The quiet epidemic

Steve McQueen died of it. The woman in this picture has it. Soon it will be claiming more lives than road accidents. Charles Arthur reports on the terrible toll of asbestos-related illness

BY RIGHTS June Hancock should be dead. Most people with mesothelioma, a cancer of the chest lining, die within one or two years. Although she was diagnosed as having the disease in January 1994 she is still active and mobile, so she is enjoying some borrowed time.

She is also enjoying spending a little money. She recently took her family from Yorkshire to spend a few days at the Waldorf Hotel in London. They saw Leeds United - she is a lifelong supporter - play at Wembley and she had tea at Fortnum and Masons. She is treating herself.

The money and the illness go together, for June Hancock has just won the last round of a historic legal battle giving her pounds 65,000 compensation for the damage done to her health by asbestos. It was the first victory of its kind in the British courts, and many more compensation claims are now likely to follow.

June is 59. When she was a child in Armley, Leeds, she and her friends played in the streets around the J W Roberts asbestos factory. At that time, the white fibrous dust from the factory is said to have filled the air and built up in drifts in corners and against walls. As the children played in the streets and park - some are said to have thrown "snowballs" - the deadly particles steadily accumulated in their lungs.

Fourteen years ago, June watched her mother die a painful death from mesothelioma. Now she has the disease too, but she is luckier, if lucky is the right word. The doctors no longer bother with exhausting therapies; she just has drugs for the pain, and she has been sustained by the fight to win compensation from Turner & Newall, the conglomerate of which J W Roberts became a subsidiary. "I'd be dead now if it hadn't been for this," she says.

June Hancock is one among many victims of a man-made epidemic that makes few headlines but is becoming impossible to ignore. While we worry that eating beef might - just might - trigger a rare brain disease, thousands of people have been dying, not from any choice they made themselves, but from having once inhaled asbestos fibres in their workplace, home or school.

ABOUT 3,000 people now die in Britain every year either from mesothelioma or from asbestosis, an inflammation of the lungs caused by inhalation of asbestos particles. Asbestos is already responsible for more occupationally related deaths than any other single cause, and the toll is rising steeply. The Health and Safety Executive (HSE), a body which is not given to wild predictions, said recently that by 2025 there could be 10,000 deaths annually. That is far more than are killed in road accidents or die from Aids, and it is 200 times more than Creutzfeldt-Jakob Disease (CJD) has ever killed in a year.

And it is not just Britain. In Australia, where asbestos was mined, 1,000 people a year are dying. In the US, by one official estimate, asbestos may eventually kill 5.4 million Americans. World-wide, insurance claims from asbestos victims are expected to total more than $50bn.

We have all learnt over the last 20 years that asbestos is dangerous stuff, to be avoided at all costs. What we hear less often is that it is too late for many thousands of June Hancocks, the people dying and doomed to die, and that thousands more are still being exposed to risk. In many places, and in many trades, asbestos is a plague to come.

Even now, not much is being done. "If we had really been taking this threat seriously, then we wouldn't be looking at the prospect of 200 people dying every week," says Rory O'Neill, editor of Hazards magazine, which looks at present and future risks to health. "There's more asbestos in this country than ever before."

Asbestos offers a particularly unpleasant way to die. Mesothelioma has no known cure, and few treatments; it is just unremittingly painful. Asbestosis leaves the victim short of breath, often gasping for air which usually has to be supplemented by an oxygen mask. Both diseases strike people who are comparatively young - in their fifties, say, when they should be able to look forward to useful years or pleasant retirements.

The parents now changing their children's diets to avoid any chance of catching CJD are probably unaware that those children have a far higher risk of being exposed to asbestos dust in their schools. In March 1988, Mr O'Neill helped the Inner London Education Authority in a study to see how much it would cost to remove asbestos from schools. Their estimate: between pounds 500m to pounds 600m. To get a national figure, multiply that by 10.

Would the Government countenance spending pounds 5bn to make sure that our children will not fight for breath when they are in their fifties? On the evidence so far, it would not. "Yet what's the cost going to be of treating those thousands of people, in terms of the hospital time, and the working hours lost, and the benefits that have to be paid?" asks Mr O'Neill. "It might not be cheap to prevent, but prevention is obviously better - you can't even say there's a cure."

The trouble with asbestos, and asbestos-related diseases, is that it is invisible in so many ways. It is not like a steak or a burger; something that is there in the butcher's or on the menu and which you can choose or not choose as you wish. You are very unlikely to know it is there in a wall or on a ceiling or in the air, and you cannot see the microscopically small mineral fibres that will kill you in the years to come. A woman of 49 died in Cardiff last year, almost certainly from the effects of breathing in asbestos that she shook from her husband's work clothes every evening before washing them.

Nobody even knows how much comprises a fatal dose; the Ontario Royal Commission in 1984 suggested that it would take 25 "fibre-years" (one fibre-year being exposure for a year to a concentration of two fibres per millilitre of air) to develop clinical asbestosis. However, an intensely polluted atmosphere (such as on the street in Armley) can give you a fibre-year's worth of exposure in a single day or night.

The danger comes when the body's defences begin to be overwhelmed by the tiny fibres arriving in the lungs. Studies suggest that our lungs can either dissolve, or otherwise dispose of, a certain number of fibres over a given period. But above that threshold, the risk of developing these diseases increases steadily.

ANOTHER reason why we overlook asbestos is that the people who suffer from it tend not to be high-profile. The best-known name to have died from mesothelioma is Steve McQueen. But McQueen's exposure to asbestos came long before he was a film star, when he was a mechanic, fitting asbestos friction components in race cars. His past caught up with him eventually.

More usually it is what the super-rich American Leona Helmsley once called "the small people" who develop these illnesses. The HSE's revised estimates, produced by Professor Julian Peto of the Cancer Research Campaign, suggest that plumbers, gas fitters, carpenters, electricians and building workers will figure heavily in future deaths.

Gary Burdett, an HSE scientist, warns that those people are at risk every time they pull away asbestos-impregnated insulating material around pipes, or drill through ceiling tiles, which may contain brown asbestos - one of the more dangerous forms. The HSE has developed and patented a lapel badge costing a few pounds that detects asbestos exposure. "Most asbestos was imported into Britain during the 1960s and 1970s, installed in buildings and is still there. So we have to take precautions now," says Dr Burdett.

The trouble is that the people at risk probably won't be working for the big firms which, mindful of the dangers, would require their employees to wear detectors. They will be the one- and two-man bands, trying to scratch a living, and dying by it.

"They are the guys who go in and see something to be done, and they haven't got the training to know if they should take precautions against asbestos or not," says John Pickering, a Leeds-based lawyer who specialises in compensation litigation. "How can anybody know by looking at a piece of board whether it's got asbestos in it or not? They just think, `Oh, it'll only take a couple of minutes to cut that up'. But you can't see the dust."

Mr Pickering is in no doubt that the number of asbestos-related cases is rising: "I don't need statistics. I just look at the number of people coming to me, and I'm only one lawyer in one place. Thirty years ago it was extremely rare to have someone coming to me about mesothelioma; now it's the most common complaint."

The lawyers are winning their cases, too. World-wide, more than 200,000 asbestos claims have been made, about half of them have been settled and the London insurance market has paid out about pounds 2bn, two-thirds of it from Lloyd's. T&N (formally Turner & Newall) has had to pay out pounds 250m world-wide to people directly affected by asbestosis and related diseases; it still has thousands of cases outstanding in the USA, and hundreds more in this country. Some of the claims date back to activities in 1925. In Belfast, the shipbuilder Harland & Wolff faces hundreds of claims from employees who often worked with minimal protection from the dust.

Our attitude to asbestos has always been an odd one. We prized it for its fireproofing, insulating properties and we have been slow to give it up, at least in Britain (see below). The long legal argument reached its most absurd pitch recently, when T&N argued against a High Court judgment forcing it to pay damages to June Hancock.

Breathing asbestos dust, argued T&N's counsel, was "like buying lottery tickets": no one could tell which particles caused individual cancers. Ergo, it was not necessarily T&N's dust that had caused the claimants' illnesses; it could have been any other they inhaled during the intervening 70 years.

Lord Justice Russell found this unconvincing. "It is not a very attractive argument for the factory owner to agree that mountains of asbestos dust were created but these cases of cancer were not the result of that," he said.

THE LAW is getting tougher. The next phase of litigation, predicts Mr O'Neill, will be when employers are imprisoned for exposing their staff to asbestos hazards. The first such case happened only last January, when Roy Hill, a builder, was sentenced at Bristol Crown Court to three months in prison and pounds 4,000 costs after admitting contaminating a building site and surrounding area with asbestos dust.

It was the first time in 20 years that imprisonment had been imposed. And it marked a breakthrough for campaigners. "Fines just roll off these people in companies. They laugh up their sleeves," said one. "But prison - that's showing them. They'll take care to stay clear of that."

June Hancock is anxious to see the epidemic acknowledged, by whatever means. "So much is made of other diseases, yet this one is almost unknown," she says. "I have every sympathy for the victims of Aids, for example, but it is hard for us to see that there is so much research, so much help and support going into Aids and there is little or nothing for mesothelioma. There is no cure for that either."

As for herself, she lives in hope. "I treat every day as it comes. Only yesterday I spoke to someone who was given six months to live, and that was four years ago. I'm ever hopeful."