Asbestos: why ‘management in-situ’ is the wrong approach

Campaigning for a national 40-year asbestos strategy

The current deaths are due to past exposure, as asbestos diseases typically have a latency period of 25 to 60 years. Thankfully, the death rates from asbestos-related disease may have, or surely will begin to decline shortly, due primarily to bold legislative action to ban high-risk asbestos in 1983/4 and all asbestos as late as 1999. The lesson here is that strong action has and will save many thousands of lives.

Photograph: iStock/LianeM

Listening to our Health and Safety Executive (HSE), you would think all is now highly controlled and that asbestos was yesterday’s problem. It is not: we have had, for the last 24 years, a policy of ‘management in-situ’ for asbestos materials, with the underlying presumption being that asbestos in-situ is safe, if left undisturbed.

So, we have this material in most UK public buildings to varying degrees, currently responsible for more than 20,000 deaths a year, (when lung cancer deaths are accounted for according to international scientific research) and we are assured it is safe. These materials are almost all more than 30 years old, with the higher risk materials more than 40 years old.

The truth is that these materials have deteriorated over time and are disturbed to varying degrees periodically or constantly. Yes, those deadly fibres, currently responsible for so many deaths, are working themselves loose through normal wear and tear within our public buildings. The much-parroted line “asbestos is safe if undisturbed” or “asbestos in-situ is safe”, is the biggest lie in public life! UK asbestos imports and deaths are in a league of their own, relative to similar European nations.

There are four major variables at play in determining rates of asbestos disease: the level of exposure, the type of fibre, the age of first exposure and the number of people exposed. Of these four factors, only one, the level of exposure, has been very substantially reduced. The fibre types installed into our buildings remain the same, while the number of people exposed has increased and the age of exposure has lowered. Let us explore the interplay between these factors.

The gross exposure from working with asbestos materials has been vastly reduced by the banning regulations, but as asbestos materials are ubiquitous in our environment, many more people are exposed, albeit to a much lower degree today, than in previous generations. Eighty per cent of schools are known to contain asbestos and 100 per cent of hospitals: we are surrounded by dilapidated asbestos materials. Just because you cannot see the fibres does not mean they are not in the air.

The age of first exposure has reduced. In earlier generations, you were grossly exposed at work, so from 16 years old onwards. Now, children are exposed in social housing and school from birth. This really matters, as the risk of mesothelioma roughly doubles for every decade earlier in life you are exposed. So, a child aged five has approximately five times the risk as their teacher aged 35, when exposed during the same incident at school, for example. Secondly, life expectancy is expected to increase. Children born today are predicted to live for 100 years. Early exposure, followed by a long life, ensures many decades of the doubling of the risk.

Charles Pickles is a campaigner and founder of Airtight on Asbestos. Photograph: Airtight on Asbestos

What is alarming in the mesothelioma statistics is, not only that the UK has the highest per capita rates in the world, but that the rates have not declined on the timescales as previously predicted by HSE. The number of deaths has remained higher than expected, for longer. In addition, female mesothelioma deaths continue to rise while the numbers of victims dying in their forties is beginning to rise.

So, while mesothelioma was characterised as an old man’s industrial disease, its nature is changing to reflect secondary or environmental exposure, not from working with asbestos but from working in buildings containing asbestos. The number of asbestos deaths will surely decline steeply over the next decades, but we can reasonably expect deaths in their hundreds due to exposure today, in 40, 50 and 60 years’ time. These deaths are already ‘baked in’, but there are pragmatic, cost-effective recommendations to curtail asbestos installed in the last century, killing our unborn children in years to come.

Aware of the problem, the UK Parliamentary Work and Pensions Select Committee, with the power to scrutinise occupational health and safety policy, undertook an inquiry into this area. The committee comprised cross-bench MPs and took written and oral evidence from a broad selection of sources and witnesses. They then published a report, on 21 April 2022, recommending numerous changes to the current regime. Significantly, they called for:

• “...a robust research framework for the systematic measurement of current asbestos exposures in non-domestic buildings, using a range of measurement and sampling techniques and informed by international experiences and approaches.”
• “...a central digital register of asbestos in non-domestic buildings, describing its location and type.”
• “...a deadline now be set for the removal of asbestos from non-domestic buildings, within 40 years. The Government and HSE should develop and publish a strategic plan to achieve this, focusing on removing the highest risk asbestos first, and the early removal from the highest risk settings including schools.”

Together these represent a rejection of the current policy of ‘management in-situ’, implying that asbestos fibres are released through the routine use of our public buildings and call for a strategic approach informed by hard, current data on asbestos presence and risk. 

So, how could we strategically reduce the occupational and environmental risks from asbestos?

All asbestos is dangerous and known to induce lung and other cancers plus mesothelioma. However, brown asbestos is known to have 100 times the carcinogenic potential of white asbestos. As discussed earlier, children have five times the risk of developing mesothelioma than do adults, when exposed. The risk assessment enables a definite case for strategic prioritisation. Children exposed to brown asbestos at school have 500 times the risk of an adult exposed to white asbestos. Brown asbestos and children present an unacceptable risk: as risk that cannot be ‘managed in-situ’.

Source: Airtight on Asbestos

So, what about the prevalence of this lethal substance? Approximately 12 per cent of the total asbestos imported into the UK was amosite/brown asbestos or crocidolite/blue asbestos. Together these fibre types are called amphibole asbestos. Reading The Inhaled Particles Study – TIPS (2018), it is apparent that 98 per cent of asbestos fibres found in the lungs of men with mesothelioma or lung cancer, born between 1940 and 1964, were brown or blue asbestos. All asbestos is dangerous but, put simply, 12 per cent of our asbestos did 98 per cent of the damage and we still have much of this lethal material in-situ.

The case for strategic prioritisation could not be clearer! Amosite is too risky to be managed in-situ in schools, social housing and other buildings where children spend a lot of time. The problem with ‘management in-situ’ as a policy is that it is not sufficiently robust and accidents leading to exposures routinely occur; it has been a ‘sticking plaster’ policy for 24 years and it really is time to move on.

Despite having the worst asbestos legacy, the UK, once a leader in asbestos management, has fallen behind in the implementation of the best techniques and technologies, over the course of the last fifteen years or so.

You can argue about the efficacy of any of the given measures in the table above of national approaches to asbestos management, but in aggregate other nations are now striding forward in their efforts to manage and eradicate their asbestos.

Should the current Government agree to implement the Select Committee recommendations, there are examples of sensitive air monitoring regimes, databases and ‘eradication’ or ‘asbestos-safe plans’ that may help them along the way. Moreover, a UK asbestos database has been actively developed for two years now and with official approval could fulfil this function.

Nothing will happen in this area unless the costs are known and asbestos policy enables the broader policy agenda. On costs, in the foreword to a recent cost-benefit analysis commissioned by the leading charity, Mesothelioma UK, Sir Stephen Timms MP wrote: “Removing asbestos from schools and hospitals over a 10-year period would, over 50 years, benefit the UK economy to the tune of around £11.6 billion and benefit the Exchequer by around £3.6 billion.

“The Government and HSE should develop a strategic plan to achieve this. It should focus on removing the highest risk asbestos first, and on early removal from the highest risk settings, such as schools and hospitals. The plan should integrate with – and take full account of – plans to upgrade buildings to meet net zero targets, and with wider waste management plans.”

Sir Stephen Timms is now the relevant Minister who has the authority to enact such change, giving many of us hope that the UK may shortly have robust and sensitive asbestos air monitoring, a national asbestos register and a national asbestos strategy. This will save many lives in the decades to come and enable broader national infrastructure renewal.

Charles Pickles worked as an asbestos consultant from 1998 to 2019. In 2002, he co-founded a company which went on to become the UK market leader in asbestos consultancy. Through his work, Charles has broad and abundant experience of asbestos management. After divesting shares in his company in 2019, Charles founded Airtight on Asbestos, a campaign dedicated to improving UK asbestos management, which has been instrumental in calling for improvements and developing recommendations for policy improvements.

For more information see:

airtightonasbestos.uk

@savetheirbreath

References

Mesothelioma numbers: Source: tinyurl.com/2sesxa6a

European Comparison of General Workplace Fatalities: tinyurl.com/2p9p84sn

European Comparison of Asbestos Fatalities: tinyurl.com/4dmrtjc5

Clearing The Air: The costs and benefits of removing asbestos from UK schools and hospitals. mesothelioma.uk.com/clearing-the-air/