Shipbuilding's Deadly Legacy/Disease: 9,000 Sick or Dead

By Bill Burke, Virginian-Pilot

In 1973, two men on two continents offered similar visions of an apocalyptic future.

On Feb. 23, Dr. Irving Selikoff, testifying before a congressional subcommittee, predicted that asbestos disease would kill 1 million American workers by the year 2000.

Selikoff, director of the Mount Sinai School of Medicine's Environmental Sciences Laboratory in New York, had been studying the effects of occupational asbestos since the 1950s. He was disturbed by what his research showed, especially in asbestos mining and in shipyards.

One study turned up an alarming statistic: Asbestos insulation workers, including those who worked in the shipyards of Hampton Roads, were dying of an asbestos-related cancer called mesothelioma at a rate 344 times higher than the general population.

Selikoff described the lethal dust of the fibrous mineral as "a hidden time bomb."

Eight months later, two executives with Lloyd's of London, the famed insurance market, were golfing on a course south of London. One of the men, Roger Bradley, would later testify about what his colleague, Ralph Rokeby-Johnson, had said on that day in October 1973.

Rokeby-Johnson had predicted that the asbestos-disease crisis in America would unleash an avalanche of lawsuits. It would be unlike anything Lloyd's had ever seen, he told Bradley.

"Asbestosis is going to change the wealth of nations," Rokeby-Johnson pronounced darkly. "It will bankrupt Lloyd's of London, and there is nothing we can do to stop it."

He, like Selikoff, used the time-bomb analogy:

"The time bombs are the young (asbestos) victims who will gradually develop lung disease. When they die, the lawyers are going to have a field day."

While Selikoff's perspective was that of a medical researcher, Rokeby-Johnson took a different view. He peered into the future and saw the financial crisis that asbestos disease would create once the lawyers got involved.

The pathologist and the actuarial expert agreed that an epidemic of asbestos disease had been unleashed. The scope of that epidemic has been startling. Between 1980 and 1995, an estimated 149,350 people in the United States died of occupational asbestos disease. That number surpassed the combined total of all other workplace injuries and illnesses for that period: 140,365.

One of the epicenters of the asbestos tragedy has been Hampton Roads, where thousands of tons of asbestos was used in building and overhauling tens of thousands of ships.

For more than 20 years, Hampton Roads has had a lung-cancer death rate significantly higher than the national average. In 1978, the National Cancer Institute designated Hampton Roads as one of 15 regions in the nation where asbestos diseases were most likely to occur, based on elevated lung-cancer rates.

Hampton Roads also is a hot spot for asbestosis deaths. From 1987 to 1996, Virginia ranked seventh among the 50 states in the number of deaths caused by asbestosis, and more than two-thirds of those deaths occurred in Southeastern Virginia. Asbestosis is more pervasive but less lethal than cancer.

But the deadliest asbestos disease is mesothelioma, which is cancer of the lining of the lung. It almost always kills, often within months of diagnosis.

In the 1970s, when Betty Knapp was cancer registrar at what is now DePaul Hospital, she suspected that the high rate of mesothelioma in Hampton Roads might be related to shipbuilding.

At about the time Selikoff delivered his prophecy of doom to Congress, the phone rang in Betty Knapp's office at Norfolk's DePaul Hospital.

As the hospital's "cancer registrar," Knapp collected data on cancer types and frequencies and reported them to the state. The caller was a state Health Department official. She said that the numbers Knapp had sent her seemed peculiar.

She told Knapp the data from Hampton Roads showed an unusually high number, or "cluster," of cases of a relatively rare cancer called mesothelioma.

The woman wanted to know if Knapp had any theories about what was happening. Knapp said she could only guess, but she supposed it might have something to do with the region's huge shipbuilding industry

The Health Department inquisitor and Betty Knapp were both right. Something was happening in Hampton Roads, and it was happening at the shipyards.

Between 1972 and 1978, a medical research team observed, there were 72 cases of mesothelioma in Hampton Roads, or 12 per year. That was four times higher than the national rate. The numbers piqued the researchers' interest and prompted a detailed study.

The results were published in the November 1980 issue of the journal Cancer Research. Interviews with the victims, most of whom were white males, revealed that 77 percent had worked in shipyards. The researchers also interviewed five of the six female mesothelioma victims and learned that four were wives of shipyard workers.

Their conclusion: Shipyard employment was responsible for the elevated rate of the cancer in the seaport cities of Southeastern Virginia.

"Since stricter controls have been instituted to reduce asbestos exposure in shipyards, mesothelioma incidence should eventually decline in coastal areas of the country such as Tidewater," the authors concluded.

But they added this ominous qualifier: "However, the long latent period of asbestos-induced mesothelioma is a matter of concern, and it seems likely that the full impact of postwar exposures has not yet been seen."

In fact, mesothelioma rates continued to rise. Before his death in 1992, Selikoff predicted that mesothelioma cases would peak at 3,060 in the year 2002.

Today, Hampton Roads is one of the nation's hot spots for the disease. Consider that:

• Between 1982 and 2000, 632 mesothelioma cases were diagnosed locally, about seven times the national rate. During those years, about one of every 26 mesothelioma cases nationwide occurred in Hampton Roads.

• The disease claims nearly one victim every 10 days in Hampton Roads.
  

Victims include people like Rebecca Martin, whose husband, Charles, a Navy enlistee who sometimes worked on ships, wore asbestos dust home on his clothes many years ago, not knowing that it could kill. Rebecca Martin died in September, seven months shy of the couple's 50th anniversary.

They include people like William R. Powell, a highly paid Visa International executive who never worked in a shipyard, but whose father did, during and after World War II, in Portsmouth. Powell, 51, died in his Virginia Beach home March 13 after waging a battle against the disease that lasted nearly four years.

The case of William L. Forbes illustrates two alarming characteristics of mesothelioma: The onset of the disease sometimes does not occur until several decades after exposure, and even a minimal contact can sow the seeds of malignancy.

Forbes' brief exposure occurred while, as a college student, he worked as a summer laborer in Norfolk shipyards in 1949 and 1950. He was not diagnosed with the disease until 1998, three years after retiring as a Chesapeake Circuit judge. He died later that year.

A roll call of mesothelioma victims has appeared on newspaper obituary pages through the years.

Feb. 11, 1977: James W. Vaughn, 49, of Norfolk, former Navy boiler tender.

June 4, 1986: Andrew O. Stampley Jr., 68, of Chesapeake, retired Navy electrician.

Dec. 26, 1994: Elliott Rosenbaum, 74, Navy veteran, former shipyard worker.

Aug. 16, 1995: Virgel William Gunter Jr., 74, of Portsmouth, retired shipyard foreman.

Nov. 11, 1996: Edgar W. "Eddy" Dunagan, 54, of Virginia Beach, retired civil service worker, avid hunter, camper and fisherman.

Nov. 29, 1999: Ralph Paul Robinson, 72; had been elected sheriff in Perquimans County, N.C., in November 1998.

Jan. 2, 2000: Retired Adm. Elmo Zumwalt Jr., former chief of naval operations, U.S. Navy.

Because little research has been conducted locally, the scope of the asbestos epidemic in Hampton Roads can only be estimated. Available data provide snapshots.

Between 1983 and 1992, 203 residents of the region died of asbestosis, according to federal researchers. Numbers for other years aren't available, but health officials estimate that there may be hundreds more victims locally, many of them still alive. An estimated 850 people exposed to asbestos in Hampton Roads have died of mesothelioma, based on reviews of court documents and interviews with medical experts and lawyers who handle asbestos cases. And even though asbestos products have been banned from area shipyards for more than 20 years, mesothelioma is likely to claim hundreds of additional victims during the next 25 to 30 years.

Even larger is the ongoing death toll from all types of asbestos-related cancer.

At least 300,000 people worked in the region's shipyards during the peak years for asbestos exposure, from 1940 to 1978. About 4,200 of those workers could be expected to die of asbestos cancer, based on a formula developed by Selikoff and fellow researchers. They projected a shipyard-worker death rate of 1.4 percent.

That toll does not include many thousands of family members who were exposed when workers carried the dust home on their clothes. The number of stricken family members could equal or surpass the number of ill workers themselves, though their exposures would have been less intensive, and their death rates lower, than the workers'.

Local lawsuits also help tell the story:

• To date in Hampton Roads, at least 9,000 people - more than 90 percent of them shipyard workers, ex-workers and family members - have settled or won legal judgments in asbestos cases, according to interviews and reviews of court documents. Of those, at least 2,000 were victims of mesothelioma and other cancers, primarily lung cancer. Most of the cancer victims have died.

• Between Oct. 1, 1986, and July 30, 2000, a total of 99,869 defendants were named in Newport News Circuit Court in all civil cases that did not involve domestic disputes. Nearly three-fourths of those filings - 74,216 - were asbestos cases, reflecting the high volume of both defendant corporations and of workers claiming deaths and injuries from asbestos exposure.
  

Many thousands of shipyard workers who suffered from asbestos disease have not filed lawsuits. Some have moved from the area. Others have had the diseases misdiagnosed or undiagnosed. Some have simply chosen not to sue. And for others, the severity of disease has not justified litigation.

The onslaught of asbestos lawsuits has devastated the asbestos industry and its insurers, as predicted by Lloyd's of London's Rokeby-Johnson in 1973.

The litigation has had little effect on the Navy, due to immunity doctrines that generally prohibit workers from suing the government while allowing them to file for worker's compensation.

That has left only the asbestos companies for victims to sue. Legal efforts by those companies to force the government to share in the liability have failed.

In 1984, Selikoff conducted the only known medical survey of local shipyard workers, at Norfolk Naval Shipyard in Portsmouth. Of 142 employees who submitted to X-rays, 113, or 79 percent, exhibited signs of lung abnormalities consistent with asbestos exposure. X-rays given to 90 wives of shipyard workers revealed that eight, or 9 percent, showed similar abnormalities.

Those workers had volunteered for the survey and thus did not represent a random sampling of shipyard workers.

Still, many employees who did not work directly with asbestos products were exposed to the dust, including tradesmen who toiled in areas where asbestos insulation was installed or removed, foremen, security guards, even architects and secretaries.

Selikoff concluded his study by noting that the results "indicate that a large proportion of the men working at the Norfolk Naval Shipyard have suffered important asbestos exposure. We also know that a proportion of those so exposed stand a significant risk of death of a variety of asbestos-associated diseases."

In the report, Selikoff recommended that the shipyard eliminate all exposure to asbestos, even the most minimal; that the government conduct its own, more extensive survey of asbestos workers; and that the Navy establish a comprehensive medical surveillance program for shipyard workers.

Selikoff had hoped the Navy would compare the results of his survey with those of similar screenings at other shipyards. Four years passed, and the Navy did not respond to his entreaties. Finally, he published the results in 1988.

Neither the naval shipyard nor Newport News Shipbuilding, the nation's largest private shipyard, has conducted an asbestos-disease study involving current or former workers, nor do they plan to, officials for the shipyards told The Virginian-Pilot.

"The hazards of working with asbestos and the controls needed to address those hazards have already been extensively studied and documented for both maritime and general industry," said a naval shipyard spokesman.

Industrial hygiene experts believe it is a mistake for the yards not to assess the scope of the asbestos-disease problem among workers.

The shipyards "should have conducted surveys," said Dr. Arthur Frank, an environmental health professor at the University of Texas Health Center at Tyler, a former Selikoff protege. "It's good public health policy."

Paul Burnsky, who was then head of the AFL-CIO's Metal Trades Department in Washington, helped Selikoff conduct the 1984 survey of shipyard workers. The Navy's failure to respond to the study angered him.

"I don't know what their hang-up is, but they are not cooperating," Burnsky said in 1988. "It is really something that the Navy is not paying any attention to."

Now retired and living in Maryland, Burnsky said during a January interview that the asbestos problem "was something the Navy simply didn't want to recognize. They avoided it."

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