Ship-breaking in Bangladesh

Researchers are reporting impressive results in testing a vaccine for mesothelioma, a cancer that attacks the lining which protects the body's internal organs. Mesothelioma is almost always caused by exposure to asbestos, which means that it's almost always industrial and occupational in origin. Asbestos miners and millworkers are at high risk for the disease, as are shipyard workers and the family members of people who work with asbestos.

Technology created the disease. Science may have found a new way to treat it. But the worldwide path of the disease and the likely arc of its treatment offer reason for reflection. 125 million people are exposed to asbestos every year, and lower-income people are far more likely to be at risk. The World Health Organization (WHO 2006) and others have noted that the best way to eliminate mesothelioma and other asbestos-related disease is to eliminate exposure, but we don't. And nanotechnology, the latest technological breakthrough, may bring the risk of another mesothelioma outbreak.

The success of the vaccine approach is worth celebrating. But, as with so many diseases, it seems we're more likely to celebrate the cure than we're willing to eliminate the cause. Should the cure be validated by future testing, the financial structure of modern medicine suggests it will be distributed as unequally and unfairly as the disease's causes have been. Economics. as much as biology, has shaped this disease's story. And economics will probably paint its future arc., a resource for disease victims, describes the disease's origins this way:

“Asbestos products were used extensively throughout the 20th century … Many of these products were responsible for asbestos exposure sustained by both the individuals who manufactured the products as well as those who used them at commercial and industrial jobsites including shipyards, refineries, power plants, steel plants and more. Several asbestos companies continued to produce these products even after they were known to be hazardous and harmful to workers and their families. Those who have become sick because of exposure to these products may now be eligible for financial compensation if they were wrongfully exposed.”

The site adds: “Asbestos was also used at many New York jobsites including Ground Zero and the former World Trade Center site. Common asbestos exposure sites in New York include the Brooklyn Navy Yard, Todd Shipyard, and the Con Edison power plant in New York City.”

Asbestos has been banned for manufacturing use in most developing countries for 40 years, but the US ban is only partial and many developing countries have no restrictions at all on its use. A group of epidemiological researchers put it succinctly: “National disparities in asbestos use will likely lead to an unequal burden of asbestos diseases,” adding: “An estimated 90,000 asbestos-related deaths occur worldwide every year, and 125 million people are occupationally exposed to asbestos.” (Driscoll et al. 2005a, 2005b; Concha-Barrientos et al. 2004). The researchers found that asbestos exposure falls heavily on the poorest nations.Ehp.0901196.g001

The European Union has banned asbestos, but Canada continues to mine and export it. At the other end of the spectrum, the unorganized low-income workers in Bangladesh's ship-breaking industry are exposed to asbestos on a daily basis without protection or training in exposure avoidance. In fact, as A. S. Chowdhury Repon reports, even labor inspectors in the area appear unfamiliar with the issue.

While the world struggles with the legacy of asbestos, researchers have identified a possible link between a new nanotechnology and mesothelioma. Research on multi-walled carbon nanotubes, which are currently being used to build tennis rackets and golf clubs and are being studied for other applications, raises serious concerns. As the International Council on Nanotechnology (ICON) notes, “Two recent studies published in the Journal of Toxicological Sciences and Nature Nanotechnology have demonstrated that some multi-walled carbon nanotubes (MWCNT or MWNT) can induce in mice a response similar to that induced by certain asbestos fibers.” Adds ICON: “…the two studies taken together point to the need for a careful assessment of the potential for MWCNT to cause injury to humans.”

Some may see mesothelioma as a man-made hell, an invitation to “deep ecology,” a confirmation of William Blake's statement that “science is the Tree of Death.” Others will see the vaccine as further confirmation of science's almost limitless ability to heal.

It's difficult and potentially facile to use disease as a metaphor, pace Susan Sontag. But mesothelioma is an essentially human-caused disease. And it's a Rorscarch test for our perception of science and technology: as a bringer of life or as a source of danger and death. In the end, science is a powerful tool, but a human one. It's an engine of transformation whose consequences closely linked to the matrix of all human behavior.

Curing mesothelioma will require science, social activism, and public communication. In an ideal world, vaccine researchers and epidemiologists would be joined by protest movements and political action, fueled by arts and literature.

What technology and inequality can cause, knowledge … in all its forms … must cure.

(written for 3 Quarks Daily)