NBD Today, Mesothelioma in 30 Years
We're asleep at the wheel on asbestos 🫁
Last fall, a house on my street was performing a pretty extensive renovation project. Based on the status of the exterior, the interior probably hadn’t been touched in 40 or more years. This is why, when I approached the dumpster of construction detritus, I made it my duty to hold my breath as I walked past it.
Has my superstition peaked?
No.
These days, my work in the interior design world has given me an inside ticket to a very dirty secret. Our houses are full of hazardous materials.
My reflections on this topic are at least four months in the making and when I received a push notification from the NYTimes on Monday morning announcing that the US was finally proposing a full ban on asbestos, I was actually bummed that the news had dropped before I could raise my alarm bell. In 2024 alone, more than half of the homes I’ve been hired to help renovate are positive for asbestos-containing materials. If that sounds exaggerated, it helps to consider the data.
According to the US Census Bureau, there were about 80 million housing units in this country in 1975, the year my parents graduated from high school. Since then, we’ve added about 65 million additional units. But this implies that excluding the impact of total teardowns, 55% of our country’s housing stock is from a time when our homes were built and insulated with asbestos-containing materials.
What does this mean?
Let’s start with some basics. Asbestos is a known carcinogen and carcinogens are cancer-causing agents. Asbestos found in shingles and vinyl floor tiles are referred to as “bound asbestos” referring to it being formulated or bound together with other chemicals. These fibers are more difficult to release. Cutting, drilling, scraping or sanding are instances when the fibers can escape and become airborne. Deterioration or product degradation (from aging, UV exposure, or mechanical wear) is another potential cause.
The asbestos that has caused more anxiety over the years are the airborne fibers that are only visible with microscopy. It would take 600 of these fibers bundled together to be the same thickness as a single human hair. When these fibers become embedded in the lungs, our body has no way to eliminate them. Asbestosis, a condition where the fibers cause pulmonary inflammation and fibrosis can lead to shortness of breath and heart failure, has been found in people (like construction workers) who’ve had long exposures to asbestos. Lung cancer is five times more common in people exposed to asbestos and the disease risk skyrockets by a factor of 30-90x in people who also smoke cigarettes. One of the most tragic pathologic outcomes is mesothelioma, a cancer of the tissue lining the lungs or abdomen. This incurable disease often causes death within a year of diagnosis. In a study of asbestos insulation workers, 10 of 124 deaths were due to mesothelioma. In the general population, mesothelioma would only be expected to impact approximately one in 100,000 people not exposed to asbestos.
Asbestos exposure often doesn’t manifest clinically for decades. Shipyard workers who were only exposed to asbestos for a few weeks during World War II ended up developing asbestos-related disease in the 1960’s.
History
Around the world, asbestos has been used for centuries to make blankets, tablecloths, and even ancient Roman ceremonial candles. As experimentation during the 20th century revealed the fire-resistant properties of asbestos, it became a common material for firefighter uniforms, hot pads, and even automotive parts.
Peak asbestos production in the US happened in the mid-1970s. The largest producers were Arizona, California, North Carolina and Vermont.
By this time, the evidence that asbestos was harmful to human health had started to stack up. The first case of mesothelioma was reported in 1953 and a major study published in 1955 linked asbestos with cancer. Yet it wasn’t until the Clean Air Act of 1970 that asbestos was classified as a hazardous air pollutant. After more than a century, mining of asbestos (a naturally occurring material) was finally suspended in full in 2002. But that didn’t stop the US from importing it for construction materials.
In yet another demonstration that the US is not always a pioneer in advancing policy to sustain and extend human life, it took us until last Monday, March 18, 2024 to advance legislation that would finally fully ban asbestos. Over 60 countries have completely banned it already, some dating back to the 1980s. Iceland was the first in 1983. Norway followed in 1984. Even countries that people in the west tend to regard as being socially or geopolitically adverse were well ahead of the curve. Saudi Arabia banned the substance in 1998. All 28 member states of the EU had completely banned asbestos by 2005.
It’s estimated that 40,000 Americans die from asbestos-related health issues each year according to research from the Asbestos Disease Awareness Organization.
Lest we not move too quickly, the EPA’s proposed ban on white asbestos would give companies 12 years to phase out the use of the product in building materials. I’ll be 50 years old then. I hope it won’t be too late to have made a difference in my life, as someone who does a lot of residential construction work these days.
Recommendations
What is a judicious homeowner to do? I’m fearful of the casual weekend warrior who likes to tackle DIY home improvement projects prompted by the latest hit HGTV series. Scraping off the popcorn texture-sprayed ceiling could be a high-risk health disaster. Turning the vacant under-stair space into a storage closet or puppy playpen might seem innocuous to an uninformed homeowner.
At a project I’m doing in San Francisco, we brought in a testing company last fall. When the results showed asbestos throughout the two-bedroom condo, I helped hire a remediation company to complete the demo work. Through this work, I got to watch a full-scale abatement process unfold, end to end. The company sealed off air vents, set up a plastic screen at the entrance and brought in high-volume air filters for a week. All material was double bagged and taken off-site for disposal. All of the surfaces were wiped clean. But I was shocked to learn that so long as all of the work was completed in a county and state-compliant manner, that there was no post-process testing required to demonstrate that the hazardous materials were fully removed. As part of my negotiation with the vendor, I was able to secure an air test on the last day of the demo to be sure there were no circulating asbestos fibers. Typically this test would cost around $700 in Northern California. But it’s good to get this assurance before the remediation company removes their filtration system since the fixed cost of returning and setting up their containment system can be thousands of dollars.
In California, homeowners are permitted to self-abate asbestos if the area is less than 100 square feet. And like so many things, the oversight and regulation of this code is loose and impossible to enforce. Bearing that in mind, here is some guidance from the California Department of Consumer Affairs about how to stay safe when performing work in your home.
Vinyl floor tiles - Asbestos is sometimes added to vinyl tile to make them stronger. It can also be present in vinyl sheet flooring and in the adhesives used to place the flooring. Fibers can be released during scraping, sanding, and cutting. Avoid over handling or damaging these materials. It would be safer to place new materials over the old ones than trying to rip the old materials out.
Patching compounds and textured paint - In older homes, there may be asbestos-containing materials in the wall and ceiling joints from 1977 or before. Do not scrape or sand this material. If you must cut or break it apart for any reason, wetting the material first will help contain the fibers from loosening up in the air.
Ceilings - Between 1945 and 1978, many buildings were sprayed or troweled with asbestos-containing material. If the material appears damaged, it’s a good idea to test it before repairing or removing. A certified and registered asbestos abatement contractor would be the best person to help with these types of jobs.
Stove insulation - Homes with wood burning stoves may contain thermal insulation to protect the floor and walls around the stove. As asbestos paper or millboard ages and wears down, asbestos fibers can be released. Avoid sanding, drilling and sawing these materials.
Furnace insulation - Oil, coal and wood furnaces with asbestos-containing insulation and cement are still found in older homes. Converting these systems to gas or electric can damage the old insulation. If the insulation is undamaged, leave it alone.
Door gaskets - The door gaskets on furnaces, ovens and wood and coal stoves may contain asbestos. With wear, even normal-use conditions may be releasing asbestos fibers. Handle the materials judiciously.
Pipe insulation - Hot water and steam pipes are sometimes covered in asbestos-containing material to reduce heat loss. After paying for almost five-figures in asbestos removal, after the wall was opened up, we found this type of insulation in our primary bathroom shower. Somehow the air test didn’t detect the presence of any circulating fibers despite the degradation of the insulation. Heat-resistant duct tape can help reseal damage like the type I recently encountered.
Wall and ceiling insulation - Homes built between 1930 and 1950 sometimes contain insulation made with asbestos. Anything that punctures this space can disturb the materials. Don’t mess around with this and instead call upon a trained asbestos contractor.
Appliances - In recent years the prevalence of asbestos containing toasters, slow cookers, dishwashers, ovens, clothes dryers and electric blankets has declined. But it’s possible that such household items are still in use. If you suspect items in your home may contain asbestos, consider replacing the items. Any repairs should be handled by a qualified technician.
Roofing, shingles, and siding - These exterior products pose little health risk due to their outdoor use. If there is damage to siding, spray paint can help re-seal the product. Unless your roofing is damaged or in need of replacement due to normal wear, it’s wise to simply leave it in place.
Without a doubt, I’ve had repeat asbestos exposures over the last few months. While for me, it’s an occupational hazard, my greater fear is that my peer group is purchasing older homes with the hope of undertaking extensive renovation work without considering the impact to their health. Across America, there is scant education about asbestos. It’s an issue of another time period, but one that won’t haunt us until decades later. It’s long overdue that we move towards banning the use of this substance, but never too late to take the time to become better educated about how to reduce personal risks if you live in and are fixing up an older home.
As for my breath holding while I was by the dumpster? It’s probably of limited use. But I’m not taking any chances since I can’t see what’s inside. If the wind is blowing in my direction, the last thing I want is a face-full of cancer causing fibers placed by uninformed homeowners that haven’t taken the time to properly make an abatement plan. I’ve already had my fair share of asbestos fibers and I’m on a personal risk mitigation mission. Maybe you’ll join me in this crusade and vow to be extra careful as you think about tackling your to do list.