Mesothelioma in Canada

After climbing steadily over the past two decades, Canada’s mesothelioma cancer rate is now one of the highest in the world.

Few in the medical community are surprised: Canada’s dedication to the mining of chrysotile asbestos and the Canadian government’s track record for permitting its production and use in thousands of products laid the groundwork for exposing citizens to the toxic mineral. The most significant increases occurred in the shipbuilding areas around Vancouver, and in Quebec, home to many of Canada’s early asbestos mines.

About 2.1 of every 100,000 Canadians are diagnosed annually with the aggressive disease, according to experts. For context, consider that in 1984, 153 Canadian men were diagnosed with mesothelioma throughout all the country’s provinces. By 2003, 344 cases were reported among men, and 78 among women. Deaths from mesothelioma totaled 515 in 2010.

Asbestos exposure is the No. 1 cause of occupational death in Canada. Since 1996, asbestos-related disease has accounted for around a third of workplace deaths.

Because of the disease’s latency period of between 20 and 50 years, medical professionals expect the death rate will not level off for several more years.

In 2018, the Canadian government proposed the Prohibition of Asbestos and Asbestos Products Regulations, sponsored by Environment and Climate Change Canada and Health Canada. This legislation to ban asbestos is expected to go into effect by the end of 2018.

Canada’s Love of Asbestos Mines

Canada’s rate of mesothelioma corresponds with the country’s long-held infatuation with asbestos, whose fibers cause all forms of the disease. The country’s first asbestos mine opened in Quebec in 1879 — the first step towards a close relationship between the country and “Canada’s Gold.”

As the 19th century slid into the 20th century, an increasing number of asbestos mines opened, taking advantage of the large deposits of the mineral found in provinces that included Quebec, Newfoundland, British Columbia and the Yukon. Companies such as Johns-Manville arrived, taking advantage of the asbestos mines to manufacture a variety of asbestos-containing products that would be used in Canada and worldwide.

But while the asbestos industry boomed and mine owners and company executives made money, workers got sick, coughing up blood, suffering from breathing difficulties and dying. Canadian mortality rates among miners were studied as early as the 1920s, and evidence exists that asbestos company executives withheld negative reports from both their employees and the public.

The Metropolitan Life Insurance Company formed the Department of Industrial Hygiene at McGill University, and it suspected asbestos was sickening workers and causing some sort of “dust disease” of the lungs. A study conducted by the organization in the 1930s discovered that, of 200 men who participated, 42 developed asbestosis. However, the findings were never published and lawyers for asbestos manufacturers in Canada and the U.S. suggested to company executives that asbestosis receive “minimum publicity.”

Quick Fact:

By 1966, Canada produced 40 percent of the world’s chrysotile asbestos. By the 1970s, doctors had declared the asbestos mining towns in Canada to be among the most dangerous in the world, with rates of mesothelioma and other asbestos diseases increasing.

It was hardly surprising: Canadian houses were constructed with asbestos-containing cement and other materials. At one point, the vast majority of homes in Canada contained any number of asbestos-laden products ranging from shingles and siding to insulation. These products contained not only chrysotile asbestos, but types of amphibole asbestos as well. Those involved in the construction industry were almost always exposed to the hazardous mineral, and, as a result, rates of asbestos-related diseases are now extremely high among construction workers. In addition, at least 4,000 household products used by Canadians during much of the 20th century contained asbestos in varying amounts.

Canadian Asbestos Mines Close

Asbestos opponents and those weary of seeing Canada’s mesothelioma rate rise celebrated in 2011 when the country’s asbestos industry ground to a standstill. Canada’s last two remaining active mines, the Jeffrey Mine in Asbestos, Quebec, and the Lac d’amiante du Canada in the nearby town of Thetford Mines, Quebec, shut down because of financial, labor and development issues — the first time in 130 years that the Canadian asbestos production stalled.

One year later, in the face of broad criticism from public health officials, asbestos victims and cancer advocacy groups, the provincial government of Quebec threw a lifeline to Canada’s beleaguered asbestos sector in the form of a $58 million guaranteed loan. The money was to cover more than two-thirds of the cost of renovating and reopening the Jeffrey Mine — the rest of the financing is private — and helping it to operate for another 20 years.

But before the government transferred money to the mine, the Quebec Liberal Party was defeated in a provincial election. The winning party, Parti Quibecois, cancelled the loan. Meanwhile, doctors and others quietly keep an eye out for the mine’s 425 former employees and whether any of them develop mesothelioma.

Professions Impacted by Mesothelioma

Those primary professions include:

• Miners
• Ship loaders
• Truck Drivers

Anyone involved in those industries is at risk for exposure to asbestos and to the diseases caused by asbestos fibers.

In many cases, loose asbestos fibers are shipped to developing countries from Canada in large reinforced paper bags, where they are handled by undertrained and inadequately protected workers.

A secondary group of workers are also considered at-risk. These are people who work in trades that are one step removed from the process of removing asbestos from mines and transporting it to second- and third-world countries who continue to use asbestos products in construction.

These high-risk trades are similar to those in other places around the world:

• Carpenters
• Construction workers
• Insulation installers
• Plumbers
• Roofers
• Shipbuilders
• Textile workers

In recent years, Canada’s domestic production and consumption of asbestos declined, so fewer mining and manufacturing workers were exposed. However, because of the renovation and demolition of the country’s aging buildings, especially in Quebec and British Columbia from the 1950s through the 1980s, the mesothelioma rate has been rising among construction and maintenance workers.

Health Canada Study

In early 2008, it was revealed that Health Canada had quietly begun to study the dangers of chrysotile asbestos. The organization said it started the research to “help further Canada’s knowledge of chrysotile asbestos fibres in relation to human health” and to update the World Health Organization’s last published assessment on the subject from 1998.

The two scientists on the project were supporters of the chrysotile asbestos industry, and the organization refused to announce when the results of the study would be released. In a written statement, Health Canada said that they found chrysotile asbestos to be “safe when used under controlled conditions,” and safe use of the material would be regulated by Canada both domestically and abroad.

Chrysotile isn’t the only form of asbestos in Canada that presents an exposure risk. Other forms of asbestos, known as amphibole asbestos, are found in various asbestos-containing products. Such products typically include construction materials, but could be found in household and commercial products as well. Types of amphibole asbestos include actinolite, amosite, anthophyllite, crocidolite and tremolite. Amphibole asbestos is considered more carcinogenic than chrysotile asbestos, meaning it may take less exposure to cause a related disease.

Mesothelioma Treatment in Canada

The large number of mesothelioma cases in Canada demands a medical system offering good treatment options for mesothelioma. Canada has a socialized medical insurance system, and it is generally believed that it is easier to get better care for rare diseases like mesothelioma in the United States than it is in Canada. In both countries, however, the treatment for the disease is the same.

Canadians generally explore one or a combination of three options for the treatment: surgery, chemotherapy and radiation. The choice of treatment options is based on factors such as the stage of the cancer, the size and location of the tumor, and the age of the patient. The goal of treatment can be “cytoreductive” to remove the cancerous tissue or “palliative” to ease the symptoms of the disease.

Treatment Centers and Doctors in Canada

Canada has a number of cancer centers, hospital and specialists dedicated to the treatment of all types of cancer.

Canada is also making headway in the treatment of mesothelioma. For example, Canadian mesothelioma specialists from the Princess Margaret Cancer Centre and Toronto General Hospital developed a different approach to treatment that practically doubled survival in one study. Rather than administering radiation therapy after surgery, they applied it before and the results were shocking. Average mesothelioma survival is around 12 to 18 months, but these study participants lived a median of 51 months. The mesothelioma specialists who led the study included Drs. Marc de Perrot, Ronald Feld and John Cho.

Cancer facilities in Canada that may offer treatment for mesothelioma patients include:

Center/Institute	Location
Cross Cancer Institute at U of Alberty	Edmonton, Alberta
Princess Margaret Cancer Centre	Toronto, Ontario
Fraser Valley Cancer Centre	Surrey, British Columbia
Vancouver Cancer Centre	Vancouver, British Columbia
Centre for Southern Interior	Kelowna, British Columbia
Nova Scotia Cancer Centre	Halifax, Nova Scotia
Margaret and Charles Juravinski CC	Hamilton, Ontario
Toronto Western Hospital	Toronto, Ontario
London Regional Cancer Centre	London, Ontario
Ottawa Hospital Regional Cancer Centre	Ottawa, Ontario
McGill University Health Centre	Montreal, Quebec
L’Hopital Laval	Quebec
Tom Baker Cancer Centre	Calgary, Alberta

Some of the doctors or experts who are researching the disease or are performing clinical trials in Canada include:

• Robert MacRae, MD
• Jean Seely, MD
• Christopher Lee, MD
• Rufus Scrimger, MD
• Marc dePerrot, MD
• John Cho, MD
• Demetris Patsios, MD
• Brenda O’Sullivan, MD
• Wally Temple, MD
• Lloyd Mack, MD
• Andrea Mcart, MD

Clinical Trials

The National Cancer Institute of Canada and the U.S. National Cancer Institute often collaborate in clinical trials to test the effectiveness of certain medications in the treatment of a number of diseases, including mesothelioma. A prime example is an ongoing Phase II trial for the drug sunitinib malate, currently being tested for its ability to stop the growth of tumor cells by blocking the enzymes needed for tumor growth.

A good source to check for open clinical trials is clinicaltrials.gov, a website run by the U.S. National Institutes of Health. It is important to speak with a doctor, as some patients may not qualify for certain trials.

Compensation for Asbestos Exposure in Canada

In Canada, mesothelioma is a compensable disease. This means patients can receive payment from provincial governments if documentation proves their asbestos exposure happened in the workplace. However, it is estimated that less than half of the affected workers actually apply for compensation. According to the Canadian Society for Asbestos Victims, some Canadians injured by asbestos do not seek compensation because they incorrectly believe that nobody knew of its dangers and thus nobody is at fault.

Asbestos Legal Issues

It has long been apparent that asbestos has resulted in the death of thousands of Canadians since use of the mineral began in the late 19th century. For almost as long, politicians have differed over the safety of the material and its mining and manufacturing. Many have long defended Canadas profitable chrysotile asbestos industry.

Asbestos Ban Controversy

For decades, the Canadian government and the government of Quebec “where the remaining asbestos mines are located “have been financially supporting the Chrysotile Institute (CI), an asbestos lobby group. But in March 2011, Ottawa chose not to allocate funds for CI for the following year, marking the first step in the right direction for asbestos ban supporters. In addition, a federation of 300,000 unionized Quebecers also pulled their funding, and experts believed the asbestos industry was starting to weaken. It turns out they were right. In April 2012, the Institute announced its intention to shut down.

Canada has long resisted a universal ban of asbestos as proposed by the World Health Organization (WHO) and many other countries. At the 2008 Rotterdam Convention, Canada, India, Pakistan and a few other countries voted to keep chrysotile asbestos off of a United Nations “watchlist” of dangerous chemicals. After many hours of deliberation, chrysotile asbestos was not added to the watchlist, and Canada continues to be a major exporter of chrysotile asbestos to many countries who do not monitor asbestos exposure or regulate its use.

The Canadian Cancer Society and the International Labour Organization have largely been ignored in their push to ban asbestos in Canada. To date, all 28 European Union countries, Australia, Egypt, Saudi Arabia, Chile and Japan have banned asbestos in their countries. The government of Canada continues to hold out on an asbestos ban, due in part to its $100 million dollar chrysotile asbestos industry.

Regulations on Asbestos Use

The Canadian government did impose some regulations on asbestos use. According to Health Canada, “The sale of pure asbestos and certain high-risk consumer products that are composed of or contain asbestos fibres is strictly regulated under the Hazardous Products Act. In addition, the emissions of asbestos into the environment from mining and milling operations are subject to the Canadian Environmental Protection Act.”

Currently, the country is spending billions of dollars to remove asbestos from schools, factories, plants and other commercial buildings.

Until just recently, laws permitted the use of chrysotile asbestos in certain children’s toys in Canada, and as recently as 2011, the government was considering the possibility of reopening the open pit Jeffrey Mine in Quebec, which would allow the asbestos exports industry to grow. Proponents claim that the industry promotes safe use of asbestos in the countries to which they sell. Those who oppose the asbestos exports industry claim that most of these countries do not have proper health and safety regulations in place to regulate use of the material. In 2014, the newly elected Liberal Party of Quebec definitively decided to not give the $58 million loan to reopen the mines.

No one expects Canada to pass an outright ban on asbestos anytime soon. In fact, the country led a successful campaign to block the listing of asbestos as a toxic material on the Prior Informed Consent list at the Rotterdam Convention in 2004 and again in 2008, backed by a number of other countries with an interest in asbestos mining.