ASBESTOS AWARENESS

1. ASBESTOS AWARENESS Pharmacy 557 Public Health Service Learning Project 2005 Jessica Sholey Rebecca Mattson Mary Beth Borgstadt Rosanne Erickson Rob Nilsson Kyle Austin Catherine Matthews

2. Course Contacts This slide show was created as part of a service learning project for students enrolled in a pharmacy course at the University of Montana. The course instructor was Dr. Jean Carter and the project supervisor was Dr. Elizabeth Putnam. For questions about the project contact Dr. Putnam at elizabeth.putnam@umontana.edu

3. HEADLINES • Louisiana Jury Awards $4.5 Million in Asbestos-Related Death Case http://www.asbestos-issues.com

4. HEADLINES • Railroad Worker's Estate, Family Win $11.43 Million in Asbestos Suit http://www.asbestos-issues.com

5. HEADLINES • Asbestos Spread Following Sawmill Fire in Montana http://www.asbestos-issues.com

6. HEADLINES • Health-care administrator to Libby residents: “You're not so sick.” http://www.asbestos-issues.com

7. What is Asbestos? • Friable • Detectable only with a microscope • Mineral Fibers • Long & Thin • Strong • Flame/Heat resistant • Durable http://www-admn.csun.edu/ehos/safeshop/ASBESTOS%20AWARENESS.ppt http://www.atsdr.cdc.gov/asbestos/asbestos_whatis.html http://www-admn.csun.edu/ehos/safeshop/ASBESTOS%20AWARENESS.ppt

8. Is Asbestos Still Around? • New uses banned in 1989 • Damage to structures • Fibers become airborne • Siding and Roofing • Cement • Insulation • Gaskets • Friction products – brake pads http://www-admn.csun.edu/ehos/safeshop/ASBESTOS%20AWARENESS.ppt http://www-admn.csun.edu/ehos/safeshop/ASBESTOS%20AWARENESS.ppt

9. Asbestos is inhaled, how do fibers get into the air? • When asbestos is disturbed particles can become airborne • Asbestos is most dangerous when friable • Friable means it can be easily crushed or crumbled http://www.trine-metcalf.com/asbestos/scarring.html

10. Health Hazards of Exposure • High blood pressure in your lungs • Heart problems • Asbestosis • Lung Cancer • Malignant Mesothelioma • Progressive Respiratory Insufficiency • Other cancers

11. Health Hazards of Exposure - Pulmonary Hypertension • Arteries of the lung become blocked or narrow due to asbestosis-related scar tissue. http://chickscope.beckman.uiuc.edu/explore/embryology/day15/alveoli.gif http:www.nlm.nih.gov/medplus/ency/imagepages/9596.htm

12. Health Hazards of Exposure -Heart Problems – Cor Pulmonale • Excess pressure in the lungs causes the right ventricle, which is responsible for bringing the oxygen poor blood into the lungs, to work harder to pump the blood. • Causing the right ventricle to weaken and possibly fail. http://health.allrefer.com/health/cor-pulmonale-cor-pulmonale.htl

13. Health Hazards of Exposure • High blood pressure in your lungs • Heart problems • Asbestosis • Lung Cancer • Malignant Mesothelioma • Progressive Respiratory Insufficiency • Other cancers

14. Health Hazards of Exposure -Asbestosis • Chronic, non-cancerous • Progressive • Leads to disability or death • Asbestos fibers cause the lung tissues to scar, scarring spreads making it harder to breathe • Symptoms – shortness of breath, a cough, blood in fluid coughed up from lungs, pain in chest or abdomen, significant weight loss, difficulty swallowing http://www.meso-lungcancer.com/ASBillnessess.htn

15. Health Hazards of Exposure • High blood pressure in your lungs • Heart problems • Asbestosis • Lung Cancer • Malignant Mesothelioma • Progressive Respiratory Insufficiency • Other cancers

16. Health Hazards of Exposure -Lung Cancer • Lung cancer causes the largest number of deaths related to asbestos exposure • The risk can be 90 times higher if you smoke and have asbestos exposure. http://www.meso-lungcancer.com/ASBillnessess.htn

17. Health Hazards of Exposure • High blood pressure in your lungs • Heart problems • Asbestosis • Lung Cancer • Malignant Mesothelioma • Progressive Respiratory Insufficiency • Other cancers

18. Health Hazards of Exposure - Mesothelioma Mesothelioma • a rare form of cancer of the lining of the lungs, chest and abdomen. • it spreads very quickly and eventually the patient cannot breathe. • it is painful and always fatal. http://www.meso-lungcancer.com/ASBillnessess.htn

19. Health Hazards of Exposure • High blood pressure in your lungs • Heart problems • Asbestosis • Lung Cancer • Malignant Mesothelioma • Progressive Respiratory Insufficiency • Other cancers

20. Health Hazards of Exposure - Other Cancers Fibers can enter the mouth and be swallowed causing cancers in the: • Esophagus • Larynx • Oral cavity • Stomach • Colon • Kidney • This can happen if you are careless with food and drinks in contaminated areas. http://www.poy.org/59/16/1601plonb02.html

21. Who is at Risk? • Nearly everyone is exposed to asbestos • Brief exposure probably won’t cause harm • Most illness caused by regular exposure, at a job or through substantial environmental contact • Paraoccupational exposure – exposure to asbestos fibers brought into homes on shoes, clothing, skin and hair of workers http://www.atsdr.cdc.gov/asbestos/libby_gallery/frameset.html

22. Libby, Montana http://en.wikipedia.org/wiki/Libby,_Montana

23. Libby, Montana • Mining began in 1920 • W.R. Grace 1963-1990 • Vermiculite Mines • Found in ores and rocks • 1979-1998 • Libby mortality rates: 40 times higher than the rest of Montana and 60 times the national rate • 1999 • EPA begins to respond to local health concerns • ATSDR sets up a screening center in Libby http://www.atsdr.cdc.gov/asbestos/vermiculite_overview.html

24. What’s different about Libby? • Most vermiculite does not contain detectable levels of asbestos…the vermiculite in Libby does • Vermiculite “pops” when heated • Libby supplied 80% of vermiculite used worldwide • Libby sits in the Kootenai River Valley • Environmental exposure a significant cause of the illness in Libby http://www.atsdr.cdc.gov/asbestos/libby_gallery/frameset.html

25. Prevention • Avoid exposure Identify asbestos – kits, professionals Have it removed or contained Stay away if friable • Stop smoking, avoid 2nd hand smoke, pulmonary sensitizers and irritants • Get regular medical care http://www.poy.org/59/16/1601plonb05.html http://www.sign.co.za/P1.htm

26. Diagnosis • Abnormal lung function – crackles with stethoscope • Chest X-ray • CT Scan • Biopsy • History of Exposure http://www/shands.org/health/imagepages/1628.htm http://www.strokecenter.org/pat/diagnosis/ct.htm

27. Treatment Non-malignant disease - Asbestosis: • No cure • Treatment involves preventing further complications and treating the symptoms • Prevent further exposure • Stop smoking!!!! • Vaccinations – flu and pneumonia • Medications – hypertension, blood thinners, pain • Supplemental oxygen – makes breathing easier • Lung transplant

28. Treatment • Malignant disease: • Resection (surgical removal of a part) • Chemotherapy • Radiation http://www.ucsf.edu/dpsl/image/chemo2.jpg http://www.fotosearch.com/ARP105/op_room

29. Fact or Myth? You can tell that a material contains asbestos just by looking at it.

30. Fact It is not possible to tell if something contains asbestos just by looking at it. The only way to tell for sure if a material contains asbestos is to have a sample of it tested at a lab.

31. Fact or Myth? A common end result of asbestos related disease is difficulty breathing.

32. Fact or Myth? The symptoms of asbestos disease will begin to appear immediately or soon after exposure.

33. Fact The latency period for the development of asbestos disease is generally 10-40 years after the initial exposure.

34. References Agency for Toxic Substances and Disease Registry. Asbestos exposure and your health (2003). Available: http://www.atsdr.cdc.gov/asbestos/index.html. Accessed October 1, 2005. Agency for Toxic Substances and Disease Registry. Asbestos exposure in Libby, Montana (2005). Available: http://www.atsdr.cdc.gov/asbestos/asbestos_study.html. Accessed October 1, 2005. U.S Environmental Protection Agency. Libby asbestos (2005). Available: http://www.epa.gov/region8/superfund/libby/. Accessed October 1, 2005. U.S Environmental Protection Agency. Mortality in Libby, Montana, 1979-1998(2003). Available: http://www.atsdr.cdc.gov/asbestos/mortality_in_libby.html. Accessed October 2, 2005. Asbestos Awareness Training. Available: http://www-admn.csun.edu/ehos/safeshop/ ASBESTOS%20AWARENESS.ppt. Accessed October 1, 2005. Asbestos – An overview of properties, health effects and WISHA rules. Available: http://wisha-training.Ini.wa.gov/training/presentations/asbestos/pps. Accessed October 1, 2005. Asbestosis (2005). Mayo Clinic Web Site. Available: http://www.mayoclinic.com/invoke.cfm?id=DS00482. Accessed October 3, 2005. Asbestos & Libby Health (n.d.). Available: http://www2.umt.edu/libbyhealth/default.htm. Accessed October 5, 2005. Asbestos Poisoning and Cancer News (n.d.). Available: http://www.asbestos-issues.com. Accessed October 16,2005. American Heart Association, Pulmonary hypertension. Available at: http://www.americanheart.org/presenter.jhtml?identifier=11076 Accessed October 27, 2005. MedlinePlus Medical Encyclopedia. Cor pulmonale. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000129.htm Accessed October 27, 2005. The Wllness Community. What is lung cancer? Available at: http://www.thewellnesscommunity.com/programs/frankly/lung/understanding/what_is_lung.asp. Accessed October 27, 2005. Lung Cancer. Mesothelioma, cancer of the lung lining. Available at : www.cancer.gov/cancertopics/factsheet/Sites-Types/mesothelioma. Accessed October 27, 2005.