ASBESTOS RELATED INFORMATION
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Research and Treatments
A centre of excellence in research, diagnosis and treatment of asbestos-related
numbers of mesothelioma and asbestos-related lung cancer's are alarmingly
on the increase. Owing to the long latency period from the exposure to
asbestos fibres and manifestation of asbestos disease (often up to 30
years or more), the epidemic of asbestos diseases is yet to peak in Australia
(around 2023). It is believed that as many as 45,000 persons may die in
Australia over the next two decades if effective medical treatments are
not found. About 2500 persons are annually diagnosed with asbestos caused
diseases, and the numbers are rising.
Research into asbestos-related diseases in Australia is virtually non-existent
except in Western Australia at Sir Charles Gairdner Hospital (SCGH). Asbestos
diseases research is more advanced at SCGH than anywhere in the world.
WA medical scientists Professors Bill Musk, Bruce Robinson and their colleagues
have an enormous amount of experience and have won a number of awards
for their work in epidemiology, diagnosis, immunology and treatment of
The research at SCGH into asbestos-related diseases, largely stems from
investigating the exposure to asbestos of former Wittenoom blue asbestos
miners. The researchers have acquired valuable expertise in the epidemiology,
cytopathology, molecular biology and immunology of mesothelioma.
It is well known both nationally and internationally that SCGH scientists
are leaders in areas of novel clinical mesothelioma treatment trials and
have a unique cell bank of human and animal mesothelioma cell lines. Thus,
they are in an ideal position to make a unique contribution to find effective
treatments for asbestos caused diseases. The SCGH research may also lead
to improved early diagnostic methods of asbestos caused diseases and an
increase in understanding similar diseases.
Importantly, research into asbestos-related diseases such as mesothelioma
and lung carcinoma may provide major insights into the mechanisms, diagnosis
and therapy of such solid malignancies as lung cancer, breast cancer,
bowel cancer and prostate cancer as well as fibrotic lung disorders. SCGH
medical scientists can only seize this unique opportunity and advance
their valuable work if the ongoing support for a Centre of Excellence
can be established.
Regrettably, the Sir Charles Gairdner Hospital research program receives
very little funding from the public purse, save for the Western Australian
Government. The lack of financial support by the Federal Government condemns
at least 2500 Australians per annum to a premature death (it is a national
Any reader of this booklet is respectfully urged to write or to speak
to his or her Federal member of Parliament and bring to their attention
the appalling situation of many doomed Australians now dying by virtue
of neglect due to the Federal Government's misguided priorities of medical
Additional information on the SCGH Clinic of Excellence and inadequacy
of the Federal Government's research funding will be provided by ringing
ADSA on our toll free number 1800 646 690.
Asbestos-related Treatment and Research Programmes at SCGH
ReVital Program (former Vitamin A Program)
In Western Australia persons with significant exposure to asbestos have
been offered participation in a program providing dietary supplements
of Vitamin A (Beta-carotene or Retinol) because of the known increased
risk of lung cancer and malignant mesothelioma.
program dispensing Vitamin A commenced in 1990 primarily to reduce the
risk of lung cancer and mesothelioma amongst former Wittenoom miners and
residents. Subsequently the program has been renamed ReVital and persons
other than Wittenoom have been added to the program including some Eastern
States members of the ADSA.
ReVital Program has been exclusively funded by the Western Australian
Government Department of Health and that was and is greatly appreciated.
In addition to former Wittenoom workers and residents, workers from other
industries where exposure to asbestos occurred are also participating
in the program.
the years, there have been several evaluations of the program; (a) comparing
rates of mesothelioma among ex-Wittenoom workers and residents on the
program with those not on the program; (b) comparing rates of mesothelioma
for all groups of subjects according to the intervention administered;
(c) comparing death rates between Wittenoom subjects on and off the program;
(d) examining associations of level of plasma retinol and disease and
lung function in all program participants; (e) reporting side effects,
withdrawals, and abnormal liver function during the ReVital Program.
policy of the ReVital Program is not to turn anyone away, however the
number of persons participating in the program are subject to the availability
of resources (funding).
encouraging results over the years have clearly shown justification to
fund the program. The latest evaluation of 18 November 2002 definitely
shows the beneficial effect it has on the participants. For example, the
participants of the program (i) continue to experience lower mortality
and mesothelioma incidence than non-participants, (ii) the magnitude of
the relative reduction in mesothelioma rate in participants observed in
the previous study has not been maintained but is still sizeable, (iii)
previous evaluations were unable to distinguish benefits from retinol
administration from overall program benefits such as health promotion
advice, or group social capital. However, the internal analyses appear
to indicate that retinol administration results in increasing plasma levels
of retinol, which in turn are associated with reduced mesothelioma incidence
and lung function improvement.
lack of funds is preventing the expansion of the life-saving program and
there are several hundred persons on the waiting list (the current funding
will expire at the end of June 2003).
2. Treatment of asbestos-related diseases
Lung Cancer: Patients with lung cancer are provided with diagnostic investigations
and appropriate conventional treatment for lung cancer. Initial studies
have evaluated the susceptibility of lung cancer cell lines to a variety
of cytotoxic drugs. The capacity of asbestos fibres to directly suppress
anti-cancer immune surveillance mechanisms has also been studied. In addition,
the utilisation of different methods of developing tumour-specific T-lymphocytes
for improvement in adoptive immunotherapy are studied.
The research work ranges from highly technological laboratory studies
through to clinical trials using new therapies in patients with mesothelioma.
Current laboratory studies are aimed in a number of areas, including the
use of gene transfer techniques to augment the body's capacity to fight
mesothelioma, the use of molecular cloning to identify proteins within
mesothelioma cells which may be recognised by the body's immune system
and hence may be useful in the early diagnosis of the disease and/or may
be useful in vaccination to prevent mesothelioma.
The sophisticated immunological techniques are used to understand how
it is that the mesothelioma cancer cells escape detection by the body's
immune anti-cancer defences.
A number of treatment trials are being used in patients with mesothelioma.
For example, the latest gene therapy approaches to transfer genes directly
into tumours of patients with mesothelioma in an attempt to boost the
body's immune system to fight the cancer.
The new chemotherapy regime has proved very powerful in laboratory studies
and early indications are that it may have some effect in shrinking mesothelioma
in patients. The two drugs being used at the moment are gemcitabine and
For information on the asbestos research programmes ring our toll
free number: 1800 646 690.
3. Research into the epidemiology of asbestos-related diseases
Former Wittenoom workforce and members of families have been traced to
determine the frequency of asbestos-related diseases and the relationships
of those diseases to the degree of asbestos exposure, smoking and other
factors to provide information vital for understanding the damaging impact
of asbestos on health.
The effects of lower levels of exposure to blue asbestos experienced by
former Wittenoom residents (not being the workers of CSR) have been studied
and a relationship between amount of exposure (determined from the date
and duration of known residence in Wittenoom) and risk of mesothelioma.