N.Y.C. Crisis Resparks Debate Over Risks Posed by Asbestos
The initial uproar over the New York City schools' emergency asbestos cleanup has subsided, but when it comes to debate over the policy questions it raised, the dust clearly has not settled.
Scientists, pundits, and politicians have reacted to the furor by questioning the wisdom of asbestos policies in New York and other school districts, as well as that of the federal mandate they are intended to carry out.
Schools nationwide have spent well over $3 billion to comply with the Asbestos Hazard Emergency Response Act of 1986. Yet researchers now say children have a far greater chance of being struck by lightning than being harmed by asbestos in school buildings. Some critics even argue that many efforts to deal with asbestos actually have increased children's exposure.
New York City officials have come under fire from two sides.
Some observers in the city have blasted the district for its asbestos-management program, which was found to be plagued by inaccurate inspections and incomplete cleanups. (See Education Week, Sept. 8, 1993.)
Other critics say district and city officials overreacted in postponing the opening of school by 11 days to allow for emergency inspections and cleanups expected to cost an estimated $30 million. Abatement efforts there were continuing last week.
Congress Questions Its Law
In a move that reflects growing doubts about federal asbestos policy, Congress is poised to drop funding for the Asbestos School Hazard Abatement Act, which provides grants and loans to schools for asbestos abatement. (See related story, page 24.)
In arguing against funding the program, Sen. Barbara A. Mikulski, D-Md., last month urged Congress to re-examine its asbestos mandates so that federal money could be freed to address bigger health threats, such as lead in drinking water.
Quoting a recent column in USA Today entitled "End the Phony 'Abestos Panic,''' Ms. Mikulski told her colleagues "the asbestos panic, started by sloppy science and spread by gullible journalists, has gone far enough.''
In response to the New York school closings, the Environmental Health and Safety Council of the American Health Foundation last month released advance copies of a report that questions whether asbestos in public buildings poses any health threat at all to occupants.
The council's report, slated for publication in the January issue of the journal Preventive Medicine, extensively reviews scientific research on asbestos and concludes that the levels of airborne asbestos found in schools and other public buildings are very low, often no greater than the levels found in outdoor air. Even the complete removal of all asbestos from all public buildings would provide "no measurable benefit to public health,'' the article concludes.
Nevertheless, many other scientists, as well as leaders of parent organizations, continued last week to regard asbestos in schools as a significant health threat and to believe that New York City acted prudently in closing schools.
"The city did the right thing in closing the schools down until inspection could be completed,'' said Dr. Philip J. Landrigan of the Mount Sinai School of Medicine in New York, which has been conducting research on the health hazards posed by asbestos for three decades. He and his colleagues, he said, now hold to "the fundamental premise that asbestos is a proven human carcinogen.''
"The fact of the matter is that contamination from any toxin is not good,'' maintained Ayo Harrington, the president of the United Parents Association, an umbrella organization of New York City parent groups that backed the closure of schools.
"As parents,'' Ms. Harrington said, "we don't want to take a chance of figuring out whether a mouthful or a tub full is what it takes to cause respiratory problems for our children 20 or 30 years down the line.''
Health Effects Unknown
The debate over asbestos policy is clouded by the fact that much about the health effects of asbestos, particularly in children, remains unknown or in dispute.
Few if any scientists question what thousands of deaths by workers have shown: that direct exposure to large quantities of the fire-resistant mineral in an industrial setting can kill.
Asbestosis, a potentially incapacitating disease that develops when asbestos fibers scar and impair the lungs, was first diagnosed in industrial workers around the turn of the century. By the 1960's, scientists also had extensively documented unusually high rates of lung cancer and mesothelioma, a cancer of the lining of the lung or abdominal cavity, among people who came into frequent contact with asbestos in industrial settings.
More recently, a 1990 study by the Mount Sinai School of Medicine showed that New York City's school custodians came into contact with large quantities of asbestos, and were at significantly greater risk of developing asbestos-related disease.
The asbestos most often is found in floor or ceiling tiles, or as insulation placed behind walls or wrapped around pipes.
Yet the dangers asbestos poses to those who do not work with it remain difficult to measure.
Based on the demonstrated health problems of asbestos workers, many scientists in the early 1980's warned it was not enough that the federal Occupational Safety and Health Administration and the Environmental Protection Agency had developed regulations to protect workers.
Led by the late Dr. Irving J. Selikoff, who was director of Mount Sinai's environmental- and occupational-health division, the scientists asserted that a significant health risk was posed by the millions of tons of asbestos-containing material that had been installed in public and commercial buildings, including schools.
Congress responded by passing the Asbestos Hazard Emergency Response Act of 1986, which required that all schools be inspected for asbestos. If asbestos was found to be deteriorating, and therefore in danger of breaking loose as dust, AHERA required schools to submit plans to contain or remove it. Intact asbestos was to be monitored and maintained.
Were Risks Overstated?
In June 1989, one month after the absolute deadline for compliance with AHERA, the New England Journal of Medicine published an article questioning whether the form of asbestos found in most schools was a health threat after all.
Seven months later, a similar article in the journal Science faulted federal policymakers for failing to differentiate between different types and concentrations of asbestos in assessing health risks. Both articles listed as their principal author Brooke T. Mossman, a professor of pathology at the University of Vermont's medical school.
Ms. Mossman and her colleagues said that the levels of airborne asbestos found in schools--even those with damaged asbestos-containing material--were about a hundredth of the federal government's current limit for the workplace, 0.2 fibers per cubic centimeter of air.
Such levels, they argued, were extremely unlikely to cause asbestosis, which requires intensive exposure, or lung cancer, which the OSHA workplace standard was designed to guard against.
Moreover, they said, almost all of the asbestos found in schools is chrysotile, meaning it has curly, pliable fibers that wash out of the lungs before they can penetrate lung tissue to cause mesothelioma. The more dangerous types, the amphiboles, are rarely found in schools, they said.
Reports issued in 1991 by the American Medical Association and the Health Effects Institute also described the health risks that asbestos poses to building occupants as low.
The American Health Foundation's new report says exposure to such low levels of airborne asbestos has never been scientifically linked to asbestos-related disease in building occupants. The hypothetical risks posed by such concentrations, it says, are "exceedingly small,'' and the real risks are probably even smaller and "may be zero.''
Even if everyone in America attended schools with airborne asbestos and half of them later became smokers, thereby increasing their vulnerability, the result would be at most a handful of new cases of asbestos-related cancer or mesothelioma each year, the report says.
Dr. Landrigan, Dr. Selikoff's successor at Mount Sinai, last week criticized Ms. Mossman and her colleagues' research as heavily based on air samples that were collected at night and on weekends, times when children would not have stirred up asbestos dust. He also disputed their assertion that chrysotile asbestos fibers are likely to wash out of the lungs and unlikely to cause mesothelioma.
"I would argue very strongly that the kids who are exposed to asbestos today in schools are going to be at significantly greater risk later on of developing lung cancer and mesothelioma,'' Dr. Landrigan said.
Because so many Americans have died from exposure to asbestos, assertions that the most common form, chrysotile, can be harmless "fly in the face of common sense,'' Dr. Landrigan said.
Such a view of the hazard appeared to be championed by Sen. Paul Simon, D-Ill., who, in arguing last month for continued federal funding for asbestos abatement in schools, said that children are especially vulnerable to asbestos because "they breathe more rapidly than we do.''
Regina L. Bushong, the chief of the field-programs branch of the E.P.A., said the position of her agency is that asbestos in schools should be taken seriously, but should not cause panic.
Scientists have not identified a level of asbestos that they definitely can call safe, but that "does not mean that every level is dangerous,'' Ms. Bushong said.
"For normal building occupants,'' she said, "there is no evidence to support that they are at any significantly increased health risk from asbestos in the building.''
Defining Acceptable Risk
Such assurances, however, often do not sit well with parents, or with the school administrators who must answer to them.
"I don't think anyone is disputing that asbestos is a carcinogen,'' said Carolyn E. Henrich, a government-relations specialist for the National PTA. "Given that, there is no known safe level.''
A high-ranking New York City school official, who spoke on the condition of anonymity, said the decision to delay school openings there was made not so much because of health concerns, but because officials feared that large numbers of parents would keep their children out of school anyway. With a mayoral campaign under way, he said, city officials did not want to be accused of putting children in danger.
But those who argue that any risk to children is unacceptable face opposition from those who espouse risk assessment, a public-health-policy strategy that seeks, based on calculations of risks, to spend money where it will do the most good.
"Using relative-risk techniques, it is crazy to escalate this to a major priority when there are many other public-health risks facing children that the money can be better spent on,'' said Morton Corn, a professor of environmental-health engineering at Johns Hopkins University and a former assistant secretary for OSHA.
"The bottom line is that it is a zero-sum game, and there is just so much money that is available to the school system,'' added Laurie A. Westley, the chief legislative counsel for the National School Boards Association.
"You will either spend it on make-believe environmental hazards,'' Ms. Westley said, "or you will spend it on real problems, or you will spend it on educational needs.''
Michigan Bans Hasty Removal
For all the disagreement over asbestos in schools, most experts agree that the E.P.A. has formulated a sound policy for dealing with it.
That policy, issued in 1991, warns that removing asbestos often is not the best course of action, and that improper removal can actually create a dangerous situation where none previously existed. It urges that schools seek, instead, to manage asbestos in place.
Studies by the E.P.A. have shown that airborne-asbestos levels often are higher in schools where the substance has been removed. Malcolm Ross, a research mineralogist for the U.S. Geological Survey, recently concluded that such buildings would need to be sealed six months or more, with their ventilation systems run at full power, to get airborne-asbestos levels down to what they were before the abatement procedures began.
An E.P.A. report on compliance with AHERA issued in 1991 concluded that little unnecessary asbestos removal appeared to be taking place. (See Education Week, Sept. 4, 1991.)
But many in the field, such as Justin P. King, the executive director of the Michigan Association of School Boards, maintain that the unnecessary removal of school asbestos has been common. School administrators, they say, have been pressured by concerned parents or given the hard sell by asbestos-removal companies.
Last spring, Dr. John J.H. Schwarz, a physician and Michigan state senator, got the state legislature to approve a bill that prohibits the removal of asbestos from schools unless strict criteria are met.
"Every dollar we save in unnecessary asbestos removal is another dollar that can go to educate our children,'' Senator Schwarz argued.
"Needless panic,'' he said, "costs money and may cost lives.''