As EPA reconsiders asbestos ban, Indiana man with asbestosis gets lifesaving lung transplant

Chicago Tribune

2 days ago

Michael Mihalik had a secret. As he celebrated Christmas with his four children, he thought it was probably his last. So in between the food and presents, he told them elaborate goodbyes in his head.
He was suffering from asbestosis, an occupational lung disease caused by inhaling asbestos fibers. The condition leads to lung tissue scarring and shortness of breath, which Mihalik knew all too well. By December 2023, he needed 10 liters of supplemental oxygen just to sit — 15 liters for any kind of movement, he said.
'I just gave up on everything. I figured this was my destiny,' said Mihalik, 66, of Kewanna, Indiana. 'It's my time to go home. The Lord wants me. I'll just go home.'
But then, by chance during that Christmas trip, he saw an article in a newspaper about a successful lung transplant for an asbestosis patient. He said he bought at least five copies of the newspaper. The information in it led him to doctors at Loyola University Medical Center, where, six months ago, he received a double lung transplant.
Now Mihalik wants to share what's possible for the thousands of others diagnosed with the disease, which he came to view as a 'slow death,' especially as the U.S. Environmental Protection Agency reconsiders the Biden administration's ban on the last type of asbestos used in the United States — chrysotile asbestos, known as 'white' asbestos — to determine whether it went 'beyond what is necessary.'
'It's a shame,' said Dr. Robert Cohen, a clinical professor of Environmental and Occupational Health Sciences at the University of Illinois Chicago. 'I'm not an economics person … but it doesn't seem like there's a reason to continue to allow a dangerous material to be used when we can substitute it. It seems like a step backwards.'
Asbestos, which is linked to tens of thousands of deaths annually and causes mesothelioma as well as other cancers, has been largely phased out in the United States. Last year, the administration of President Joe Biden sought to finish the decades-long fight by banning chrysotile asbestos.
However, the EPA said in a June court filing that it would reconsider the Biden administration's rule over roughly the next 30 months. The EPA didn't respond to a request for comment.
Like many diagnosed with asbestosis, Mihalik held various jobs in steel plants and lumber yards in the 1970s and '80s. He remembers, for example, carrying 80-pound bags of asbestos on a furnace floor in Texas and pulling pipes with asbestos gaskets apart at steel mills in Indiana.
'When you would walk out of them places and hit the air, you would start coughing. You would cough up, especially in the foundries, this black, nasty stuff,' Mihalik said. 'And in the steel mills, it usually didn't hit me until when I was lying down to sleep, and then I would start coughing up the stuff. We just thought it was dust. We were totally ignorant of it.'
By the 1990s, Mihalik said he already could feel his health taking a turn for the worse, so he shifted to truck driving full time. He remembers getting short of breath frequently, and he eventually carried a nebulizer machine with him in his truck. He later had to fashion a backpack to carry tanks of oxygen and wore a mask just to mow the lawn.
After a series of misdiagnoses, including asthma, emphysema and chronic obstructive pulmonary disease, he eventually learned he had asbestosis about a decade ago. At that time, he believed he wouldn't qualify for a lung transplant.
'For me, I was relieved (to receive the diagnosis), because then I knew, 'OK, there's no fixing this,'' he said. 'You know, live your life the best you can, and when the Lord's ready for you to go home, I was ready to go.'
His wife of 32 years, Darla Mihalik, said her husband's condition — particularly in the year leading up to his lung transplant — was like 'watching a part of you die every day.' It was challenging to see her once active husband struggle to walk to the kitchen. She retired from her job at the post office in 2023 to spend more time with him.
'It's kind of a roller coaster. You spend a lot of time saying, 'No, we can't go there. We can't do this,' because you could get sick,' she said. 'A cold, to him, is not just a cold.'
At his clinic at Northwestern Medicine, Cohen treats patients with asbestosis and other occupational lung diseases, although he isn't Mihalik's physician. Asbestosis is scarring in the lung that's caused by inhaling asbestos fibers. There's no way to reverse the scarring, he said.
Those most at risk include shipbuilders, insulators, sheet metal workers or others who come in contact with insulation or brake pads made of asbestos, he said. Cohen said he has also seen wives who were exposed by washing their husbands' clothing. If doctors don't ask patients about their work history, he said it's possible to misdiagnose asbestosis.
'I've got some people that have had some pleural scarring and mild disease that do well for a long time, and then others that have had more severe exposures … who can be very, very ill more quickly,' Cohen said. 'It really depends on how severe the scarring is.'
Chrysotile asbestos, which is found in products like brake blocks, asbestos diaphragms and sheet gaskets, is less toxic than other types, Cohen said, meaning it has lower rates of asbestosis and lower rates of cancer. However, it is by no means safe, he said.
'It's like having a menthol cigarette or something that's maybe slightly less nicotine, but it still is toxic and it still is carcinogenic, and there's no reason to still have it,' he said.
Cohen added that using masks and clothing for protection is 'inferior to just getting rid of the stuff.'
Chrysotile asbestos was banned under the Toxic Substances Control Act, which was broadened in 2016. When the ban was announced, there were eight U.S. facilities that used asbestos diaphragms in the chlor-alkali sector for the manufacture of chlorine and sodium hydroxide, chemicals commonly used as water disinfectants. The facilities were given at least five years to make the change.
Kevin Conway, a personal injury attorney at Cooney & Conway in Chicago, said he's represented dozens of people for decades with mesothelioma, asbestosis and asbestos-related lung cancer. Reversing a ban on chrysotile, the most commonly used type of asbestos, would be a 'real tragedy,' he said.
'The use of asbestos today would be unconscionable,' he said. 'It would be deadly, and it would be horrific in my opinion.'
Mihalik, for his part, hasn't heard much about the EPA reconsidering the ban on chrysotile asbestos. But he said it's a shame when money and profits come above human life, particularly in the mining of asbestos overseas.
'We're still using it, but it's not talked about,' he said. 'The dangers of what it does to a man, a human being. The exposure of it, what it does to the human body.'
About a year after Mihalik planned to tell his kids goodbye, his doctors at Loyola informed him they found a match, 'divine intervention' when he was at death's door, he said. Mihalik received the double lung transplant on Dec. 7, 2024.
'It was a very long battle, but we got our hope and then we got our blessing,' said Darla Mihalik, who added that she felt 'shocked' and 'blessed' when she learned the news.
Before receiving a transplant, patients receive a litany of tests to make sure they're good candidates, said Liz Schramm, a post lung transplant coordinator at Loyola Medicine. Mihalik, for example, was otherwise in relatively good health and had a strong support system at home, she said.
'Once I met Mike in person, he's very charismatic, a very kind person,' she said. 'He asked questions. He made sure he was doing the right thing. They write everything down, and he's a great advocate.'
It's fairly common to have a few bumps along the way, especially within the first year after a transplant. She said patients are essentially exchanging one disease for another, and that a transplant requires 'lifelong care and dedication.' Some patients may wait for a transplant for days and others for years depending on their condition, she added.
Now, Mihalik is focused on his recovery. He's had some setbacks with adjusting medications, but said he's enjoying having an easier time walking and moving around. He and his wife even got to go out to eat chili dogs. He also plans to write a letter to his lung donor's family to thank them.
'I'm grateful. The Lord has blessed me,' he said. 'I am grateful to be here today, and I'm grateful for the team at Loyola.'