The report identifies groups of people most at–risk from exposure to this form of asbestos, makes public health recommendations for these sites and identifies 78 other sites that also received Libby vermiculite. All but one of the sites are former vermiculite exfoliation facilities located in 36 states.

Vermiculite is a group of minerals with a flaky, mica–like structure, used in insulation and gardening. No research has linked serious health effects with exposure to this mineral.

However, the specific vermiculite mined in Libby and distributed across the United States was contaminated with amphibole asbestos, which has been linked to pulmonary diseases including asbestosis, lung cancer, and mesothelioma. As many as 15 to 30 years can pass between a person’s exposure to asbestos and the time disease develops.

Workers were exposed to asbestos through a process called exfoliation, in which vermiculite is heated until it expands. Since the Libby vermiculite contained asbestos, heating released asbestos fibers into the air where they could be inhaled.

People who believed they may have been exposed to amphibole asbestos are encouraged to discuss this with their health care professional. In addition ATSDR also recommends that exposed persons stop smoking, as smoking combined with asbestos exposure greatly increases the risk of developing lung cancer.

“While the number of people who were exposed to this asbestos is relatively low, ATSDR and our public health department partners are concerned about the health effects of this substance on the people who worked and lived around these facilities when they actively processed vermiculite from the Libby mine,” said William Cibulas, Ph.D., director of ATSDR’s Division of Health Assessment and Consultation. “The information we have developed and shared will help these people better understand the potential risks for exposure and what to do if they feel they have been exposed.”

The report identifies three groups at greatest risk for amphibole asbestos exposure:

• Persons who worked in exfoliation facilities at some time from the 1920s to the early 1990s.
• Persons who lived in the same households with these workers were exposed through asbestos–laden dust carried home on workers’ clothing.
• Members of the community – particularly children – who had frequent, direct contact with vermiculite and waste rock ( a by–product of exfoliation ) from these facilities.

“Most people who live or work around these sites today are not being exposed to asbestos from the Libby mine,” Dr. Cibulas said. “Our goals are to inform the public and reach out to workers and families who may have been exposed and have not yet sought out necessary medical screening.”

ATSDR’s report calls for continued health education for persons who have been exposed to amphibole asbestos. The agency has prepared health education kits to assist public health and health care professionals and community members.

ATSDR’s investigations found that residual amphibole asbestos likely remains in settled indoor dust at former exfoliation sites as well as in exterior soil. With many of these sites still in use as commercial and industrial operations, ATSDR is recommending existing data for these sites be re–evaluated to learn more about the residual asbestos that may remain.

The ATSDR study also determined that non–exfoliation sites which handled vermiculite from Libby do not require follow–up studies at this time. However, the agency does recommend using the criteria of the U.S. Environmental Protection Agency’s ( EPA ) Technical Review Workgroup to review existing data for all sites that exfoliated Libby vermiculite using ATSDR’s improved methodologies.

ATSDR began evaluating Libby–related vermiculite sites at the request of EPA in response to documented health reports related to asbestos in Libby. In May 2008, ATSDR and EPA announced an $8 million initiative to advance the scientific understanding of asbestos–like fibers that occur naturally in the environment.

The document is Summary Report: Exposure to Asbestos–Containing Vermiculite from Libby, Montana at 28 sites in the United States.

ATSDR, a non–regulatory federal public health agency, will continue to provide technical assistance to state and local officials in communities where sites have been identified.

For information about the report, please visit the ATSDR Web site: http://www.atsdr.cdc.gov/asbestos/sites/national_map

The paper is the result of research conducted by collaborators at the Brander Cancer Research Institute and Department of Pathology at New York Medical College and Alfacell. The study demonstrated that silencing the glyceraldehyde 3-phosphate dehydrogenase (GAPDH) gene (an abundant and ubiquitously expressed housekeeping gene) in human lung adenocarcinoma A549 cells by siRNA was effectively prevented by ONCONASE. While transfection of cells with GAPDH siRNA reduced expression of this protein by nearly 70 percent, the expression was restored in the cells exposed to ONCONASE for 48 or 72 hours. The data thus provide evidence that one of the targets of ONCONASE (ranpirnase) is siRNA.

"This data provide further evidence of the impact of ONCONASE on the RNAi mechanism," said Kuslima Shogen, Alfacell’s chief executive officer.
"Furthermore, the data may provide the explanation for the preferential effectiveness of ONCONASE toward tumor cells as well as its ability to sensitize cells to other antitumor agents. As seen in our Phase III clinical trial results, ONCONASE has demonstrated significant efficacy in patients with malignant mesothelioma that failed prior chemotherapy."

About ONCONASE®

ONCONASE is a first-in-class therapeutic product candidate based on Alfacell’s proprietary ribonuclease (RNase) technology. A natural protein isolated from the leopard frog, ONCONASE has been shown in the laboratory and clinic to target cancer cells while sparing normal cells. ONCONASE triggers apoptosis, the natural death of cells, via multiple molecular mechanisms of action.

Alfacell has licensed the U.S. commercial rights for ONCONASE to Strativa Pharmaceuticals, a division of Par Pharmaceutical, Inc. Strategic marketing and distribution agreements for ONCONASE have been secured with BL&H Co. Ltd. for Korea, Taiwan and Hong Kong, USP Pharma Spolka Z.O.O., an affiliate of US Pharmacia, for Eastern Europe, GENESIS Pharma, S.A. for Southeastern Europe, and Megapharm Ltd. for Israel.

ONCONASE has been granted fast track status and orphan-drug designation for the treatment of malignant mesothelioma by the FDA. Additionally, ONCONASE has been granted orphan-drug designation in the European Union and Australia.

About Alfacell Corporation

Alfacell Corporation is the first company to advance a biopharmaceutical product candidate that works in a manner similar to RNA interference (RNAi) through late-stage clinical trials. The product candidate, ONCONASE, is an RNase that overcomes the challenges of targeting RNA for therapeutic purposes while enabling the development of a new class of targeted therapies for cancer and other life-threatening diseases. Alfacell has completed Phase III clinical trials of ONCONASE in unresectable malignant mesothelioma and, in addition to ongoing efforts to complete the related rolling New Drug Application, Alfacell is currently planning for Phase II clinical trials in other oncology indications. For more information, visit www.alfacell.com.

In 2004 - 2005, the Bilray Demolition Company, Inc. demolished the former Seaboard Foundry in Johnston, following a fire that occurred at the facility. When the Rhode Island Department of Health inspected the facility during the demolition, it found asbestos-containing materials in the facility.

EPA alleges that Bilray failed to thoroughly inspect for asbestos prior to demolishing the facility, failed to provide EPA with prior written notification of its intent to demolish, failed to adequately wet asbestos during its stripping operations, failed to keep asbestos adequately wet until it was collected and contained for disposal, and failed to properly dispose of asbestos waste.

The CAA and Asbestos NESHAP require owners and operators of demolition and renovation operations to follow certain inspection and notification requirements prior to beginning such operations, and to abide by specific work practice and waste disposal requirements when the owners and operators will disturb regulated asbestos-containing material. Violations of these requirements can pose significant health risks to the communities where demolitions or renovations occur, as well as to employees conducting these operations, who could have been exposed to asbestos fibers during these activities.

In September 2005, Bilray conducted asbestos abatement at the facility. Bilray removed eighty-one cubic feet of regulated asbestos-containing material from the facility at that time.

For more information:

• Enforcement of the Clean Air Act in New England (epa.gov/ne/enforcement/air/index.html)
• Asbestos Information (http://www.epa.gov/asbestos/)

The former owners of the site, Newell Holdings Delaware, Inc., installed an 11-acre soil cap earlier this year at the site to cover more than 117,000 cubic yards of ceramic pottery waste and soils contaminated with lead, PCBs, and other hazardous substances. The property, located at 8th and Plutus streets, is now owned by Rock Springs Enterprises, a West Virginia company.

In August, inspectors from EPA and the West Virginia Department of Environmental Protection determined that Rock Springs Enterprises had begun demolition work on the abandoned factory building located adjacent to the capped site. According to inspectors, this work could create an environmental and health hazard by disturbing suspect asbestos materials and also damaging the recently completed cap.

Under one of EPA’s orders—filed under the Clean Air Act—Rock Springs must halt its demolition activities. According to the order, asbestos has been found in the building, and there is a risk of airborne releases of asbestos fibers. The order alleges, among other things, that Rock Springs failed to notify officials prior to beginning demolition. It also requires Rock Springs to have a certified asbestos inspector determine the extent of asbestos in the building prior to further demolition.

EPA’s other order—filed under the Superfund program—specifically requires Rock Springs to refrain from disturbing the cap at the site. According to this order, during the last two weeks of August, EPA discovered that Rock Springs was conducting demolition and metal-scrapping activities at the site that were damaging the cap and subjecting it to erosion. Under the order, Rock Springs must refrain from disturbing the cap and maintain a fence around the site and vegetation on the cap.

Rock Springs can resume demolition work when it complies with EPA’s orders.

The Asbestos Disease Awareness Organization (ADAO), the largest organization in the United States dedicated to serving as the voice of asbestos victims, today applauded the U.S. House of Representatives and the Subcommittee on Environment and Hazardous Materials for introducing H.R. 6903, the "Bruce Vento Ban Asbestos and Prevent Mesothelioma Act of 2008" — a critical piece of legislation that once passed, will help to stop exposure to the lethal asbestos mineral. The bill, introduced by Chairman Gene Green (D-TX), will amend the Toxic Substances Control Act to reduce the health risks posed by asbestos-containing products and help fuel public education programs.

ADAO praises Chairman John D. Dingell (D-MI) and Chairman Gene Green (D-TX) and Cosponsors Reps. Betty McCollum (D-MN); Hilda Solis (D-CA), the Vice-Chair of the Subcommittee; Lois Capps (D-CA); Jan Schakowsky (D-IL); G.K. Butterfield (D-NC); Doris Matsui (D-CA); Tammy Baldwin (D-WI) and Steve Cohen (D-TN) for their leadership role in moving this important, bipartisan piece of legislation forward. ADAO has worked with Congress for more than four years to advocate for the passage of such a bill and strongly encourages the House to quickly move it through to the President for his signature. The bill is also strongly supported by the Committee to Ban Asbestos in America (CBAA), recently formed by ADAO and The John McNamara Foundation, dedicated to preventing asbestos exposure and eliminating asbestos-caused diseases.

"As we remember the tragedy of 9-11, thousands still suffer from the irreversible damage caused from asbestos exposure. An asbestos ban prohibiting its importation, manufacturing, processing and distribution is absolutely necessary and long overdue," stated Linda Reinstein, Co-Founder and Executive Director of the Asbestos Disease Awareness Organization. "Other countries look to us to set global examples of responsibility and accountability. We must ban asbestos to eradicate the deadly diseases caused from asbestos exposure that plague so many families. As the largest volunteer organization in the United States, we are enormously pleased to support H.R. 6903 banning asbestos, a known human carcinogen, to protect public health."

"I also commend the Asbestos Disease Awareness Organization, not only for supporting this important legislation to ban asbestos in America once and for all, but also for all they do to help patients and families dealing with asbestos diseases," said Rep. Lois Capps (D-CA). "I’m proud to work with them to move this legislation forward."

The occurrence of asbestos-related diseases, including mesothelioma, lung cancer and asbestosis, continues to increase. Studies estimate that during the next decade, 100,000 victims in the United States will die of an asbestos related disease — equaling 30 deaths per day.

About Asbestos Disease Awareness Organization

Asbestos Disease Awareness Organization (ADAO) was founded by asbestos victims and their families. ADAO seeks to give asbestos victims and concerned citizens a united voice to help ensure that their rights are fairly represented and protected, while raising public awareness about the dangers of asbestos exposure and often deadly asbestos related diseases. ADAO is an independent organization funded through voluntary contributions and staffed by volunteers. For more information visit www.asbestosdiseaseawareness.org.

The consent decree, if entered by the Court, would resolve a 2007 complaint against the City of Winslow, former City Administrator John Roche, and former owner William Christie for the improper demolition of nine buildings, collectively known as the Apache Apartments, located on the 1100 block of Apache Avenue. The complaint named John Roche a defendant in the case because of his key role in controlling and supervising the alleged unlawful demolition activities, including the breaking up, collection, transport and burning of asbestos-containing materials.

“We are glad the City of Winslow is taking responsibility for these serious violations,” said Deborah Jordan, Air Division Director for the EPA’s Pacific Southwest region. “These laws protect workers and the public from exposure to friable asbestos, a known carcinogen.”

In 2002, the City declared the apartment buildings uninhabitable and proceeded to demolish four of the nine buildings. Under federal law, certain demolition activities require prior notification to proper authorities and inspection for asbestos-containing materials. The City failed to conduct such an inspection and also failed to notify the Arizona Department of Environmental Quality of its intent to carry out these activities. Tipped off by local residents, ADEQ inspectors ordered Winslow to cease the demolition, pending an inspection for asbestos-containing materials.

Follow-up investigations revealed asbestos-containing materials were present in the remaining five buildings at levels which required demolition and disposal to be regulated. Despite the inspection results and instructions from ADEQ on proper demolition and disposal, the City, under John Roche’s supervision, demolished the remaining five buildings and hauled some debris to a City-owned vacant parcel, where it was burned – resulting in additional asbestos release and exposure to workers and the public.

The proposed Consent Decree, lodged in the United States District Court for the District of Arizona, resolves defendants’ alleged violations of the Clean Air Act’s National Emission Standard for Asbestos, including:

• failure to notify the Arizona Department of Environmental Quality of asbestos removal activities,
• failure to remove asbestos-containing materials that were susceptible to being broken up during the demolition,
• failure to keep the regulated asbestos-containing materials adequately wet to prevent air-borne fibers,
• failure to ensure that no visible emissions from asbestos-containing waste materials were emitted into the air, and
• failure to keep waste shipment records for all asbestos-containing materials transported off the demolition site.

Asbestos is classified as a hazardous air pollutant. Individuals exposed to asbestos fibers are at risk of contracting illnesses such as mesothelioma and lung cancer.

For more information on asbestos removal, visit: http://www.epa.gov/iaq/asbestos.html

Linda Reinstein, Executive Director and Co-Founder of ADAO:

“September 7, 2008 will mark five years since the world lost one of its greatest musicians and song writers, and a still mourning family lost an irreplaceable part of its lineage. On the anniversary of Warren’s passing this year, our ADAO family of volunteers and loved ones send our heartfelt prayers and well wishes to Jordan Zevon and his family. We are continually grateful to Jordan for his tireless support as ADAO Spokesperson as he works with us to ban asbestos globally. With continued strong momentum in Congress for a bill to fully ban this lethal mineral in the United States, we are extremely close to setting a critical example for the rest of the world to follow. Although this accomplishment will never replace Warren Zevon or the countless others who have been taken by asbestos, it will go a long way to help prevent future tragedy.”

Jordan Zevon, National Spokesman of ADAO:

“This year began with a bang with the release of my debut record. And if that wasn’t exciting enough, then came the arrival of our beautiful daughter, Willow. As tremendous as these milestones have been, they are overshadowed by the sadness that my father cannot be here to celebrate. That sadness motivates me to continue my work with ADAO to fight for the rights of asbestos victims and their families because I know that together we are so much stronger than we ever could be alone. ADAO has made huge strides in eradicating asbestos and providing a forum of education and unity that knows no geographic boundaries. Building on this work, I am increasingly hopeful that I will be able to add another joyous milestone to 2008 – when a bill to ban asbestos is passed in this country."

About Asbestos Disease Awareness Organization

Asbestos Disease Awareness Organization (ADAO) was founded by asbestos victims and their families in 2004. ADAO seeks to give asbestos victims a united voice to help ensure that their rights are fairly represented and protected, and raise public awareness about the dangers of asbestos exposure and the often deadly asbestos related diseases. ADAO is funded through voluntary contributions and staffed by volunteers. For more information visit www.asbestosdiseaseawareness.org.

Asbestos Disease Awareness Organization (ADAO)
Doug Larkin
Director of Communications
Cell: (202) 391-1546
doug@asbestosdiseaseawareness.org

The national priorities list is a national list of sites where hazardous contaminants could impact public health and/or the environment. NPL sites undergo a thorough investigation to determine the full nature and extent of contamination. EPA or the parties responsible for the contamination then address whatever risks the sites pose to human health and the environment.

Once a site has been proposed for inclusion to the NPL, there is a 60-day comment period. A final decision on listing the sites will be made after EPA has evaluated and responded to all the public comments in writing. Nationwide, EPA is proposing to add 11 sites to the Superfund list.

The Borit asbestos site was used to dispose of asbestos-containing material from the 1930s to the 1970s that came from a nearby asbestos-manufacturing plant. The site is divided into three parcels: an asbestos waste pile owned by Kane-Core Inc., a reservoir owned by Wissahickon Valley Watershed Association and a former park/playground owned by Whitpain Township.

The waste pile covers approximately two acres of the six-acre parcel, and is about 20 feet above the ground surface. The berm of the 15-acre reservoir was constructed of asbestos shingles, millboard and soil. Asbestos product waste, such as piping and tiles, is visible surrounding the reservoir and stream banks. The third disposal area, which covers about 11 acres, was a depression that was filled and leveled, and eventually used as a park/playground. In the mid-1980s, the area was fenced due to asbestos contamination.

The site is being considered for the NPL because of the potential exposure of the nearby residential population to airborne asbestos and asbestos contamination along the Wissahickon Creek. For Federal Register notices and supporting documents for this and other proposed sites, please visit http://www.epa.gov/superfund/sites/npl/current.htm

According to EPA, a March 1, 2007 inspection resulted in three violations, including:

1. failure to conduct initial inspections to identify any friable and non-friable asbestos containing materials located in the school buildings. Any building leased or acquired on or after October 12, 1988, that is to be used as a school building, is required to conduct initial inspections for asbestos.
2. failure to develop and submit an asbestos management plan for the school building to an agency designated by the governor.
3. failure to notify in writing parent, teacher and employee organizations of the availability of management plans.

A management plan helps prevent exposure to asbestos by ensuring that any maintenance or other routine school activities will not result in the disturbance of asbestos. In addition, whenever asbestos needs to be disturbed, only accredited persons are to be used by the school. Annual notification on the availability of the management plan, allows parents, teachers and employee organizations the opportunity for reviewing all information regarding asbestos in the school.

Pencader was assessed a civil penalty of $2,421.30. Since the school spent $2,744 to come into compliance with AHERA, the civil penalty is considered to be paid in full.

Asbestos was once widely used in building materials due to its insulation and fire retardant properties. Damaged or disturbed asbestos may release fibers which, if inhaled, create a risk of asbestosis, lung cancer, and other respiratory illnesses. However, intact, undisturbed asbestos materials generally do not pose a health risk, if managed in accordance with AHERA safeguards. For general information about asbestos and its regulation, visit www.epa.gov/asbestos Information on asbestos in schools is available at http://www.epa.gov/asbestos/pubs/asbestos_in_schools.html.

The standard treatment for pleural mesothelioma is currently surgery to remove the patient’s lung - a potentially debilitating consequence.

"Current surgical and chemotherapy treatments of patients with malignant pleural mesothelioma are unsatisfactory, and have not been shown to significantly prolong survival. In this study, we will investigate whether a combination of chemotherapy and radiation targeted directly at the lung’s lining can improve outcomes while avoiding surgery," says Dr. Robert Taub, the study’s principal investigator, director of the Mesothelioma Center at New York-Presbyterian/Columbia and professor of clinical medicine at Columbia University College of Physicians and Surgeons. "In addition, this approach has shown to have minimal toxic side effects compared to systemic chemotherapy."

"This trial is also significant because our center is the only one nationwide that is offering this experimental therapy to treat pleural mesothelioma," added Dr. Taub. "We are very focused on offering these patients the best treatment that medical technology can offer while simultaneously working to preserve quality of life."

Researchers also anticipate that the radiation therapy will kill the cancer cells on surface of the lung while sparing other parts of the lung and surrounding vital tissues.

"Delivery of radiation therapy directly into the pleural cavity is a strategy that has been employed since 1945. Today, direct injection of radioactive isotope P-32 may prove to be a significant and effective therapeutic approach for selected mesothelioma patients," adds Dr. Rashid Fawwaz, study co-investigator, radiologist at New York-Presbyterian/Columbia and professor of clinical radiology at Columbia University College of Physicians and Surgeons.

"Overall, it is hoped that this study will decrease the need for patients to undergo radical surgery," states Dr. Joshua Sonett, study co-investigator, chief of general thoracic surgery, surgical director of the Lung Transplant Program and surgical director of the High-Risk Lung Assessment Program at New York-Presbyterian/Columbia and professor of clinical surgery at Columbia University College of Physicians and Surgeons.

Participating patients will receive several rounds of targeted chemotherapy using the drugs cisplatin and doxorubicin via surgically implanted catheters. Some patients will be randomly selected to receive additional systemic (intravenous) chemotherapy using the drugs cisplatin and pemetrexed. All patients will receive targeted radiotherapy using the P-32 radioisotope. Patients may elect to receive additional surgical treatment, including removal of the affected lung lining or lung. Subsequently, patients will be offered outpatient systemic chemotherapy with cisplatin and pemetrexed.

The investigators previously led a prospective study that employed a similar protocol for patients with pleural mesothelioma as well as those with the more retractable sarcomatous disease. Completed in 2002, the study reported a median survival of 70 months, and a three-year survival of 67 percent (American Journal of Clinical Oncology, February 2008).

The study is being conducted at the Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center at New York-Presbyterian Hospital and Columbia University Medical Center.

Drs. Taub, Fawwaz and Sonett are joined by co-investigators Drs. Mark Ginsberg and Lyall Gorenstein - both of New York-Presbyterian Hospital and Columbia University Medical Center.

From 1940 through 1979, approximately 28 million U.S. workers were exposed to asbestos at work. An estimated 3,000 people died of mesothelioma in the late 1990s. It is unknown how asbestos causes the disease.

Columbia University Medical Center

Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, nurses, dentists, and public health professionals at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree. Among the most selective medical schools in the country, the school is home to the largest medical research enterprise in New York State and one of the largest in the United States. For more information, please visit www.cumc.columbia.edu.

Herbert Irving Comprehensive Cancer Center

The Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center and New York-Presbyterian Hospital encompasses pre-clinical and clinical research, treatment, prevention and education efforts in cancer. The Cancer Center was initially funded by the NCI in 1972 and became a National Cancer Institute (NCI)–designated comprehensive cancer center in 1979. The designation recognizes the Center’s collaborative environment and expertise in harnessing translational research to bridge scientific discovery to clinical delivery, with the ultimate goal of successfully introducing novel diagnostic, therapeutic and preventive approaches to cancer. For more information, visit www.hiccc.columbia.edu.

New York-Presbyterian Hospital

New York-Presbyterian Hospital, based in New York City, is the nation’s largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly a million patient visits in a year, including more than 220,000 visits to its emergency departments - more than any other area hospital. New York-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: New York-Presbyterian Hospital/Weill Cornell Medical Center, New York-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children’s Hospital of New York-Presbyterian, New York-Presbyterian Hospital/Allen Pavilion and New York-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth in U.S.News & World Report’s guide to "America’s Best Hospitals," ranks
first on New York magazine’s "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine’s "Best Doctors" issue, and is included among Solucient’s top 15 major teaching hospitals. The Hospital’s mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation’s leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit www.nyp.org.

Office of Public Affairs
New York-Presbyterian Hospital/Columbia University Medical Center
627 West 165th Street
New York, NY 10032
tel: 212.305.5587
fax: 212.305.8023
email: pr@nyp.org

note: The Mesothelioma Center within the Herbert Irving Comprehensive Cancer Center is unrelated to the The Mesothelioma Center web site (www.mesotheliomacenter.org).