Western Australias Asbestos Legacy
In the run-up to International Workers Memorial Day (April 28, 2015), salient reminders were present in the media and throughout the fabric of everyday life that the population of Western Australia (WA) remains at serious risk of deadly asbestos diseases. From the April 22 publication of a report exposing the inability of WA agencies to manage asbestos in the public sector,1 to the sighting of a skip full of broken asbestos-cement sheeting in a Subiaco side street, to the discovery that a family friend was living in a house full of asbestos products,2 evidence abounds that in 2015 asbestos is a fact of life in Western Australia, despite its use being banned in 2003.
West Australias industrial history includes the discovery and exploitation of rich seams of crocidolite asbestos at Wittenoom, in the north of the state. Thousands of Wittenoom miners and mill workers have died from asbestos-related diseases as have many of the towns residents. But asbestos disease has also devastated other WA groups including dockside workers, railway yard employees, insulators, carpenters and home renovators. Originally founded by former Wittenoom workers to address the needs of asbestos victims among their colleagues, the Asbestos Diseases Society of Australia (ADSA) has, increasingly, over the last thirty-five years sought to obtain justice and treatment for all asbestos victims, particularly in WA, and forged links with like-minded groups globally. It is not surprising to note that whereas many people speak of three waves of asbestos disease, ADSA President Robert Vojakovic claims that WA with the appearance of home-renovators among those diagnosed with asbestos cancers is now seeing a fifth wave of victims.3
On April 12, 2015, the ADSA held its Annual General Meeting. The figures provided to those attending were ample evidence of the battles being fought by the Society to achieve justice and support for its members. During the last year, ADSA staff dealt with nearly 400,000 pieces of correspondence, replied to 25,731 general enquiries and 2,736 environmental enquiries, 1,488 members were reviewed by the ADSA Medical Advisor Dr. Gregory Deleuil, 876 asbestos-related diseases were confirmed and 297 members succumbed to their diseases. Welcoming society members to the AGM, President Robert Vojakovic highlighted ongoing efforts to achieve parity for WA asbestos victims with their counterparts in other states, most of which have more equitable legal regimes.
ADSA President Robert Vojakovic addressing Society members at the AGM.
After the results of the election of ADSA board members were announced, Simone Vojakovic provided details of the Societys fund raising program for 2015 which would include a charity walk from Albany to Perth via the Stirling Ranges and the Great Southern Highway in September and a Fundraising Golf Day. Last year, the $55,000 raised from the Rod Triplett Tribute Walk for Research and Awareness were, Simone reported, donated to Professor Anna Nowak of the Queen Elizabeth II Medical Centre to support ongoing research on improving treatment for asbestos-caused cancers and ultimately finding a cure for these diseases.
Simone Vojakovic reporting on fund raising activities.
It has been the custom at the ADSA AGMs to include short presentations by guest speakers. The 2015 presentations were, in order of delivery: Brief outline of SKG Services, by radiologist Peter Leaver; Mesothelioma moving forward from 2015 Overview of current clinical practice in Mesothelioma as well as clinical research taking place at the State Comprehensive Cancer Centre at Sir Charles Gairdner Hospital, by Professor Anna Nowak; Update on Asbestos Compensation and Law Reform with regard to Provisional Damages and Sullivan v Gordon Damages, by solicitor Laine McDonald; Brief update to members and friends, by politician Chris Hatton, MLA Member for Balcatta, Perth; Asbestos 2015: Are We Safe? by Laurie Kazan Allen of the International Ban Asbestos Secretariat.
The Society has had a long and fruitful association with SKG Services right from the earliest days of the application of CT scanning for the diagnosis and monitoring of mesothelioma. In his presentation, after a brief overview of the principles of CT scanning, Peter Leaver from SKG discussed earlier concerns about the large doses of radiation associated with scanning that had led to the current use of low-dose technology. However, reduction of dosage came at a cost and, as he demonstrated with slides, resolution was reduced to unacceptable levels if the reduction in dose was carried too far.
In her presentation, Professor Nowak showed a series of CT scans demonstrating the development of mesotheliomas and pleural plaques, including images showing that, for some patients, a reduction of the bulk of tumors could be achieved by chemotherapy; even in mesothelioma this could relieve the severity of symptoms. Regrettably, she reported, there had been little change in 10 years in the standard treatment of mesothelioma. However, a lot of research had been done as a result of which clinicians were now better at controlling symptoms: able to deal with fluid accumulating around the lungs, control pain better, improve appetite, settle night sweats and improve breathlessness. The hope for the future, she believed, would be found in research now being conducted for targeted therapies and immunotherapy.
Laine McDonald was in tune with the views of the society in pressing for changes to WA personal injury law in her presentation, to bring the state in line with other Australian jurisdictions. Particular areas for concern were provisional damages and Sullivan v Gordon damages. In WA, provisional damages were not allowed. With respect to asbestos diseases, this meant that once compensation has been paid for an asbestos injury, claimants could not submit claims for additional compensation if at a latter date they contracted more serious conditions, such as mesothelioma. Sullivan v Gordon damages which compensate a victim for inability to provide domestic assistance to dependants (particularly important for victims who were also carers) were also not available in WA, whereas they were in other states.
Member of Parliament Chris Hatton expressed admiration for the work of the ADSA and endorsed President Vojakovics call for more government funding for asbestos disease research. He thought that there was hope that a bill to address some of the concerns raised in Laine McDonalds presentation could be submitted at some future date, but would have to address concerns raised when a similar bill had failed in 2014.
I was privileged to address the meeting on the subject of Asbestos 2015: Are We Safe. Despite its ban Australia, like many other countries, is still importing prohibited products as evinced by scandals over the purchase of asbestos-contaminated plasterboard, gaskets, trains, mining equipment and cars from China. The disconnect between the public perception of asbestos as a carcinogenic pariah in industrialized countries and the increasing use of it in developing countries was illustrated with a series of photographs showing the lack of protective equipment and clothing provided for Indian workers in an asbestos-cement factory.
The last segment of the AGM consisted of the presentation of the Emeritus Professor Eric G. Saint Memorial Award 2015. Following introductory speeches by Dr. Greg Deleuil and Rose Marie Vojakovic, the award was presented by MP Chris Hatton to radiologist Dr. Peter Leaver in recognition of his dedicated and compassionate approach to identify and characterise the early process of asbestos caused diseases facilitating early intervention and better patient care. Accompanied by an engraved plaque the award for 2015 was an original painting containing leaf motifs traditionally said to promote healing.
Peter Leaver (center) with Rose Marie Vojakovic and Chris Hatton MP.
The State of Western Australia comprises one third of the land mass of the Australian continent; its capital Perth is more than 2,500 miles from Sydney, Australias largest city and arguably its center of power. Were you to drive, it would take 44 hours to make the trip. Fortunately, with modern aviation Peter Tighe, Director of the Asbestos Safety and Eradication Agency (the Agency)4 was able to cover the distance in five hours. On April 23, 2015, Mr. Tighe, on his first visit to the Society, was welcomed at the Osborne Park offices of the ADSA by President Robert Vojakovic, Counsellor Rose Marie Vojakovic, Dr. Gregory Deleuil, and myself.
From left: Robert and Rose Marie Vojakovic, Peter Tighe, Laurie Kazan-Allen, and Dr. Greg Deleuil.
During the day, Director Tighe was given a guided tour of the premises and was briefed on the history and work of the Society since its formation in the early 1980s. The particular challenges being faced by asbestos victims in WA were outlined, as were the strategies being pursued to improve their legal rights and access to medical treatment. Mr. Tighe discussed the genesis of the Agency and its plans to ensure that when it came to asbestos issues each Australian state was following best practice protocols as delineated in the Agencys National Strategic Plan for Asbestos Awareness and Management.
The next day (April 24, 2015), Peter Tighe and I went to the Harry Perkins Institute of Medical Research in Nedlands, Perth to meet with staff at the National Centre for Asbestos Related Diseases (NCARD).5 This was Mr. Tighes first visit to this WA centre of excellence. Throughout the day, we were provided with the opportunity to discuss with NCARD researchers and staff the pioneering work being done to develop novel approaches, improve technological resources, collaborate with international colleagues and experiment with new medicines and drug combinations applicable to the diagnosis and treatment of asbestos-related diseases.
NCARD researchers and staff with visitors Laurie Kazan-Allen and Peter Tighe.
A lunchtime symposium was held in the McCusker Auditorium on the topic of The Global Mesothelioma Landscape 2015. In the course of my thirty-minute talk, I contrasted the detailed knowledge about mesothelioma in a few countries with the total lack of information for over 70% of the worlds population. Global asbestos trade data were presented and conclusions were drawn as to the likely repercussions of increasing asbestos use in developing countries, the majority of which were in Asia.
Laurie Kazan-Allen speaking at NCARD.
According to grassroots activist Mohit Gupta of the Occupational and Environmental Health Network of India:
Asbestos is a threat to everyone, not just workers. From children in schools, to young and old in private and public buildings wherever asbestos is present, whole communities are at risk. Banned in most developed countries, asbestos is Indias next big killer. There is no safe level of exposure, so there is no acceptable level of exposure. Due to daily toxic exposures, many jobs in India are virtual death sentences. Companies arent penalized for taking short cuts on employee safety and most doctors dont know how to diagnose occupational diseases. There is an immediate need to identify all victims of asbestos related disorders and provide medical treatment, rehabilitation and compensation for them. To prevent more avoidable deaths, an immediate ban on the use of this material is of utmost importance.
During this session, a new film released by the World Health Organization entitled: Victims of chrysotile asbestos voices from South East Asia had its WA premiere.
The presentation was followed by a question and answer session which was chaired by Professor Bruce Robinson.
Laurie Kazan-Allen and Bruce Robinson.
Although NCARD joint initiatives already exist, options for further collaboration with colleagues in India and other Asian countries were explored during the meeting.
I know that on every occasion I have spent time with Perth colleagues at the ADSA and NCARD, I am re-energized by their enthusiasm and dedication to the tasks in hand; the latest visits were no different. I feel confident that Peter Tighes first visits to these amazing institutions will not be his last. Perth may indeed be far from the Agencys Sydney office but it is at the epicentre of the countrys battle against Australias asbestos legacy.
May 10, 2015
1 Kagi J. Asbestos inspections not done regularly by WA government agencies, report finds. April 22, 2015.
2 Thirty per cent of all Australian homes contain asbestos, a product that was embraced by Australian builders after the Second World War with an enthusiasm virtually unmatched anywhere else in the world.
3 For more on the work of the Society see:
Kazan-Allen L. Australias Asbestos Awareness Month. December 12, 2014.
Kazan-Allen L. Grace Under Fire. April 22, 2014.