In early 2012, reports circulated detailing some of the profit-centered entitlement raids that occurred at Bain Capital under Republican Presidential nominee, Mitt Romney. The Mesothelioma Cancer Alliance became intrigued when asbestos industry defendants appeared on a list of these types of corporate liquidations and commissioned a three-month investigation of the company’s handling of GS Industries through journalist, Gary Cohn. What we uncovered is the true human tragedy of collateral damage stemming from this profit model. We found a community affected by decades of toxic exposure, gasping for breath while picking up the pieces among an uncertain future.

A Promise Not Kept

John Cottrell had health problems, but in his heart he believed he was covered. After all, GS Industries, the Kansas City steel company where he had worked for 30 years had guaranteed his health insurance and pensions in the event of a shutdown. John retired in poor health from asbestos-related respiratory problems in 2000, but he and his wife Shirley felt secure knowing that their most critical employee benefits were guaranteed for life.

Then everything changed. Bain Capital, the private equity firm which gained control of GS Industries in 1993, declared bankruptcy for the mill in 2001, and quickly shut down the plant. A few months later, Bain dropped another hammer on the workforce: it was reneging on its promise to cover the lifetime worker benefits. Suddenly, the Cottrells’ future was very much in doubt.

“He thought these things couldn’t be touched,” said Shirley Cottrell in an interview. “He and the other workers trusted the company’s promises.”

These are the personal stories of Cottrell and other GS Industry workers and how their peace of mind and medical safety net were ripped apart. It will portray the suffering on an individual level, and show the damage done when people’s futures are controlled by a company that bases life-changing decisions primarily on financial considerations, regardless of the promises it made and the healthcare repercussions suffered by its workforce.

John Cottrell's pension and health coverage evaporated before his eyes after Bain's raid of GSI. His wife, Shirley was forced to drop her coverage to support John's growing asbestos-related medical expenses.

“They left us high and dry.”

John Cottrell had been on the job for 23 years when, in 1993, Mitt Romney’s Bain Capital assumed control of Worldwide Grinding Systems, the 105-year-old Kansas City steel mill where he worked. In the next seven years, before Cottrell retired in poor health in 2000, the mill went through some tough times, due in part to outdated machinery, the cyclical nature of the steel industry, and emerging international competition.

In response, Bain merged Worldwide with a steel mill in South Carolina, and renamed the new company GS Industries (GSI). In 1997, it endured a nasty 10-week worker strike that was motivated by the union’s skepticism that, if there was a shutdown, GSI had not earmarked sufficient reserves to cover its benefit and pension commitments.

“He thought these things couldn’t be touched. He and the other workers trusted the company’s promises.” – Shirley Cottrell

Ultimately, a settlement was reached that increased employee pensions and guaranteed that employees would continue to receive health and life insurance, even if the plant closed down.

Which it did. In 2001, just one year after Cottrell retired with guaranteed lifetime benefits, Bain elected to put GSI into bankruptcy and close down the plant, along with its 750 jobs. The private equity firm then announced it would no longer honor its recent promise to cover employee healthcare and pension benefits if the plant closed.

Bain’s decision under Romney is ironic, considering the candidate’s recently released statement where he classified 47% of Americans as freeloaders who refuse to “take personal responsibility.” The sole reason that GSI’s workers did not lose their entire pensions was because the mill's Bain-backed management applied for, and received, a bailout from the U.S. Pension Benefit Guarantee Corp. This federal handout came to $44 million; a sum that covered only the non-supplemental portion of the workers’ “guaranteed” pensions.

The workers did still have a healthcare option, though it was costly. They could continue to get coverage under GSI's existing healthcare plan through COBRA, but the company would now contribute nothing, so the workers were on the hook for 100% of the premiums -- if they could afford them. Not surprisingly, this additional expense proved prohibitive for many workers, especially older or retired ones who were suffering from asbestosis or other serious medical disorders picked up in their longtime service to the plant.

The Cottrells were stunned. “They took away something from the people who worked all those years and left us high and dry,” said John Cottrell’s wife Shirley.

John Cottrell had a stroke in 2006 that severely limits his activities and ability to communicate. Significant medical problems stemming from his asbestos exposure clearly manifested while he was still working at the steel mill, and forced his retirement.

Asbestosis, which John contracted, is a degenerative respiratory condition that often manifests as a pre-cursor to mesothelioma, an aggressive occupational-related cancer that develops in the lining of the lungs and abdominal cavity. There is no known cure for mesothelioma.

“They took away something from the people who worked all those years and left us high and dry.” – Shirley Cottrell

“Yes, John had to retire due to his asbestos problem”, said Shirley Cottrell. “His doctor told him in November, 1999, that he could no longer go back to work there because of the dirty air he had to breathe, which caused him to constantly have bronchitis."

“His breathing capacity was very bad and he had to have lots of different treatments from this doctor. It was attributed to his working environment,” she added.

But just a year after John’s retirement, Bain shut down the plant and broke its promise of continuous benefit payments, so the Cottrells were cornered into making a gut-wrenching healthcare decision. Now faced with prohibitively expensive COBRA insurance premiums, the Cottrells felt they had no option but to roll the dice. “I know that because of the expense of this insurance, I dropped my coverage, but we kept John's insurance because of his health issues,” Shirley Cottrell explained.

In Shirley Cottrell’s mind, the injustice of their circumstances is clear. “I do know that he gave 30 years to that plant and is suffering today for some of the mistakes that were made in their daily operations,” she concluded.

Many GSI workers spent decades working at the factory, it's entrance shown here in disrepair, even as the walls began to fall down around them and the air became toxic. (Reuters)

“I was one of the lucky ones.”

While undoubtedly the physical condition of some workers suffered from losing their healthcare and pension benefits, the mental anguish they experienced was often just as debilitating. Compounding their healthcare uncertainty, anxious workers now also had to deal with the real and present danger of having to drain their retirement funds to pay for unanticipated medical expenses.

To ex-crane operator Ed Mossman the effects were obvious. He worked at the plant almost 30 years, from 1972 until it closed in 2001. Like most others, Mossman was caught flat-footed by the sudden change to his health insurance benefits. “I hadn’t had time to get anything done yet,” he said in an interview. “I was assuming I had health insurance. Why didn’t they tell me when they cut my health insurance?”

Mossman does not have an asbestos-related disease, but he knows plenty of co-workers who do. “A lot of guys my age have it. I was one of the lucky ones,” he said.

Mossman also considers himself lucky for another reason. As ex-military, he had a viable back-up health insurance option, so he wasn’t subject to the exorbitant increase in coverage premiums like most others. “I was fortunate to be a veteran because health benefits were cut right after we shut down,” he said.

Not that Mossman got away unscathed: he says his monthly pension was reduced by 35%, from $1,400 to $900. “I lost over a third of my pension – that’s a lot of money for working people.”

“I hadn’t had time to get anything done yet. I was assuming I had health insurance. Why didn’t they tell me when they cut my health insurance?” - Ed Mossman

Mossman managed to adjust, but he couldn’t help but notice the tangible distress caused by the unexpected loss in benefits. “It was stressful,” he said. “A lot of people lost their marriages. We all lost all of our health insurance.”

The worst part, said Mossman, was the uncertain future now faced by older, longstanding workers. “We lost any peace of mind,” he said softly, before channeling his resentment toward the mill’s management. “My opinion is the company did not keep its word the last one-and-a-half years on anything.”

The belief that management broke its word seemed to be a common theme among the GSI rank and file. Ed Stanger, a 30-year veteran with the plant, echoed the sentiment. “I believed we were promised health insurance for life,” he said in an interview. “They (Bain) put the screws to so many people – It cost me my life insurance and hospitalization (health insurance), and my pension took a beating.”

Ed Stanger is now 71 and living with his wife in Independence, Missouri. He worked at the Kansas City plant for 30 years, from 1965 to 1995. The Stanger family’s service to the plant is multigenerational: his father worked for Armco (GSI’s previous name) for almost 35 years.

Many of the workers at GSI were made sick by airborne asbestos fibers from exposed pipe linings like those seen here.

Those decades of exposure to asbestos have taken their toll on Ed. ”Everyone was around it (asbestos) year after year. You do your job and don’t think anything about it. I have COPD. I’m the only one in my family that has it.”

For the Stangers, the unforeseen increase in insurance premiums was potentially devastating. “They (COBRA) wanted $1,300 a month,” he said. “I lost my health insurance. We went without health insurance, the wife and I.”

”Everyone was around it (asbestos) year after year. You do your job and don’t think anything about it. I have COPD. I’m the only one in my family that has it.” - Ed Mossman

Fortunately, the Stangers made it through and are now covered by Medicare. But Stanger is still dismayed and angry at Bain. “Promised? We always thought we’d have hospitalization (health insurance) for life. It’s a crying shame.”

David Foster goes further in his condemnation. Foster was the Steel Workers regional director in charge of coordinating union bargaining during the period the “guaranteed” deal was negotiated.

In an interview, Foster explained the details of labor deal. “Bain assumed all the liabilities associated with the Kansas City plant, including pension and retiree health insurance under contracts (previously) negotiated; there were shut down pension penalties if closed by owners -- this was a financial incentive not to shut down,” he said.

Because Bain put GSI into bankruptcy, there were no legal ramifications for breaking its promise of continued worker benefits. However, Foster believes the company is still culpable for its actions. “There’s a strong moral obligation,” he said. “They took on the responsibility of management and should stick with it through good times and bad times.”

Foster witnessed firsthand the suffering and anguish this caused, especially for older workers. “The loss was significant and devastating,” he said, especially “for many of the workers between 55 and 65.”

One of those workers was Donnie Box, who worked for the company for 32 years as a skilled craftsman and an assistant chief union steward. “They notified us they were cancelling our health insurance, plus I lost a big chunk of my pension,” he said in an interview.

“It was choreographed. They could make money quicker by shutting the place down.” - Donnie Box

As an overhead crane operator, Box was exposed to asbestos on a regular basis. “I was up in rafters all the time among asbestos-wrapped pipes,” he explained. Box has respiratory problems, though at this point has not been diagnosed with a specific asbestos-related disease. But his symptoms are troubling: “I have problems because of exposure…had pneumonia four years in a row,” he said.

Adding insult to injury, Box feels that it was greed, pure and simple, that motivated Bain’s actions. “They said they just didn’t have money for it. At the same time, they were paying bonuses to managers”, he remembered. “It was choreographed. They could make money quicker by shutting the place down.”

The workers at GSI often joked about Bain's aloof corporate-types tiptoeing around their industrial worksite. Here, Mitt Romney greets steelworkers on the campaign trail. (NPR)

“It was indefensible management.”

Though not unanimous among people associated with the situation, the perception that Bain’s greed and operational mismanagement contributed significantly to, or actually caused, the plant’s downfall was a common theme.

Romney ran Bain until 1999, when he left to run the Salt Lake City Olympics. He was in position to oversee the majority of operational and financial changes the private equity firm made for GS Industries before Bain put it into bankruptcy in 2001. Despite his departure, Romney still maintained a significant financial stake in Bain, and continued to collect dividends from Bain afterwards.

Significant criticism, much of it by people not associated with Bain, Romney, GSI or its workers, has been made against Bain’s management of the steel company, according to prior coverage. Commonly cited operational problems included hiring supervisors with little or no industry experience and introducing numerous cost-cutting measures that backfired, eventually costing the company extra.

However, it was the financial actions taken by management that various outsiders and insiders alike believe were the primarily causes of GSI’s downfall. Many believe this trend started early in Bain’s tenure, when it paid itself hefty dividends soon after acquiring the mill. Ultimately, it was this action that may have burdened the struggling company with a too-heavy debt load and prevented much-needed financial flexibility.

Many couldn’t help but notice that, despite the mill’s spiraling financial situation, Bain profited handsomely from its investment in GSI. According to published reports, for its $8 million original stake, Bain took back $12 million, plus a minimum of $4.5 million for consulting services.

David Foster was a union negotiator and the Steel Workers Union regional director during the period when the “guaranteed” deal was made. Although over a decade has passed since those events, the facts remained clear in Foster’s mind.

In a recent interview, Foster recounted the chain of events, and Bain’s perceived culpability, after it acquired majority control of GSI in 1993. “There was an uptick in the steel industry, but what Bain did, instead of using this period to pay down debt and reinvest, was to load up on debt and pay themselves a dividend,” he said. “It was a situation that put the company on a disaster course and inevitably led to bankruptcy and collapse.”

“There was an uptick in the steel industry, but what Bain did, instead of using this period to pay down debt and reinvest, was to load up on debt and pay themselves a dividend” – David Foster

Foster added that Bain “loaded the company up with debt; toward the end of the decade there was an oversupply in the global market and prices started to drop. When the crash came in 2001, GSI had no capacity to weather the business downturn; it was indefensible management…unsustainable.”

But Foster believes that this was Bain’s fallback plan all along. Bain’s goal was to “pull cash out during boom times and be prepared to walk away from it,” he said. “It was a no-lose proposition.”

No-lose for Bain, perhaps; for the workers it was a much different story. “The 750 union employees were big losers,” said Foster. “They got nothing for retiree health insurance. They shut down pensions. The promises Bain had stated were wiped out. This was a financial stripping of the company by Bain Capital. The looting of the company and the destruction did not have to happen.”

So, despite shutting down the plant, Bain got rich (or richer). Not surprisingly, many in GSI’s workforce firmly believe it was at their expense.

Ed Mossman agrees. When asked whether he thought Bain’s mismanagement caused the company’s downfall, he was emphatic. “Absolutely. There’s no doubt in my mind,” he said.

It was Ed Stanger who probably best summed up the feelings of the GSI workforce. “The Bain Corporation is the one that did it. It really ticks me off the way this thing was handled,” he said. “They didn’t care about the little guy -- we were expendable.”

“They left us with the bones…”

The upcoming presidential election may hinge on which candidate the public believes can best fix the nation’s struggling economy. Mitt Romney, the Republican candidate, has repeatedly promoted his track record as a successful businessman; that his financial experience makes him the best candidate for this responsibility.

Many disagree with this premise, and point to Bain’s handling of GSI as a prime example of its disproportionately profit-centric approach. Specifically highlighted was Bain’s willingness to fire workers and cut benefits while ensuring it made a sizable profit.

Former union executive David Foster believes that, in general, private equity firms like Bain sometime follow an unethical and unsustainable economic path to cultivate profits. “There’s nothing ennobling about this model and certainly nothing about job creation,” he said. “They took as much out as fast as they could. It was finding a way to dip your hand in cookie jar when nobody was looking and eat your fill.”

He continued: “It certainly says to me about Romney that he doesn’t have the kind of values I want sitting in the White House. GST steel was built up over lifetimes. He pulled money out of the company and walked away from his obligations. Bain looked at the risk and walked away from it.’

“This was a financial stripping of the company by Bain Capital. The looting of the company and the destruction did not have to happen.” - David Foster

Foster ended by saying that Bain was “draining cash out of the company. They were about maximum short term gain for investors. I think it was financial hucksterism at its worst.”

Whether hucksterism or not, Bain’s choices have clearly caused distress and disillusionment for many of the GSI workforce and their families. This seems especially true for people like the Cottrells, who like many others, still suffer from asbestosis, or other serious medical problems, that were triggered by their long-term service to the company.

Among the GSI community, perhaps Shirley Cottrell best summed-up the general sentiment toward the company that profited significantly while reneging on its benefits obligations. “No, (Bain) was not a good thing," she said. "They took all the gravy and left us with the bones."

# # #

Rick Feldman contributed writing and editing to this story.

Note* In the interest of journalistic fairness, the author of this story attempted on many occasions to reach Mitt Romney’s presidential campaign for comment. Those attempts to obtain comment were unsuccessful.

For mesothelioma and other asbestos-related disease victims, the Supreme Court’s landmark decision upholding the Affordable Care Act (ACA) should mean lifesaving medical coverage, according to Linda Reinstein, a mesothelioma widow and the co-founder and president of the Asbestos Disease Awareness Organization.

"As a mesothelioma widow, I think the Affordable Care Act will save lives and dollars for Americans who may have been exposed to asbestos” said Reinstein in an interview. “The continuation of primary care is essential for those exposed to asbestos and diagnosed with asbestos-caused diseases. Now they can be treated promptly and appropriately."

Reinstein, whose late husband Alan was diagnosed with mesothelioma in 2003, said that the recent decision would benefit victims and their families through two key provisions: the elimination of insurance company discrimination based on pre-existing conditions, and the abolishment of annual and lifetime caps.

"Eliminating the annual and lifetime insurance caps are significant to ensure expert medical care and maintain the patient's quality of life," Reinstein said, explaining that medical coverage for asbestos-related victims is often continuing and costly.

Millions of Americans Affected

Overall, the Supreme Court’s milestone decision upholding the ACA should translate into significantly enhanced medical coverage for tens of millions of Americans. As Reinstein stated, the key provisions will put an end to existing lifetime/annual expenditure caps and policy discrimination against people with pre-existing conditions. Both are specifically relevant for patients diagnosed with asbestos-related or other forms of cancer.

According to the Department of Health and Human Services, between 50 million to 129 million Americans under the age of 65 have pre-existing conditions, with cancer patients comprising a significant percentage of the group.

Dick Woodruff, VP of federal affairs, ACS-CAN

According to Dick Woodruff, vice president of federal affairs for the American Cancer Society's Cancer Action Network, many uninsured adults who die prematurely are cancer patients. "Without good insurance coverage, surviving cancer is very expensive or very difficult," Woodruff said in an interview with the Sarasota Herald Tribune. "There are currently 12 million cancer survivors in this country, all of whom have a pre-existing condition.”

Without the Supreme Court’s ruling, added Woodruff, “it's doubtful that those people, aside from the wealthy, would be able to afford treatment."

While it is tempting to look at the court’s decision simply in terms of the massive number of Americans that will benefit, its significance becomes truly evident when looked at through the prism of individual cases, where the effect on people’s lives is extraordinary.

In the wake of last week’s decision, cancer patients from across the country have come forward to tell their stories and talk about the positive impact the law will have on their mental and physical health going forward.

Bev Veals

“The Dignity of Being Covered”

One is the story of Bev Veals, a 48-year-old North Carolina housewife with two children. She is a breast cancer survivor who was forced to go without medical insurance for an extended period, but who obtained coverage in 2011 under a key interim provision in the Affordable Care Act.

Over an extremely-trying 10-year span, the cost of Veals’ breast cancer treatments led to bankruptcy and foreclosure on her family’s home. Finally, four years ago, the out-of-pocket costs were so debilitating that Veals had to drop off the family insurance policy so their monthly payments could drop from an exorbitant $1,700 to an affordable $400.

Veals went the next two-plus years without health insurance, until 2011, when she became eligible for the stopgap policy offered by the Affordable Care Act that temporarily covers individuals previously denied coverage for pre-existing conditions. (This provision runs until 2014, when the pre-existing-conditions ban officially kicks-in.) She now pays $377 per month for her insurance.

Being covered again also produced a pronounced boost of Veals’ self-respect. "It has only been a little over a year for me, but I can't tell you the dignity being covered brings," Veals told the Associated Press.

"My biggest fear was I would have to beg for help to cover medical bills; Panhandling to pay a doctor's bill -- not my idea of the American Dream."

Veals’ experience has also had an impact on her political views. "As a conservative, I believed if you can't make your way, you don't get your way. Now I've cost more medically than I will ever be able to make. I've changed my political stance because of this," she said. "It doesn't do our economy any good when we have so many people having to file for medical bankruptcy."

Not Just for the Uninsured

The positive ramifications of the Supreme Court’s ruling can also have life-saving implications for cancer patients who have always had comprehensive medical coverage. One example is Robert, a 58-year old PhD from Brooklyn, who is a Shakespearean scholar and former Professor of English at Queens College.

Robert, who asked that his last name not be disclosed to protect his privacy, was diagnosed with lymphoma 8 years ago. He beat that, but was then diagnosed with mesothelioma four years ago. He currently receives chemotherapy treatments every three weeks for the disease.

Until now, Robert’s insurance coverage has never been a problem. He initially got his medical insurance through his employer over 20 years ago, well before he was diagnosed with the cancers. As there was a cancer history in his family, he wisely purchased a catastrophic supplemental plan at the same time, and this policy has proved to be enormously beneficial.

Robert is well aware that, in terms of medical coverage, he has been more fortunate than many of his fellow patients. “If I had tried to buy that Insurance Plan after being diagnosed with cancer, I would have been turned down. Now with Obamacare, a pre-existing condition would not disqualify me,” he said in a recent interview with this reporter.

But even for longtime survivors like Robert the Court’s ruling could be a lifesaver. “That Catastrophe/Supplemental Insurance plan, which luckily I held on to, has a cap or ceiling, which could be reached if my condition eventually requires expensive surgical procedures, like bone marrow transplants. Now with Obamacare, there is no cap or ceiling on benefits,” he said.

Mailet Lopez

“The Result is Awesome”

Mailet Lopez, a 38-year old, Cuban-born Long Island woman diagnosed with breast cancer five years ago, said that for cancer survivors, the Supreme Court decision is tremendously beneficial for both their physical and mental health.

"The result is awesome" said Lopez in an interview with the Guardian (UK). "There is a buzz on Facebook and Twitter right now among my community. Because they all had cancer, they have been affected by the pre-existing condition provisions, and they don't need to worry about that anymore."

When Lopez was first diagnosed with breast cancer at the age of 33, she called the chemotherapy process "pretty terrifying". Lopez subsequently wanted to try alternative therapy, and her health insurance company allowed her to go out of network. Though she had to go out-of-pocket up front, she was eventually reimbursed for the treatment, which cost $20,000. She has been cancer-free for four years.

While Lopez had few problems with her insurance company, she was disqualified for a supplementary policy she wanted that her company offered. "There are so many loopholes for insurance companies who won't cover people with cancer,” said Lopez. "Even if you do have insurance, if you lose your job, you lose your healthcare and it is really, really difficult to get healthcare again.

Lopez feels that overhauling the current way most people get their medical insurance is crucial. “People have to stay with the same employer for the rest of their lives because they are afraid of losing their insurance. There aren't a lot of options," she said.

“I Don’t Know What I’d Do.”

Another example of the ACA’s extraordinary benefits is the story of Brian Rose, a 34-year old Wichita man and coach of a local minor-league baseball team. Three years ago, Brian was diagnosed with Stage 4 melanoma, a deadly skin cancer. The cancer has extended to his brain, bones and liver.

While Rose did initially qualify for emergency Medicaid coverage for his illness, the policy only lasted six months. Now, under the ACA, his monthly premium is $200, which is literally lifesaving, as his medical bills for the prior year exceeded $250,000.

Without that coverage; "I don't know what I'd do," said Rose in an interview with USA Today. Insurers had denied his earlier applications for coverage by designating his cancer as a pre-existing condition.

Having medical coverage has changed his outlook for the future and given him peace of mind. "I can't fathom the concept of not having any kind of health care," he says.

“But Is It Feasible?”

While the general reaction among cancer patients and their doctors has been overwhelmingly positive, some health care professionals have tempered their enthusiasm with caution.

One is Dr. Caroline Hastings, a pediatric oncologist at Oakland’s Children’s Hospital who has seen "hundreds" of cancer-stricken children denied adequate treatment because their parents’ insurance companies consider cancer a pre-existing condition and were subsequently denied coverage.

Though Hastings was elated with the Supreme Court decision, she was skeptical of how it would actually play out.

"It’s great,” she said in an interview with KNTV-TV in San Jose. “But how is it feasible? What insurance product will be available that is comprehensive and affordable? Or, I worry that the insurance that will be affordable will be like not having insurance at all."

“What we can expect is very predictable – an absolute catastrophe of death and disease,” Dr. Arthur Frank, chairman of environmental and occupational health at Drexel University, said in a recent interview with this reporter. He added that the coming catastrophe is “all preventable.”

“What we can expect is very predictable – an absolute catastrophe of death and disease”
- Dr. Arthur Frank, Chairman of Environmental and Occupational Health, Drexel University

Frank’s cautionary words parallel numerous scientific studies and expert predictions forecasting a surge in mesothelioma and other asbestos-related diseases in Asia in the coming decades. This is primarily because India, China, and other countries on the continent continue to use – or in some cases, even increase – their dependence on asbestos for cheap roofing insulation, in cement, and other widespread applications.

Another expert, Dr. Amir Attaran, a scientist, lawyer and acknowledged expert on global health issues, said that the consequences of continued heavy use of asbestos will be felt particularly hard in India, a growing nation of 1.2 billion people with few limits or controls on the use of asbestos.

“It’s a scientific failure, a clinical failure, and a social and moral failure of India. It is a failure of culture and science”
-Dr. Amir Attaran

When asked about the consequences of the country’s widespread use of asbestos, Attaran, a leader in the fight to stop exports of the material to Third World countries, quickly replied: “In disease terms, incalculable. India has no public health controls. They will pay dearly for this with an epidemic of mesothelioma.”

“It’s a scientific failure, a clinical failure, and a social and moral failure of India. It is a failure of culture and science,” Attaran added.

Asbestos and Asia

Asbestos has historically been used as cheap insulation material in construction, ships and cars. In the United States and Europe, it has been banned for most uses because of its clear-cut links to mesothelioma and other diseases, but it is still widely used in Asia and other nations because it is effective, yet relatively inexpensive. In Asia, it is used primarily for cheap roofing insulation, and in cement and power plants. The health hazard of exposure is compounded by the fact that Asian workers often toil in factories with poor ventilation.

A few Asian nations, such as Japan and South Korea, have banned asbestos, but they are the exceptions.

In recent years, numerous studies have documented the anticipated rise in mesothelioma and other asbestos-related diseases over the next several decades in Asia. One recent study, in the Journal of the Asian Pacific Society of Respirology, said that Asia, with its large, developing countries, currently accounts for about 64% of the world’s asbestos use. This represents a steady increase -- the continent accounted for a 33% share from 1971 to 2000, and 14% from 1920 to 1970.

Medical experts say that it generally takes people 20 to 50 years after exposure to asbestos to develop mesothelioma and other asbestos-related diseases. This timetable clearly forecasts that Asia’s current rate of usage is likely to lead to a huge hike in asbestos-related diseases in the coming decades.

An Asbestos Tsunami

Ken Takahashi, the lead author and acting director of the World Health Organization Collaborative Center for Occupational Health, has said that Asia can anticipate an “asbestos tsunami,” in the coming decades. In response, WHO has identified asbestos as one of the most dangerous occupational carcinogens in the world, and says there is an urgent need to stop asbestos use in order to curtail the enormous associated health damages.

An estimated 107,000 people worldwide die each year from asbestos-related diseases, a number that will continue to grow if efforts to curb its usage fail.

While already substantial, this assessment is probably low, according to leading public-health experts, as it is difficult to categorically track deaths from asbestos-related diseases in Asia because India, China and other countries do not to keep reliable data on them.

In recent years, some Asian nations, including Japan and South Korea, have banned or limited asbestos use. But in most other Asian nations, most significantly India and China, the use of asbestos has continued with little or no regulation or oversight. (This reporter got a first-hand view of the problem in the late 1990s while investigating India’s notorious shipbreaking facilities in Alang, where thousands of unprotected workers worked on large, retired vessels with high asbestos content).

Many public health experts, such as Frank of Drexel University, have called for a ban on asbestos exports to Asia. Last year, Frank led a group of 120 medical doctors and other health professionals in a campaign to stop Canada from exporting asbestos to developing nations. Canada, which has largely banned asbestos for domestic use, is the second-largest exporter of asbestos to Asia, behind only Russia.

In an appeal to Canadian medical experts, Frank and his colleagues warned that Canada is morally obligated to consider the “enormous harm to health for generations,” if the exports continue – a plea that so far has gone unheeded.

In the recent interview, Frank reiterated the urgency to stop developed nations such as Canada from exporting asbestos to the Third World, along with the need for Asian nations to ban asbestos and start using available non-lethal substitutes.

“What needs to be done is very simple,” Frank told me. “They should stop using asbestos in Asia.”

However, this is unlikely to happen as long as established countries continue to chase the profits from exporting the carcinogen. “Canada is the world’s biggest hypocrite when it comes to asbestos,” said Frank. “It is taking it (asbestos) out of Parliament buildings but willing to sell it overseas.”

Next up: The hypocrisy of asbestos-exporting nations. Canada, for example, has banned the use of asbestos domestically and is scheduled to begin a $1 billion renovation project to clean its parliamentary buildings of asbestos this summer. Yet Canada remains one of the world’s biggest exporters of asbestos to the Third World.

Greetings,

My name is Gary Cohn and I’ll be serving as lead reporter on a number of different investigative projects in the coming months. Here you will find a fresh perspective on topics that matter most to our site’s visitors and members of the larger cancer community in general. We’ll address healthcare access, the role of pharmaceutical companies in cancer care, environmental concerns and the lesser-known public policy matters that affect people’s lives- including your own.

We’ll be speaking with the world’s leading experts in occupational illness, medical professionals and government representatives to ensure our visitors and larger communities as a whole are enlightened and informed about what’s happening in the news areas they care about most.

With over 30 years of award winning investigative journalism experience for some of the world’s leading publications, I have a voracious curiosity for issues that affect people’s daily lives. As a professor of journalism at the University of California Annenberg School of Journalism, I encourage my students not only to inform the public, but hopefully to incite change and inspire others to express their voice over the issues that matter to them.

I urge you check back frequently and let us know what issues matter to you, as well as share our content and findings. I welcome a two-way dialogue about the issues we’ll be covering and welcome your feedback. Please do not hesitate to contact us!

Enjoy,
Gary