The discovery of asbestos containing materials (ACMs) in a hospital, as would naturally be expected, is a major cause for concern among staff, patients and the local community. In some cases, the presence of asbestos materials may only come to light when a hospital building is to be either renovated or demolished to make way for a new development.

In recent years, there has been a significant number of publicised cases where there was a failure to properly deal with asbestos even when its presence was known about, and an accompanying lack of asbestos awareness, management and in-house personnel training.

While the unexpected discovery of asbestos can signal an immediate alarm over the very real potential risks of exposure and the inhaling of fibre dust particles released into the surrounding atmosphere, much depends on the condition of the materials found. In addition, ACMs should always be suspected of being present in any building built or previously renovated up to the mid 1980s when asbestos was first banned. A management survey to uncover hidden asbestos should always be carried out before any works commence.

When in 2011, ACMs were found in service ducts during a routine safety check at Liverpool’s Alder Hey Hospital, health authorities found that the asbestos had originally been safely ‘encapsulated’ in the 1980s, preventing fibre particles from being released into the surrounding air and therefore, posing no risk to any of the staff, patients, wards or offices in the building.

Doctors, nurses and porters at risk

However, not every discovery of asbestos in a hospital environment leads to a safer and more satisfactory outcome. The risk of exposure and the contracting of mesothelioma or asbestosis disease continues to this day, some thirty years after white asbestos fibres were banned from being used as insulation and fireproofing materials in the building industry.

Yet during this same period, it has been found that many doctors, nurses and porters could have been at risk in their particular hospital environment. Just this year, a consultant anaesthetist aged just 54, died from mesothelioma he contracted when exposed to asbestos lining the pipes attached to walls of walkway tunnels during his six years training as a student at a central London hospital. Three other doctors who trained at the same hospital were also diagnosed with the same incurable cancer and subsequently died.

Among the other applications, such as insulation wallboard, a mixture of asbestos fibres and cement was commonly used as “lagging” to insulate hot water pipes in public buildings. It could often be standard practice to house pipes below ground level, which would run along the interior or exterior walls of service / pedestrian tunnels and walkways accessible by hospital staff and to heat basement canteens.

Failure to manage asbestos

More recently, it was reported that three hospital trusts, which had identified the presence of asbestos materials at their sites, continued to carry out maintenance work over a 11 year period but failed to put into place a management or monitoring plan to control the risk of potential fibre dust release. It was also found that the NHS Trust maintenance staff could have disturbed asbestos fibres without knowing they were at risk of exposure or possessing the equipment for safe protection.

More alarmingly, it was only at the end of 2011 that additional surveys discovered greater quantities of ACMs than first identified, which were not being managed.

Following the 2011 survey and an investigation by the HSE, the NHS Trust immediately put control measures in place. However, it was determined at the subsequent proceedings, which the HSE brought against the Trust that potentially all hospital workers were at risk of exposure to asbestos throughout the entire 11 year period.

In the last quarter of 2012, HSE released new figures, which reveal that asbestos-related, occupational cancer had caused the deaths of 4,500 people – or 56 per cent of 8,000 fatalities each year in England and Wales. Of a total of 1,335 occupation-related female mesothelioma deaths, the number of nurses was 52, one less and second only to the highest number of 53 for primary and nursery education teaching professionals.