Joe Amento, a lifelong resident of Ambler, Pennsylvania, was 53 when he died of a rare cancer with one main cause — exposure to asbestos.
He was fine at Christmas 2002. In January, a pain in his side kept him awake at night. He was found to have the disease in March. Before August, he was gone.
He left a wife, two children, and a community that to this day wrestles with the uncertain legacy of the huge asbestos factories that once brought the town jobs and prosperity, then sickness and death.
Amento never worked in the factories. He simply lived nearby. But his father, like many, found a job there as a young Italian immigrant.
Although the last factory closed decades ago, the piles of asbestos waste have remained in what are now two Superfund sites.
Even as the U.S. Environmental Protection Agency monitors the completed cleanup at one site, and heavy machinery growls as it progresses at the second, many in the community remain edgy.
Mesothelioma has a 40-year latency period — the time between exposure and sickness. So people who have lived or worked just blocks away wonder: “Am I going to get sick?”
The University of Pennsylvania’s Center of Excellence in Environmental Toxicology has received a $10 million federal grant to seek answers.
Over four years, researchers from genetics to chemistry will study how people are exposed. They will investigate why some get mesothelioma and others don’t. Is there a genetic component?
Ultimately, is there a way to test individuals before symptoms even arise? Can it be prevented?
“If we answer those questions, it will have a significant impact on human health, generalizable to everyone who is exposed to asbestos,” said pharmacologist Ian Blair, director of Penn’s new Superfund center.
This is the first research program that tackles the problem of asbestos with an interdisciplinary team, “and the synergy there will solve some sticky problems,” said William Suk, director of the Superfund research program within the National Institute of Environmental Health Sciences, which awarded the grant.
“There are some significant public health concerns,” he said. “If it wasn’t as complex as it is, it would already be done.”
When the first of Ambler’s factories began making asbestos insulation in 1897, little was known — or later acknowledged — about the harm the tiny fibers could do to the human lungs.
As time passed, the piles of asbestos-containing waste outside the plants grew so high that people dubbed them the white mountains of Ambler. One topped out at 92 feet.
Even in summer, children sledded down the hills on flattened cardboard boxes. The area was a magnet for kids with bikes. Joe Amento was among them, said his brother, Pete.
The two sites total about 55 acres, a big chunk of land in the small, quaint town of Ambler, which was built around the factories as workers moved in.
A municipal park was once built atop the second site. It later was closed.
Even today, playgrounds, backyards, and businesses are less than a block away. That big hill behind the McDonald’s on West Butler Pike near the train station? It’s a dirt-encased pile that contains asbestos.
It seemed every family knew someone who had a lung disease. Joe Amento’s father died of asbestosis. His mother died of COPD, chronic obstructive pulmonary disease.
In a recent analysis covering 1992 to 2008, health officials found that the Ambler zip code had 28 cases of mesothelioma rather than the expected nine for a population of its size — about 30,000.
Presumably, there would have been even more when the factories were operating, said Lora Siegmann Werner, a representative of the federal Agency for Toxic Substances and Disease Registry.
And that was only the cancer data. Officials would expect a larger number of less severe cases of asbestosis or COPD.
The data also would not have captured people who lived in Ambler but moved away and died in a different zip code.
So one of the Penn projects will involve poring over census and real estate records and interviewing current residents to track down their former neighbors.
“This has never really been properly done for a community,” said Edward Emmett, an occupational and environmental medicine specialist at Penn. “We’re getting to the edge of memories, but we think we can capture it.”
Another surprising trend arose from the data: The rate of mesothelioma in Ambler was greater for women than for men.
Presumably, men in the factories would have had higher occupational exposure. Women would have been exposed to a lesser degree by, say, asbestos dust brought home on their husbands’ clothes.
And what of those who merely lived nearby?
To get answers, researchers need to know who was exposed. So Blair will look for a molecular needle in a haystack — an exposure biomarker.
New instruments allow them to examine the serum of people they know were exposed — one batch is from Philadelphia dockworkers — seeking subtle differences among complicated molecules. “That’s a challenge,” he said. “How can you tell from this morass of data what is different and why?”
Next, are there substances that might prevent mesothelioma? The team will use mice to test antioxidants and other compounds.
Further, can they develop a blood test for mesothelioma so people could seek early treatment?
Ultimately, Blair said, “we see this as a prototype” that would be applicable to other cancers.
Another distinction of the project is that it begins not with researchers’ questions but the public’s questions, which Emmett conceded could have more value “in the real world.”
A community advisory group the EPA formed in 2007 has no shortage of questions.
Its co-chair Bob Adams said that its roughly two dozen members have “every range of opinions you can imagine.” Meetings “can get pretty hot,” he said. “That’s good. That’s the democratic process.”
But he says most feel “really positive” about the Penn project. “A lot of the questions they are looking at are things we have been asking for years.”
Air tests show no elevated levels of asbestos now.
Even so, community members worry about past exposure. “The latency period ought to be kicking in,” Adams said.
As director of stewardship with the Wissahickon Valley Watershed Association, Adams has worked across the Wissahickon Creek from the site for 16 years. “There’s asbestos washing off that site, down the creek. . . . If they can find a marker for that disease, I’d be willing to be part of that study.”
Even as the cleanup progresses, the researchers hope to answer one final question: Will the work be protective enough for the people of Ambler?
So far, entombment has been the basic plan. “Our whole approach to these piles is to cover and contain, so asbestos has no avenue to get into the water or air,” said Jim Feeney, the EPA’s remedial project manager for Ambler Asbestos Piles, as the first site is known.
The EPA will have to monitor the dirt-covered mounds indefinitely to ensure that fallen trees, groundhog holes, and other disturbances to the soil barrier have not exposed the asbestos underneath.
Likewise, excavation at the second site, BoRit, was ruled out as too dangerous and too costly. One calculation held that removing all the waste would require a truckload every 25 minutes for 10 years, Emmett said. And what about the safety concerns, the noise, the diesel emissions?
Not everyone is appeased. Borough council member Sharon McCormick, who got into politics because of her objection to what was happening at the sites, insists: “It’s not dangerous to remove it. It’s dangerous here. . . . EPA calls this a cleanup. It’s not. They’re throwing dirt on it.”
Pete Amento, also a borough council member, is OK with the plan. “If every 20 to 30 years they have to put more dirt on it and hide the piles, that’s what they should be doing.”
McCormick says more sites exist, although her barrage of photos, reports, and other materials has not convinced the EPA.
But the authorities have been wrong before. They initially disregarded the BoRit site, only to reconsider amid public outcry over a developer’s plans to level the hill, cap it, and build a 17-story condo.
McCormick calls Ambler’s asbestos legacy “the elephant in the room.” Some wish she would just be quiet. Others thank her for speaking up.
So far, the EPA has spent $26.8 million on the two sites. Although some costs have been recovered — the sites have gone through multiple owners and a bankruptcy — some in the community fault the EPA for not going after what are called “potentially responsible parties” more vigorously.
Ambler Asbestos, as the first site is called, is considered remediated and was removed from Superfund’s priority list in 1996.
The “emergency response” to BoRit is expected to be completed by next fall. No long-term remedy has been determined, the EPA said.
Helping formulate one will be another task of the Penn initiative, Blair said. Researchers will investigate whether asbestos is moving from the site and, if so, how does it move? Where does it go?
One of the projects that the NIEHS’s Suk finds tantalizing will explore whether a promising-looking fungus will be able to break down the asbestos and make it less toxic.
Meanwhile, the hill at Ambler Asbestos Piles has been planted with trees.
The hill at BoRit sports a froth of wildflowers.
At its base, a reservoir rumored to hold sunken trucks — it turned out to be only a few feet deep — was drained so the banks can be stabilized and covered. Refilled, it will be a waterfowl preserve.
Just outside the fence line of the Ambler site, one original building, its smokestack intact, has been rehabbed into environmentally certified offices.
But most of the property, Feeney said, presents “very limited options” for reuse. “Nothing can disturb the constructed remedy,” he said.
The more public use, the better, Adams said, although a playground likely would be ruled out.
“One of the things that really galls people” is that both sites are sitting on valuable real estate, he said. “The town gets no benefit. If we can get this safely cleaned up and made into a resource, that would be the best possible outcome.”
These days, Pete Amento emphasizes how safe the bustling community of Ambler is. “There is nothing to be afraid about,” he said. “Ambler is a sought-after community.”
His brother’s widow, Marilyn Amento, settled a lawsuit for an undisclosed sum and now works with the Asbestos Disease Awareness Organization, an advocacy nonprofit.
She wrestles with her opinions — and her emotions. “I don’t like talking about it too much,” she said of her husband’s death. “That doesn’t mean I don’t love him dearly. . . . He was such a good man.”
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