Document 1Qwab11jL5GZ5d7rL0NbQ5pqo
FILE NAME Brakes BRK
DATE 1965
DOC BRK022
DOCUMENT DESCRIPTION Journal Article - Annals of the New York Academy
of Sciences - Asbestos in Great Britain
ee Ann
Ann N.Y. Acad 1965 Fr. Sci W. 132
7 t SECTION III HUMAN EXPOSURE TO ASBESTOS INDUSTRIAL POPULATIONS
McVittie Asbestosis in Great Britain
129
ill
ASBESTOSIS IN GREAT BRITAIN
to princpal safeguard number principal safeguard
safeguard
against
against
the
ill
effects
of
asbestos
dust
in
the
lungs
wawass
sup res ion
to bebe found inin improved venvteinltaitiloantion and dustdust supsuprpesionressionsupresion aand nd a number
recomendations
S
C. McVittie
ofrecormmendeationcs ommendations were made
A
important
A, Ministry of Pensions and National Insurance London England The resresuultlsts the rreeppo orrtt were also important Under section 79 of the
results Hate
FFacatcortyory aand nd
Workshops
Workshops ActAct 1901 the Secretary of State issued issued a certificate
to the Factory efct Workshops Workshops examination car-
effect that the the manipulatimaonipnulation of asbestos asbestos and the the manufacture aanndd
eR mortem Our knowledge of asbestosis dates from a
articles
repair
repair
repair
of
articles
composedcomposed
wholly wholy or partly
of asbestos
and
processes
in-
findings articles ried out at the Charing Cross Hospital London 64 years ago The
cidental
dangerous The section in the Workmen's
cidental
tate
were given by Montague Murray in evi-
Workmen's CompCeomnpe-n-
thereto of that mortem examination
for Industrial
for
ssaatitonion ActAct of
1925
which
provpirdeodvided
for
the
application aplication
aplicationapplication
of
thathtat
AcActt
to to
work-
mice Committee on Compensation
suffering
silicosis
silicosis
Departmental dence before a
of the morbid anatomy of
men suffering
from
from
silicosis
was
extended
to
certain
processes
involving
peat asbestos Diseases in 1906. He gave a good description
exposure
asbestos dust and in 1931 asbestosis became a compensatacbompelnsaetable
compensatable
produced pulmonary asbestosis and he
photographs photographs taken from specimens
fairly
wide
dis-
didisseeaasese Compensation
cover
was
was
fairly
wide
and
thethe
compensatable
dis-
evan
in the lungs of his young patient who died
and
showing spicules of asbestos
easewas ddeefifnedined as ffiibbrroossisis of the lungs due to asbestos dust or that
e+
to cardroom dust Eighteen years were to elapse
oe
after 10 years exposure
directed attention to the
disease accompanied by tuberculosis Medical Boards Boards of spspecialey ciaqlulyalquiafliifeiedd
medical before another mortem examination again
apointed
medimediccal al
practitioners
were
were appointed
to
make
the
medical
examinations examinations
cenaru extensive pulmonary fibrosis In the
examinations
practitioners possibility that silicates may cause
the more im-
aandndgive
initial
periodical the medicalmedical certificacetretisficates initial and periodical
examinations
eexxaammiinnaattiioonnss of
erct interval interest was concentrated on what was regarded as
workers
certain sscchedhuleedduled
in the industry were instituted and
risk associated with dusts containing free silica
processes
initial
were
and
prescribed
standard certain portant and widespread
the first to appear in Eng-
tthhe setandard
of
physique physique
physique
requrierqeudired
on
initialinitial exaemxianmaitniaotnion was prescribed
of The second case was reported by Cooke in 1924
Special Special
regulations regulations
regulations
which
defined
asbestos
as
any
fibroussilsiicaltiecate
lay
frequently His case is
associated with the dis-
instructions
, lay
down lish medical literature
in the lungs of
down spsepecciiffiicc instriunsctrtuictoinonss as to exhaust ventilation the prevention ooff dusdustt
of curious bodies but what Cooke demonstrated
covery
ggaianing ining
gaining
gaining
acceaces ss
to
the
atmosphere workrooms of of atmosphere
atmospher
the
damping
of
floors
and
cleanies female textile worker were actual particles of asbestos
of
floors
young tuberculous
of the diagnosis did not
bbenecnhecs hes
the the
cleanliness cleanlines
cleanliness
of
flooflrosors
and
plantsplants
the the
stsotroraaggee
of
asbestos
and
fibers and dust and he always insisted that proof
with tthe heemployment employment of young persons The regulations came into fowrceith
came
suggested include the presence of curious bodies
1927 and 1931 a whole new literature relating
Then suddenly between
asbes-
in Britain The clinical picture of pulmonary
to asbestos appeared
ray findings by
described by Oliver and the clinical and
tosis was
McDonald described the his-
Seiler Burton Wood and Ellman Stuart referred to certain highly character-
tology of pulmonary asbestosis and
all sections He advanced the
istic yellowish brown bodies abundant in
fibers in the process
that the bodies were portions of asbestos
hypothesis
how the characteristic bodies could be
of alteration Stewart described
he de-
detected immediately by making a lung squeeze Unfortunately
asbestosis bodies Later Roodhouse Gloyne
seribed them as
the new literature the
that asbestos bodies would be a better name In
and Price in 1930 was outstanding The report
report by Merewether recommendations following an extensive inves-
gave their conclusions and
the manufacturing side of the
tigation of workers and of conditions on
On the medi-
on number of counts
asbestos industry and was important
of asbestosis
cal side the investigation established the occupational cause
in four of the sample of 363 workers examined
Merewether found that one
dust and he
fibrosis attributable to asbestos
had evidence of pulmonary
workers in the industry
calculated that on the sample one in eight of all
the
would be found to have evidence of fibrosis It was made clear that
128
general application on March 1 1932
in Case finding
has in GGrreeaat t BriBrtitaaiin n then has arisen mainly in two waywsaysfrom mainly
carried
in
certain
high
stautory finding ththee ststautaory tutory periodical examienxatmionnastions carried out in certain hhiigh grhisk
examinations
cupations in the industryindustry and from examinations following applications
disablementdisablemnt compensation under compensation disablement and
the Workmen's Compensation Acts and clcalaiimmss for
Industrial
the
Act
death benefit underunder the IndusItndurstiriaall InIjnujruiersies Act whicwhhich
superseded superseded thethe Workmen's Compensation Act of 1948 1948
Injuries
Injuries Under the the IndustriIndusatriall
Act
the
words
silicosis silicosis
and and
asbestosis asbestosis
asbestosis
dropped sseerere droped
comprehnsive
and
the comprehensive comprehensive
comprehnsive
term
pneumoconiosis pneumoconiosis
wawass
introducinetrodduced
dropped PneumocPnoenuimoosciosniosis
in
Pneumoconiosis wawass dedfefineid ned in the Act fibrosis of the lungs due to
Pneumoconiosis silica dust asbestos dust or other dust The Act provided tht aththe e
in
fefeccttss of tutuberculosi berculosis pulmonary in a person suffering from pneumo-
tuberculosis coniosis were to be
as the effects of the pneumoconiosis , Cover wawass
treated provideprovidded forfor all the main occupations in the industry
handling aa thethethe working workingworkingworkiwonrkging or
of asbestos asbesasbestos tos or any any admixturadmixturee admixture admixture admixture of of asbestos asbetos asbestos asbestos ;
manufacture b the manufacture
of
manufacture
or repair
or repair of asbestos textiles or other articles con-
taining or composed of asbestos
( c thethe cleaning clcelaenaniinngg of any any machinery oror plantplant used used used any of the the fofroergoeignogingforegoing
operations operations and and of any chambers chacmbhearsmbers , fifxixturestures fixturfeisxtures and andand appliaanpcleisances ap liances apliances applianaplicanceseapliancess for for for the the
collection collection of asbestos dust
.
130
Annals New York Academy of Sciences
L
d substantial exposure to the dust arising from any of the foregoing
operations The diagnosis and disablement questions arising on claims for disablement benefit under the Industrial Injuries Act are decided by the Pneu-
moconiosis Medical Panels of the Ministry of Pensions and National Insurance The Panels also advise Insurance Officers on death claims Post-
mortem examinations are carried out in the vast majority of cases and the lungs are always examined by two members of the Panel thus in number of cases not seen in life the diagnosis of asbestosis has been made mortem A number of cares have also been found following examinations under a special benefit scheme for older workers who were barred for compensation under the Workmen's Compensation Acts The Panels also carry out the periodical medical examinations at the prescribed interval of two years These different kinds of examination provide the only source of information about the prevalence of asbestosis in the country as a whole
Between 1931 and December 1963 748 cases of asbestosis were diagnosed in life under the Workmen's Compensation Act and Industrial Injuries Act
TABLE L shows the number of cases diagnosed each year under the In-
dustrial Injuries Act It shows that the number of new cases is increasing The average of 45 for the last five years suggests that the incidence rate
may be at least five per thousand exposed Four the Ministry's Pneumoconiosis Medical Panels account for the
TABLE 1 NUMBER OF NEW CASES OF ASBESTOSIS DIAGNOSED IN LIFE
UNDER THE INDUSTRIAL INJURIES ACT 1948
McVittic Asbestosis in Great Britain
131
TABLE 2 NEW CASES OF ASBESTOSIS 1955-68 ANALYZED
BY PRINCIPAL OccupatION
Principal occupation
Opening disintegrating
Insulating Laggers Sprayers
Mattress makers Others
Weaving Carding spinning etc. Slab and pipe making Brake lining Miscellaneous
Total
Grand total
No.
%
41
16.6
72
13 41.0
5
12
16
21.5 37
20
8.1
4
1.6
27
11.0
247
1950 9 months
1951
1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963
Total
17
17
wn
15
23
Sen
31
es
48
Nene
31
At
eae 56
27
37
29
43
52
67
__
494
Detailed statistics of cases under the Industrial Injuries Act were not
maintained until April 1950
eran
ee
Po
mda
WANE
At four Panels London Manchester Newcastle Sheffield
1955 concerned majority 63 per cent of asbestosis cases They are also the Panels mainly
Panels
mainly
concerned
with
with
periodical
medical
periodical medical
examinations examinations
In
the
year
period
1963 these Panels diagnosed 247 fresh cases of asbestosis including
female workers 31 31 female
They grouped according workers workers
They have have been
to the procesprsoceessses in
whwichhich
each
was
mamiainnllyy
employedemployed
and
with
with
similar
simislimailarr
processes
processes
grouped
grouped
to-
gether
shows the TABLE 2
shows
principal cases
cases analyzed by principal occupation It shows that
the insulinsulating ating section of the industry gave rise to 41 per cent of the total total
etc. carding spinning TheThe
ooccccuuppaattiioonnss
of
of
opening
opening
carding spin ing
and
and the miscellane- miscellane-
miscellane-
ououss group which
includesincludes
maintemnanace intenance
men
were
important
important
impiomrptoarnttant
ccaauusseess
of
of
asbestosis
TABLE 3 shows whether diagnosis was the examination
examinationexaminexamination ation
or
or
the
result result
result
of
a
claim
claim
Well
result of initial or periodical
over
half
the
ccaasseess
resulted resulted
resulted
direct
direct
claims ,
claims and
the
majority
majority of these
60 per cent
were
from
the
insulating section of the industry
Fork acidemy acidemy of Sciences
NEW
ATS ATS OF
TABLE ASBITOST ASBITOST DIAGNOSED DIAGNOSED 1953
1962
Principal occupation
| Diagnosis resulted from
| Initial or
| periodical exam
Claim to benefit
" L>
183
McVittie Asbestosis in Great Britai
183
TABLE 1
NEW CASES OF ASBESTOSIS ASBESTOSIS DIAGNOSED 195 1963
ANALYZED BY DATE ENTRY INTO INDUSTRY
Principal occupation
Entered
industry
before 1933
Entered
industry
1933 or after
Total
Opening disintegrating
24
17
41
Opening disintegrating
3
38
41
Insulating Laggers
Insulating
3
69
72
Laggers
41
31
72
Sprayers
13
13
Sprayers
1
12
13
Mattress makers
5> 5
Mattress makers
2
3
5
Others
7
5
12
Others
3
9
12
Weaving
13
Carding spinning etc.
29
Slab and pipe making
8
Brake lining
2
Miscellaneous
13
Total
104
3
16
8
37
12
20
2
4
14
27
143
247
At four Panels-- London Manchester Newcastle Sheffield
TABLE 4 shows the cases analyzed by principal occupation and date of entry into the industry The year 1933 was chosen because it was considered that by that date the regulations regarding ventilation and dust control were effective It is recognized however that there were enormous difficulties in this regard during the war years The majority 66 per cent of the group entered the industry in 1933 or after
TABLE 5 shows the average exposure and the range of exposure in the principal occupations The figures of average exposures in opening and
figures disintegrating and weaving are an improvement on Merewether's
for these occupations in 1930 but there is no room for complacency Since
1933 the disease has been produced over short exposures In practically
every principal occupation asbestosis has developed following exposures of
under 10 years It is still developing
Weaving
Carding spinning etc. Slab and pipe making Brake lining
Miscellaneous Total
6 10
3
3 10
82 33
10 27 17
1 17
165 67
16 37 20
4 27 247
100
At four London Manchester Newcastle Sheffield
TABLE 6 shows an analysis by some of the principal occupations and date of entry into the industry after 1950 well after war conditions applied Two of the insulating workers who entered in 1956 had only four years
exposure The sprayer who entered in 1953 had seven years exposure
The worker who entered carding and spinning in 1952 had five and one half
years exposure One of the sprayers who entered in 1951 and had nine years exposure has since died and asbestosis was confirmed at mortem
Scrutiny of the material suggests that age at entry into the industry was not a factor in the development of asbestosis At periodic and other
examinations the facts about duration of exposure and dates of exposure
can be elicited but these examinations have not so far provided the means
of relating working conditions as measured by dust counts to development
of the disease The tables and the knowledge of the processes involved in
Artmus New York Academy of Sciences
TABLE
NEW
CASES NEW CASE
WORKERS
ASBESTOSIS ASBESTOSIS DIAGNOSED DIAGNOSED 1955 963
WORKERS WHO INTERED INTERED THE INDUSTRY ININ 1935 1935 1935 OR OR 1-11-010
nue nuet t stosis in Gred Britan
TALEP C
NEW CAS of ANALYZED ANALYZED EN OF ENTRY
A BESTOSIS BESTOSIS
NOSE,, A 195 190
PRINCIPAL OCCUPATION OCCUPATION AND DATE
INTO INTO THE INDUSTRY INDUSTRY AFTER 1950
Principal occupation
| exposure in years
|
Opening disintegrating |
14
Insulating
Laggers
| 26
Sprayers
8.3
Mattress makers
11
Others
13
Weaving
15
Carding spinning etc.
16
Slab and pipe making
16
exposur 11.
years
4-2
a
Principal occupation
_
Opening disintegrating
Year worker entered industry
1951 | 1952 | 1953 | 1954 | 1955 | 1956
Total
1-
-
-
113
113
113
8-44 3-12 5-22 9-27 9-23 6-27 5-30
Insulating Sprayers
2
1
1
-
I
1
4
Mattress makers
1-
-
-
-
12
12
Weaving
-
1
1
-
I
1
2
Carding spinning etc.
1315
1315
1315
1315
1315
1315
1315
Slab and pipe making
2
-----
-----
-----
-----
-----
2
7
4
2
-
1
4
18
Total
Brake lining
Miscellaneous
14
12-16
16
4-26
At four Panels London Manchester Newcastle Sheffield
the principal occupations suggest that development of the disease wawas s re-
lated to dustiness of the job Scrutiny of the working histories suggests sug ests
that range of exposure depended on for instance whether raw material
was freely handled whether laggers and their laborers made mattresses
the on site and broke down old asbestos lagging and whether high sspepedeed
departments speed cutting and sawing were carried out in the sectional
Diagnostic Criteria
Diagnosis was made on adequate exposure to asbestos dust plus two
positive finger findings from the following - presence of basal r^les
club-
studies bing radiological appearances and pulmonary function
Experience has shown that in some occupations recent exposure of
three to four years is adequate and this may be related to type of asbestos
Generally exposure is re- speaking however something like eight years is
adequate quired the other other hahand nd very short past exposures 20 years ago are also
At four Panels-- Manchester Newcastle Sheffield
Characteristic persistent crackling r^lesat the bases were very commonly present Finger clubbing though not so common as basal r^leswas noted in 35 per cent of the total This finding however was subject to inter and
intra observer error
The radiological appearances were very variable A large number of films showed the changes characteristic of interstitial fibrosis or of pleural thickening or both A honeycomb appearance just above the diaphragm a ground glass appearance made up of linear markings and small discrete opacities in the lower lobes obliteration of the costo phrenic angle shaggy
heart shadow and thickening of the interlobar septae were common find-
ings Calcified plaques were also fairly common and were seen mainly in the films of insulation workers The Pneumoconiosis Medical Panels consider that bilateral calcified pleural plaques are almost diagnostic of asbestosis The absolute symmetry in many cases and the slow progression
can hardly be explained except on the basis of occupation The Pneumoconiosis Medical Panels had found that workers with as-
bestosis had little tendency to asthma and other forms of airways obstruetion but that they did not do a stepping test well The pathology of asbestosis - the mall firm lung that stands up on the table that cuts with
a clean edge that shows parenchymal fibrosis without significant pleural
Amals Amals New Academy of Sciences
i
i?
thickeni t}hicketnhiicnkgeninthickengg g thickening thickening
show
show
PHUCK
Gd thiebentionsa Taorde
f
.
macrosmacrocscopic opic
macroscopic
macroscopic
parenchymal
parenchymal
parenchymal parenchymal
fibrosis
thitchkiecnkuenu thickenu
thickenu Niels
without
wwiithotuthout
1
;
Ss ugroee
suggested
suggested
that that useful useful dusefulugnostic
1
d disablement : disablemnt disablementdisablement disablement would be provided proviprovdideed
dugnostic
but and
with
exteexntenssivie ve
extensexitevnseive
macrost
macrost
dugnostic
byusing
and2
much betterbetter a2
gation centos fer Since Panels have referred asbestos workers multiple multiple Since
centos gation of lung function The tests have shown special
fr
characteris
consistent highly characteris consistent combination combination changes changes e.g
characteris
inspiratory inspiratory capacit well maintained maintained for volume volume highhigh F.E.V. F.E.V. Vi. nspiratC ory . capacit capacit
diseases capacity and loss compliance compliance These arse pecific specifc re: duceredduced reduced
The The disablement asbestosis asbestosis is
cases moderate disablement at the date diagnosis diagnosis assessed assessed slight slight
slight |
as compliscatledightcompliccomaptliecadted active tuberculosis tuberculosis tuberculosis 81 severe severe in 26. cases were tumor
by carcinoma the at the date diagnosis diagnosis two pleurat l umor
by carcinoma of the lung
Follow Follow
have
cases
all
causcauese s
causes
causes
57
yyeeaarrss
years
years
One
death
died
The average age age death fr
Panel
all MedicaMedlical Panel
The i.TheThe causes causes
:
wy e causes Asbestosis
Panel
Panel
and
and
one
other
case
there
reported
reported
the
PneumoconPnieuomosconios
of of
death
death
death
the remaining
remaining
remaining
57
were
mortem
examin examin
exatmin
remaining
Asbestosis Asbestosis cor pulmonale remaining were as follows
Asbestosis Asbestosis pulmonary Cancer - lung pulmonary infection
Mesothelioma Mesothelioma Mesothelioma
Mesothelioma Mesothelioma peritoneum Coronary cancers disease
Other cardiovascular Acute intestinal cardiovascular Acute meningitis obstruction Mesenteric Mesenteric thrombosis
cases diagnosis cases diagnosis
8 9
2112 cent
1
5
5
5
1
1
1
exposure
adequate
adequate adequate
exposure
exposure
exposure
to
asbestos
asbestos
asbestos
dust
slight
dust
coal
and
radiological
due
miners
minerspneumoconiponesuimosconiosis
pnpenuemuomcooconniioossiiss
exposur
two
cases
radiological
radiological
radiological
changes
were
were
miners
cases diagnosis
examination examinationwas
showed gross examinationaverage examination showed
basbaseed d
mainly mainly
mainly
mainly
a
on
low
diffusing
diagnosis
asbestosis
asbestosis
emphysema
emphysema
emphysema
Excluding
capacity Excluding
sis
Post
mortem mortem mortem
age average
death
death
death death
those
age death and those who dwhoied
was asbestosis from who died
asbestosis
57. cases
cancer lung pleura average average
who findings asgimielar of of those who died from other causes was pleura 55
These 35 workers in similar area those in consecutive consecutive consecutive post mortems mortems asbestos
workers asbestos and
age the London London Panel The average age death asbestos
>
the average death fiom fiom findings similar to those in 138 consecutive post-mortems
are al seath fiom workers in the area on the London Panel. The average age
MeV AS os utile ol wot
cae
ad. ot LOG males was 97 and of 32 fermales
2 the MeVitu MeVitu
Pus LOnIS
ses
of the mia who died at b
age at deat )
at death of mater
L verage
London London groun groun 106 males was and
. ises the
the mai wh died asbestosis
infection verage age dear's of
yy
at Pashe tosIS 59. average
died infection was and
59 age as death males
was and females
Se
Dis-
Under National cancer
Industrial Injuries Injuries Prescribed Prescribed
Regulations National Insurance
prescribed Dis-
ses
of prescribed diseases are treated
seases Pneumoconiosis sequelae sequelae seases
Panels Panels accept cancer cancer prescribed
asbestosis Pneumoconiosis Pneumoconiosis Medical
prevalence lung
ala
with asbestosis the abnormally abnormally high
associated associated
risk of including including lung cancers due
+ ancers
has been accepted accepted the
unreasonable
t other other causes
not unreasonable unreasonable accepted this attitude seems
and the cases who died
the average death the 1955 63 series series
There There
between first exposure
interval interval between
period was death from cancer was years
was only which which the period
This worker worker worker
and exposed for
industry industry the age entered entered
post exposed to asbestos dust
There was very slight asbestosis
years There
dustrial
cancer, Conference Conference Conference on this
In addition to the figures of death from lucngancer of survivors and
survivors
in the series to the figures deatpermanhently incapacitated incapacitated asbestosis survivors survivors
effusion at present present permanently
and other and
pleural
cancer cancer diagnosed diagnosed
two mesothelioma two lung
Seven other survivors are other other
manently incapacitated pleura suspected bronchitis one per- The
asbestosis and
Scrutiny of the
manently incapacitated by asbestosis tuberculosis tuberculosis Scrutiny
benefit history sheets giving
certified cause incapacity other other
long
survivors shows that asbestotics frequently incapacitated for
periods by bronchitis and chest
However a small number number no
without infection
have reached retiring age
recorded chest illness since 1955
medical initial pneumoconioses Initial Periodical Periodical Examinations
effects asbestos asbestos the the role of
Against this background the effects
dust the initial Our
examinations workers workers
Our as-
Pneumoconiosis periodical
Panels consider these examinations considered
Medical
the examinations as- are
Pneumoconiosis most worth worth of all No doubt the
happier when the
kept under observation observation are
doctors doctors Regular that they are being
doctors opportunities opportunities the
visits factories factories Panel meet factory doctors
first hand Asbestosis opportunities
the to study the processes processes
Asbestosis
the most difficult
diagnose diagnose periodical periodical
inations inations provide experience experience pneumoconioses film reading reading in the clinical aspects of of
disease this regard
lung function tests carried carried
when the worker worker enters initial initial anbde used as controls May these these
examinations examinations however however give in industry
sense security security security
have everything everything industry industry false false
idea doctors
control What evidence evidence
on the idea that the doctors have everything
138
Annals New York Academy of Sciences
is there that periodical examinations have preventers the de asbestosis and its sequelae As regards initial examinations
moconiosis Medical Panels have to decide whether whether new entrants
for employment in the industry The question that should be use 1 whether the employment is suitable for the worker In our expera very appreciable improvements in working conditions have been m de some sections of the industry by some employers What some can de can do Let us remember the answer and the warning given by Mera t.-
30 years ago When asked whether two years exposure was suffic ent
cause asbestosis in a voung girl he replied Yes if she lives long enough
References
MURRAY MONTAGUE 1.
H.
MONTAGUE 1907. Report of the Departmental Committee 1
Compensation
for
Industrial
Diseases
Minutes
of
Evidence
Append.o Apend.o
Apend.o
and Index : 127
2. COOKE W. 1921. Brit Med J. 2 147 3. OLIVER T. 1927. J. Indus Hyg : 9 4. SEILER H. E. 1928. Brit Med J. 2 982
5. BURTON WOOD W 1928. Tubercle 353
6. ELLMAN P. 1930. Proc Roy Soc Med
7. MCDONALD MCDONALD STUART 1927. Brit Med J. 1025
8. STEWART M. J. 1930. J. Path Bacteriol 33 848 9. GLOYNE S. ROODHOUSE 1929 Tubercle 10 404 10. MEREWETHER E. A. & C. W. PRICE 1930. Effects of Asbestos Dust e
Lungs and Dust Suppression in the Asbestos Industry H. M. Stationery Industry
Office London England 11. WORKMEN'S COMPENSATION Silicosis and Asbestosis ACT 1930
12. SILICOSIS AND ASBESTOSIS Medical Arrangements SCHEME 1931
13. ASBESTOS INDUSTRY REGULATIONS 1931
THE OCCURRENCE OF ASBESTOSIS AMONG
INSULATION WORKERS IN THE UNITED STATES
I. J. Selikoff J. Churg C. Hammond
Section on Environmental Environmental Health The Mount Sinar Hospital New York NY
Information currently available concerning asbestosis has been derived angely from studies of employees of asbestos textile factories and should roperly be referred to such individuals It is inadequate to speak now of asbestos workers With the growth of asbestos utilization including rapid multiplication of the number and variety of its applications it would percaps be more accurate to categorize workmen exposed to asbestos as as-
restos textile workers asbestos insulation workers asbestos miners sbestos mill workers asbestos workers etc. The different oc-
pations vary widely in important respects m intimacy intensity and iration iration of exposure in variety and grade of asbestos used in working
onditions in concomitant exposure to other dusts or inhalants The im-
portance of this distinction and the parallel obligation to evaluate and tudy the experience of asbestos exposure in other trades is emphasized y the fact that asbestos textile workers are now a minority of those ex-
posed during the industrial use of asbestos There were good reasons for the early emphasis on asbestos textile
workers The first cases of asbestosis were in textile workers | Following he republication of Cooke's case in 1927 with its rapid confirmation by the report of another case by Seiler the Factory Department in Great Britain had to decide whether these were exceptional occurrences or repre-ented a significant health risk in industry Accordingly an investigation into the problem was undertaken during 1928 and 1929. The scope of the study had to be restricted The textile industry was selected for study since only here was there pure or almost pure asbestos exposure Since it was urgent to investigate the effect of this dust limiting the investigation to this branch of the industry avoided the possible complications which might be introduced by the presence of other potentially fibrogenic dusts Moreover in other asbestos trades there were varying portions of asbestos in the dust to which workers were exposed which would have added another complicating factor It was accepted that there were considerable numbers of workers exposed to mixed dusts whose risk would not be docu-
mented by study of the asbestos textile industry Subsequent surveys similarly designed to study the risk of industrial
11
asbestos exposure were also largely confined to asbestos textile works~
This study was supported by the Health Research Council of the City of New
York
139