No safe use

Canada’s embrace of the ‘miracle mineral’ has seeded an epidemic of cancers. Yet many Canadians are still exposed to asbestos every day
John Nolan, 67Mr. Nolan is battling mesothelioma, a cancer caused by exposure to asbestos. Listen to his story, then scroll to read more.
Listen to my story
Part 1

The invisible

Photo John Nolan in 2012, prior to his diagnosis, with his daughter, Liz Nolan. Mr. Nolan was exposed to asbestos while working as manager of a convention centre. His career also included stints as a tour guide all over the world, and as a stage manager in London, working with the likes of Judi Dench and Ian McKellen. (Courtesy of the Nolan family)

For John Nolan, the first warning signs came mid-November of last year while he was leading a tour in the Peruvian Andes.

Mr. Nolan, 67, who lives in Fort Erie in southwestern Ontario, was guiding a group through the mountains near the storied Incan city of Cuzco.

He had criss-crossed the planet for years as a tour guide, and knew what higher altitudes typically felt like. But something terrifying happened while he was hauling his luggage up some steep stone steps to his cabin.

“I’ve never been out of breath in such a panicky, horrible way,” Mr. Nolan says in a raspy voice between laboured breaths. “Normally, when you run out of breath, you know you’re going to get it back. This was different. It was as if you were hitting a stone wall, with no hope of getting air. It was like suffocating.”

The diagnosis, back at home, was swift and cruel. It was mesothelioma — an incurable cancer caused almost exclusively by asbestos exposure. Mr. Nolan was initially given a few months to live.

Asbestos is the top on-the-job killer in Canada. But a Globe and Mail investigation has found that this stark fact has been obscured by the country’s longstanding economic interest in the onetime “miracle mineral.” Even though Canada’s own asbestos industry has dwindled from pre-eminence to insignificance — the country’s last two mines closed in 2011 — the federal government has dragged its feet as other nations have acknowledged asbestos’s deadly impact and moved to protect their populations from it.

Top 25 sources of workplace death in Canada, 2007-2012 (from approved workers’ compensation claims)

Infographic View the sources of death across Canada using the drop-down menu. Select jurisdictions to show deaths by province or territory. While this data only goes back to 2007, most of the increase in accepted workplace death claims since 1996 is due to asbestos exposure. (Source: The Association of Workers' Compensation Boards of Canada)

Ottawa, in fact, holds to the position that asbestos can be safe, despite an international consensus among doctors and researchers to the contrary.

And despite evidence that even low levels of exposure can be harmful, asbestos products continue to enter the country. Unlike at least 52 other countries, from Australia and Japan to Sweden and the United Kingdom, Canada has never banned imports or exports of asbestos.

“Many people are under the misconception that we’ve banned asbestos. But the fact is, no, we still use asbestos for some things,” says Paul Demers, one of the country’s leading experts on asbestos-related disease.

Ongoing uses (such as brake pads) are not even the biggest threat. “The problem is that asbestos doesn’t simply go away,” says Dr. Demers, who is a University of Toronto professor in public health and director at the Occupational Cancer Research Centre at Cancer Care Ontario, a provincial agency. “We may not use as much new asbestos now, but there’s a lot of it in our environment, in older buildings and structures,” he says.

With asbestos so prevalent, Canada faces an invisible epidemic: mesothelioma. The disease has a long latency period, of 20 to 40 years; Mr. Nolan’s asbestos exposure occurred in the late 1980s when he was manager of Windsor’s Cleary Auditorium and Convention Centre.

His office was located within 25 feet of renovations, where workers in protective suits removed asbestos from the ceiling and walls. The room was covered in plastic sheeting — but the ventilation pumped air right from the dusty renovation into his windowless office. (He also recalls asbestos was present in the basement’s pipes.)

The crew took safety precautions, but “for those of us who were still working there, we just carried on,” he says.

“Nobody came by to say ‘this is a really bad thing here, you’ve gotta get out of the building, you’ve gotta move out of the building.’”

“We were relying on a mechanical system that ventilates and so as they’re taking the asbestos out, how the hell do they know where it’s going as they’re removing it? Well it obviously was coming into the office next door.”

“It was, I guess, dumb on our part too because there’s somebody 20 feet away with this heavy-duty ventilator and mask and complete covering, and there I am standing with my street clothes on.”

Photo Cases like Mr. Nolan’s demonstrate that mesothelioma and other asbestos-related diseases are no longer restricted to blue-collar occupations. Victims are increasingly found in professions such as teaching, as well as among the families of people who worked directly with asbestos. (Louie Palu for The Globe and Mail)

By striking both blue-collar workers and white-collar workers, like Mr. Nolan, mesothelioma has racked up a record as the most common cause of workplace deaths in Canada for every year between 2007 and 2012, with more than 1,200 successful claims for fatality benefits made in that time, data from the Association of Workers’ Compensation Boards of Canada show. Asbestosis (fibrosis of the lungs, which impairs breathing, but is not typically fatal) is the fourth-most common claim.

Other asbestos-related diseases include lung cancer and pleural plaque (a calcification on the lungs). Asbestos exposure also raises the risk of several other of cancers.

The climbing toll of Canada’s top occupational killer is reflected in workers’ compensation statistics. In Alberta, for example, 63 workers died in 2013 of mesothelioma, asbestosis and asbestos-related conditions, compared with 28 deaths a decade earlier, according to the province’s Workers Compensation Board.

Top 25 causes of workplace death in Canada, 2007-2012 (from approved workers’ compensation claims)

Infographic View causes of death across Canada using the drop-down menu. Select jurisdictions to show deaths by province or territory. Mesothelioma was the most common cause of workplace death in Canada for every year between 2007 and 2012. (Source: The Association of Workers' Compensation Boards of Canada)

The number of accepted claims for mesothelioma in Canada rose 216.4 per cent between 1997 and 2010, a 2013 paper by Dr. Demers and Dr. Ann Del Bianco reports. Across Canada, seven in 10 accepted occupational cancer death claims involve exposure to asbestos.

The Ontario Workplace Safety and Insurance Board has pegged the average cost of a mesothelioma claim at $532,844 (with much of that in survivor benefits, along with health-care costs and loss of earnings).

Mesothelioma deaths are even higher when statistics for non-workplace-related cases are included. Between 2000 and 2011, more than 4,000 people died of mesothelioma, Statistics Canada data show. The number of new cases has almost doubled, to about 500 people per year, since 1992.

The figures likely understate the number of people affected. Workers’ compensation data is based only on the number of successful claims, so that anyone who is not covered by the system of no-fault workplace coverage, who doesn’t file or is unsuccessful in their claim doesn’t show up in the stats.

Indeed, only about half of mesothelioma cases are filed with the workers’ compensation boards, in the estimation of Dr. Demers. And mesothelioma itself is frequently misdiagnosed as lung cancer, so death rates are likely underreported. Asbestosis, too, tends to be under-diagnosed and under-reported.

The continued imports, along with mesothelioma’s long latency period and continuing exposures to asbestos that is already in place across the country, add up to a dire prognosis: Canada’s invisible epidemic hasn’t even peaked yet.

Part 2

is still

Number of Canadians exposed to asbestos at work, by occupation

Infographic Workers who are exposed to asbestos are predominantly employed in construction trades. Researchers say safety procedures are not always followed in construction for a variety of reasons, including rushing to meet deadlines and precarious employment that make workers less likely to be aware of their rights or to speak up. (Source: Carex Canada)

Many Canadians are unknowingly exposed to asbestos every day. It is still found in the country’s schools, hospitals, homes and building materials. No research has been done on how much of the total Canadian population is exposed.

A tally of workplace exposures taken by Carex Canada, a research project funded by the Canadian Partnership Against Cancer (which in turn is funded by Ottawa), found that 152,000 Canadians, from builders to auto mechanics and engineers, are exposed to asbestos in the workplace. But the study did not include low exposures.

The federal government allows its workers to be exposed to one fibre of asbestos per cubic centimetre of air — a level at least 10 times higher than what is permitted in the U.S. or Europe (most provinces have now introduced lower levels).

Canada has seen a decade-long building and home renovation boom; as walls, pipes and ceilings are torn out, asbestos can be released. Home renos account for an increasing share of the workload of lawyer Rohan Atherton, who represents mesothelioma patients.

Many exposures today stem from lack of knowledge on the workers’ and homeowners’ part. Manny Oliveira, co-owner of Toronto-based asbestos-removal firm Greenstream Environmental Inc., estimates that “less than 10 per cent” of the thousands of home renos under way in Toronto have had testing for asbestos and then followed proper procedures for safe removal.

He has watched contractors haul out bags of asbestos to the dump and then reuse the bags. He has been called into homes after other firms have botched a job, stirring up asbestos in an attic and spreading it throughout the premises. “There tends to be a lot of cowboys out there who aren’t following the rules,” Mr. Oliveira says. “A lot of times they leave the place in a worse state than if they’d never showed up.”

Canadian imports of asbestos and related products, 2004-2013

Asbestos and related products imported in 2013

Infographic Declining imports reflect the ongoing decline of asbestos use. The industry’s golden era came to an end in the 1970s, when health concerns led countries to control the use of asbestos, or to ban it as an import or export. Canada, however, has continued importing commonly used products such as brake pads and pipes. Because of its flame-retardant qualities, asbestos has sometimes been used in protective clothing such as suits for firefighters or gloves for foundry workers. Crocidolite is a type of amphibole asbestos, also known as blue asbestos. (Source: Statistics Canada - International Accounts and Trade Division)

Canada’s imports of asbestos products add to the exposure risk. Last year, the country imported $4.9-million in raw asbestos and products containing asbestos, according to Statistics Canada. The agency’s trade data from 2004 to 2014 show that the products include replacement brake pads, pipes, tiles and even clothing.

A refrain in Ottawa’s position over the years has been that asbestos is safe if not airborne. But asbestos easily becomes airborne, in multiple ways.

When pipes and tiles containing asbestos are cut to size, fibres are often released.

Materials also naturally break down over time. Warning labels fade. And it’s hard to police all workplaces to ensure young workers in particular are wearing protective gear, and observing proper procedures for sawing pipes and cutting tiles, given rushed deadlines or precarious, informal jobs that make people less likely to complain.

Schools are a particular hot spot. Many elementary and high schools and universities were built prior to 1990, when asbestos was a favoured material. Many of those buildings are now showing their age — ceilings are crumbling, pipe wraps deteriorating, and water damage seeping in. These heavy-use buildings also take knocks all the time: Every time a volleyball thumps a gym ceiling, a teacher drills holes to hang art, technicians install Internet cables or renovators make space for full-day kindergarten, any asbestos that is in the structure might be released.

“Asbestos has been a huge issue,” says Laura Lozanski, a former nurse who is occupational health and safety officer for the Canadian Association of University Teachers. Not only do universities have huge buildings containing lots of asbestos, but “as time goes on, things degenerate and it all becomes friable [crushable in one’s hand].”

“People complain a lot about seeing white dust on their desks,” she says.

In May, the University of Windsor temporarily closed its biology building after a fire exposed asbestos in a ceiling above a lab. And in April a Toronto high school was closed after tests of its air ducts found asbestos in six out of 18 samples.

Beyond such continuing problems, there are disasters to contend with. Flooding is an increasing problem; when the water recedes after incidents like last year’s inundation of Calgary, demolitions and repairs follow, and with them the potential to release asbestos. The 2008 explosion at Sunrise Propane company resulted in the release of asbestos throughout a Toronto neighbourhood.

Part 3

The boom

Advertisement During its heyday, asbestos was used in thousands of products. As this advertisement in The Globe from 1920 shows, the mineral’s durability was a key selling point. Asbestos tiles are still used as a roofing material in India.

The word asbestos comes from Ancient Greek, meaning — ominously, in today’s context — “inextinguishable.”

Asbestos boasts some striking qualities — it is strong, flexible and resistant to heat, weather and most chemicals. It can be used as a thermal, electrical and acoustic insulator. The mineral fibre is “fireproof, rot-proof and practically indestructible,” as one 1930s ad puts it.

Humans have long loved the miracle mineral, as asbestos was called in the 1950s. Deceased Egyptian pharaohs were wrapped in asbestos cloth to preserve their bodies more than 4,500 years ago. Clay pots in Finland of roughly the same vintage contain asbestos, which was used to strengthen and flameproof them. Romans wove the fibres into napkins (and cleaned them by throwing them into the fire). In the Middle Ages, suits of armour were insulated with asbestos cloth.

Asbestos use ramped up in the Industrial Revolution. By the late 1800s, the mineral was used to insulate steam pipes, turbines and kilns.

Canada’s history with asbestos began when a farmer found it in 1876 in Thetford Township, Quebec. The discovery of this “white gold” made the town of Thetford Mines the so-called asbestos capital of the world. Exploitation of the Quebec resource was followed on a smaller scale in British Columbia, Newfoundland, Ontario and Yukon.

By 1947, Canada was the world’s top producer of asbestos, mining and milling two-thirds of the world’s supply. Apart from its purely economic role, the mineral had a starring role in the launch of Quebec’s Quiet Revolution: The Asbestos strike of 1949 helped make a star of a young lawyer named Pierre Trudeau.

Asbestos is so versatile and durable that it found its way into thousands of products and places between the 1940s and 1980s, from ceilings and roof tiles in homes to insulation in schools and pipes in hospitals. It was regularly used in housing on military bases and First Nation reserves. Much of it remains in public buildings and homes today.

Photo Asbestos was used to simulate snow in the classic 1939 film The Wizard of Oz. Consumers, meanwhile, could buy boxes of "pure white" asbestos snow to decorate their homes at Christmas. (The Kobal Collection / MGM / George Hommel )

Some uses verged on the bizarre: Asbestos was used in crayons, modelling clay and talcum powder for babies. Consumers bought boxes of “pure white” asbestos snow to decorate their homes at Christmas. One 1950s advertisement for an asbestos product seems like a joke, but is not: The Micronite filters in a pack of Kents boasted “the greatest health protection in cigarette history.”

To meet manifold demand, companies such as then New York-based Johns Manville, which owned the Jeffrey asbestos mine in Quebec, opened several factories in Canada. One, in Scarborough, Ont., manufactured products for the building industry from 1948 to 1980. At its height, the company was the world’s largest producer of asbestos-fibre products.

Evidence was mounting all along, however, of the deadly toll the mineral takes on human health. The first documented case of asbestos-related death appeared in 1906. A 1918 document noted that asbestos workers were generally rejected as customers by the Canadian and U.S. insurance industry. By the 1970s, health concerns prompted some countries to limit use of asbestos or ban it outright, causing demand to wane.

Part 4

Six months
to live

How asbestos causes cancer in the lungs

Infographic Victims of mesothelioma experience difficulty breathing, weight loss and acute pain. Once diagnosed, they are typically given between six months and a year to live. Patients can require litres of the fluid to be removed from their lungs. (Sources: Stanford School of Medicine, – 2013, Dr. John Cho; Graphic: Matthew Bambach / The Globe and Mail)

Mesothelioma most commonly attacks the lining of the lungs (pleural mesothelioma). Once diagnosed, victims are generally given between six months and a year to live.

Other types of the disease include peritoneal mesothelioma, which forms in the tissue lining the inside of the abdomen, and — in very rare cases — pericardial mesothelioma, which starts in the lining around the heart.

Mesothelioma is developing in waves. The first wave was miners, mill workers and ship builders, who worked in the post-Second World War asbestos boom times and came home caked with dust.

Now different sorts of workers are getting sick. They include people who work with asbestos products: carpenters, electricians, car mechanics, plumbers, caretakers and factory workers, workers’ compensation rulings show. The majority of mesothelioma victims are men.

Another wave is family members — “bystanders,” in medical parlance — who are dying from the equivalent of second-hand smoke: Victims include spouses who washed their husbands’ dusty clothes and children who snuggled with dads after work.

Other victims work in environments where asbestos has been disturbed, such as teachers, professors and other white-collar workers, like John Nolan, as well as home contractors. Exposures may be at lower levels, or for shorter periods of time, but they still can cause illness.

“You see more educated people getting it — white-collar workers, though still the majority are blue-collar,” says Brenda O’Sullivan, clinical research manager at Toronto’s Princess Margaret Cancer Centre, who has tracked mesothelioma cases for the past decade. “Now it’s the next generation coming up — children of the workers, who are now lawyers and doctors themselves, or teachers, people who work in old buildings, people who are doing a home reno and living in the house at the same time.”

Occupations with highest numbers of asbestos-related deaths in Canada, 2007-2012 (from approved workers’ compensation claims)

Infographic While statistics like these show the toll asbestos has taken among people in blue-collar professions, the new cohort of victims in other lines of work is only just starting to appear. View occupations using the drop-down menu. Select jurisdictions to show deaths by province or territory. (Source: The Association of Workers' Compensation Boards of Canada)

She reads off a list of mesothelioma cases she’s seen: teachers, a nuclear physicist, an architect, a sales associate who sold pens to asbestos companies, children of insulators, a seamstress, tailors, a housewife, screenwriters, photographers, members of the Canadian army, firefighters and police. “If anything, these levels are going to go up again,” she says, pointing to more recent exposures.

Heidi von Palleske knows all about the first wave, and also all about the bystanders. She’s an asbestos orphan. Her father died first, in 2007, with asbestosis and lung and prostate cancer. The former worker at the Johns Manville Scarborough plant lost 50 pounds in four months and “wasted away.”

Ms. von Palleske’s mother, who shook out and washed her husband’s clothes for years, died of mesothelioma in 2011 in debilitating pain, barely able to breathe. Ms. von Palleske’s sister and brother have since been diagnosed with pleural plaque.

Ms. von Palleske remembers running into her dad’s arms after work, and being given chunks of asbestos to play with as a girl. Kids would walk through the plant at company Christmas parties, and workers would have pretend snowball fights with it.

“I still have panic attacks of not being able to breathe after watching my parents basically suffocate to death.”

A 1984 Royal Commission said the asbestos-induced disaster at that plant “ranks with the worst that have been recorded in the international epidemiological literature on asbestos.” In the past three decades, at least 187 asbestos-related claims by Johns Manville workers have been allowed in Canada, according to Ontario’s Workplace Safety and Insurance Board.

(As for Johns Manville, in 1982 asbestos-related lawsuits forced it into the biggest bankruptcy in U.S. history to that time. It is still in the insulation and roofing business, but does not use asbestos. Since 2001 it has been owned by Warren Buffett’s Berkshire Hathaway Inc.)

For the victims and their families, the burden of asbestos takes many forms.

Photos For most of 2013, Lyle Cassidy (seen at left with his grandson, Breck) led an active lifestyle that included roping calves in a rodeo. But since February of this year, after complications in his mesothelioma treatment, he has been bedridden at a hospital in Toronto. (L-R: Courtesy of the Cassidy family; Louie Palu for The Globe and Mail)

Gayle Cassidy, of Stettler, Alta., figures her family has spent $100,000 in flights, missed work, a condo rental and cab fares over the course of her husband Lyle Cassidy’s Toronto hospital stay.

Mr. Cassidy was most heavily exposed in 1969 while working at a generating station. He insulated steam pipes with asbestos without any protection. He went on to start his own construction company, where asbestos was present in products such as flooring and drywall.

Until recently, Mr. Cassidy, 64, was in perfect health: He roped calves in a rodeo last summer. But by the end of November, he was short of breath. On Dec. 10, doctors drained two litres of fluid from his lung. Several days later, they drained another two litres.

On New Year’s Eve, he was diagnosed with malignant pleural mesothelioma, and in the subsequent weeks, it became clear that doctors had little experience with the disease or treatment options. The family eventually accessed a new treatment in Toronto, but since undergoing surgery in February, Mr. Cassidy has had a sea of complications, from C. difficile to pneumonia.

Letter This letter written by Lyle Cassidy’s grandson, Breck, who is 9, was read aloud by his mother to a Canadian Mesothelioma Foundation conference. (Courtesy of the Cassidy family)

“It is so crazy that a word that we had never heard of five months ago is impacting our family like this,” says Lyle’s daughter Carrie. “I think that is part of the problem... we know asbestos is bad, but most people don’t know just how bad it is.”

Mrs. Cassidy has been with her husband at the hospital in Toronto since the February surgery that led to complications.

She looks exhausted — and she is bitter. “There is zero awareness in our country of what asbestos can do. Even the medical profession and the construction industry don’t know what [mesothelioma] is.”

“It’s a lot of stress on everybody,” says Dorn Cassidy, Lyle’s youngest son. Like the rest of his family, he’s dismayed that no one knew about the dangers lurking in asbestos. “People exposed to it are dying from it, and it’s through no fault of their own. And it’s preventable.”

Worry cascades through affected families, from sons and daughters of mesothelioma victims who fear they too may have been exposed, to grandchildren who feel dread every time they hear their mom or dad cough.

“To this day, if I’m under the weather, my daughter yells, ‘You are not sick!’” says Ms. von Palleske. “It hangs over us.”

Sisters Stacy Cattran and Leah Nielsen’s father was diagnosed with mesothelioma in 2008. A former electrician and labourer in the Sarnia area, he spoke of putting asbestos blankets over air ducts to block unwanted breezes. Two months and five days after the diagnosis, he died, having lost 50 pounds.

Photo Stacy Cattran holds a photograph of her father, Bill Coulbeck, with her daughter, Ava. In May, 2008, shortly after this picture was taken, Mr. Coulbeck died of mesothelioma, aged 72. (Louie Palu for The Globe and Mail)

“We were told it’s the most painful cancer there is — it’s the lining of your lungs, so every breath you take is excruciating,” says Ms. Nielsen.

“The pain went down into his legs. Even just adjusting the sheets on him, he would cringe in pain,” says Ms. Cattran, adding, in tears, that her own children scarcely remember their grandfather.

Yet more suffering is coming. “We have not yet reached the peak of the mesothelioma epidemic and we expect cases will continue for the next 20 years,” says Mark Parent, executive director of the Occupational Health Clinics for Ontario Workers for Sarnia and Windsor.

Indeed, Nordic countries that banned asbestos use as far back as the 1980s have still not seen mesothelioma cases subside. In Canada, where there is no ban, “we’re certainly going to be behind them,” says Dr. Demers.

Part 5

safe in Canada

In asbestos policy, Canada is at odds with other developed countries, almost all of which have both banned asbestos and launched national campaigns to educate their citizens on its dangers.

Regarding exports and imports, Canada’s long-standing position is that “safe and controlled use” of the mineral poses little risk to human health.

Health Canada’s website maintains that chrysotile (the form of asbestos mined in Quebec) is safer than other types of asbestos, and that asbestos poses risks only when its fibres become airborne and “significant quantities” are inhaled. It plays down the causal relationship between asbestos and some forms of cancer. The website does not inform Canadians that asbestos is the No. 1 cause of work-related deaths. (In contrast, the U.S. Acting Surgeon General, Boris Lushniak, reminded the American public in April that there is no known safe level of asbestos exposure.)

“Chrysotile is different from the amphiboles both structurally and chemically. It is generally accepted that chrysotile asbestos is less potent and does less damage to the lungs than the amphiboles.”

If asbestos fibres are enclosed or tightly bound in a product, for example in asbestos siding or asbestos floor tiles, there are no significant health risks. Asbestos poses health risks only when fibres are present in the air that people breathe.”

“Asbestos poses health risks only when fibres are present in the air that people breathe. How exposure to asbestos can affect you depends on:

  • The concentration of asbestos fibres in the air
  • How long the exposure lasted
  • How often you were exposed
  • The size of the asbestos fibres inhaled
  • The amount of time since the initial exposure”

“Approximately one third of all homes built in Australia contain asbestos products. The widespread use of asbestos has left a deadly legacy.”

Both friable and non-friable asbestos pose a significant health risk to all workers and others if the materials are not properly maintained or removed carefully.”

“Asbestos is a known carcinogen, and the inhalation of asbestos fibres is associated with increased incidences of a number of diseases including pleural disease, asbestosis, lung cancer and mesothelioma. Even limited or short-term exposure to asbestos fibres can be dangerous but exposure does not make development of an asbestos related disease inevitable.”

Policy comparison As these excerpts from government websites show, Canada has played down the risks of asbestos compared to countries like Australia. "Friable" means easily crumbled. (Sources: Health Canada and Australian Government Asbestos Safety and Eradication Agency)

Between 2006 and 2011, Canada was the only developed nation to oppose bringing asbestos under the control of the Rotterdam Convention, a United Nations-sponsored treaty, signed in 1998, that requires the exporters of hazardous substances to disclose the risks.

Indeed, the Conservative government has been a stalwart friend of the industry. “Only the Conservative party will defend this industry here and everywhere in Canada,” Prime Minister Stephen Harper said in Quebec on the campaign trail in 2011. While the Tories were fighting international efforts to restrict trade in asbestos, the government was simultaneously spending millions to remove asbestos from the Parliament buildings and the prime minister’s residence.

Ottawa’s support, however, predates the Harper era and was for many years seconded in Quebec City. For two decades, both the federal and Quebec governments provided millions of dollars in funding to an industry lobby group, The Asbestos Institute, which was rebranded as the Chrysotile Institute in 2004.

Canada’s last two mines, both in Quebec, closed in 2011 amid rising costs and after one failed to get bank-loan guarantees it sought from the provincial government. In 2012, the federal government said it will stop blocking asbestos’ inclusion under the Rotterdam Convention (the next round of decision making is in 2015). The Chrysotile Institute quietly closed in 2012.

Photos Two scenes from the Black Mine in Quebec. The town of same name (right), which is part of the municipality of Thetford Mines, is engulfed by tailings from the dormant mine, which is owned by LAB Chrysotile. (Louie Palu for The Globe and Mail)

Still, the Canadian government’s position remains much as it was a decade ago — advising safe and controlled use of chrysotile asbestos — even though there is no longer much of an industry to defend, and despite mounting evidence of the hazards of exposure to asbestos, no matter the type.

Newfoundland’s Baie Verte asbestos mine offers a case study. The first worker health registry of its kind in Canada, released as part of a study last year, examined the health of 1,003 former workers at the mine. One hundred and sixty nine of them have asbestos-related disease. The exposures to chrysotile asbestos, “one of the most dangerous industrial toxins known,” as the study calls it, happened between the 1950s and the early 2000s, affecting everyone from miners to managers.

Because some workers had already died, and some cases were not diagnosed, the total of 169 understates the extent of cases, while new cases “could very well be diagnosed for some years to come,” the study says. The lead author of the study is not impressed by Ottawa’s claim that chrysotile can be safe.

“The high levels of disease incidence in our cohort make it clear that that claim is blatantly false,” says Stephen Bornstein, director of the Newfoundland Labrador Centre for Applied Health Research at Memorial University. “Chrysotile is probably not quite as toxic as the amphibole [varieties] but it is still very toxic.”

The Newfoundland study along with a large body of scientific research belies Ottawa’s position.

“There is no scientific doubt that all forms of asbestos are dangerous as well as carcinogenic,” says Richard Lemen, an Atlanta-based epidemiologist and retired Assistant Surgeon General of the U.S. Public Health Service. “I am surprised Canada has not completely banned import and export of all forms of asbestos.”

(The U.S. hasn’t introduced a ban, but has more stringent regulations and curbed its use earlier than Canada.)

Photo Tailing piles like these in the town of Thetford Mines are a byproduct of the asbestos mining boom that began in the region after a farmer discovered deposits of the mineral in 1876. (Louie Palu for The Globe and Mail)

The World Health Organization concurs with Dr. Lemen and other scientists that all forms of asbestos are carcinogenic to humans, noting that it can cause not only mesothelioma but also cancer of the lung, larynx and ovary. The most efficient way to stop asbestos-related diseases, it says, “is to stop the use of all types of asbestos.” Even very low exposures raise the risk of cancer, it says.

Among the organizations that have called on federal and provincial governments to ban the use and export of asbestos are the Canadian Medical Association, the Canadian Lung Association, the Canadian Public Health Association and the Public Health Physicians of Canada.

Canada needs “a comprehensive strategy to phase out the use and export of asbestos, as well as improved monitoring of exposures and asbestos-related diseases,” says Dr. Robert Nuttall, director of cancer control policy at the Canadian Cancer Society.

The federal government would not make any spokesperson available for an interview about its current position on asbestos. The requests, repeated over a three-week period, were made to the Department of Trade, Health Canada and Environment Canada. In an e-mail, Health Canada said the information on its website “remains accurate,” and that the government has “consistently acted to protect Canadians from the health risks of asbestos.”

In an interview about occupational health and safety on May 15, federal Labour Minister Kellie Leitch, a surgeon by profession, said that exposure to asbestos had not come up as a concern during her 10 months in the portfolio. “You are the first person to raise it with me,” she said. Asked whether Ottawa would flag government buildings containing asbestos, as Saskatchewan does, or ban imports, she said, “I’m open to any suggestions that make workers safer on the worksite.”

The minister’s office declined several requests for a follow-up interview expressly about asbestos exposures, saying she is too busy.

“It's a man-made disease. Canada should ban the use and trade of [asbestos] products in all forms and ultimately work towards safe removal and disposal from the environment.” — Geoff Fary, chairman of Australia's Asbestos Safety and Eradication Council.

Countries like Australia have taken a much more pro-active approach to asbestos.

Australia was once one of the world’s largest consumers of asbestos and also mined it. The country banned asbestos exports and imports in 2003.

“The only way that you can prevent people from contracting asbestos-related diseases is by not pussyfooting around,” says Geoff Fary, chairman of the Asbestos Safety and Eradication Council, in an interview from Melbourne.

Australia considers any exposure unsafe, no matter how small. A particular concern is brake parts, and the possibility that a motor vehicle with asbestos pads could spray dust while “someone’s walking on a sidewalk.” (Canada imported $3.2-million worth of asbestos brake pads last year, largely from China.)

Australia’s government has proposed a strategic plan to manage the legacy of asbestos containment. Apart from further publicizing the dangers involved, it would take inventory of locations containing asbestos, develop standards for its safe removal, and fund medical research into treatments.

The country’s efforts are starting to pay off. While mesothelioma cases have not yet peaked, there has been a decline in other asbestos-related diseases such as asbestosis and pleural plaque.

Canadian exports of asbestos and related products, 2004-2013

Asbestos and related products exports in 2013

Infographic In the late 1940s, Canada was the world’s top producer of asbestos. By 2009, it ranked fifth. The country’s two remaining mines closed in 2011 but Canada continues to export asbestos products, including tiles, pipes and other building materials. Crocidolite is a type of amphibole asbestos, also known as blue asbestos. (Source: Statistics Canada - International Accounts and Trade Division)

Australia’s experts in the field have long been puzzled by Canada. “It's a man-made disease. Canada should ban the use and trade of [asbestos] products in all forms and ultimately work towards safe removal and disposal from the environment,” Mr. Fary says.

Canada’s “safe-use” approach also baffles other international experts. “There have been no long-term studies showing the efficacy or safety for so-called ‘safe use’ or for a ‘safe form’ of asbestos, which are promotional terminology used by the asbestos industry,” says Dr. Lemen. “Even the smallest exposures to asbestos show an increased risk of fatal asbestos-induced disease.”

The global picture is daunting. About 125 million people around the world are currently exposed at the workplace, according to WHO estimates. More than 107,000 people die a year from asbestos-related diseases.

By its calculations, one in every three deaths from occupational cancer is caused by asbestos. The WHO recorded 92,253 mesothelioma deaths between 1994 and 2008 (noting the scale is likely underestimated) and says it expects deaths to shift to the developing world where asbestos use is rising.

An unknown number of deaths abroad are attributable to Canadian exports. As of 2009, Canada was the world’s fifth-largest producer of asbestos, after Russia, China, Kazakhstan and Brazil.

Canada’s position that asbestos can be used safely ignored the reality of its key markets, like India, where asbestos tiles, cut by hand, are a common building material, and safety regulations are little-known. Canada sent almost 70,000 tonnes of asbestos to India in 2010, worth $40-million.

Canada’s last export of raw asbestos was in November, 2011, after the Quebec mines shut down. But Canada continues to export products, such as building materials, that contain asbestos. Operations at Canada’s idled mines could resume almost immediately if the economics of competing against countries like Kazakhstan improve.

Part 6

What can
be done?

Photo As a Canadian manufacturer has shown, brake pads can be made without asbestos. Above, non-asbestos brake pads enter a painting machine at the ABS Friction factory in Guelph, Ont. (Pawel Dwulit for The Globe and Mail)

If Canada were serious about protecting its people from asbestos exposure, the first steps would include warning the public of the danger of asbestos and banning its use and export. “We should totally eliminate its use,” says Dr. Demers, a view also shared by Dr. Cameron Mustard, president of the Toronto-based Institute for Work & Health, along with many other health professionals.

Victims and their families concur. Stacy Cattran and her sister now campaign for a ban on asbestos. “A plain ban. No products containing asbestos allowed into Canada, no ifs, ands or buts,” says Ms. Nielsen.

Safer substitutes for asbestos exist and have been introduced in many countries without major economic disruption, although some alternatives may be more expensive. In Australia, however, “when the government decided to proceed with the ban, it was remarkable how quickly companies were able to source other products,” says Mr. Fary.

Some asbestos-free alternatives are made in Canada. ABS Friction, based in Guelph, Ont., has made asbestos-free brake pads since its founding in 1995, competing with cheaper imports that do contain asbestos. “Unfortunately, asbestos makes a great brake pad — as a friction material, it works really well and there’s no noise,” says president John Burns. “But by the very nature of a brake on a car, it breaks down into dust.”

Mr. Burns, whose firm employs 80 people and exports to 25 countries, wants to see a complete asbestos ban in Canada. “The competition will rise to meet it,” he says.

Photo Ryan Dorrance at work at ABS Friction, an asbestos-free brake-pad factory. The company works instead with materials such as ceramic and metal fibres. ABS president John Burns wants to see a complete asbestos ban in Canada. “The competition will rise to meet it,” he says. (Pawel Dwulit for The Globe and Mail)

Canada could also consider Saskatchewan’s efforts. It has started a mandatory registry of asbestos in public buildings. “If, as a result of this we prevent one person from becoming ill, we’ve done a good thing,” says Dan Morgan, Minister of Labour Relations and Workplace Safety.

The country as a whole could also look to British Columbia, where WorkSafeBC has launched an awareness campaign for construction workers on the dangers of asbestos.

Homeowners contemplating a renovation, particularly those with houses built before the mid-1980s, should have testing done to detect the presence of asbestos. It may be located in drywall, ceiling tiles, insulation and floor tiles. If asbestos is found, the project’s budget should be revised to cover abatement.

Do-it-yourself renovators should be aware that paper masks are not sufficient protection against asbestos, nor are ordinary vacuums. Asbestos fibres are so tiny — invisible to the naked eye — that special respirators are required. Materials containing asbestos should be kept wet to prevent fibres from becoming airborne.

Canada could take a page from Finland and develop an occupational disease registry to better understand links between exposures, work and health.

The health-care system could better prepare doctors on how to detect diseases that stem from asbestos. Doctors should ask about work history, and be better informed of clinical trials and new methods of treatment. And patients should be told where they can seek help, especially since new treatments are available. Smokers should be made aware that their risk for asbestos-related diseases is dramatically higher thanks to the synergistic relationship between tobacco smoke and other airborne carcinogens.

Part 7

‘Stuck in
this body’

Video John Nolan, who suffers from mesothelioma, was exposed to asbestos when its risks were less well-known than they are today. He says there is now no excuse for not eliminating asbestos exposures in Canada.

There is payoff to early detection. Princess Margaret Cancer Centre has a new treatment that can prolong peoples’ lives — but it works best if the cancer is caught early. The treatment is aggressive — doctors blast the cancer site with high doses of radiation before removing a lung. But it can extend peoples’ lives by several years.

John Nolan had the treatment this spring — his right lung was removed, along with parts of his diaphragm and part of the lining of his heart.

“Before I had mesothelioma, I didn’t think about the breathing, so it’s just there,” he said. “The mesothelioma requires you to think, first of all, on how you’re going to get the next breath. There’s someone pushing a pillow on your face. Can you breathe past that, can you not panic? It can consume you with an effort to keep calm.

“I’m pretty lucky in the treatment I’ve had, so I’m slowly recovering from the removal of my lung... [It does] require you to learn how to breathe without one lung. It’s possible but it’s not as easy — you have to learn to breathe all over again.”

Photos Mr. Nolan bears a massive scar from where his right lung was removed in the spring of this year. He is seen at his home in Fort Erie, Ont. At right, his heart is checked by Pat Eberly, a palliative care visiting nurse. (Louie Palu for The Globe and Mail)

He’s hopeful the treatment will buy him some time. He’s booked tickets for this fall to take the train to Vancouver with his wife of 34 years, retracing their honeymoon. They will take an Alaskan cruise, something his wife has always wanted to do. It’s beyond their budget, but gives him a goal to focus on, to avoid facing the “blackness of time.”

He looks out the window, breath audible, and adds, “If you had to go through what I’ve gone through, you would run a mile from asbestos.”

Mr. Nolan, who wouldn’t wish what he’s gone through on anyone, is horrified to learn that asbestos is still being imported and used in Canada.

He wishes he had known of the dangers. And he, like others directly affected, wants to see all asbestos use in Canada stopped.

“It’s a terrible thing. If the people who are responsible for importing or exporting this material were feeling like I have felt, they certainly wouldn’t be doing what they are doing.”

Photo Mr. Nolan and his wife, Christine Nolan, hope the drastic treatment he has undergone will give him some time. The couple, who have been married for 34 years, plan to retrace their honeymoon on a train trip to Vancouver next fall. (Louie Palu for The Globe and Mail)

His days are now punctuated with pills. He gives himself injections to prevent blood clotting. He has lost 25 pounds in four months, has no appetite and is plagued with nausea. He has a painful bed sore that won’t heal and cannot walk further than the driveway. He lives in pain.

“I’m stuck in this body. I can’t breathe and I’m drowning.”