Asbestos a risk for Des Moines Workers and Residents

Des Moines, Iowa - May 11, 2009

Des Moines residents and workers who have spent time in the Equitable Building face are now concerned that they may be at risk for developing asbestos-related health problems such as mesothelioma.

Workers may have been exposed to asbestos for several years while the building was under renovation. The building's owner, Bob Knapp, has been fined $500,000 for failing to identify and properly remove asbestos.

When asbestos dust and fibers become airborne, which can happen during renovations, the tiny particles can become permanently lodged in the soft tissues of the lungs. Asbestos can cause mesothelioma, lung cancer, and asbestosis.

Offices in the building have been tested, and results revealed that asbestos fibers were present in the office.

This is not the first time Mr. Knapp has been cited for asbestos-related mishaps. By law, building owners and all others who discover asbestos and wish to conduct subsequent abatement must inform their local and state environmental protection authorities before proceeding. A permit is required for asbestos removal, and follow-up air quality monitoring is also typically required.

Asbestos is commonly found in older buildings, where it is a component in building materials ranging from siding to insulation to fireproofing. Asbestos is a naturally occurring mineral, and it was once prized for use in certain building materials because it has a natural resistance to chemicals and flame.

Washington State Honors Fallen Workers, Asbestos Deaths

Olympia, Washington - May 10, 2009

Last year 81 workers died as a result of job-related injuries or illnesses in Washington State.

The Washington State Department of Labor and Industries held a memorial ceremony last week to honor those workers who perished due to workplace injury or illness. The governor spoke, and friends and families of the dearly departed rang a memorial bell to honor those who lost their lives in the last year.

In Washington and throughout the nation, about 2,500 people are diagnosed with mesothelioma each year. Mesothelioma is an aggressive form of cancer, and can kill victims within months of diagnosis. Mesothelioma is attributed almost exclusively to asbestos exposure.

Workers at shipyards, mines, schools, and other locations around the United States risk asbestos exposure on a daily basis if their workplace contains the deadly substance. Due to a long latency period, it can be up to several decades after the initial exposure until mesothelioma is diagnosed.

There were 13 cases of death by asbestos-related disease on the list of 81 people who perished. All were people who died long after their initial contact with the deadly material.

In a world where people are going crazy about finding masks to ward off the swine flu, it is chilling to note that the number of asbestos-related deaths may not peak until 2010. Perhaps more people should wear the masks when doing home renovations, a growing risk for asbestos exposure.

Other professions that were featured on the list include fisherman, loggers, police officers, a mechanic, and a computer technician who fell to his death from a skylight.

Asbestos Issues a Big Distraction at Georgia High School

Columbus, Georgia - May 9, 2009

Ongoing asbestos issues at Carver High School in Columbus, GA are raising public ire. There is asbestos in the ceiling, mold on the walls and water stains on the carpet.

The oldest buildings on the campus date from 1954.

Administrators, teachers and students say that the time has come to put an end to the near-constant stream of repairs, and build an entirely new school.

However, demolition and building a new school would cost an estimated $45 million. For school districts with already-tight budgets, asbestos abatement is often a cost that just cannot be covered without additional aid, often from state grants or federal funding.

One hallway is known to have asbestos in the ceiling, which prompted workers to drill into the walls to run conduits for electrical lines and Internet. If asbestos was disturbed, the asbestos dust could be inhaled by students and teachers, which could lead to mesothelioma later in life.

A public forum was recently held to discuss the issues plaguing the school. Members of the community feel that the school's issues have been neglected for too long.

Walter Gould said he was concerned about the asbestos and mold issues in the school, and is disappointed in the way that school district has let the school fall into such disrepair.

"Carver High didn't just come up with these problems yesterday," he said at the forum held at Baker Middle School on Monday.

Superintendent Susan Andrews responded: "You're right, it did not get in that shape overnight. It's been added onto and added onto. Some of it is the age of different pieces," Andrews said. "Some of it is deferred maintenance."

Asbestos Issues Kept Massachusetts School Closed Last Week

Taunton, Massachusetts - May 6, 2009

After building inspectors found a potential asbestos issue in the school, administrators decided to be cautious and sent the students home.

Mayor Charles Crowley said the preliminary tests and inspections indicate that there is likely no threat to the health of students and teachers, but he wants to wait for final written confirmation before allowing the school to reopen.

City building inspectors were conducting a review of the school on Wednesday when they found that some asbestos insulation on a pipe in a basement crawl space was starting to peel.

After the discovery, the Mayor decided to close the school and conduct asbestos air quality tests.

"This is purely precautionary," Crowley said. "We want to make sure we have it in writing."

Depending on the final test results on the asbestos, students could return to the Maxham School as early as May 4th.

Asbestos exposure can lead to the development of mesothelioma later in life. Mesothelioma, a rare form of cancer, is incredibly aggressive. Most sufferers perish from the disease within 2 years of being diagnosed, and many only live a matter of months.

Mayor Charles Crowley said the city is "erring on the side of caution."

"Every old building has asbestos in it," he said. "If it's in good condition, it's not a problem."

The potential asbestos issue at Maxham is the latest event in a series on ongoing concerns related to school buildings. Earlier this year, a comprehensive inspection was required for all city-owned buildings. Many buildings had not been properly inspected in decades.

Concert to raise funds for asbestos removal in Illinois

Peru, Illinois - May 5, 2009

A North Central Illinois school is taking a unique approach in order to raise funds to replace the floor of its asbestos-laden gymnasium.

Students at Holy Family School in Peru, Illinois will get their gym renovations thanks to a country music concert.

Proceeds from the show (which will feature performances by country bands Little Big Town and Zac Brown Band) at the Cedar Point Sportsman Club will go toward renovations on Holy Family School's gym. The show will be called "Concerts for a Cause".

The current floor has not aged gracefully, and it sheds paint and wax. The deteriorating gym floor poses a health risk for several reasons, but school officials and parents are most concerned about potential asbestos exposure.

"We had contacted several companies about the gym floor," said Principal Jasiek. "It was becoming increasingly dangerous."

Ripping up the old floor would expose asbestos tile. Asbestos is usually considered safe if it is sealed away and not disturbed. Airborne asbestos can lead to mesothelioma. Rather than undergo costly asbestos abatement, the school has decided to lay the new floor on top of the old one.

As long as all safety precautions are followed during the installation of the new floor, the likelihood that anyone in the building will be exposure to harmful asbestos fibers is small.

"Concerts for a Cause," organized by a committee and Lou's LaGrotto restaurant in Peru, has funded school projects in the past. The concert series chooses worthy recipients by reading through letters asking for aid sent by local schools.

The committee and Merry Noonan, co-owner of Lou's and concert organizer, visited the school twice Tuesday. That clinched the decision, Noonan said.

"They wouldn't be able to have basketball games and tournaments," Noonan said. "If we can help, we will help you."

$5.1 million allotted to fix WA pipes, laden with asbestos

Startup, Washington - May 4, 2009

In Startup, Washington, officials are pleased to have a fresh source of funding to tackle the town's asbestos issues.

Startup water commissioner Karen Eaton was becoming increasingly fearful of the health impact the deteriorating water pipes under the town could have.

The aging pipes are 50 years old, and in poor shape. Eaton described them to one journalist as crumbling, near collapse, and a threat to public health.

Miles of asbestos-cement pipes that deliver water to the tiny town are deteriorating "like wet cardboard," according to Ms. Eaton.

So news that the town will be receiving over $5 million to update the water pipes came as great news to Eaton and other town officials.

The Startup Water District will receive $5.1 million from the Department of Health's Office of Drinking Water, which the town will use to update every water main in the system.

"We were thrilled," said Eaton, one of three water commissioners. "We've been working on this for months."

The water commissioners first realized the pipes were rotten after a series of waterline breaks. The tiny town was forced to pay out thousands to repair a series of breaks in the mains.

The fire department became reluctant to conduct training exercises, in fear of doing further damage to the water system.

But what was even more concerning was the knowledge that asbestos in the pipes could build up to dangerous levels, putting the town at risk.

Asbestos exposure is linked to medical conditions such as lung cancer, asbestosis, and mesothelioma. Few studies related to asbestos exposure via drinking water are available, and the most common method of exposure is inhalation of airborne asbestos dust.

The entire project is expected to take about 2 years to complete.

Minnesotans Honor Workers Memorial Day

Minneapolis, Minnesota - May 3, 2009

People nationwide, especially members of labor unions, recognized Workers Memorial Day this past week.

The event was marked all across America by various services and memorials. Many workers unions took special care to honor their fallen members.

The annual event remembers workers who died in the previous year from workplace accidents or workplace illnesses. Most important of all, it is a yearly reminder of the importance for campaigning for increased workplace safety and fair workman's compensation programs.

Mike Hawthorne, business manager of the Minneapolis Building and Construction Trades Council, reported that the rate of workplace injuries and illnesses in Minnesota has dropped, from a rate of 6.8 cases per 100 full-time workers in 2000 to 4.6 cases per 100 workers in 2007 a drop of 32 percent, according to Minnesota OSHA.

At this year's ceremony, Mr. Hawthorne only had to read the names of three workers: Thomas Raymond Johnson, Sr., a member of Pipefitters Local 455, who died of mesothelioma at age 64; Clarence Roger Olson, a member of Pipefitters Local 455, who died of lung cancer at age 61; and Roberto Pearson, a member of Boilermakers Local 647, who died in an accidental fall at age 25.

Workers Memorial Day in recent year has become a major rallying point for mesothelioma awareness advocates. Professions that may face an elevated risk of developing mesothelioma after workplace-related exposure to asbestos include mechanics, teachers, shipyard workers, and pipe fitters.

Nationwide, 5,657 fatal workplace injuries took place 2007, according to the national AFL-CIO.

Because mesothelioma has a long latency period, it can be several decades before a worker develops an illness after exposure to asbestos.

Former School Building Requires Asbestos Removal

Waverly, Pennsylvania - May 2, 2009

The village of Waverly is still working to secure a closing date for the purchase of the old school building, which is expected to cost approximately $290,000.

Village officials have chosen the firm Hunt Engineers to conduct the asbestos testing at the former school building. It has been reported that it will cost the village $3,909 to pay for Hunt to conduct the tests.

This project is part of a maximum $2.9 million project passed by voters through a December referendum. The former Ithaca Street School will undergo any needed asbestos abatement and renovations in order to transform the building from a school house into a new village hall.

Trustee Jerry Sinsabaugh explained that the engineering firm will primarily be looking at the building's floor tiles and pipe joints. These areas of the building were previously identified as possible asbestos sources during an engineering report that was conducted by Hunt Engineers.

Asbestos abatement is important during renovation in order to protect workers and average citizens from being exposed to the deadly substance. Asbestos, when inhaled, can lead to medical conditions including pleural mesothelioma, a rare but aggressive form of cancer.

Asbestos was once a common component in building materials, including pipe insulation, floor and ceiling tiles, textured paints, popcorn ceilings, and even siding. Despite the institution of strict asbestos regulations in the early eighties, asbestos materials are still found in over 35 million homes, commercial buildings and schools nationwide.

Scientists Declare All Forms of Asbestos Toxic

Through the development of the Chrysotile Asbestos Fact Sheet (CAFS), the Environmental Information Agency (EIA) and the Asbestos Disease Awareness Organization have concluded that chrysotile asbestos is a carcinogenic substance.

In addition, the EIA and ADAO stated there is enough evidence to support that all forms of asbestos can be responsible for causing asbestos-related lung cancers, laryngeal cancer and ovarian cancer. Chrysotile, among other forms of asbestos, is listed as one of the few mesothelioma causes.

According to their Web site, the EIA is a multidisciplinary association that collects, generates and disseminates information concerning environmental health hazards to occupants of buildings, industrial sites and other facilities.

The ADAO is an organization founded by asbestos victims and their families. Established in 2004, the ADAO “seeks to give asbestos victims a united voice to help ensure that their rights are fairly represented and protected, while raising public awareness about the dangers of asbestos exposure.”

Structured by asbestos medical experts and scientists with more than 300 collective years of experience, the CAFS provides clear information concerning the hazards of chrysotile. Scientists hope to present the CAFS to the United States Congress in support of the continued effort to ban asbestos.

Brent Kynoch, the Managing Director of the EIA, said “The Environmental Information Agency is proud to collaborate with the Asbestos Disease Awareness Organization to produce the Chrysotile Asbestos Fact Sheet in an effort to clarify the misinformation released on the very real dangers of asbestos exposure.”

Linda Reinstein, Executive Director of ADAO, said, “Asbestos exposure is the world’s leading cause of cancer in the workplace and the United States Congress must act now and ban asbestos. Prevention is our only cure for asbestos-caused diseases.”

According to a 2004 study published by the Environmental Working Group, approximately 10,000 Americans pass away each year from asbestos exposure. In addition, the study estimated that one million U.S. workers are exposed to asbestos each year.

Additional information about mesothelioma and asbestos exposure may be found through the Mesothelioma Cancer Center.

Canadian Politician Labeled as a "Liar" Due to Statements on Asbestos Exports

OTTAWA - Canada has long been criticized by numerous world leaders because of the nation's shameful, large-scale production and exportation of asbestos-a well known cancer-causing substance. In a statement issued in early April, Liberal Party leader Michael Ignatieff said he unequivocally favored a ban on Canada's export of extremely toxic asbestos to developing countries that are known to have a lax attitude about protecting the health of its citizens.

"I'm probably walking right off the cliff into some unexpected public policy bog of which I'm unaware, " Ignatieff stated, "but if asbestos is bad for parliamentarians in the parliament of Canada, it just has to be bad for everyone else. Our export of this dangerous product overseas has got to stop."

All well and good, and Ignatieff had been widely praised by numerous environmentalist groups for his comments, but, during a discussion with reporters last week, the liberal politician seemed to backtrack on his calling for a nationwide ban on the exportation of asbestos by saying, "We have 60 years of experience with this product. What I said in answer to a question is that we have an obligation to international agreements to the countries that we export to, to make them aware of the risks. That's all I said."

Others would disagree. Kathleen Ruff, who is a senior advisor on the subject of international human rights for the Ottawa-based think-tank Rideau Institute, has a different interpretation of Ignatieff's latest statements on the subject of asbestos. "I knew he would be under pressure to retract what he said, but that's an out-and-out lie," said Ruff. It should be noted that the Rideau Institute and the Canadian Cancer Society have both advocated tirelessly on behalf of a complete ban on Canada's export of asbestos.

Asbestos was once an extremely popular material that had been embraced by countless industries worldwide. The material can be mined in abundance from below ground deposits or extracted from exposed rock formations that can be located in nations around the globe. Asbestos is relatively inexpensive, nearly fireproof, has a high tensile strength, resists damage from harsh chemical corrosives, and has superior insulating qualities. For all these reasons and more, asbestos found its way into a wide variety of products from building materials to hair curlers to home appliances to talcum powder.

In the early 1970s, health researchers confirmed the fact that asbestos posed a dire threat to the health of those individuals who inhaled microscopic, airborne asbestos fibers. These oftentimes needle-like fibers become permanently lodged in soft lung tissues where they can, up to 50 years later, cause serious respiratory disease such as asbestosis and the far more dreaded cancer killer known as malignant pleural mesothelioma. Because asbestos poses such a significant threat to human health, Canada's continued export of the toxic substance is deemed by many to be "inexcusable."

Canadian occupational health agency studies have concluded that exposures to asbestos accounted for approximately 60 percent of all work related deaths in the country in 2005. In spite of these dramatic numbers, Canada remains one of the world's largest producers of asbestos, all of it coming from a single asbestos mine in Quebec. Approximately 90 percent of the asbestos that comes from the Quebec mine is exported to developing nations where it's typically used in a variety of cement-based products.

To further defend Ignatieff's retraction of his earlier endorsement of a ban on asbestos exports, a spokesman for the politician said, "We've long known about the risks of asbestos, and we have a duty to warn countries that we export to about these risks and work to end any practices that put health at risk, at home or abroad." Ignatieff's critics dismissed the spokesperson's comments and vow to continue to fight Canada's asbestos export policies.

Mesothelioma deaths still increasing according to CDC

The Centers for Disease Control reports that deaths from mesothelioma are rising in the United States.

This week's Morbidity and Mortality Weekly Report covered mesothelioma fatalities over the past several years.

The CDC counted 18000 mesothelioma deaths in the US over the seven-year period from 1999 to 2005, with 2704 deaths in 2005. The number of malignant mesothelioma fatalities is rising year to year in rough proportion to the population: the annual death rate has been steady at about 14 per million.

The agency expects the number of mesothelioma deaths to peak next year, and to begin to decline, as the improvements in safety and reduction in asbestos use instituted decades ago payoff. The latency period of mesothelioma can be decades long, so even though asbestos is used less widely today, people continue to get mesothelioma due to their exposure in the past.

The writers of the report admit a limitation in their analysis is the lack of asbestos exposure history on death certificates and a general dearth of information on work history.

Consistent with their public health mission, the CDC states "maintenance, renovation, or demolition activities that might disturb asbestos should be performed with precautions." The Mesothelioma Web has been relaying this advice for years.

Previous analysis by the National Institute of Occupational Safety and Health found high rates of mesothelioma among people who worked in ship building, chemicals, refining, and construction.

The full text of the Morbidity and Mortality Weekly Report is on-line at:

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5815a3.htm?s_cid=mm5815a3_x

How much asbestos exposure does it take to get mesothelioma?

An exposure of as little as one or two months can result in mesothelioma 30 or 40 years later and in some cases, as much as 70 years later.

How long does it take after asbestos exposure for mesothelioma to show up?

People exposed in the 1940s, '50s, '60s, and '70s are now being diagnosed with mesothelioma because of the long latency period of asbestos disease.

How is mesothelioma diagnosed?

Mesothelioma is diagnosed by pathological examination from a biopsy. Tissue is removed, placed under the microscope, and a pathologist makes a definitive diagnosis and issues a pathology report. This is the end of a process that usually begins with symptoms that send most people to the doctor: a fluid buildup around the lungs (pleural effusions), shortness of breath, pain in the chest, or pain or swelling in the abdomen. The doctor may order an X-ray or CT scan of the chest or abdomen. If further examination is warranted, the following tests may be done:

• Thoracoscopy
  
  For pleural mesothelioma, the doctor may look inside the chest cavity with a special instrument called a thoracoscope. A cut will be made through the chest wall and the thoracoscope will be put into the chest between two ribs. This test is usually done in a hospital using a local anesthetic or painkiller.
  
  If fluid has collected in your chest, your doctor may drain the fluid out of your body by putting a needle into your chest and using gentle suction to remove the fluid. This is called thoracentesis.



• Peritoneoscopy
  
  For peritoneal mesothelioma, the doctor may also look inside the abdomen with a special tool called a peritoneoscope. The peritoneoscope is put into an opening made in the abdomen. This test is usually done in the hospital under a local anesthetic.
  
  If fluid has collected in your abdomen, your doctor may drain the fluid out of your body by putting a needle into your abdomen and using gentle suction to remove the fluid. This process is called paracentesis.



• Biopsy
  
  If abnormal tissue is found, the doctor will need to cut out a small piece and have it looked at under a microscope. This is usually done during the thoracoscopy or peritoneoscopy, but can be done during surgery.
  
  Unfortunately, in some cases, tumor cells can grow along the tract where the biopsy is taken. This can be minimized with the use of radiation to the area.

COMPREHENSIVE CANCER CENTERS

The National Cancer Institute (NCI) has designated 40 cancer centers throughout the United States as "Comprehensive" centers. These elite centers have been recognized for their focus on scientific excellence and have dedicated themselves to the prevention, treatment and cure of cancer, including malignant mesothelioma. Following is a list of Cancer Centers by state.

For veterans wishing to be treated at a Veterans Health Administration (VA) cancer care facility, click here for a listing by state.

Alabama

UAB Comprehensive Cancer Center
1802 6th Avenue, S.
Birmingham, AL 35294
Request an appointment: (800) UAB-0933 or (205) 975-8222

Arizona

Arizona Cancer Center
1515 N. Campbell Avenue
Tucson, AZ 85724
Request an appointment: (520) 626-2900

California

City of Hope National Medical Center
1500 E. Duarte Road
Duarte, CA 91010
Request an appointment: (866) 434-HOPE (4673)

University of California, San Diego (UCSD) Moores Cancer Center
3855 Health Sciences Drive
La Jolla, CA 92093
Request an appointment: (866) 773-2703 or (858) 822-6200

UCLA Jonsson Comprehensive Cancer Center
10833 Le Conte Avenue
Los Angeles, CA 90095
Request an appointment: (800) 825-2631

USC/Norris Comprehensive Cancer Center
1441 Eastlake Avenue
Los Angeles, CA 90033
Request an appointment: (800) USC-CARE

University of California, Irvine (UCI) Chao Family Comprehensive Cancer Center
101 The City Drive, S.
Orange, CA 92868
Request an appointment: (877) UCI-DOCS (824-3627)

University of California, San Francisco (UCSF) Comprehensive Cancer Center
1600 Divisadero Street
San Francisco, CA 94115
Request an appointment: (888) 689-8273 or (415) 885-7777

Stanford University Comprehensive Cancer Center
875 Blake Wilbur Drive
Stanford, CA 94305
Request an appointment: (650) 498-6000

Colorado

University of Colorado Cancer Center
1665 N. Ursula Street
Aurora, CO 80045
Request an appointment: (800) 473-2288 or (720) 848-0300

Connecticut

Yale Cancer Center
15 York Street
New Haven, CT 06510
Request an appointment: (203) 785-4191

District of Columbia

Lombardi Comprehensive Cancer Center at Georgetown University
3800 Reservoir Road, NW
Washington, DC 20007
Request an appointment: (202) 444-2223

Florida

H. Lee Moffitt Cancer Center & Research Institute
12902 Magnolia Drive
Tampa, FL 33612
Request an appointment: (888) 860-2778 or (813) 979-3980

Illinois

Robert H. Lurie Comprehensive Cancer Center of Northwestern University
Galter Pavilion
675 N. St. Clair, 21st Floor
Chicago, IL 60611
Request an appointment: (866) LURIE-CC (587-4322)

Iowa

University of Iowa Holden Comprehensive Cancer Center
200 Hawkins Drive
Iowa City, IA 52242
Request an appointment: (319) 356-4200 8:00 am - 5:00 pm (M-F)
(800) 777-8442 or
(319) 384-8442 (After hours)

Maryland

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins
401 N. Broadway
Baltimore, MD 21231
Request an appointment: (410) 955-5222

Massachusetts

Dana-Farber Cancer Institute
44 Binney Street
Boston, MA 02115
Request an appointment: (877) 332-4294

Michigan

University of Michigan Comprehensive Cancer Center
1500 E. Medical Center Drive
Ann Arbor, MI 48109
Request an appointment: (800) 865-1125

Barbara Ann Karmanos Cancer Institute
4100 John R
Detroit, MI 48201
Request an appointment: (800) KARMANOS (527-6266)

Minnesota

University of Minnesota Cancer Center
425 E. River Road
Minneapolis, MN 55455
Request an appointment: (888) CANCER MN (226-2376)
(Toll Free in IA, MN, ND, SD, WI)
(612) 624-2620 (Outside Area)

Mayo Clinic Cancer Center
200 First Street, SW
Rochester, MN 55905
Request an appointment: (507) 538-3270

Missouri

Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
660 S. Euclid Avenue
St. Louis, MO 63110
Request an appointment: (877) 251-6485 or (314) 747-3046

New Hampshire

Norris Cotton Cancer Center
One Medical Center Drive
Lebanon, NH 03756
Request an appointment: (603) 653-9000

New Jersey

Cancer Hospital of New Jersey at Robert Wood Johnson University Hospital
195 Little Albany Street
New Brunswick, NJ 08903
Request an appointment: (732) 828-3000

New York

Roswell Park Cancer Institute
Elm and Carlton Streets
Buffalo, NY 14263
Request an appointment: (800) ROSWELL (767-9355)

Memorial Sloan-Kettering Cancer Center
1275 York Avenue
New York, NY 10021
Request an appointment: (800) 525-2225

Herbert Irving Comprehensive Cancer Center
161 Fort Washington Avenue
New York, NY 10032
Request an appointment: (877) NYP-WELL (697-9355)

North Carolina

University of North Carolina (UNC) Lineberger Comprehensive Cancer Center
450 West Drive
Chapel Hill, NC 27599
Request an appointment: (866) 828-0270

Duke Comprehensive Cancer Center
2424 Erwin Road
Durham, NC 27705
Request an appointment: (888) ASK-DUKE (275-3853)

Wake Forest University Comprehensive Cancer Center
Medical Center Boulevard
Winston-Salem, NC 27157
Request an appointment: (800) 446-2255 or (336) 716-2255

Ohio

Case Comprehensive Cancer Center, Ireland Cancer Center
11100 Euclid Avenue
Cleveland, OH 44106
Request an appointment: (800) 641-2422

Comprehensive Cancer Center - Arthur G. James Cancer Hospital & Richard J. Solove Research Institute
300 W. 10th Avenue
Columbus, OH 43210
Request an appointment: (800) 293-5066 or (614) 293-5066

Pennsylvania

Abramson Cancer Center of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104
Request an appointment: (800) 789-PENN (7366)

Fox Chase Cancer Center
333 Cottman Avenue
Philadelphia, PA 19111
Request an appointment: (215) 728-2570

University of Pittsburgh Cancer Institute
5150 Centre Avenue
Pittsburgh, PA 15232
Request an appointment: (412) 647-2811

Tennessee

Vanderbilt-Ingram Cancer Center
691 Preston Building
Nashville, TN 37232
Request an appointment: (800) 811-8480

Texas

University of Texas M. D. Anderson Cancer Center
1515 Holcombe Boulevard
Houston, TX 77030
Request an appointment: (800) 392-1611 or (713) 792-6161

Vermont

Vermont Cancer Center at the University of Vermont
89 Beaumont Avenue
Burlington, VT 05405
Request an appointment: (802) 656-4414

Washington

Fred Hutchinson Cancer Research Center
1100 Fairview Avenue, N.
Seattle, WA 98109
Request an appointment: (800) 804-8824 or (206) 288-1024

Wisconsin

University of Wisconsin Comprehensive Cancer Center
600 Highland Avenue
Madison, WI 53792
Request an appointment: (800) 622-8922

NATIONAL CANCER INSTITUTE CANCER CENTERS

UC Davis Cancer Center
4501 X Street
Sacramento, CA 95817
Request an appointment: (800) 362-5566 or (916) 734-5900

University of Chicago Hospitals
5841 S. Maryland Avenue
Chicago, IL 60637
Request an appointment: (888) UCH-0200

NYU Cancer Institute
550 First Avenue
New York, NY 10016
Request an appointment: (888) 7-NYU-MED (769-8633)

The Cleveland Clinic, Taussig Cancer Center
9500 Euclid Avenue
Cleveland, OH 44195
Request an appointment: (866) 320-4573 or (216) 444-5501

National Institutes of Health (NIH) Clinical Center, Bethesda, MD
National Insitutes of Health
10 Center Dr.
Bethesda, MD 20892
Request an appointment: 301-496-2626

Navy Jobs and Asbestos Exposure

Mesothelioma, a cancer of the lining of the lung or the lining of the abdominal cavity, poses a real and ongoing threat to veterans of military service, particularly those who served in the Navy aboard our nation's warships. Although not all asbestos diseases are as devastating or as rare as mesothelioma, thousands of veterans are now dealing with health problems relating to exposure that occurred decades ago.

Asbestos-containing materials (ACMs) were prevalent aboard Navy ships of the World War II, Korean War and Viet Nam era, and most Navy veterans experienced varying degrees of exposure to these products in the course of carrying out their jobs.

The following table lists various Navy job classifications and the probability of exposure to asbestos for each. Not everyone exposed to asbestos will develop an asbestos-related disease, but knowledge of potential exposure as well as periodic testing for exposed individuals is important.

Note: Some Job Code designations may have changed and others have been added over time. This list is not all-inclusive.

Job Code	Job Classification	Probability of Asbestos Exposure
AA	Airman Apprentice	Minimal
AB	Aviation Boatswain's Mate	Probable
ABE	Aviation Boatswain's Mate (Launch & Recovery)	Probable
ABH	Aviation Boatswain's Mate (Aircraft Handler)	Probable
AC	Air Controlman	Minimal
ADJ	Aviation Machinist's Mate (Jet Engine Mechanic)	Probable
ADR	Aviation Machinist's Mate (Reciprocating Engine Mechanic)	Probable
AE (After 1948)	Aviation Electrician's Mate	Probable
AFCM	Aircraft Maintenanceman (Master Chief)	Minimal
AG	Aerographer's Mate	Minimal
AK	Aviation Storekeeper	Minimal
AM (Before 1948)	Aviation Metalsmith	Probable
AM (After 1948)	Aviation Structural Mechanic	Probable
AME	Aviation Structural Mechanic (Safety Equipment)	Probable
AMH	Aviation Structural Mechanic (Hydraulics)	Probable
AMS	Aviation Structural Mechanic (Structures)	Probable
AN	Airman	Minimal
AO (After 1948)	Aviation Ordnanceman	Minimal
AQ	Aviation Fire Control Technician	Highly Probable
AR (After 1948)	Airman Recruit	Minimal
ARM	Aviation Radioman	Probable
AS (After 1965)	Aviation Support Equipment Technician	Probable
AT	Aviation Electronics Technician	Probable
AW	Aviation Antisubmarine Warfare Operator	Probable
AZ	Aviation Maintenance Administrationman	Minimal
BM	Boatswain's Mate	Minimal
BR	Boilermaker	Highly Probable
BT	Boilerman	Highly Probable
BU	Builder	Probable
CD	Construction Driver	Probable
CE	Construction Electrician's Mate	Probable
CM	Construction Mechanic	Minimal
CN	Constructionman	Probable
Cox	Coxswain	Minimal
CS	Commissaryman	Minimal
CT	Communications Technician	Minimal
CTR	Communications Technician (Collections Branch)	Minimal
DC	Damage Controlman	Minimal
DK	Disbursing Clerk	Minimal
DP	Data Processing Technician	Minimal
DS	Data Systems Technician	Minimal
DT	Dental Technician	Minimal
EM	Electrician's Mate	Probable
EN	Engineman	Probable
EO	Equipment Operator	Minimal
ET	Electronics Technician	Probable
F	Fireman	Highly Probable
FC	Fire Controlman	Highly Probable
FP	Pipefitter	Highly Probable
FT	Fire Control Technician	Highly Probable
FTG	Fire Control Technician (Gun Fire Control)	Highly Probable
GM	Gunner's Mate	Minimal
GSM	Gas Turbine System Technician (Mechanical)	Probable
HM	Hospital Corpsman	Minimal
HN	Hospitalman	Minimal
HT	Hull Maintenance Technician	Highly Probable
IC	Interior Communications Electrician	Probable
IM	Instrumentman	Highly Probable
LI	Lithographer	Minimal
M, ME	Metalsmith	Minimal
ML, MI	Molder	Probable
MM	Machinist's Mate	Probable
MN	Mineman	Minimal
MoMM	Motor Machinist's Mate	Probable
MR	Machinery Repairman	Minimal
MS	Mess Management Specialist	Minimal
MT	Missile Technician	Probable
MU (After 1948)	Musician	Minimal
NC	Navy Counselor	Minimal
OM	Opticalman	Minimal
OS	Operations Specialist	Minimal
PC	Postal Clerk	Minimal
PhoM	Photographer's Mate	Minimal
PhM	Pharmacist	Minimal
PN	Personnelman	Minimal
PrTr	Printer	Minimal
PT	Photographic Intelligenceman	Minimal
Ptr	Painter	Probable
QM	Quartermaster	Minimal
RD	Radarman	Minimal
RM	Radioman	Minimal
S	Seaman	Minimal
SC	Ship's Cook	Minimal
SD	Steward	Minimal
SF	Shipfitter	Minimal
SFP	Shipfitter (Pipefitter)	Minimal
SH	Ship's Serviceman	Minimal
SK	Storekeeper	Minimal
SM	Signalman	Minimal
SO	Sonarman	Highly Probable
SoM	Soundman	Highly Probable
ST (After 1948)	Sonar Technician	Highly Probable
STG	Sonar Technician (Surface)	Highly Probable
STS	Sonar Technician (Submarine)	Highly Probable
StM	Steward's Mate	Minimal
SW	Steelworker	Probable
TA	Steward Apprentice	Minimal
TD	Tradesman	Minimal
TE	Teleman	Minimal
TM	Torpedoman's Mate	Probable
TN	Stewardsman	Minimal
UT	Utilitiesman	Highly Probable
WT	Water Tender	Highly Probable
Y	Yeoman	Minimal

Asbestos Exposure

The government has designated asbestos as a carcinogen, and there is no safe threshold of exposure. The degree of risk is related to the length of exposure and how high the asbestos fiber concentration was in the air when the person was exposed. Exposure to asbestos is the major known cause of malignant mesothelioma.

Materials Containing Asbestos

Most insulation materials before the mid-1970s contained asbestos. Many other construction materials also contained asbestos. Some of the most common products were:

• Insulation on pipes
• Boiler insulation
• Insulating cements, plasters and joint compounds that came in powder form and created a lot of dust before being completely mixed with water
• Fireproofing spray insulation
• Firebrick and gunnite used for internal insulation of furnaces, boilers and other vessels
• Roof, floor and ceiling tiles
• Transite siding
• Brakes and clutches

Most Commonly Exposed Personnel

The following Navy personnel could have worked around asbestos:

• Boilermen
• Enginemen
• Firemen
• Machinist Mates
• Shipfitters
• Pipefitters
• Electrician's Mates
• Seabees (military construction)
• Civilian shipyard workers

Shipboard Exposure

Fire and engine rooms aboard ship typically had the highest exposure because of the insulation and refractory products necessary in these high-heat areas, but no area was considered safe. Pipe coverings throughout the ship were covered with asbestos lagging, and literally ran inches over the bunks in the sleeping quarters. In addition, ships crews generally lived and worked aboard ships during routine maintenance operations and sometimes while their ships were overhauled in dry docks over months long periods.

Shipyard Exposure

During World War II, large quantities of asbestos used by shipyards as they built, overhauled and decommissioned warships, exposed thousands of shipyard workers to its insidious effects. Based on statistics, working in an American shipyard during the war years was almost as deadly as fighting in the war itself. The combat death rate was roughly 18 per thousand service members. For every thousand wartime shipyard employees, about 14 died of asbestos-related cancer, and unknown numbers died of asbestosis or related complications. See our section on asbestos exposure and the Seabees.

In 1984, a medical survey of shipyard workers at Norfolk Naval Shipyard in Portsmouth, VA, showed that 79 percent of these workers exhibited signs of lung abnormalities consistent with asbestos exposure, while x-rays given to 90 wives of workers revealed 8 to 9 percent showed similar abnormalities.

U. S. Government (Naval) Shipyards where ships were built and/or overhauled include:

• Boston Naval Shipyard, Charlestown, MA
• Charleston Naval Shipyard, Charleston, SC
• Hunter's Point Naval Shipyard, San Francisco, CA
• Long Beach Naval Shipyard, Long Beach, CA
• Mare Island Naval Shipyard, Vallejo, CA
• New York Naval Shipyard, Brooklyn, NY
• Norfolk Naval Shipyard, Portsmouth, VA
• Philadelphia Naval Shipyard, Philadelphia, PA
• Portsmouth Naval Shipyard, Kittery, ME
• Puget Sound Naval Shipyard, Bremerton, WA

Private Sector Shipyards where Navy ships, Liberty ships and Victory ships were also built include:

• Alabama Dry Dock & Shipbuilding Company, Mobile, AL
• American Bridge Company, Pittsburgh, PA
• Associated Shipbuilders, Inc., Seattle, WA
• Bath Iron Works Corporation, Bath, ME
• Bethlehem Steel Company, Hingham, MA
• Bethlehem Steel Company, Quincy, MA
• Bethlehem Steel Company, San Francisco, CA
• Bethlehem Steel Company, San Pedro, CA
• Bethlehem Steel Company, Staten Island, NY
• Bethlehem-Fairfield Shipyards, Inc., Baltimore, MD
• Brown Shipbuilding Company, Houston, TX
• California Shipbuilding Corporation, Los Angeles, CA
• Chicago Bridge & Iron Company, Seneca, IL
• Consolidated Steel Corporation, Orange, TX
• Cramp Shipbuilding Company, Philadelphia, PA
• Defoe Shipbuilding Company, Bay City, MI
• Delta Shipbuilding Company, New Orleans, LA
• Dravo Corporation, Pittsburgh, PA
• Dravo Corporation, Wilmington, DE
• Electric Boat Company, Groton, CT
• Federal Shipbuilding & Dry Dock Company, Kearny, NJ
• Federal Shipbuilding & Dry Dock Company, Port Newark, NJ
• Gulf Shipbuilding Corporation, Chickasaw, AL
• J. A. Jones Construction Company, Brunswick, GA
• J. A. Jones Construction Company, Panama City, FL
• Jeffersonville Boat & Machine Company, Jeffersonville, IN
• Kaiser Company, Richmond, CA
• Kaiser Company, Vancouver, WA
• Lake Washington Shipyards, Houghton, WA
• Manitowoc Shipbuilding Corporation, Manitowoc, WI
• Marinship Corporation, Sausalito, CA
• Missouri Valley Bridge & Iron Company, Evansville, IN
• Moore Dry Dock Company, Oakland, CA
• New England Shipbuilding Company, South Portland, ME
• New York Shipbuilding Company, Camden, NJ
• Newport News Shipbuilding & Dry Dock Company, Newport News, VA
• North Carolina Shipbuilding Company, Wilmington, NC
• Oregon Shipbuilding Company, Portland, OR
• Permanente Metals Corporation, #1 Yard, Richmond, CA
• Permanente Metals Corporation, #2 Yard, Richmond, CA
• Southeastern Shipbuilding Corporation, Savannah, GA
• St. John's River Shipbuilding Company, Jacksonville, FL
• Sun Shipbuilding & Dry Dock Company, Chester, PA
• Tampa Shipbuilding Company, Inc., Tampa, FL
• Todd Houston Shipbuilding Corporation, Houston, TX
• Todd Pacific Shipyards, Inc., Seattle, WA
• Todd Pacific Shipyards, Inc., Tacoma, WA
• Todd Shipyards, Inc., Los Angeles, CA
• Western Pipe & Steel Company of California, San Pedro, CA
• Willamette Iron & Steel Corporation, Portland, OR
• Walsh-Kaiser

Mesothelioma Detection

Early Detection

It is strongly encouraged that anyone who has had past asbestos exposure be checked periodically for asbestos disease. Early detection is vital, since even lung cancers have a higher survival rate if caught early. Non-cancerous disease may be diagnosed through a normal front and side view x-ray (also called a PA and lateral), with the x-ray films read preferably by a radiologist called a Certified B-reader. This should be an adequate diagnostic test to determine if any scarring is present which would be consistent with asbestos exposure. Click here for a current listing of these radiologists. If anything suspicious appears on the x-ray films, the patient would be referred to a specialist for further evaluation. Cancerous disease, although it may be suspected through tests such as an x-ray or CT scan, can only be confirmed through a tissue biopsy. Be sure you understand the significance of your diagnosis.

Non-Cancerous

• Pleural disease - often noted as a scarring of the lining of the lung, and sometimes expressed as "pleural thickening", "pleural plaque" or "pleural calcification".
• Asbestosis - defined as a scarring of the lower lobes of the lungs bilaterally (on both sides); often referred to as "asbestos in the lung".

If you have been diagnosed with a non-cancerous disease, it is important that your doctor monitor your condition with regular x-rays and/or high resolution CT scans, and pulmonary function tests. It is also important to compare new and old radiographic films and review any other pertinent test results to check for progression of disease.

Note: Although these diseases are non-cancerous at the onset, they can be progressive, eventually leading to a need for inhalers or oxygen. They also constitute a significantly greater risk of future cancer in those who have a prior smoking history, or those who continue to smoke.

Cancerous

• Lung cancer - diagnosed as non-small cell (which includes adenocarcinoma, squamous cell or large cell) and small cell (which includes oat cell, lymphocytic, intermediate or combined); lung cancer may be contributed to by asbestos exposure, although it is not normally the sole cause.
• Mesothelioma - a rare form of cancer of the lining of the lung (pleural mesothelioma) or the lining of the abdominal cavity (peritoneal mesothelioma), or in rare cases, the lining of the heart (pericardial mesothelioma); exclusive to asbestos exposure.

If you have been diagnosed with lung cancer, it is important to make a treatment decision, and then follow your doctor's recommendations. Additional information on various types of lung cancer may be obtained through the National Cancer Institute at 1-800-4-CANCER.

Lung Cancer Deaths associated with Smoking and Asbestos Exposure
(Data from Hammond et al., 1979)

Group	Mortality Ratio
Non-Smoker without Asbestos Exposure	1*
Smoker without Asbestos Exposure	5
Smoker without Asbestos Exposure	11
Smoker with Asbestos Exposure	53

*Note: A mortality ratio of A1" would translate to 1 death from lung cancer per 9,000 individuals

Asbestos Disease

MESOTHELIOMA

Mesothelioma is a rare form of cancer almost exclusive to asbestos exposure. This is the most serious of the asbestos-related cancers, and may develop from exposures ranging from heavy, daily exposure to minimal exposure. While the latency period of from 20 to 50 years or more is a medical fact, it is often difficult for victims and their families to imagine that this can occur after so long a period of time.

Mesothelioma originates in the sac lining of the chest (pleura) or the abdomen (peritoneum). In the advanced stages of the disease, it is possible to have both pleural and peritoneal mesothelioma. Although mesothelioma is not curable, early detection is a factor in having a cho ice in treatment options. Mesothelioma specialists and world-class cancer centers, as well as new surgical approaches, chemotherapy drugs and ongoing clinical research all play an important part in helping extend life expectancy and in increasing quality of life.

Symptoms

The early symptoms of mesothelioma are generally non-specific, and may lead to a delay in diagnosis. Sometimes resembling viral pneumonia, symptoms of pleural mesothelioma may include shortness of breath, chest pain and/or persistent cough. A chest x-ray may show a build-up of fluid called pleural effusion. Less common symptoms are fever, night sweats and weight loss. Symptoms of peritoneal mesothelioma may include pain or swelling in the abdomen due to a build-up of fluid, nausea, weight loss, bowel obstruction, anemia or swelling of the feet. It is important to keep in mind that these symptoms may be caused by mesothelioma or by other less serious diseases. Only your doctor can make a definitive diagnosis, and while mesothelioma may be suspected by using imaging techniques such as x-rays or CT scans, in most cases it can only be confirmed through a tissue biopsy.

Treatment

Traditional approaches such as surgery, chemotherapy and radiation are most commonly used in the treatment of mesothelioma, however, multi-modality treatments which combine all three methods are now widely accepted. Other still experimental approaches include gene therapy, photodynamic therapy and immunotherapy. There are also a number of promising new drugs being evaluated in the clinical trial system.

LUNG CANCER

Asbestos is the most common industrial substance known to cause lung cancer. When asbestos fibers break apart, microscopic particles are released into the air. These fibers are easily inhaled and can lodge in the lungs, damaging cells and increasing the risk of cancer. The risk of asbestos-related lung cancer is substantially higher for those who were, or are now smokers, as opposed to those who have never smoked.

Symptoms

Symptoms of lung cancer include persistent cough, coughing up blood, chest pain, shortness of breath, wheezing, repeated pneumonia or bronchitis, fatigue, loss of appetite or weight loss.

Treatment

Options for the treatment of lung cancer depend on factors such as the size, location and type of the cancer, and the overall health of the patient. As with all cancers, early diagnosis may be the most important element in a successful treatment program.

ASBESTOSIS

Asbestosis is a form of diffuse pulmonary fibrosis caused exclusively by inhaling asbestos fiber. It is a chronic and irreversible lung condition characterized by scarring of the lower lobes of the lungs, leading to a decrease in healthy tissue. As a result, the lungs become stiff and do not allow for normal expansion and contraction.

Symptoms

Symptoms may include shortness of breath, coughing, tightness in the chest, chest pain, a crackling sound in the chest or clubbing of the fingers. Diagnosis of asbestosis is generally made through a chest x-ray, with the films interpreted by a Certified B-reader, or through a high resolution CT scan.

Treatment

Since asbestosis is a progressive disease, monitoring on a regular basis is essential following a diagnosis. If the disease worsens, inhalers or oxygen may be necessary to alleviate discomfort.

Managing Your Care

Mesothelioma is a major challenge and keeping up with activities involving your treatment and doctor visits can be overwhelming. The patient, the family, and close friends are faced with new and unfamiliar experiences. A methodological approach to your care can often make life easier for everyone.

The concept of a personal medical file is becoming more popular, and these files can be especially useful for cancer patients who see multiple doctors and receive treatment at more than one location. The personal medical file helps ensure that you always have access to critical data (even when your doctor’s office is closed) and there is a backup of the most important documents. When you visit a new health care provider, you will have comprehensive access to the information they need. More on personal medical files.

Keeping track of the medications you are taking can be a hassle, especially given the amount of prescriptions the typical mesothelioma patient takes. You need to know what medicines you are taking, which doctor prescribed them, what the dosage is and how many pills a day you take. A formal file and notebook organizer can help here. More tips on managing your medications.

Keeping track of your expenses is important. Everyone has different financial resources, insurance coverage, and Medicare eligibility. Many mesothelioma patients can get compensation from the asbestos industry, which can help with medical costs. Whatever the source of your funding, you need to keep track of all bills from hospitals and clinics, bills from drugs stores, and insurance claims and payments. Tips on managing your expenses.

Because mesothelioma is a rare cancer, your doctor may not have much experience dealing with it. There is nothing wrong with getting a second opinion from another physician. Here are some ideas on second opinions. You may wish to look at our list of mesothelioma specialists. Contact us if you are interested in reaching these doctors. Note that the type of doctor that specializes in cancer treatment is called oncologists. However, because mesothelioma is so rare, even most oncologists have seen a limited number of cases. Also you may wish to look into the community clinical oncology program, sponsored by the federal government, which offer access to clinical trials to patients at cancer centers around the country.

Keeping a Personal Medical Records File

When you or a family member is going through the diagnostic process, or are being treated for mesothelioma, it is an undeniable fact that there will be a multitude of paperwork and reports involved. Although each individual medical professional or facility will keep its own record of your care, it is also important that you maintain an accurate, up to date medical history of your own.

It is likely that several different doctors, possibly at various locations, will be involved in your care, and each will generate a series of test results, treatment reports, scripts for medications, etc. By consolidating and organizing this information in one file, you will always have access to what you need if questions arise, or if a report is lost or inadvertently destroyed. It will also give you an opportunity to go over your records in your own time, and make note of any questions or concerns you might have. In this way, you will become a more active participant in your health care, and will feel more knowledgeable and in control of your situation. Keeping a personal medical file is also helpful in managing your health insurance claims, taxes and other legal matters.

Your personal medical record file should include the following:

• Information on past medical history, including the dates and details of any previously diagnosed illnesses such as diabetes or heart disease.
• Information on past physical examinations and screening tests.
• Immunization records.
• Contact information for all doctors, clinics and/or hospitals involved in your diagnosis, treatment or other care.
• Dates of initial diagnosis and a schedule for subsequent treatments.
• Copies of reports and diagnostic tests, including laboratory results, pathology reports and imaging tests (x-ray, CT, MRI, PET).
• Treatment information including surgical reports, names and dosages of drugs used for chemotherapy and sites and dosages for radiation therapy.
• Notes on treatment results including any complications or side effects experienced.
• Information on supportive care such as pain management or nutritional support. All medications you are taking, including prescription and over the counter drugs, should be listed by name, dosage and how often they are taken.

If you have been diagnosed with mesothelioma, it is best to collect information for your file each time you have an appointment, test or procedure. At each doctor appointment, ask for any records being added to your file, and if you have a laboratory test or a procedure of any kind, request a copy of the test results or the procedure report. If you are hospitalized for any reason, request a complete copy of your hospitalization records when you are released. Keep copies of medical bills and insurance claims.

How you organize your file is a matter of personal preference. Some people prefer a filing cabinet, while others prefer a folder, binder or box; some prefer to scan documents into a computer file. Records can be divided according to date or by category such as appointments, tests or treatments. However you choose to compile your file, be sure it is stored in a safe place. You may wish to leave an additional copy with a relative or friend in case of emergency.

The Health Insurance Portability and Accountability Act of 2003 assures that all patients have access to their medical records, so if you did not start a medical file when you were first diagnosed or treated, you can still obtain the information you need. In this case, it may be necessary to request your records in writing, and you may need to complete an "Authorization to Release Medical Information". Unfortunately, requesting records after the fact can take time, and you may be charged copying fees.

Related: Managing your medications.

Managing Your Medical Expenses

The volume of paperwork involved in managing insurance claim forms, co-pays, benefits statements, etc., can be overwhelming for a mesothelioma patient who is trying to concentrate on their health care, but by keeping organized, accurate records, you can eliminate unnecessary stress.

Perhaps the simplest way of keeping information to be referred to when filing an insurance claim, is to use a paper calendar to make note of all doctor's appointments, lab tests, procedures and treatments, as well as prescription drugs purchased. If this information is recorded on the day it occurs, you will have a complete chronological record when you need it. Other records you should organize in an expandable folder or binder include:

• Bills from all health care providers.
• Bills or receipts for prescription drugs.
• Receipts from co-pays or other health care related costs.
• Insurance claims filed.
• Reimbursements received.

Keeping medical expenses entered on a basic computer spreadsheet is another option, or, there is specialized software available for those who prefer a better display of information and the ability to search for and sort information. One of these programs is the "Medical Expense Manager" offered by Quicken. This program will allow you to track and organize medical expenses, tax deductions, medical and prescription history for multiple individuals, insurance payments and deductibles and billing or claims disputes.

Another alternative is to hire someone to manage your claims for you, and if you feel you need professional help, there are health insurance claims assistance services available in many areas. These professionals can file and track claims, contact health care providers and insurance companies to resolve claim issues, review medical bills for accuracy and appeal rejected claims. Fees for services rendered can vary significantly according to provider.

For those with Medicare coverage, a health insurance assistance program is available in every state. Counselors can help Medicare recipients understand their benefits, and can make suggestions on establishing a record keeping system.

Mesothelioma Doctors List

This is a list of doctors who reportedly treat mesothelioma patients. Their appearance on this website is not a recommendation. You should treat these doctors as you would any unknown physician and ask many questions about their experience with other mesothelioma patients.

Arizona
	Linda Garland, M.D. Arizona Cancer Center - Hematology/Oncology Tucson, Arizona Tel. 520-694-CURE (2873) Dr. Garland is an oncologist and the Director of the Arizona Cancer Center Clinical Lung Program where one of her specialties includes Mesothelioma. For more information, click here.
	Helen J. Ross, M.D. Mayo Clinic, Hematology/Oncology Scottsdale, Arizona Tel. 1-800-446-2279 Dr. Ross is a Thoracic Oncologist and Associate Professor of Medicine at the Mayo Clinic. For more information, click here.
California
	Robert B. Cameron, M.D. UCLA Medical Center Los Angeles, California Tel. 310-794-7333 Dr. Cameron is the Director of Thoracic Oncology at UCLA Medical Center. He is board-certified in general surgery and cardiothoracic surgery. His research interests include lung cancer, esophageal cancer and mesothelioma. For more information, click here.
	David Jablons, M.D. UCSF Comprehensive Cancer Center San Francisco, California Tel. 1-800-888-8664 or 415-885-7777 Dr. Jablons is the Professor and Chief of the Section of General Thoracic Surgery at UCSF. He is Board Certified in General Surgery and Thoracic Surgery. For more information, click here.
	Theirry Jahan, M.D. UCSF Comprehensive Cancer Center San Francisco, California Tel. 415-567-5581 Dr. Jahan is an associate clinical professor of medicine at UCSF. He specializes in the treatment of lung cancer, mesothelioma, sarcomas and endocrine tumors and the use of multiple treatments. For more information, click here.
Connecticut
	Graeme L. Hammond, M.D., F.A.C.S. Yale University School of Medicine, Department of Surgery New Haven, Connecticut Tel. 203-785-2704 Dr. Hammond is a professor with the Department of Surgery at the Yale University School of Medicine in New Haven, Connecticut. He is board-certified in surgery and thoracic surgery. For more information, click here.
Florida
	Lary A. Robinson, M.D. H. Lee Moffitt Cancer Center & Research Institute at The University of South Florida Tampa, Florida Tel. 813-745-8412 Dr. Robinson is the Director of the Division of Cardiovascular and Thoracic Surgery at the H. Lee Moffitt Cancer Center. For more information, click here.
Massachusetts
	Raphael Bueno, M.D. Brigham and Women's Hospital, Division of Thoracic Surgery Boston, Massachusetts Tel. 617-732-6824 Dr. Bueno is the Associate Chief of the Division of Thoracic Surgery for Brigham and Women's Hospital. He is board certified in Surgery, Surgical Critical Care and Thoracic Surgery. His clinical interests include tracheal surgery, lung cancer and mesothelioma. For more information, click here.
	David J. Sugarbaker, M.D. Brigham and Women's Hospital, Division of Thoracic Surgery Boston, Massachusetts Tel. 617-732-6824 Dr. Sugarbaker is Chief of the Division of Thoracic Surgery at Brigham and Women's Hospital. Malignant pleural mesothelioma has been a central focus of Dr. Sugarbaker's clinical and laboratory research. For more information, click here.
	Scott J. Swanson, M.D. Brigham and Women's Hospital/Dana Farber Cancer Institute Boston, Massachusetts Tel. 617-732-6824 Dr. Swanson is board certified in Surgery and Thoracic Oncology and Thoracic Surgery. For more information, click here.
Nebraska
	Dr. Brian Loggie Creighton University School of Medicine Omaha, Nebraska Tel. 402-280-3273 Dr. Loggie is a Professor of Surgery, Chief of the Division of Surgical Oncology, and Director of the Cancer Biology Program at Creighton University School of Medicine. His special interest include: Peritoneal carcinomatosis and malignant ascites, and peritoneal mesothelioma. For more information, click here.
New York
	Manjit Bains, M.D., F.A.C.S Memorial Sloan Kettering Cancer Center New York, New York Tel. 212-639-7450 Dr. Bains is board certified in Surgery and Thoracic Surgery and has clinical expertise in mesothelioma. For more information, click here.
	Lee M. Krug, M.D. Memorial Sloan Kettering Cancer Center New York, New York Tel. 212-639-8420 Dr. Krug is a medical oncologist who specializes in the treatment of thoracic cancers. He is board-certified in internal medicine and medical oncology. His research is focused primarily on small cell lung cancer and mesothelioma. For more information, click here.
	Valerie Rusch, M.D., F.A.C.S Memorial Sloan Kettering Cancer Center New York, New York Phone: 212-639-5873 Dr. Rusch is a surgeon who treats patients with cancers of the lung, esophagus, mediastinum, and chest wall, including those with mesothelioma. She is board certified in surgery and thoracic surgery. For more information, click here.
	Harvey I. Pass, M.D. New York University Medical Center New York, New York Tel. 212-731-5414 Dr. Harvey Pass is the Director of the New York University Medical Center Division of Thoracic Surgery and is Chief of Thoracic Oncology. He is one of the world's leading authorities on mesothelioma. For more information, click here.
	Robert N. Taub, M.D. NewYork-Presbyterian/Columbia New York, New York Tel. 212-659-6815 Dr. Taub is Board Certified in Hematology, Allergy and Immunology, Internal Medicine and Oncology. Dr. Taub is involved in developing combined chemotherapeutic and surgical techniques to combat mesothelioma. For more information, click here.
North Carolina
	David H. Harpole, Jr., M.D. Duke University Health System Durham, North Carolina Tel. 919-668-8413 Dr. Harpole is Vice Chair of Faculty Affairs and a member of the Division of Cardiovascular and Thoracic Surgery in the Department of Surgery of the Duke University Health System. His clinical interests include thoracic oncology, and mesothelioma. For more information, click here.
Pennsylvania
	Daniel Sterman, M.D. University of Pennsylvania Medical Center Philadelphia, PA 19104-4283 Tel. 215-614-0984 Dr. Sterman is Associate Professor of Medicine, Associate Professor of Medicine in Surgery, Director of Interventional Pulmonology, and Clinical Director, Thoracic Oncology Gene Therapy Program at the University of Pennsylvania Medical Center. He is involved in various studies involving mesothelioma. For more information, click here.
Texas
	W. Roy Smythe, M.D. Texas A&M University Health Sciences Center Temple, Texas Tel. 254-724-2595 Dr. Smythe is involved in the surgical diagnosis and treatment of mesothelioma patients at the Texas A&M University Health Sciences Center. For more information, click here.
Washington, D.C.
	Paul H. Sugarbaker, M.D. Washington Cancer Institute Washington DC Tel. 202-877-3627 Dr. Sugarbaker is the Director of the Program in Peritoneal Surface Malignancy at the Washington Cancer Institute. His clinical interests include mesothelioma. For more information, click here.
Washington State
	Eric Vallieres, M.D. Swedish Medical Center Seattle, Washington Tel. 206-215-6800 Dr. Vallieres is a thoracic surgeon with the Swedish Medical Center. He is board-certified in general surgery and thoracic surgery. His areas of interest and expertise include mesothelioma and pleural diseases. For more information, click here.

Mesothelioma Lawyers - Important Information for Patients

By Michael Horwin, MA, JD*

Deciding to pursue legal recourse and selecting an attorney to represent you in a mesothelioma or asbestos lawsuit are important decisions that should be made carefully. I have seen some families receive $500,000 and others be awarded nearly $30 million. I have seen some lawyers reject a case only to have another firm accept it and make a big success of it. And I have seen some families wait nearly three years to receive their first check while others received large checks within three months of filing a claim. The main reasons for these differences are the facts of the patient's situation and the law firm chosen.

The Facts of Your Situation

Some mesothelioma patients know they worked around asbestos, but many do not know how they were exposed or how often. In fact, many people are not sure if they were ever near this carcinogen. Unfortunately, there have been thousands of products that contained asbestos - cigarette filters, hair dryers, brakes, basement and roof materials, pipes, boilers, insulation, and many other products found throughout the home and at work. If you were diagnosed with mesothelioma it is more than likely that you were exposed to asbestos multiple times in your life and that this happened decades before your diagnosis.

In general, the value of your case depends on how many asbestos containing products you were exposed to, the number of identifiable defendants that still exist (many have declared bankruptcy), your age and earning capacity. And the speed of your case can depend on a number of variables including the state where you worked and lived when you were exposed to asbestos.

The Law Firm You Choose

When you have been given the news about this terrible disease, you may not feel that you have the time to deal with the legal questions - Should I talk to a lawyer? Should I file a claim? However, you should not wait too long to learn about your legal rights for at least three reasons:

1. Statutes of Limitations - There are statute of limitations which means you only have a limited time to file your case after diagnosis. The statute of limitations time period is set by individual states and varies. The clock usually starts ticking on the day of diagnosis.
   
   
2. Financial Pressure - A mesothelioma diagnosis can bring financial stress, less income, more expenses, and treatments that are not covered by insurance. Knowing that money may be on the way from filing a claim can bring financial relief.
   
   
3. Lawyers Can be Excellent Resources - The more experienced mesothelioma lawyers and law firms can often be excellent sources of information about various doctors and treatment options available for this disease.

But, picking a lawyer is serious business and you should not use TV ads as the reason to hire an attorney. Actual credentials are what counts. For example, what type of accomplishments has the law firm achieved? How committed are they to mesothelioma/asbestos cases? Are these cases a substantial part of their practice or just a small piece? How many other cases like yours have they handled?

Also, make sure you understand the fees being charges. Contingency is the term that means that the lawyer gets paid only after they collect money for you. The amount of the contingency fee that your lawyer can charge varies and is usually between 33% and 40%. It is important to discuss fees openly, ask what services they cover, how they are calculated, and whether there will be any extra charges.

Finally, for something as important as a mesothelioma lawsuit, your attorney should not only be experienced, skilled, and dedicated, but also a trusted partner who understands that your health needs always take precedence. The best lawyers are those that are not only expert at what they do, but are also caring, supportive, thoughtful and compassionate.

Below are experienced mesothelioma law firms you can contact. If you would like additional information on choosing a reputable mesothelioma law firm please feel free to call me at 1-619-599-3112.

California

Paul & Hanley If you are a resident of California and were diagnosed with mesothelioma please call Jerry Neil Paul of Paul & Hanley. Paul & Hanley has garnered many of the most significant California verdicts and they are dedicated to helping victims of mesothelioma. Call: 1-800-281-9804.

New York and New Jersey

Levy Phillips & Konigsberg LLP ("LPK") If you or someone you know has mesothelioma and has ever lived (or performed any work) in NY or NJ, call LPK for a free consultation, 24 hours a day, 7 days a week (1-800-637-6529) or visit their website. LPK has over three decades of experience, including many top mesothelioma jury awards in NY and NJ.

Maryland, Delaware, Washington D.C., Pennsylvania or Tennessee

The Law Offices of Peter G. Angelos, P.C. If you or someone you know has mesothelioma and has ever lived or performed work in Md., De., D.C., Pa. or Tn. please call or email the The Law Offices of Peter G. Angelos, P.C. for a free consultation, 24 hours a day, 7 days a week. 1-800-556- 5522, www.angeloslaw.com. The Law Offices of Peter G. Angelos, P.C. has specialized in asbestos litigation since the early 1980's.

All Other States

Michael Horwin, MA, JD Michael Horwin is an attorney, the President of Cancer Monthly, and the publisher of cancer books and reviews including: Surviving Mesothelioma and Other Cancers: A Patient's Guide, A Mesothelioma Survivor's Story, CancerWire, and Mesothelioma Treatment Update. He has helped hundreds of mesothelioma patients over the years. He can help you identify reputable mesothelioma law firms in all states. His number is 619-599-3112.