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Sep 26, 2023

Do asbestos concrete pipes pose a threat to our health?

Asbestos was once regarded as a miracle substance, known for its versatility,

Asbestos was once regarded as a miracle substance, known for its versatility, durability, and resistance to fire, but in the 1970s, the public eventually became aware that, when inhaled, the naturally occurring mineral can cause a host of negative health impacts.

According to the Canadian Centre for Occupational Health and Safety, when asbestos is inhaled, the fibres can cause lung disorders such as pulmonary fibrosis, rounded atelectasis (otherwise known as folded lung) and other diseases such as lung cancer and malignant mesothelioma—an intrusive and often fatal type of cancer.

A recent CTV W5 investigation revealed that 85 communities in Canada, including Fort St. John, still use asbestos concrete (A/C) pipes to deliver drinking water to residents.

Fort St. John currently has about 89 km of asbestos concrete pipes, which make up approximately 47 per cent of the city's network.

Many of Fort St. John's asbestos concrete pipes are also nearing the end of their operational lifespan, making them more susceptible to breaks.

These pipes deliver drinking water to thousands of residents daily, yet the water is not tested to monitor what amount of asbestos, if any, is present.

This is because, despite the negative health impacts of asbestos inhalation being well-known for decades, there is not as much known about the ingestion of asbestos.

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Health Canada currently has no limit on the level of asbestos allowed in drinking water, stating there is "no consistent, convincing evidence" that ingesting asbestos through drinking water is harmful to one's health.

This aligns with the position taken by the World Health Organization, however, the US Environmental Protection Agency has had an asbestos limit for drinking water in America since 1992.

This month, Energeticcity Investigates looks into the safety of asbestos concrete pipes delivering the water we drink, speaking with the City of Fort St. John, the B.C. Ministries of Health and Environment, the BCCDC, Health Canada, and other experts.

During our investigation, it became apparent that there is not a straightforward answer regarding the safety of asbestos ingestion, so we decided to present both sides and let residents decide for themselves.

Ryan Harvey with the City of Fort St. John said when asbestos first came out, it was arguably a revolutionary substance.

"It was strong, naturally occurring, inexpensive, and fire resistant. All of those pieces, in theory, made it a great piece until they realized the hazards of it later on," Harvey stated.

From 1940 to the 1960s, the asbestos concrete pipe was a popular choice for water main construction, according to a 2008 report from members of the National Research Council of Canada.

The report continues, stating that in the 1970s, the use of asbestos concrete pipes was predominately discontinued in North America due to health concerns related to the manufacturing process of the pipes and the potential release of asbestos fibres from deteriorating pipes.

Harvey told Energeticcity the city of Fort St. John stopped installing asbestos concrete pipes in the 1970s.

He adds that work is ongoing to replace Fort St. John's aging asbestos cement pipes with PVC, which he says was one of the driving forces behind the 100th Street Corridor project.

"There were several breaks on 100th Street, which is some of the oldest underground infrastructure we have in the community," he said, adding that before the project began, some of the pipes under 100th Street were made of asbestos concrete while some sanitary pipes were made of wood.

"For us, the big thing is not only building the new things and making sure that the parks are improved and all of those other pieces. It's also making sure we replace pipes in areas that are serviced by asbestos concrete pipes, which are aging and reaching the end of their lifespan."

Harvey said the city has no established timeline for when all of the 89 kilometres of remaining asbestos concrete pipe in Fort St. John will be replaced.

When we asked about the level of asbestos that could potentially be present in Fort St. John's drinking water, Harvey explained the city doesn't test its water for asbestos because Health Canada doesn't have a guideline on the maximum acceptable concentration (MAC) of asbestos in drinking water.

"We test our water regularly as required by Northern Health, and those results are published on our website. There's a listing of them, and I’d have to say it's probably over 20 items that we have to test for and report on, and each of them has an allowable maximum. There's no allowable maximum on asbestos in Canada," Harvey clarified.

While Canada has no maximum limit on asbestos, the U.S. has a limit of seven million fibres per litre.

Harvey said even if the city tested for it, there would be nothing to compare the potential results to.

"So if we tested for it and we found one fibre, or we found a million fibres, what's that level?" he said.

Health Canada developed a technical guideline for asbestos in drinking water back in 1989 and says the scientific review conducted at that time found there was "no need" to implement a guideline because there was "a lack of conclusive evidence" that ingesting asbestos is hazardous.

The government agency told Energeticcity it assessed new scientific data on asbestos in 2009, 2013, and 2018, including studies that were evaluated by the Texas State Department of Health and the U.S. Environmental Protection Agency.

"Our recent review of the hazard and exposure data related to ingestion of asbestos in drinking water still supports the conclusion from the 1989 technical document that there is little evidence suggesting a causal relationship between asbestos ingestion and cancer," Health Canada said in a statement.

This stance on asbestos ingestion aligns with other organizations, including the World Health Organization (WHO).

In a 2021 background document titled "Asbestos in drinking-water," the World Health Organization said although the scientific data on adverse health effects after asbestos ingestion aren't clear, the "overall weight of evidence from available epidemiology and animal studies does not suggest an increased risk of cancer following ingestion of asbestos in drinking-water."

The organization added a caveat a few lines later in the document, stating that because of the uncertainties and limitations of available data, it would be appropriate to decrease the concentrations of asbestos fibres in drinking water "as far as practical."

Health Canada said it has an ongoing guideline review process in place, and said it will collaborate with provinces and territories to review any new studies on the impacts of ingested asbestos on human health.

The government organization said its next reassessment of the asbestos drinking water guideline is slated for 2023 and will include a review of any exposure data—like monitoring results of asbestos in drinking water from Canadian cities. It will also include any available studies on the impacts of ingested asbestos on an individual's health.

"If necessary, Health Canada will update its guideline and consider developing a MAC for asbestos in drinking water," the organization said.

On its website, Health Canada states there is " no consistent, convincing evidence that asbestos ingested through drinking water is harmful to your health."

Dr. Arthur Frank, a physician and professor of environmental and occupational health and medicine at Drexel University in Philadelphia, disagrees with this statement.

"I think the operative word that gets them out of it is ‘consistent’," Frank began.

"Of course, there's going to be positive studies and negative studies. There are still people that have negative studies about smoking causing lung cancer. You could make the same statement saying there's no consistent evidence. That's a way of getting out of dealing with an issue, a very political way of dealing with it."

Frank has been studying asbestos since 1968 when he met Dr. Irving Selikoff, an American medical researcher who extensively studied the link between asbestos inhalation and lung conditions—like mesothelioma—by observing industrial workers 30 years after they were exposed to asbestos.

He said that in the last 50 years, there has been clear, mounting evidence that asbestos ingestion can cause an array of GI tract cancers.

"We’re talking about esophagus, stomach, and colorectal cancers. Kidney cancers as well. The evidence, as more and more people look at it, is mounting, and the studies are all positive," Frank explained.

"Of course, you’re going to find people saying ‘No, no, it doesn't happen,’ but you have to look and see who's paying their bills," stated Frank, pointing out that at one time, Canada was the largest supplier of chrysotile asbestos worldwide.

He said there's also been a growing amount of literature from around the world showing that when water flows through asbestos concrete pipes, the pipes will release asbestos fibres into the water, especially if the water is fairly acidic.

While most of the health risks from asbestos concrete pipes are present when the pipe is either being made, installed or removed, Frank believes the ingestion of asbestos fibres also poses a risk to human health.

"If you look at the literature about ingesting asbestos fibres, which is how it gets to the tissues, people have found it in the esophagus and in the stomach and in colonic tissue, and they found it in kidney tissue. This is where you get the cancers. This is where you find the asbestos, and you find those cancers in excess," Frank explained.

He said the only way asbestos fibres would be present in those tissues would be by ingestion or through the bloodstream.

"Now that said, the number of fibres that are generally ingested are far less than what ends up in people's lungs, which is why you probably get lower rates of cancer," Frank added.

He said because these cancers are fairly common, it can be hard to trace the root cause back to asbestos ingestion.

Once in the body, asbestos fibres have the ability to translocate or move around. Frank said that once fibres are in the GI tract, such as the colon, they are able to work their way out into other areas of the body.

"The fibres migrate from the inside out into the peritoneal cavity, and that's where you get peritoneal mesotheliomas."

According to the American National Cancer Institute, the peritoneal cavity is the space in a person's abdomen that houses the liver, stomach and intestines.

Dr. David McVea, a public health physician in the BCCDC's environmental health services department, doesn't believe there's a health risk from the ingestion of asbestos fibres through drinking water.

According to McVea, there are a couple of key differences between the inhalation and ingestion of asbestos, the first being the types of tissues being impacted.

He said the lining of the stomach and intestines is unlike the lining of the lungs, adding that those linings have different sensitivities and thus will react to things in the environment in other ways.

The second difference, according to McVea, is the size and shape of asbestos fibres present in the air and in drinking water.

"The actual asbestos fibres that are in drinking water are different from the ones that are in the air. When you inhale them, there are different sizes and different shapes, and those are key factors that lead to their carcinogenicity, or their ability to cause cancer when you inhale them," McVea stated.

When asked if Fort St. John and other municipalities using asbestos concrete pipes to deliver drinking water is cause for concern, McVea said no.

"Residents shouldn't worry about the health effects of asbestos in their drinking water. Both Health Canada, the World Health Organization and BC as well have reviewed the evidence and continue to do so over the years and haven't found any evidence that asbestos is linked to health impacts in people through drinking water," McVea stated.

"It is absolutely clear that asbestos is a cause of cancer when it's inhaled, but it's quite a different story when it is ingested through drinking water," he continued.

However, when we asked Frank the same question, he said the short answer is yes, but the risk that comes with drinking the water is lower than the risk of making the pipe, installing it, or removing it.

"The levels are probably low, and you’re talking about, in general, fairly common cancers, so sorting out a contributing cause would be difficult," Frank said.

However, just because the levels may be low doesn't mean that action shouldn't be taken to replace the pipes, Frank said, adding that the main idea behind preventative medicine is preventing disease, not waiting to prove without a doubt to everyone that there is a hazard.

He said by not acting to reduce resident's exposure, federal and provincial officials are perpetuating something Frank calls the "dead bodies in the street routine."

"Do you wait 20 or 30 or 40 years when you have all these dead bodies that you could have prevented to finally do something, or do you look at the growing scientific literature and say, you know these cancers—even if it's not a proven 100 per cent—have a great likelihood to be related to asbestos, maybe we ought to protect people now," Frank said.

After receiving a tip from a resident, Energeticcity Investigates decided to delve into the safety of asbestos concrete pipes for our most recent investigation.

After speaking with federal, provincial and local government officials as well as doctors, it became obvious that there is no clear answer as to the safety of these pipes, especially their delivery of drinking water.

While the City of Fort St. John is working to replace these pipes, there is not a huge sense of urgency because, like Health Canada and the BCCDC, it doesn't believe there is a risk of danger to residents stemming from the use of the pipes.

But some scientists, like Dr. Arthur Frank, believe that there is a risk stemming from asbestos ingestion and point to mounting evidence that asbestos ingestion may cause a variety of GI tract cancers.

Energeticcity Investigates believes that residents should be informed in order to make their own decisions, so while we didn't uncover a clear answer, we decided to share the information and perspectives we gathered during our investigation.

Health Canada said it regularly reviews new studies regarding the potential health risks from the ingestion of asbestos, adding that the next review is slated for 2023.

To read more of our investigative stories, click here.

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