Cancer linked to asbestos is killing residents in Maine at the highest rate in the country, decades after the implementation of federal regulations to limit exposure, according to the U.S. Centers for Disease Control and Prevention.
Inhaling or swallowing asbestos fibers can cause malignant mesothelioma, an aggressive and deadly cancer that most often develops in the tissue surrounding the lungs.
The disease is difficult to treat and is often advanced by the time symptoms appear.
“Basically you’ve got a death sentence,” said Elizabeth Johnston, who lost her husband to mesothelioma on Dec. 17, 2011, just months after his diagnosis.
Johnston’s husband was among the deaths the CDC analyzed in a March report calling fresh attention to the dangers of asbestos. Researchers found that between 1999 and 2015, the annual death rate from malignant mesothelioma in Maine was 22.06 per million people, higher than in any other state.
Only Maine and Washington state exceeded death rates of 20 per million annually.
The death rates were adjusted for age.
Across the country, 45,221 people — mostly men — died from mesothelioma during that period, the analysis found. That’s an increase of 4.8 percent during those years.
Health officials point out that most of those deaths occurred in people older than 85, likely reflecting asbestos exposure from many years earlier. Mesothelioma typically develops slowly, causing symptoms anywhere from 20 to more than 70 years after an individual inhales tiny asbestos fibers.
Still, mesothelioma continues to claim lives long after the U.S. began regulating workers’ exposure to asbestos in 1971. The Environmental Protection Agency also bans the use of asbestos in some products, while allowing it in other materials, such as roofing supplies.
Mesothelioma deaths are decreasing among people under age 55, but the fact that they continue at all suggests workers are still being exposed, the CDC noted.
“Despite regulatory actions and decline in asbestos use, the annual number of malignant mesothelioma deaths remains substantial,” the analysis states. “Contrary to past projections, the number of malignant mesothelioma deaths has been increasing. The continuing occurrence of mesothelioma deaths, particularly among younger populations, underscores the need for maintaining efforts to prevent exposure” and for ongoing surveillance.
“Prevention is important,” Dr. Chris Pezzullo, Maine’s chief medical officer, said. But the new data “reflects exposures decades ago, so it would not be reasonable to use this data to form a conclusion about current asbestos exposure prevention in Maine,” he said.
In Maine, most cases of mesothelioma are diagnosed between the ages of 55 and 84.
The CDC study focused on worksite exposure to asbestos, which also occurs naturally in rock and soil. The study cited some traditional Maine industries as high risk, including construction, shipbuilding and boatbuilding.
Maine’s housing stock is among the oldest in the country — with 31 percent of units built before 1950 — and therefore more likely to contain asbestos than homes in many other states. Materials that contain asbestos, once favored for insulation and as fire retardants, generally pose no health risk while undisturbed. But demolition, renovation and repair work can release the dangerous fibers into the air.
Johnston’s husband was exposed while he served in the Navy during the Korean War, removing asbestos from pipes on ships that had been mothballed since World War II, she said.
“That was his job every single day,” Johnston, who lives in Washington County, said.
After he left the Navy in the early 1950s, he started a construction business with a friend and was exposed to asbestos again, she said.
Her husband finally saw a doctor after complaining of shortness of breath. Johnston said she has since realized his symptoms began cropping up years before. Many of the early signs of the disease are common to other ailments, such as a cough, excessive sweating, fatigue, weight loss and trouble swallowing.
“We couldn’t put our fingers on anything,” she said. “Looking back it was there. Could they have done anything about it? Probably not.”
Other factors could account for Maine’s high death rate from mesothelioma. It would include, for example, people who died in Maine after being exposed to asbestos in another state, such as Johnston’s husband.
Larger states could have a greater overall number of residents dying from mesothelioma, but the rate of death in Maine is highest when scaled against the population. The incidence of the disease is also high in Maine and in several other states — particularly those home to former asbestos mines — but the new data suggest mesothelioma is deadlier in Maine.
Johnston’s husband died at the Togus VA Medical Center, where he received excellent hospice care, she said. An earlier diagnosis and more familiarity with mesothelioma among doctors could have eased his pain and suffering long before that, she said.
A diagnosis of mesothelioma is also required for patients and their families to benefit from settlement funds, said Johnston. She spoke out last year against an ultimately failed bill that would have made it harder for asbestos victims to collect settlement monies in Maine.
At the federal level, the EPA will again evaluate the risks of asbestos under the newly reformed Toxic Substances Control Act. While the law gives the agency more power to regulate hazardous chemicals, many doubt it will exercise that authority under President Donald Trump, who has targeted the EPA for significant funding and personnel cuts.
The EPA attempted to ban asbestos in 1989, but the rule was overturned on appeal two years later.
Johnston urges homeowners to take precautions during renovations and warns anyone possibly exposed to asbestos, particularly veterans of her husband’s era, not to write off breathing trouble, even if they smoke.
“I think there’s a lot more people undiagnosed in that age group than not,” she said.