Asbestos and asbestos are synonymous and refer to a naturally occurring mineral silica that was largely applied as an insulator in ship and building construction. The use of asbestos began with the steam engine, spread in the 30s and 40s in the United States (the twin towers of New York contained it) and its use in Spain reached its peak in the 70s and 80s There were more than 3,000 applications for asbestos.
As Dr. Carmen Diego, pulmonologist and coordinator of the area of Occupational and Environmental Diseases of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) explains to Infosalus, since 2002 there has been a regulation in Spain and since 2005 in the European sphere that prohibits the use of asbestos.
"Exploitations and mines still exist worldwide in developing economies and Canada is one of the large exporting countries even though its use is prohibited within its borders.", says the specialist, who adds that although asbestos has been replaced by other artificial fibers or ceramics there is still no scientific evidence that these substitutes are harmless for humans.
The 70s and 80s were decades of intensive use of asbestos in Spain. The downspouts, pipes and community heaters of the buildings built in these years most of them carry this material.
Currently there are specialized companies to carry out the removal works of this material whose workers must comply with strict safety measures to avoid exposure to asbestos. These workers cannot work for more than 8 hours or two hours in a row and their suits are special and not easy to handle since they require self-contained breathing apparatus similar to those used in the management of Ebola patients.
Regarding the asbestos that still exists in the buildings, the recommendation is that if the facilities are not deteriorated, they should be maintained since there is no ‘deamiating’ policy. What the specialist does point out is the recommendation to contact specialized companies if renovations are going to be carried out and the ceilings are made of corrugated iron or the downspouts may carry asbestos.
One of the main problems of asbestos is that its effects on health, specifically on the lungs, have a very long latency time, they do not develop until 15 to 40 years later. The main pathologies occur in workers and their partners who were exposed for a long time and to very high concentrations. These are pleurosis, asbestosis, lung cancer and mesothelioma, an aggressive type of cancer of the pleura (the membrane that surrounds the lung) for which there is no other treatment than palliative.
UP TO 3,000 APPLICATIONS
But asbestos was not only found in buildings, it was also carried by small electrical appliances of the time such as toasters, ovens or plates. Asbestos was also used in a variety of formats, pure, powdered, bonded in mortar, rope fluff, etc. Union data indicates that up to 60,000 workers may have been exposed to asbestos.
"Only in Ferrol, in the naval shipyards, in metallurgy, but also all those who worked in the manufacture of electrical appliances, were exposed 15,000 workers who in many cases are not in any registry since they were auxiliary companies (contracts) that worked for companies national".
These people are currently being monitored through the Occupational Health Unit and are included in a health safety protocol. In the consultation, the doctor has about 1,500 registered people and of them 80% suffer from asbestos pathologies and are retired workers of the Galician shipyards.
The consequences of exposure to this metal have been evident up to 45 years later in these people. What makes the average age of these affected is 70 years.
Although in Galicia, where Dr. Diego practices, its use was prohibited in 1987, many workers were still exposed in the demolition of buildings and the scrapping of ships. "There are still many people who are not monitored after retirement, although with the ban on asbestos, the workers who were in contact with the material have to continue to be checked in the health system", says the specialist.
THE PATHOLOGIES OF ASBESTOS
The most common is pleurisy (pleural thickening), followed by asbestosis that causes pulmonary fibrosis and whose main symptom is respiratory failure, lung cancer, the most common cause of cancer death, and, although rare, the devastating mesothelioma , for which there is no curative treatment. There is no progression between the different diseases, there are people who develop some pathologies or others.
"They tend to be asymptomatic patients and when the symptoms appear only the work history can lead to the clinical diagnosis. The fundamental thing is to make the profession aware that if they see radiological alterations in the lung, they must consult the work history", says Diego.
Although the unions and the population that has worked in industrial activities are aware and receive attention from the health services, there is a large silent mass that has not yet been detected. In Spain there are no mines but the amount of asbestos that was imported in the 70s and 80s is known and it is considered that until the year 2040 the cases of mesothelioma will continue to increase and then decline.
For mesothelioma, there is no treatment other than palliative, chemotherapy increases survival, surgery reduces the tumor but its growth in the pleura invades the entire lung and it is only possible to reduce the tumor burden and apply radiotherapy. Survival is one to two years after diagnosis.
Mesothelioma also comes from household exposure to family members derived from work clothes and the fibers in these clothes. There is no safe threshold for developing mesothelioma when you have been persistently exposed to asbestos. The vast majority are men and women who worked in uralite factories and who lived with them.
Asbestosis causes pulmonary fibrosis that requires a lung transplant two to five years after diagnosis. It is the mildest, slowest, and not as severe form as the idiopathic (the spontaneous form and of unknown cause). Pleural thickening (pleuritis) is a thickening of the pleura and is due to the inhalation of asbestos that remains in the lung and therefore the response is different from idiopathic.