Does chrysotile asbestos cause mesothelioma? Yes. Even the asbestos company
defendants today largely agree with that simple, irrefutable truth. Their
strategy, instead, has been to persuade the Judge to prevent the plaintiff
from bringing to trial medical experts to testify about causation without
first producing job-specific epidemiology studies that shows an elevated
risk of disease among workers exposed to chrysotile fibers only. Neither
medical science nor the law requires such a showing.
The following is a review of the opinions, based on reliable science, of
four experts who have testified on the issue of whether chrysotile fibers
from friction and clutch products cause mesothelioma among automobile
brake workers. They also address the contrived defense "issue"
whether epidemiology showing general causation (i.e., does the group of,
say, auto mechanics have an increased risk of disease?) is a prerequisite
to allowing in evidence of specific causation (i.e., did this plaintiff's
exposure to defendant's chrysotile containing brake product help cause
- Dr. Richard Lemen, Ph.D
- Dr. Arthur Frank, MD
- Dr. Sam Hammar, MD
- Dr. Ron Dodson, Ph.D
Dr. Richard Lemen, PhD
Dr. Richard Lemon, Ph.D. is an epidemiologist and former Deputy Director
of NIOSH and Assistant Surgeon General.
Dr. Lemen has testified as follows in cases in which the plaintiff with
mesothelioma was exposed to brake and friction products:
Epidemiological studies are not needed for every occupation and every type
of exposure because asbestos is the known cause of disease. The amount
of exposure determines whether disease occurs.
Those who work with asbestos containing friction products are at risk of
developing asbestos diseases.
Many factors make it difficult to do epidemiological studies to show risk,
including, but not limited to the difficulty of bringing together a heterogeneous
group of brake workers because they suffer from different confounders.
The more the accumulation of the asbestos exposure, the greater the risk
of asbestos disease. All fiber types cause asbestos disease. Brief exposure
to asbestos can cause disease. Friction products release chrysotile fibers
in an amount and size that are capable of producing asbestos disease.
Exposures vary from individual to individual, and one must look at it on
an individual basis to determine risk for a particular person.
Dr. Arthur Frank is a toxicologist, who attended medical school at Mt.
Sinai School of Medicine while Dr. Irving Selikoff was conducting his
landmark studies concerning the hazards of asbestos and assisted with
that work. Dr. Frank has testified as follows in brake cases:
There are a number of factors that clearly point to the relationship between
exposure to asbestos from brakes and the development of asbestos disease.
There is scientific literature that the type of asbestos found in brakes,
chrysotile, has the ability to produce all asbestos diseases including
mesothelioma, lung cancer and asbestosis.
As is true for all carcinogens, each and every exposure to asbestos carries
risks. As the exposure levels increase the risk of developing disease
Dr. Frank helped examine the individuals seen in the Lorimer study. With
the detailed occupational histories obtained and the X-ray findings, the
only tenable diagnosis was asbestosis. For many of the cases the only
reasonable explanation for the asbestosis was brake and clutch work.
The report by Nicholson et al (1982) documents the hazards of asbestos
to brake mechanics. There were reports of fiber counts up to 72 f/ml reported
by Rohl, et al., and the measurements by Nicholson show concentrations
There is a greater prevalence of X-ray abnormalities in mechanics who repair
brakes than among controls or mechanics who do not engage in brake work.
Epidemiological studies are not necessary for each and every group exposed
to asbestos in order to opine that asbestos causes disease. One basic
principle in all of occupational and environmental medicine is that the
hazardous material is the issue, not the job category. The human body
has the same response to inhalation of asbestos, regardless of one's
The position that a twofold excess in a specific group is required is unsubstantiated.
There has been scientific documentation that there is a greater than twofold
excess for mesothelioma, lung cancers, and asbestosis following exposure
Much of the epidemiological literature on brake mechanics has serious inaccuracies,
including the use of gross terms like "motor mechanics," which
do not always describe those doing brake repair.
While it is true that some brake materials is altered into fosterite during
wear, there is still a significant amount of asbestos. For those doing
brake repair, who regularly handle, grind and drill brand new brakes,
extremely high levels of exposure can occur.
Even under the strictest rules that have ever existed, the Occupational
Safety and Health Administration (OSHA) has concluded that additional
cases of mesothelioma and lung cancer will occur.
Fibers from brakes have the same biological activity as fibers from other
sources and can be additive in causing disease. Exposure to asbestos from
brakes can cause asbestos related disease.
Brakes should not in any way be considered an inconsequential source of
asbestos, or in any way, not capable of producing significant disease.
Dr. Samuel Hammar, M.D. is a pathologist, who is member of the elite U.S./Canadian
Mesothelioma Panel and a member of a World Health Organization panel on
lung tumors. Dr. Hammar has testified as follows:
An exposure level of .1 fiber cc years or less can cause mesothelioma.
Elliott McCaughey and Arthur Langer published a paper describing a 56-year-old
man who was a career-long brake worker who died from mesothelioma. The
only type of asbestos found in his lung tissue was chrysotile asbestos.
Based on the data that has been published on the amount of fibers that
are released during brake work, one can conclude that this work is a contributing
cause of mesothelioma and other asbestos diseases.
Even though there may not be any published epidemiological evidence that
exposure to asbestos from working as a brake mechanic causes an increased
incidence of mesothelioma, there have been 174 cases recorded.
If one has mesothelioma, one has been exposed to asbestos. Calcified pleural
plaques are independent evidence of exposure because if the plaques are
grinded and viewed through an electron microscope, they contain asbestos.
Tissue burden analysis involves counting asbestos fibers in the tissue
and comparing it to a control population of people that do not have mesothelioma.
If the fibers found are in excess of background levels, it demonstrates
that mesothelioma was caused by asbestos. If both amocite and chrysotile
are found at levels above background in the lung tissue, then both are causal.
Dr. Hammar co-authored a paper with Dr. Dodson entitled Asbestos in Extrapulmonary
Sites. They discovered that when one finds asbestos in the peritoneal
lining, it tends to correlate with having asbestos fibers of the same
types in the lungs. Dr. Hammar has found chrysotile, amocite and crocidolite
in the peritoneum and found the same fibers in the lungs.
If one has chrysotile in the peritoneum, he will likewise have a substantial
amount of in his lungs.
Chrysotile goes to the pleura where the mesothelioma develops.
Dr. Ronald Dodson is a cellular biologist at the University of Texas Health
Center in Tyler, Texas. Dr. Dodson has testified as follows:
Tissue burden analysis provides information with regard to the number and
type of asbestos fibers that are in the tissue.
The asbestos fibers typically used in friction products are not usually
as long as eight microns. Thus, in looking at the fiber burden created
by friction products, the light microscope is not a sensitive. The most
sensitive tool for analyzing asbestos fibers is the transmissions electron
microscope. It is possible to look at lung tissue with a light microscope
and not see any asbestos bodies, but then look at that same tissue with
a transmission electron microscope and see chrysotile fibers in levels
Short fibers are removed more easily than long ones, and chrysotile fibers
from brake products are more characteristically short. In being cleared
from the lungs, chrysotile fibers can be dispersed into other areas of
the body, including, but not limited to the linings of the lung and lymph nodes.
Mesothelioma is a cancer of the serosal membranes, the pleural lining of
the chest cavity, the lining of the abdominal cavity or the lining around
the heart. Generally, short fiber is most readily transported from the
lung to the pleura where mesothelioma occurs.
Chrysotile can fragment and create shorter more respirable fibers.
In attempting to count the number of asbestos fibers that are actually
present in the tissue of a person, and only counting fibers that are 5
microns in length, one can miss up to 95 percent of the fiber burden.
One could essentially overlook all of the chrysotile. Because shorter
fibers carry with them a risk of producing disease and pathogenicity,
it is important to include them in the count.
Federal Agencies Agree: Chrysotile Causes Meso
OSHA has determined that chrysotile asbestos is a Human Carcinogen.
Report on Carcinogens, Public Health Service, National Toxicology Program (2004), 11
Exhibit 2; Dept. of Labor, OSHA,
Fed. Reg., Vol. 51, No. 119, June 20, 1986,
Rules and Regulations, pg. 22615,
Federal agencies have issued recommendations and regulations restricting
the use of asbestos based upon determinations that such products emit
concentrations of asbestos capable of causing disease. The U.S. Department
of Health and Human Services unequivocally states, "[a]sbestos and
all commercial forms of asbestos are known to be human carcinogens based
on sufficient evidence of carcinogenicity in humans."
Rpt. on Carcin. 11
OSHA states that it "is aware of no instance in which exposure to
a toxic substance has more clearly demonstrated detrimental health effects
on humans than has asbestos exposure."
Fed. Reg., Vol. 51, No. 119, p. 22615,
Government Agencies: Asbestos Brake Dust Causes Meso
In 1975, the Center for Disease Control issued a bulletin alerting recipients
"to recently gathered information indicating a potential health hazard
for persons exposed to asbestos during the servicing of motor vehicle
brakes and clutch assemblies."
Exhibit 4 ("a review of the scientific literature on the association between
asbestos exposure and mesothelial tumors…has revealed at least
four cases of these rare tumors in persons who were employed in jobs involving
automobile brake servicing"). This bulletin concludes, "[t]he
environmental studies of brake lining servicing operations outlined above
together with the observation of mesothelial tumors in persons so employed
affirms the necessity of instituting and maintaining recommended control
In 1986, the United States Environmental Protection Agency published a
bulletin, "Guidance for Preventing Asbestos Disease Among Mechanics,"
Exhibit 6, that states:
Friction materials, such as brake linings and clutch facings,
often contain asbestos. Millions of asbestos fibers can be
released during brake and clutch servicing. Grinding and
beveling friction products can cause even higher exposures.
While lowering exposure lowers risk, there is no known level
of exposure to asbestos below which health effects do not occur
. Mesothelioma is a type of fatal cancer of the lining of the
chest or abdominal cavity. It can be caused by very low
exposures to asbestos. This cancer has occurred among
brake mechanics, their wives, and their children.
Ex. 6 (
Dr. Lemen has published a peer-reviewed article on the subject. In this
article, he, concludes: that "encapsulated asbestos containing brakes
do release asbestos fibers…at concentrations capable of causing
disease," Lemen, 2004,
Ex. 1 at p. 234; "short asbestos fibers…pose a risk of disease,"
Ex. 1 at p. 235; and, that "OSHA has stated that their current standard
for asbestos [0.1 f/cc] will not eliminate the risk of asbestos-induced
cancers." Lemen, 2004,
Ex. 1 at p. 235. He notes that "[a] review of the published peer reviewed
literature reveals at least 165 cases of mesothelioma in end-product users
of friction products[, and that a]dditional government studies have reported
other cases." Lemen, 2004,
Ex. 1 at p. 234 ("[t]hese numbers cannot be attributed to ambient air exposure
or to chance alone").
In a 1976 study, Rohl reported 2-15% chrysotile fiber and/or fibril forms
in dust samples from car brake drums. Lemen, 2004,
Ex. 1 at p. 231. He found concentration of 16 fibers/ml of air from blow out
operations, and measurable concentrations 75 feet away 15 minutes later.
Ex. 1 at p. 231. Other studies have found intact chrysotile fibers released
during brake repair in the range of 3.8 fibers/ml.
See Lemen, 2004,
Ex. 1 at p. 231-32. "[W]hile average concentrations can average much lower,
excursion levels can reach much higher concentrations during certain operations
of the brake maintenance and repair process exceeding the OSHA excursion
limits and the 8 hour TWA for asbestos." Lemen, 2004,
Ex. 1 at p. 232. Researchers have concluded that "excessive exposure to
asbestos fibers occurs during brake servicing."
"Fiber release studies of actual brake repair and replacement and
the laboratory simulation studies both demonstrate the ability of encapsulated
asbestos-containing brake products, to release respirable asbestos fibers
at concentrations capable of causing asbestos related disease." Lemen, 2004,
Ex. 1 at p. 232.
The EPA has reported that millions of asbestos fibers are released during
brake and clutch servicing, and that this asbestos lingers in the garage.
Ex. 1 at p. 232. Studies found releases of asbestos fibers around and above
the OSHA PEL (as of 2004). Lemen, 2004,
Ex.1 at p. 232. One study found that when the worst control techniques were
used, those engaged in brake and clutch repair operations for 7.25 hours
per day would experience exposures in excess of the OSHA standard of 0.1
f/cc. Lemen, 2004,
Ex. 1 at p. 232. As early as 1948, in a report by a GM employee, "[t]he
National Safety Council reported that asbestos used in brakes was potentially
harmful." Lemen, 2004,
Ex. 1) at p. 233. Several studies report mesothelioma among auto mechanics, their
wives and children.
"Epidemiological studies have been equivocal." Lemen, 2004,
Ex. 1 at p. 233. The plant where Teta et al. found three cases of mesothelioma,
was the Raybestos brake manufacturing facility.
Id. Another study found 17 mesothelioma deaths at a friction production plant
(4.3% of the total).
Id. "[Spairtas] reports 33 cases of mesothelioma in persons having stated
as part of their occupational history brake repair work. One of the confounding
factors preventing [Spairtas] from calculating a relative risk was that
an overwhelming majority of those workers had also been exposed as insulators
or shipbuilders." Lemen, 2004,
Ex. 1 at p. 233. Teschke et al. found 6 cases of mesothelioma in vehicle mechanics
among 51 cases, but did not conclude that mechanics showed an excess risk.
Still, they acknowledge that most of these cases were caused by asbestos
exposure and that "their findings were based on small numbers of
cases and any judgments about causal associations would be speculative."
Ex. 1 at p. 234. Even a conservative interpretation of the Australian tumor
registry study puts the rate of mesothelioma among automobile mechanics
at 22.6 /million/year-"a rate substantially above the upper limit
of the estimated background rate of 1-2 mesotheliomas per million person-years
or around a 10-fold increase." Lemen, 2004,
Ex. 1 at p. 234.
As early as the 1930's, there were published reports of asbestosis
among workers in plants manufacturing brake linings.
See Lanza, McConnell, Fehnel, (1935), "Effects of Inhalation of Asbestos
Dust on the Lungs of Asbestos Workers,"
Publ. Health Rept. 50: 1-12,
Exhibit 7 (high prevalence of asbestosis among workers, including plant manufacturing
friction materials); Goerge, A.W. & Leonard, R.D., (1939), "An
X-ray Study of the Lungs of Workman in the Asbestos Industry Covering
a period of Ten Years,"
Radiology, 33: 196-209,
Exhibit 8 (documents asbestosis in friction manufacturing workers since 1928); Stone,
M.J., (1940), "Clinical Studies in Asbestosis,"
Amer. Rev. Tuberc., 41: 12-21,
Exhibit 9 (asbestosis in 148 friction manufacturing workers); Stone, M.J., (1940),
"Studies in Asbestosis," Dis
. Chest, 6: 170-171,
Exhibit 10 (asbestosis in 148 friction manufacturing workers). An industrial hygienist
from General Motors published a report in the National Safety News, in
1948, concerning protective practices to be used when grinding friction
Exhibit 11. In 1963, a former General Motors industrial hygienist said of "[t]he
sawing, filing, drilling and grinding of brake linings" that "[i]t
is desirable in asbestos exposure to keep the dust count down to 5 million
particles or less, per cubic foot of air." Patty, F.A., (1963), Industrial
Hygiene and Toxicology (2
nd ed.), NY: Interscience, pp. 2243-44,
One study found unaltered chrysotile in garage air samples and concluded,
"exposure of garage mechanics during brake lining maintenance and
repair show that fiber concentrations frequently in excess of regulated
limits are common." Rohl, A.N., Langer, M.S., Wolff, M.S. & Weisman,
J. (1976), "Asbestos Exposure During Brake Lining Maintenance and
Environ. Research, 72: 110-128,
Exhibit 16. There are numerous published reports of mesothelioma in persons working
with friction products.
Chrysotile asbestos causes mesothelioma. It causes lung cancer, asbestosis
and pleural disease. Scientists may dispute certain issues, such as the
dustiness of a product, but these disputes are for a jury to decide.
The issue for the jury, not the judge, is whether asbestos exposure was
a proximate cause of the illness and death of a plaintiff. Chrysotile
asbestos fibers do not respect job classifications. Asbestos exposure
increases the risk of mesothelioma, regardless of the person's job
title. The issue is whether the injured person was exposed and how much
and whether that exposure contributed to the disease or cancer.
As one court wrote: " As a matter of public policy, courts should
not be hampered in the search for the truth by the rigid proposition that
no expert, however qualified, can reliably opine on the causal link between
a toxic substance and injury without epidemiological studies conducted
according to strict guidelines."
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