Opinion | The asbestos crisis facing Diné veterans

By Jonathan Sharp

Editor’s note: Jonathan Sharp serves as chief financial officer of the Environmental Litigation Group P.C., a Birmingham, Alabama–based law firm that represents victims of toxic exposure and their families in pursuing justice and rightful compensation.

The Navajo people faced several external threats during their long and honorable history with the U.S. Armed Forces, but one of the greatest dangers they faced and continue to face lies a lot closer to home. Military bases, ships, aircraft, and protective gear were filled with asbestos, ultimately causing them to suffer several major health conditions.

Risks associated with asbestos have gone down in recent years following the introduction of stricter laws. However, the toxic substance remains responsible for too many deaths among Navajos. In Arizona and New Mexico, where many Navajo people reside, there were 5,157 and 1,447 deaths from 1999 to 2017 due to asbestos. From these figures, mesothelioma claimed the lives of 970 people in Arizona and 274 in New Mexico during the same period.

Mesothelioma is a rare cancer that is primarily caused by asbestos exposure. Patients typically suffer a poor prognosis because the disease is prone to late detection and frequent misdiagnosis. Since the military extensively used asbestos until the 1970s, veterans are particularly vulnerable. Out of the 3,000 new cases of mesothelioma each year, approximately 30% are military personnel. This is alarming for the Diné community because Native Americans are the largest ethnic group who enlist for service.

Pleural mesothelioma, the most common type of mesothelioma, is challenging to diagnose because some of its symptoms overlap with those of other respiratory conditions. Adding to the complexity is its decades-long latency period, which is around 20 to 60 years. Given its rarity, clinicians rarely consider mesothelioma as the primary cause of disease.

As a result, more than 80% of stage 1 mesothelioma cases were eventually pronounced more advanced. Inaccuracy occurs across the illness’s different stages. Over 69% of stage 2 diagnoses, 35.4% of stage 3 diagnoses, and 12.8% of stage 4 diagnoses were later declared less severe. Misdiagnosis often leads to late treatment and early death. A Florida-based cancer center shared that only 12% of patients survive for five years, while a mere 5% live until the 10th year.

Low survival rates make the disease more difficult to study and medical breakthroughs harder to achieve. Mesothelioma cases generally take two to three years before reaching national statistics. After the initial diagnosis, the case could take up to six months before it’s disclosed to a cancer registry. It then takes another one to two years before the information reaches U.S. Cancer Statistics.

With a 50% mortality rate within the first year of diagnosis, researchers are hard-pressed to find living patients whose health information they can use. A national mesothelioma registry could make a significant difference by providing scientists with faster and more updated patient information. Instead of contending with lengthy delays and the limited information in census data, they would be able to more thoroughly examine vital epidemiological characteristics like risk factors, long-term issues, incidence, prevalence, and demographics.

More importantly, they could develop superior diagnostic techniques and therapeutic approaches that improve early detection, diagnostic accuracy, and life expectancy.

In addition, a nationwide mesothelioma registry for veterans offers a data-driven preventive approach to managing mesothelioma and mitigating its impact. Its centralized information would empower doctors to monitor patients and explore treatment options more closely. While there is no cure, patient outcomes can be better if those who are at risk can be identified and encouraged to attend regular health evaluations.

Several medical screenings mean more opportunities to correctly diagnose the disease and its progression, making a national mesothelioma registry immensely valuable. With this database, veterans who have or might have mesothelioma can be contacted, assessed, and treated as soon as cancer cells are detected. Affected veterans would also have greater access to clinical trials.

Improving outcomes through regular screenings

A national mesothelioma registry would greatly aid early detection and timely interventions, especially for over 140,000 veteran Native Americans who are still alive. Through the centralized database, at-risk veterans, including Navajo service members, would be advised to attend regular mesothelioma screenings, increasing the chances of receiving an accurate diagnosis. Spearheaded by the Department of Veterans Affairs (VA) and the Department of Defense (DoD), such a registry would proactively address mesothelioma and potential cases of mesothelioma. It would enhance patient outcomes while giving our service members the quality healthcare they deserve.

 

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