Asbestos: The tiny fibres that threaten our lives
The first time that Dr Jayabalan A. Thambyappa came across a patient suffering from mesothelioma was back in 1993. At that time, he was working at a private hospital in Malaysia as a medical officer.
A man in his late 50s had come to the hospital complaining of shortness of breath and had been coughing for a few months.
“The physician who saw him diagnosed him as possibly suffering from tuberculosis. He was sent for an x-ray.
“The diagnosis of mesothelioma was made by an astute radiologist in the hospital. This information was communicated to the physician who decided to treat the patient conservatively,” recounts Dr Jayabalan, who has been working with the Consumers’ Association of Penang (CAP), on getting asbestos banned since the 1990s.
Mesothelioma is a cancer that starts as a growth of abnormal cells from a thin layer of tissue that covers many internal organs.
The biggest risk factor for mesothelioma is being around asbestos, a natural mineral used in insulation, roofing, fire- proofing materials, including car brake pads.
The problem is it can take years for the disease to emerge. For instance, despite banning asbestos over 35 years ago, Singapore is still seeing cases of malignant mesothelioma. According to a paper on “Occupational malignant mesothelioma in Singapore” in the Singapore Medical Journal, 94 cases were confirmed from 1984 to 2019, a majority of them male.
The reason for this, says Dr Jayabalan, is the long latent period of the appearance of the disease from the injury suffered from exposure to asbestos.
“The disease does not immediately appear. There could be a latent period of as much as 40 years, which means the disease will only be seen after 30 to 40 years,” he explains in a recent interview.
Treatment for this disease, says Dr Jayabalan, is usually palliative care, which is specialised medical care for people living with serious illnesses that focuses on providing relief from symptoms and the stress of the illness to improve quality of life for both the patient and their family.
“Chemotherapy is offered but not only are results disappointing but it’s very distressful to the patients.
“At best, once diagnosed, they can live at the most for 18 months,” he adds.
Valued for its usefulness
Asbestos is a general name given to several minerals; currently, the most commonly used is chrysotile, or white asbestos.
Made up of tiny fibrous materials, asbestos does not dissolve in water or evaporate, and is resistant to heat and fire as well as chemical and biological degradation. Basically, it’s almost indestructible, explaining its popularity in construction and manufacturing sectors.
The problem begins when the fibres become airborne by being damaged or disturbed when the material is cut or processed. The tiny fibres can be inhaled and become lodged in the lungs and other organs.
According to the World Health Organisation (WHO) website, all forms of asbestos, including chrysotile, are carcinogenic to humans.
“Globally, more than 200,000 deaths are estimated to be caused by occupational exposure to asbestos – more than 70% of all deaths from work-related cancers,” it says.
The International Ban Asbestos Secretariat counts over 70 countries – not including Malaysia – that have implemented bans on asbestos due to its severe health risks; however, some of these bans may be partial in that they do not cover certain industries or its use under specific conditions.
In Malaysia, it has been prohibited to use asbestos materials in schools, clinics, and hospitals built by the government since 1999; this ban was extended to all government buildings in 2005.
However, asbestos construction materials such as roof and ceiling tiles are still sold in the market, and there are also no legislative acts or regulations prohibiting its use in private.
Despite actions by groups like CAP and individuals like Dr Jayabalan in urging for a full ban in Malaysia over the years, there has been none coming.
So it was a bit of a surprise when in January, Natural Resources and Environmental Sustainability Minister Nik Nazmi Nik Ahmad told reporters that the government was reviewing a proposal to “fully ban” the use of asbestos.
“We will assess how this issue is currently managed under existing legislation and policies. If there are gaps, we may need to improve them,” he said.
In July 2024, CAP had submitted a memorandum to the government urging a complete ban on all forms of asbestos, arguing there is no “safe use” of asbestos that can be ensured across the supply chain.
It was repeating a similar call it made in a memorandum in May 2001.
Of course, while a pledge to review is not a pledge to ban, many are wondering why only now?
Legacy problems
Chrysotile asbestos, says CAP’s Mageswari Sangaralingam, is still allowed to be imported and used in the manufacturing sector under the “controlled use” concept in Malaysia.
“At a meeting we had attended, we were informed that only one industry is still producing asbestos roofs.
“However, there are existing asbestos roofs, ceilings, and asbestos in other products that we have to be concerned about.
“This includes asbestos cement pipes delivering water which were laid decades ago that should be looked into, if not replaced,” she says in an e-mail interview.
Why has it taken so long for Malaysia to even consider a complete ban?
Mageswari says this question should be put to the government, adding that she believes it could have been due to lobbying by industry interests.
“We do not know what happened in Malaysia, and do not want to speculate,” she states.
Malaysia, she says, does not have to further delay the ban.
“There are alternatives that have been used by other countries, even in South-East Asia,” she points out.
But even after a full ban, this doesn’t mean there won’t be health impacts for years to come, primarily – as Mageswari has mentioned – from legacy products, such as asbestos-containing materials that were manufactured and installed in the past and are still present in existing infrastructure and products today.
The concern arises when they are disturbed during renovations, demolitions, or by natural deterioration, potentially releasing harmful asbestos fibres into the air.
A check with a local asbestos survey service company shows that it receives around an average of two or three inquiries a month.
“While asbestos sampling and testing are generally not expensive, the asbestos removal process can be quite costly.
“This is due to the requirement for professional, trained personnel, the setup of a decon [decontamination] unit, and necessary utility connections,” says a staff member from the company’s industries and environment division.
A decontamination unit is a facility or mobile unit designed to safely remove hazardous contaminants from people, clothing, and equipment.
Additionally, the removal, explains the staff member, must follow the Occupational Safety and Health Department Guide-lines for Asbestos Removal 2017.
“Even after removal, the waste must be treated with great care.
“As a result, some companies may be reluctant to engage in asbestos removal due to the high costs, often without fully considering the potential health risks associated with exposure to the material,” she says.
Besides her firm, there are several global third-party inspection companies and other local companies that also provide both asbestos sampling and removal services.
Should a full ban be mulled, who would oppose it?
There is no mining or milling of asbestos in Malaysia, with the main commercial activities confined to the manufacturing of asbestos products for sale in domestic and export markets, according to the memorandum by CAP.
The memorandum also quotes the United States Geological Survey agency as putting the consumption of asbestos fibre in Malaysia at 3,830 tonnes in 2022, down from 11,500 tonnes in 2010.
According to Asia Ban Asbestos Network records, in 2022, Malaysia imported 4,322 tonnes of asbestos cement from Indonesia, and 2,794 tonnes of asbestos fibre from Russia.
The beginning of the end?
Local contractors, according to the Master Builders Association Malaysia, would surely support a proposal to completely ban the use of all asbestos materials as it is their workers who have to handle and install the material and are the most exposed to the carcinogenic fibres, says president Oliver Wee.
Asbestos, he explains, is naturally fireproof and usually used in fireproofing, insulation, roof materials, and walls and ceilings in high temperature environments. Also offering sound proofing properties, it is used in ceiling tiles and wall panels to reduce noise.
“As contractors, we actively advise and propose that clients replace materials containing asbestos with safer alternatives as we are responsible for installation.
“Alternative materials such as fibreglass, cellulose, or polyethylene foam can be considered as replacements,” he points out.
The association, adds Wee, constantly carries out programmes to disseminate the latest updates and training in the dangers of asbestos to create awareness and share knowledge among its members.
“However, to have a comprehensive plan to abolish the use of all asbestos materials, it requires the commitment of all stakeholders – everyone from architects and consultants to developers as well,” he says.
Asked if the construction sector is committed to replacing asbestos with safer products, Wee says the practice in the local construction industry is for contractors to use whatever materials are listed in contract documents or specifications.
The initiative, he says, lies with the designers or consultants to specify alternative materials.
“That would make the manufacturers produce the approved type of materials without any asbestos content.
“When there is no demand, there won’t be any supply.”
Source: The Star, 16 April 2025