Lung Cancer Causes – Asbestos

Lung Cancer Causes – Asbestos

Asbestos is a mineral that consists of very fine microscopic, needle-shaped fibers. It is composed of silicon, oxygen, hydrogen and other metal ions. Asbestos fibers are strong, flexible, resist heat, acids, and friction and are virtually indestructible. Asbestos has been used in older plastics, paper products and floor tiles. In most cases, asbestos fibers are mixed with a material that binds them together producing asbestos containing material. Many industrial products are made with asbestos materials including sealants, thermal insulation, fireproofing acoustical texture products, textile and cloth products (asbestos gloves, blanket etc.), Gaskets and packing, Ceiling tiles, wallboard, siding and roofing and more. 

For thousands of years, people mined and used a group of six fibrous minerals known collectively as asbestos. These naturally-occurring minerals possess certain traits that make them useful; they are plentiful and can be found all over the world. They also resist high temperatures and chemical reactions, have tensile strength, and do not conduct electric currents. These qualities helped to make asbestos a widely-used product in shipbuilding, heavy manufacturing industries, and construction. However, as useful as asbestos may have been in various industries, they are also toxic carcinogens that cause deadly diseases, including lung cancer.

It is well known that lung cancer is primarily caused by cigarette smoking. However, many people do not realize that asbestos exposure is also an established cause of lung cancer. Studies showing that asbestos causes lung cancer date back to the 1940s and 1950s. For example, a study by Sir Richard Doll in 1955 found that asbestos workers were about 10 times more likely to develop lung cancer as compared to people who had not been exposed to asbestos.

Asbestos related lung cancer is caused by breathing in asbestos dust. It has been known for many years that a heavy exposure to asbestos dust can cause this disease.

Lung cancer, caused by abnormal cell growth in the lung tissues, is a devastating diagnosis. This form of cancer is strongly linked to tobacco smoking, but it may also be caused by asbestos exposure. However, this is not to say that asbestos-based lung cancer is the same condition as pleural mesothelioma. Both conditions affect the lungs, but lung cancer affects the breathing tubes and is a much more common affliction than mesothelioma.

If a person with lung cancer had both a significant smoking history and asbestos exposure history, which exposure caused the person’s lung cancer? The answer is both cigarette smoking and asbestos. This very issue was discussed in a landmark study in 1968 by Drs. Selikoff and Hammond2 entitled, “Asbestos Exposure Smoking and Neoplasia.” Prior to this study, it was known that both smoking and asbestos were both causes of lung cancer. What Selikoff and Hammond demonstrated is that when the lung cancer risk from smoking is combined with the lung cancer risk from asbestos exposure these separate risks multiply and produce an extraordinary high risk. Drs. Selikoff and Hammond stated, “There is an extraordinary risk of developing and dying from lung cancer for asbestos workers who smoke cigarettes regularly. In the group studied the combination of asbestos exposure and cigarette smoking increased the risk approximately 90 times compared with men who neither work with asbestos nor smoke.

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The amount of asbestos dust needed to cause lung cancer is similar, or even greater, than the amount needed to cause asbestosis.

The combined effect of cigarette smoke and asbestos exposure on the risk of lung cancer is known as a “synergistic effect” or synergy. In a follow-up study in 19793, Drs. Hammond and Selikoff concluded: “Evidence from this study indicates a strong synergistic effect between two types of exposure (asbestos dust and cigarette smoking) in respect to risk of lung cancer.

The primary cause of asbestos-related diseases is prolonged exposure to asbestos dust in materials which contain either chrysotile or amphibole asbestos fibers. Chrysotile (white) asbestos fibers are spiral-shaped and are sometimes referred to as serpentine asbestos. This is the most widely-used form of asbestos in industrial and construction applications. Amphibole asbestos fibers are needle-shaped and come in several forms, including amosite, crocidolite, and tremolite.

It is a different disease from Mesothelioma, which is a cancer of the lining of the lungs caused by asbestos exposure. Any type of lung cancer can be caused by asbestos exposure.

In 1997, experts from around the world met in Helsinki, Finland, and published a consensus report4 establishing a criteria for determining when a lung cancer could be attributed to asbestos exposure. This group of international experts concluded that all major types of lung cancer can be caused by asbestos, including squamous cell, adenocarcinoma, large cell and small cell lung cancer. The group also concluded that 1 year of heavy asbestos exposure can double the risk of developing lung cancer. Although certain experts for asbestos companies in asbestos litigation contend that a person must have a diagnosis of asbestosis to attribute a lung cancer to asbestos exposure, the Helsinki consensus report concluded that a diagnosis of asbestosis is not necessary and concluded that: “Cumulative exposure, on a probability basis, should…be considered the main criterion for the attribution of a substantial contribution by asbestos to lung cancer risk.” In other words, a lung cancer can be attributed, at least in part, to asbestos exposure based on a worker’s asbestos exposure history.

Asbestos usually enters the body when it is either inhaled or swallowed. Inhalation is the most common method of infiltration because the fibers are small and are easily introduced into the air by human activity. The majority of asbestos exposure cases occur during the mining and processing of the raw minerals, the constant handling of asbestos-containing materials (ACMs), or when older buildings made before the early 1980s are renovated or torn down. In some instances, asbestos is transferred second-hand to family members via clothing and protective gear.

Many people who have been exposed to asbestos dust have also smoked. Smoking is in fact the most common cause of lung cancer. There are no physical differences between a lung cancer caused by asbestos exposure and lung cancer caused by smoking.

Asbestos are tiny, hair-like fibers found in some types of rock. Asbestos is a natural mineral that is fireproof and insulating and was used in building construction materials and in some manufacturing processes. When asbestos is inhaled, the fibers can irritate the lung and may eventually cause lung disease. People who smoke and are exposed to asbestos have a higher risk of developing lung cancer. Fortunately, professional protective breathing equipment can reduce the risk of breathing in asbestos fibers for those who work with or around asbestos.

Fifty years after a landmark medical study definitively established that asbestos kills, the exact death toll remains unknown (Selikoff 1964).

The overall scale of asbestos-related lung cancer deaths has to be estimated rather than counted. This is because asbestos is one of a number of factors, including smoking, that can cause lung cancer. Individual cases usually have no specific clinical signs suggesting a particular cause, and factors such as asbestos exposure and smoking often act together to increase the risk.

• Research suggests there are probably about as many asbestos-related lung cancer deaths each year as there are mesothelioma deaths.

• This implies there are currently in excess of 2,000 lung cancer deaths each year in Great Britain that can be attributed to past asbestos-exposure.

• This estimate is uncertain, and since asbestos and smoking act together to increase the risk, it is affected by past smoking habits as well as asbestos exposure.

• The ratio of lung cancers to mesotheliomas is expected to fall over time suggesting less than one asbestos-related lung cancer per mesothelioma in the future. 

• There were 285 cases assessed for disablement benefit in 2014. (IIDB).

• There were an estimated 96 cases of occupational lung cancer reported by chest physicians in 2014. (THOR).

• The much lower number of cases identified via IIDB and THOR highlight the difficulty in attributing individual cases to asbestos exposure.

The fact that cigarette smoking is clearly a major cause of lung cancer does not change the fact that asbestos exposure is also a cause of lung cancer. There can be no doubt that asbestos is a cause of lung cancer. In fact, the United States Government has recognized this fact time and again. For example, in 1986, the Occupational Safety and Health Administration (OSHA) concluded that, of all diseases caused by asbestos, lung cancer constitutes the greatest health risk for American asbestos workers, and that lung cancer has been responsible for more than half of the excess mortalities (deaths) from asbestos. In 1986, OSHA also concluded that lung cancer can result from low cumulative exposure to asbestos5. On the issue of smoking and asbestos exposure, OSHA also concluded, that asbestos exposure contributes to almost 80% of lung cancer deaths even among workers who also smoked.

Another way in which asbestos can enter the body is by being swallowed. This can occur if someone isn’t wearing protective gear when working in an area where asbestos is located or if asbestos fibers get into people’s food and other consumables.

EWG Action Fund’s exclusive analysis finds that exposure to asbestos kills at least 12,000 to 15,000 Americans a year. Despite a significant reduction in the use of asbestos since the 1980s, the number of annual deaths held steady for more than a decade, because asbestos-related diseases may not strike victims for decades after they were exposed to these dangerous mineral fibers.

Levy Konigsberg LLP (LK) has represented people in asbestos lung cancer cases for more than 25 years and has obtained some of the largest jury verdicts and settlements in lung cancer cases, in which both asbestos exposure and cigarette smoking was a cause. LK is also one of the only asbestos law firms to have also won a lung cancer case against a tobacco company. Based on its track record of success, LK was recently named the Plaintiff Product Liability Law Firm of the Year for 2013 by U.S. News and World Report. Lung cancer attorneys at LK are educated on the legal and medical aspects of lung cancer and use this expertise in the prosecution of lung cancer cases. To speak with a lung cancer lawyer at LK, call 1-800-637-6529 or submit an online inquiry on this website using our live chat or email form.

No matter how asbestos becomes lodged in the body, asbestos fibers can build up in delicate tissue after exposure. Asbestos fibers can’t be expelled completely by the body’s natural defenses. Instead, they linger in the soft, vulnerable tissue of the mesothelium, the lungs, and other organs in the chest and abdomen. Over time, the asbestos fibers cause scarring and inflammation in the tissue where they are lodged. Eventually, these inflammations mutate into cancerous growths that cause several life-threatening illnesses, including lung cancer.

From 1999 to 2013, the years for which data are currently available, we have estimated the number of deaths from asbestos exposure in the U.S. at 189,000 to 221,000 people, or 12,000 to 15,000 deaths a year (Figure 1). Those figures are based on a review of federal records of deaths from diseases caused exclusively by asbestos, plus a calculation using a formula developed by international cancer researchers to estimate the number of lung cancer deaths likely caused by asbestos (CDC 2015, McCormack 2012). Asbestos kills 12,000 to 15,000 Americans each year. According to the American Cancer Society (ACS),  there is no such thing as “safe” asbestos.

Even though asbestos use in the U.S. has declined sharply over the past 40 years, its widespread use in a myriad of industries throughout much of the 20th Century places everyone at some level of risk to asbestos exposure. Though other materials are used as alternative insulators, asbestos is still legally used by a few industries, primarily by automobile manufacturers to make brake shoes and clutch pads.

A more exact number can’t be pinned down, because asbestos-related deaths are not precisely recorded or reported by public health authorities. Our estimate is conservative.

In addition, homes, schools, public buildings, and other structures built before the early 1980s still contain large amounts of asbestos-derived materials, including insulation, vinyl flooring, roofing materials, and various types of pipes. Also, since asbestos occurs naturally, people can be exposed to small amounts if they live near abandoned mines or rocky deposits which undergo wind and water erosion.

Asbestos exposure is not usually listed as a cause of death for lung cancer victims, even though researchers believe that many more people die of lung cancer triggered by asbestos than of other diseases exclusively associated with asbestos. Nor does our estimate account for undiagnosed diseases or errors on death certificates that result in misclassification of asbestos-related diseases.

• Per the National Cancer Institute (NCI), the risk factors for asbestos exposure are:

• Dose (the amount of asbestos a person is exposed to on a regular basis)

• Duration (the amount of time a person undergoes exposure to asbestos)

• Shape, size, and chemical composition of the asbestos fibers

• Exposure source (if it occurs in nature or if it is caused by human activity)

• Individual risk factors (pre-existing lung illnesses or smoking tobacco products)

Three major diseases are caused by inhalation of airborne asbestos fibers:

Mesothelioma is a rare and always fatal cancer that strikes the mesothelium, a thin membrane lining the lungs, heart, chest cavity, gastrointestinal system and reproductive organs. Mesothelioma is primarily caused by exposure to asbestos (ACS 2015). For the purpose of this analysis all mesothelioma victims are presumed to have been exposed to asbestos at some point in their lives.

Asbestosis is caused by inhaled asbestos fibers that lodge deep in the lungs, scarring the organs or triggering the growth of excess tissue, a condition known as fibrosis. Asbestosis makes breathing excruciatingly painful and often leads to death from lung or heart failure; the victim essentially suffocates. There is no known cure. Because its symptoms are similar to other respiratory diseases, asbestosis may not always be recorded as the cause of death.

Lung cancer can be caused by inhalation of asbestos fibers. Estimating the number of lung cancer deaths attributable to asbestos exposure is difficult, since death certificates citing the cause of death as lung cancer do not indicate if the person had any exposure to asbestos. However, we estimate that many more people die of asbestos-related lung cancer than from mesothelioma or asbestosis.

Though risk factors vary from person to person, the type of asbestos fibers involved in long-term exposure determines the severity of the negative consequences. For instance, the needle-like structure of amphibole asbestos makes it more likely for a person to develop mesothelioma. Amphibole asbestos tends to penetrate tissue easier and lingers longer in the body. Chrysotile asbestos’ prolific use by various industries is more likely to cause lung cancer because the more rigid structure of amphibole asbestos doesn’t lend itself to the manufacture of as many derivatives.

Researchers believe that some cancers of the larynx, ovaries, stomach and colorectal area are triggered by asbestos exposure (NAS 2006). The number of cases is impossible to estimate based on existing evidence. It is likely fewer people die from these cancers than from mesothelioma, asbestosis or lung cancer.

In addition, people who smoke regularly increase their chances of developing lung cancer. Asbestos exposure can cause lung cancer in non-smokers, but heavy smokers are more likely to develop cancers in the respiratory system, including the throat and lungs.

EWG Action Fund searched the WONDER database of the U.S. Centers for Disease Control and Prevention, which currently holds Multiple Causes of Death files for all fatalities recorded for the years 1999 to 2013 (CDC 2015). We obtained data for deaths from mesothelioma and asbestosis.  Asbestosis is a non-cancer respiratory disease attributed to asbestos exposure. Because the files allow local health officials to record more than one cause of death, we counted all deaths for which mesothelioma or asbestosis is listed as the primary or contributing cause.

Asbestos exposure causes a type of cancer known as small-cell lung cancer. According to ACS, between 10 and 15% of all lung cancers are of this type. The primary cause is smoking, although non-smokers are at risk if they are exposed to second-hand smoke, radon, and asbestos fibers.

The data show that between 1999 and 2013, mesothelioma was listed as the cause of 39,870 deaths, or about 2,848 a year (ICD-10 code C45). Asbestosis was listed as the cause of 20,317 deaths, or about 1,451 a year (ICD-10 code J61). Both conditions are listed as the causes of 1,285 deaths, or about 92 people per year (Table 1).

Table 1: Mesothelioma and Asbestosis Deaths, 1999-2013

Like mesothelioma, most lung cancers do not manifest themselves through signs and symptoms until it’s too late to treat them. By the time a physician detects and diagnoses small-cell lung cancer, the disease is usually too advanced. Thus, any medical treatment of the cancer will only alleviate a patient’s symptoms and extend life expectancy for a period of time, but it will not cure the disease.

Asbestosis was recorded as the primary cause of death in the cases of 40 to 50 percent of asbestosis victims. In the remainder, asbestosis was recorded as a contributing cause. As a result, our estimates of asbestosis deaths are higher than those of the Centers for Disease Control, which counts only the primary cause of death (CDC 2008, Bang 2013).

Per the National Institutes of Health’s National Lung, Heart, and Blood Institute (NHLBI), no treatments exist that can undo the adverse effects of asbestos on the lungs. Medical intervention can, however, relieve a patient’s symptoms, slow the development of the lung cancer, and stave off complications.

Yet our estimates are still conservative, because some unknown number of deaths may have been attributed to pneumonia, other respiratory disease or lung fibrosis of unknown origin (Reynolds 2014). If doctors failed to ask patients about asbestos exposure, or if patients were unaware they had been exposed to asbestos, the death certificate would not mention asbestos as a cause.

Patients with small-cell lung cancer have several options for treatment. Currently, there are four major types of treatment: surgery, chemotherapy, radiation therapy, and/or targeted therapy. These treatments can slow down the progress of the cancer by surgically removing affected tissue or killing off cancer cells with radiation or chemicals. Sometimes, a combination of two or more of these treatments can prevent, or at least delay, the onset of complications caused by cancer. They may also extend a patient’s life expectancy by months, even years.

Mesothelioma and asbestosis are only part of the devastation wrought by asbestos. Studies of people who worked with asbestos indicate that they have higher rates of lung cancer as well. However, there has been little effort to tally the toll of asbestos-related lung cancer.

Inhaling asbestos dust can cause asbestos-induced lung cancer. However, it is well established that lung cancer is commonly associated with smoking tobacco and proving that it is a result of inhaling asbestos fibres can be very difficult.

Most lung cancer in the U.S. results from cigarette smoking. Studies of smokers exposed to asbestos consistently find higher rates of lung cancer than among smokers who were not exposed (Moon 2013). The combination of asbestos exposure and smoking is particularly deadly.

Repeated exposure to asbestos fibers, either at home or in the workplace, also is considered a risk factor for lung cancer. Studies show that compared to the general population, asbestos workers are seven times more likely to die from lung cancer. Asbestos workers who smoke increase their risk of developing lung cancer by 50-100 times. Besides asbestos, mining industry workers who are exposed to coal products or radioactive substances, such as uranium, and workers exposed to chemicals, such as arsenic, vinyl chloride, mustard gas , and other carcinogens, also have a higher than average risk of contracting lung cancer.

The increased risk of lung cancer in a given group of people depends on how much they smoked and on the severity and timing of their asbestos exposure, making it difficult to estimate risks for the general population from a single study. Because asbestos is essentially the sole cause of mesothelioma, and mesothelioma risk is not influenced by smoking, many studies have attempted to estimate the number of asbestos-related lung cancer deaths based on the number of mesothelioma deaths.

If you are diagnosed with asbestosis (interstitial pulmonary fibrosis) it is normally accepted by the medical and legal profession that if lung cancer also develops, it was caused by asbestos, even if you are a smoker.

Four diseases have been linked to asbestos exposure: 1. Asbestosis, a serious, chronic, non malignant fibrous hardening and scarring of the lungs; 2. pleural plaque and thickening, scarring of the lining of the lung; 3. lung cancer; and 4. Mesothelioma, a cancer of the thin membranes lining the thoracic and abdominal cavities and surrounding internal organs.

Scientists at the International Agency for Research on Cancer, part of the United Nations’ World Heath Organization, reviewed 55 studies that reported the rates of both lung cancer and mesothelioma in groups of people exposed to asbestos (McCormack 2012). In a study published in 2012, these scientists suggest that the best way to estimate asbestos-related lung cancer in a population is based on the number of mesothelioma deaths for that group. Their analysis suggests that there are 3.2 to 4 lung cancer deaths in the U.S. for every mesothelioma death among individuals exposed to asbestos.

If asbestosis is not present, it is only possible in very limited circumstances, to prove that lung cancer was caused by asbestos, where proof of prolonged and / or heavy occupational asbestos exposure is required.

Even though the average asbestos levels in buildings today seem to be very low, an estimated 3 million employees in construction and general industry face significant asbestos exposure on the job. The heaviest exposures are in construction, primarily during the removal of asbestos during renovation or demolition. Workers are also likely to be exposed during the manufacturing of asbestos products like textiles, insulation, automotive brake and clutch work. Asbestos-related illness have also occurred in shipyard workers, school custodians and even movie set workers.

Still, the number of lung cancer deaths EWG Action Fund estimates with this method may also be too low, according to Richard Lemen, a former U.S. assistant surgeon general who now heads the Science Advisory Panel of the Asbestos Disease Awareness Organization. Dr. Lemen believes the number of lung cancer deaths would have been greater if the authors of the International Agency for Research on Cancer study had based their calculation on fewer and higher quality mortality studies (Lemen 2013). Indeed, a recent review of occupational studies found that studies with better data collection and longer followup of participants produced higher estimates of lung cancer deaths. (Lenters 2011, 2012).

If diagnosed, asbestos-related lung cancer is recognised by the Department of Work and Pensions (DWP) as an Industrial Disease, and sufferers may be entitled to Industrial Injuries Disablement Benefit, and a payment under the Pneumoconiosis scheme, subject to meeting certain eligibility criteria. Lung cancer sufferers may also be able to claim compensation from a former employer or insurer if it can be proved that their condition was caused by asbestos.

It varies with each individual. Asbestosis and other asbestos-related diseases are often not seen for 15 and up to 40 plus years after initial exposure. Because of the latent nature of these diseases, you should have regular screening tests. Asbestos-related diseases are progressive, so when a respiratory problem arises and you have had potential exposure to asbestos, you should immediately be tested.

Another review by the World Health Organization says the number of lung cancer deaths could be greater than the first study estimates. It says that in workers exposed to chrysotile, the most common type of asbestos, lung cancer deaths are six times higher than mesothelioma deaths (WHO 2014). If this were true for the U.S. population the number of asbestos-related lung cancer deaths would be much greater than we estimate. More research is urgently needed to clarify the asbestos-related lung cancer burden for Americans.

The most common symptoms of asbestos exposure are coughing, coughing blood, shortness of breath, chest pain and weight loss. The detectable symptoms of asbestos exposure can appear up to 25 years after exposure, which is why annual asbestos detection tests are recommended.

All told, when annual deaths from lung cancer, mesothelioma and asbestos are tallied, the scale of asbestos mortality is staggering. We calculate that from 1999 to 2013, between 11,586 and 15,510 Americans died each year from asbestos-related diseases. Over this period there was no apparent decline in asbestos deaths. For those who were exposed years ago but may not yet show symptoms, the prognosis is grim, although research to find a mesothelioma cure continues. To keep even more victims from exposure, suffering and death, the nation needs a total ban on asbestos.

Deep breathing difficulties, chest infections, gastro-intestinal problems, and asbestosis. The more serious diseases are lung cancer and Mesothelioma.

Normally the time limit for bringing a personal injury claim for an asbestos-related disease such as lung cancer is three years. However, because of the extended period over which the disease may develop, (the onset of asbestos-induced lung cancer can occur decades after the initial exposure to asbestos dust or asbestos fibres) the 3 year period begins when the person has reason to believe they have developed the disease. Typically, this is usually from the time the diagnosis is confirmed by an appropriately qualified doctor, such as a chest consultant.

Get tested. I recommend that you consult your primary care physician for an immediate x-ray or CT referral.

In the event of the victim’s death, the family must bring the claim for asbestos compensation within three years from the date of death or the date when they become aware that the death was caused by an asbestos-related disease, whichever date is the later. The cause of death is often confirmed by post mortem examination or at a Coroner’s inquest.

If you have been diagnosed with asbestosis, lung cancer, or Mesothelioma you should contact a lawyer at once to learn of your rights to file a legal claim for damages. A lawyer will make sure you follow the necessary steps and make assurances that the statute of limitations does not expire.

Asbestos-related compensation claims can be very complicated personal injury claims that require sensitive and efficient handling. Clear Answers’ solicitors can offer expert confidential advice as they are proven specialists in all types of personal injury claims linked with exposure to asbestos dust.