Seven doctors and nurses have lost their lives to fatal mesothelioma cancer of the lung linings in just the last six years, according to a BBC news report. It was also revealed that more than 9 in 10 of London hospitals contain asbestos. The shock news once again highlights the continuing presence of asbestos in many hospitals, which has never been fully resolved, and potentially adds to the many challenging conditions that the NHS faces daily.

A spokesperson for the NHS has admitted that “many parts of the NHS estate date from an era when asbestos was widely used” but at the same time says asbestos is considered safe “if it is undisturbed”. Tragically, the history of asbestos insulation used in hospital building or renovation, regular discoveries of dust and the hospital workers who are later diagnosed with asbestosis diseases may tell a different story.

Apparent failure to maintain regular management

Asbestos was widely used as commercial and industrial insulation in Britain for more than 100 years. It’s application as a low cost and effective building product reached its peak during three decades after 1945 before a first ban on the most toxic brown and blue asbestos was introduced in the mid 1980s. Many hospitals built during the 20th century still contain asbestos, which has been left in place under a policy of asbestos management.

However, problems of airborne dust continue to be reported at hospitals around the country as a result of an apparent failure to maintain adequate and regular management. When three different hospital trusts identified the presence of asbestos materials during renovations, an investigation found that there was a failure to put into place a management or monitoring plan to control the risk of airborne dust. There may have also been a lack of asbestos awareness by NHS Trust maintenance staff who could have disturbed asbestos fibres without knowing they were at risk of exposure and without protection equipment.

An official announcement declaring that asbestos left undisturbed within the fabric of a building poses no risk, might suggest that a plan for the management of asbestos is being fully implemented and regularly checked. Sadly, it is not always the case.

No information on the location or condition of asbestos

At one NHS Foundation Trust in the north of England there was no information on the location or condition of asbestos previously found in the door frames of the wards. The lack of communication led to the release of asbestos dust into the air when holes were drilled into the doors when cables were being installed and a potential risk posed to patients, nurses, doctors and other hospital staff.

The use of asbestos insulation in a wide variety of building applications means it can still be found in areas such as heating ducts, ceiling voids and wall linings where – if encapsulated, left undisturbed, and regularly monitored – could pose a reduced risk. However, asbestos was most often used to line boilers and lag hot water pipework.

The asbestos fibre and cement mix lagging would deteriorate, crumble and release fibre dust into air, and broken pieces fall on the floor. It could often be standard practice to house pipes below ground level to heat basement canteens, which would run along the interior or exterior walls of service / pedestrian tunnels and walkways accessible by hospital staff. Close proximity and regular exposure could inevitably lead to tragic outcomes.

Exposure to asbestos lagged pipes

It was reported that a 51 year old physician developed mesothelioma, suspected of being the result of exposure to asbestos lagged pipes when he was a medical student, thirty year earlier. He would walk to and back from lectures via underground hallways connecting different buildings at a midlands university campus. It is believed that dust fibre particles were released into the atmosphere from deteriorating asbestos used as insulation lagging around the water pipes running along the length of the corridor. An almost identical case occurred in London, when an anaesthetist claimed he was exposed to asbestos walking through the underground tunnels linking hospital buildings as a student in the late 1970s, early 80s.

Recently, a former hospital worker was just 65 years old when diagnosed with mesothelioma. The father of four was employed at a Surrey hospital as a porter between 1970 and 1981. While the former porter never actually handled asbestos over the eleven years he worked at the hospital, it is believed he inhaled the tiny dust particles during the periods he spent in the hospital boiler room, which was also used as a porter’s rest room.

Cannot be safely assumed that asbestos is being properly managed

Under Regulation 4 of the Control of Asbestos Regulations 2012, every Hospital Trust has a duty to manage asbestos within all of its properties. In addition they must provide all staff with appropriate information regarding the presence of asbestos in the buildings where they may be required to carry out their daily duties. Any individual who may risk contact with asbestos must also be given relevant awareness training.

In recent years, the NHS has come under increasing pressure due to many factors involving budgets and resources. The problems of managing asbestos may also come under pressure. It cannot be safely assumed that all asbestos in place is encapsulated, being properly managed, and not releasing fibre dust into the air.

Many experts now believe that nothing less than the total removal of all asbestos from every public building, including hospitals, can be only real answer to the potential risk of exposure.