When American Technologies, Inc. was established in 1989, the company operated strictly as an asbestos abatement company. Today, we are recognized as a leader in this service. In fact in 2007, Engineering News-Record, a leading construction magazine, ranked our company as one of the top 10 asbestos abatement contractors in the country. We service a wide variety of facilities including:
• Schools
• Hospitals
• Hotels
• Casinos
• Manufacturing plants
• Commercial buildings
• Government buildings
• Apartment complexes
Where it's found and why it needs to go
Asbestos may be found in structures that were built prior to the early 1980s. Certain types of asbestos do not burn, conduct heat or conduct electricity. Because of these unique characteristics, these particular types were used in making building materials such as:
• Acoustic ceilings
• Button board
• Drywall
• Duct work
• Fireproofing
• Lath and plaster
• Linoleum
• Mastic
• Plaster
• Stucco
• Tape and mud
• Texture coating
• Transite piping and siding
• Vinyl asbestos tile
• Vinyl sheet goods
Asbestos is often discovered when the material containing the substance is disturbed. This may happen during a renovation, remodeling job, demolition or after a natural disaster. Once the asbestos-containing material is disturbed, abatement is recommended to prevent any potential health threats to the building occupants. According to the US Department of Labor Occupational Safety and Health Administration, exposure to asbestos could potentially increase the risk of developing cancer of the lung or other organs.
Our approach
We offer comprehensive asbestos abatement services ranging from the initial investigation to project completion. For each job, we assign a project manager and supervisor to oversee the following activities:
• Write and submit a project proposal and budget.
• Coordinate and facilitate an initial asbestos survey and investigation.
• Retrieve samples and test.
• Finalize the work plan.
• Remove asbestos-containing materials using industry approved techniques.
• Track and compile asbestos waste manifests.
• Prepare and submit a close-out package including a final report detailing project activities and necessary documentation.
Wednesday, October 22, 2008
Training, Other Qualifications, and Advancement
No formal education beyond a high school diploma is required for a person to become a hazardous materials removal worker. However, Federal, State, and local government standards require specific types of on-the-job training. The regulations vary by specialty and sometimes by State or locality. Employers are responsible for employee training.
Education and training. Hazardous materials removal workers usually need at least 40 hours of formal on-the-job training. For most specialties, this training must meet specific requirements set by the Federal Government or individual States.
Licensure. Workers who treat asbestos and lead, the most common contaminants, must complete a training program through their employer that meets Occupational Safety and Health Administration (OSHA) standards. Employer-sponsored training is usually performed in-house, and the employer is responsible for covering all technical and safety subjects outlined by OSHA.
To become an emergency and disaster response worker and treatment, storage, and disposal worker, candidates must obtain a Federal license as mandated by OSHA. Employers are responsible for ensuring that employees complete a formal 40-hour training program, given either in house or in OSHA-approved training centers. The program covers health hazards, personal protective equipment and clothing, site safety, recognition and identification of hazards, and decontamination.
In some cases, workers may discover one hazardous material while abating another. If they are not licensed to work with the newly discovered material, they cannot continue to work with it. Many experienced workers opt to take courses in additional types of hazardous material removal to avoid this situation. Mold removal is not regulated by OSHA, but is regulated by each State.
For decommissioning and decontamination workers employed at nuclear facilities, training is most extensive. In addition to obtaining licensure through the standard 40-hour training course in hazardous waste removal, workers must take courses dealing with regulations governing nuclear materials and radiation safety as mandated by the Nuclear Regulatory Commission. These courses add up to approximately 3 months of training, although most are not taken consecutively. Many agencies, organizations, and companies throughout the country provide training programs that are approved by the U.S. Environmental Protection Agency, the U.S. Department of Energy, and other regulatory bodies. Workers in all fields are required to take refresher courses every year to maintain their license.
Other qualifications. Workers must be able to perform basic mathematical conversions and calculations when mixing solutions that neutralize contaminants and should have good physical strength and manual dexterity. Because of the nature of the work and the time constraints sometimes involved, employers prefer people who are dependable, prompt, and detail-oriented. Because much of the work is done in buildings, a background in construction is helpful.
Education and training. Hazardous materials removal workers usually need at least 40 hours of formal on-the-job training. For most specialties, this training must meet specific requirements set by the Federal Government or individual States.
Licensure. Workers who treat asbestos and lead, the most common contaminants, must complete a training program through their employer that meets Occupational Safety and Health Administration (OSHA) standards. Employer-sponsored training is usually performed in-house, and the employer is responsible for covering all technical and safety subjects outlined by OSHA.
To become an emergency and disaster response worker and treatment, storage, and disposal worker, candidates must obtain a Federal license as mandated by OSHA. Employers are responsible for ensuring that employees complete a formal 40-hour training program, given either in house or in OSHA-approved training centers. The program covers health hazards, personal protective equipment and clothing, site safety, recognition and identification of hazards, and decontamination.
In some cases, workers may discover one hazardous material while abating another. If they are not licensed to work with the newly discovered material, they cannot continue to work with it. Many experienced workers opt to take courses in additional types of hazardous material removal to avoid this situation. Mold removal is not regulated by OSHA, but is regulated by each State.
For decommissioning and decontamination workers employed at nuclear facilities, training is most extensive. In addition to obtaining licensure through the standard 40-hour training course in hazardous waste removal, workers must take courses dealing with regulations governing nuclear materials and radiation safety as mandated by the Nuclear Regulatory Commission. These courses add up to approximately 3 months of training, although most are not taken consecutively. Many agencies, organizations, and companies throughout the country provide training programs that are approved by the U.S. Environmental Protection Agency, the U.S. Department of Energy, and other regulatory bodies. Workers in all fields are required to take refresher courses every year to maintain their license.
Other qualifications. Workers must be able to perform basic mathematical conversions and calculations when mixing solutions that neutralize contaminants and should have good physical strength and manual dexterity. Because of the nature of the work and the time constraints sometimes involved, employers prefer people who are dependable, prompt, and detail-oriented. Because much of the work is done in buildings, a background in construction is helpful.
Nature of the Work
Increased public awareness and Federal and State regulations are resulting in the removal of more hazardous materials from buildings, facilities, and the environment to prevent further contamination of natural resources and to promote public health and safety. Hazardous materials typically possess at least one of four characteristics—ignitability, corrosivity, reactivity, or toxicity. Hazardous materials removal workers identify, remove, package, transport, and dispose of various hazardous materials, including asbestos, radioactive and nuclear materials, arsenic, lead, and mercury. These workers are sometimes called abatement, remediation, or decontamination workers. Removal workers often respond to emergencies where harmful substances are present.
Hazardous materials removal workers use a variety of tools and equipment, depending on the work at hand. Equipment ranges from brooms to personal protective suits that completely isolate workers from the hazardous material. Because of the threat of contamination, workers often wear disposable or reusable coveralls, gloves, hardhats, shoe covers, safety glasses or goggles, chemical-resistant clothing, face shields, and devices to protect one’s hearing. Most workers are also required to wear respirators while working, to protect them from airborne particles or noxious gases. The respirators range from simple versions that cover only the mouth and nose to self-contained suits with their own air supply.
Asbestos and lead are two of the most common contaminants that hazardous materials removal workers encounter. Through the 1970s, asbestos was used to fireproof roofing and flooring, for heat insulation, and for a variety of other purposes. It was durable, fire retardant, resisted corrosion, and insulated well, making it ideal for such applications. Embedded in materials, asbestos is fairly harmless; airborne, however, it can cause several lung diseases, including lung cancer and asbestosis. Today, asbestos is rarely used in buildings, but there are still structures that contain the material that must be remediated. Similarly, lead was a common building component found in paint and plumbing fixtures and pipes until the late 1970s. Because lead is easily absorbed into the bloodstream, often from breathing lead dust or from eating chips of paint containing lead, it can cause serious health risks, especially in children. Due to these risks, it has become necessary to remove lead-based products from buildings and structures.
Asbestos abatement workers and lead abatement workers remove asbestos, lead, and other materials from buildings scheduled to be renovated or demolished. Using a variety of hand and power tools, such as vacuums and scrapers, these workers remove the asbestos and lead from surfaces. A typical residential lead abatement project involves the use of a chemical to strip the lead-based paint from the walls of the home. Lead abatement workers apply the compound with a putty knife and allow it to dry. Then they scrape the hazardous material into an impregnable container for transport and storage. They also use sandblasters and high-pressure water sprayers to remove lead from large structures. The vacuums utilized by asbestos abatement workers have special, highly efficient filters designed to trap the asbestos, which later is disposed of or stored. During the abatement, special monitors measure the amount of asbestos and lead in the air, to protect the workers; in addition, lead abatement workers wear a personal air monitor that indicates the amount of lead to which a worker has been exposed. Workers also use monitoring devices to identify the asbestos, lead, and other materials that need to be removed from the surfaces of walls and structures.
Transportation of hazardous materials is safer today than it was in the past, but accidents still occur. Emergency and disaster response workers clean up hazardous materials after train derailments and trucking accidents. These workers also are needed when an immediate cleanup is required, as would be the case after an attack by biological or chemical weapons.
Some hazardous materials removal workers specialize in radioactive substances. These substances range from low-level contaminated protective clothing, tools, filters, and medical equipment, to highly radioactive nuclear reactor fuels used to produce electricity. Decontamination technicians perform duties similar to those of janitors and cleaners, but the items and areas they clean are radioactive. They use brooms, mops, and other tools to clean exposed areas and remove exposed items for decontamination or disposal. Some of these jobs are now being done by robots controlled by people away from the contamination site. Increasingly, many of these remote devices are being used to automatically monitor and survey surfaces, such as floors and walls, for contamination.
With experience, decontamination technicians can advance to radiation-protection technician jobs and use radiation survey meters and other remote devices to locate and evaluate materials, operate high-pressure cleaning equipment for decontamination, and package radioactive materials for transportation or disposal.
Decommissioning and decontamination workers remove and treat radioactive materials generated by nuclear facilities and power plants. With a variety of handtools, they break down contaminated items such as “gloveboxes,” which are used to process radioactive materials. At decommissioning sites, the workers clean and decontaminate the facility, as well as remove any radioactive or contaminated materials.
Treatment, storage, and disposal workers transport and prepare materials for treatment or disposal. To ensure proper treatment of the materials, laws, typically regulated by the U.S. Environmental Protection Agency (EPA) or Occupational Safety and Health Administration (OSHA), require these workers to be able to verify shipping manifests. At incinerator facilities, treatment, storage, and disposal workers transport materials from the customer or service center to the incinerator. At landfills, they follow a strict procedure for the processing and storage of hazardous materials. They organize and track the location of items in the landfill and may help change the state of a material from liquid to solid in preparation for its storage. These workers typically operate heavy machinery, such as forklifts, earthmoving machinery, and large trucks and rigs.
To help clean up the Nation’s hazardous waste sites, a Federal program, called Superfund, was created in 1980. Under the Superfund program, abandoned, accidentally spilled, or illegally dumped hazardous waste that poses a current or future threat to human health or the environment is cleaned up. In doing so, the EPA along with potentially responsible parties, communities, local, State, and Federal authorities, identify hazardous waste sites, test site conditions, formulate cleanup plans, and clean up the sites.
Mold remediation is a new aspect of some hazardous materials removal work. Some types of mold can cause allergic reactions, especially in people who are susceptible to them. Although mold is present in almost all structures and is not usually defined as a hazardous material, some mold—especially the types that cause allergic reactions—can infest a building to such a degree that extensive efforts must be taken to remove it safely. Molds are fungi that typically grow in warm, damp conditions both indoors and outdoors year round. They can be found in heating and air-conditioning ducts, within walls, and in showers, attics, and basements. Although mold remediation is often undertaken by other construction workers, large scale mold removal is usually handled by hazardous materials removal workers, who take special precautions to protect themselves and surrounding areas from being contaminated.
Hazardous materials removal workers also may be required to construct scaffolding or erect containment areas prior to abatement or decontamination. In most cases, government regulation dictates that hazardous materials removal workers be closely supervised on the worksite. The standard usually is 1 supervisor to every 10 workers. The work is highly structured, sometimes planned years in advance, and team oriented. There is a great deal of cooperation among supervisors and workers. Because of the hazard presented by the materials being removed, work areas are restricted to licensed hazardous materials removal workers, thus minimizing exposure to the public.
Work environment. Hazardous materials removal workers function in a highly structured environment to minimize the danger they face. Each phase of an operation is planned in advance, and workers are trained to deal with safety breaches and hazardous situations. Crews and supervisors take every precaution to ensure that the worksite is safe. Whether they work with asbestos, mold, lead abatement, or in radioactive decontamination, hazardous materials removal workers must stand, stoop, and kneel for long periods. Some must wear fully enclosed personal protective suits for several hours at a time; these suits may be hot and uncomfortable and may cause some individuals to experience claustrophobia.
Hazardous materials removal workers face different working conditions, depending on their area of expertise. Although many work a standard 40-hour week, overtime and shift work are common, especially for emergency and disaster response workers. Asbestos and lead abatement workers usually work in structures such as office buildings, schools, or historic buildings under renovation. Because they are under pressure to complete their work within certain deadlines, workers may experience fatigue. Completing projects frequently requires night and weekend work, because hazardous materials removal workers often work around the schedules of others. Treatment, storage, and disposal workers are employed primarily at facilities such as landfills, incinerators, boilers, and industrial furnaces. These facilities often are located in remote areas, due to the kinds of work being done. As a result, workers employed by treatment, storage, or disposal facilities may commute long distances to their jobs.
Decommissioning and decontamination workers, decontamination technicians, and radiation protection technicians work at nuclear facilities and electric power plants. Like treatment, storage, and disposal facilities, these sites often are far from urban areas. Workers, who often perform jobs in cramped conditions, may need to use sharp tools to dismantle contaminated objects. A hazardous materials removal worker must have great self-control and a level head to cope with the daily stress associated with handling hazardous materials.
Hazardous materials removal workers may be required to travel outside their normal working areas in order to respond to emergencies, the cleanup of which sometimes take several days or weeks to complete. During the cleanup, workers may be away from home for the entire time.
Hazardous materials removal workers use a variety of tools and equipment, depending on the work at hand. Equipment ranges from brooms to personal protective suits that completely isolate workers from the hazardous material. Because of the threat of contamination, workers often wear disposable or reusable coveralls, gloves, hardhats, shoe covers, safety glasses or goggles, chemical-resistant clothing, face shields, and devices to protect one’s hearing. Most workers are also required to wear respirators while working, to protect them from airborne particles or noxious gases. The respirators range from simple versions that cover only the mouth and nose to self-contained suits with their own air supply.
Asbestos and lead are two of the most common contaminants that hazardous materials removal workers encounter. Through the 1970s, asbestos was used to fireproof roofing and flooring, for heat insulation, and for a variety of other purposes. It was durable, fire retardant, resisted corrosion, and insulated well, making it ideal for such applications. Embedded in materials, asbestos is fairly harmless; airborne, however, it can cause several lung diseases, including lung cancer and asbestosis. Today, asbestos is rarely used in buildings, but there are still structures that contain the material that must be remediated. Similarly, lead was a common building component found in paint and plumbing fixtures and pipes until the late 1970s. Because lead is easily absorbed into the bloodstream, often from breathing lead dust or from eating chips of paint containing lead, it can cause serious health risks, especially in children. Due to these risks, it has become necessary to remove lead-based products from buildings and structures.
Asbestos abatement workers and lead abatement workers remove asbestos, lead, and other materials from buildings scheduled to be renovated or demolished. Using a variety of hand and power tools, such as vacuums and scrapers, these workers remove the asbestos and lead from surfaces. A typical residential lead abatement project involves the use of a chemical to strip the lead-based paint from the walls of the home. Lead abatement workers apply the compound with a putty knife and allow it to dry. Then they scrape the hazardous material into an impregnable container for transport and storage. They also use sandblasters and high-pressure water sprayers to remove lead from large structures. The vacuums utilized by asbestos abatement workers have special, highly efficient filters designed to trap the asbestos, which later is disposed of or stored. During the abatement, special monitors measure the amount of asbestos and lead in the air, to protect the workers; in addition, lead abatement workers wear a personal air monitor that indicates the amount of lead to which a worker has been exposed. Workers also use monitoring devices to identify the asbestos, lead, and other materials that need to be removed from the surfaces of walls and structures.
Transportation of hazardous materials is safer today than it was in the past, but accidents still occur. Emergency and disaster response workers clean up hazardous materials after train derailments and trucking accidents. These workers also are needed when an immediate cleanup is required, as would be the case after an attack by biological or chemical weapons.
Some hazardous materials removal workers specialize in radioactive substances. These substances range from low-level contaminated protective clothing, tools, filters, and medical equipment, to highly radioactive nuclear reactor fuels used to produce electricity. Decontamination technicians perform duties similar to those of janitors and cleaners, but the items and areas they clean are radioactive. They use brooms, mops, and other tools to clean exposed areas and remove exposed items for decontamination or disposal. Some of these jobs are now being done by robots controlled by people away from the contamination site. Increasingly, many of these remote devices are being used to automatically monitor and survey surfaces, such as floors and walls, for contamination.
With experience, decontamination technicians can advance to radiation-protection technician jobs and use radiation survey meters and other remote devices to locate and evaluate materials, operate high-pressure cleaning equipment for decontamination, and package radioactive materials for transportation or disposal.
Decommissioning and decontamination workers remove and treat radioactive materials generated by nuclear facilities and power plants. With a variety of handtools, they break down contaminated items such as “gloveboxes,” which are used to process radioactive materials. At decommissioning sites, the workers clean and decontaminate the facility, as well as remove any radioactive or contaminated materials.
Treatment, storage, and disposal workers transport and prepare materials for treatment or disposal. To ensure proper treatment of the materials, laws, typically regulated by the U.S. Environmental Protection Agency (EPA) or Occupational Safety and Health Administration (OSHA), require these workers to be able to verify shipping manifests. At incinerator facilities, treatment, storage, and disposal workers transport materials from the customer or service center to the incinerator. At landfills, they follow a strict procedure for the processing and storage of hazardous materials. They organize and track the location of items in the landfill and may help change the state of a material from liquid to solid in preparation for its storage. These workers typically operate heavy machinery, such as forklifts, earthmoving machinery, and large trucks and rigs.
To help clean up the Nation’s hazardous waste sites, a Federal program, called Superfund, was created in 1980. Under the Superfund program, abandoned, accidentally spilled, or illegally dumped hazardous waste that poses a current or future threat to human health or the environment is cleaned up. In doing so, the EPA along with potentially responsible parties, communities, local, State, and Federal authorities, identify hazardous waste sites, test site conditions, formulate cleanup plans, and clean up the sites.
Mold remediation is a new aspect of some hazardous materials removal work. Some types of mold can cause allergic reactions, especially in people who are susceptible to them. Although mold is present in almost all structures and is not usually defined as a hazardous material, some mold—especially the types that cause allergic reactions—can infest a building to such a degree that extensive efforts must be taken to remove it safely. Molds are fungi that typically grow in warm, damp conditions both indoors and outdoors year round. They can be found in heating and air-conditioning ducts, within walls, and in showers, attics, and basements. Although mold remediation is often undertaken by other construction workers, large scale mold removal is usually handled by hazardous materials removal workers, who take special precautions to protect themselves and surrounding areas from being contaminated.
Hazardous materials removal workers also may be required to construct scaffolding or erect containment areas prior to abatement or decontamination. In most cases, government regulation dictates that hazardous materials removal workers be closely supervised on the worksite. The standard usually is 1 supervisor to every 10 workers. The work is highly structured, sometimes planned years in advance, and team oriented. There is a great deal of cooperation among supervisors and workers. Because of the hazard presented by the materials being removed, work areas are restricted to licensed hazardous materials removal workers, thus minimizing exposure to the public.
Work environment. Hazardous materials removal workers function in a highly structured environment to minimize the danger they face. Each phase of an operation is planned in advance, and workers are trained to deal with safety breaches and hazardous situations. Crews and supervisors take every precaution to ensure that the worksite is safe. Whether they work with asbestos, mold, lead abatement, or in radioactive decontamination, hazardous materials removal workers must stand, stoop, and kneel for long periods. Some must wear fully enclosed personal protective suits for several hours at a time; these suits may be hot and uncomfortable and may cause some individuals to experience claustrophobia.
Hazardous materials removal workers face different working conditions, depending on their area of expertise. Although many work a standard 40-hour week, overtime and shift work are common, especially for emergency and disaster response workers. Asbestos and lead abatement workers usually work in structures such as office buildings, schools, or historic buildings under renovation. Because they are under pressure to complete their work within certain deadlines, workers may experience fatigue. Completing projects frequently requires night and weekend work, because hazardous materials removal workers often work around the schedules of others. Treatment, storage, and disposal workers are employed primarily at facilities such as landfills, incinerators, boilers, and industrial furnaces. These facilities often are located in remote areas, due to the kinds of work being done. As a result, workers employed by treatment, storage, or disposal facilities may commute long distances to their jobs.
Decommissioning and decontamination workers, decontamination technicians, and radiation protection technicians work at nuclear facilities and electric power plants. Like treatment, storage, and disposal facilities, these sites often are far from urban areas. Workers, who often perform jobs in cramped conditions, may need to use sharp tools to dismantle contaminated objects. A hazardous materials removal worker must have great self-control and a level head to cope with the daily stress associated with handling hazardous materials.
Hazardous materials removal workers may be required to travel outside their normal working areas in order to respond to emergencies, the cleanup of which sometimes take several days or weeks to complete. During the cleanup, workers may be away from home for the entire time.
Some facts
Breathing in asbestos fibers has been linked to cancer and other diseases. When asbestos-containing material is disturbed or damaged it releases tiny fibers into the air that are too small to be filtered by a dust mask. There is no safe level of exposure, so contact with any amount of asbestos can be harmful.
The best way to handle asbestos-containing material is to hire a licensed asbestos abatement contractor (external PDF file) to perform the work. Most home repair or remodeling contractors do not have an asbestos abatement license or certified workers who are trained and equipped to work safely with asbestos.
Protect yourself and your family from the dangers of improper asbestos removal. Call the Southwest Clean Air Agency at 360-574-3058 to get more information and advice before you remodel, hire a contractor or attempt to handle asbestos yourself.
What is asbestos?
Asbestos is a mineral that can be broken down into very fine fibers that are heat-resistant and extremely durable. Because of these properties, asbestos was widely used in construction materials.
Depending on its condition, asbestos in your home may be hazardous to your health. As long as asbestos is not disturbed, damaged or worn, or the material is sealed, it is not considered a health hazard.
If you're thinking of buying a house that needs remodeling, or planning to remodel your current home, hire a qualified AHERA inspector to survey the house for asbestos before you buy or remodel. Improper handling of asbestos-containing materials can be expensive.
Does your house have asbestos-containing materials?
Note: The following list does not include every product or material that may contain asbestos. It is intended as a general guide to show which types of materials may contain asbestos.
* Cement pipes
* Cement wallboard
* Cement siding
* Asphalt floor tile
* Vinyl floor tile
* Vinyl sheet flooring
* Flooring backing
* Construction mastics (floor tile, carpet, ceiling tile, etc.)
* Acoustical plaster
* Decorative plaster
* Textured paints/coatings
* Ceiling tiles and lay-in panels
* Spray-applied insulation
* Blown-in insulation
* Fireproofing materials
* Taping compounds (thermal)
* Packing materials (for wall/floor penetrations)
* High temperature gaskets
* Laboratory hoods/table tops
* Laboratory gloves
* Fire blankets
* Fire curtains
* Elevator Equipment Panels
* Elevator brake shoes
* HVAC duct insulation
* Boiler insulation
* Breaching insulation
* Ductwork flexible fabric connections
* Cooling towers
* Pipe insulation (corrugated air-cell, block, etc.)
* Heating and electrical ducts
* Electrical panel partitions
* Electrical cloth
* Electric wiring insulation
* Chalkboards
* Roofing shingles
* Roofing felt
* Base flashing
* Thermal paper products
* Fire doors
* Caulking/putties
* Adhesives
* Wallboard
* Joint compounds
* Vinyl wall coverings
* Spackling compounds
Be safe! Treat all suspect materials as if they contain asbestos until you know for sure.
You cannot identify asbestos by looking at it. The only safe way to find out if material contains asbestos is to have a laboratory analyze a sample of the suspect material.
The best way to handle asbestos-containing material is to hire a licensed asbestos abatement contractor (external PDF file) to perform the work. Most home repair or remodeling contractors do not have an asbestos abatement license or certified workers who are trained and equipped to work safely with asbestos.
Protect yourself and your family from the dangers of improper asbestos removal. Call the Southwest Clean Air Agency at 360-574-3058 to get more information and advice before you remodel, hire a contractor or attempt to handle asbestos yourself.
What is asbestos?
Asbestos is a mineral that can be broken down into very fine fibers that are heat-resistant and extremely durable. Because of these properties, asbestos was widely used in construction materials.
Depending on its condition, asbestos in your home may be hazardous to your health. As long as asbestos is not disturbed, damaged or worn, or the material is sealed, it is not considered a health hazard.
If you're thinking of buying a house that needs remodeling, or planning to remodel your current home, hire a qualified AHERA inspector to survey the house for asbestos before you buy or remodel. Improper handling of asbestos-containing materials can be expensive.
Does your house have asbestos-containing materials?
Note: The following list does not include every product or material that may contain asbestos. It is intended as a general guide to show which types of materials may contain asbestos.
* Cement pipes
* Cement wallboard
* Cement siding
* Asphalt floor tile
* Vinyl floor tile
* Vinyl sheet flooring
* Flooring backing
* Construction mastics (floor tile, carpet, ceiling tile, etc.)
* Acoustical plaster
* Decorative plaster
* Textured paints/coatings
* Ceiling tiles and lay-in panels
* Spray-applied insulation
* Blown-in insulation
* Fireproofing materials
* Taping compounds (thermal)
* Packing materials (for wall/floor penetrations)
* High temperature gaskets
* Laboratory hoods/table tops
* Laboratory gloves
* Fire blankets
* Fire curtains
* Elevator Equipment Panels
* Elevator brake shoes
* HVAC duct insulation
* Boiler insulation
* Breaching insulation
* Ductwork flexible fabric connections
* Cooling towers
* Pipe insulation (corrugated air-cell, block, etc.)
* Heating and electrical ducts
* Electrical panel partitions
* Electrical cloth
* Electric wiring insulation
* Chalkboards
* Roofing shingles
* Roofing felt
* Base flashing
* Thermal paper products
* Fire doors
* Caulking/putties
* Adhesives
* Wallboard
* Joint compounds
* Vinyl wall coverings
* Spackling compounds
Be safe! Treat all suspect materials as if they contain asbestos until you know for sure.
You cannot identify asbestos by looking at it. The only safe way to find out if material contains asbestos is to have a laboratory analyze a sample of the suspect material.
Removal of Asbestos
Sears, Roebuck and Co. will pay a civil penalty of $55,000 to the State of Massachusetts for a violation of its Clean Air Act and Consumer Portection Act following the improper removal of asbestos from a customer’s home. The story in the Wicked Local Pembroke reports Sears contractors improperly removed asbestos when replacing a boiler in October 2004.
The news agency reports that the complaint filed in Suffolk Superior Court notes that Sears assured its customer that it could remove an existing boiler, which contained asbestos insulation, and replace it with a new one, safely and cost-effectively. The complaint says Sears assured the customer the workers would be properly licensed and trained.
However, the workers who arrived to complete the work - a plumber and second subcontractor - were not licensed or trained to handle asbestos. The complaint notes that the workers removed the existing boiler wearing no protective gear, did not seal the area, and dropped the boiler, breaking it open and releasing asbestos into the air when the insulation crumbled. The workers cleaned up the spilled asbestos insulation material with their bare hands, and disposed of it in regular black trashbags, the Wicked Local reports.
Asbestos dust was released into the air in the customers’ basement and first-floor area, exposing them to carcinogens. Asbestos is linked to the development of asbestos related diseases including mesothelioma and asbestosis.
According to the Massachusetts Department of Environmental Protection (MassDEP), contractors need to determine whether asbestos is present pior to conducting any renovation or demolition activity. Companies doing work on a project that possibly contains asbestos are required to hire a Division of Occupational Safety (DOS) certified asbestos abatement contractor.
If asbestos is present, there are MassDEP requirements for anyone handling asbestos, including special supplies and equipment, specific work practices including setting up a containment area, air filtration equipment, packaging and labeling of waste. If the area is contaminated by improper handling of asbestos, MassDEP says, cleanup procedures specific to the job are required.
Contractors should check with their state office of Environmental Protection or Occupational Safety before beginning any project that may involve asbestos, as regulations may vary from state to state.
According to the Massachusetts complaint, Sears subcontractors never notified their Department of Environmental Protection or filed an Asbestos Notification Form when removing the boiler.
The Wicked Local reports part of the settlement will require Sears to develop and implement a customized asbestos training program for salespeople and managers, and to provide enhanced supervision on all jobs where asbestos may be present.
The news agency reports that the complaint filed in Suffolk Superior Court notes that Sears assured its customer that it could remove an existing boiler, which contained asbestos insulation, and replace it with a new one, safely and cost-effectively. The complaint says Sears assured the customer the workers would be properly licensed and trained.
However, the workers who arrived to complete the work - a plumber and second subcontractor - were not licensed or trained to handle asbestos. The complaint notes that the workers removed the existing boiler wearing no protective gear, did not seal the area, and dropped the boiler, breaking it open and releasing asbestos into the air when the insulation crumbled. The workers cleaned up the spilled asbestos insulation material with their bare hands, and disposed of it in regular black trashbags, the Wicked Local reports.
Asbestos dust was released into the air in the customers’ basement and first-floor area, exposing them to carcinogens. Asbestos is linked to the development of asbestos related diseases including mesothelioma and asbestosis.
According to the Massachusetts Department of Environmental Protection (MassDEP), contractors need to determine whether asbestos is present pior to conducting any renovation or demolition activity. Companies doing work on a project that possibly contains asbestos are required to hire a Division of Occupational Safety (DOS) certified asbestos abatement contractor.
If asbestos is present, there are MassDEP requirements for anyone handling asbestos, including special supplies and equipment, specific work practices including setting up a containment area, air filtration equipment, packaging and labeling of waste. If the area is contaminated by improper handling of asbestos, MassDEP says, cleanup procedures specific to the job are required.
Contractors should check with their state office of Environmental Protection or Occupational Safety before beginning any project that may involve asbestos, as regulations may vary from state to state.
According to the Massachusetts complaint, Sears subcontractors never notified their Department of Environmental Protection or filed an Asbestos Notification Form when removing the boiler.
The Wicked Local reports part of the settlement will require Sears to develop and implement a customized asbestos training program for salespeople and managers, and to provide enhanced supervision on all jobs where asbestos may be present.
Fibrous Silicate
Asbestos is the name given to a number of naturally occurring, fibrous silicate minerals mined for their useful properties such as thermal insulation, chemical and thermal stability, and high tensile strength. Asbestos is commonly used as an acoustic insulator, and in thermal insulation, fire proofing and other building materials. Many products in use today contain asbestos.
Asbestos is made up of microscopic bundles of fibers that may become airborne when asbestos- containing materials are damaged or disturbed. When these fibers get into the air they may be inhaled into the lungs, where they can cause significant health problems.
This page provides access to information about asbestos. On this Web site, you may access general information about asbestos and its health effects. You may also read about what to do if you suspect asbestos in products, in your home or in your school (en español- asbesto en las escuelas).
If you wish to obtain more information on asbestos, EPA maintains a listing of asbestos resources available to the public. If you would like to locate an asbestos contact, EPA maintains a listing of federal and state asbestos contacts.
The National Directory of AHERA Accredited Courses (NDAAC) contains information about training providers and approved courses nationwide and is meant to serve as a comprehensive reference and resource document. It should be useful for those training providers who offer accredited asbestos courses and to all consumers of these training services. It is also intended for use by federal and state agencies involved in the training and accreditation of asbestos control professionals under the federal law, the Asbestos Hazard Emergency Response Act (AHERA).
EPA maintains a listing of the laws and regulations applicable to asbestos. A 1989 regulation to ban most asbestos-containing products was later overturned in court.
Asbestos is made up of microscopic bundles of fibers that may become airborne when asbestos- containing materials are damaged or disturbed. When these fibers get into the air they may be inhaled into the lungs, where they can cause significant health problems.
This page provides access to information about asbestos. On this Web site, you may access general information about asbestos and its health effects. You may also read about what to do if you suspect asbestos in products, in your home or in your school (en español- asbesto en las escuelas).
If you wish to obtain more information on asbestos, EPA maintains a listing of asbestos resources available to the public. If you would like to locate an asbestos contact, EPA maintains a listing of federal and state asbestos contacts.
The National Directory of AHERA Accredited Courses (NDAAC) contains information about training providers and approved courses nationwide and is meant to serve as a comprehensive reference and resource document. It should be useful for those training providers who offer accredited asbestos courses and to all consumers of these training services. It is also intended for use by federal and state agencies involved in the training and accreditation of asbestos control professionals under the federal law, the Asbestos Hazard Emergency Response Act (AHERA).
EPA maintains a listing of the laws and regulations applicable to asbestos. A 1989 regulation to ban most asbestos-containing products was later overturned in court.
Abatement Practices
SHC furnishes all labor, materials, employee training, pollution, general liability, errors and omissions insurance coverage, expertise, and equipment necessary to carry out specified asbestos abatement projects. SHC will also secure all required permits including any necessary state, regional and local licenses. Although the owner is responsible for providing required notification to the EPA and any regional, state or local authority having jurisdiction on projects for asbestos removal, SHC will provide assistance to the owner as required.
Qualification Submittals
For each project SHC submits the following materials in order to establish our competency and capability to perform the specified work:
§ Work and educational qualifications and other background information that attests to the ability of SHC and its staff to competently complete the asbestos abatement tasks in question.
§ Proof that all air samples will be analyzed in a qualified laboratory: i.e., a laboratory that participates in the NIOSH Proficiency Analytical Testing Program (PAT) and has been found proficient, or a laboratory that is accredited by the AIHA for asbestos.
§ Proof that all workers have been trained in an EPA-approved asbestos training course and that all site supervisors have attended an EPA-approved abatement supervisory training course appropriate for the specific job.
§ Proof that all workers have had medical examinations as required by OSHA.
§ The name of the landfill that will be used for asbestos disposal and assurance that all regulations/laws pertaining to such disposal will be met in the form of a disposal manifest signed by the owner, transporter and landfill operator.
§ Evidence of legitimate asbestos-specific general liability insurance coverage, workman's compensation insurance and vehicle insurance.
§ When required by the client, an industrial hygienist will be provided to oversee the implementation of all aspects of safety and health procedures.
Qualification Submittals
For each project SHC submits the following materials in order to establish our competency and capability to perform the specified work:
§ Work and educational qualifications and other background information that attests to the ability of SHC and its staff to competently complete the asbestos abatement tasks in question.
§ Proof that all air samples will be analyzed in a qualified laboratory: i.e., a laboratory that participates in the NIOSH Proficiency Analytical Testing Program (PAT) and has been found proficient, or a laboratory that is accredited by the AIHA for asbestos.
§ Proof that all workers have been trained in an EPA-approved asbestos training course and that all site supervisors have attended an EPA-approved abatement supervisory training course appropriate for the specific job.
§ Proof that all workers have had medical examinations as required by OSHA.
§ The name of the landfill that will be used for asbestos disposal and assurance that all regulations/laws pertaining to such disposal will be met in the form of a disposal manifest signed by the owner, transporter and landfill operator.
§ Evidence of legitimate asbestos-specific general liability insurance coverage, workman's compensation insurance and vehicle insurance.
§ When required by the client, an industrial hygienist will be provided to oversee the implementation of all aspects of safety and health procedures.
Overview
While initially quiet, the connections between asbestos exposures and respiratory health consequences have been whispered about since the 1950’s. Unfortunately, its use continued to be widespread until the late 1970’s when it was officially banned by the U.S. federal government.
Contrary to popular belief, not all asbestos is truly hazardous. When asbestos-containing materials (materials containing 1% or more asbestos) are structurally intact, they are generally not hazardous as their fibers aren’t available for inhalation. However, when the fibers are damaged, they are rendered friable. The official working definition for friable materials is those which are able to be crushed or destroyed by human hand pressure. If any asbestos-containing material is in this condition it is potentially hazardous and necessitating abatement.
Asbestos abatement is a growing industry in which safe removal of asbestos is overseen by regulated firms. Each asbestos abatement firm must obtain a state license to practice abatement within a given state. Regulations and guidelines are stringent with regards to the safe ways to handle and dispose of friable asbestos material.
Under no circumstances should any unlicensed person conduct abatement activities unless under consultation with an abatement firm or state guidelines concerning the proper procedures. Unlicensed abatement can lead to potentially harmful inhalation of friable asbestos fibers, which can have serious health consequences. For more information contact a licensed asbestos abatement firm and be sure to read up on local guidelines for asbestos removal in your area.
Contrary to popular belief, not all asbestos is truly hazardous. When asbestos-containing materials (materials containing 1% or more asbestos) are structurally intact, they are generally not hazardous as their fibers aren’t available for inhalation. However, when the fibers are damaged, they are rendered friable. The official working definition for friable materials is those which are able to be crushed or destroyed by human hand pressure. If any asbestos-containing material is in this condition it is potentially hazardous and necessitating abatement.
Asbestos abatement is a growing industry in which safe removal of asbestos is overseen by regulated firms. Each asbestos abatement firm must obtain a state license to practice abatement within a given state. Regulations and guidelines are stringent with regards to the safe ways to handle and dispose of friable asbestos material.
Under no circumstances should any unlicensed person conduct abatement activities unless under consultation with an abatement firm or state guidelines concerning the proper procedures. Unlicensed abatement can lead to potentially harmful inhalation of friable asbestos fibers, which can have serious health consequences. For more information contact a licensed asbestos abatement firm and be sure to read up on local guidelines for asbestos removal in your area.
Environmental Health & Safety
Asbestos Abatement
This section of Environmental Health & Safety is responsible for the testing and abatement or removal of asbestos containing materials on OSU property. Considering the size and number of these buildings,
this is a large task for the 10-member crew.
All abatement and removal is conducted according to rules and regulations set forth by the Oklahoma State Department of Labor. These regulations require yearly refresher training courses and worker re-certification.
Not every pipe and ceiling tile contains asbestos material, but whether it does or not cannot be determined by the naked eye. Samples of the suspect material (collected by licensed workers) are analyzed under a microscope (using polarized light microscopy) in the EHS laboratory (its license is limited to asbestos projects on University property). Every sample is positive until proven otherwise.
Asbestos is removed only when required for renovation, remodeling or maintenance. This usually involves moving ceiling tile, repairing plumbing or anything else that contains asbestos. It is the responsibility of campus maintenance personnel or contractors to arrange for inspection and/or removal of asbestos by EHS.
Emergency removal is conducted when asbestos has been accidentally disturbed--usually because of water leaks involving contaminated ceiling tile. The affected area is immediately evacuated and secured, all air handlers serving that area are shut down, and the "spill" is reported to the Oklahoma Department of Labor. Every effort is made to return the affected area to its normal occupancy as soon as possible.
Abatement is done inside enclosures to prevent the fibers from spreading. Air handling units serving the affected area are turned off until the work is completed to keep the fibers from spreading to other areas. Workers wear respirators and disposable coveralls to protect themselves while working. To prevent any attached fibers from getting into the surrounding air, the coveralls are disposed of when the worker exits the enclosure.
When a job has been completed, samples of the surrounding air are analyzed under a phase-contrast microscope. Based upon the results, the area is either cleared or re-cleaned and re-sampled. If the area is declared "clear," it is opened to normal occupancy and all warning signs are removed.
Asbestos--What Is It?
Asbestos is a generic term for a group of minerals known for their strength, flame and heat resistance, and seemingly indestructible qualities.
Once considered a “miracle mineral,” asbestos was used for many years in building construction. It can be found in many forms and places. Asbestos was used in boiler and pipe insulation, plasters, floor tile, electrical insulation, and as a fireproofing material on structural members in buildings. It has also been sprayed on ceilings and walls as acoustic insulation.
Because of its indestructible qualities, asbestos is harmful to the human body. The body cannot digest, break down, or change asbestos; it can only attempt to encapsulate it with scar tissue.
Several types of asbestos were banned by the EPA in the mid-70’s due to concern over the health effects (especially cancer) associated with exposure to such materials. It is important to remember that asbestos generally has been found to be hazardous to humans when it is inhaled into the lungs.
Asbestos occurs naturally as a fiber; individual fibers are so small they are invisible to the naked eye. Most asbestos is not hazardous in its original, undisturbed state; only when it is disturbed does it release asbestos fibers.
Symptoms of asbestos-related diseases do not occur soon after exposure. Those who are sick today because of asbestos may have been exposed 20 to 40 years ago. Controlling exposures now will prevent disease and suffering decades later.
This section of Environmental Health & Safety is responsible for the testing and abatement or removal of asbestos containing materials on OSU property. Considering the size and number of these buildings,
this is a large task for the 10-member crew.
All abatement and removal is conducted according to rules and regulations set forth by the Oklahoma State Department of Labor. These regulations require yearly refresher training courses and worker re-certification.
Not every pipe and ceiling tile contains asbestos material, but whether it does or not cannot be determined by the naked eye. Samples of the suspect material (collected by licensed workers) are analyzed under a microscope (using polarized light microscopy) in the EHS laboratory (its license is limited to asbestos projects on University property). Every sample is positive until proven otherwise.
Asbestos is removed only when required for renovation, remodeling or maintenance. This usually involves moving ceiling tile, repairing plumbing or anything else that contains asbestos. It is the responsibility of campus maintenance personnel or contractors to arrange for inspection and/or removal of asbestos by EHS.
Emergency removal is conducted when asbestos has been accidentally disturbed--usually because of water leaks involving contaminated ceiling tile. The affected area is immediately evacuated and secured, all air handlers serving that area are shut down, and the "spill" is reported to the Oklahoma Department of Labor. Every effort is made to return the affected area to its normal occupancy as soon as possible.
Abatement is done inside enclosures to prevent the fibers from spreading. Air handling units serving the affected area are turned off until the work is completed to keep the fibers from spreading to other areas. Workers wear respirators and disposable coveralls to protect themselves while working. To prevent any attached fibers from getting into the surrounding air, the coveralls are disposed of when the worker exits the enclosure.
When a job has been completed, samples of the surrounding air are analyzed under a phase-contrast microscope. Based upon the results, the area is either cleared or re-cleaned and re-sampled. If the area is declared "clear," it is opened to normal occupancy and all warning signs are removed.
Asbestos--What Is It?
Asbestos is a generic term for a group of minerals known for their strength, flame and heat resistance, and seemingly indestructible qualities.
Once considered a “miracle mineral,” asbestos was used for many years in building construction. It can be found in many forms and places. Asbestos was used in boiler and pipe insulation, plasters, floor tile, electrical insulation, and as a fireproofing material on structural members in buildings. It has also been sprayed on ceilings and walls as acoustic insulation.
Because of its indestructible qualities, asbestos is harmful to the human body. The body cannot digest, break down, or change asbestos; it can only attempt to encapsulate it with scar tissue.
Several types of asbestos were banned by the EPA in the mid-70’s due to concern over the health effects (especially cancer) associated with exposure to such materials. It is important to remember that asbestos generally has been found to be hazardous to humans when it is inhaled into the lungs.
Asbestos occurs naturally as a fiber; individual fibers are so small they are invisible to the naked eye. Most asbestos is not hazardous in its original, undisturbed state; only when it is disturbed does it release asbestos fibers.
Symptoms of asbestos-related diseases do not occur soon after exposure. Those who are sick today because of asbestos may have been exposed 20 to 40 years ago. Controlling exposures now will prevent disease and suffering decades later.
Asbestos Theory
Asbestos Abatement
As a licensed and responsible professional you must be aware of and identify the presence or absence of these materials when dealing with building retrofits. Failure to advise your client(s) or contractors working on a project of the presence of hazardous materials in and/or on a property may present you with potential future liabilities. It is your obligation to protect the interests of your client(s), the health and safety of workers, and the natural environment.
National Environmental Contracting will arrange an independent consultant for hazardous materials and other potential environmental concerns on residential, commercial and industrial properties. Each assessment includes sampling of all suspected hazardous materials, confirmatory laboratory analysis and complete reporting of all findings. We can also complete specifications and tender packages for any required remedial activities and perform project management services.
All environmental consultants and environmental engineers are licensed, have errors and omissions insurance and pollution, asbestos and environmental coverage.
What to Do if You Have It
North America has become asbestos conscious. With so many buildings and facilities containing asbestos, the prudent building manager must implement an Asbestos Management and Maintenance Program.
Beginning in the 1920's and continuing into the mid 1970's asbestos insulation and building material were widely used in the construction industry due to its low cost, strength and ability to withstand high temperatures. In Canada, there are thousands of miles of asbestos pipe covered materials. However, it is not always economically feasible or desirable to carry out removal procedures.
The Asbestos Management and Maintenance Program
STEP ONE: Assessment and Survey
The first step of the Asbestos Management Program is to do an asbestos survey to assess the location, identify the type of asbestos, the condition of the asbestos and identify a maintenance record. This asbestos inventory or assessment is usually carried out by an independent consulting firm. This assessment or survey will include:
1. Identification and location of the Asbestos Containing Materials (ACM)
2. Assessing the condition of asbestos and its accessibility.
3. Preparing a long term plan to outline the corrective action(s) to be taken and the immediate and long-term costs associated with the corrective action(s).
STEP TWO: Notification
Once the assessment or survey is completed, this will allow the building manager to implement the second step of the program, which includes notifying tenants, custodial and maintenance staff, building maintenance and service contractors. This notification includes identifying the location of the asbestos containing materials.
STEP THREE: Worker Training
A Health and Safety Training Program should be established including an inspection policy and employee training program. Employees who are most likely to come into contact or work with asbestos should be included. Good communication is vital. All sub trades and maintenance contractors should be notified.
STEP FOUR: Corrective Measures - Correction and Remedial Action
Where the survey or assessment has identified Asbestos Containing Materials (ACM) which are severely damaged or deteriorated, the building manager then decides which of the following three methods of corrective or remedial measures are going to be used.
1. Removal By Type 1, Type 2, or Type 3 Operational Procedures As a rule, removal will initially be the most expensive method. However, depending on the circumstances, in the long run, asbestos removal can be an economically preferred option. Removal of asbestos is the only permanent solution.
In most cases, where Asbestos Containing Materials (ACM) are removed, an appropriate substitute material must be reinstalled. Fibreglass pipe covering is a widely used product and the costs associated with supplying and installing this new material are relatively low.
In Type 3 Operational Procedures, an eight chamber Decontamination Structure is installed. A Dirty Area Room, Garbage Storage Area and Clean Area & Room with airlocks are temporarily installed. These Decon's have filtered showering facilities. The water is filtered through a .05 micron filter collected into 45-55 gallon drums for testing prior to any discharge.
Under Type 3, the area is kept constantly under negative pressure. HEPA Filtered Negative Air Pressure Units are installed strategically and vented outside. All electrical equipment, HEPA Vacuums, temporary lighting and Negative HEPA Air Units are hooked up to temporary Ground Fault Interrupt (GFI) panels. The area will have electrical lockouts where required.
2. Encapsulation Encapsulation is a successful option in dealing with asbestos and involves covering the asbestos with a sealant.
Asbestos Containing Materials (ACM), all piping, elbows, boilers and all mechanical insulation covered with ACM and asbestos are HEPA vacuumed and covered with a canvas fire-rated adhesive sealant (encapsulation). Depending on the application, there are a number of types of sealant.
The sealant's function is to enclose and prevent the asbestos fibres from breaking away from the material. In the case of asbestos pipe insulation, elbows or trees, a canvas with a fire retardant lockdown adhesive lagging is applied to cover and provide a hard-shell coating.
Encapsulation requires periodic inspections, quarterly or annually, to monitor the condition of the Asbestos Containing Materials.
2. Enclosure The Enclosure method permanently closes the asbestos. The enclosure must be completely airtight and this method is best used only where access to electrical, plumbing or ventilation services are not required.
STEP FIVE: Hiring an Asbestos Control Contractor
The Asbestos Control Contractor should be experienced in all of the three methods mentioned above: Removal, Encapsulation and Enclosure and Insulation procedures.
References must be checked thoroughly to determine the quality of services:
* was the client satisfied with the contractor's performance?
* was the contractor's staff knowledgeable and fully trained?
* did they complete the job on time?
* what is the availability and schedule performance?
PROTECT YOUR PERSONAL AND CORPORATE ASSETS
For Asbestos Containing Materials (ACM) that require immediate attention, a qualified Asbestos Control Contractor can be retained on the following terms:
1. GUARANTEED PRICE CONTRACT - to complete the initial removal or encapsulation work required by the consultant's recommendations, for a fixed lump sum price.
2. SERVICE CONTRACT - on standing offer and on a time and material basis. The contractor must be available to service your asbestos, just as your mechanical contractor services you air conditioning. Every building manager should have an Asbestos Service Contractor in case of an emergency.
One requirement of the regulation governing asbestos on construction sites is the classification of the work. This classification can be thought of in terms of work representing a high (Type 3) or medium (Type 2) or low hazard (Type 1). In evaluating the hazard, there are two necessary considerations:
* the airborne concentrations of asbestos that will be generated by the work
* the duration of the exposure
Factors that effect the level of airborne asbestos include the following:
* the nature of the asbestos materials
* how the work is performed - Quality and Health and Safety Training
* the availability of controls to limit exposure
Conclusion
The key factors are in a successful Asbestos Management and Maintenance Program are management, communication and control. You and your company must implement an asbestos management control program and define the company's asbestos policy in a long term plan.
The long term plan allows you to be in control of the asbestos and be ready to respond quickly and decisively and to avoid costly emergency crisis situation.
As a licensed and responsible professional you must be aware of and identify the presence or absence of these materials when dealing with building retrofits. Failure to advise your client(s) or contractors working on a project of the presence of hazardous materials in and/or on a property may present you with potential future liabilities. It is your obligation to protect the interests of your client(s), the health and safety of workers, and the natural environment.
National Environmental Contracting will arrange an independent consultant for hazardous materials and other potential environmental concerns on residential, commercial and industrial properties. Each assessment includes sampling of all suspected hazardous materials, confirmatory laboratory analysis and complete reporting of all findings. We can also complete specifications and tender packages for any required remedial activities and perform project management services.
All environmental consultants and environmental engineers are licensed, have errors and omissions insurance and pollution, asbestos and environmental coverage.
What to Do if You Have It
North America has become asbestos conscious. With so many buildings and facilities containing asbestos, the prudent building manager must implement an Asbestos Management and Maintenance Program.
Beginning in the 1920's and continuing into the mid 1970's asbestos insulation and building material were widely used in the construction industry due to its low cost, strength and ability to withstand high temperatures. In Canada, there are thousands of miles of asbestos pipe covered materials. However, it is not always economically feasible or desirable to carry out removal procedures.
The Asbestos Management and Maintenance Program
STEP ONE: Assessment and Survey
The first step of the Asbestos Management Program is to do an asbestos survey to assess the location, identify the type of asbestos, the condition of the asbestos and identify a maintenance record. This asbestos inventory or assessment is usually carried out by an independent consulting firm. This assessment or survey will include:
1. Identification and location of the Asbestos Containing Materials (ACM)
2. Assessing the condition of asbestos and its accessibility.
3. Preparing a long term plan to outline the corrective action(s) to be taken and the immediate and long-term costs associated with the corrective action(s).
STEP TWO: Notification
Once the assessment or survey is completed, this will allow the building manager to implement the second step of the program, which includes notifying tenants, custodial and maintenance staff, building maintenance and service contractors. This notification includes identifying the location of the asbestos containing materials.
STEP THREE: Worker Training
A Health and Safety Training Program should be established including an inspection policy and employee training program. Employees who are most likely to come into contact or work with asbestos should be included. Good communication is vital. All sub trades and maintenance contractors should be notified.
STEP FOUR: Corrective Measures - Correction and Remedial Action
Where the survey or assessment has identified Asbestos Containing Materials (ACM) which are severely damaged or deteriorated, the building manager then decides which of the following three methods of corrective or remedial measures are going to be used.
1. Removal By Type 1, Type 2, or Type 3 Operational Procedures As a rule, removal will initially be the most expensive method. However, depending on the circumstances, in the long run, asbestos removal can be an economically preferred option. Removal of asbestos is the only permanent solution.
In most cases, where Asbestos Containing Materials (ACM) are removed, an appropriate substitute material must be reinstalled. Fibreglass pipe covering is a widely used product and the costs associated with supplying and installing this new material are relatively low.
In Type 3 Operational Procedures, an eight chamber Decontamination Structure is installed. A Dirty Area Room, Garbage Storage Area and Clean Area & Room with airlocks are temporarily installed. These Decon's have filtered showering facilities. The water is filtered through a .05 micron filter collected into 45-55 gallon drums for testing prior to any discharge.
Under Type 3, the area is kept constantly under negative pressure. HEPA Filtered Negative Air Pressure Units are installed strategically and vented outside. All electrical equipment, HEPA Vacuums, temporary lighting and Negative HEPA Air Units are hooked up to temporary Ground Fault Interrupt (GFI) panels. The area will have electrical lockouts where required.
2. Encapsulation Encapsulation is a successful option in dealing with asbestos and involves covering the asbestos with a sealant.
Asbestos Containing Materials (ACM), all piping, elbows, boilers and all mechanical insulation covered with ACM and asbestos are HEPA vacuumed and covered with a canvas fire-rated adhesive sealant (encapsulation). Depending on the application, there are a number of types of sealant.
The sealant's function is to enclose and prevent the asbestos fibres from breaking away from the material. In the case of asbestos pipe insulation, elbows or trees, a canvas with a fire retardant lockdown adhesive lagging is applied to cover and provide a hard-shell coating.
Encapsulation requires periodic inspections, quarterly or annually, to monitor the condition of the Asbestos Containing Materials.
2. Enclosure The Enclosure method permanently closes the asbestos. The enclosure must be completely airtight and this method is best used only where access to electrical, plumbing or ventilation services are not required.
STEP FIVE: Hiring an Asbestos Control Contractor
The Asbestos Control Contractor should be experienced in all of the three methods mentioned above: Removal, Encapsulation and Enclosure and Insulation procedures.
References must be checked thoroughly to determine the quality of services:
* was the client satisfied with the contractor's performance?
* was the contractor's staff knowledgeable and fully trained?
* did they complete the job on time?
* what is the availability and schedule performance?
PROTECT YOUR PERSONAL AND CORPORATE ASSETS
For Asbestos Containing Materials (ACM) that require immediate attention, a qualified Asbestos Control Contractor can be retained on the following terms:
1. GUARANTEED PRICE CONTRACT - to complete the initial removal or encapsulation work required by the consultant's recommendations, for a fixed lump sum price.
2. SERVICE CONTRACT - on standing offer and on a time and material basis. The contractor must be available to service your asbestos, just as your mechanical contractor services you air conditioning. Every building manager should have an Asbestos Service Contractor in case of an emergency.
One requirement of the regulation governing asbestos on construction sites is the classification of the work. This classification can be thought of in terms of work representing a high (Type 3) or medium (Type 2) or low hazard (Type 1). In evaluating the hazard, there are two necessary considerations:
* the airborne concentrations of asbestos that will be generated by the work
* the duration of the exposure
Factors that effect the level of airborne asbestos include the following:
* the nature of the asbestos materials
* how the work is performed - Quality and Health and Safety Training
* the availability of controls to limit exposure
Conclusion
The key factors are in a successful Asbestos Management and Maintenance Program are management, communication and control. You and your company must implement an asbestos management control program and define the company's asbestos policy in a long term plan.
The long term plan allows you to be in control of the asbestos and be ready to respond quickly and decisively and to avoid costly emergency crisis situation.
Asbestos Abatement Effects
Asbestos Abatement
Once hailed as a "miracle" mineral, asbestos has been used since the early 1900s for fireproofing, insulation and sound control. Time, however, has proven asbestos to be a significant health hazard, being linked to a serious lung disease and two types of cancer.
Health Effects of Asbestos
The most dangerous asbestos fibers are too small to be visible. After they are inhaled, they can remain and accumulate in the lungs. Asbestos can cause lung cancer, mesothelioma (a cancer of the chest and abdominal linings), and asbestosis (irreversible lung scarring that can be fatal). Symptoms of these diseases do not show up until many years after exposure began. Most people with asbestos-related diseases were exposed to elevated concentrations on the job; some developed disease from exposure to clothing and equipment brought home from job sites.
Corvera Abatement Technologies has the expertise, the experience and the equipment to protect yourself, your staff, and the environment from the hazards of this dangerous material. Using state-of-the-art equipment, advanced systems, and fully trained and certified workers, we can help you meet your legal, health, and safety requirements.
Removal
We have the facilities for removal and proper disposal of pipe, duct, boiler, and other insulations, sprayed-on fire retardant and sound insulation, floor and ceiling tiles, panel boards, and other asbestos-containing products. All work is performed in full accordance with federal, state and local regulations.
Containment
In many cases, containment may provide an equally satisfactory and less costly solution to the dangers of asbestos exposure. Procedures may include encapsulation, coating, and/or removal of deteriorating sections only. Procedures and materials meet federal and local standards.
Management
Where no immediate danger is posed, an ongoing operations & maintenance (O&M) asbestos management program may provide necessary levels of safety assurance. The O&M program may include such elements as building surveys, hazard assessment, regular inspection, testing and analysis of materials, air sampling, and contingency removal or containment plans.
Once hailed as a "miracle" mineral, asbestos has been used since the early 1900s for fireproofing, insulation and sound control. Time, however, has proven asbestos to be a significant health hazard, being linked to a serious lung disease and two types of cancer.
Health Effects of Asbestos
The most dangerous asbestos fibers are too small to be visible. After they are inhaled, they can remain and accumulate in the lungs. Asbestos can cause lung cancer, mesothelioma (a cancer of the chest and abdominal linings), and asbestosis (irreversible lung scarring that can be fatal). Symptoms of these diseases do not show up until many years after exposure began. Most people with asbestos-related diseases were exposed to elevated concentrations on the job; some developed disease from exposure to clothing and equipment brought home from job sites.
Corvera Abatement Technologies has the expertise, the experience and the equipment to protect yourself, your staff, and the environment from the hazards of this dangerous material. Using state-of-the-art equipment, advanced systems, and fully trained and certified workers, we can help you meet your legal, health, and safety requirements.
Removal
We have the facilities for removal and proper disposal of pipe, duct, boiler, and other insulations, sprayed-on fire retardant and sound insulation, floor and ceiling tiles, panel boards, and other asbestos-containing products. All work is performed in full accordance with federal, state and local regulations.
Containment
In many cases, containment may provide an equally satisfactory and less costly solution to the dangers of asbestos exposure. Procedures may include encapsulation, coating, and/or removal of deteriorating sections only. Procedures and materials meet federal and local standards.
Management
Where no immediate danger is posed, an ongoing operations & maintenance (O&M) asbestos management program may provide necessary levels of safety assurance. The O&M program may include such elements as building surveys, hazard assessment, regular inspection, testing and analysis of materials, air sampling, and contingency removal or containment plans.
Asbestos Abatement
Asbestos was once a commonly used building material because it is not affected by heat or chemicals and does not conduct electricity. Now, however, it is considered a serious indoor air pollutant with links to such serious respiratory diseases as asbestosis, mesothelioma, and lung cancer. Asbestos was used in many products that were installed in Illinois' schools and commercial buildings for decades.
In the mid-1980s, newly enacted state and federal legislation required that schools be inspected for asbestos and that plans for its management be developed. The Department's Division of Environmental Health reviews asbestos management plans for elementary and secondary school facilities and inspects abatement projects to ensure compliance with state and federal laws. More recently enacted legislation regulates persons who perform asbestos-related activities in commercial and public buildings and requires that such activities be carried out safely. People who manage or abate asbestos in elementary and secondary schools must be trained and licensed. Now, more than 10,000 people are licensed each year.
The Division of Environmental Health has established separate licensing criteria for various asbestos management disciplines. All licenses expire on May 15 each year, except Workers, which expire on February 1 each year.
Asbestos Workers & Contractors
*
Workers who manage or abate asbestos in schools, commercial, or public buildings must be trained and licensed.
* Contractors are responsible for conducting asbestos abatement projects. All contractors who conduct asbestos abatement projects must have insurance and are required to be licensed.
Asbestos Professionals (Supervisors, Project Managers, Air Sampling Professionals, Project Designers, Inspectors, Management Planners)
* Supervisors are the Contractor's designees on asbestos abatement projects and are responsible for ensuring that work is conducted in accordance with state and federal regulations.
* Project Managers are the building owner's or school district's representative on school projects and are responsible for ensuring that the workers and supervisors are complying with the contract specification and state and federal regulations. Projects Managers are not required to oversee asbestos abatement projects in commercial and public buildings, but if a building owner chooses to have an individual oversee the project, then the Department requires that the person be licensed.
* Air Sampling Professionals are responsible for taking air samples to determine the airborne concentration of asbestos inside and outside the work area. The Air Sampling Professional conducts aggressive clearance air monitoring at the end of asbestos abatement projects to ensure that the concentration of asbestos in the air is acceptable for reoccupation of the area.
* Project Designers are required to develop project designs for school buildings. The project designers are required to draw up specifications and contracts that contractors must follow to complete an asbestos abatement project that meets state and federal regulations. If a project design is developed for asbestos abatement in commercial and public buildings, then it must be completed by a licensed Project Designer.
* Inspectors are required to identify asbestos-containing materials by sampling suspected asbestos-containing materials discovered during an inspection.
* Management Planners are required to develop management plans based upon information from an Inspector. Each school in Illinois must develop and maintain an asbestos management plan describing the management of the school's asbestos-containing building materials. Commercial and public buildings in Illinois are not required to develop management plans.
In the mid-1980s, newly enacted state and federal legislation required that schools be inspected for asbestos and that plans for its management be developed. The Department's Division of Environmental Health reviews asbestos management plans for elementary and secondary school facilities and inspects abatement projects to ensure compliance with state and federal laws. More recently enacted legislation regulates persons who perform asbestos-related activities in commercial and public buildings and requires that such activities be carried out safely. People who manage or abate asbestos in elementary and secondary schools must be trained and licensed. Now, more than 10,000 people are licensed each year.
The Division of Environmental Health has established separate licensing criteria for various asbestos management disciplines. All licenses expire on May 15 each year, except Workers, which expire on February 1 each year.
Asbestos Workers & Contractors
*
Workers who manage or abate asbestos in schools, commercial, or public buildings must be trained and licensed.
* Contractors are responsible for conducting asbestos abatement projects. All contractors who conduct asbestos abatement projects must have insurance and are required to be licensed.
Asbestos Professionals (Supervisors, Project Managers, Air Sampling Professionals, Project Designers, Inspectors, Management Planners)
* Supervisors are the Contractor's designees on asbestos abatement projects and are responsible for ensuring that work is conducted in accordance with state and federal regulations.
* Project Managers are the building owner's or school district's representative on school projects and are responsible for ensuring that the workers and supervisors are complying with the contract specification and state and federal regulations. Projects Managers are not required to oversee asbestos abatement projects in commercial and public buildings, but if a building owner chooses to have an individual oversee the project, then the Department requires that the person be licensed.
* Air Sampling Professionals are responsible for taking air samples to determine the airborne concentration of asbestos inside and outside the work area. The Air Sampling Professional conducts aggressive clearance air monitoring at the end of asbestos abatement projects to ensure that the concentration of asbestos in the air is acceptable for reoccupation of the area.
* Project Designers are required to develop project designs for school buildings. The project designers are required to draw up specifications and contracts that contractors must follow to complete an asbestos abatement project that meets state and federal regulations. If a project design is developed for asbestos abatement in commercial and public buildings, then it must be completed by a licensed Project Designer.
* Inspectors are required to identify asbestos-containing materials by sampling suspected asbestos-containing materials discovered during an inspection.
* Management Planners are required to develop management plans based upon information from an Inspector. Each school in Illinois must develop and maintain an asbestos management plan describing the management of the school's asbestos-containing building materials. Commercial and public buildings in Illinois are not required to develop management plans.
Saturday, September 20, 2008
After Mesothelioma Diagnosis
Shock
"I can't believe it. It can't be true."
Feeling shocked is often the first reaction when mesothelioma is diagnosed. You may
Feel numb and not believe what is happening
Be unable to express any emotion
Find you can only take in small amounts of information
Ask the same questions or need to be told the same thing over and over again
Needing to have information repeated is a common reaction to shock.
Some people may find their feelings of disbelief make talking about their illness with family and friends difficult. Others feel the urge to talk about it as a way of helping them to accept the news themselves.
Fear
"Am I going to die?" "Will I be in pain?"
The first thing people ask about having mesothelioma cancer is: "Am I going to die?"
Remember - Mesothelioma patients can live for many years.
Mesothelioma clinical trials provides new hope. Today, many things can be done to help with any pain or discomfort or to slow the cancer down. (Look in Treating Pain Section for more information).
Many people are worried about their treatment and whether it will be very unpleasant. Remember that research into making treatments easier to cope with, and reducing and controlling side effects has been going on for years and will continue. Stories you hear about people being treated years ago will be out of date. It is best to talk to your doctor about your treatment before relying on rumor or other incorrect information.
Denial
"There's nothing really wrong with me. I don't have mesothelioma."
Some people choose to cope with their situation by
Not wanting to know anything about their mesothelioma cancer
Talking about it as little as possible
If that's how you feel, tell the people around you quite firmly that, for the time being, you don't want to talk about your illness.
But sometimes you may find it is the other way around. Your family and friends may
Deny your illness
Appear to ignore the fact that you have mesothelioma
Play down your anxieties and symptoms
Deliberately change the subject
These sorts of reactions may arise because people are frightened or embarrassed to talk about cancer, or because mesothelioma is such a rare form of cancer, they do not understand what it entails. Others may feel that if they don't talk about it, they can try to pretend it isn't happening. You may, however, want them to support you by sharing how you feel. If the reactions of others upset or hurt you,
Try telling them how you feel
Reassure them that you know what is happening
Explain that talking to them about your illness will help
Anger
Anger about your illness may be directed at
Those who are closest to you
The doctors and nurses who are caring for you
The companies that made the asbestos products and knew they were dangerous
God, if you are religious
You don't have to feel guilty about your angry thoughts or moods. But relatives and friends don't always realize that you are not angry with them but are angry with your illness. It may help to
Tell them this at a time when you are not feeling quite so angry
Ask them to read these pages, if talking is difficult
If you are finding it difficult to talk to your family, you may want to discuss this with a counselor.
Blame and Guilt
Sometimes in trying to find reasons why cancer has happened you may blame yourself or other people for your illness.
While asbestos exposure is the trigger, many factors must coincide to cause mesothelioma cancer. Chance plays a big part. Some people are more prone to developing a mesothelioma cancer because of their genes. Also, workers and other exposed to asbestos were never informed about the dangers; so there is no way that the average person could have avoided these dangers.
In addition, many experts believe a single tiny strand of asbestos is sufficient to trigger mesothelioma, which with the widespread use of asbestos, is impossible to avoid. Finally, you had to work to earn a living and provide for your family - that was not a choice. Nevertheless, it may be difficult to avoid blaming yourself, but talking about these feelings helps.
Why Me?
Having mesothelioma cancer can make you feel cross with people who are well. Why should this have happened to you and not to someone else? You may feel
Angry
Sad
Bad tempered
These feelings may crop up from time to time throughout your illness and treatment. Relatives may also be angry that your illness interferes with their lives.
It helps to express your feelings openly. Bottling it up may upset everyone.
Leave Me Alone
There may be times during your illness when you want to be left alone to sort out your own feelings. This can be hard for family and friends who may not understand how you feel, and want to share this difficult time with you. You can make it easier for them by telling them that
You don't feel like talking about your illness now, but you will talk to them when you do
You still care about them even if you do not want to talk about your illness
Depression
Depression is often triggered by a diagnosis of mesothelioma. You might not be able to think clearly or do things, or you might not want to get up in the morning. You may want to talk to your doctor or nurse who can
Explain to you that these feelings are common with mesothelioma patients
Prescribe a course of drugs that may help you
Refer you to a doctor or counselor who specializes in the problems of cancer patients
It is quite common for people with cancer to feel depressed, so don't feel you are different if you need to ask for help.
Positive Thinking
One of the things that people with mesothelioma are often encouraged to do is to "be positive". But that is not that easy. Living with mesothelioma and its treatment can be frightening. There will be times when you may feel low and fear for you future.
Most people with mesothelioma cancer are frightened about how they might die and what will happen to their families if they do die. There are obviously very trying emotions, and it is very difficult to "just take it your stride". Friends and family, however, may advise you to think positively. It may help to remember that being positive
Doesn't mean being cheerful and optimistic
Means recognizing some of the fearful possibilities that arise from having mesothelioma cancer
Nobody should expect you to feel good when confronting fear.
Being positive and thinking positively can even include
Feeling upset
Feeling frightened
Such feelings can be a sign of strength - and may reflect your courage in facing up to an uncertain future.
Being positive may include expressing your full range of emotions. It is, perhaps, more about being able to balance the bad with the good, and not allowing negative emotions overwhelm you.
"I can't believe it. It can't be true."
Feeling shocked is often the first reaction when mesothelioma is diagnosed. You may
Feel numb and not believe what is happening
Be unable to express any emotion
Find you can only take in small amounts of information
Ask the same questions or need to be told the same thing over and over again
Needing to have information repeated is a common reaction to shock.
Some people may find their feelings of disbelief make talking about their illness with family and friends difficult. Others feel the urge to talk about it as a way of helping them to accept the news themselves.
Fear
"Am I going to die?" "Will I be in pain?"
The first thing people ask about having mesothelioma cancer is: "Am I going to die?"
Remember - Mesothelioma patients can live for many years.
Mesothelioma clinical trials provides new hope. Today, many things can be done to help with any pain or discomfort or to slow the cancer down. (Look in Treating Pain Section for more information).
Many people are worried about their treatment and whether it will be very unpleasant. Remember that research into making treatments easier to cope with, and reducing and controlling side effects has been going on for years and will continue. Stories you hear about people being treated years ago will be out of date. It is best to talk to your doctor about your treatment before relying on rumor or other incorrect information.
Denial
"There's nothing really wrong with me. I don't have mesothelioma."
Some people choose to cope with their situation by
Not wanting to know anything about their mesothelioma cancer
Talking about it as little as possible
If that's how you feel, tell the people around you quite firmly that, for the time being, you don't want to talk about your illness.
But sometimes you may find it is the other way around. Your family and friends may
Deny your illness
Appear to ignore the fact that you have mesothelioma
Play down your anxieties and symptoms
Deliberately change the subject
These sorts of reactions may arise because people are frightened or embarrassed to talk about cancer, or because mesothelioma is such a rare form of cancer, they do not understand what it entails. Others may feel that if they don't talk about it, they can try to pretend it isn't happening. You may, however, want them to support you by sharing how you feel. If the reactions of others upset or hurt you,
Try telling them how you feel
Reassure them that you know what is happening
Explain that talking to them about your illness will help
Anger
Anger about your illness may be directed at
Those who are closest to you
The doctors and nurses who are caring for you
The companies that made the asbestos products and knew they were dangerous
God, if you are religious
You don't have to feel guilty about your angry thoughts or moods. But relatives and friends don't always realize that you are not angry with them but are angry with your illness. It may help to
Tell them this at a time when you are not feeling quite so angry
Ask them to read these pages, if talking is difficult
If you are finding it difficult to talk to your family, you may want to discuss this with a counselor.
Blame and Guilt
Sometimes in trying to find reasons why cancer has happened you may blame yourself or other people for your illness.
While asbestos exposure is the trigger, many factors must coincide to cause mesothelioma cancer. Chance plays a big part. Some people are more prone to developing a mesothelioma cancer because of their genes. Also, workers and other exposed to asbestos were never informed about the dangers; so there is no way that the average person could have avoided these dangers.
In addition, many experts believe a single tiny strand of asbestos is sufficient to trigger mesothelioma, which with the widespread use of asbestos, is impossible to avoid. Finally, you had to work to earn a living and provide for your family - that was not a choice. Nevertheless, it may be difficult to avoid blaming yourself, but talking about these feelings helps.
Why Me?
Having mesothelioma cancer can make you feel cross with people who are well. Why should this have happened to you and not to someone else? You may feel
Angry
Sad
Bad tempered
These feelings may crop up from time to time throughout your illness and treatment. Relatives may also be angry that your illness interferes with their lives.
It helps to express your feelings openly. Bottling it up may upset everyone.
Leave Me Alone
There may be times during your illness when you want to be left alone to sort out your own feelings. This can be hard for family and friends who may not understand how you feel, and want to share this difficult time with you. You can make it easier for them by telling them that
You don't feel like talking about your illness now, but you will talk to them when you do
You still care about them even if you do not want to talk about your illness
Depression
Depression is often triggered by a diagnosis of mesothelioma. You might not be able to think clearly or do things, or you might not want to get up in the morning. You may want to talk to your doctor or nurse who can
Explain to you that these feelings are common with mesothelioma patients
Prescribe a course of drugs that may help you
Refer you to a doctor or counselor who specializes in the problems of cancer patients
It is quite common for people with cancer to feel depressed, so don't feel you are different if you need to ask for help.
Positive Thinking
One of the things that people with mesothelioma are often encouraged to do is to "be positive". But that is not that easy. Living with mesothelioma and its treatment can be frightening. There will be times when you may feel low and fear for you future.
Most people with mesothelioma cancer are frightened about how they might die and what will happen to their families if they do die. There are obviously very trying emotions, and it is very difficult to "just take it your stride". Friends and family, however, may advise you to think positively. It may help to remember that being positive
Doesn't mean being cheerful and optimistic
Means recognizing some of the fearful possibilities that arise from having mesothelioma cancer
Nobody should expect you to feel good when confronting fear.
Being positive and thinking positively can even include
Feeling upset
Feeling frightened
Such feelings can be a sign of strength - and may reflect your courage in facing up to an uncertain future.
Being positive may include expressing your full range of emotions. It is, perhaps, more about being able to balance the bad with the good, and not allowing negative emotions overwhelm you.
Mesothelioma Chrysotile
Chrysotile asbestos is the main cause of malignant pleural mesothelioma. The three most common forms of asbestos are chrysotile, amosite, and crocidolite. Chrysotile or white asbestos accounts for approximately 95% of the asbestos used in US production of asbestos products and is the only member of the serpentine group of minerals.
The fine fibers of asbestos made it a great source for insulation and as a fire retardant but they their entry into the human body can trigger the onset of mesothelioma. Sometimes the asbestos fibers enter the body through the air and are breathed into the lung area of the body. Once they are taken in through the respiratory passages these fibers lodge themselves in the mesothelial cells around the lungs. This can cause direct damage to the lungs by traveling to the ends of small passages and reach the pleura area around the lungs.
Once lodged in the plural area these fibers can injure lung cells and cause lung cancer or asbestosis which is a term used to describe replacing healthy lung tissue with damaged or scar tissue. In addition, asbestos fibers can also be directly swallowed by people working in close of confined spaces with exposed asbestos. These fibers can go directly to the stomach and abdominal cavity and may lead to the development of stomach cancer or peritoneal mesothelioma.
The most common way to get is through directly working with asbestos as part of a job or career. Many people get mesothelioma as a result of their jobs working in mining, construction, shipbuilding and any other job that required a regular exposure to asbestos fibers. It is possible as well to get mesothelioma from being exposed to asbestos fibers in your home of office. Many houses still contain asbestos lined insulation that can be a grave danger if it becomes opened or exposed to humans. As long as the asbestos remains in a sealed unit or wrapped around a pipe with its exterior sealant intact, there is little danger. But if any of these materials break out of their sealed units they could easily contaminate any one who comes into contact with them.
Finally it is also possible to develop mesothelioma through direct physical contact with the clothes of someone else that has come directly into contact with asbestos. There are numerous cases of wives and spouses of miners and construction workers who have developed mesothelioma from breathing in the fibers that their husbands or wives brought home with them from the plant, mine or construction site. If that person worked in the insulation industry at a time when asbestos use was at its peak they have a much higher chance of developing this deadly disease than others who may have had minimal exposure to asbestos fibers as a result of their daily working activities.
Today mesothelioma is one of the most commonly recognized industrial or workplace diseases and special programs have been developed to recognize mesothelioma symptoms and to provide support to those who suffer from this disease.
The fine fibers of asbestos made it a great source for insulation and as a fire retardant but they their entry into the human body can trigger the onset of mesothelioma. Sometimes the asbestos fibers enter the body through the air and are breathed into the lung area of the body. Once they are taken in through the respiratory passages these fibers lodge themselves in the mesothelial cells around the lungs. This can cause direct damage to the lungs by traveling to the ends of small passages and reach the pleura area around the lungs.
Once lodged in the plural area these fibers can injure lung cells and cause lung cancer or asbestosis which is a term used to describe replacing healthy lung tissue with damaged or scar tissue. In addition, asbestos fibers can also be directly swallowed by people working in close of confined spaces with exposed asbestos. These fibers can go directly to the stomach and abdominal cavity and may lead to the development of stomach cancer or peritoneal mesothelioma.
The most common way to get is through directly working with asbestos as part of a job or career. Many people get mesothelioma as a result of their jobs working in mining, construction, shipbuilding and any other job that required a regular exposure to asbestos fibers. It is possible as well to get mesothelioma from being exposed to asbestos fibers in your home of office. Many houses still contain asbestos lined insulation that can be a grave danger if it becomes opened or exposed to humans. As long as the asbestos remains in a sealed unit or wrapped around a pipe with its exterior sealant intact, there is little danger. But if any of these materials break out of their sealed units they could easily contaminate any one who comes into contact with them.
Finally it is also possible to develop mesothelioma through direct physical contact with the clothes of someone else that has come directly into contact with asbestos. There are numerous cases of wives and spouses of miners and construction workers who have developed mesothelioma from breathing in the fibers that their husbands or wives brought home with them from the plant, mine or construction site. If that person worked in the insulation industry at a time when asbestos use was at its peak they have a much higher chance of developing this deadly disease than others who may have had minimal exposure to asbestos fibers as a result of their daily working activities.
Today mesothelioma is one of the most commonly recognized industrial or workplace diseases and special programs have been developed to recognize mesothelioma symptoms and to provide support to those who suffer from this disease.
Mesothelioma - Database
Mesothelioma is a rare form of cancer in which malignant (cancerous) cells are found in the mesothelium, a protective sac that covers most of the body's internal organs.
Microscopic view of the mesothelium
What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.
The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart.
What is mesothelioma? Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
How common is mesothelioma? Over 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. See statistics for more details.
What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in the majority of cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Click here to learn more about asbestos
Who is at increased risk for developing mesothelioma? Since the early 1940s, millions of American workers have been exposed to asbestos dust. An increased risk of developing mesothelioma was originally found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other trades people. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
There is evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers.
What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. Doctor looking at x-rays
How is mesothelioma diagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful.
A biopsy confirms a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist removes a sample of tissue for examination under a microscope by a pathologist. (See Pathology Diagnosis to learn why some patients request a second opinion.)
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
What is the conventional approach to treating mesothelioma? Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Standard treatment for all but localized mesothelioma is generally not curative. 1 (See survival rates for median survival rates with different treatments.)
Surgery - Extrapleural pneumonectomy in selected patients with early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown. Pleurectomy and decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumor. Operative mortality from pleurectomy/decortication is <2%, while mortality from extrapleural pneumonectomy has ranged from 6% to 30%. 2
Radiation/Chemotherapy - The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated; however, the duration of symptom control is short-lived. Single-agent and combination chemotherapy have been evaluated in single and combined modality studies. The most studied agent is doxorubicin, which has produced partial responses in approximately 15% to 20% of patients studied. Some combination chemotherapy regimens have been reported to have higher response rates in small phase II trials; however, the toxic effects reported are also higher, and there is no evidence that combination regimens result in longer survival or longer control of symptoms. 3
Alimta - The only FDA approved chemotherapy for malignant pleural mesothelioma (in combination with cisplatin) is pemetrexed (Alimta). In the key clinical trial that led to its approval, Alimta was combined with another chemotherapy drug (cisplatin) and compared with cisplatin alone. The patients who received the two drugs (Alimta and cisplatin) had their cancers progress (grow/spread) in 5.7 months (median). The patients who only received cisplatin had their tumors progress in 3.9 months (median). The median survival for the patients who received both drugs was 12.1 months versus 9.3 months for cisplatin only. 4
For some physicians, these therapeutic gains are not impressive. For example, some have written, "For the treatment of mesothelioma, there is little evidence that current therapies (chemotherapy, radiation, surgery) provide significant benefit for survival or quality of life.[R]adical treatments, occupying the 3 months after diagnosis, can take up the best 3 months that the patient might have had.Malignant mesothelioma has largely defeated treatment
Microscopic view of the mesothelium
What is the mesothelium? The mesothelium is a membrane that covers and protects most of the internal organs of the body. It is composed of two layers of cells: One layer immediately surrounds the organ; the other forms a sac around it. The mesothelium produces a lubricating fluid that is released between these layers, allowing moving organs (such as the beating heart and the expanding and contracting lungs) to glide easily against adjacent structures.
The mesothelium has different names, depending on its location in the body. The peritoneum is the mesothelial tissue that covers most of the organs in the abdominal cavity. The pleura is the membrane that surrounds the lungs and lines the wall of the chest cavity. The pericardium covers and protects the heart.
What is mesothelioma? Mesothelioma (cancer of the mesothelium) is a disease in which cells of the mesothelium become abnormal and divide without control or order. They can invade and damage nearby tissues and organs. Cancer cells can also metastasize (spread) from their original site to other parts of the body. Most cases of mesothelioma begin in the pleura or peritoneum.
How common is mesothelioma? Over 2,000 new cases of mesothelioma are diagnosed in the United States each year. Mesothelioma occurs more often in men than in women and risk increases with age, but this disease can appear in either men or women at any age. See statistics for more details.
What are the risk factors for mesothelioma? Working with asbestos is the major risk factor for mesothelioma. A history of asbestos exposure at work is reported in the majority of cases. However, mesothelioma has been reported in some individuals without any known exposure to asbestos. Click here to learn more about asbestos
Who is at increased risk for developing mesothelioma? Since the early 1940s, millions of American workers have been exposed to asbestos dust. An increased risk of developing mesothelioma was originally found among shipyard workers, people who work in asbestos mines and mills, producers of asbestos products, workers in the heating and construction industries, and other trades people. Today, the U.S. Occupational Safety and Health Administration (OSHA) sets limits for acceptable levels of asbestos exposure in the workplace. People who work with asbestos wear personal protective equipment to lower their risk of exposure.
There is evidence that family members and others living with asbestos workers have an increased risk of developing mesothelioma, and possibly other asbestos-related diseases. This risk may be the result of exposure to asbestos dust brought home on the clothing and hair of asbestos workers.
What are the symptoms of mesothelioma? Symptoms of mesothelioma may not appear until 30 to 50 years after exposure to asbestos. Shortness of breath and pain in the chest due to an accumulation of fluid in the pleura are often symptoms of pleural mesothelioma. Symptoms of peritoneal mesothelioma include weight loss and abdominal pain and swelling due to a buildup of fluid in the abdomen. Other symptoms of peritoneal mesothelioma may include bowel obstruction, blood clotting abnormalities, anemia, and fever. If the cancer has spread beyond the mesothelium to other parts of the body, symptoms may include pain, trouble swallowing, or swelling of the neck or face. Doctor looking at x-rays
How is mesothelioma diagnosed? Diagnosing mesothelioma is often difficult, because the symptoms are similar to those of a number of other conditions. Diagnosis begins with a review of the patient's medical history, including any history of asbestos exposure. A complete physical examination may be performed, including x-rays of the chest or abdomen and lung function tests. A CT (or CAT) scan or an MRI may also be useful.
A biopsy confirms a diagnosis of mesothelioma. In a biopsy, a surgeon or a medical oncologist removes a sample of tissue for examination under a microscope by a pathologist. (See Pathology Diagnosis to learn why some patients request a second opinion.)
Mesothelioma is described as localized if the cancer is found only on the membrane surface where it originated. It is classified as advanced if it has spread beyond the original membrane surface to other parts of the body, such as the lymph nodes, lungs, chest wall, or abdominal organs.
What is the conventional approach to treating mesothelioma? Treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. Standard treatment options include surgery, radiation therapy, and chemotherapy. Sometimes, these treatments are combined. Standard treatment for all but localized mesothelioma is generally not curative. 1 (See survival rates for median survival rates with different treatments.)
Surgery - Extrapleural pneumonectomy in selected patients with early stage disease may improve recurrence-free survival, but its impact on overall survival is unknown. Pleurectomy and decortication can provide palliative relief from symptomatic effusions, discomfort caused by tumor burden, and pain caused by invasive tumor. Operative mortality from pleurectomy/decortication is <2%, while mortality from extrapleural pneumonectomy has ranged from 6% to 30%. 2
Radiation/Chemotherapy - The use of radiation therapy in pleural mesothelioma has been shown to alleviate pain in the majority of patients treated; however, the duration of symptom control is short-lived. Single-agent and combination chemotherapy have been evaluated in single and combined modality studies. The most studied agent is doxorubicin, which has produced partial responses in approximately 15% to 20% of patients studied. Some combination chemotherapy regimens have been reported to have higher response rates in small phase II trials; however, the toxic effects reported are also higher, and there is no evidence that combination regimens result in longer survival or longer control of symptoms. 3
Alimta - The only FDA approved chemotherapy for malignant pleural mesothelioma (in combination with cisplatin) is pemetrexed (Alimta). In the key clinical trial that led to its approval, Alimta was combined with another chemotherapy drug (cisplatin) and compared with cisplatin alone. The patients who received the two drugs (Alimta and cisplatin) had their cancers progress (grow/spread) in 5.7 months (median). The patients who only received cisplatin had their tumors progress in 3.9 months (median). The median survival for the patients who received both drugs was 12.1 months versus 9.3 months for cisplatin only. 4
For some physicians, these therapeutic gains are not impressive. For example, some have written, "For the treatment of mesothelioma, there is little evidence that current therapies (chemotherapy, radiation, surgery) provide significant benefit for survival or quality of life.[R]adical treatments, occupying the 3 months after diagnosis, can take up the best 3 months that the patient might have had.Malignant mesothelioma has largely defeated treatment
Risk factors
Doctors often cannot explain why one person develops cancer and another does not. But research shows that certain risk factors increase the chance that a person will develop cancer. These are the most common risk factors for cancer:
* Growing older
* Tobacco
* Sunlight
* Ionizing radiation
* Certain chemicals and other substances
* Some viruses and bacteria
* Certain hormones
* Family history of cancer
* Alcohol
* Poor diet, lack of physical activity, or being overweight
Many of these risk factors can be avoided. Others, such as family history, cannot be avoided. People can help protect themselves by staying away from known risk factors whenever possible.
If you think you may be at risk for cancer, you should discuss this concern with your doctor. You may want to ask about reducing your risk and about a schedule for checkups.
Over time, several factors may act together to cause normal cells to become cancerous. When thinking about your risk of getting cancer, these are some things to keep in mind:
* Not everything causes cancer.
* Cancer is not caused by an injury, such as a bump or bruise.
* Cancer is not contagious. Although being infected with certain viruses or bacteria may increase the risk of some types of cancer, no one can "catch" cancer from another person.
* Having one or more risk factors does not mean that you will get cancer. Most people who have risk factors never develop cancer.
* Some people are more sensitive than others to the known risk factors.
The sections below have more detailed information about the most common risk factors for cancer. You also may want to read the NCI booklet Cancer and the Environment.
* Growing older
* Tobacco
* Sunlight
* Ionizing radiation
* Certain chemicals and other substances
* Some viruses and bacteria
* Certain hormones
* Family history of cancer
* Alcohol
* Poor diet, lack of physical activity, or being overweight
Many of these risk factors can be avoided. Others, such as family history, cannot be avoided. People can help protect themselves by staying away from known risk factors whenever possible.
If you think you may be at risk for cancer, you should discuss this concern with your doctor. You may want to ask about reducing your risk and about a schedule for checkups.
Over time, several factors may act together to cause normal cells to become cancerous. When thinking about your risk of getting cancer, these are some things to keep in mind:
* Not everything causes cancer.
* Cancer is not caused by an injury, such as a bump or bruise.
* Cancer is not contagious. Although being infected with certain viruses or bacteria may increase the risk of some types of cancer, no one can "catch" cancer from another person.
* Having one or more risk factors does not mean that you will get cancer. Most people who have risk factors never develop cancer.
* Some people are more sensitive than others to the known risk factors.
The sections below have more detailed information about the most common risk factors for cancer. You also may want to read the NCI booklet Cancer and the Environment.
Tuesday, September 2, 2008
Neuroblastoma
US scientists have discovered genetic faults that appear to be behind the majority of inherited cases of the childhood cancer neuroblastoma.
Neuroblastoma is the most common solid cancer in early childhood, accounting for around seven per cent of all childhood cancers and around one in six of all childhood cancer deaths.
The disease starts in the child's developing nerves and often appears as a tumour in the chest or abdomen.
*This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy.* - Dr John Maris, director, Children's Hospital of Philadelphia's Centre for Childhood Cancer Research
However, inherited neuroblastoma is relatively rare compared to non-hereditary forms of the disease.
Researchers at the Children's Hospital of Philadelphia have now discovered that many cases of inherited neuroblastoma involve faults in one particular gene, and that the same gene also plays a significant role in some forms of non-inherited neuroblastoma.
The researchers, whose findings are published in the journal Nature, identified the crucial gene while analysing DNA from ten families with a history of the disease.
They discovered a link between a region of DNA on chromosome 2 and the disease, and narrowed it down to a gene called anaplastic lymphoma kinase (ALK) in eight of the ten families.
The researchers then discovered that around one in eight tumour samples taken from non-inherited cases of neuroblastoma also had ALK mutations.
The findings could eventually lead to new prevention and treatment strategies. Study author Dr Yael Mosse, a paediatric oncologist at Children's Hospital, said that the discovery enables the first ever genetic tests for families affected by the inherited form of the disease.
She commented: "This finding means that it is possible to offer simple, non-invasive screening for patients with a family history of neuroblastoma.
"Furthermore, because there already are drugs in development that target the same gene in adult cancers, we can soon begin testing those drugs in children with neuroblastoma.
"As we increase our knowledge of ALK mutations, we will also offer specialised diagnostic testing for all newly diagnosed patients with neuroblastoma, to eventually allow oncologists to better customise treatment to a child's genetic profile."
Dr John Maris, director of Children's Hospital's Centre for Childhood Cancer Research, added: "This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy."
The team now plan to carry out clinical trials of drugs that target ALK in children with high-risk neuroblastoma.
Neuroblastoma is the most common solid cancer in early childhood, accounting for around seven per cent of all childhood cancers and around one in six of all childhood cancer deaths.
The disease starts in the child's developing nerves and often appears as a tumour in the chest or abdomen.
*This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy.* - Dr John Maris, director, Children's Hospital of Philadelphia's Centre for Childhood Cancer Research
However, inherited neuroblastoma is relatively rare compared to non-hereditary forms of the disease.
Researchers at the Children's Hospital of Philadelphia have now discovered that many cases of inherited neuroblastoma involve faults in one particular gene, and that the same gene also plays a significant role in some forms of non-inherited neuroblastoma.
The researchers, whose findings are published in the journal Nature, identified the crucial gene while analysing DNA from ten families with a history of the disease.
They discovered a link between a region of DNA on chromosome 2 and the disease, and narrowed it down to a gene called anaplastic lymphoma kinase (ALK) in eight of the ten families.
The researchers then discovered that around one in eight tumour samples taken from non-inherited cases of neuroblastoma also had ALK mutations.
The findings could eventually lead to new prevention and treatment strategies. Study author Dr Yael Mosse, a paediatric oncologist at Children's Hospital, said that the discovery enables the first ever genetic tests for families affected by the inherited form of the disease.
She commented: "This finding means that it is possible to offer simple, non-invasive screening for patients with a family history of neuroblastoma.
"Furthermore, because there already are drugs in development that target the same gene in adult cancers, we can soon begin testing those drugs in children with neuroblastoma.
"As we increase our knowledge of ALK mutations, we will also offer specialised diagnostic testing for all newly diagnosed patients with neuroblastoma, to eventually allow oncologists to better customise treatment to a child's genetic profile."
Dr John Maris, director of Children's Hospital's Centre for Childhood Cancer Research, added: "This is a very important discovery, as it not only helps us understand the genetic roots of this terrible disease, but also has led to dramatically new ideas for curative therapy."
The team now plan to carry out clinical trials of drugs that target ALK in children with high-risk neuroblastoma.
Cancer cells may spread earlier than thought
Cancer cells may spread around the body much earlier in the disease process than was previously thought, a new US study suggests.
Cancer spread (metastasis) was thought to only occur when the disease was advanced and cells had become more aggressive. But the latest study from the Memorial Sloan-Kettering Cancer Centre in New York suggests that apparently 'normal' cells may move away from the original tumour site and lie dormant in other parts of the body until cancer genes within the cells are switched on.
The researchers injected mice with breast cells that had been modified so that cancer genes could be switched on at various times.
*These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage.* - Liz Baker, senior science information officer, Cancer Research UK
They found that the cells travelled in the bloodstream to the lungs and were able to survive there in their 'normal' state for up to 16 weeks before the cancer genes were activated, after which the cells began to grow aggressively there.
According to the researchers, the finding could help to explain why breast cancer can spread in some people long after the initial tumour has been treated.
The discovery is likely to spark a rethink of the process by which cancer spreads around the body and could lead to new ways to treat the disease.
Lead researcher Dr Katrina Podsypanina commented: "These findings indicate that properties inherent in normal cells are sufficient for negotiating a significant portion of the metastatic cascade.
"The finding that metastatic disease can arise from untransformed mammary (breast) cells in the circulation refines our conception of cancer progression, and suggests that each step in the metastatic cascade should be examined to establish its functional requirements, including those performed by normal cells."
She added that recurrent cancers could be targeted by treatments that destroy cells that have moved away from the primary tumour site and are lying dormant before a secondary tumour begins to take hold.
Commenting on the study published in the journal Science, Liz Baker, senior science information officer at Cancer Research UK, said: "Learning more about the spread of cancer - or metastasis - is essential because it is harder to treat the disease once it has spread.
"These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage and improve the outcome for people affected by this disease."
Cancer spread (metastasis) was thought to only occur when the disease was advanced and cells had become more aggressive. But the latest study from the Memorial Sloan-Kettering Cancer Centre in New York suggests that apparently 'normal' cells may move away from the original tumour site and lie dormant in other parts of the body until cancer genes within the cells are switched on.
The researchers injected mice with breast cells that had been modified so that cancer genes could be switched on at various times.
*These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage.* - Liz Baker, senior science information officer, Cancer Research UK
They found that the cells travelled in the bloodstream to the lungs and were able to survive there in their 'normal' state for up to 16 weeks before the cancer genes were activated, after which the cells began to grow aggressively there.
According to the researchers, the finding could help to explain why breast cancer can spread in some people long after the initial tumour has been treated.
The discovery is likely to spark a rethink of the process by which cancer spreads around the body and could lead to new ways to treat the disease.
Lead researcher Dr Katrina Podsypanina commented: "These findings indicate that properties inherent in normal cells are sufficient for negotiating a significant portion of the metastatic cascade.
"The finding that metastatic disease can arise from untransformed mammary (breast) cells in the circulation refines our conception of cancer progression, and suggests that each step in the metastatic cascade should be examined to establish its functional requirements, including those performed by normal cells."
She added that recurrent cancers could be targeted by treatments that destroy cells that have moved away from the primary tumour site and are lying dormant before a secondary tumour begins to take hold.
Commenting on the study published in the journal Science, Liz Baker, senior science information officer at Cancer Research UK, said: "Learning more about the spread of cancer - or metastasis - is essential because it is harder to treat the disease once it has spread.
"These are important but early results in mice. If they are confirmed by further studies they could reveal new ways of stopping cancer spread at an earlier stage and improve the outcome for people affected by this disease."
Radiofrequency Ablation
Radiofrequency Ablation (RFA) of Lung Tumors
RFA is a promising local therapy that has evolved rapidly in recent years for the treatment of primary and secondary cancers in the lung. The feasibility and safety profile in humans are well established. Complications following RFA are similar to those of CT-guided lung biopsies. However, sufficient long term results beyond 5 years are not yet available due to the relatively short time that this technology has been in use. Patients with smaller tumors (less than or equal to 3 cm) and fewer tumor nodules (less than or equal to 5 lesions) who are considered poor surgical candidates or who develop residual or recurrent disease despite maximal conventional therapy, and have tumors that are away from vital structures are the best candidates for RFA. Hence, RFA can be safely offered to patients who cannot undergo surgical resection. However the role of RFA in patients who are candidates for surgical resection is unproven, and there is no evidence on whether RFA is more or less effective that focused radiation (sterotactic body radiation therapy). Overall, RFA is a highly promising modality that may be used to our patients' advantage either as a solitary treatment or in combination with conventional therapy.
RFA is a promising local therapy that has evolved rapidly in recent years for the treatment of primary and secondary cancers in the lung. The feasibility and safety profile in humans are well established. Complications following RFA are similar to those of CT-guided lung biopsies. However, sufficient long term results beyond 5 years are not yet available due to the relatively short time that this technology has been in use. Patients with smaller tumors (less than or equal to 3 cm) and fewer tumor nodules (less than or equal to 5 lesions) who are considered poor surgical candidates or who develop residual or recurrent disease despite maximal conventional therapy, and have tumors that are away from vital structures are the best candidates for RFA. Hence, RFA can be safely offered to patients who cannot undergo surgical resection. However the role of RFA in patients who are candidates for surgical resection is unproven, and there is no evidence on whether RFA is more or less effective that focused radiation (sterotactic body radiation therapy). Overall, RFA is a highly promising modality that may be used to our patients' advantage either as a solitary treatment or in combination with conventional therapy.
10 Tips
1. Stay away from smoking and chewing of tobacco products to reduce risk of lung cancer, Mouth, colon cancer and urinary bladder cancer incidence.
2. Regular screening for major cancers. We can prevent cancers of breast, prostate, colon, skin and cervix by screening.
3. Reduce alcohol consumption to prevent cancers of breast, colon, pancreas, oesophagus and head-neck.
4. Use sunscreen to prevent skin cancer or reduce incidence.
5. Regular exercise for 3-4 hours per week will reduce cancer incidence by 30-50%.
6. Control your weight by making proper diet changes and with regular exercise to prevent cancers of colon, breast, pancreas, kidney, liver and endometrium. Junk foods are major culprits for rise in obesity incidence.
7. Women should not post-menopausal hormonal therapy to reduce risk for cancers of breast, ovary and endometrial cancers.
8. Avoid exposure to carcinogens and radiation.
9. Vegetarians have low risk of getting cancer. Eat foods and green leafy vegetables and stay away from high calorie foods like soft drinks.
10. One should take proper medication to reduce cancer risk by consulting oncologist.
2. Regular screening for major cancers. We can prevent cancers of breast, prostate, colon, skin and cervix by screening.
3. Reduce alcohol consumption to prevent cancers of breast, colon, pancreas, oesophagus and head-neck.
4. Use sunscreen to prevent skin cancer or reduce incidence.
5. Regular exercise for 3-4 hours per week will reduce cancer incidence by 30-50%.
6. Control your weight by making proper diet changes and with regular exercise to prevent cancers of colon, breast, pancreas, kidney, liver and endometrium. Junk foods are major culprits for rise in obesity incidence.
7. Women should not post-menopausal hormonal therapy to reduce risk for cancers of breast, ovary and endometrial cancers.
8. Avoid exposure to carcinogens and radiation.
9. Vegetarians have low risk of getting cancer. Eat foods and green leafy vegetables and stay away from high calorie foods like soft drinks.
10. One should take proper medication to reduce cancer risk by consulting oncologist.
Breast Cancer
Breast Cancer Death Rates Differ by Race
On whole, the report shows the continuation of a welcome trend -- a steady decrease each year in the rate of breast cancer deaths. Thanks to better methods of detecting cancers early and treatment advances, American women today are less likely to die of breast cancer than they have been in decades, said Harmon J. Eyre, MD, chief medical officer of the American Cancer Society.
Looking at the issue of race -- and the socioeconomic and genetic factors associated with race -- it becomes clear that this good news is better for some groups of women than for others. "Perhaps most troubling," said Eyre, "is the striking divergence in long-term mortality trends seen between African-American and white females that began in the early 1980s and that by 2004 had led to death rates being 36% higher in African-American women."
Other key statistics included in the report:
* An estimated 178,480 new cases of invasive breast cancer in women will be diagnosed in 2007, and approximately 40,460 deaths will be recorded. Only lung cancer accounts for more cancer deaths in women.
* In 2004 (the latest year for which figures are available), approximately 2.4 million women living in the US had a history of breast cancer. Breast cancer accounts for more than 1 in 4 cancers in US women.
* On average, the breast cancer death rate decreased by 2.2% each year between 1990 and 2004. Younger women saw an even more significant decline during that period.
* Breast cancer incidence among white women -- that is, the rate at which new breast cancers are diagnosed in this group -- fell by 3.7% a year during 2001-2004. Also declining during this time: the use of mammography and hormone replacement therapy (HRT) by white women. There was no significant change in breast cancer incidence among African-American women during this time, coinciding with stable mammography rates and HRT use.
* Among women 50 and older, incidence rates have been on a steep decline (by 4.8% per year) since 2001. Among women under age 50, incidence rates have remained stable since 1986.
* Since 2000, the incidence rate of smaller tumors has declined by 3.8% per year. In contrast, the incidence rate of larger tumors (>5.0 cm) has increased by 1.7% per year since 1992. (Larger tumor size at diagnosis is associated with decreased survival.) Both trends may be tied to an increase in obesity in postmenopausal women, HRT use, or both.
On whole, the report shows the continuation of a welcome trend -- a steady decrease each year in the rate of breast cancer deaths. Thanks to better methods of detecting cancers early and treatment advances, American women today are less likely to die of breast cancer than they have been in decades, said Harmon J. Eyre, MD, chief medical officer of the American Cancer Society.
Looking at the issue of race -- and the socioeconomic and genetic factors associated with race -- it becomes clear that this good news is better for some groups of women than for others. "Perhaps most troubling," said Eyre, "is the striking divergence in long-term mortality trends seen between African-American and white females that began in the early 1980s and that by 2004 had led to death rates being 36% higher in African-American women."
Other key statistics included in the report:
* An estimated 178,480 new cases of invasive breast cancer in women will be diagnosed in 2007, and approximately 40,460 deaths will be recorded. Only lung cancer accounts for more cancer deaths in women.
* In 2004 (the latest year for which figures are available), approximately 2.4 million women living in the US had a history of breast cancer. Breast cancer accounts for more than 1 in 4 cancers in US women.
* On average, the breast cancer death rate decreased by 2.2% each year between 1990 and 2004. Younger women saw an even more significant decline during that period.
* Breast cancer incidence among white women -- that is, the rate at which new breast cancers are diagnosed in this group -- fell by 3.7% a year during 2001-2004. Also declining during this time: the use of mammography and hormone replacement therapy (HRT) by white women. There was no significant change in breast cancer incidence among African-American women during this time, coinciding with stable mammography rates and HRT use.
* Among women 50 and older, incidence rates have been on a steep decline (by 4.8% per year) since 2001. Among women under age 50, incidence rates have remained stable since 1986.
* Since 2000, the incidence rate of smaller tumors has declined by 3.8% per year. In contrast, the incidence rate of larger tumors (>5.0 cm) has increased by 1.7% per year since 1992. (Larger tumor size at diagnosis is associated with decreased survival.) Both trends may be tied to an increase in obesity in postmenopausal women, HRT use, or both.
Sunday, August 31, 2008
New Directions
New Directions for Treating Mesothelioma
Because conventional therapies are not curative for the overwhelming majority of mesothelioma patients, researchers are investigating new types of mesothelioma treatments and therapies. One approach that may yield promising results is anti-angiogenesis. Anti-angiogenesis is a form of therapy that uses drugs or other substances to stop tumors from making new blood vessels. Without a blood supply, the cancers cannot grow effectively. Today, there are several hundred clinical trials of anti-angiogenesis drugs under way. For example, Veglin is an anti-angiogenesis drug undergoing clinical trials at the University of Southern California's Keck School of Medicine. Under the supervision of Parkash S. Gill, M.D. and financed by grants from the Mesothelioma Research Foundation of America, a Phase I study of Veglin has demonstrated some success in patients suffering from lymphoma, sarcoma, and colon and lung cancers. Phase II studies are on-going with the hope they will demonstrate continued clinical efficacy in mesothelioma and other cancers.
Because conventional therapies are not curative for the overwhelming majority of mesothelioma patients, researchers are investigating new types of mesothelioma treatments and therapies. One approach that may yield promising results is anti-angiogenesis. Anti-angiogenesis is a form of therapy that uses drugs or other substances to stop tumors from making new blood vessels. Without a blood supply, the cancers cannot grow effectively. Today, there are several hundred clinical trials of anti-angiogenesis drugs under way. For example, Veglin is an anti-angiogenesis drug undergoing clinical trials at the University of Southern California's Keck School of Medicine. Under the supervision of Parkash S. Gill, M.D. and financed by grants from the Mesothelioma Research Foundation of America, a Phase I study of Veglin has demonstrated some success in patients suffering from lymphoma, sarcoma, and colon and lung cancers. Phase II studies are on-going with the hope they will demonstrate continued clinical efficacy in mesothelioma and other cancers.
Mesothelioma Treatments and Therapies
Standard treatment for all but localized mesothelioma is generally not curative.1 Surgery and radiotherapy have a limited role in highly selected mesothelioma patients and chemotherapy is the only potential treatment option for the majority of people diagnosed with mesothelioma. Sometimes, these mesothelioma therapies are combined. Despite activity of some chemotherapy, the results are still modest, with a median survival of approximately one year. For individual patients, treatment for mesothelioma depends on the location of the cancer, the stage of the disease, and the patient's age and general health. The only FDA approved chemotherapy for malignant pleural mesothelioma (in combination with cisplatin) is pemetrexed (Alimta). In the key clinical trial that led to its approval for mesothelioma, Alimta was combined with another chemotherapy drug (cisplatin) and compared with cisplatin alone. The median survival for the patients who received both chemotherapy drugs was 12.1 months versus 9.3 months for mesothelioma patients who only received cisplatin.
Orthotic Therapy
Leaders in Effective Treatment Using Orthotics
Orthotics and ankle-foot orthotics (AFOs) are our most useful , effective and versatile treatment. Our podiatrists’ unique credentials make them some of the nation’s most skilled at custom-designing these devices to precisely control function and resolve your problem. The doctors evaluate the biomechanics of your gait themselves, then take a mold of your foot — still the most exacting method — with their own hands. The nation’s highest-tech orthotics lab then creates your devices to high tolerances. We guarantee the comfort of your orthotics, and we can make most needed adjustments right in the office. Drs. Hale and Huppin are committed to providing the best in foot orthotic therapy, and they know that’s a function of their own skill and experience.
What are Orthotics?
The term "orthotic" can refer to almost any device which is worn inside a shoe. Items called “orthotics” can be found in infomercials, retail stores and even at trade shows. There are three very different types of “orthotics” – custom, customized and off-the-shelf. The educated consumer should be aware of each type.
There is a confusing amount of information available on orthotics. For many consumers making an informed decision is difficult. Recognizing a sales pitch and separating it from facts is the key to better health. The information in this section should provide the information you need to make an informed decision.
Orthotics and ankle-foot orthotics (AFOs) are our most useful , effective and versatile treatment. Our podiatrists’ unique credentials make them some of the nation’s most skilled at custom-designing these devices to precisely control function and resolve your problem. The doctors evaluate the biomechanics of your gait themselves, then take a mold of your foot — still the most exacting method — with their own hands. The nation’s highest-tech orthotics lab then creates your devices to high tolerances. We guarantee the comfort of your orthotics, and we can make most needed adjustments right in the office. Drs. Hale and Huppin are committed to providing the best in foot orthotic therapy, and they know that’s a function of their own skill and experience.
What are Orthotics?
The term "orthotic" can refer to almost any device which is worn inside a shoe. Items called “orthotics” can be found in infomercials, retail stores and even at trade shows. There are three very different types of “orthotics” – custom, customized and off-the-shelf. The educated consumer should be aware of each type.
There is a confusing amount of information available on orthotics. For many consumers making an informed decision is difficult. Recognizing a sales pitch and separating it from facts is the key to better health. The information in this section should provide the information you need to make an informed decision.
Thursday, August 21, 2008
Epithelial Mesothelioma Cancer
Epithelial mesothelioma is a rare and deadly form of cancer affects the membrane lining the chest cavity, heart, lungs and abdominal cavity. There are three forms of epithelial mesothelioma: the most common, pleural mesothelioma; the second most common, peritoneal mesothelioma (accounting for only a quarter of the cases) and the rarest form, pericardial mesothelioma.
The vast majority of epithelial mesothelioma cases are the result of asbestos exposure. Indeed, one of the most frustrating aspects of this type of cancer is that patients who develop it were generally exposed 15 to 40 years before hand, which often makes the time and place the disease was contracted difficult to determine.
The early symptoms of epithelial mesothelioma are subtle and somewhat general. Shortness of breath and chest pain are the most common early symptoms. It is because these symptoms are so generic that epithelial mesothelioma is rarely detected early on. Usually when its discovered it is already in an advanced stage and treatment options, particularly localized options such as surgery, are somewhat limited.
If the cancer is in a less advanced stage, aggressive surgery treatments can be sought. Aggressive treatments are treatments aimed at curing the mesothelioma or at least increasing the patients longevity. In some cases an extrapleural pneumonectomy can be performed to try to stop the spread of the mesothelioma.
However this operation is risky and many medical centers will not perform it because of its high mortality rate. Additionally this procedure involves removing an entire lung, as well as extensive epithelial tissue, thereby reducing the patients breathing capacity in half. Even when it is successful it rarely eliminates the mesothelioma, but rather only slows its progress.
Palliative surgery (surgery only aimed at alleviating symptoms) is an option at any stage of the disease. Usually this comes in the form of a "fine needle aspiration" or pleural tap. A pleural tap involves injecting a long needle into the chest or abdomen cavity and draining the pleural space of fluid build up. This procedure may greatly reduces symptoms associated with mesothelioma.
Radiation therapy and chemotherapy are other options. Both are systemic treatments and have the draw back of affecting surrounding tissues as well as cancerous tissues. Radiation therapy is often used in combination with surgery treatments as a way of attempting to remove cancerous growth that could not be removed through surgery. Chemotherapy still has not proved very effective against epithelial mesothelioma but doctors and researcher continue to experiment with new techniques.
The vast majority of epithelial mesothelioma cases are the result of asbestos exposure. Indeed, one of the most frustrating aspects of this type of cancer is that patients who develop it were generally exposed 15 to 40 years before hand, which often makes the time and place the disease was contracted difficult to determine.
The early symptoms of epithelial mesothelioma are subtle and somewhat general. Shortness of breath and chest pain are the most common early symptoms. It is because these symptoms are so generic that epithelial mesothelioma is rarely detected early on. Usually when its discovered it is already in an advanced stage and treatment options, particularly localized options such as surgery, are somewhat limited.
If the cancer is in a less advanced stage, aggressive surgery treatments can be sought. Aggressive treatments are treatments aimed at curing the mesothelioma or at least increasing the patients longevity. In some cases an extrapleural pneumonectomy can be performed to try to stop the spread of the mesothelioma.
However this operation is risky and many medical centers will not perform it because of its high mortality rate. Additionally this procedure involves removing an entire lung, as well as extensive epithelial tissue, thereby reducing the patients breathing capacity in half. Even when it is successful it rarely eliminates the mesothelioma, but rather only slows its progress.
Palliative surgery (surgery only aimed at alleviating symptoms) is an option at any stage of the disease. Usually this comes in the form of a "fine needle aspiration" or pleural tap. A pleural tap involves injecting a long needle into the chest or abdomen cavity and draining the pleural space of fluid build up. This procedure may greatly reduces symptoms associated with mesothelioma.
Radiation therapy and chemotherapy are other options. Both are systemic treatments and have the draw back of affecting surrounding tissues as well as cancerous tissues. Radiation therapy is often used in combination with surgery treatments as a way of attempting to remove cancerous growth that could not be removed through surgery. Chemotherapy still has not proved very effective against epithelial mesothelioma but doctors and researcher continue to experiment with new techniques.
Malignant Mesothelioma
According to The National Cancer Institute, malignant mesothelioma, a rare form of cancer, is a disease in which cancer (malignant) cells are found in the sac lining of the chest (pleura), the abdomen (peritoneum), or the heart (pericardium). Most people diagnosed with mesothelioma have worked on jobs where they breathed asbestos. Asbestos may cause a variety of diseases, from non-cancerous forms such as asbestosis, to much more serious diseases such as mesothelioma. Workers exposed to asbestos in the 1940s, 50s, 60s, and 70s, are coming down with these diseases decades later due to the long latency period associated with all asbestos disease.
The Department of Health and Human Services, the World Health Organization, and the Environmental Protection Agency have determined that asbestos is a human carcinogen. It is well documented that breathing asbestos fibers can increase the risk of cancer in people. Exposure to asbestos has been considered a major occupational health hazard since the first adverse effects were noted in the mid-20th century. At that time, there appeared to be an association between asbestos and lung cancer. Subsequently, it was noted that asbestos also caused pleural thickening. By the 1960s, a definite association between asbestos and mesothelioma, a rare cancer of the lining of the lung or the lining of the abdominal cavity was apparent.
The association between lung cancer and asbestos exposure is now well established. Although in most studies, all histologic types of cancer are seen, there appears to be a preponderance of adenocarcinoma. Lung cancer in asbestos-exposed workers is thought to occur at a slightly younger age than other lung cancers, and these cancers are more commonly located in the lower lobes of the lungs. There is what is called a "synergistic effect" between cigarette smoking and asbestos exposure, thus the risk of getting lung cancer rises to extraordinarily high levels if the exposed person is also a smoker. If you have been exposed to asbestos, you should stop smoking. This may be the most important action you can take to improve your health and decrease your risk of lung cancer.
The risk of non-cancerous asbestos-related diseases generally increases with increasing levels of exposure, however, this dose-response relationship is less clear for mesothelioma, where even short-term occupational exposure, or secondary household exposure occur. Cigarette smoking has no relationship to mesothelioma. We are all exposed to asbestos in the air we breathe, however, these levels are generally considered "acceptable". There has been no correlation drawn as to why, given the same set of circumstances and amounts of exposure, one person contracts mesothelioma and the person next to them does not, or why the more heavily exposed individual never contracts an asbestos-related disease, yet his wife is diagnosed after washing his work clothing.
Your Question or Comment:
The Department of Health and Human Services, the World Health Organization, and the Environmental Protection Agency have determined that asbestos is a human carcinogen. It is well documented that breathing asbestos fibers can increase the risk of cancer in people. Exposure to asbestos has been considered a major occupational health hazard since the first adverse effects were noted in the mid-20th century. At that time, there appeared to be an association between asbestos and lung cancer. Subsequently, it was noted that asbestos also caused pleural thickening. By the 1960s, a definite association between asbestos and mesothelioma, a rare cancer of the lining of the lung or the lining of the abdominal cavity was apparent.
The association between lung cancer and asbestos exposure is now well established. Although in most studies, all histologic types of cancer are seen, there appears to be a preponderance of adenocarcinoma. Lung cancer in asbestos-exposed workers is thought to occur at a slightly younger age than other lung cancers, and these cancers are more commonly located in the lower lobes of the lungs. There is what is called a "synergistic effect" between cigarette smoking and asbestos exposure, thus the risk of getting lung cancer rises to extraordinarily high levels if the exposed person is also a smoker. If you have been exposed to asbestos, you should stop smoking. This may be the most important action you can take to improve your health and decrease your risk of lung cancer.
The risk of non-cancerous asbestos-related diseases generally increases with increasing levels of exposure, however, this dose-response relationship is less clear for mesothelioma, where even short-term occupational exposure, or secondary household exposure occur. Cigarette smoking has no relationship to mesothelioma. We are all exposed to asbestos in the air we breathe, however, these levels are generally considered "acceptable". There has been no correlation drawn as to why, given the same set of circumstances and amounts of exposure, one person contracts mesothelioma and the person next to them does not, or why the more heavily exposed individual never contracts an asbestos-related disease, yet his wife is diagnosed after washing his work clothing.
Your Question or Comment:
Clinical Trial Basic
Clinical trials are studies of the safety and/or effectiveness of new drugs being tested on humans. For mesothelioma, trials are being conducted to find a better and more effective means of treatment. Anyone interested in participating in a clinical trial should discuss the particular trial thoroughly with their doctor before a making a decision on whether it is right for them.
All clinical trials carry potential benefits and risks, and it is important that you have a complete understanding of what you might expect. For instance, since clinical trials are often conducted at larger cancer centers, in many cases, travel may be necessary to receive treatment and routine tests. On the other hand, care is provided at top-notch facilities by physicians who are leaders in the field of cancer research. Another benefit would be having access to the new drug before it is widely available, however, the new drug may ultimately be proven not as effective as the “standard” of care.
Eligibility requirements for clinical trials are not the same; each study has specific guidelines to participate. Some trials allow participation after other treatments have failed, while others require that the patient have no prior treatment. Your doctor should be able to advise you which trial might be the best fit in your particular case.
Some treatment trials are “randomized”, meaning the new treatment is compared with a current standard of treatment. Depending on which arm of the protocol you are assigned, you may receive the new treatment or the standard. You should be informed in advance of this eventuality by the doctor conducting the trial. Placebos (pills that contain no active ingredient) are rarely used in cancer trials.
All clinical trials carry potential benefits and risks, and it is important that you have a complete understanding of what you might expect. For instance, since clinical trials are often conducted at larger cancer centers, in many cases, travel may be necessary to receive treatment and routine tests. On the other hand, care is provided at top-notch facilities by physicians who are leaders in the field of cancer research. Another benefit would be having access to the new drug before it is widely available, however, the new drug may ultimately be proven not as effective as the “standard” of care.
Eligibility requirements for clinical trials are not the same; each study has specific guidelines to participate. Some trials allow participation after other treatments have failed, while others require that the patient have no prior treatment. Your doctor should be able to advise you which trial might be the best fit in your particular case.
Some treatment trials are “randomized”, meaning the new treatment is compared with a current standard of treatment. Depending on which arm of the protocol you are assigned, you may receive the new treatment or the standard. You should be informed in advance of this eventuality by the doctor conducting the trial. Placebos (pills that contain no active ingredient) are rarely used in cancer trials.
Powers of Attorney
A Power of Attorney (POA) is a written document in which you (“the Principal”)designate another person (“the Agent or Attorney-in-Fact”) to act on your behalf in making property, financial and other legal decisions. The most common types of Powers of Attorney include:
* Durable Power of Attorney
A Durable Power of Attorney allows the Agent or Attorney-in-Fact to act for the Principal even after the Principal is not mentally competent or physically able to make decisions. The Durable Power of Attorney may be used immediately, and is effective until it is revoked by the Principal, or until the Principal’s death.
* Nondurable Power of Attorney
A Nondurable Power of Attorney is often used for a specific transaction, such as the closing on the sale of a residence, or the handling of the Principal’s financial affairs while the Principal is traveling out of the country. A Nondurable Power of Attorney takes effect immediately and remains in effect until it is revoked by the Principal, or until the Principal becomes mentally incompetent or dies.
* Springing Power of Attorney
A Springing Power of Attorney becomes effective at a future time when an Agent, or another third party, such as the Principal’s physician, determines that the Principal in no longer competent to handles his or her own financial affairs. A Springing Power of Attorney remains in effect until the Principal’s death, or until revoked by a court.
Powers of Attorney are important legal documents, and should be given only after careful consideration. A licensed attorney in your state can:
* Provide you with advice about the powers that are appropriate to be delegated
* Provide counsel on the choice of an Agent.
* Outline the Agent’s legal and fiduciary obligations while acting under a Power of Attorney.
* Ensure that the Power of Attorney is properly executed and meets all legal requirements.
* Durable Power of Attorney
A Durable Power of Attorney allows the Agent or Attorney-in-Fact to act for the Principal even after the Principal is not mentally competent or physically able to make decisions. The Durable Power of Attorney may be used immediately, and is effective until it is revoked by the Principal, or until the Principal’s death.
* Nondurable Power of Attorney
A Nondurable Power of Attorney is often used for a specific transaction, such as the closing on the sale of a residence, or the handling of the Principal’s financial affairs while the Principal is traveling out of the country. A Nondurable Power of Attorney takes effect immediately and remains in effect until it is revoked by the Principal, or until the Principal becomes mentally incompetent or dies.
* Springing Power of Attorney
A Springing Power of Attorney becomes effective at a future time when an Agent, or another third party, such as the Principal’s physician, determines that the Principal in no longer competent to handles his or her own financial affairs. A Springing Power of Attorney remains in effect until the Principal’s death, or until revoked by a court.
Powers of Attorney are important legal documents, and should be given only after careful consideration. A licensed attorney in your state can:
* Provide you with advice about the powers that are appropriate to be delegated
* Provide counsel on the choice of an Agent.
* Outline the Agent’s legal and fiduciary obligations while acting under a Power of Attorney.
* Ensure that the Power of Attorney is properly executed and meets all legal requirements.
Symptoms Managed through Palliative Care
Some of the common symptoms managed through palliative care include:
* Pain
* Shortness of breath
* Fatigue
* Dry Mouth
* Loss of appetite
* Gastrointestinal problems
* Skin problems
* Anxiety/Depression
Pain
Pain management is one of the most important aspects of palliative care. Because it is now considered a medical specialty, you may wish to consult a physician well versed in pain management if your physician seems unable or unwilling to provide adequate pain control.
Many people with cancer experience pain. Statistics show that 30 to 40 per cent of patients in active cancer therapy, and 70 to 90 percent of patients with advanced cancer report pain. In most cases, pain can be controlled through medications prescribed according to the World Health Organization's Analgesic Ladder, an approach using various levels of medication based on the severity of pain. This type of pain treatment, using drugs, is called pharmacological therapy. Medications may include innon-opioid pain relievers, opioid pain relievers, adjuvant medications (those whose primary purpose is not for pain, but for other conditions), and topical treatments such as a patch, gel, or cream. A study published the Annals of Oncology found a reluctance among cancer patients to take opioid medications due to a belief that such medications are offerred only at the end of life.
Non-pharmacological therapies, those that do not rely primarily on medication to achieve effect, include therapeutic exercise and cognitive behavioral techniques such as deep breathing, muscle relaxation, imagery, meditation, biofeedback therapy, and distraction. Complementary and/or alternative approaches include acupuncture and massage therapy. Integretive medicine refers to the combination of mainstream conventional treatment such as surgery, chemotherapy and radiation with complementary therapies proven to have sound scientific evidence as to their safety and effectiveness.
Shortness of Breath
Shortness of breath, or dyspnea, affects 20 to 80 percent of palliative care patients. Causes of this condition may include, lung disease, fluid in the lungs, infection, anemia, or emotional factors such as anxiety. While medications or oxygen may be used to treat shortness of breath, sometimes measures such as changing position, using relaxation techniques, or improving air circulation may help. More on anemia from chemotherapy treatment.
Fatigue
Cancer-related fatigue may be the result of the general progression of the disease, the effects of medication, or the after effects of treatments such as surgery, chemotherapy, or radiation therapy. The following symptoms are usually associated with fatigue:
* Diminished energy level disproportionate to activity
* Diminished activity associated with physical or intellectual performance
* Diminished motivation; lack of interest in activities
* Exhaustion, apathy, or lethargy
* Generalized tiredness
* Sleep abnormalities
* Irritability, impatience, or changes in mood
The treatment of fatigue is based on first identifying, and then managing, the underlying cause of the fatigue. Once that is accomplished, interventions such as medication, exercise, stress management, and nutrition are used. More on fatigue in mesothelioma patients.
Dry Mouth
Dry mouth, or xerostoma, is another symptom addressed in palliative care. Causes may be dehydration, depression or anxiety, or may be a side effect of medications such as pain relievers, antidepressants, diuretics, or tranquilizers. Chemotherapy treatments or radiotherapy may also be a cause.
Relief of dry mouth can often be achieved by:
* Drinking plenty of fluids
* Sucking on ice chips or Vitamin C tablets
* Chewing sugarless gum
* Maintaining good oral hygiene
* Providing humidified air
Loss of Appetite
Patients with life-threatening illnesses often lose their appetite, and subsequently, lose weight. If the condition becomes too severe, it is called cachexia. Doctors uniformly agree that nutrition plays a vital role in the patient's well being. Causes of weight loss include inadequate intake of nutrients because the patient can not or does not want to eat, poor absorption of the food that is eaten, and changes in the patient's metabolism.
Weight loss may be managed by:
* Eating smaller, more frequent meals
* Eating high calorie, high protein foods
* Receiving nutritional counseling
There are also medications which may help depending on the patient's desired goal. Some of these medications stimulate appetite, but do not usually increase weight, some stimulate appetite and cause slight weight gain, and still others help prevent nausea and vomiting.
Gastrointestinal Problems
Gastrointestinal problems may be associated with the disease process itself, or as a side effect of treatments or medications the patient is receiving. These may include nausea, vomiting, constipation, and diarrhea.
As mentioned above, there are medications which can help with nausea and vomiting. Your doctor or a nutritionist may also be able to provide eating hints and/or special diets tailored to fit the patient's individual needs. More on diarreah in mesothelioma patients.
Skin Problems
There are a variety of skin problems which may accompany cancer, including dryness, itching, rash, sores, and ulcers. It is important to treat these conditions as quickly as possible in order to reduce discomfort and the risk of infection.
* Dryness may be lessened by adding baby or mineral oil to warm bath water, and by applying moisturizers. It is also important to drink 8-10 glasses of water per day.
* Itching and rash may be lessened by adding baking soda to cool bath water, or by applying a cool, moist cloth to itchy areas. Avoid harsh laundry detergents, and change sheets and towels daily.
* Keep skin clean and dry and check skin daily for pressure sores or ulcers which may become infected.
Anxiety/Depression
Anxiety is a hallmark of a life-threatening illness. Feelings of fear, worry, or apprehension may lead to long-term generalized anxiety, or short, intense panic attacks. Causes may include difficulty in coming to terms with the illness, fear of isolation and separation, poorly controlled pain, or side effects of medication.
Treatments to control anxiety may include stress management techniques, counseling, support of family and friends, and control of pain or side effects from medication.
Depression, while less common, often affects family members as well as the patient themselves. Depression may be related to loss of the ability to function, changing family roles, limited social and financial support, pain, or other symptoms such as shortness of breath.
Control of the above symptoms is accomplished through antidepressant medication, support and counseling, pain management, and stress management.
* Pain
* Shortness of breath
* Fatigue
* Dry Mouth
* Loss of appetite
* Gastrointestinal problems
* Skin problems
* Anxiety/Depression
Pain
Pain management is one of the most important aspects of palliative care. Because it is now considered a medical specialty, you may wish to consult a physician well versed in pain management if your physician seems unable or unwilling to provide adequate pain control.
Many people with cancer experience pain. Statistics show that 30 to 40 per cent of patients in active cancer therapy, and 70 to 90 percent of patients with advanced cancer report pain. In most cases, pain can be controlled through medications prescribed according to the World Health Organization's Analgesic Ladder, an approach using various levels of medication based on the severity of pain. This type of pain treatment, using drugs, is called pharmacological therapy. Medications may include innon-opioid pain relievers, opioid pain relievers, adjuvant medications (those whose primary purpose is not for pain, but for other conditions), and topical treatments such as a patch, gel, or cream. A study published the Annals of Oncology found a reluctance among cancer patients to take opioid medications due to a belief that such medications are offerred only at the end of life.
Non-pharmacological therapies, those that do not rely primarily on medication to achieve effect, include therapeutic exercise and cognitive behavioral techniques such as deep breathing, muscle relaxation, imagery, meditation, biofeedback therapy, and distraction. Complementary and/or alternative approaches include acupuncture and massage therapy. Integretive medicine refers to the combination of mainstream conventional treatment such as surgery, chemotherapy and radiation with complementary therapies proven to have sound scientific evidence as to their safety and effectiveness.
Shortness of Breath
Shortness of breath, or dyspnea, affects 20 to 80 percent of palliative care patients. Causes of this condition may include, lung disease, fluid in the lungs, infection, anemia, or emotional factors such as anxiety. While medications or oxygen may be used to treat shortness of breath, sometimes measures such as changing position, using relaxation techniques, or improving air circulation may help. More on anemia from chemotherapy treatment.
Fatigue
Cancer-related fatigue may be the result of the general progression of the disease, the effects of medication, or the after effects of treatments such as surgery, chemotherapy, or radiation therapy. The following symptoms are usually associated with fatigue:
* Diminished energy level disproportionate to activity
* Diminished activity associated with physical or intellectual performance
* Diminished motivation; lack of interest in activities
* Exhaustion, apathy, or lethargy
* Generalized tiredness
* Sleep abnormalities
* Irritability, impatience, or changes in mood
The treatment of fatigue is based on first identifying, and then managing, the underlying cause of the fatigue. Once that is accomplished, interventions such as medication, exercise, stress management, and nutrition are used. More on fatigue in mesothelioma patients.
Dry Mouth
Dry mouth, or xerostoma, is another symptom addressed in palliative care. Causes may be dehydration, depression or anxiety, or may be a side effect of medications such as pain relievers, antidepressants, diuretics, or tranquilizers. Chemotherapy treatments or radiotherapy may also be a cause.
Relief of dry mouth can often be achieved by:
* Drinking plenty of fluids
* Sucking on ice chips or Vitamin C tablets
* Chewing sugarless gum
* Maintaining good oral hygiene
* Providing humidified air
Loss of Appetite
Patients with life-threatening illnesses often lose their appetite, and subsequently, lose weight. If the condition becomes too severe, it is called cachexia. Doctors uniformly agree that nutrition plays a vital role in the patient's well being. Causes of weight loss include inadequate intake of nutrients because the patient can not or does not want to eat, poor absorption of the food that is eaten, and changes in the patient's metabolism.
Weight loss may be managed by:
* Eating smaller, more frequent meals
* Eating high calorie, high protein foods
* Receiving nutritional counseling
There are also medications which may help depending on the patient's desired goal. Some of these medications stimulate appetite, but do not usually increase weight, some stimulate appetite and cause slight weight gain, and still others help prevent nausea and vomiting.
Gastrointestinal Problems
Gastrointestinal problems may be associated with the disease process itself, or as a side effect of treatments or medications the patient is receiving. These may include nausea, vomiting, constipation, and diarrhea.
As mentioned above, there are medications which can help with nausea and vomiting. Your doctor or a nutritionist may also be able to provide eating hints and/or special diets tailored to fit the patient's individual needs. More on diarreah in mesothelioma patients.
Skin Problems
There are a variety of skin problems which may accompany cancer, including dryness, itching, rash, sores, and ulcers. It is important to treat these conditions as quickly as possible in order to reduce discomfort and the risk of infection.
* Dryness may be lessened by adding baby or mineral oil to warm bath water, and by applying moisturizers. It is also important to drink 8-10 glasses of water per day.
* Itching and rash may be lessened by adding baking soda to cool bath water, or by applying a cool, moist cloth to itchy areas. Avoid harsh laundry detergents, and change sheets and towels daily.
* Keep skin clean and dry and check skin daily for pressure sores or ulcers which may become infected.
Anxiety/Depression
Anxiety is a hallmark of a life-threatening illness. Feelings of fear, worry, or apprehension may lead to long-term generalized anxiety, or short, intense panic attacks. Causes may include difficulty in coming to terms with the illness, fear of isolation and separation, poorly controlled pain, or side effects of medication.
Treatments to control anxiety may include stress management techniques, counseling, support of family and friends, and control of pain or side effects from medication.
Depression, while less common, often affects family members as well as the patient themselves. Depression may be related to loss of the ability to function, changing family roles, limited social and financial support, pain, or other symptoms such as shortness of breath.
Control of the above symptoms is accomplished through antidepressant medication, support and counseling, pain management, and stress management.
Ascites and Peritoneal Cavity Fluid
Ascites build up inside the abdomen in a membrane called the peritoneum. This membrane consists of two layers, one that lines the abdominal wall and one that encloses the organs of the abdomen. The peritoneum produces a fluid that serves as a lubricant allowing the organs of the abdomen to glide easily over one another. Usually this fluid is present in a very small quantity. Ascites is the build up, or overabundance of this fluid and is often the first tangible indication that mesothelioma is present in the body, it the most common early sign of peritoneal mesothelioma.
The symptoms of ascites are unpleasant. Usually the stomach becomes bloated and sometimes pain, and nausea accompanies this bloating. Its not uncommon for patients to experience a loss of appetite, or for sitting, standing, and walking to become restricted and uncomfortable. Fatigue, lethargy and breathlessness are also possible symptoms.
When ascites is first detected, the treating doctor will drain the fluid in a procedure known as a Paracentesis. By draining the fluid doctor's can reduce symptoms caused by the build up as well as gather a sample to learn the reason for its occurrence. A paracentesis is a relatively easy procedure that can take place in the hospital bed or in the outpatient clinic. Occasionally doctors will perform the procedure in the ultra sound department so that they can more easily locate the fluid build up. Ultra sounds are particularly useful when fluid has collected in multiple pockets, as will sometimes occur when the ascitic build up is smaller.
After the doctor injects the patient with a local anesthesia he will make a small incision in the abdomen wall in order to pass a cannula into the abdomen. The cannula is a thin tube that is attached to drainage bag for the paracentesis. Using gentle suction the doctor will draw the ascitic fluid from the abdomen into the drainage bag. If there is only a small amount of ascitic fluid the procedure can usually be accomplished in an outpatient setting, if there is a larger amount, however, the drain may remain in place for two to three days.
At the beginning of the paracentesis up to a liter of fluid may be drained quickly and safely. After this initial amount, however, the drain must be performed slowly because a sudden release of abdominal pressure may cause blood pressure to drop as well. During the procedure doctors will monitor the heart rate of the patient to make sure this doesn't occur. Sometimes during the procedure the drain will become blocked, but often the solution is just a matter of the patient repositioning him or herself (sitting up, lying back etc.). Occasionally the cannula can be a source of infection (a variation in blood pressure will tell doctors if this is the case).
If a patient has been diagnosed with ascites but the cause has not yet been determined, it is very possible that the ascites is not a result of mesothelioma. Cirrhosis is the most common cause of the ascites build up, accounting for 80% of its occurrences. Tuberculosis, endometriosis, Familial Mediterranean fever, Whipple's disease, are all possible causes of ascites. Generally speaking cancer is the cause of ascitic build up only 10 % of the time.
The symptoms of ascites are unpleasant. Usually the stomach becomes bloated and sometimes pain, and nausea accompanies this bloating. Its not uncommon for patients to experience a loss of appetite, or for sitting, standing, and walking to become restricted and uncomfortable. Fatigue, lethargy and breathlessness are also possible symptoms.
When ascites is first detected, the treating doctor will drain the fluid in a procedure known as a Paracentesis. By draining the fluid doctor's can reduce symptoms caused by the build up as well as gather a sample to learn the reason for its occurrence. A paracentesis is a relatively easy procedure that can take place in the hospital bed or in the outpatient clinic. Occasionally doctors will perform the procedure in the ultra sound department so that they can more easily locate the fluid build up. Ultra sounds are particularly useful when fluid has collected in multiple pockets, as will sometimes occur when the ascitic build up is smaller.
After the doctor injects the patient with a local anesthesia he will make a small incision in the abdomen wall in order to pass a cannula into the abdomen. The cannula is a thin tube that is attached to drainage bag for the paracentesis. Using gentle suction the doctor will draw the ascitic fluid from the abdomen into the drainage bag. If there is only a small amount of ascitic fluid the procedure can usually be accomplished in an outpatient setting, if there is a larger amount, however, the drain may remain in place for two to three days.
At the beginning of the paracentesis up to a liter of fluid may be drained quickly and safely. After this initial amount, however, the drain must be performed slowly because a sudden release of abdominal pressure may cause blood pressure to drop as well. During the procedure doctors will monitor the heart rate of the patient to make sure this doesn't occur. Sometimes during the procedure the drain will become blocked, but often the solution is just a matter of the patient repositioning him or herself (sitting up, lying back etc.). Occasionally the cannula can be a source of infection (a variation in blood pressure will tell doctors if this is the case).
If a patient has been diagnosed with ascites but the cause has not yet been determined, it is very possible that the ascites is not a result of mesothelioma. Cirrhosis is the most common cause of the ascites build up, accounting for 80% of its occurrences. Tuberculosis, endometriosis, Familial Mediterranean fever, Whipple's disease, are all possible causes of ascites. Generally speaking cancer is the cause of ascitic build up only 10 % of the time.
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