Investigation report into asbestos-related disease in Sunshine North. 30 June 2015

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1 Investigation report into asbestos-related disease in Sunshine North 30 June 2015

2 Authorised and published by the Victorian Government, 1 Treasury Place, Melbourne. State of Victoria, June 2015

3 Contents 1. Introduction History of the Wunderlich asbestos factory site Immediate response to concerns of current contamination on the site Asbestos environmental testing program a) Selection of homes for testing b) Recruitment of homes c) Analytical methods d) Summary of results of home testing program e) Discussion Review of asbestos-related conditions in Sunshine North a) Incidence of mesothelioma in Victoria over time b) Types of asbestos exposure c) Mesothelioma incidence in the Sunshine North area d) Lung cancer incidence in the Sunshine North area e) Asbestos-related admissions to Victorian hospitals f) Limitations in the review g) Summary of findings Discussion Conclusion Going forward... 26

4 1. Introduction On Sunday 12 October 2014, the Herald Sun presented a five month special investigative report revealing they had identified an alarmingly high number of cases of asbestos-related disease (ARD) in the neighbourhood of the former Wunderlich asbestos factory involving local residents without occupational exposure. The report in part read: At least 16 people who grew up within 1 km of the plant none of whom worked there have died of asbestos-related diseases...another eight are known to be sick. The article also reported finding asbestos fibres in the roof space dust of eight homes and raised concerns about asbestos found on and next to the former factory site. As the story emerged it became clear there were three distinct issues that needed to be investigated and addressed: 1. The alleged increase in ARD involving a range of exposures (not work-related) to asbestos from the Wunderlich factory site before it ceased operating over 30 years ago. These illnesses were reported to be a result of past exposures before the closure and remediation of the factory site. 2. The possibility of a previously unknown, present-day risk of asbestos exposure from fibres in the roof space dust of homes close to the former Wunderlich factory. 3. Asbestos found on and next to the former factory site, as a result of previously buried asbestos coming to the surface and illegal dumping of asbestos materials. The Acting Chief Health Officer (A/CHO) urgently requested the Victorian Cancer Registry to conduct an analysis of mesothelioma and lung cancer involving people living around the site (47 McIntyre Rd, Sunshine North). The Department of Health and Human Services (DHHS) analysed the Victorian Admitted Episodes Dataset (VAED) for asbestos-related disease, to determine whether there were more than expected admissions for people living near the former asbestos factory in Sunshine North. An expert advisory group was urgently put together to provide advice to the A/CHO and was chaired by Professor Robert Thomas, Chief Advisor on Cancer for the Victorian Government. The group membership comprised an Occupational Physician and Epidemiologist, Respiratory Physician, Western Health representative, Occupational Environmental Medicine specialist and a nursing representative. The Environmental Protection Authority Victoria (EPA) immediately started an investigation into the current state of the site which was known to have significant quantities of asbestos buried and capped on the premises, undertaken as part of the site s clean-up and remediation following closure. The EPA and DHHS initiated an environmental testing program involving tests for asbestos in roof space dust, indoor air and soil of 50 residences with ambient (outdoor) air testing done at the same time. The testing program was undertaken by the occupational hygiene consultancy, AMCOSH who have extensive experience in assessing asbestos contamination. The aim was to identify the nature, extent and distribution of asbestos in the immediate area of the former factory and determine the implications to health. In addition, EPA sought to offer the same testing package to the 10 homes tested by the Herald Sun and 6 participated. Page 4

5 This report contains; - the actions undertaken by EPA to ensure the safety of the former Wunderlich site - the results and findings of the environmental testing program - the review into asbestos-related disease in the area around the former factory site. Investigation into asbestos-related disease In Sunshine North Page 5

6 2. History of the Wunderlich asbestos factory site The term Westend site in this report means the entire 47 McIntyre Road site and is otherwise referred to as the former Wunderlich factory site. It is almost nine hectares and extends from McIntyre Road in the east, south to a laneway, north to Fuchs Lubricants (Australia) (at 49 McIntyre Road) and west to the railway line boundary. The earliest information on the general area of the Westend site is in a history of the Sunshine Harvester works. The Sunshine Harvester works provided a focal point for Sunshine, with the proprietors of the works, HV McKay and family, owning significant land holdings in Sunshine. It was vacant until development as an industrial estate, the Harvester Industrial Estate, in the 1920s. It was purchased by Wunderlich from HV McKay and was developed as a manufacturing site by Wunderlich producing asbestos cement flat and corrugated sheet products (known as Durabestos) and associated mouldings. Terracotta tiles were also produced at the site. During early manufacturing operations, it was surrounded to the north and east by vacant land. Early aerial photographs suggest the asbestos products manufacturing process generated large volumes of sludge that were spread across the western portion and surrounding land. Image 1 Street view of Westend site Page 6

7 Image 2 Image 3 Early images of the former Wunderlich factory Image 4 Aerial view today, with approximate site boundaries (in red) Image 5 Image 6 Aerial view 1942 Aerial view 1956 Investigation into asbestos-related disease In Sunshine North Page 7

8 Image 7 Image 8 Aerial view 1970 Aerial view 1984 Aerial photos and a review of historical information suggest the manufacturing works covered a much larger area than that currently occupied by Westend Market Hotel. The Wunderlich operations probably extended to the north and south into neighbouring properties. A significant portion of the Wunderlich land to the north was sold in the 1960s. James Hardie and Company Ltd took over the Wunderlich Company in James Hardie ceased operations at the site in November It is not known when terracotta tile manufacturing stopped, but it is assumed that it was before this time. The asbestos manufacturing operation involved the processing of asbestos fibre, including drying of the separated fibres. The asbestos was then combined into a cement-water mix and the slurry poured onto moulds for drying. Waste slurries were dried and then sent to settling ponds in the western part of the Westend site. The effluent (run-off) from the settling ponds was discharged to Stony Creek up to the end of The site s licence was formally revoked in April Closure and remediation of the majority of the site was carried out between 1983 and 1986, and involved a number of regulators including EPA and the forerunner to WorkSafe. The bulk of the work involved moving the remaining asbestos materials into the slurry pits, and capping these within the site. Page 8

9 3. Immediate response to concerns of current contamination on the site In response to the media reports relating to asbestos material found on or near the former factory, EPA immediately undertook an extensive investigation of the site and surrounding areas. Whilst within site boundaries the capping measures (the sealing of the site to contain asbestos) were found to be in good condition, a number of issues were found around the border and at sites nearby. The EPA found a small amount of exposed asbestos in the rail corridor. This appears to have surfaced as a result of rabbits digging into the ground. In nearby sites, the edge of the capping in some places was inadequate and presented a risk of asbestos becoming exposure. In each case a risk was identified and notices were issued to rectify the hazard. Discussions with personnel currently at the site, identified that asbestos was occasionally discovered during site works in the past. EPA had experience of this issue on the Westend site when activities such as fencing works and signage installation exposed asbestos. In each case, incidents were deemed low risk by EPA and regulatory notices were issued to prevent future cases. The other issue identified in the EPA investigation was a small quantity of illegally dumped asbestos sheeting in the rail corridor. Dumping of such waste in industrial areas is common across metropolitan Melbourne, including the City of Brimbank. The annual cost to Council to clean-up and manage illegally dumped rubbish is around $1 million. Popular locations for illegal dumping includes easily accessible but isolated areas, such as industrial estates, laneways, vacant lots, rail reserves and parks. Council operates a rapid-response unit for dumped rubbish if it affects road access, is in a public area or contains hazardous material. Qualified contractors are used where clean-up of asbestos is required. Investigation into asbestos-related disease In Sunshine North Page 9

10 4. Asbestos environmental testing program The Herald Sun investigation reported that in eight of the 10 homes they tested, small amounts of asbestos was found in roof space settled dust. This finding raised concerns that asbestos could have blown off the Wunderlich factory site when it was operating and potentially contaminated neighbouring homes.the Department of Education and Training rapidly conducted air quality monitoring in 12 schools across 15 campuses, spanning an area up to 2.4km from the Wunderlich site. This air quality monitoring was undertaken in mid-october 2014 using Phase Contrast Microscopy and showed no detectable levels of asbestos. The scientific literature was searched for information about the prevalence and risk of asbestos in roof dust. No relevant reports were identified to indicate whether small amounts of asbestos in roof spaces was typical in homes of this age or homes situated in a semi-industrial setting. The EPA engaged a specialist occupational hygiene consultancy, AMCOSH, to undertake an extensive sampling program to better understand the nature, extent and distribution of asbestos in the immediate area of the former factory. At all stages through the testing program, the residents involved were informed of the process, and were provided with detailed results by specialist personnel so that any questions could be answered. a) Selection of homes for testing A number of inclusion criteria were required to be met for a home to become available for selection in the testing program. Each home was to: have been built before 1980 (prior to the closure of the asbestos factory). have a terracotta tile roof. The purpose of this criterion was to ensure the testing only included homes with the most permeable roofing material, thereby obtaining results for the worst case scenario. All homes with corrugated iron, slate and asbestos roofing were excluded. be located within the specified distances of the former factory site such that 30 homes were within 1 km, 10 homes between 1 2 km and 10 homes, between 2 3 km. The homes were spread across each zone to get the best quality information. In the end, 30 homes were tested within 1 km, nine within 1 2 km and 11 in the 2 3 km of the site. belong to the resident in order to facilitate the required consent for testing. have resident s willingness to participate and formal consent. b) Recruitment of homes An initial letter of introduction was sent to a number of homes that were identified as qualifying for the testing program. Homes were then door-knocked by EPA and DHHS officers to discuss the testing program in person. This occurred predominantly during business hours, at which time residents were made aware: that they were not obligated to participate; the testing was free of charge and would be carried out by trained technicians at an agreed time and date; that the results of the testing program would be provided and explained; and that the results would be treated as confidential. Environmental testing program phases The environmental testing program was implemented in two phases: Phase 1 Phase 1 involved testing homes up to 1 km from the former factory site from a list of 100 homes provided by Brimbank Council that met the home selection criteria. This phase was prioritised as it Page 10

11 focused on houses closest to the factory to determine if there was an immediate risk to the community. In early November 2014 four teams of officers from the DHHS and Brimbank Council visited homes during business hours to request permission for their participation in the program. A total of 71 homes were visited during business hours, and consent was granted by 22 of these households. Phase 2a Homes up to 3km from the former factory site Following a review of test results from Phase 1, the testing program was continued to homes up to 3 km from the former factory site. In early December 2014, a second list of 100 qualifying homes was generated by Brimbank Council. Officers from the DHHS and Brimbank Council again visited a total of 71 homes during business hours and 22 households provided consent to participate. Residents from these homes were advised that as the lead up to Christmas would likely be a busy period for them, testing would not occur until after the holiday period, in mid-january Phase 2b In January 2015, four households withdrew from the program. An additional door-knock of the remaining qualifying homes was undertaken both during and outside of business hours, however no additional homes were able to be recruited. At this stage a total of 40 homes had been tested, out of the target of 50 homes. Before selecting the final 10 homes, a review was undertaken to ensure adequate coverage of all areas had been achieved. A final list of 140 homes that met the home selection criteria and which were located in areas so far underrepresented in the testing program, was generated by Brimbank Council. All 140 eligible homes were invited by mail to call the DHHS if they wished to have their homes considered for the testing program. Fifteen of the 140 households (10%) responded to this invitation however two subsequently withdrew following discussions with departmental staff about the details of the program. The final 10 homes were selected from the remaining 13 on the basis of those homes that provided the best geographical coverage within the target area. The EPA offered the testing program to those homes initially tested by the Herald Sun and 6 homes became involved. In total, 56 households participated in the testing program. c) Analytical methods a) Air sampling method and analysis For each home, the intention was to collect two indoor airborne fibre monitoring samples - the first from a bedroom and the second from the living room. The samplers were positioned at head height and filtered air over a period of hours. Ambient (outdoor) airborne fibre monitoring samples were also collected in the area of the home. The samplers were positioned at head height and filtered air over 24 hours. The monitoring and analysis of the samples was conducted according to the Guidance Note on the Membrane Filter Method for Estimating Airborne Asbestos Fibres 2nd Edition [NOHSC:3003(2005)] and AMCOSH s NATA accredited Method 2. Each membrane used to filter the air was cut in half with one half analysed using Phase Contrast Microscopy (PCM) and the other using Transmission Electron Microscopy (TEM). Investigation into asbestos-related disease In Sunshine North Page 11

12 The PCM analysis was conducted according to the recommended standard method for measuring airborne asbestos fibres and is commonly used in workplaces in Australia. It identifies and counts respirable fibres which have a technical definition relating to their geometry: namely >5µm in length, <3µm in width, with an aspect (length-to-width) ratio of 3:1. The method used for TEM analysis used the international standard. Using TEM meant that both very thin fibres (down to 0.02 um diameter) and low concentrations of fibres (down to fibres per millilitre) could be detected. TEM analysis is recommended for monitoring asbestos in the air in nonoccupational environments by the national environmental health body, enhealth. TEM analysis for asbestos is not routinely used in Australia and expertise in this technique is not available in Australia. So even though it caused a significant delay, air samples were sent to the United States for this very sensitive analysis using an appropriately accredited laboratory. b) Roof space settled dust sampling A combined sample of the settled dust on the horizontal surfaces of the roof beams at a height of approximately 1 metre from the roof space floor was collected using a spatula. Two of the 56 homes involved in the testing did not have testing of their roof dust. The first had the roof spaced cleaned in the late 1980s because of another matter and the second didn t have suitable access. c) Soil sampling A combined surface soil sample was collected using a small spade from a number of locations of the dwelling. The locations were chosen based on soil areas with the least likelihood of recent disturbance. d) Roof space settled dust and soil analysis Each of the settled dust and soil samples were transferred to a numbered sealable plastic sample bag and returned to AMCOSH s laboratory for analysis. Both the settled dust and soil samples were analysed using the relevant Australian Standard. A trace analysis (looking for tiny amounts of asbestos) was undertaken on all soil and dust samples. d) Summary of results of home testing program Across the whole testing program involving 56 homes the following results were found: Air testing results Including duplicate samples and repeat tests all 118 indoor airborne fibre monitoring results obtained by phase contrast microscopy all were below the limit of detection of 0.01 fibres/ml for respirable fibres. This involved 55 separate homes 1 as one home had failures of both air samplers and declined repeat sampling. The results of all 106 indoor air samples analysed by TEM were also below the limit of detection of fibres/ml for asbestos fibres longer than 5µm in length (and diameter down to 0.02µm) 1 Two of these homes had single air sampler failure and only one sample from each home was available for analysis. In addition 5 homes had repeat indoor air testing to obtain suitable samples for TEM analysis. Page 12

13 and for respirable fibres. This involved 54 separate homes 2 as one had dual pump failures and one had insufficient volume of air tested. Both declined re-testing. The 25 outdoor airborne fibre monitoring results obtained by phase contrast microscopy were all below the limit of detection. This involved 29 sites however two sites had air sampler failures, one site had too much dust to allow for counting and one had a damaged filter which prevented counting. The 26 outdoor air samples analysed by TEM were also below the limit of detection. The site with excessive dust (see above) still allowed analysis by TEM. These results are comparable to those published in the literature for buildings with no asbestos issues or with asbestos products in good condition. They are also consistent with ambient (outdoor) air samples for background levels of asbestos in urban environments. All air testing for asbestos was below the level of detection. The transmission electron microscopy analysis indicated that there is negligible risk of inhaling airborne respirable asbestos fibres and confirmed the results obtained by the PCM method. Roof dust Of the 56 homes involved in the testing program, one did not have a suitable means of entry into the roof space and the other had their roof cleaned in the 1980s for an unrelated issue. Roof space dust samples were not taken from these homes. Of the 54 homes where roof dust samples were collected, 12 were found to have very small concentrations of asbestos. Four samples were found to have trace amounts of asbestos, (ranging between 0.02% % w/w 3 ). As a comparison asbestos cement sheeting is about 15%. Eight homes had identified fibre bundles which were estimated to be at very low levels (0.003% % w/w). This is weight-for-weight equivalent to one drop of water in 1.5 litres down to one drop in 25 litres. All homes with any asbestos bundles found in roof space dust were located within 350m from the boundary of the former Wunderlich site (See Figure 1 & 2). 2 Two of these homes had single air sampler failure and only one sample from each home was available for analysis. 3 w/w refers to the proportion of asbestos in the sample by weight. Investigation into asbestos-related disease In Sunshine North Page 13

14 Figure 1 Locations where asbestos was detected in roof space dust Figure 2 Locations where asbestos was detected in roof space dust 350 m boundary No respirable asbestos fibres were detected in any of the 54 roof space dust samples. AMCOSH concluded from their analysis that even if the roof space dust is disturbed, it is highly unlikely to result in detectable levels of respirable airborne fibres. Page 14

15 It would be extremely unlikely that any activities within the roof space would result in sufficient break-up of the asbestos fibre bundles to produce respirable-sized fibres. It is not necessary to clean the settled dust from the roof space. It is always recommended that personal protective equipment be worn during any activities likely to result in exposures to hazardous materials. This includes entry into roof spaces where synthetic mineral fibres (fibreglass), lead dust, biological matter such as animal droppings or simply high dust concentrations may be present. Wearing a P1 or P2 dust mask is recommended during entry into any roof space and remains the general recommendation for homes in Sunshine North. The very small amounts of asbestos detected in roof space dust of 12 homes were of a non-respirable size and considered to pose a negligible risk. Soil Soil samples were collected at each of the 56 homes tested. Asbestos fibre bundles (loose and in small cement sheet chips) were identified in nine of the 56 soil samples collected (16%). Only chrysotile was detected and no respirable asbestos fibres were detected in any of the 56 samples. Asbestos chips were found in the soil samples taken from six homes while only loose asbestos fibre bundles were detected in the remaining three. One home had both chips and loose fibres. The asbestos chips identified in six homes were considered to be present as a result of activities with asbestos containing material in the yard. Four homes were within 500m; one between 500 and 1000m; and one more than 1km from the former factory site. The fibre bundles were estimated to be at very low concentrations (<0.0002%). Of the homes with fibre bundles two of these homes were located within 350m and the third beyond 350m of the former factory site. The occupational hygiene consultants AMCOSH, considered it possible that residual asbestos cement sheet debris may be present in some of the properties as a result of earlier demolition or storage of asbestos cement sheet materials. It was therefore recommended that before undertaking major soil disturbance works that a thorough visual inspection and possibly further sampling and analysis of any suspect material in the soil is undertaken. Very small amounts of asbestos were detected in the soil of a minority of homes. The risk of exposure to asbestos from the soil is negligible and it is considered safe for occupants of the dwellings to conduct normal activities in their yards with regards to the asbestos hazard. Investigation into asbestos-related disease In Sunshine North Page 15

16 Figure 3 - Locations where asbestos was detected in soil e) Discussion It was noted by AMCOSH in their report that: The presence of asbestos fibre bundles in the settled dust samples does not imply that there is a risk of airborne asbestos exposure. Asbestos fibres are hazardous only if they are sufficiently fine, airborne and inhaled in sufficient quantity. Thus the asbestos hazard is related to both the fibre numbers and fibre sizes present in the air. Only fibres of a certain size are capable of being inhaled, and only a fraction of these (classified as respirable) are capable of avoiding deposition in the nose and throat and remaining airborne until they reach the terminal airspaces of the lung. Negligible asbestos contamination was detected in the roof space dusts of two thirds (12/19) of homes tested within a 350m distance from the boundary of the former Wunderlich site. It is not possible to determine conclusively the source of the contamination although environmental sources such as the former Wunderlich site and/or other nearby local sources cannot be ruled out. The expert occupational hygienists, AMCOSH, have concluded that disturbance of the roof space dust would not result in detectable levels of respirable asbestos fibres. No detectable levels of airborne respirable asbestos fibres were found in the indoor and ambient air even when using the very sensitive transmission electron microscopy technique. The risk of asbestos exposure in these dwellings was therefore negligible and the homes were assessed as safe to occupy with no further actions required. Negligible asbestos contamination was detected in nine of the 56 soil samples taken. The source of the asbestos containing cement chips in six of the nine homes was considered most likely from activities on the properties, such as the demolition of asbestos cement sheet clad sheds or external toilets, rather than from environmental contamination from the former Wunderlich site. This is because these cement chips would not remain airborne and travel long distances from their source. Page 16

17 The presence of asbestos in soil at the concentrations estimated in these samples does not present a risk of asbestos exposure to occupants and users of the yards. The findings of this environmental testing program indicate that there is no evidence of widespread asbestos contamination of dwellings tested within 3000m (3km) of the former Wunderlich site. Investigation into asbestos-related disease In Sunshine North Page 17

18 5. Review of asbestos-related conditions in Sunshine North a) Incidence of mesothelioma in Victoria over time Australia has one of the highest rates of mesothelioma in the world 4 and this has been associated with asbestos mining, manufacturing and use in the building and construction industry. In the 1950s Australia had the highest per capita use of asbestos products in the world 5. The incidence of mesothelioma increased yearly in Australia from 1982, when data first became available, through to the early 2000s, when the number of new cases per capita began to decrease. Victoria has experienced a similar trend, with a decline in the number of overall cases diagnosed with the disease. This was largely due to declining cases in men. Figure 1. Incidents of mesothelioma, by sex, Victoria Age-standardised rate per 100,000 population Males Females Year of diagnosis Source: Victorian Cancer Registry, Cancer Council Victoria b) Types of asbestos exposure Asbestos exposures are generally classified into two major types: 1. Occupational exposure This type of exposure includes those who directly handle asbestos as well as those exposed by virtue of working in the close vicinity but not directly handling asbestos (eg receptionist in an asbestos factory). 2. Non-occupational exposure Exposures can occur outside the work place and there are three major categories: Environmental exposures, which occur from natural sources of asbestos in the environmental or from historical industrial sources. Domestic exposures, which result from asbestos fibres being brought into the home on the clothing of a worker and particularly exposes the person cleaning them. 4 In 2013, there were 575 Australians diagnosed with mesothelioma 123 of these people were Victorians. 5 Australian Mesothelioma Registry 2014, Mesothelioma in Australia: 3 rd annual report, Cancer Institute New South Wales, Alexandria, New South Wales. Page 18

19 Neighbourhood exposures, which can occur when living in the vicinity of an operational commercial site such as a working mine or manufacturing facility. This may be in the form of asbestos fibres released directly into the air or from exposure to asbestos materials that had been incorporated into the neighbourhood environment. c) Mesothelioma incidence in the Sunshine North area The Victorian Cancer Registry was originally asked by the Victorian Acting Chief Health Officer, Department of Health and Human Services, to undertake a review of mesothelioma and lung cancer incidence in the Sunshine North area. This analysis undertaken by the Registry involved calculating the actual number of mesothelioma and lung cancer cases for people living within 1, 2 and 3 kilometres of the former factory site between 2001 and An analysis was also done for people living within the Brimbank City Sunshine Statistical Local Area (SLA) and the Brimbank Local Government Area (LGA) between1996 and (see figure 2) The results for mesothelioma as a whole were indicative of a higher number of observed cases than would otherwise be expected. 6 Within 500 metres: 0 cases were diagnosed, less than 1 case was expected Within 1 km: 4 cases were diagnosed, 2 cases were expected Within 2 km: 16 cases were diagnosed, 10 were expected Within 3 km: 25 cases were diagnosed, 21 were expected Within the Sunshine SLA: 39 cases were diagnosed, 35 were expected Within the Brimbank LGA: 59 cases were diagnosed, 63 were expected. Of the 25 mesothelioma cases identified within 3 km of the site, approximately three quarters were males and a quarter females. This is similar to the breakdown for all of Victoria in Most cases of the disease were diagnosed in people aged 65 years and over. In response to this incident, the Australian Mesothelioma Registry was approached for information about known asbestos exposures among those diagnosed with mesothelioma, living within 3 km of the site of the former Wunderlich factory. The Australian Mesothelioma Registry (AMR) began monitoring all new cases of mesothelioma diagnosed from 1 July 2010 in Australia. The AMR collects information about past asbestos exposure from Australians diagnosed with mesothelioma. The information is collected via a postal survey questionnaire and telephone interview. The AMR has asbestos exposure information for about 450 mesothelioma cases nationwide, where a diagnosis has been made after July The AMR advised that they have asbestos exposure information for only one individual diagnosed with mesothelioma living within 3 km of the site. Given exposure details of a single case will not benefit the analysis, it was not pursued. 6 Testing showed standardised incidence ratio (ie the ratio between observed / expected numbers) were not statistically significant (p > 0.05), so it is possible the higher number of observed cases compared to expected cases, may be due to chance. Investigation into asbestos-related disease In Sunshine North Page 19

20 Figure 2. Areas used for analysis of observed verses expected cases Brimbank LGA 1 km radius Sunshine SLA 2 km radius 3 km radius Sunshine postcode 3020 d) Lung cancer incidence in the Sunshine North area The results of the lung cancer analysis by geographical area also showed a higher number of observed cases than would otherwise be expected 7. Interpretation of these results is difficult, however, due to a lack of information about past patterns of smoking, which is the major risk factor for lung cancer. Without smoking data going back decades, we don t know if Sunshine North has more lung cancer compared to the rest of Victoria because of higher smoking, or asbestos exposure, or both. Within 500 metres: 10 cases were diagnosed, 7 cases were expected Within 1 km: 47 cases were diagnosed, 38 cases were expected Within 2 km: 183 cases were diagnosed, 166 were expected Within 3 km: 436 cases were diagnosed, 357 were expected Within the Brimbank LGA: 1225 cases were diagnosed, 1100 were expected ( ) Inhaled asbestos exposure and cigarette smoking are independent risk factors for lung cancer however, when they are combined their effects are synergistic. That is, the risk of developing lung cancer from exposure to asbestos and smoking is more than just adding the risks of each together. The analysis was not able to take account of whether there was more smoking in the affected 7 Testing showed standardised incidence ratio (ie the ratio between observed/expected numbers) reached statistically significance (p > 0.05) at the 3 km radius and within the Brimbank Local Government Area) Page 20

21 population of Sunshine North so it was not possible to draw any conclusions about the specific role of asbestos exposure in the higher number of observed lung cancers. e) Asbestos-related admissions to Victorian hospitals The Victorian Admitted Episodes Dataset (VAED) contains records for people who have been admitted and later discharged from a Victorian hospital. An analysis of asbestos-related admissions was undertaken to see whether there were more than the Victorian average of admissions for people living near the site of the former Wunderlich asbestos factory in Sunshine North. The asbestos-related diseases that were considered in the analysis included asbestosis, pleural plaques with asbestosis, pulmonary fibrosis, mesothelioma, lung cancer, laryngeal cancer, ovarian cancer and some gastrointestinal cancers. The number of hospital admissions 8 per capita for people living within the postcode 3020 and were compared to hospital admissions per capita for people living elsewhere in Victoria, during the five years to The postcode 3020 incorporates the suburbs of Sunshine, Sunshine North, Sunshine West and Albion. The results of the analysis undertaken showed admission rate were higher for people living within the postcode 3020 with a diagnosis of pleural plaques with asbestosis, mesothelioma and laryngeal, lung and colon (6%) cancer compared to the rest of Victoria. It should be noted however, the primary causative factors for laryngeal, lung and gastrointestinal cancers is not asbestos and is not the major driver of these diseases in the community. Asbestosis is exclusively caused by asbestos, but the number of admissions for asbestosis was very small (<10). f) Limitations in the review The Victorian Cancer Registry receives notifications of new diagnoses of cancer and records patient addresses at the time of diagnosis. There is a latency period of years following exposure to a carcinogen before most cancers develop. In the case of mesothelioma, the latency period may be up to or beyond 50 years. The analysis presented does not include people who may have lived near the site but had since moved out of the area and then gone on to develop mesothelioma or lung cancer. Similarly, the analysis may include cases involving people who were exposed to asbestos in another environment, who have moved into the area near the factory site and subsequently developed mesothelioma or lung cancer. There is a large non-residential area close to the factory. This means there are fewer residents involved in the analysis particularly close to the factory and these small numbers are prone to large variations year on year. The time boundaries of the analysis were limited to the period between for the <500m, 1, 2 and 3 km analyses and for the SLA and LGA analysis. This was due to the limited data available to calculate the expected number of cases used in the analysis. It should be noted that the Victorian Cancer Registry does not collect information on cases about possible exposures to known carcinogens. Therefore, it is not possible to know if the mesothelioma or lung cancer cases reported to the Registry involved a known exposure related to the Wunderlich factory. No information is available on whether a case had worked at Wunderlich, played on the site, cleaned the clothing of a worker from Wunderlich or simply lived close by the factory. Nor was there information on whether the exposure was unrelated to the factory altogether. 8 These hospital admissions were for people aged 50 years and over Investigation into asbestos-related disease In Sunshine North Page 21

22 Similar to the data from Victorian Cancer Registry, the Victorian Admitted Episodes Dataset does not contain asbestos exposure information and the admissions data only involved people who lived in the postcodes 3020 at the time they were admitted to hospital. It is noted that total cancer incidence for the Brimbank LGA in 2012 was 399 per 100,000 population, which was lower than the rate for Victoria (522 per 100,000 population) 9. g) Summary of findings The incidence of mesothelioma in Australia and Victoria has decreased in recent years. In spite of the limitations, the results of the analysis undertaken are indicative of an excess of asbestos-related disease in close proximity to the site of the former Wunderlich asbestos factory. Information from the Victorian Cancer Registry suggests there is an excess of mesothelioma in close proximity to the site of the former Wunderlich asbestos factory. Due to the potentially long period of time between asbestos exposure and the development of mesothelioma 10, the findings are consistent with exposures from many decades ago when the factory was operating. A higher number of lung cancer cases were observed than would be expected in close proximity to the factory site. However, a lack of information about the smoking history of people diagnosed with the disease makes it difficult to interpret these results as smoking is the main risk factor for lung cancer. The Victorian Admitted Episodes Dataset indicate a higher than expected number of hospitalisations for asbestos-related diseases including mesothelioma, among people living in the postcode (3020) around the site, for the five years to However, the primary cause of a number of these diseases is not asbestos, although it is a known risk factor. As the Victorian Cancer Registry and the Victorian Admitted Episodes Dataset do not contain individual exposure details, it is not possible to conclude the nature (occupational, domestic, onsite non-occupational, neighbourhood or other), or the specific source of asbestos exposure. 9 Victorian Cancer Registry 2012, cited in Department of Health 2014, Local government area profiles, data definitions, Department of Health, Melbourne. 10 The period between exposure and development of mesothelioma can be up to 50 years Page 22

23 6. Discussion This investigation into a reported increase in cancers and related illnesses is unusual. Such investigations usually involve trying to determine if there is a hazard (such as chemicals or radiation) and whether there have been suitable exposures (exposure pathway and dose) to explain the increase. From the beginning with Sunshine North, the hazard (asbestos) was already known. A source (the former Wunderlich factory) was also recognised. Several people with asbestos-related disease had already described exposures to this source. The descriptions of children playing in piles of asbestos are as tragic as the consequences that have been reported. Other sources of possible exposure, however, have not been excluded. Yet taken at face value, it should be no surprise if an asbestos-related disease follows significant exposure such as those described by residents. The immediate response was to identify and manage any current risk to the local community. To that end the EPA rapidly undertook site assessments and arranged suitable removal and containment of asbestos material on and around the former Wunderlich factory site. The next pressing task was to investigate and address the risks and concerns related to the detection of asbestos in roof space dust involving eight homes close to the former factory site. These raised the prospect of local community contamination, previously unknown, and potentially posing a present-day risk to health. The findings from the environmental testing program showed very low concentrations of nonrespirable asbestos detected in the roof space settled dust and in the soil of a minority of homes. They were all assessed as posing a negligible risk to health. All air monitoring for respirable asbestos fibres, including the very sensitive TEM analysis, were below the limit of detection and all homes were deemed safe to occupy with no further actions required. The testing program used strict criteria to identify homes suitable for testing, (eg age and roofing type), in order to best detect any asbestos that may have blown into the roof space from the former Wunderlich factory or any other local source. From these, 50 homes were recruited so, as a group, they could provide an understanding of the nature, extent and distribution of possible contamination. Six homes originally tested by the Herald Sun, were also included in the analysis. The investigation found asbestos in roof space dust was limited to within 350 metres from the boundary of the former factory site, (although seven of the19 homes within that area did not have asbestos detected in roof space dust). All 35 homes beyond 350 metres did not have any asbestos detected in roof space dust. No viable alternative explanation has emerged to explain this geospatial distribution and a local source, including the former Wunderlich factory would be consistent with these findings. The models showing where and how much dust might have travelled from the Wunderlich site in the past are not perfect. However the homes with roof space asbestos detections, match these quite well. Unfortunately asbestos cannot be fingerprinted and traced back to its source in any way and so it is not possible to be make any conclusive comment as to the origin of the asbestos in the roof space settled dust. In spite of this it is still possible to make assessments as to the risk in general, from asbestos in Sunshine North. The homes tested were specifically selected to have the greatest chance of roof space contamination from asbestos materials blown into the air from a local source. As all 12 homes found with asbestos in roof space settled dust, contained such low levels of non-respirable asbestos and all assessed as safe to occupy with no further action, it is concluded that in general, all other homes in the area of the former Wunderlich site are similarly safe. Investigation into asbestos-related disease In Sunshine North Page 23

24 It should be noted that wearing a P1 or P2 dust mask is recommended during entry into any roof space to protect against the full range of health hazards 11 present and this remains the general recommendation for homes in Sunshine North. The third aspect of the response was to determine if there is an increase in asbestos related cancers and diseases recognising that they can take decades to develop and reflect exposures in the past. The data analysed from the Victorian Cancer Registry and the VAED are indicative of an increase of asbestos-related disease including mesothelioma, in close proximity the former Wunderlich asbestos factory site. However this data does not have people s histories of asbestos exposure. Although these cases of mesothelioma involved people who lived in close proximity to the factory site, exposure from the Wunderlich site is possible but not certain. As asbestos-containing materials are ubiquitous in the Australian community, it is not possible to exclude alternative asbestos exposures. That said it is entirely possible that those who lived closest to the factory were also more likely to have worked in or played on the Wunderlich factory site whilst it was operating and sustained repeated and significant exposures resulting in their disease. In the same way, those living closest may have been more likely to have had domestic type exposures (from asbestos fibres carried home on the clothing of workers from the factory or children who play on the site) or neighbourhood types exposures (from asbestos blown off the site). As a result, finding an increase in asbestos-related disease in those living closest to the factory is consistent with what we know about asbestos exposure and disease development years later. These findings are consistent with the tragic stories of significant exposure from the former factory reported by some community members many years ago. They are consistent with a terrible legacy of exposure from a factory closed over 30 years ago. 11 Health hazards may include fiberglass, lead dust, droppings from animals, fungal spores, pesticides or a general high level of airborne dust. Page 24

25 7. Conclusion The Herald Sun report raised three distinct issues relating to the former Wunderlich factory. Firstly, they reported there was an alarmingly high number of people with asbestos-related disease who detailed a range of differing exposures (not work-related) to the Wunderlich factory site whilst it was operating over 30 years ago. Secondly, the possibility of a previously unknown, present-day risk of asbestos exposure from fibres in the roof space dust of homes close to the former Wunderlich factory Thirdly, asbestos found on and next to the former factory site, as a result of previously buried asbestos coming to the surface and illegal dumping. In relation to these three distinct but related issues, this report concludes: There is an indicative excess of asbestos-related disease in close proximity to the site of the former Wunderlich asbestos factory which is consistent with a legacy of exposures more than 30 years ago. The environmental testing program concluded that all of the homes tested are safe to live in. Similarly all other homes in the area are considered safe. Issues with exposed asbestos on or near the former site were identified, addressed and continue to be monitored. Dumped asbestos remains a significant and costly challenge to Council but is also being rapidly addressed and monitored. In addition: The investigation was unable to conclusively attribute the source of the asbestos in the roof space dust. It is not necessary to clean the settled dust from the roof space, but it is recommended that standard precautions are taken where entry is required into these spaces. No asbestos in roof space dust was detected in 42 of the 54 homes sampled. Very small amounts of non-respirable asbestos in roof space dust was limited to 12 of the 54 homes sampled, all were within 350m from the factory site and all thought to pose a negligible risk to health. Given the undetectable levels of asbestos found in air sampling and the negligible risk from the levels of asbestos detected in the soil, it is concluded that there is a negligible present-day risk to those residents who were involved in the testing program. All homes tested are safe and suitable to live in with no further action required. In general, homes in the area of the former Wunderlich site are considered safe. Investigation into asbestos-related disease In Sunshine North Page 25

26 8. Going forward We sincerely hope that the findings of this report are reassuring regarding the current risk of asbestos exposure in Sunshine North, which is negligible. However, this incident has revealed a terrible legacy of illness and death related to the Wunderlich asbestos factory. There are individuals who may remain physically unaffected but will be concerned about the possible consequences of asbestos exposure into the future. The National Asbestos Exposure Register 12 is managed by the Asbestos Safety and Eradication Agency and can be used by members of the community who would like to record their exposures to asbestos. We know that exposure to asbestos fibres can significantly increase the risk of both mesothelioma and lung cancer. Unfortunately there is no proven medical benefit of early detection of mesothelioma as there are no effective interventions at this point in time. There is, however, increasing evidence that deaths from lung cancer could be partly prevented from early detection. In addition, as the risk of lung cancer from asbestos exposure significantly increases with associated tobacco smoking, it is of great benefit for those exposed to be advised and supported to quit. The historical exposure cannot be erased, but our deeper understanding of the dreadful legacy issues can now form the basis of providing better care for those affected Page 26

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