are very hard to pry loose. Do you know what our construction crew did? They took a grinder and started to cut the nails from asbestos tiles. Have you seen what happens when you use a grinder on asbestos?’

I have, once. Nothing raises bigger clouds of dust than asbestos. That is why workers need to wear coveralls, use only hand tools and sprinklers to make the air wet so the dust won’t hover in the air.

‘It was a warm day and they worked on that roof stripped to the waist. They threw tiles to the ground where they crumbled. I asked them if they were insane. The said they’ve been doing this for 10 years.’

Eternit waited for a whole year in the backyard. Rafał lives on the edge of the village, ‘inconvenient’ place for a pick up.

‘They called me after a year and told me they’ll take the eternit. From a firm that had all necessary permits and certificates. I’ve pictured guys in white coveralls and instead saw two twentysomethings, once again stripped to the waist. They said hello and started to load the tiles, throwing them on the back of a truck.’

This sad picture (matching a stereotype of Poles’ approach to OHS) is confirmed by National Labour Inspectorate statistics. In 2021, inspectors examined 188 firms that removed asbestos. It is hard to find at least one that ended well. 48 percent of firms stored asbestos material the wrong way, 42 percent organized the working place improperly, 38 percent didn’t provide adequate protective equipment for their employees. The list goes on and on. Those numbers have not changed for years. The only one that had dropped applies to inspections. There were 277 in 2014. 

In Poland, works on a proper asbestos bill are on the way. We should know the end results next year. The European Union is also working on asbestos abatement regulations. Soon, the EU will start to disburse billions of euros on energy efficiency and emission reduction projects (National Recovery Plan is worth 724 billion of euros alone). And last but not least, politicians read the estimates about 90 thousand deaths caused by asbestos in Europe every year.

The European Parliament approved, by a vast majority of votes, an asbestos cataloging project for the whole EU and compensations for victims, and lowered the permissible exposure level for work with asbestos by 100-fold. The European Commission proposes a much less restrictive solutions. At the same time, British nurse Helen Bone says in her interview: ‘I miss my job and my old life. It’s unfair. It’s hard to write down a will when you are 40.’ 

International investigation ‘Asbestos: a deadly inheritance’ is a result of cooperative work by journalists from Investigative Reporting Denmark, ‘Knack’ from Belgium, Ostro from Croatia and Slovenia, IRPI from Italy, ‘De Groene Amsterdammer’ from Holland, Grupo Merca2 from Spain, ‘Al Jazeera English’ from UK, and Fundacja Reporterów and ‘Tygodnik Powszechny’ from Poland. The project was created with support from Journalismfund.eu.