Asbestos Diseases Society of Victoria: Submission to the Asbestos Management Review

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1 Asbestos Diseases Society of Victoria: Submission to the Asbestos Management Review 1. Introduction The Asbestos Diseases Society of Victoria (ADSVIC) is a volunteer run, registered, not-for-profit organisation which provides peer- based support for people who have been diagnosed with an asbestos related disease, their carers, families and friends, and bereaved carers, families and friends. We also provide community education and advocacy campaigns with the aim of preventing future asbestos exposure and illness. In examining the issues paper provided by the Asbestos Management Review, we have decided to take the option of a separate submission as this best enables us to state our views on the treatment, care and support of those suffering with asbestos related diseases and their families and carers and also comment on issues related to education, awareness and advocacy. The effectiveness of people living with asbestos related disease as educators who raise awareness is well understood and respected in Victoria and other states where bodies such as ours are actively engaged in both support and prevention. Before dealing with other matters, ADSVIC fully supports the conclusions of the National Summit that took place in Sydney in This unique event, which brought together 11 asbestos support groups and the union organisations, passed a national declaration Towards an Australian Safe Asbestos Environment. The central plank of this declaration was the aim of eliminating asbestos related disease by 2030 and the creation of a National Asbestos Authority to bring this about. The role of the national body could include coverage of treatment, care and support issues in addition to its role in developing a strategy to safely remove asbestos from the Australian environment. In regards to this latter aim ADSVIC supports the need for a national audit of asbestos and ACMS in the built environment. The need for this has been emphasised by recent research in Western Australia on asbestos disease and home renovation. 2. Taking a Public Health Perspective We suggest a public health perspective is relevant to the issues involved with exposure to asbestos in Australia. The combination of the high levels of asbestos in the built environment and elsewhere, and the ignorance surrounding the threat to health involved makes this essential. Aspects of a public health perspective we would focus on are: Public awareness and education programs Education initiatives aimed at specific groups 1

2 Treatment, care and support Targeted research interventions 2.1 Public Awareness and Education Programs Given the level of risk from asbestos in Australia it is surprising that there has never been a major public awareness program. Now that the threat from asbestos has widened from the workplace to the home (home renovation) and public buildings (schools and hospitals) and the environment (illegal dumping and old mining sites), the public has a right to know of the risks they may encounter. Currently there is a major TV campaign on the dangers of smoking linked to a web page (www.meetmick.org.au), which involves a 49 year old man with emphysema. There has never been such a campaign around asbestos. While it might be argued that the threat from smoking is more widespread, the deaths and disability from ARD are significant and will increase over the next twenty years. In addition to the 600+ people who contract mesothelioma each year, there is a larger number of cases of lung cancers where asbestos is a factor. Awareness is a critical factor for people at risk and a government funded awareness campaign is now essential. This is particularly true as some groups, such as home renovators, have little or no knowledge of asbestos exposure. In the ADSVIC support group there is one participant who contracted mesothelioma through dismantling an asbestos shed with her father many years ago. There was little information available to the public at that time on the risks involved and our fear is that little has changed since. People living with ARD can play an important role in specific awareness and education programs, and asbestos support and awareness groups need access to funding to fulfil their contribution. ADSVIC supports the development of coalitions and partners. We find the current asbestos awareness week gives us an opportunity to work with other groups, but has limitations. A more focused and continuous program of awareness raising and education is needed and ADSVIC and other support groups around Australia would be happy to participate. 2. Educating Specific Groups a) Construction and Maintenance Workers As the issues paper points out, there are a number of formal training programs for tradespeople and apprentices that deal with the risk associated with asbestos exposure. ADSVIC believes that there should be a national audit of the training provided to these groups, who are particularly at risk. Employer based and union based training need to be included in this audit. This audit should be used to design a series of evaluations of the coverage and effectiveness of this training. The Safe Work Australia study indicates that coverage and effectiveness of current training does not necessarily lead to appropriate precautions being taken at work. An ADSVIC management committee member who works in the TAFE sector has advocated that the dangers of handling asbestos is taught to apprentices, with little success. There are a large number of TAFES and RTOs involved in apprentice 2

3 training and it is difficult to ascertain whether they all deal adequately with the asbestos issue. One possibility would be to make a unit dealing with asbestos safely mandatory for the relevant trades. b) The Education of Construction and Maintenance Management While it is appreciated that there are specific regulations in the construction and maintenance industry for employers, it should not be assumed that that there is full compliance with these regulations. It also seems to be the case that the advice and guidelines given to workers can downplay the risks involved in handling asbestos. Here are two quotations from advice given to workers in the domestic plumbing industry by a major supplier and installer. Many thousands of people have been killed and maimed over the years as a result of direct exposure to asbestos. However these diseases are believed not to have occurred as the result of acute (i.e. short term) exposure to low concentrations of airborne asbestos fibres. Asbestos fibres are strongly bonded into the matrix of asbestos cement products and even in broken pieces the fibres are difficult to remove and have little or no chance of becoming airborne as respirable fibres. Statements such as these are both irresponsible and wrong. It is now generally accepted that no exposure to asbestos fibre is the only sure way of preventing asbestos related disease. ADSVIC believes that an area of specific focus should be the advice given by management to people working and still at risk. C) Home Renovators Home renovation is an area of specific concern. This is often referred to as the third wave of asbestos related disease. Recent research carried out in Western Australia has concluded that: Malignant Mesothelioma (MM) after exposure to asbestos during home renovation is an increasing problem in WA and these cases seem to have a shorter latency period than other types of exposure. MM cases related to renovation will probably continue to increase, because of the many homes that have contained and still contain asbestos building products The increase in non-industrial cases has also been noted by legal firms dealing with compensation cases. Margaret Kent who is practice group leader in asbestos litigation at Slater & Gordon has noticed a gradual and very discernable trend in the nature of asbestos exposure. The decrease in occupationally exposed people and the increase in nonoccupationally exposed people have been very obvious. Once upon a time most 3

4 people who called us would be occupationally exposed and that is not the case anymore She goes on to refer to cases of exposure in the general environment, bystander cases and home renovation. A survey carried out by ADSVIC and the Victorian Trades Hall at a safety reps Conference in October 2010 highlighted how common it was for people not to take precautions when dealing with home renovations. 19% of a sample of 295 safety reps had encountered asbestos when carrying out renovations, but slightly more than a third had taken no precautions. This third wave emphasises again the importance of a national public awareness program. Much more also needs to be done. ADSVIC commends the work of the GARDS in this area who have promoted truly innovative and effective work. By providing a cheap and effective disposal system for renovators, together with advice on how to handle the removal of asbestos that is less than ten square metres, home renovators are in a position to deal with the risks they face. ADSVIC believes that a system based on the GARDS approach should form the basis of a national scheme. In addition to public awareness programs and initiatives like the GARDS scheme there are other players who can assist home renovators, but seem reluctant to do so. In particular, the home renovation and backyard blitz shows could decide to deal with asbestos removal. ADSVIC has lobbied production companies who produce these shows and the TV companies, to no avail. ADFA in NSW is currently campaigning for the asbestos issue to be included in TV shows, to little effect. Major retail hardware stores are also reluctant to participate in providing leaflets and guidance for all the home renovators that use their stores. ADSVIC believes that these are important networks to raise awareness and provide advice. If home renovators are to be persuaded to act safely then they need access to information about the risks and an effective way of dealing with the risk. Cheap and effective removal and dumping is critical to any change in behaviour. On the question of registered removalists who deal with large quantities of asbestos, the cost of these services is an issue and the Government should examine the possibility of subsidies for home renovators who need these services. 3. Treatment, Care and Support While the review deals predominately with the management of asbestos, it is the view of ADSVIC that some of the recommendations could deal with certain aspects of treatment, care and support for those living with ARD. When support group members were asked about the difficulties that they experienced with handling mesothelioma themselves, or as carers, then the following issues were raised: One management group member, whose father had recently died, talked of difficulties involved with diagnosis and treatment. She found that she had to 4

5 do her own research on the radical radiation treatment available at a Melbourne hospital, for example. Another group member who had recently lost her husband confirmed that late diagnosis had been a problem, as were clinical trials that were not fully explained to those participating. She also suggested that the medical profession lacked knowledge of the valuable work done by support groups in helping people living with Mesothelioma. It is often the case that new members of the ADSVIC support group are referred by channels other than the medical profession. It is the view of many involved in ADSVIC that there needs to be specialist treatment centres or units in all states to deal effectively with those suffering from Mesothelioma. While this matter is outside the jurisdiction of the management review, there are things that could be done by the National Asbestos Authority to assist people living with ARD. One suggestion from an ASDVIC management group member was for a national hot line for ARD sufferers. This help line would give information on treatment, clinical trials and support group activity. The NAA could also distribute information on ARD to GPs and oncologists. 4. Targeted interventions A common research tool in public health is to design targeted interventions to examine how human behaviour might be changed. It would appear that with the exception of the excellent work that has been done in Western Australia and one or two other centres there has been little research work done of this nature. The scope for such interventions is large. Such interventions could include, for example: What public messages would be effective in persuading home renovators to take reasonable precautions when they renovate their own homes and how should these messages be delivered? What is needed to ensure that trades people are not only aware of the risk of asbestos exposure, but will be encouraged to take appropriate precautions? How can those in the medical profession who refer, diagnose and treat people with asbestos related disease, improve the quality of information available to patients and how this is best communicated? While the NAA is unlikely to have the resources to carry out this research itself, it could identify key areas that researchers should focus on for the successful elimination of the disease. Summary and Recommendations ADSVIC welcomes the asbestos management review as a significant opportunity to deal effectively with the dangers of future exposure to asbestos in Australia, which has the highest per capita rate of mesothelioma in the world. We make the following recommendations: 1. ADSVIC supports the central aim of the 2010 summit to eliminate asbestos related disease in Australia by

6 2. The creation of a national asbestos authority with sufficient resources and expertise is essential. This body should have within its scope both the management of asbestos in the Australian environment and information on the treatment, care and support of people with asbestos related diseases. 3. The National Asbestos Authority should carry out a national audit of asbestos and asbestos building products in Australia. It should then develop a strategy for the safe removal of asbestos material using a prioritised removal system 4. The National Asbestos Authority should provide a hot line for those people diagnosed with an ARD or who are worried that they may be susceptible at a later stage in their life. This hot line would provide initial information on asbestos disease and provide information on referral to specialists, doctors and palliative care. It should also give advice and link to asbestos support groups. 5. The National Asbestos Authority should actively promote targeted interventions designed to assess behaviour around asbestos exposure and how this behaviour might be improved. 6. There should be a public awareness campaign from the federal government to warn the general public of the dangers that exist in Australia of being exposed to asbestos. This should include TV advertising and targeted communication with groups particularly at risk. Shows that encourage renovation, and hardware stores who sell renovation products, must be encouraged to accept responsibility for informing the public. 7. Means should be put at the disposal of asbestos support groups to participate in education and awareness. 8. A national audit of the current training of tradespeople in construction and maintenance should be carried out to examine whether OH and S elements of this training include the safe handling of asbestos. This audit must include apprentice training in appropriate trades. The effectiveness of this training in bringing about safe practices should be assessed. 9. ADSVIC recommends that the work carried out by GARDS / La Trobe Council in providing a kit for the safe removal of asbestos from the home be extended nationally. Where registered removalists are needed, the government should introduce subsidies to assist the home owner. On the sale of a property, an asbestos audit of the property should be carried out for any house built before

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