In response to the United States Environmental Protection Agency's (EPA) identification of major sources of public asbestos exposure in Michigan, the Barbara Ann Karmanos Cancer Institute and the Center for Occupational and Environmental Medicine (COEM) affiliated with Wayne State University (WSU) have joined forces to establish The National Center for Vermiculite and Asbestos-Related Cancers.

The joint program is addressing an immediate public health need for early diagnosis and aggressive treatment of asbestos-related diseases in Michigan.

A federal health investigation is underway into facilities across the country, including the former W.R. Grace plant on Henn Street in Dearborn that processed vermiculite contaminated with asbestos for decades until it shut down in the late 1980s. More than 300 million pounds of asbestos-contaminated vermiculite mined in Libby, Montana, by the W.R. Grace Company was processed at this Dearborn plant into Zonolite-brand insulation and subsequently used in more than 800,000 Michigan homes. This includes virtually all the single-family housing in Flint and nearly 280,000 homes throughout southeast Michigan. Eight additional W.R. Grace vermiculite-processing plants were located in River Rouge, Warren, Milan, Reed City, Elsie and Grand Rapids.

Persons exposed to asbestos-contaminated vermiculite, either occupationally or environmentally, are at risk of developing asbestosis, a progressive and potentially fatal, long-term disease of the lungs, lung cancer and mesothelioma, an extremely aggressive cancer of the covering of the lungs and intestine whose only known cause is asbestos. Smokers who have been exposed to asbestos are 50 times more likely to develop lung cancer than nonsmokers. Additionally, those who have been exposed to asbestos have been shown to have twice the chance of developing colorectal cancer.

“The overall extent of asbestos-related cancers and other diseases related to vermiculite exposure is unclear but initial studies suggest it is substantial,” says Harvey Pass, M.D., professor of surgery and oncology for Karmanos Cancer Institute and WSU. “COEM has had a long interest in asbestos-related diseases and the Karmanos Cancer Institute is heavily involved in both clinical and basic research on asbestos-related cancers,” says Dr. Pass.

“Through this Center we can quickly pull together the expertise and resources necessary to study and treat this problem immediately.”

Spearheaded by longtime collaborators Dr. Pass and Michael Harbut, M.D., M.P.H, chief of COEM, The National Center for Vermiculite and Asbestos-Related Cancers brings together a highly experienced team of specialists in pulmonary medicine, cardiology, gastroenterology, radiology and medical oncology to:

• Implement a program of early detection and treatment of human cancers and asbestosis resulting from chronic exposure to asbestos contaminated vermiculite including mesothelioma and lung cancer;
• Provide a means to rapidly test large numbers of potentially affected individuals;
• Define populations at increased risk of asbestos exposure prior to it becoming a major medical-legal issue;
• Examine the health consequences of chronic exposure to asbestos contaminated vermiculite and related fibers;
• Increase the basic scientific understanding of asbestos-related cancers; and
• Intensify physician education of asbestos-related diseases throughout Michigan.
  

“This will probably become a recognized public health problem,” says Dr. John Ruckdeschel, M.D., president and CEO of the Karmanos Cancer Institute, and recognized specialist in lung cancer.

“We’ve quickly organized some of the nation’s leading physicians and scientists in this field to provide people exposed to vermiculite and related substances with fast, easy, accurate and orderly screening, conducted by the right doctors in the proper clinical settings,” he says. “These patients will be screened and assessed in good order and proper sequence for the early detection of mesothelioma and it’ll be done in an integrated clinical and scientific environment. This is an opportunity to get it right the first time, and we’re going to do just that.”

“The peak usage of asbestos in the United States was in l978,” notes Dr. Harbut. “There is usually a 15 to 30 year waiting period for diseases related to asbestos to show up after first exposure. But we are now in the middle of the peak of expected cases of asbestosis and only at the beginning of the peak of expected asbestos-related cancers.”

Persons at risk for asbestos-related diseases include anyone who:

• Worked in a vermiculite processing facility;
• Lived with someone who worked in a vermiculite processing facility;
• Lived in close proximity to a vermiculite processing facility;
• Currently works in the building trades and other industries which use or have used asbestos;
• Lived in a house with vermiculite insulation; and
• Has participated in a lawyer-driven asbestos screening program and has not received appropriate medical follow-up.
• In addition to vermiculite, taconite, an “asbestiform” material found in the iron mines of Michigan’s upper peninsula, is often contaminated with asbestos. Miners from this area are also at risk for asbestos related diseases and should be examined. There are a number of other materials currently under review.

Through The National Center for Vermiculite and Asbestos-Related Cancers, individuals who have been exposed to asbestos contaminated vermiculite will first see Dr. Harbut at his Royal Oak office where he will make appropriate referrals if an asbestos-related disease is identified.

Dr. Pass will coordinate all surgical needs at the Institute’s midtown Detroit location. Dr. Pass and the Karmanos Cancer Institute hope to enroll interested vermiculite and asbestos exposed individuals in a trial validating a novel blood test later this spring, which will help identify the presence of mesothelioma. Primary care physicians of individuals visiting the Center will remain highly involved in their patients’ care and kept thoroughly informed throughout the entire process.

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