For Emily Ward, everything started with a chronic cough.
It was 2012 and treatment for pneumonia did nothing. So, her doctor sent her to the hospital to get images of her lungs taken. She was driving back to her home in Cornish, Maine, when her doctor rang.
“I was almost home and he calls me on my cell phone and says, ‘Um, I think you better go back to the hospital. Your lung has collapsed,’” Ward, 70, recalled.
After a battery of tests, doctors determined that Ward had mesothelioma, a rare form of cancer that’s almost always caused by exposure to asbestos, a naturally occurring fiber that is useful in various construction products but can cause long-term, life-threatening ailments if inhaled.
Ward started treatment at Boston’s Brigham and Women’s Hospital and at the Dana-Farber Cancer Institute. She also started working with lawyers to figure out where she was exposed to asbestos. They don’t know for sure, but Ward — who is a nurse — says they have a good guess.
In the 1970s, Ward worked at a hospital that was undergoing a major renovation. She had to clock in near the construction side and then walk past it month after month to get to her unit.
“There was plastic sheeting up, and stuff like that, but it was dusty, dirty. We were going through the basement,” Ward said.
The link between asbestos fibers and life-threatening respiratory ailments, including mesothelioma, lung cancer and asbestosis, came to light in the late 1960s, '70s and '80s. There was a wave of lawsuits that bankrupt several companies, and efforts at regulations soon followed.
In the decades since, the use of asbestos in building materials has decreased significantly in the U.S. but has not been federally banned — as it has in more than 50 other countries since the early 1970s. Massachusetts Attorney General Maura Healey took a leading role in the fight against asbestos three years ago by launching an initiative to reduce exposure to it nationally and locally. A report on her efforts, released Monday, outlines the steps she has taken, including calling on Congress to ban asbestos.
An estimated 12,000 to 15,000 people nationwide die from asbestos exposure each year, according to the EWG Action Fund.
In 1989, the United States came the closest it has ever come to an outright federal ban on asbestos. The Environmental Protection Agency (EPA) issued the Asbestos Ban and Phase-Out Rule, which would have banned asbestos-containing products. But manufacturers who used asbestos filed a lawsuit, and the ban was struck down in 1991. The courts said the EPA hadn’t proven that this was the “least burdensome alternative.” The EPA, under the administration of George H. W. Bush, did not appeal the ruling.
“Ever since the early 90s, it’s been a tug of war between industry interests on one side and people advocating for public health on the other side,” said Daniel King of The Mesothelioma Center at Asbestos.com. “And there’s been a stalemate, essentially.”
The power and risks of asbestos
For the better part of the 1900s, asbestos was widely used in construction materials because the naturally occurring fiber makes things stronger.
“It’s essentially a type of stone that you can pull apart into natural fibers,” said King. “You can make asbestos paper, it’s fireproof. You can make asbestos cloth, it’s fireproof. You can mix asbestos into cement, it makes it more durable. You can mix it into all types of insulation, it’s a great insulator.”
But when it’s inside a human, that’s not good.
“When you look at this through a microscope, these asbestos fibers are like needles that can get lodged inside a person’s lung tissue and other parts of their body,” he said.
Once inside a person, the asbestos fibers take decades to cause health consequences. The time between first exposure and the development of cancer is anywhere between 20 and 70 years, King said.
Within the manufacturing industry, the risks of asbestos exposure became evident in the first half of the 1900s but “the dangers of asbestos exposure were covered up in the United States for decades,” King said.
It was only in the '60s, '70s, and '80s with the onslaught of health issues and lawsuits, he said, that the use of asbestos began to decrease significantly.
“There are still many legal uses of asbestos and the chief reason that we are not using asbestos as much in American industries is because of legal liabilities associated with it, rather than the regulatory environment,” King said.
More than 50 countries have banned or restricted the use of asbestos, including formerly big producers such as Canada and Brazil. And Healey would like to see the U.S. join them.
Combating asbestos locally and nationally
Three years ago, Healey launched an initiative to protect residents against future asbestos use and all the asbestos that's already in our buildings.
"Basically, what we are trying to do is three things: Educate the public about asbestos safety; we are taking action against landlords or contractors who break the law; and we're advocating for strong federal protections," Healey said.
The attorney general’s office has put together the first public database of which school buildings — public and private — have asbestos, so that parents and teachers can ask questions and make sure any renovations are done with the right precautions.
She's also brought dozens of cases against those who are doing remodeling or demolition without proper asbestos remediation.
Healey said vigilance is especially important here.
“Massachusetts is a wonderful place, but we've got a lot of old buildings, old structures, old homes. And so, there's maybe a greater likelihood of asbestos appearing in places," she said.
On the federal front, she led a coalition of states in calling on Congress to ban asbestos in July. She also led a coalition of states in suing the EPA, saying the agency failed to require the chemical industry to report information necessary to regulate asbestos.
The American Chemistry Council advocates for asbestos producers, and generally calls for less regulation. In a statement to WGBH News, the council said, "It is important to allow the EPA to both complete its risk evaluation and implement any necessary risk management.”
In May, Michael Walls, the vice president of regulatory and technical affairs for the ACC, testified before Congress that the council uses asbestos safely and, in many cases, within a highly regulated framework. Walls also said human exposures are prevented by the rigorous use of personal protective equipment.
But that's not reassuring for Healey, especially under the EPA's current leadership, she said.
"A lot of what the Trump administration does is murky, and certainly when it comes to actions by the EPA, it's without any regard to science or facts or recommendations of their own internal scientists," Healey said.
And in the meantime, she said, there's work to be done locally to reduce the risk of exposure to asbestos.
