2010 House Staff Briefing


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  • I’ve been a business manager and executive for nearly 4 decades. My career has spanned the aerospace/defense, electric power, electronic communications, and biomedical devices industries. I’ve directly managed nearly all functions of business. I’m currently co-founder and chief operating officer of C8 MediSensors, a medical device startup. I hold bachelor’s and master’s degrees in mechanical engineering from Caltech, and a master’s degree in business administration from Golden Gate University. I have also been treated for peritoneal or abdominal mesothelioma, caused by asbestos exposures. In response, I engage in philanthropy and public advocacy toward ending asbestos poisoning, improving medical treatments, and maintaining and strengthening the legal rights of victims and their families.
  • My documented exposures to asbestos were from my father’s occupation, home repair work that I performed, and my work as an engineer in the aerospace and power industries. My original treatment included extensive surgery and chemotherapy. I had a recurrence in 2006 and am currently undergoing diagnosis of a new suspicious mass. The direct medical expenses for my treatment have reached nearly a half-million dollars. In addition, I’ve lost over 6 months of work time in recovery from treatments, and hundreds of hours in medical examinations, consultations, tests and follow-ups. I have already survived longer than the median survival for my cohort of patients, so I’m on borrowed time. I feel that my duty is to do as much good as I can with the time I have left. I’m going to address the business case for prohibiting asbestos-containing products in the US, to the extent of describing the factors that ought to be important to Congress.
  • Patients of asbestos-related diseases and their families incur enormous economic impacts. Medical expenses can be huge by the time a patient dies. Much of the total is not covered by Medicare or other insurance. Patients lose productive time to diagnosis, treatment and follow-ups, and considering that many are struck in their 50s or even earlier, many work years are lost to experienced, productive employees. Most suffer some level of disability. Considering that we lose at least 10,000 people each year to asbestos-related diseases, and that there are currently some 30-40,000 Americans suffering from such diseases, it’s easy to see that the overall economic impact to families is substantial. Even caregivers within families often must give up work time and sometimes their own jobs. Some families are left destitute in the end. And we know of families that are struck over generations, such as the woman I knew who died of mesothelioma, as did her father and grandfather, both of whom were shipyard workers. Here’s a rather staggering thought: A scaling of worldwide data on asbestos-related diseases from the World Health Organization suggests that every year, the US loses about 150,000 total person-years of potential life due to premature mortality and actual person-years of productive life due to disability.
  • Asbestos-related diseases lead to huge costs for businesses attempting to defend themselves in criminal or civil courts. Businesses often incur substantial costs for removal of asbestos from buildings, and the work is often done improperly, leading to additional direct and indirect costs. One recent investigation in Texas indicated that about 90% of abatements were done improperly. Businesses lose the productivity of employees struck with asbestos-related diseases, and they suffer increased premiums for workers’ compensation and medical insurance. These costs adversely impact job creation within the operational segments of businesses. However, within this challenge lurks a great opportunity: Prohibiting asbestos-containing products would create productive jobs, because thousands of products would have to be reformulated or replaced, and manufacturers and marketers would be freed to divert investment from legal defense and compliance to growing their businesses, while fewer and fewer workers would be brought down by asbestos-related diseases.
  • Asbestos-related diseases cost the Federal and state governments in the form of benefits for medical care, disability, and other workers’ benefits. The continuing presence of asbestos in products in commerce increases the costs of regulatory enforcement at the Federal and state levels. Federal and other government agencies also incur asbestos abatement costs for public buildings. We all are aware of the enormous problem right here in the Capitol tunnels. Beyond these costs, a burden is placed upon the criminal and civil justice systems.
  • I assert that there is a strong business case in favor of Federal investment to prohibit asbestos-containing products, to support related public education and awareness so as to mitigate exposures from existing products, and to provide effective incentives for regulatory compliance. The direct return to the Federal Government on this investment would be quite favorable, based on reducing Federal benefits payments and operational costs, and extending the productive working years of individuals. Perhaps more importantly, such an investment would lead to the creation of private-sector jobs in the replacement of asbestos as a product ingredient and in eliminating asbestos as a product contaminant. These jobs would range from factory labor, to engineering, to marketing and sales, to other business functions.
  • 2010 House Staff Briefing

    1. 1. “Asbestos Impact on Public Health, Environment and Economy” June 15, 2010 Linda Reinstein, Co-Founder Asbestos Disease Awareness Organization (ADAO) linda@adao.us www.adao.us6.15.2010 - Reinstein
    2. 2. U.S. House of Representatives Staff Briefing Speakers Linda Reinstein, Asbestos Disease Awareness Organization Richard A. Lemen, PhD, MSPH, Assistant Surgeon General, USPHS (ret.) Celeste Monforton, DrPH, MPH, immediate past chair, Occupational Health & Safety Section, American Public Health Association Brent Kynoch, Environmental Information Association Barry Castleman, ScD, Environmental Consultant John Walke, National Resource Defense Council Paul Zygielbaum, MS, MBA, Business Executive and Mesothelioma Patient6.15.2010 - Reinstein
    3. 3. Dedicated to Young Mesothelioma Victims6.15.2010 - Reinstein
    4. 4. Alan Reinstein, former ADAO President Pleural Mesothelioma Victim May 2005 May 20066.15.2010 - Reinstein
    5. 5. Asbestos is a proven human carcinogen and there is no safe level of exposure.6.15.2010 - Reinstein
    6. 6. How small is asbestos? 2-3 rice grains 20,000 Asbestos Fibers 5-6 human hairs6.15.2010 - Reinstein
    7. 7. Environmental and Occupational Exposure Continues6.15.2010 - Reinstein
    8. 8. Exposure Continues from Libby, the U.S. Capitol Tunnels and WTC6.15.2010 - Reinstein
    9. 9. www.adao.us6.15.2010 - Reinstein
    10. 10. Richard A. Lemen, Ph.D. Assistant Surgeon General, U.S.P.H.S. (ret.) 15 June 2010
    11. 11. What Happens to Asbestos in the Respiratory System Nose Filters out fibers >100µ long Cilia Clears mucus (and fibers) from lung Lung Ca Free Alveolar Macrophages (FAMs): Phagocytize fibers within Mesothelioma lungBy R.A. Lemen
    12. 12. Are Asbestos-Related Diseases a Pandemic? A pandemic is the excessive occurrence of a disease in a large portion of the worldH1N1 Pandemic Asbestos-related diseases 14,142 Deaths worldwide  More than 90,000* Deaths worldwide each year  More than 10,000 Deaths in the U.S. each year***90,000 is probably an underestimate because it doesn’t include othercancers (e.g. Larynx and Ovary)**WHO 2009, Update 84
    13. 13. Asbestosis deaths increased 20-fold from 1960s to 1990s and are continuing 1600 Number of Asbestosis Deaths 1400 1200 ICD-10 ICD-9 1000 ICD-8 800 600 400 200 0 68 70 72 76 80 82 84 88 92 94 96 00 04 74 78 86 90 98 02 20 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 19 20 20From: NIOSH
    14. 14. Relative Inhalation Toxicity of Chemicals Listed in the EPA’s Toxic Release Inventory Asbestos (friable) (1332-21-4) Known Carcinogen 1,000,000 Benzidine (92-87-5) Known Carcinogen 480,000 Bis(chloromethyl) ether (542-88-1) Known Carcinogen 440,000 N-Nitrosodiethylamine (55-18-5) Known Carcinogen 310,000 Propyleneimine (75-55-8) Known Carcinogen 300,000 N-Nitroso-N-ethylurea (759-73-9) Known Carcinogen 280,000 Diisocyanates (N120) Non-Carcinogen 180,000 N-Nitrosodimethylamine (62-75-9) Known Carcinogen 100,000 Acrolein (107-02-8) Non-Carcinogen 90,000 Cadmium and cadmium compounds (7440-43-9) Known Carcinogen* 90,000 Chromium and chromium compounds (7440-47-3) Known Carcinogen 86,000 Polybrominated biphenyls (PBBs) (N575) Known Carcinogen* 71,000Toxicity weight: is a proportional numerical weight applied to a chemical based on its toxicity. The toxicity ofa chemical is assessed using EPA-established standard methodologies. For each exposure route, chemicals areweighted based on their single, most sensitive adverse chronic human health effect (cancer or the mostsensitive noncancer effect). In the absence of data, the toxicity weight for one pathway is adopted for theother pathway. The range of toxicity weights is approximately 0.01 to 1,000,000.
    15. 15. Celeste Monforton, DrPH, MPH Occupational Heath and Safety Section American Public Health Association
    16. 16. Impact of Asbestos Exposure on Public Health: Worker Health and Safety The exposure limit to protect workers from disease and disability is inadequate. The US Dept of Labor Occupational Safety and Health Administrations (OSHA) standard to protect asbestos-exposed workers was issued in 1994. At the current exposure limit, an estimated 6 out of 1,000 workers exposed over their working life will still develop cancer and  5 out of 1,000 will develop asbestosis. This same exposure limit was adopted in 2008 by the US Dept of Labor Mine Safety and Health Administration (MSHA).
    17. 17. Impact of Asbestos Exposure on Public Health: Worker Health and Safety  Producers of construction aggregate, represented by the National Stone, Sand and Gravel Association (NSSGA), argue that only some mineral fibers are harmful to health. *  A peer-reviewed intelligence bulletin prepared by CDCs National Institute for Occupational Safety and Health (NIOSH), however, indicates that exposure to thoracic-size elongate mineral particles (EMPs) should be eliminated or effectively controlled.** * NSSGA. Accurate Definition of Federally Regulated Minerals, http://www.nssga.org/government/Position_Paper/fedmin.html. ** US Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. NIOSH Current Intelligence Bulletin: Asbestos Fibers and Other Elongate Mineral Particles: State of the Science and Roadmap for Research, Version 4 (draft), January 2010.
    18. 18. Impact of Asbestos Exposure on Public Health: Worker Health and Safety  Research on occupational and community exposures to EMPs and health outcomes are needed, but conduct of toxicological and epidemiological should not forestall action to protect public health today.
    19. 19. J. Brent Kynoch Managing DirectorTHE ENVIRONMENTAL INFORMATION ASSOCIATION 6935 Wisconsin Ave, Chevy Chase, MD 20815 888-343-4342 www.eia-usa.org “our multi-disciplinary membership collects, generates and disseminates information about environmental issues in buildings and facilities” THE ENVIRONMENTAL INFORMATION ASSOCIATION
    20. 20. DefinitionsASBESTOS-CONTAINING PRODUCT (ACP): Any product (including any part) to which asbestos is deliberately added or used, or in which asbestos is otherwise present in any concentration less than 1% by weight. (from S. 742)ASBESTOS-CONTAINING MATERIAL(ACM):Any material or product which contains morethan 1% asbestos.(from TSCA, Subchapter II, AHERA) I T E HE A NVIRONMENTAL NFORMATION SSOCIATION
    21. 21. Asbestos-Containing Products Numerous studies have concluded that significant exposures can occur from materials that are less than 1% asbestos. These materials are not regulated. South Carolina Dept. of Health and Environmental Control study – wet methods for demolition of non-ACM still showed exposures. THE ENVIRONMENTAL INFORMATION ASSOCIATION
    22. 22. Enforcement  By EPA’s own admission, enforcement is “dismal.”1  Existing regulations are sufficient to protect worker and environmental health.  Budgets continue to be cut, but “encouragement” could be pushed downhill.1. Presentation of Glen Schaul, USEPA, at EIA Conference 3/28/06 THE ENVIRONMENTAL INFORMATION ASSOCIATION
    23. 23. Enforcement Issues  Marco Island, FL – June 5, 2010 settlement.1. Presentation of Glen Schaul, USEPA, at EIA Conference 3/28/06 THE ENVIRONMENTAL INFORMATION ASSOCIATION
    24. 24. Enforcement Issues  Marco Island, FL – June 5, 2010 settlement - $81,772 – neither contractor nor city take liability  New York convictions – June 9, 2010 Paul Mancuso, Steven Mancuso and Lester Mancuso – jail time and fine. Repeat offender.1. Presentation of Glen Schaul, USEPA, at EIA Conference 3/28/06 THE ENVIRONMENTAL INFORMATION ASSOCIATION
    25. 25. Two points EPA enforcement is dismal; violations continue. Abatement contactors know the likelihood of getting caught is slim, so new and ingenious ways of breaking the law continue. Violations mean exposures. Exposures mean disease. Disease means death. By prohibiting the import, manufacturing, distribution, and processing of asbestos in the US, eventually we will stop the exposures, the disease, the deaths, the cost of abatement of these materials, and the cost of disposal of these materials. THE ENVIRONMENTAL INFORMATION ASSOCIATION
    26. 26. Barry Castleman, ScD Environmental ConsultantUS Asbestos Product Imports and Contaminant-Asbestos
    27. 27. U.S. Imports of AsbestosImports of Asbestos- 2009 USGS Imports Cement Products  A-C Products • (10,600 tons)  Gaskets, packing, & seals • (244 tons)  Paper, millboard, and felt • (~ $200k China)  Jointing • ($420k Mexico)  Brake linings & pads • (~$2.2 M China & India)  Mixtures of asbestos and magnesium carbonate • (33.6 tons Mexico)
    28. 28. ADAO Product Testing5 Products contaminated with asbestos Monitoring Needed Once a ban is enacted, the US will need to analyze imported products so that Americans will not be endangered by unlabeled asbestos products which may already be coming in (violating OSHA regulations).
    29. 29. Substitutions No U.S. manufacturers make asbestos brake pads, gaskets, and A-C pipes. Banning imports of these asbestos products protects U.S. workers and companies. Non-asbestos diaphragms and membrane cell technology are alternatives to discredited asbestos diaphragm and mercury cell technology.
    30. 30. Contaminant Asbestos in Stone and Minerals NIOSH is looking into contaminant asbestos in talc, stone, & other minerals. Ban legislation can provide support and research funding for continuing efforts. The California Air Resource Board (CARB 435) limit of 0.25% asbestos in stone and gravel should be able to be met nation- wide.
    31. 31. 52 Countries Banned Asbestos *exemptions for minor useArgentina Denmark Ireland New Caledonia SloveniaAustralia Egypt Italy Norway South Africa Austria Estonia* Japan Oman Spain Bahrain Finland Jordan3 Poland SwedenBelgium France Korea (South) Portugal* Switzerland Brunei Gabon Kuwait Qatar Taiwan UnitedBulgaria Germany Latvia Romania Kingdom Chile Greece* Lithuania* Saudi Arabia UruguayCroatia2 Honduras Luxembourg SeychellesCyprus* Hungary* Malta* Singapore Czech Iceland Netherlands Slovakia*Republic*
    32. 32. John WalkeNational Resource Defense Council
    33. 33. Toxic Substances Control Act The Toxic Substances Control Act (TSCA) is broken and needs to be comprehensively reformed; asbestos is the poster-child for how TSCA is broken.
    34. 34. Toxic Substances Control Act The TSCA "discussion draft" contains numerous provisions that would dramatically improve the EPAs ability to regulate asbestos. However, regarding chemicals for which we already know enough about, including asbestos, it is not enough just to allow EPA to take action. Instead Congress should direct EPA to take specific action on asbestos and set a deadline, without waiting for additional assessment of the safety of asbestos.
    35. 35. Economic Impacts ofAsbestos-Related Disease Paul S. Zygielbaum, MS, MBA Business Executive Peritoneal Mesothelioma Patient
    36. 36. Asbestos and Me Exposures: occupational, para-occupational, household Malignant peritoneal mesothelioma: diagnosed 2004 10-hour surgical debulking and chemotherapy 2004 Surgery for recurrence 2006 Currently under diagnosis for possible recurrence Direct and indirect medical expenses nearly $500,000
    37. 37. Economic Impacts: Patients and Families Medical costs often exceed $1 million • Many patients and families bear substantial portions • Many cases of insurers dropping coverage Occupational disruption • Disability • Lost jobs: patients and/or caregivers Family financial devastation • Many families left destitute upon patient’s death • Sometimes multi-generational impact
    38. 38. Economic Impacts: Businesses Criminal justice and civil litigation costs • Defense of intentional “failure to warn” • Defense of inadvertent contamination or violations • Verdicts and settlements Abatement costs • Normal costs for proper abatement • Remediation costs for improper abatement Operational and overhead costs • Lost productivity and jobs • Increased workers’ compensation premiums • Increased medical insurance premiums
    39. 39. Economic Impacts: Government Federal benefits • Medicare • Social Security disability payments • Workers benefits Regulatory enforcement costs • EPA/OSHA compliance verification • Prosecution of improper abatement • Hazardous waste disposal Abatement costs • Schools and other public buildings across the nation • United States Capitol
    40. 40. Economically Sound Strategy Federal investment • Prohibit asbestos-containing products • Support public education and awareness • Incentivize regulatory compliance Return on investment • Job creation • Decreased Federal benefits • Decreased operational costs
    41. 41. Questions & Answers www.adao.us