Assure 360

FAAM brings us the latest developments in the asbestos world and inspiring Mavis Nye

Written by Nick Garland on 29/11/2018
 

The inaugural FAAM (Faculty of Asbestos Assessment and Management) conference on 8 – 9 November lived up to expectation. Not just a one day seminar, this was a rigorous academic conference with internationally recognised speakers.

The asbestos conference opened with the inspiring Mavis Nye, the first mesothelioma patient to enter remission and the founder of the Mavis Nye Foundation. Her and her husband Ray, and others just like them, are the reason we do what we do and they certainly keep me going.

The keynote speaker on Friday, Dr John Moore-Gillon, shared the other side of that same story, the diseases and their treatment. He talked about his 42 years as a doctor: the first 37 years saw incremental change in treatment but the last five have seen extraordinary progress. ‘Today, there is no point in writing a textbook on cancer treatment’, he said. ‘It will be out of date before it gets to the publisher’. This was one of the stand out moments for me at conference.

Real risk assessments based on data

We were all plunged early into a fascinating talk on how to understand raw data and translate it to actual risk. As professionals, we may believe that we can do that already – but the reality is typically that we go from the readings to an assessment via opinion and experience. Some of us may go back to WHO figures – but there is a great deal of ‘us’ in the end result. Andrey Korchevskiy and Andrew Darnton brought us back to published research. They presented a simplified method of using this data to produce lifetime risk answers and the probable extra cancer cases that would result from that exposure.

Asbestos in our homes and  everyday life

Next came three related presentations:

  • Sean Fitzgerald, a respected analytical geologist from the US, – Global Issues, Asbestos in the USA
  • David de Vreede (Center of Expertise for Asbestos & Fibers in Holland) – Asbestos found in cosmetics
  • Yvonne Waterman and Jasper Kosters (European Asbestos Forum) – Asbestos imports into Europe

All three had enormous detail and on the surface were very different, but they had a common thread running through them.

Talc.

The scandal in the US has, ridiculously when we think about it, seemed so far away, almost not real. But running through all of these talks was the fact that the mineral talc is formed by exactly the same geological conditions as asbestos is. This means that most, if not all talc mines, also contain asbestos to a greater or lesser degree. The risk is recognised to an extent by the mines and quality control put in place to eliminate the contaminant. However, the techniques used are woefully inadequate resulting in an erroneous clean bill of health.

If we look as Sean Fitzgerald does with transmission electron microscopy (TEM), or scanning electron microscopy (SEM) the story is very, very different. He illustrated that with a modified preparation technique, the very fine fibres that are invisible to the standard technique are revealed.

All three talks discussed the global nature of the talc mining industry and consequently how much of the talcum powder in the world is contaminated with asbestos.

David De Vreede talked about his campaign to highlight the dangers of asbestos in talc. He was instrumental in alerting the EU to asbestos found in some of Claire’s products. The EU subsequently sent out a recall of those products back in April.

Yvonne Waterman and Jasper Kosters continued the theme of the inadequacy of standards and testing of talc used in Europe.

I guarantee everyone there was thinking about the cosmetics in their hotel room and back home.

Is asbestos ever not asbestos?

John Addison (the John Addison) came next with his talk on amphiboles. This left me with more questions than answers – as a 30 minute talk on such a broad subject will inevitably do. Rather than there only being five amphibole species – there are in fact over 100 – and these are just the ones catalogued by Mindat.com. All of these can cleave, causing elongated fibres in the respirable range. But does this make them asbestos?

Asbestos or ‘asbestiform’ is a term we use to describe the capacity to produce hazardous fibres. The definition is as follows:

  • a range of aspect ratios ranging from 20:1 to 100:1 (or higher); 
  • capability of splitting into very thin fibrils;
  • two or more of the following:
    • parallel fibres occurring in bundles;
    • fibre bundles displaying frayed ends;
    • fibres in the form of thin needles;
    • matted masses of individual fibres; and/or
    • fibres showing curvature.’

Then comes birefringence. Summarised brutally – when we pass light through a mineral suspended in special fluids, we see different colours depending on the direction that light passes through it. When specific colours are observed this is the final evidence we need for identification. Here would be a ‘positive result’ for chrysotile (Taken from HSG248).

John argues that the key test that is not always performed in the lab is durability – can the fibres be bent without breaking them – or does it splinter like bamboo? If it can’t, then even if the birefringence indicates ‘asbestos’ then John would argue that it isn’t.

However regular analytical laboratories would not have the skills, never mind the accreditation, to positively identify these rare species.

He also added that most of the soil in the midwestern states of the US contain amphibole minerals (from the last ice age). John posed the question – if they all qualified as asbestos,- where are the bodies?’

I’m not sure where that leaves us, but I am certainly going to look further.

Why PCL is still a critical tool in the asbestos analyst’s box

The morning of the second day ran through analytical techniques – Phase Contrast Light Microscopy (PLM), Scanning Electron Microscopy (SEM) and it’s big brother Transmission Electron Microscopy (TEM). In talk after talk we had been told how inferior PLM was to either of the two electron methods. But, the speed of the test and the relative cheapness means that many more instant tests can be made.

Building on this, Jean Prentice reminded us all of why PLM was selected in the first place and where it sits in the analyst’s toolbox. I started my career in the early 90s. My mentor at the time still referred to visual inspections as being relatively new, before that the analyst only had an air test to pass or fail some work. Unsurprisingly, as all enclosures were dripping wet, many filthy enclosures (in the absence of a visual) would pass first time. The HSE’s position is that the most important part of the Four Stage Clearance (4SC) is the visual. Get that 100% right and the air test will probably be OK. A key feature of the airtest is therefore the speed of response. Within an hour or two of starting a PLM test, the analyst knows whether there is a problem or not. Being secondary, it is merely a final indicator on whether something has been missed in the cleaning process.

What is the purpose of the 4SC? Jean reminded us that it is in reality a quality control check on the LARCs cleaning. It is not intended as an absolute measure of how much asbestos has been left in the area – there should be none. She asked the question – would increasing the sensitivity of the air test improve standards? Would lavishing more time and money by moving to SEM analysis help? Or would this distract us from the more important stage – the visual? Something I had lost track of and represented a moment of clarity for me.

An inspiring closing keynote from Moore-Gillon

Dr John Moore-Gillon, the keynote speaker, who closed this asbestos conference, was truly inspirational. He built up his presentation, giving us real insights into the various asbestos-related diseases and the seemingly insurmountable challenges they present. The sheer scale of a developed mesothelioma tumour is daunting.

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