Jag satt efter mitt pass med 100 ungdomar på bussen (nummer 16) hem. Bussen var knökfull och när vi stannar till vid en hållplats stiger det på två äldre damer (läs tanter). Självklart RESER MAN SIG UPP FÖR DEM - eller? Jag gjorde iaf det men en kille på 16 år satt kvar på sin plats och lät den närmare 80-åriga damen (läs tanten) stå upp bredvid honom. FY FAN vad sånt gör mig ARG! Hur svårt är det att fatta att det inte är så lätt att stå upp på en knökfull buss när man e 80 bast och har dramaten full av mat. Skitsamma, men tänk på det i fortsättningen. Jag var SÅ nära att säga till honom, men det hade nog varit att krossa the line so to speak.
Basgruppsträff idag. Mycket trevligt, Bree och Gabriella klagade lite på att Susan (jag) hade väldigt stökigt hos mig, men va fan jag är ju en konstnärs själ oh drabbas ofta av smärre depressioner som leder till att det ser ut som 78:e världskriget här. Snart skall jag ju dock flytta så då kommer Richie att hålla koll på mig, shit vilken pedant-tant han e. Men jag har en fråga. Skulle Bree verkligen lämna en smörgåsskalk på bordet? Don't think so!!! Vi har bestämt vår redovsining till litteraturprojektet oxå. Mia skall vara en pappa som inte rakat sig på länga därför tar hon allt sitt hår och binder det runt hakan. Skulle rekommendera er att gå in på lindis blogg för mer info och bildbevis. Själv skall jag vara en skoputsande litenpojke vid namn Sesé...Linda e min bror, Totaco eller nått...Altt detta gör vi för att visa vår oerhörda skådespelartalang, eller för att slippa redovisa på ett seriöst sätt. Anna den goda - kommer att få läsa och vara berättare större delen hon står alltså för prettot i gruppen.
Imorgon blir det avfärd till LONDON!
Vi bor precis bakom The Eros fountain som ni ser på bilden (bilden är förövrigt tagen på picadilly om ni inte visste det)
Min babe Elin och hennes kille Martin kommer hit vid 12:30 - då blir det lunch och sen vid 13:45 kommer taxin i form av min pappa...
Puss och katekes - ut och res
16 kommentarer:
Problemas de deudas?
Usted no esta solo! Las personas se encuentran en deudas por muchas
razones; Por perdida del trabajo, deudas atrasadas, una prolongada
enfermedad u otra emergencia personal, ... todas estas son comunes
situaciones. Por cualquier razón las personas quienes están en una
dificultad financiera, frecuentemente necesitan de una guía
profesional
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Var är dagens empati till andra påväg, har ungdomar nu mera ingen vett. Det är sorgligt, vart e världen påväg.
Anna är pretto endast för att Anna saknar all talang för teater och hatar att skådespela! Tur vi har dig! Ha det nu så underbart i London om vi inte ses imorgon, jag kommer att vara sjukt avundsjuk när jag jobbar hela helgen!! :)
Ja nu är vi snart påväg! Bussen går om en halvtimma från vårt residens. Martin e seg som vanligt. Känner att energin har runnit ur mig för ögonblicket. Har tjatat hela morgonen på att han ska få röven ur.
Puss och kram amalgam
Oh good post! Picadilly Circus, i remember this place,
Greetings from Barcelona
Asså jag tänkte ju skriva något om inlägget... men seriöst. Vilka sjuka och konstiga kommentarer. Haha... puzz
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CaliforniaLoanRate.com
Things To Know And FAQ's About Loan Modification
These are common questions that are asked about Loan Modifications or Mortgage Modification
1. What Is A Loan Modification?
A Loan Modification is a negotiation between a lender and a borrower that results in the terms of the existing loan being restructured without refinancing. The rate and terms of your loan are restructured to fit your current financial situation.
2. How do you do It?
In these market conditions, the banks and lenders have been mandated by the Federal government to do everything they can to work out a payment plan with their borrowers. This is great for today's borrowers, especially for those who are running late on their payments or are having trouble making them on time. The banks and lenders would rather take less money and keep you in your home making a payment that you can afford, rather than go through the expense foreclosing on the home, hiring a listing agent, rehabilitating a home, and letting it sit empty on the market for months, only to lose thousands in the process. We currently work with almost every major lender and several small lenders and banks to secure a Loan Modification to help them help you. In many cases we actually have taught smaller banks and lenders how to go about completing a Loan Modification. Within 24 hours after receiving your package, our legal team will contact your lender to notify them that they will be negotiating a Loan Modification on your behalf. From then on, they will be working with you and your lender in order to find a solution to your mortgage problems.
3. Are lenders and banks really willing to negotiate?
Definitely! Lenders do not want to foreclose on your home, unless they have no other alternative. If you can present them with a realistic professional proposal that makes sense, they are very open and receptive to the Loan Modification process.
4. Who qualifies for a Loan Modification?
Anyone who can prove they are having a tough time. Especially those who are currently a few months behind, those with negative amortizing loans, those with loans that are about to adjust, those who are upside down on their loan and those who would rather keep their home than do a short sale.
Basically, the bigger the hardship you are having, the more negotiating power you have with your lender. Remember, they don't want to foreclose on you. They would rather keep you in your home and create a solution that will be affordable to you rather than go through the cost and expense of foreclosing on your property.
5. Why didn't my mortgage lender tell me about this?
Your mortgage lender is in the business of originating and/or servicing loans. Modification of existing loans and foreclosures are simply a result of being in the business they are in and, as such, they aren't a priority for the mortgage lender.
This program is not that costly and quite frankly, they are so busy dealing with other homeowners who are already going through tough times, that they don't have time to deal with your situation.
6. Why should I choose a Loan Modification?
If you are having trouble and behind on your payments you have several different options to fix your problem.
Reinstatement Plan - Where your lender will reinstate the original terms of your loan once you are caught up.
Repayment Plan - Where your lender will tack on an extra amount onto each payment for a set period of time.
Loan Modification - Where you negotiate a restructure of your current loan terms without
refinancing.
Loan Refinance - Refinancing may be an option if you have the equity and credit required.
Forbearance Agreement - Where your lender negotiates a repayment plan and may force you to list your home for sale.
Short Sale - You sell your property for less than you owe but your lender accepts it as payment in full.
Pre-Foreclosure Sale - You agree to sell your property before foreclosure takes place.
(requires equity).
Deed-in-Lieu of Foreclosure - You agree to sign your property back over to your bank and walk away.
Bankruptcy - You have to file bankruptcy to protect yourself, but if you miss one payment you will be right back in foreclosure.
A Loan Modification is a good solution if you cannot refinance, are behind on your payment or struggling to make your payments, have experienced a genuine hardship, and you want to stay in your home.
A Loan Modification is a permanent solution to your situation and is not meant to be used as a temporary stop to the foreclosure process.
7. Can I negotiate a Loan Modification myself?
In short, yes you can. You can contact your lender or your bank and see about going through the process of Loan Modification.
But, keep in mind that your bank has their best interest at heart. They neither have the time nor the inclination to hear about what troubles you might be experiencing. What usually occurs is that the bank will negotiate an agreement that helps them, but still leaves you with only a temporary solution.
This also takes many hours of communication and back and forth information exchanges in order to accomplish. It is not easy to complete on your own and the outcome may not be favorable to you. When you contact the bank, they will ask for a "hardship letter" from you. When they receive that letter, they will usually tell you that they will get back to you in about 8 weeks. By the time you get back with them, or if you are lucky enough to get a call from them, you're already in worse shape than when you first started negotiation.
8. How Come You Have More Success?
Our attorneys have been doing hundreds of Loan Modifications every month, working with virtually every bank and lender. They have open lines of communication with most lenders, which gives them the ability to negotiate directly with the person who is in charge of making a decision on your loan.
We also create a professional legal file on your behalf which includes all of your financial data such as income, assets, expenses, and unexpected intangible expenses. They couple this with a full property analysis and package this together in a file that makes it easy for the lender to read and understand, allowing for a more comprehensive and quicker response than you would get through other forms of negotiation.
9. How much does it cost?
The costs associated with an attorney based Loan Modification will vary depending on the value of your property, the type of loan, the lender, and the number of loans held against our property.
The modification cost usually comes close to equaling the same as about one month's mortgage payment. Since every Loan Modification is different, it requires a varied amount of negotiation. After your initial application is reviewed and if the attorneys accept your case, your Loan Modification representative can help determine what the exact cost of your Loan Modification will be.
Our primary goal is helping homeowners who want to keep their homes, find a beneficial solution for their situation. We will work with you to ensure that we can obtain an affordable solution for your Loan Modification needs.
10. What do you need from me to get started?
If our attorneys believe they can help you and accept your case, then we will need to submit a complete Loan Modification file that outlines your current financial situation.
They will contact you directly if other paperwork is required by the lender in order to negotiate a successful Loan Modification. They will also determine the current value of your property and put together a professional proposal for your lender.
11. What makes you different from other companies?
We are not a store front Loan Modification company, but a service provider helping you find the right legal representation needed to negotiate on your behalf. Loss mitigation departments at major banks and lenders give much more credence to modification proposals submitted by attorneys. Maybe it is fear of a lawsuit if they do not negotiate in good faith, but banks and lenders are much more responsive to attorneys than they would be with the actual homeowner or other third party negotiator.
12. Will I have to meet with my lender or deal with any of their paperwork?
Absolutely not. We take care of all the paperwork and all of the negotiating on your behalf.
13. How long does the process usually take?
It can be completed in as little as five days but usually takes from 5 - 12 weeks depending on the lender, type of loan, and individual situation.
14. What paperwork do I need to complete the process?
We provide you with a complete list of the documents the attorney will need in the file to complete the process and will help prepare the file. Of course, no legal representation can begin until counsel has been properly retained and you have given written authorization to proceed.
After we receive these items from you, we can begin your Loan Modification process.
Please contact us with any other questions or concerns. Remember that time is not on your side, so if you are having problems or struggling to keep up with rising mortgage payments, don't delay and call us immediately for a free and confidential consultation.
We want to help you keep your home, period.
15. By utilizing the Loan Modification option to bring an asset current, can the mortgagee include all fees and corporate advances?
Mortgagee Letter 00-05, page 21, paragraph F, "Allowable Provisions" states: "All or a portion of the PITI arrearage (principle, interest, Taxes and Insurance) may be capitalized to the mortgage balance. Foreclosure costs, late fees and other administrative expenses may not be capitalized.
16. Does the repayment plan have to be completed prior to completing the Loan Modification documents, or can the mortgagee attach the plan once the option has been completed?
It is a mortgagee decision as to when to complete the repayment plan for outstanding fees, costs and administrative expenses.
17. When utilizing a Loan Modification option, can a mortgagee capitalize an escrow advance for Homeowner's Association fees?
HUD Handbook 4330.1 REV-5, Paragraph 2-1, Section B, Escrow Obligations states:
Mortgagees must also escrow funds for those items which, if not paid, would create liens on the property positioned ahead of the FHA-insured mortgage.
18. Will HUD subordinate a Partial Claim, should a mortgagor subsequently default and qualify for a Loan Modification?
If a mortgagor subsequently defaults and qualifies for a Loan Modification, HUD will
subordinate the Partial Claim.
19. When an asset is modified is the homeowner eligible for the upfront premium refund at payoff of the loan?
It depends upon when the closing date occurred. For assets closed: After July 1, 1991 but before January 1, 2001, the 7-year unearned premium refund schedule shown in Mortgagee Letter 1994-1 remains in effect. On or after January 1, 2001 that are subsequently refinanced, the 5-year refund schedule shown in the attachment of Mortgagee Letter 2000-46 applies. On or after December 8, 2004, refunds of upfront MIP are eliminated except, when the mortgagor refinances to another FHA insured mortgage. The refund schedule attached to Mortgagee Letter 2005-03 has been modified to a 3-year period.
20. Can a mortgagee qualify an asset for the Loan Modification option when the mortgagor is unemployed, the spouse is employed, but the spouse name is not on the mortgage?
The mortgagee should consult with their legal counsel to determine the legality and validity of such a mortgage instrument.
21. I'm unemployed. My spouse does have a job, but her name isn't on the mortgage. Can I qualify for a Loan Modification?
This isn't a simple question that can be answered "yes" or "no". What typically happens in situations like this is that the mortgagee - your lender - will conduct a financial review of your household income and expenses to determine if the spouse's income is sufficient to meet the new modified mortgage payment, but insufficient to pay back the arrears. Once this process has been completed your lender will then get together with their legal counsel to determine if you're eligible for a Loan Modification, since the spouse is not on the original mortgage.
22. Are there any guarantees on the outcome of my Loan Modification?
It would be impossible for us to guarantee that some other entity (the lender) will do what we suggest that they do. We can say we have a VERY high success rate in obtaining
modifications for our past clients. If no modification is achieved, then you get some or all of your retainer back.
23. How does Loan Modification affect my credit?
If we are successful in obtaining a modification for you, the loan will, from that point forward, be reported as being paid as agreed. Assuming you make all of your payments on time, you may see your credit begin to get better over time. Obtaining a Loan Modification is the least damaging to your credit when compared with a short sale or a foreclosure.
24. Will having a Loan Modification affect my taxes?
We are not CPA's or enrolled agents and therefore can't offer you tax advice. We suggest
you check with your tax professional.
25. Do I have to be behind on my mortgage to qualify?
No. Although falling behind on your mortgage payments is an obvious indicator of financial hardship. Some clients are forced use reserves or credit cards to keep there mortgage payments current. In this situation it is only a matter of time before they fall behind. If an obvious fanatical hardship exists a modification may be possible although the payments are current.
26. Do I have to owe more than my house is worth to qualify?
No. The basic formula is to have less than 20% equity in your home. The less equity you have in your home, the more the investor stands to lose in a foreclosure situation. If you
have negative equity, that is even more incentive for your lender to work with us.
27. Can I have my 1st and 2nd mortgage combined?
Yes. In some cases where the first and seconded mortgage are with the same investor that investor may elect to combine both mortgages into one. Keep in mind if the investors are
different a combined mortgage outcome is VERY unlikely.
28. I'm about to or already filed for bankruptcy, is it too late?
No. If you are currently in bankruptcy and your property is not included in your bankruptcy and you meet all other qualifications you are eligible immediately. If your property is included in your bankruptcy you may be able to ask your bankruptcy attorney to remove it from the bankruptcy. Keep in mind your bankruptcy attorney may charge an additional fee for service to pull the property out of your bankruptcy.
29. I already have a sale date for my home, can I still save my home?
Yes. Traditionally we need a minimum of ten days prior to the sale date to be able to achieve a postponement of the sale. In some cases we are able to postpone the sale as late
as the day before.
http://Californialoanrate.com
CaliforniaLoanRate.com with a Straight Modification, typically the best option for our clients and is our primary. Contact us today to get pre-qualified for a There is no company better qualified to provide assistance in getting a loan modification, we worked as negotiators for mortgage companies, we know the business. A loan modification is a change in your mortgage agreement that could lower the interest rate, lower the principal balance, and/or extend the term of the loan resulting in lower payments. There is typically a fee for a loan modification called a contribution that lenders require to modify a loan. We will explain the process for you to make you an informed homeowner...
The information and disclosures relate to advertised terms made by or through CaliforniaLoanRate.com
Interest rates and terms are from a lender or lenders with whom CaliforniaLoanRate.com may match you and that offer the particular product. The disclosures are current as of the date indicated.
CaliforniaLoanRate.com is not a lender in any transaction. All credit decisions, including loan approval and the conditional rates and terms you are offered, are the responsibility of the participating lenders and will vary based upon your loan request and determined by the lenders to whom you are matched. Not all consumers will qualify for the advertised rates and terms.
You may not be matched with the lender making a particular conditional loan offer, and CaliforniaLoanrate.com does not guarantee that any lender will make you a conditional loan offer. CaliforniaLoanRate.com arranges for multiple conditional loan offers either through its network of non affiliated lenders or though its affiliate.
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Asbestos is made up of microscopic fibers that may become airborne
when asbestos containing materials and products are damaged or
disturbed.
Most asbestos fibers are invisible to the unaided human eye because
their size. When asbestos fibers get into the air they may be inhaled
into the lungs or swallowed into he digestive system where they can
cause significant health problems. The word "asbestos" is derived from
a Greek adjective meaning inextinguishable.
There are three most commonly used types of asbestos: white, brown,
and blue. Brown and blue asbestos are most commonly associated with
mesothelioma.
Six minerals are defined as "asbestos" including: chrysotile, amosite,
crocidolite, tremolite, anthophyllite and actinolite.
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fire proof cloth for use in power plants or petroleum refineries.
Asbestos also has excellent insulation and noise deadening qualities.
Asbestos was used in many construction products, including floor and
ceiling tiles and wall board. Any home built before 1978 probably
contains asbestos somewhere.
New Asbestos Cases
It has been well documented for many years that asbestos exposure can
result in the development of deadly cancers, particularly
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Mesothelioma has a latency period of 20 to 50 years after the first
exposure to asbestos. It is estimated that there will be about 250,000
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During the 20th century, some 30 million tons of asbestos were used in
industrial sites, homes, schools, shipyards and commercial buildings
in the U. S.
Through 2003, more than 700,000 People have filed claims against more
than 6,000 Asbestos companies. These same companies knew of the
dangers for many years before ever warning the public of those risks.
It is thought that around eight million people in the United States
have been exposed to asbestos over the past half a century, and many
more cases - are expected to be reported in the next 25 years.
The National Institute of Health in 1978 estimated that eight to
eleven million U.S. workers had been exposed to asbestos by that date.
In fact, by 1970, it is estimated that some 25 million tons of
asbestos were used in the U.S.
Asbestos And Mesothelioma
Mesothelioma is a rare form of cancer that is caused by exposure to
asbestos. Mesothelioma cancer comes from inhaling or digesting
asbestos dust particles. Mesothelioma is a life-threatening disease
and should not be left untreated. Most cases of mesothelioma begin in
the pleura or peritoneum.
Mesothelioma cancer occurs in the thin layer of tissue that covers
your internal organs (mesothelium). The mesothelium is a membrane that
covers and protects most of the internal organs of the body. It is
composed of two layers of cells: One layer immediately surrounds the
organ; the other forms a sac around it.
The mesothelium produces a lubricating fluid that is released between
these layers, allowing moving organs (such as the beating heart and
the expanding and contracting lungs) to glide easily against adjacent
structures.
Mesothelioma is most common in the pleura (outer lining of the lungs
and chest cavity), but it may also occur in the peritoneum (the lining
of the abdominal cavity) or the pericardium (a sac that surrounds the
heart).
Most people who develop mesothelioma have worked on jobs where they
inhaled asbestos particles, or they have been exposed to asbestos dust
and fibre in other ways, such as by washing the clothes of a family
member who worked with asbestos.
There are funds available for asbestos victims.
Asbestos Exposure
Millions of Americans and people all over the world have been poisoned
by toxic levels of asbestos, putting them at risk for mesothelioma,
asbestosis, lung cancer, and other deadly diseases that are directly
caused by the inhalation of asbestos fibers.
Before the grave dangers of asbestos were known, and even for years
after the dangers were known, asbestos was used in literally thousands
of products that humans and animals encounter every day — particularly
in building components such as ceiling and floor tiles, walls, bricks
and stucco, and in automotive parts such as brakes and clutches.
People who worked in the asbestos industry or in fields in which
asbestos is used as a component of a product are most at risk for
mesothelioma.
Many individuals who have mesothelioma labored for years or even
decades in jobs that required frequent contact with asbestos. When
this mineral is mined, processed, woven, sprayed or otherwise
manipulated, its microscopic fibers can be released into the air,
where they may be inhaled, initiating the development of mesothelioma.
Asbestos exposure occurs when the asbestos that is in the products
becomes damaged. Once damaged, the asbestos fibers are released into
the air. The fibers are microscopic, smaller even than a grain of
pollen, and invisible to the naked eye. The asbestos fibers, if
inhaled or ingested, can become lodged into the body where it can
create severe medical problems.
Approximately 100,000 people in the United States have died, or will
die, from asbestos exposure related to ship building.
There were approximately 4.3 million shipyard workers in the United
States during WWII; for every thousand workers about 14 died of
mesothelioma and an unknown number died from asbestosis.
Occupations that have high rates of asbestos exposure include ship
builders, oil refinery workers, steel workers, power plant workers,
Navy shipyards, pipe fitters, auto workers, railroad workers and
construction workers.
Asbestos Symptoms
Asbestos symptoms include shortness of breath due to pleural effusion
(fluid between the lung and the chest wall) or chest wall pain, and
general symptoms such as weight loss.
Asbestos Signs and Symptoms:
abdominal pain
bowel function problems
chest wall pain
weight loss
pleural effusion, or fluid surrounding the lung
shortness of breath
fatigue or anemia
wheezing, hoarseness, or cough
blood in the sputum (fluid) coughed up (hemoptysis)
Asbestos Signs and Symptoms in Severe Cases:
blood clots in the veins, which may cause thrombophlebitis
disseminated intravascular coagulation, a disorder causing severe
bleeding in many body organs
jaundice, or yellowing of the eyes and skin
low blood sugar level
pleural effusion
pulmonary emboli, or blood clots in the arteries of the lungs
severe ascites
Asbestos and Asbestosis
Asbestosis is a scarring of lung tissue caused by the inhalation of
asbestos fibers. A portion of the fibers reach the alveoli (air sacs)
where oxygen is transferred into the blood. Asbestos activates the
lung's immune system and starts a reaction best described as an
inflammatory process.
Scavenger white blood cells (macrophages) try to break down the
asbestos (phagocytosis) but are not successful, causing other cells
(fibroblasts) to grow and form connective-tissue-based scars.
The formation of scar tissue or collagen in the lungs is known as
fibrosis. The scar tissue slowly builds up, often reducing the lung's
ability to deliver oxygen to the blood and remove carbon dioxide
(reduced diffusion capacity). The total lung capacity or TLC may also
be reduced. In severe cases, the impairment of lung function can
strain the heart, or even result in heart disease, such as right-sided
heart failure or "cor pulmonale."
The inflammatory process starts within hours or days after inhalation
of asbestos and injury at the cellular level begins shortly
thereafter. In people who develop asbestosis, the inflammatory process
continues to progress, fueled by indestructible asbestos fibers, even
after exposure to asbestos ceases.
This asbestosis inflammatory process may continue undetected for
decades causing no pain or respiratory symptoms. In many people, the
process eventually produces symptoms-breathing abnormalities and
radiographic changes. Usually, the first symptoms are shortness of
breath and a dry cough. These symptoms often precede abnormalities on
chest x-ray or pulmonary function tests. The period between exposure
and diagnosis is called "latency" and may range from 10 to 50 years.
Asbestosis is a chronic inflammation of the lungs. The inflammation is
a direct result of exposure to asbestos. Asbestosis is a progressive
disease with no cure. The inflammation causes shortness of breath,
which will get progressively worse as the disease progresses.
Physicians can treat some of the symptoms of asbestosis with auxiliary
oxygen, but it will not cure the disease. Death due to asbestosis
occurs by respiratory failure.
Asbestos and Smoking
Unlike lung cancer, there is no association between mesothelioma and
asbestos cancer and smoking.
Smoking does not appear to increase the risk of mesothelioma and
asbestos. However, the combination of smoking and asbestos exposure
significantly increases a person’s risk of developing cancer of the
lungs.
The Kent brand of cigarettes used asbestos in its filters for the
first few years of production in the 1950s and some cases of
mesothelioma and asbestos have resulted. Smoking modern cigarettes
does not appear to increase the risk of mesothelioma and asbestos.
The combination of smoking and asbestos exposure significantly
increases a person's risk of developing cancer of the airways (lung
cancer, bronchial carcinoma).
If you do smoke, stop. In addition to mesothelioma and asbestosis,
there is research that indicates that those who suffer from asbestos
exposure and smoke are at a greatly increased risk of developing
mesothelioma and asbestos lung cancer.
Asbestos Historical Usage
The name Asbestos was given to this mineral by the Ancient Greeks. The
word “Asbestos” literally means inextinguishable.
The Greeks termed asbestos the "miracle mineral" because of its soft
and pliant properties, as well as its ability to withstand heat.
The Greek geographer Strabo and the Roman naturalist Pliny the Elder
noted that the material damaged lungs of slaves who wove it into
cloth.
Asbestos became increasingly popular among manufacturers and builders
in the late 19th century due to its resistance to heat, electricity
and chemical damage, its ability to absorb sound.
By the mid 20th century asbestos use included fire retardant coatings,
concrete, bricks, pipes and fireplace cement, heat, fire, and acid
resistant gaskets, pipe insulation, ceiling insulation, fireproof
drywall, flooring, roofing, lawn furniture, and drywall joint
compound.
Asbestos has been mined and used commercially since the late 1800s. It
was used widely used during World War II.
Asbestos Facts:
By 1970, it is estimated that some 25 million tons of asbestos were
used in the U.S.
A history of asbestos exposure in the workplace is reported in about
80 percent of all mesothelioma cases.
Eight million people in the United States have been exposed to
asbestos over the past half a century.
Studies estimate that approximately 3,000 different types of
commercial products include asbestos.
The National Institute of Health in 1978 estimated that eight to
eleven million U.S. workers had been exposed to asbestos by that date.
Through 2003, more than 700,000 People had filed claims against more
than 6,000 Asbestos companies.
Many building materials used in both public and domestic premises
prior to the banning of asbestos may still contain asbestos.
The U.S. Occupational Safety and Health Administration (OSHA) set
limits for acceptable levels of asbestos exposure in the workplace.
In 2005, 2.2 million tons of asbestos were mined worldwide. Russia was
the largest producer with about 40% world share followed by China and
Kazakhstan.
The first documented death related to asbestos was in 1906. In the
early 1900s researchers began to notice a large number of early deaths
and lung problems in asbestos mining towns.
The term Mesothelioma was not used in medical literature until 1931,
and was not associated with asbestos until sometime in the 1940s.
Asbestos exposure becomes a health concern when high concentrations of
asbestos fibers are inhaled over a long time period.
Asbestos was used in the first 40 floors of the World Trade Center
towers causing an airborne contamination among lower Manhattan after
the towers collapsed in the attacks on September 11th, 2001
Inhaled asbestos fibers remain in the body and cannot be expelled.
Because of this, the fibers can easily penetrate body tissues and may
deposit themselves in airways and in the lung tissue.
It is estimated that 27.5 million Americans were exposed to asbestos
between 1940 and 1979.
Mesothelioma has a latency period of 20 to 50 years after the first
exposure to asbestos.
Many asbestos-containing products remain in buildings, ships,
industrial facilities and other environments where the fibers can
become airborne.
Mesothelioma from asbestos occurs more often in men than in women and
risk increases with age, but this disease can appear in either men or
women at any age.
Family members and others living with asbestos workers have an
increased risk of developing mesothelioma, and possibly other asbestos
related diseases.
If you are a grieving family member or executor of the will of a
person who has died from asbestos-related disease or mesothelioma, you
may be eligible to file a claim as well.
Asbestos
Mesothelioma is a form of
cancer that is almost always caused by previous exposure to Asbestos.
In this disease, malignant cells develop in the mesothelium, a
protective lining that covers most of the body's internal organs. Its
most common site is the pleura (outer lining of the lungs and internal
chest wall), but it may also occur in the peritoneum (the lining of
the abdominal cavity), the heart, the pericardium (a sac that
surrounds the heart) or tunica vaginalis.
Most people who develop Mesothelioma have worked on
jobs where they inhaled Asbestos particles, or they
have been exposed
to Asbestos dust and
fiber in other ways. Washing the clothes of a
family member who worked with asbestos can also put a person at risk
for developing mesothelioma. Unlike lung cancer, there is no
association between Mesothelioma and smoking.
Compensation via Asbestos
funds or lawsuits is an important issue in
mesothelioma (see Asbestos and the law).
The symptoms of Mesothelioma include
shortness of breath due to pleural effusion (fluid between the lung
and the chest wall) or chest wall pain, and general symptoms such as
weight loss. The diagnosis may be suspected with chest X-ray and CT
scan, and is confirmed with a biopsy (tissue sample) and microscopic
examination. A thoracoscopy (inserting a tube with a camera into the
chest) can be used to take biopsies. It allows the introduction of
substances such as talc to obliterate the pleural space (called
pleurodesis), which prevents more fluid from accumulating and pressing
on the lung. Despite treatment with chemotherapy, radiation therapy or
sometimes surgery, the disease carries a poor prognosis. Research
about screening tests for the early detection of mesothelioma is
ongoing.
Symptoms of Mesothelioma
may not appear until 20 to 50 years after exposure to Asbestos.
Shortness of breath, cough, and pain in the chest due to an
accumulation of fluid in the pleural space are often symptoms of
pleuralMesothelioma
Symptoms of peritoneal Mesothelioma include weight
loss and cachexia, abdominal swelling and pain due to ascites (a
buildup of fluid in the abdominal cavity). Other symptoms of
peritoneal Mesothelioma
may include bowel obstruction, blood clotting abnormalities, anemia,
and fever. If the cancer has spread beyond the mesothelium to other
parts of the body, symptoms may include pain, trouble swallowing, or
swelling of the neck or face.
These symptoms may be caused by Mesothelioma or by other,
less serious conditions.
Mesothelioma that affects
the pleura can cause these signs and symptoms:
chest wall pain
pleural effusion, or fluid surrounding the lung
shortness of breath
fatigue or anemia
wheezing, hoarseness, or cough
blood in the sputum (fluid) coughed up (hemoptysis)
In severe cases, the person may have many tumor masses. The individual
may develop a pneumothorax, or collapse of the lung. The disease may
metastasize, or spread, to other parts of the body.
Tumors that affect the abdominal cavity often do not cause symptoms
until they are at a late stage. Symptoms include:
abdominal pain
ascites, or an abnormal buildup of fluid in the abdomen
a mass in the abdomen
problems with bowel function
weight loss
In severe cases of the disease, the following signs and symptoms may be present:
blood clots in the veins, which may cause thrombophlebitis
disseminated intravascular coagulation, a disorder causing severe
bleeding in many body organs
jaundice, or yellowing of the eyes and skin
low blood sugar level
pleural effusion
pulmonary emboli, or blood clots in the arteries of the lungs
severe ascites
A Mesothelioma does not
usually spread to the bone, brain, or adrenal glands. Pleural tumors
are usually found only on one side of the lungs.
Diagnosing Mesothelioma
is often difficult, because the symptoms are similar to those of a
number of other conditions. Diagnosis begins with a review of the
patient's medical history. A history of exposure to Asbestos may
increase clinical suspicion for mesothelioma. A physical examination
is performed, followed by chest X-ray and often lung function tests.
The X-ray may reveal pleural thickening commonly seen after asbestos
exposure and increases suspicion of Mesothelioma A CT (or CAT)
scan or an MRI is usually performed. If a large amount of fluid is
present, abnormal cells may be detected by cytology if this fluid is
aspirated with a syringe. For pleural fluid this is done by a pleural
tap or chest drain, in ascites with an paracentesis or ascitic drain
and in a pericardial effusion with pericardiocentesis. While absence
of malignant cells on cytology does not completely exclude
mesothelioma, it makes it much more unlikely, especially if an
alternative diagnosis can be made (e.g. tuberculosis, heart failure).
If cytology is positive or a plaque is regarded as suspicious, a
biopsy is needed to confirm a diagnosis of Mesothelioma A doctor
removes a sample of tissue for examination under a microscope by a
pathologist. A biopsy may be done in different ways, depending on
where the abnormal area is located. If the cancer is in the chest, the
doctor may perform a thoracoscopy. In this procedure, the doctor makes
a small cut through the chest wall and puts a thin, lighted tube
called a thoracoscope into the chest between two ribs. Thoracoscopy
allows the doctor to look inside the chest and obtain tissue samples.
If the cancer is in the abdomen, the doctor may perform a laparoscopy.
To obtain tissue for examination, the doctor makes a small incision in
the abdomen and inserts a special instrument into the abdominal
cavity. If these procedures do not yield enough tissue, more extensive
diagnostic surgery may be necessary
The mesothelium consists of a single layer of flattened to cuboidal
cells forming the epithelial lining of the serous cavities of the body
including the peritoneal, pericardial and pleural cavities. Deposition
of asbestos fibres in the parenchyma of the lung may result in the
penetration of the visceral pleura from where the fibre can then be
carried to the pleural surface, thus leading to the development of
malignant mesothelial plaques. The processes leading to the
development of peritoneal Mesothelioma remain
unresolved, although it has been proposed that Asbestos fibres from
the lung are transported to the abdomen and associated organs via the
lymphatic system. Additionally, Asbestos fibres may be
deposited in
the gut after ingestion of sputum contaminated with Asbestos fibres.
Pleural contamination with Asbestos or other mineral
fibres has been
shown to cause cancer. Long thin asbestos fibers (blue Asbestos,
amphibole fibers) are more potent carcinogens than "feathery fibers"
(chrysotile or white asbestos fibers).[6] However, there is now
evidence that smaller particles may be more dangerous than the larger
fibers. They remain suspended in the air where they can be inhaled,
and may penetrate more easily and deeper into the lungs. "We probably
will find out a lot more about the health aspects of Asbestos from
[the World Trade Center attack], unfortunately," said Dr. Alan Fein,
chief of pulmonary and critical-care medicine at North Shore-Long
Island Jewish Health System. Dr. Fein has treated several patients for
"World Trade Center syndrome" or respiratory ailments from brief
exposures of only a day or two near the collapsed buildings.
Mesothelioma development
in rats has been demonstrated following intra-pleural inoculation of
phosphorylated chrysotile fibres. It has been suggested that in
humans, transport of fibres to the pleura is critical to the
pathogenesis of mesothelioma. This is supported by the observed
recruitment of significant numbers of macrophages and other cells of
the immune system to localised lesions of accumulated asbestos fibres
in the pleural and peritoneal cavities of rats. These lesions
continued to attract and accumulate macrophages as the disease
progressed, and cellular changes within the lesion culminated in a
morphologically malignant tumour.
Experimental evidence suggests that asbestos acts as a complete
carcinogen with the development of Mesothelioma occurring in
sequential stages of initiation and promotion. The molecular
mechanisms underlying the malignant transformation of normal
mesothelial cells by Asbestos fibres remain
unclear despite the
demonstration of its oncogenic capabilities. However, complete in
vitro transformation of normal human mesothelial cells to malignant
phenotype following exposure to asbestos fibres has not yet been
achieved. In general, asbestos fibres are thought to act through
direct physical interactions with the cells of the mesothelium in
conjunction with indirect effects following interaction with
inflammatory cells such as macrophages.
Analysis of the interactions between Asbestos fibres and DNA has
shown
that phagocytosed fibres are able to make contact with chromosomes,
often adhering to the chromatin fibres or becoming entangled within
the chromosome. This contact between the Asbestos fibre and the
chromosomes or structural proteins of the spindle apparatus can induce
complex abnormalities. The most common abnormality is monosomy of
chromosome 22. Other frequent abnormalities include structural
rearrangement of 1p, 3p, 9p and 6q chromosome arms.
Asbestos has also been shown to mediate the entry of foreign DNA into
target cells. Incorporation of this foreign DNA may lead to mutations
and oncogenesis by several possible mechanisms:
Inactivation of tumor suppressor genes
Activation of oncogenes
Activation of proto-oncogenes due to incorporation of foreign DNA
containing a promoter region
Activation of DNA repair enzymes, which may be prone to error
Activation of telomerase
Prevention of apoptosis
Asbestos fibers have been shown to alter the function and secretory
properties of macrophages, ultimately creating conditions which favour
the development of mesothelioma. Following asbestos phagocytosis,
macrophages generate increased amounts of hydroxyl radicals, which are
normal by-products of cellular anaerobic metabolism. However, these
free radicals are also known clastogenic and membrane-active agents
thought to promote Asbestos carcinogenicity.
These oxidants can
participate in the oncogenic process by directly and indirectly
interacting with DNA, modifying membrane-associated cellular events,
including oncogene activation and perturbation of cellular antioxidant
defences.
Asbestos also may possess
immunosuppressive properties. For example,
chrysotile fibres have been shown to depress the in vitro
proliferation of phytohemagglutinin-stimulated peripheral blood
lymphocytes, suppress natural killer cell lysis and significantly
reduce lymphokine-activated killer cell viability and recovery.
Furthermore, genetic alterations in asbestos-activated macrophages may
result in the release of potent mesothelial cell mitogens such as
platelet-derived growth factor (PDGF) and transforming growth factor
which in turn, may induce the chronic stimulation and proliferation of
mesothelial cells after injury by Asbestos fibres
Incidence
Although reported incidence rates have increased in the past 20 years,
mesothelioma is still a relatively rare cancer. The incidence rate is
approximately one per 1,000,000. The highest incidence is found in
Britain, Australia and Belgium: 30 per 1,000,000 per year.[7] For
comparison, populations with high levels of smoking can have a lung
cancer incidence of over 1,000 per 1,000,000. Incidence of malignant
Mesothelioma currently
ranges from about 7 to 40 per 1,000,000 in industrialized Western
nations, depending on the amount of asbestos exposure of the
populations during the past several decades.[8] It has been estimated
that incidence may have peaked at 15 per 1,000,000 in the United
States in 2004. Incidence is expected to continue increasing in other
parts of the world. Mesothelioma occurs more
often in men than in women and risk increases with age, but this
disease can appear in either men or women at any age. Approximately
one fifth to one third of all mesotheliomas are peritoneal.
Between 1940 and 1979, approximately 27.5 million people were
occupationally exposed to asbestos in the United States [4]. Between
1973 and 1984, there has been a threefold increase in the diagnosis of
pleural Mesothelioma in
Caucasian males. From 1980 to the late 1990s, the death rate from Mesothelioma in the USA
increased from 2,000 per year to 3,000, with men four times more
likely to acquire it than women. These rates may not be accurate,
since it is possible that many cases of Mesothelioma are
misdiagnosed as adenocarcinoma of the lung, which is difficult to
differentiate from mesothelioma.
Risk factors
Working with Asbestos is
the major risk factor for Mesothelioma A history of
Asbestos exposure exists
in almost all cases. However, Mesothelioma has been
reported in some individuals without any known exposure to asbestos.
In rare cases, Mesothelioma has also been
associated with irradiation, intrapleural thorium dioxide
(Thorotrast), and inhalation of other fibrous silicates, such as
erionite.
Asbestos is the name of a
group of minerals that occur naturally as
masses of strong, flexible fibers that can be separated into thin
threads and woven. Asbestos has been widely
used in many industrial
products, including cement, brake linings, roof shingles, flooring
products, textiles, and insulation. If tiny Asbestos particles float
in the air, especially during the manufacturing process, they may be
inhaled or swallowed, and can cause serious health problems. In
addition to Mesothelioma,
exposure to Asbestos
increases the risk of lung cancer, Asbestos (a
noncancerous, chronic lung ailment), and other cancers, such as those
of the larynx and kidney.
The combination of smoking and Asbestos exposure
significantly
increases a person's risk of developing cancer of the airways (lung
cancer, bronchial carcinoma). The Kent brand of cigarettes used
asbestos in its filters for the first few years of production in the
1950s and some cases of Mesothelioma have resulted.
Smoking modern cigarettes does not appear to increase the risk of
mesothelioma.
Some studies suggest that simian virus 40 (SV40) may act as a cofactor
in the development of Mesothelioma
Exposure
Asbestos was known in
antiquity, but it wasn't mined and widely used
commercially until the late 1800s. Its use greatly increased during
World War II. Since the early 1940s, millions of American workers have
been exposed to Asbestos
dust. Initially, the risks associated with
Asbestos exposure were
not publicly known. However, an increased risk
of developing Mesothelioma was later found
among shipyard workers, people who work in asbestos mines and mills,
producers of Asbestos
products, workers in the heating and
construction industries, and other tradespeople. Today, the U.S.
Occupational Safety and Health Administration (OSHA) sets limits for
acceptable levels of Asbestos exposure in the
workplace, and created
guidelines for engineering controls and respirators, protective
clothing, exposure monitoring, hygiene facilities and practices,
warning signs, labeling, recordkeeping, and medical exams. By
contrast, the British Government's Health and Safety Executive (HSE)
states formally that any threshold for Mesothelioma must be at a
very low level and it is widely agreed that if any such threshold does
exist at all, then it cannot currently be quantified. For practical
purposes, therefore, HSE does not assume that any such threshold
exists. People who work with asbestos wear personal protective
equipment to lower their risk of exposure. Recent findings have shown
that a mineral called erionite has been known to cause genetically
pre-dispositioned individuals to have malignant Mesothelioma rates much
higher than those not pre-dispositioned genetically. A study in
Cappadocia, Turkey has shown that 3 villiages in Turkey have death
rates of 51% attributed to erionite related mesothelioma.
Occupational
Exposure to Asbestos
fibres has been recognised as an occupational
health hazard since the early 1900s. Several epidemiological studies
have associated exposure to Asbestos with the
development of lesions
such as Asbestos bodies
in the sputum, pleural plaques, diffuse
pleural thickening, asbestosis, carcinoma of the lung and larynx,
gastrointestinal tumours, and diffuse Mesothelioma of the pleura
and peritoneum.
The documented presence of Asbestos fibres in water
supplies and food
products has fostered concerns about the possible impact of long-term
and, as yet, unknown exposure of the general population to these
fibres. Although many authorities consider brief or transient exposure
to asbestos fibres as inconsequential and an unlikely risk factor,
some epidemiologists claim that there is no risk threshold. Cases of
Mesothelioma have been
found in people whose only exposure was breathing the air through
ventilation systems. Other cases had very minimal (3 months or less)
direct exposure.
Commercial asbestos mining at Wittenoom, Western Australia, occurred
between 1945 and 1966. A cohort study of miners employed at the mine
reported that while no deaths occurred within the first 10 years after
crocidolite exposure, 85 deaths attributable to Mesothelioma had occurred by
1985. By 1994, 539 reported deaths due to mesothelioma had been
reported in Western Australia.
Paraoccupational secondary exposure
Family members and others living with Asbestos workers have an
increased risk of developing Mesothelioma and possibly
other Asbestos related
diseases. This risk may be the result of
exposure to Asbestos dust
brought home on the clothing and hair of
asbestos workers. To reduce the chance of exposing family members to
asbestos fibres, Asbestos
workers are usually required to shower and
change their clothing before leaving the workplace.
Asbestos in buildings
Many building materials used in both public and domestic premises
prior to the banning of Asbestos may contain
asbestos. Those
performing renovation works or DIY activities may expose themselves to
asbestos dust. In the UK use of Chrysotile asbestos was banned at the
end of 1999. Brown and blue Asbestos was banned in the
UK around 1985.
Buildings built or renovated prior to these dates may contain Asbestos
materials.
Environmental exposures
Incidence of mesothelioma had been found to be higher in populations
living near naturally occurring asbestos. For example, in Cappadocia,
Turkey, an unprecedented Mesothelioma epidemic caused
50% of all deaths in three small villages. Initially, this was
attributed to erionite, however, recently, it has been shown that
erionite causes mesothelioma mostly in families with a genetic
predisposition
Treatment of malignant Mesothelioma using
conventional therapies in combination with radiation and or
chemotherapy on stage I or II Mesothelioma have proved on
average 74.6 percent successful in extending the patients life span by
five years or more [commonly known as remission][this percentage may
increases or decrease depending on date of discovery / stage of
malignant development] (Oncology Today, 2009). Treatment course is
primarily determined by the staging or development. This is unlike
traditional treatment such as surgery by itself which has proved only
be 16.3 percent likely to extend a patients life span by five years or
more [commonly known as remission]. Clinical behavior of the
malignancy is affected by several factors including the continuous
mesothelial surface of the pleural cavity which favors local
metastasis via exfoliated cells, invasion to underlying tissue and
other organs within the pleural cavity, and the extremely long latency
period between Asbestos
exposure and development of the disease
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