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PubMed2004

Asbestos in brakes: exposure and risk of disease.

Asbestos has been incorporated into friction products since the early 1900s. Epidemiological studies have been equivocal in their analysis of the incidence of disease among mechanics servicing brakes. Decomposition of asbestos occurs during the normal usage of the brake due to thermal decomposition into forsterite, although not all asbestos is so converted. Short fibers, below 5 microm in length, are also found in brake products. Several facts are discussed including the toxicity of the remaining asbestos fibers, short asbestos fibers, and the health implications of exposure to forsterite. Control methodologies, when used appropriately, have reduced exposure to asbestos during brake servicing, but have not been able to entirely eliminate exposure to asbestos, thus bring into question the controlled use of asbestos for friction product such as brakes. Even the so called "controlled" use of asbestos containing brakes poses a health risk to workers, users, and their families.

Air Pollutants, Occupational↗
PubMed2004

Asbestos-related pleural diseases: dimensional criteria are not appropriate to differentiate diffuse pleural thickening from pleural plaques.

BACKGROUND: In the literature, the criteria used to define pleural plaques (PP) and diffuse pleural thickening (DPT) are very heterogeneous and often imprecise. A multicenter restropective study was conducted to assess the relevance of two radiographic definitions of DPT. METHODS: The study population consisted of 287 subjects with asbestos-related pleural thickening. Two definitions were used to characterize DPT on postero-anterior chest radiographs: definition 1: pleural thickening associated with obliteration of the costophrenic angle; definition 2: pleural thickening at least 5 mm wide, extending for more than one quarter of the chest wall. Prevalence of respiratory symptoms and pulmonary function tests were compared in the DPT and PP groups resulting from the two definitions of DPT. RESULTS: According to definition 1, 34 patients (11.8%) were classified in the DPT group. Prevalence of chronic sputum, dyspnea, and chest pain was significantly higher in this group than in the PP group. FEV(1), FVC, and TLC were significantly lower. The differences persisted after adjustment for confounding factors. According to definition 2,102 patients (36.6%) were classified in the DPT group. DPT and PP groups did not differ in terms of prevalence of respiratory symptoms, or pulmonary function tests. Agreement between readers was significantly better when using definition 1. CONCLUSIONS: Obliteration of costophrenic angle is a much more reliable sign than dimensional criteria to characterize DPT.

Asbestos↗
PubMed2004

Attorney-directed screenings can be hazardous.

BACKGROUND: The history of occupational health screenings indicate that they are often necessary to protect the health and interests of workers. However, medical screenings for asbestos and other occupational diseases which are organized and funded by attorneys may result in serious adverse outcomes to those screened. METHODS: We report a case of death that appears to have been heavily influenced by an attorney-initiated and -directed screening program. RESULTS: While well-run medical screening programs are essential to disease detection in workers, attorney-run and corporate screenings can be fraught with ethical and practical problems. Screenings have been used by corporations to identify workers with occupational illness in order to terminate their employment and avoid legal liability. Screenings can also be used to motivate workers to stop smoking and implement workplace controls. However, these screenings must be conducted responsibly. CONCLUSIONS: Although this is only one case it illustrates the gravity and potential danger of attorney-directed screening programs.

Aged↗
PubMed2001

A historical cohort mortality study among shipyard workers in Genoa, Italy.

BACKGROUND: A historical cohort mortality study was conducted among 3984 shipyard workers assigned to ship repair, refitting, and construction in the harbor of Genoa, Italy, between 1960 and 1981. These workers were exposed to asbestos fibers, welding fumes and gases, silica dust, polycyclic aromatic hydrocarbons, and solvents. METHODS: Workers were classified in 20 different job-titles depending upon the type of activity. Standardized mortality ratios (SMRs) were computed using male residents of the Province of Genoa as the referent population. RESULTS AND CONCLUSIONS: For the whole cohort significantly increased SMRs were detected for all causes, all cancers, liver, larynx, lung, pleural and bladder cancers, respiratory tract diseases, and cirrhosis of the liver. The analysis by job-title showed increased SMRs not only for pleural cancer, but also for lung, laryngeal cancers and respiratory tract diseases in occupations entailing heavy asbestos exposure. Bladder and liver cancers and liver cirrhosis mortality also appeared to be related to occupational exposure.

Adult↗
PubMed2004

Asbestos-related pleural disease due to tremolite associated with progressive loss of lung function: serial observations in 123 miners, family members, and residents of Libby, Montana.

BACKGROUND: The community of Libby, Montana has recently been the focus of national attention secondary to widespread amphibole contamination associated with vermiculite mining and processing. METHODS: Patients who had occupational and non-occupational exposure to amphibole asbestos in Libby, Montana were evaluated for progressive loss of pulmonary function. RESULTS: Of the 123 patients evaluated, 94 demonstrated average age-corrected accelerated loss per year of vital capacity at 3.2%, total lung capacity (TLC) 2.3%, and DLCO 3.3%. All patients all had predominantly pleural changes with minimal to no interstitial disease. CONCLUSIONS: The study demonstrates a progressive loss of pulmonary function in patients exposed to tremolite asbestos.

Aged↗
PubMed2005

Occupational asbestos exposure and predictable asbestos-related diseases in India.

BACKGROUND: India imports nearly 100,000 metric tons of asbestos per year, and small-scale asbestos (chrysotile and tremolite) mining and milling contributes nearly 5%-10% of the total national usage. The industry is relatively young, having started in the 1950s and 1960s. METHODS: Surveys of asbestos-exposed workers have identified significant occupational exposures, early pleural and parenchymal changes on chest radiograph, and decrements in lung function. RESULTS AND CONCLUSIONS: Based on knowledge of past and current exposures to asbestos in industry, we can predict a future occurrence of clinical asbestos-related diseases-pleural changes, pulmonary fibrosis, bronchogenic carcinoma, and diffuse malignant mesothelioma. These cases of asbestos related disease are expected to occur in asbestos exposed workers from mining, milling, and manufacturing as well as in those with secondary exposures to asbestos-containing materials, including construction and maintenance workers, users of asbestos-containing consumer products, and the occupants of asbestos-containing buildings.

Asbestos, Serpentine↗
PubMed2005

A report on the health of asbestos, Quebec miners 1940.

BACKGROUND: Twenty years after the start-up of the Canadian asbestos industry, reports began to appear of respiratory disease and deaths in asbestos workers in England and in France. An inquiry from the UK in 1912 as to the health of Quebec miners was met by a denial of ill-health, but the loading of the premiums of asbestos workers in the 1930s indicated that, despite further reassuring health studies on Quebec miners, actuaries had data that gave cause for serious concern. METHODS: A report made to the Canadian asbestos industry by a company doctor in 1940, reviewing the literature and presenting his health findings on some 500 employees, was studied in the context of the published information available at the time, and of unpublished contemporaneous material subsequently obtained by legal discovery. RESULTS: The physician denied that the health and longevity of Quebec's miners and millers were adversely affected, and was dismissive of earlier reports of there being serious health risks associated with working with asbestos. CONCLUSIONS: The methodology employed in his health study was defective and his denial of the literature uninformed. The study was widely circulated, and while it may have boosted Canadian industry morale, it met with a sceptical response from British industry. In denying that conditions in Quebec's asbestos mines and mills disabled and killed workers, the author allied himself to fellow professionals loyal to Government and to industry.

Asbestos↗
PubMed2006

Finnish Institute of Occupational Health (FIOH): prevention and detection of asbestos-related diseases, 1987-2005.

BACKGROUND: Between 1987 and 1992, the Finnish Institute of Occupational Health (FIOH) initiated and implemented the Asbestos Program that aimed at reducing asbestos-related risks. It was a cooperative effort between government authorities, labor market organizations, and health care and labor protection personnel. METHODS: During the Program and its follow-up since 1993 several preventive actions were taken, and considerable new legislation and official instructions were issued. RESULTS: Approximately 200,000 people in Finland have been exposed to asbestos in their work. Through the cooperative efforts of government, labor, health care and worker protection programs, the import of asbestos was ceased in 1993 with a few exceptions. Almost all imports ceased in 2005 following European Union directives. Regulation of asbestos abatement companies has been greatly increased. The occupational exposure limit has been reduced from 2.0 fibers/cm(3) to the present 0.1 fibers/cm(3). Asbestos-related diseases are closely monitored and education of health care providers regarding the occupational source of these conditions is now emphasized. CONCLUSIONS: The success of the primary goal of the Program, a reduction in asbestos-related morbidity, will not be fully realized for many decades.

Asbestos↗
PubMed2006

Revising the British Occupational Hygiene Society asbestos standard: 1968-1982.

BACKGROUND: In 1968 the British Occupational Hygiene Society (BOHS) published a chrysotile asbestos hygiene standard. As a consequence of acknowledged inadequacies of the data, it underestimated the risks of exposure, but its influence was international and operated for longer than it merited. Five years later, BOHS reported the standard not to be in need of amending, despite its own doubts and no cognizance having been taken of the cancer hazard. Within months, stung by criticism from Dr. Irving J. Selikoff, industry required it to review the standard, which BOHS continued to do for a number of years before giving up. METHODS: Material obtained for the American Courts by means of legal discovery from an asbestos company's archive, provided information on the membership of the new BOHS committees, and on its operation. RESULTS: Alterations in the composition of the new committees included importantly the introduction of certain independent scientists, whose rigor militated against the ready production of a new hygiene standard acceptable to industry. CONCLUSIONS: There was a time in Britain when a learned society might with impunity omit to consult the views of workers or their representatives when making value judgments about their health and safety, but consider it proper to accede to industry's decision as to what hygiene standard it would accept. Health and Safety at Work legislation in 1974, established an organization on which industry and labor were represented, with the onus for recommending hygiene standards. For several years the BOHS Asbestos Sub-Committee continued attempting to reconcile the interests of industry, until finally abandoning hygiene standard setting as its mission.

Academies and Institutes↗
PubMed2007

The 2nd ADAO Asbestos Conference.

On National Asbestos Awareness Day 2006, a conference was held at Mount Sinai, the home ground of Dr. Irving J. Selikoff, who, more than any other single individual, started the debate about occupational hazards in the U.S. Four decades after the pioneering conference on the Biological Effects of Asbestos was organized by Drs. Selikoff and Churg, asbestos victims and their relatives, public health campaigners, medical professionals, journalists and community representatives convened in New York City to assess the progress that had been made in raising public, professional and political awareness of asbestos-related diseases. The report which follows conveys the substance of their presentations and highlights key issues which were discussed.

Asbestos↗
PubMed1980

Lung cancer prevalence among shipyard workers.

The prevalence of lung cancer has been ascertained during a survey of 286 shipyard workers all 20 to 45 years from onset of asbestos exposure in shipyard work. Two men had had previous thoracic surgery for lung cancer. In addition, bronchogenic carcinoma was found in five men. One was among the 35 men less than 30 years in the yard; three were in the 191 who had begun work 30 to 39 years before, and one was in the group of 60 men who were 40+ years from onset. The potential usefulness of large-scale surveillance programs for the early detection of lung cancer among current and former shipyard workers is discussed.

Aged↗
PubMed1982

Incremental value of oblique chest radiographs in the diagnosis of asbestos-induced pleural disease.

To assess the value of oblique chest radiographs in the diagnosis of asbestos-related pleural disease, we identified 100 asbestos-exposed construction workers and provided separate interpretations of the postero-anterior (PA), left anterior oblique (LAO), and right anterior oblique (RAO) projections using the International Labour Office (ILO) system. We found that the LAO projection identified left-sided pleural thickening more effectively than the PA view and the RAO view improved diagnosis of right-sided disease comparably. Of 62 cases of bilateral pleural thickening, only 43 (68%) were diagnosed by the PA projection alone. The increased diagnostic efficiency of approximately 50% in identifying bilateral pleural thickening appears to justify the routine use of oblique chest films in screening asbestos-exposed populations. Since bilateral pleural thickening among asbestos-exposed workers is an indicator of significant asbestos exposure and increased risk of other asbestos-induced conditions, early detection of this abnormality can lead to interventions designed to reduce asbestos-related morbidity and mortality.

Adult↗

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