Dangers of Asbestos

Asbestos mining, which was once South Africa’s third most valuable mineral export, after gold and coal, has caused more harm than good. Asbestos is a fibrous mineral found in the crust of the earth. The main commercial advantages of Asbestos were its fire and acid resistance. Mainly used in building materials and for insulation purposes. There were over 300 applications documented over the years. South Africa held the main deposits found in the Northern Cape and North West provinces (Cape Blue or Crocidolite asbestos), Limpopo province (amosite, also known as brown asbestos, together with Transvaal Blue asbestos) and Mpumalanga province (chrysotile or white asbestos).

 Asbestos seams are mined together with attaching host rock. In earlier times any host rock attaching to the fibre was chiselled off manually to produce a clean „cob‟. Crushing and milling plants were later introduced which facilitated automatic separation of rock and dust to produce clean basic fibre. The fibre, being lighter than grit, was airlifted by a suction process and then cleaned, graded and bagged. Approximately 95 percent of the fibre produced in South Africa was exported.

 Medical evidence records that lung diseases caused by asbestos are more severe than those caused by most other minerals. In the case of asbestos related lung cancer and mesothelioma this is certainly true. Mesothelioma is a rare form of cancer which develops mainly in the lung lining or peritoneum. This disease was recognised as being caused predominantly by asbestos. Worldwide calls for the discontinuance of the use of this mineral were called for and leveraged.

 Richard Spoor a renowned SA lawyer interested in finding legal remedies for the victims affected had this to say: “There must be a special place in hell reserved for those who mined and processed this mineral knowing that thousands of the men who worked on the mines and thousands more of their family members who were exposed when their husbands brought the dust home on their work-clothes, would die a painful death”.

 South Africa has many well-known health problems, such as HIV infection and tuberculosis. The rate of silicosis among gold miners is high. Although occupational disease is neglected the world over, the burden of occupational disease is especially invisible in South Africa.

 A tremendous amount of work has been achieved by both the Kgalagadi Relief Trust and the Asbestos Relief Trust. Since their inception, R 329 528 179 in compensation has been paid to 4880 beneficiaries. Thousands of individuals exposed to asbestos have been medically screened and hundreds more victims of mesothelioma have received palliative care to ease their dying pains. Radiographers were trained, equipment furnished to public hospitals and levels of awareness of the dangers of asbestos, in the most affected areas were increased enormously.

 Naturally there is so much still to be done. Our Government through its indifference or simple lack of capacity and competence has not contributed as it should. Scores of people continue to be exposed to potentially harmful quantities of asbestos fibre across the country. The rehabilitated mines and dumps are far from being adequately maintained. Compensation legislation remains unreformed and many victims remain ineligible to be compensated under the rules of the ART and KRT trust.

 Asbestosis & Rehabilitation

Asbestosis  is a chronic inflammatory and fibrotic medical condition affecting the parenchymal tissue of the lungs caused by the inhalation and retention of asbestos fibers. It usually occurs after high intensity and/or long-term exposure to asbestos (particularly in those individuals working on the production or end-use of products containing asbestos). People who experience extensive occupational exposure to the mining, manufacturing, handling, or removal of asbestos are at risk of developing asbestosis. Sufferers may experience severe dyspnea (shortness of breath) and are at an increased risk for certain malignancies, including lung cancer. Asbestosis specifically refers to interstitial (parenchymal) fibrosis from asbestos.

In asbestosis there is scarring of lung tissue resulting from the inhalation of asbestos fibers. When such fibers reach the alveoli (air sacs) in the lung, where oxygen is transferred into the blood, the foreign bodies (asbestos fibers) cause the activation of the lung’s local immune system and provoke an inflammatory reaction. This chronic inflammatory reaction coupled with a slow ongoing progression of the immune system in an attempt to eliminate the foreign fibers. The result is interstitial fibrosis. The fibrotic scar tissue causes alveolar walls to thicken, which reduces elasticity and gas diffusion, reducing oxygen transfer to the blood as well as the removal of carbon dioxide.

The characteristic pulmonary function finding in asbestosis is a restrictive ventilatory defect. This manifests as a reduction in lung volumes. The total lung capacity may be reduced through alveolar wall thickening. In addition to a restrictive defect, asbestosis may produce reduction in diffusion capacity and arterial hypoxemia.

Mesothelioma is by a long way the worst of the asbestos related diseases. It is invariably fatal and the dying is slow and extremely painful. The sensitivity of malignant mesothelioma to chemotherapy has been poor and the agents used rather toxic. However, chemotherapy in malignant mesothelioma can be applied in a neo-adjuvant context within a surgical treatment program (extrapleural pneumonectomy, pleurectomy and decortication) or in the context of a medical treatment where no operative procedure or radiotherapy is indicated.

 There is no curative treatment for asbestosis. Oxygen therapy at home is often necessary to relieve the shortness of breath and correct underlying hypoxia. Supportive treatment of symptoms includes respiratory physiotherapy to remove secretions from the lungs by postural drainage, Nebulized medications may be prescribed in order to loosen secretions .

 Role of ozone therapy in Asbestosis

Ozone therapy enhances oxygenation of the blood and tissues. Ozone stimulates oxygen metabolism as it increases red blood cell glycolysis rate leading to stimulation of 2,3-diphosphoglycerate enzyme (2,3-DPG) . This enzyme increases amount of oxygen released to tissues. In addition ozone activates Krebs cycle leading to stimulation of production of adenosine tri-phosphate (ATP) and accordingly more energy on the cellular level.

Ozone stimulates blood circulation as it reduces clumping of red cells and restore its flexibility and oxygen carrying ability. The arterial oxygen partial pressure increases and viscosity decreases leading to better tissue oxygenation.

Ozone therapy has an anti-inflammatory action and immuno-modulating action. In addition ozone therapy leads to stimulation of the production of the enzymes which act as a free radical scavengers and cell wall protectors: Glutathione Peroxidase, Catalase, and Superoxide Dismutase This will lead to decrease the tissue reaction and decrease the fibrotic response of the lung tissue to asbestos fibers.

The outcome will lead to better oxygenation and accordingly fewer symptoms

Ozone therapy is administered by systemic application, either Major Auto-Hemo-therapy (By withdrawal of 50-100 ml of blood, adding a calculated amount and concentration of medical ozone to the blood, then re-infusing the blood again )or Rectal Insufflation (by giving a calculated amount  and concentration of medical ozone by a small Cather into the rectum). Two to three sessions per week for not less than 24 sessions. In addition ozone is administered by Minor Auto-Hemotherapy one to two times per week for not less than 12 sessions.

Asbestosis can lead to cancer lung. In this case ozone has an important role in the management.

 Ozone Therapy and Cancer

Ozone therapy in cancer is complementary, however it is very effective and it have been proven that it has the following effects:

• An anti-cancer effect. This effect is through direct oxidation to cancer cells that are devoid of the defensive anti oxidant enzymes and flourishing an aerobic medium which is not suitable for the cancer cells that grows in anaerobic medium. In addition ozone therapy stimulate of the immunity that combats cancer.
• Potentiate Chemotherapy and Radiotherapy
• Diminish the side effects of Chemotherapy and Radiotherapy being a free radical scavenger.
• Has a protective effect on normal cells including lung,  liver, kidney, heart … etc. This is achieved by antioxidant enzymes up-regulation.
• Stimulate the Immunity by increasing interleukins and interferon to the proper physiological levels.
• Stimulate the Psychological status and sense of wellbeing.
• It was found that the size of the tumor regress and the tumor markers decrease proved statistically. Also the psychological status and QUALITY OF LIFE becomes much better

Ozone therapy sessions are similar to that mentioned before. Ozone sauna can be added.

The asbestos mining industry is no longer in operation. High-profile court cases against asbestos mining companies have brought some visibility to the problem in South Africa and limited financial relief to some affected people. The scale of environmental contamination and the widespread use of manufactured products will continue to have a devastating impact on the health of South Africans. The future challenge is to develop effective public health prevention programs that go beyond technical solutions.

Ref: Asbestos Relief Trust (ART) & Kgalagadi Relief Trust (KRT); Prof. M Nabil Mawsouf – (Professor of Pain Management & Head of Ozone Therapy Unit, NCI, Cairo University. Ozone Therapy Consultant, Saltanate Of Oman. Vice President of International Scientific Committee of Ozone Therapy Madrid.