Document 5b906MboRq346yyGGgov18knD

FILE NAME Power Generation POW DATE 1990 DOC POW031 DOCUMENT DESCRIPTION Mesothelioma in Power Plant Workers $ Zmesos Zmesos Zmesos Zmesos British Journal of Industrial Medicine 281-282 281 Asbestos related health hazards among power plant workers itvn ironic - house linical olvent dom- -case- -term Work Mixed idy of ents on hagen effects al fluid sure to | 100 tides as versen Menum men i Pr atogra- acids by Idialde- neuro- 669-78 acids 7-8 plasma - 587 9 tbook of em 2nd aurine in able RJ urology update jima H. > in lum- iousness and their between the hip- lenod M. ne in rat cortex in ree amino bethylene 1-7 Y Lerman A Finkelstein Y Levo M Tupilsky Mimi Baratz A Solomon G Sackstein asbestos Studies of insulation workers have shown - pleural effusion was present The attentuation higher death rate than expected due to malignant mesothelioma Although asbestos has been bers of the irregularly thickened pleura were con- widely used in power plants to provide thermal insulation siderably higher than the accompanying free pleural fluid The suggested diagnosis was of for steampipes and turbines asbestos related health effects are rarely described pleural mesothelioma The extensive presence of a calcified J workersand among power plant Bonnell et al XVIII International pleural plaque on the right posteriorpleural surface indicated exposure to asbestos in the Conference on Occupational Health Brighton ) fig remote past fig 1975 We report two cases of malignant pleural mesothelioma in a clerk and an insulator worker of an A pleural biopsy showed a thickened fibrous electric pleura partially covered by hyperplastic mesothelial power plant cells and fibrin Within the fibrous stroma were family failure Case report bundles of spindle cells some with enlarged hyper- year old man was admitted because of left chromatic nuclei These findings were interpreted as 4 pleuritic chest pain productive cough dysp- consistent with cellular fibrous mesothelioma fig 2 The noea and progressive weakness Past and patient died seven months later from respiratory : .. history were contributory Family history was a bone - positive for cancer and cancer in two Case report = = year siblings The patient was a retired employee of a A 54 because old man admitted because because of recurrent - .. , power plant where he had worked for years as pleural effusion He had been an insulator . |. clerk until seven years before admission Before his employment in worker for . 31 years and worked the same power : the power plant he had been as the first patient He had no history of exposure to construction worker for five years anda manager in asbestos On examination the patient of . the wood industry for nine years No history nourished and not in was well- well- | - exposure to asbestos other than in the power plant pulmonary distress Expansion * of the left chest was decreased The wasobtained _ ; . to lunwg as dull Ca, On examination the patient was malnourished percussion and breath sounds were decreased over oS in There and the same A chest radiograph showed a massive *- ' mild pulmonary distrmeasssses , tenderness or palpable was no chest wall left pleural effusion - Pleuroscopy showed the - On percussion the ; sounds lung .left field dull and breath | were gp ~ appreciably decreased chest radiograph showed a left pleural thickening with effusion the right hemithorax was normal A pleural tap yielded 800 cc ' pomevnr ' of haemorrhagic exudative fluid Histological examination of the fluid showed many lymphocytes histiocytes with few mestothelial cells , Computed tomography of the chest showed that the left hemithorax was of small volume compared to the right There was circumferential crenated pleural cncasement affecting the left lung and a left basal Prnpeusma Israel Defence Forces Medical Medical Centre Tel Aviv Israel Corps Ichilov Y A Lerman A Solomon Finkelstein Y Levo M Tupilsky M Baratz Israel Electric Company Medical Division Tel Aviv ene rae G Sackstein Figure Computed tomography of chest showing encasement of left lung with thick pleural mass accompanied pboystpelreiuorralsuerfffaucseioonfpClaelcuirfaied pleural plaque is seen on right 282 Lerman Finkelstein Levo Tupilsky Baraiz Solomon Sackstein station workers and J Bonnell 1975 Bonnell reported on asbestos related disease among 77 insula- among tion of workers an electric power station in London _ eight cases ofmesothelioma were described Another survey of55 full time power station workers in France showed that the risk of exposure to asbestos was not confined to workers engaged in lagging operations ferruginous bodies and asbestos related o9 abnormalities abnormalities mainly pleural thickening and lead cification were also present among workers in other y eSe!aco nee,at ly , y G the i) Figure 2 Bundles of spindle cells within fibrous stroma ( Haematoxylin & eosin ^ 100 presence of 1500 cc of greenish exudative fluid and a gelatinous mass covering the lower third of the visceral pleura diaphragm and pericardium Biopsy of the pleural mass showed malignant epithelial mesothelioma with many Schauman bodies The patient received intrapleural treatment with nitrogren mustard thiotepa and yttrium Itrium and intravenous treatment with adriamycin An abdominal tap of ascitic fluid four months later showed malignant mesothelial cells He died 12 months later from respiratory failure job categories Inrecent review Cammarano et al reported on site specific mortality among thermoelectric power plant workers in Italy Eighteen patients with neoplasms were observed whereas only 8.32 were expected There were five cases of lung cancer expected 83 but no cases of mesothelioma workers exposure The nature of exposure of the first patient reported here is a low level long term exposure type Several authors have suggested that even minimal such as experienced by maintenance by- stander exposure or by neighbourhood or house- hold members induce malignant mesothelioma The risk of asbestosis after this type of ~ exposure is minimal Under suchconditions of low level exposure to asbestos cases of mesothelioma serve as an index of the potential health hazards The cases reported here emphasise the need for popula- tion based studies among power plant workers to evaluate the risk accurately Discussion Thermal power stations produce electric energy by generators The generators are complex units consis- ting of two principal units the boiler and the turbine The heat generated by the turbines and steampipes is one of several health hazards in power stations and it is essential to provide thermal insulation Asbestos has been widely used for this purpose Measurements of asbestos in air inside and outside power stations show low fibre counts but higher concentrations are found in storerooms where asbes- tos is deposited and handled The asbestos related health risk in power plants was also confirmed by the presence of ferruginous bodies in the sputum of power station workers. 1 Selikoff IJ Lee DHK Academic Press 1978 Asbestos and disease New York electricity 2 Hirsch A Di Menza L Carre A. Asbestos risk workers in an among time Acad Sci 137 45 power station Ann NY 3 Parmeggiani L ed Encyclopaedia of occupational health and safety Vol 2. 3rd 1778-80 ed Geneva International Labour Office 4 Burger H. Asbestos fundamentals Origin properties mining processing utilisations New York Chemical Publishing Com- pany 1963 thermoelec- 5 Cammarano G Crosignani P Bernino F et al Additional follow of cancer mortality among workers in tric power plant Scand J Work Environ Health 631 2 Epler GR Gerald MXP Gansler EA et al Asbestos related disease from household 229-40 exposuure Respiration 1980 Although asbestos related health effects have been well described among insulation workers only rarely have such effects been described among power 7 Chen W Mottel NK Malignant mesotheloma with asbestos exposure Human Pathol minimal 253 8 Accepted 12 June 1989 British Jour Hydr conce P J^/ppine Hydrogen several occi mills P Ji refineries indicator of exposure ] are known been deterr combined u high conce could be d method us improved b sodium hyc allows bloo trations and hydrogen si Although enzymes es thase ALA been repor hydrogen si been difficu sulphide poi present worl sulphide cor thesising en Material a There were poisoning Finland but cases origina The subject from about c of Draeger : after the ac hydrogen su hundred ppr were most p Occupationa 55800 Imatra P J^/ppinen Department Helsinki Hel R Tenhunen