Patients exposed to asbestos come from across the country for this national expert's diagnoses
Detroit News, Sofia Kosmetatos
Published August 26, 2007
ROYAL OAK -- Richard Marshall, a former GM pipe fitter with asbestosis, quickly recounts the measures he has taken to keep from aggravating his scarred lungs.
He avoids sick people and smoky bars. He carries antibiotics when traveling overseas in case he develops pneumonia. And, every few months, he visits Dr. Michael Harbut.
The soft-spoken occupational and environmental medicine doctor, a native of Detroit, treats and diagnoses hundreds of patients with incurable asbestos-related diseases each year, including scores of former auto workers and those from other industries in Michigan.
As one of the nation's best-known asbestos doctors, Harbut has written the standards for diagnosing asbestosis -- a scarring of the lungs caused by asbestos exposure -- for the American Thoracic Society. And in partnership with Karmanos Cancer Institute, Harbut is helping to guide research to more swiftly diagnose deadly asbestos-caused cancers and track asbestos-related diseases in residents of homes with contaminated insulation.
"He offers hope," said Linda Reinstein, executive director and co-founder of the Asbestos Disease Awareness Organization, a nonprofit that represents asbestos victims and their families. She founded the organization in 2004, after her husband Alan was diagnosed with mesothelioma, a cancer in the lining of the lungs, heart or intestines.
"For patients that are diagnosed with incurable diseases," Reinstein said, "hope is a vital form of medicine."
No one knows for sure how many Americans have asbestos-related diseases, said Harbut, noting they are significantly underreported. That's partly because doctors often attribute lung problems to other causes, particularly smoking, Harbut said.
But according to Environmental Working Group, a Washington, D.C.-based nonprofit organization, 10,000 Americans die each year from asbestos-related diseases, a quarter of them from mesothelioma.
The nonprofit and Harbut say the numbers will only get worse, as many people who were exposed in the 1960s and 1970s are just now exhibiting symptoms or dying from related diseases. Asbestos diseases have a 20- to 50-year latency period, according to Environmental Working Group, and will likely cause 100,000 more Americans to die by 2015.
There is no cure for asbestos-related illness. Treatment for patients with non-malignant diseases, like asbestosis, usually involves managing symptoms to try to prevent further complications. A patient short of breath could be prescribed an inhaler, for example. For patients with cancer, the options might include chemotherapy or surgery.
Harbut's mission is to advance medicine and science that gives patients with asbestos-related diseases the longest and best quality of life.
Partnership with Karmanos
For patients with mesothelioma, a swiftly-moving cancer that is difficult to diagnose, every second counts. That's why, in partnership with Karmanos Cancer Institute, Harbut helped develop a blood test a few years ago to help screen for the disease.
"Even if you can give somebody a couple of months, with this blood test, it's an important gift," he said.
The partnership at Karmanos that Harbut co-directs, called the National Center for Vermiculite and Asbestos-Related Cancers, is at the forefront of asbestos-related research today. A $2 million federally funded project is studying the relationship of asbestos-related cancers and other diseases to homes containing asbestos-laden vermiculite insulation.
In the 1970s and 80s, tons of that insulation was processed by W.R. Grace and Co. plants in Dearborn and other parts of the state and used in some 800,000 Michigan homes, including an estimated 280,000 homes in Southeast Michigan. Harbut estimates it was used in some 20 million homes in the United States.
Patients praise treatment
At the Center for Occupational and Environmental Medicine, his modest practice tucked in a storefront near Royal Oak's downtown, Harbut cares for patients from around the country and the state.
Last summer and earlier this year, workers who maintained utility tunnels on Capitol Hill traveled to Michigan to be examined by him, after learning that they had been misled by their employer about the extent of their exposure to asbestos in the workplace.
Irene Karkoski, a former autoworker from Redford with asbestosis, is one of scores of patients who rave about Harbut's bedside manner. He never hurries through visits, rarely keeps patients waiting, and is incredibly thorough. First-time patients are told to plan on a three- to four-hour visit.
Karkoski, 80, sips air through thin plastic tubes attached to a portable oxygen tank about the size of a two-liter bottle of soda. It's one of the treatments Dr. Harbut has prescribed to help her breathe -- and Karkoski welcomes every measure that keeps her in good health.
"I haven't been in the hospital for over two years," she said.
You can reach Sofia Kosmetatos at (313) 222-2401 or
skosmetatos@detnews.com.
