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On August 5, 2008, a temporary worker at the Matanuska-Susitna Borough’s central landfill in Alaska said he and three others were exposed last winter to asbestos dust when a bulldozer ripped open bags holding the hazardous material.

“We’re looking into the matter,” said the borough’s interim human resources manager, Marshall Watson.

“We’re looking into the entire procedures at the landfill. We’re going to interview employees who were there when the alleged exposure took place,” he said.

Watson said the investigation began in the middle of last week, but he didn’t know how long it would last.

He offered little information, saying the investigation is still in its infancy.

Ray Rossiter, the worker who complained of the incident, said it was only recently that the borough recognized the event took place.

Rossiter, 58, said in an injury report with the Department of Labor and Workforce Development that he and three others were exposed when the dozer he was driving to move rebar and concrete tore into bags holding the dust.

He contends that the dozer was in poor repair and allowed the dust to enter the cab.

“My lungs still burn,” he said from his fifth-wheel trailer parked at Kepler-Bradley State Park.

He said he suffers from fatigue he blames on the exposure.

Greg Goodale, borough Solid Waste Division manager, said the kind of asbestos Rossiter was working with at the time is non-friable, or not likely to become airborne.

He also said there are specific procedures in place to handle the friable asbestos.

“Anything Ray was working with does not present a health threat,” Goodale said.

The medical director at Alaska’s only public mental hospital said in court on March 13, 2008, that patients taking the anti-psychotic drug Zyprexa needlessly developed diabetes because doctors didn’t have all the information about risks. Currently, the state of Alaska is suing drug manufacturer, Eli Lilly and Co. over Zyprexa, challenging that the company failed to advise of problems including weight gain, high blood sugar and diabetes. Alaska wants Lilly to pay the costs to Medicaid of treating those health problems.

In opening statements during the week of March 3, 2008, in Anchorage Superior Court, a lawyer for Lilly told jurors that the company, not the state, would call Duane Hopson, medical director of Alaska Psychiatric Institute (API), to testify, and that he would talk about how Zyprexa was still prescribed at the hospital. But when Hopson, a psychiatrist and president of the Alaska Psychiatric Association, testified on March 13, 2008, it was as the state’s witness.

Label Changes

Zyprexa was initially approved by the FDA for treatment of schizophrenia in 1996 and then in 2000 for treatment of bipolar mania. The drug’s label was changed a number of times over the years and eventually included warnings and recommendations to test patient glucose levels for signs of diabetes.

But only in 2007, 11 years after Zyprexa came on the market did the label say it was more likely to raise a patient’s blood sugar than most similar anti-psychotic drugs.

“Do you believe patients who were placed on Zyprexa developed diabetes who otherwise would not have developed diabetes if you knew then what you’ve been told now?” asked a lawyer, who is part of the team representing the state.

“I think there are,” Hopson answered.

Even before Lilly advised it, API began closely monitoring patients on Zyprexa, he said. The hospital in October 2004 changed its protocol and began to weigh patients and test their blood for glucose and lipids as concerns about Zyprexa mounted, he said. Patients with elevated blood sugar would probably be given another drug, he said.

Allen also asked Hopson about seemingly contradictory information from Lilly. In February 2000, the company was working to change the drug’s label and was reviewing data from clinical trials that showed 3.6 percent of patients on Zyprexa had elevated blood sugar compared with 1 percent on a placebo.

But it submitted different information to the federal Food and Drug Administration, and the 2001 Physician’s Desk Reference, a thick guide to medications used by doctors said the clinical trials found almost no difference between the drug and a placebo in terms of blood sugar.

Hopson agreed with Allen that the company was implying the drug is safe, and that the information was inconsistent with what it said in 2000.

After court ended for the day, a spokeswoman for Lilly said that the 2000 report was preliminary and that further study went into the information eventually sent to the FDA. The science is constantly evolving, Lilly has maintained.

Still Prescribed at API

Hopson also told jurors that Zyprexa is still prescribed for patients at API, but that doctors try not to use it if something else is effective. It might be needed for patients who are seeing hallucinations, hearing voices, delusional or violent those who are in “psychic turmoil and a lot of psychic pain,” he said.

But don’t psychiatrists at API prescribe it without restriction? Nina Gussack, a lawyer for Lilly, asked Hopson under cross-examination.

They do, he said. If a patient won’t agree to take it, the state may even go to court to force them to do so, he said. Gussack asked Hopson if he was consulted about the lawsuit before it was filed.

He wasn’t, he said. He only learned about the case in the newspaper. He never was asked by the lawyers suing to give his views on the case, he said.

The court day started with a scare. Just as jurors were filing into the courtroom, a juror in his 60s became light-headed and collapsed, hitting his head on the way down. Someone called 911. A psychiatrist who may testify for the state rushed in to help. Medics came and took Juror No. 13 away on a gurney. He wasn’t at either Providence Alaska Medical Center or Alaska Regional Hospital later in the day, so it wasn’t possible to get his condition.

Lilly asked for a mistrial. Superior Court Judge Mark Rindner ruled against the company.

The trial resumed, with 12 jurors. Both alternates now have been excused. Testimony began a week ago and is expected to take another seven days or so.

A retired medical officer with the U.S. FDA has testified that drug manufacturer Eli Lilly & Co. downplayed the health risks of its popular schizophrenia drug Zyprexa so that the company could increase profits.

John Gueriguian appeared in Anchorage Superior Court on behalf of the state of Alaska, which is suing Lilly over the Zyprexag. Alaska contends that it needs to recover costs to its Medicaid system for serious health problems caused by Zyprexa.

“Simply put, it’s putting profit over the concern of the consumer,” Gueriguian told the jury. Gueriguian was employed at the FDA for 20 years and is now a consultant. Lawyers working for the state hired him to analyze Lilly documents and e-mails.

Lilly attorney John Brenner told reporters the company turned over its data to the FDA, which approved the drug in 1996. “We didn’t hide anything,” Brenner said. “There’s an ongoing debate being played out in the medical community.”

Alaska is one of nine states suing Lilly over Zyprexa and is the first to go to trial and the company.

Zyprexa is sold in the United States and more than 80 other countries. Worldwide sales of the Zyprexa reached approximately $4.8 billion last year.

Internal e-mails revealed during the trial show that at least a few Lilly employees were aware of concerns over the drug leading to diabetes. One employee wrote that consultants were concerned over the company’s handling of the issue.

“I do believe they made a very strong point that unless we come clean on this, it could get much more serious than we might anticipate,” Thomas Brodie wrote in an Oct. 9, 2000, e-mail to others at Lilly.

The next day, another Lilly employee responded that the real concern seemed to be about weight gain, and that the consultants wanted the company to “aggressively face the issue” and work with doctors to help them manage patients’ weight.

Lilly spokeswoman Marni Lemons said on March 7, 2008, that the state’s lawyers are focusing on a few misleading or poorly worded documents out of millions of pages of records.