Followingthereleaseofthestudy,Thetaskforcedistributed

ACTGOVERNMENT

ACTAsbestosHealthStudy

Thestudyfoundtheriskofcontractingmesotheliomawaslow,buttherateofmesotheliomainmenlivinginMrFluffyhomeswas2.5timeshigherthaninmennotlivinginthesehouses.

ThiscorrespondedtofourextracasesofmesotheliomainmaleMrFluffyresidentsbetween1984and2013(thatis,additionaltothenumberexpectedtooccurinthisgroup,evenifthere

Outcomes

TheACTGovernmentnotedthefindingsofthefinalreportofthestudyindicatinganincreasedriskofmesotheliomaamongmenlivinginaMrFluffyproperty.

Followingthereleaseofthestudy,thetaskforcedistributed

LinktotheNationalStrategicPlan:

Strategy:Research

Deliverable:

Commission and promoteresearchthatreducestheriskofexposuretoasbestosandminimisestheimpactof asbestos-relateddisease

Outcome:

Commissionedresearchidentifiespractical and innovativeapproachestopreventorminimiserisksfromexposuretoasbestosfibres,andsupportforpeoplewithasbestos-relateddiseases

Location:ACT

Theissue

In2015theACTGovernmentrespondedtocallsfromcommunityresidentsfordetailedinformationaboutthepotentialhealthimpactsassociatedwithlivinginapropertycontaminatedwithloosefillasbestos insulation (MrFluffy).

FundedthroughtheAsbestosResponseTaskforce(theTaskforce)theACTGovernmentcommissionedthe National Centre for EpidemiologyandPopulationHealth(NCEPH)attheAustralianNationalUniversity(ANU)toundertakeatwo-yearstudytoimproveunderstandingofthehealth

risksassociatedwithMrFluffyloosefillasbestosinsulation.Thepurposeofthestudywastogainanadditionalunderstandingoftheriskofdevelopingmesothelioma from living in a housecontainingloose fill asbestosinsulation.

On21June2017theNCEPHattheANUreleasedtheirfinalreportoftheACTAsbestosHealthStudy.

Actiontaken

TheACTGovernmentprovidedfundingof$415,807overtwoyearstotheANU’sNCEPHtosupportthestudy.IndependentresearchersfromtheNCEPHundertookthestudyinconsultationwithexternalcancerepidemiologyexpertsfromSydneyUniversityandtheKarolinskaInstitutet,Sweden.TheresearchwasoverseenbyaSteeringCommitteethatincludedrepresentationfromACTHealth,theTaskforce,NCEPH,theNSWChiefHealthOfficerandotherexpertsasrequired.

Therewerefourseparatestagestothestudy:

1.ananalysisofmesotheliomaratesanddistributionintheACT (September2015)

2.focusgroupsheldwithcurrentandrecentresidentsofaffectedhousestodiscusstheirhealth-relatedconcerns(February2016)

3.asurveylookingatthelikelyexposurelevelsandhealthrelated concerns of current and recentresidents(February2017)

4.astudylinkinganumberofdatasetstoestimatetheriskofdevelopingmesotheliomaincurrentandformerresidents compared with the generalpopulation

(June2017).

Theuniquenatureofasbestosexposurecausedbyloosefillasbestosmeantthatdirectevidencewasnotavailablefromscientificliteratureorfromothercountriesaboutpotentialhealthrisks.Thisstudymakesanimportantcontributiontoknowledge of the risks of low-level domestic exposuretoloosefillasbestos.

Results

StagefourofthestudylinkedMedicaredata,deathregistrationsand the Australian Cancer Database to compare theincidenceofmesotheliomainpeoplewhohavelivedinaMrFluffyhousewiththeincidenceinthosewhohavenotlivedinahousewithloosefillasbestosinsulation.

ThestudycoveredtheperiodfromNovember1983toDecember2013andfoundaround17,000peoplehadlivedinaMrFluffyhouseinCanberra,representing1.7percentofthepopulation.

Intotal,285currentandformerresidentsoftheACTwerediagnosedwithmesotheliomaoverthestudyperiod.OnlysevenoftheseresidentshadlivedinaMrFluffyhousebeforetheirmesothelioma wasdiagnosed.

hadnotbeenloosefillasbestosinsulationinstalledinthese

houses).

TherewerenocasesofmesotheliomainwomenwhohadlivedinaMrFluffyaffectedproperty.OnaverageinAustraliaatpresent,therateofmesotheliomainfemalesisaboutafifthofthat inmales.

Thestudyalsofoundthattherateofcolorectalcancerwas1.3timeshigherinmaleMrFluffyresidentsand1.7timeshigherinfemaleMrFluffyresidentsthanthecorrespondingratesinresidentswhodidnotliveinaffectedpremises.Thesewere

higherthanexpectedandmightbeduetounavoidablebiasinthe study’sdesign.

Prostatecancerrateswerealsofoundtobe1.3timeshigherinmaleresidentsofaffectedpremises.Thisresultwasunexpectedanditisuncertainwhetherornotitwasduetoasbestosexposureintheaffectedhouses.

Theelevatedratesofcolorectalandprostatecancersidentifiedinthestudyforresidentsofloosefillasbestosinsulationweresomewhatunexpected.Otherstudieshavefound,atmost,weakassociationsbetweenasbestosexposureandthesecancers.Studyresearcherssuggestedadditionalexplanationsfortheseassociationsshouldbeconsidered,includingotherriskfactorsthatwereunabletobemeasured,suchassmokingordiet,andparticularlyinthecaseofprostatecancer,peopleseeking screening forcancer.

Althoughthestudyfoundtherateofmesotheliomawashigherinmenwhohadlivedinaloosefillasbestosinsulationpropertythaninmenwhohadnot,theriskofdevelopingmesotheliomawasverylowevenamongMrFluffyresidents.

Theincreasedriskofmesotheliomainmenlivinginaffectedpropertiesmayreflecthigherexposuretoloosefillasbestosthrough activities like entering roof spaces ordoingrenovations.Theseactivitieswerereportedmorefrequentlybymenthanwomeninthecrosssectionalsurvey(Report3oftheAsbestos HealthStudy).

Resultsfromthestudyshouldbeinterpretedwithcare,astherewas:

nodatapriortoNovember1983

littleinformationonotherpossibleexplanatoryfactors,suchasoccupationalhistoryofasbestosexposure

statisticaluncertaintyduetosmallnumbersofsomecancers.

thereportandadvicefromtheChiefHealthOfficeronhealthimplicationstohomeowners,residentsandregisteredformerresidents.Thiscorrespondenceadvisedthatpeopleconcernedabouttheirhealthshouldseekadvicefromaqualifiedmedicalpractitionerwhocouldprovideanassessmentofindividualcircumstances.Informationonothersupportservicesavailablewasalsoprovided,includinghelpforpeopleexperiencingpsychologicaldistress.

Theresultsofthestudyalsoreinforcedtheneedforpeoplewhocontinuetoliveinaffectedpropertiestohaveanasbestosmanagementplan(AMP)preparedbyalicensedasbestosassessorinplace,andtomakesurethatanyremediationworkrecommendedintheseplansiscarriedout.WorkSafeACT

continuestomonitorcompliancewithAMPsintheseproperties.

Thetaskforce’spersonalsupportteamcontinuestoprovideongoinginformationandadvicetoassisthomeownersexperiencingpsychologicaldistressandhealthconcerns,andtoconnectthemwiththefreesupportservicesprovidedthroughcommunitypartners.

Nextsteps

Toenablefuturerevisitingoftheissue,thedatasetsarebeingpreservedinkeepingwiththerelevantethicscommitteeapprovalrequirements.

AdvicefromtheNCEPHandtheACTChiefHealthOfficeristhatmesotheliomatakesalongtimetopresent,sowhilstitmightbeusefultore-runthedatalinkageandanalysis,thisshouldnotoccur for severalyears.

Moreinformation

Figure27:Loosefillasbestosinsulationadvertisement

6869