The Politics of Asbestos

Understandings of Risk, Disease and Protest

Linda Waldman

• Publisher: Routledge
• Year: 2012
• Topic: Social Sciences
• eBook ISBN:
  9781136537462
• Subtopic: Ecology
• Index: Social Sciences

Around the world, asbestos-related diseases are on the increase. Meanwhile, in many newly-industrialising and developing countries, asbestos use continues unabated. This book, based on anthropological fieldwork in the UK, India and South Africa, explores people's understandings of their illness, risk, compensation and regulation, contrasting these personal and community narratives with formal medical and legal understandings.

Linda Waldman shows how the domination of medical and legal framings of risk and disease over those of workers, sufferers and activists can narrow the responses chosen by government. This provides important lessons for researchers, policy makers and regulators, demonstrating that opening up to alternative understandings can create more effective policy responses to move towards sustainability and social justice.

Published in association with the Economic and Social Research Council (ESRC).

Chapter 1

Introduction: The Problem of Asbestos

On 4 April 2007, Alasdair Packard ¹ was diagnosed as having pleural plaques by a radiologist in South Africa. He had travelled from Dagenham, London, where he worked as a lagger (thermal insulation specialist), to Cape Town, South Africa, specifically for a chest X-ray. As a lagger, Alasdair had experienced massive exposure to asbestos and, as a result, he had annual medical check-ups by his local doctor in the UK to ensure that he was not suffering from an asbestos-related disease (ARD). But when these check-ups stopped performing routine chest X-rays, Alasdair was concerned: ‘They always say my breathing is fine, my lungs are good, come back in two years [for your next X-ray], but I’ve always had that worry [of ARDs]… How are they going to find out if they aren’t X-raying? You can breathe, but how do you breathe?’

South Africa has a long history of recognizing – and refusing to recognize – ARDs: pioneering medical research among South African asbestos mine workers took place in the 1950s and identified the links between mesothelioma and asbestos (Abratt et al, 2004). Despite official‘blindness’ to the working conditions and health hazards of asbestos mines throughout the apartheid era (1948–1994), the government-run Medical Bureau for Occupational Diseases (MBOD) diagnosed and compensated miners for pleural plaques in a manner described by one British medical specialist in 2006 as ‘generous’ in comparison with the UK's provision for ARD compensation.

South African asbestos mines – many of which were owned by UK companies – flourished for about 100 years (1893–1997), producing a large proportion of the world's asbestos.² Much of this asbestos was exported to the UK, to the Cape plc factory in Barking, London – just a short distance from where Alasdair Packard now lives – where it was used in the production of yarn, cloth, millboard, steam packings, ropes, respirator filters, brake linings, fireproof boards and clothing as well as for insulation in large-scale infrastructure and power stations.

When Alasdair returned from South Africa, he made an appointment at the East Ham Chest Clinic for his usual check-up. He was informed that he was ‘fine’, with his breathing improved and with ‘no problems’ in his chest. To this, Alasdair responded: ‘Well if you think I’m all right, I don’t think so,’ and he handed over the X-rays and South African diagnosis. ‘Oh yes,’ said the doctor, ‘I can see that you’ve got pleural plaque now and you can get your claim going,’ but ‘us doctors don’t believe in pleural plaque.’

Alasdair Packard is a member of the Dagenham branch of Britain's General Union (or GMB). Had he been diagnosed with pleural plaques before January 2006, he would have been able to claim compensation. But recent changes to the law have meant that he has to wait until he is diagnosed with a more severe form of ARD before being able to take his former employers to court. Alasdair is not alone in his struggle; he is one of a group of laggers and trade unions who are actively challenging the UK government's stance on ARDs. The GMB and the laggers, like many other anti-asbestos campaigners, would like to see the UK medical and legal systems recognize pleural plaques as a form of occupational disease– as indeed it did between 1985 and 2005.

This brief vignette introduces many of the issues of this book. In the first place, it highlights the dynamics surrounding asbestos, its governance and the way different categories of disease are recognized by different medical and legal systems around the world. These are constantly changing domains and people diagnosed with ARDs find themselves caught up in these dynamic situations. As the example makes clear, medical and legal definitions of ARDs are not static categories but are shifting in relation to governments, labour campaigns or insurance lobbies, medical expertise and so forth. Alasdair Packard's story also hints at the ways in which different countries – and experts within these countries– understand and respond to ARDs. Despite the highly scientific nature of these topics (asbestos is a geological phenomenon and ARDs are recognized medical conditions), these varied understandings form a central theme throughout this book. Linked to these different framings,³ the interrelationship between science, governance and mobilization is pursued in this book through an examination of how people exposed to asbestos or diagnosed with a related disease understand and interpret their asbestos-related experiences in India, the UK and South Africa.

Asbestos once symbolized the possibilities of a new modernist era and, as I shall later show, in India these associations still have resonance. It has also been – and often continues to be – ubiquitous, ominous, enabling, empowering and disempowering. As such, asbestos is a product which ‘draws us in and repels us’ through its uncanny nature (Turkle, 2007, p8). An appreciation of asbestos fibres, asbestos pollution and the associated diseases that people contract through exposure to these fibres provides insights into broader processes about society, science and technology. This involves understanding how individuals and collectivities experience exposure to toxic products, it requires an exploration of how medical and legal discourses frame disease, how people in power conceptualize asbestos and its consequences – or, put differently, how dominant narratives about asbestos exist – and it necessitates analysing processes of governance. Focusing on asbestos is also a means of opening up broader ontological questions such as the role of science and technology in society and the character of industrial growth and scientific innovation in the future.

This book is an anthropological exploration of asbestos pollution, disease and protest. It expands the study of science and society by asking questions about meaning, value and emotions. Objects, says Turkle (2007, p6), convey both ideas and emotions: ‘we live our lives in the middle of things’. Asbestos, and the associated pollution and disease, have come to mean different things to different people at different times. Once used to symbolize modernization, progress and economic growth, today it is shorthand for a lack of corporate social responsibility, a lack of recognition of the victims of ARDs and a lack of governmental responsibility – but these associations are not, as this book will later show, universal. An analysis of asbestos leads one into discussions of global/ local relationships and processes, of risk and uncertainty, of economic versus moral responsibility and of modern advancement in opposition to traditional stagnation. These are all themes explored in this book, which shows that such oppositional understandings do not reflect the complex, contested and often contradictory situations that people exposed to asbestos find themselves in. Using asbestos as a lens through which to focus on South Africa, India and the UK, this book explores the manner in which individual experiences of health and well-being are socially constructed and interconnected with social and political processes. It further examines the framings employed by legal, medical and political processes in relation to ARDs and the ways in which disease and identity are interconnected. There is, as Harding has argued (1996, p24), a ‘good deal more thinking’ to be done ‘both with and about science’ in order to develop specific, complete and appropriate conceptualizations of the interface between science and society which advance democratic possibilities.

The central argument of this book is that disease, compensation, identity, medical science, legal expertise, governance, social movements, politics and protest come together in different ways in South Africa, India and the UK and, in so doing, create or foreclose particular pathways to sustainability and social justice. The book identifies three potential pathways. The first involves integration of the voices of the poor through a process which exposes policy- makers and other powerful government actors to poor people's day-to-day realities and struggles in their local contexts. The second pathway employs the integration of activists and victims into science and technology debates in order to bring about the politicization of science. The third pathway entails the building of networks and alliances across political and geographic spaces, and ensuring that these networks criss-cross international, national and local contexts. Although elements of these pathways are evident in South Africa, India and the UK, the South African example demonstrates the most successful use of all three pathways. In this case, victims of ARDs have worked with non- governmental organizations (NGOs), community organizations, activists and other prominent individuals. Activists and campaigners have managed to balance grassroots initiatives and local meanings with complex international networks and alliances. This, in turn, shaped the way asbestos is dealt with within South Africa, influenced international processes of governance and supported new engagements with science in local settings.

The problem of asbestos

Asbestos is most famous for its fireproofing and insulating qualities. The word ‘asbestos’ stems from Greek and refers to its incombustible nature. Asbestos is a generic term for fibrous silicate minerals or, in other words, for rocks which are fibrous. It is found in several different forms, of which the most common are white asbestos (also known as chrysotile), blue asbestos (or crocidolite) and brown asbestos (less commonly referred to as amosite). The largest deposits of asbestos are to be found in Canada and Russia, but it has been mined – and in some cases continues to be mined – in Australia, Brazil, Canada, China, India,Italy, Kazakhstan, Russia, South Africa and Zimbabwe.

The fibrous nature of asbestos means that it can be woven into a thread and developed into a fabric:

In appearance asbestos fibres are as light as eiderdown and yet as hard as any stone. To the touch a piece of raw asbestos is like rock, but with the fingers individual fibres can be teased apart. When placed under the microscope each fibre can be seen to consist of thousands of fine threads. Asbestos can be subdivided almost infinitely until molecular dimensions are achieved. A single strand weighing less than an ounce can be spun out for three hundred feet and a square yard of woven cloth will weigh less than eight ounces. (McCulloch, 2002, p1)

Asbestos is also very durable and long-lasting; it does not corrode easily and animals and vermin find it unattractive. It does not work as a conductor of electricity and therefore can be put to an incredible number of uses. After the two World Wars, during which asbestos had assumed immense strategic importance as a product for insulating warships, ‘manufacturers promoted asbestos as a miracle product, which enhanced the quality, longevity or safety of any commodity into which it was incorporated’ (McCulloch, 2002, p4). Asbestos fibre was used in a myriad of manufacturing processes including cigarette filters, mattresses, beer filters, brake linings, buildings and ships (Competition Commission, 1973; McCulloch, 2002). Asbestos, wrote Bartrip (2006, p1), ‘was the perfect material for an industrialising and electrifying world of heat, combustion, and high- speed locomotion’. From this perspective, there is no problem with asbestos.

Unfortunately, however, asbestos fibres can cause a range of diseases which, alongside other toxic threats, are widely recognized for their insidious, fearsome and tainted nature (Douglas and Wildavsky, 1982; Bourke, 2005). The association of these diseases with cancer echoes a widespread connection between cancer and death (Balshem, 1991). ARDs can affect anyone exposed to microscopic asbestos fibres, although there is a raging scientific debate regarding the different types of asbestos, their toxicity and how technological processes might control exposure (discussed later in this book). In their review of ARDs, Mossman and Gee (1989) categorize four types of benign pleural disorders (namely pleural effusion or fluid on the lungs, pleural plaques, pleural thickening or fibrosis and rounded atelectasis). Most people suffering from these benign pleural disorders do not experience pain but may experience shortness of breath and some discomfort. Three forms of disease, which have more serious and debilitating consequences, are also caused by asbestos: asbestosis and lung cancer are primarily occupational hazards as contracting these diseases is linked to rates of exposure to asbestos, whereas mesothelioma (a malignant cancer) is unrelated to dosage and trivial exposure can lead to cancer of the abdominal cavity or lung lining. Mesothelioma is always fatal and people afflicted with this disease face a painful, imminent death. All ARDs have extended latency periods and only manifest themselves in physical symptoms 20–40 years after exposure to asbestos. Recent UK research on Alimta (pemetrexed disodium) has shown this to be a drug that prolongs life and alleviates the distressing symptoms of mesothelioma, but this is not a cure and all forms of ARDs are ultimately untreatable.

Estimates of how many people have been exposed to asbestos and of how many people are likely to become ill are incredibly difficult, not only because of the microscopic nature of exposure, the extended latency period and the lack of historical records detailing employment on the mines or contracting and subcontracting arrangements in industrialized countries and the difficulty (and discrepancies) inherent in diagnosis, but also because these are politically charged issues. Nonetheless, some figures are necessary to situate the discussion. One estimate, by Kasperson and Pijawka (2005), is that up to 11 million people have been exposed to asbestos in the past 70 years. The World Health Organization (WHO) suggested, in 2006, that 123 million people spread across the world still experienced occupational exposure to asbestos (WHO, 2006). LaDou argues (2004, p285), however, that 10 million people will need to die before exposure is brought to an end by a truly global ban on asbestos. The scale of ARDs, the expected rise in numbers of sufferers and the enormity of the problem have led some researchers to refer to a ‘global asbestos epidemic’ (Rantanen, 1997). To date, according to the International Ban Asbestos Secretariat (IBAS), a conservative estimate of work-related asbestos deaths is 100,000 people per year worldwide. In western Europe, medical experts forecast that half a million men will die from asbestos-related causes between 1995 and 2029 (Kazan-Allen, 2003).

Asbestos is only one example in an endless list of toxic wastes, industrial accidents, environmental degradation and other hazardous processes. It is, however, a hazard which has passed ‘unnoticed’ and ‘unattended’ for decades, despite the fact that its carcinogenic nature was documented in medical and legal literature from the early 1900s. It has thus been seen, as Kasperson and Kasperson (2005) argue, as a ‘hidden hazard’. This characteristic of concealment stems partly from the nature of the hazard itself and partly from the nature of the society which exploits the product. The concealment of risk, in turn, is ‘at once purposeful and unintentional, life-threatening and institution sustaining, systematic and incidental’ (2005, p116). In addition, governments and citizens tend to concentrate on visible pollution (such as automobile fumes, smog, landfills and raw sewage) and on hazards associated with a particular place and with closely correlated cause and effect. Kasperson and Kasperson argue that factors such as the innocuous appearance of asbestos fibres, the microscopic levels of exposure necessary to cause harm, the geographic separation between extraction of asbestos and its application in industrialized settings and the extended delay between exposure and the onset of disease contribute to asbestos's elusiveness.⁴ The elusiveness of asbestos is, however, also a question of framing and politics. This book thus asks to whom asbestos is elusive and hidden, who frames the fibres as innocuous and who challenges these understandings, using what kinds of framings?

All over the world, there are now people campaigning to ban asbestos and to ensure that never again will people be deliberately exposed without prior knowledge of the dangers. This has, however, particular consequences for developing⁵ countries. Laurie Kazan-Allen, coordinator of the IBAS, argues that as ‘industrialized nations reduced their use of asbestos, producers have increasingly targeted consumers in the developing world’ (2005, p53). These processes are, as Kasperson and Kasperson point out, obscured by the political compartmentalization of the world because, as toxic hazards, they are rooted within particular values and assumptions which either elevate the benefits of such technology or underrate the consequences, and because the prioritization of economic growth over other social and political goals acts to sanction these activities. At a global level, they point out that often, in the case of ‘elusive’ toxic hazards, it is those who occupy the margins of societies and economies who are most affected by the hazard which ‘remains concealed to those at the centre or in the mainstream’ (Kasperson and Kasperson, 2005, p125).

Asbestos, its fibres and the consequences of using these products, thus permeate national and international processes such as global trade, national economic growth, national health and well-being, manufacturing standards, international trade and regulation. At a more local level, exposure to asbestos affects individuals’ health, their individual identities as men and women, collective well-being, their levels of activism and desire to participate in social movements mobilizing for change as well as much of their everyday life. It is precisely because of the way discussions about the uses – and abuses – of asbestos span these different categories and contexts, that it is ‘good to think with’. In order to exemplify this, this book asks fundamental questions about how asbestos is framed, by whom, and about how this affects people in India, South Africa and the UK. It explores who is affected by asbestos, how disease is defined by different actors and who benefits and who loses from these definitions, in order to demonstrate how processes of knowledge, power and political relations contribute to the ‘hidden’ status of asbestos.

The three countries explored in this book have all had different relationships with asbestos production, but are woven together through a history of colonialism, decolonization and development. Both South Africa and India were colonized by the UK in an era of conquest and European expansion. This was followed, in the 18th century, by a period of industrial capitalism, in which the UK invested in its colonies as it competed with other European countries for trade, resources and imperial domination. Yet, as UK companies mined asbestos in South Africa (McCulloch, 2002; Jacobs, 2003) and developed asbestos cement products in India (Tweedale, 2008), these investments were ‘orientated towards imperial economic interests and needs, and institutionalized racial and cultural inequalties’ (Watts, 2005, p90). In the UK itself, the era of colonial capitalism saw the importation of asbestos for the extensive manufacture and use of asbestos products. By the late 1940s and early 1950s, the management of colonies had developed into an institutional system based on technical and scientific expertise developed in the West (van Beusekom and Hodgson, 2000). Scienti...

Table of contents

• cover
• Half Title
• Issues in Forensic Psychology
• Title Page
• Copyright
• Dedication
• Contents
• Preface
• Acronyms
• 1 Introduction: The Problem of Asbestos
• 2 ‘I’ve Got the Dust as Well’: Asbestos Litigation, Pleural Plaques and Masculinity in the UK
• 3 Evaluating Science and Risk: Living with and Dying from Asbestos in South Africa
• 4 ‘Show Me the Evidence’: Science and Risk in Indian Asbestos Issues
• 5 ‘Through No Fault of Our Own’: Asbestos Diseases in South Africa and the UK
• 6 Reframing Risk: Comparative Framings of Asbestos and Disease
• 7 Conclusion: Diseased Identities and Social Justice
• References
• Index