Document 5baKODB1JzvnV7p3E1wb2QZE5

ADesk Fteference for Communicators L U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service National Institutes of Health ASARCO ALV 0003727 A Desk Reference for Communicators U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service National Institutes of Health National Cancer Institute Bethesda, Maryland 20014 DHEW Publication No. (NIH) 79-1622 ASARCO ALV 0003728 This publication was produced by the Office of Cancer Communications, National Cancer Institute, Bethesda, Maryland 20014. Suggestions or revi sions may be sent to Patricia A. Newman. May 1978 ASARCO ALV' 00037329 Table of Contents Page Section 1: Risks in the Workplace 1. Who may be at risk of developing asbestos-related diseases? ..................-..................................... ................. 1 2. What diseases may be caused by asbestos?.................... 2 3. What is the role of cigarette smoking?........................... 2 4. Are there other work-related exposures that may aggravate risks?................................................................ 2 5. How' does asbestos cause disease?................................. 3 !! 6. How much exposure is hazardous?............................... 3 l. Section 2: Nature of Asbestos 7. What is asbestos?.............................................................. 8. How much is used?.......................................................... 9. How is it used?................................................................ 10. How has it been used in shipyards?............................... 3 4 4 4 !. Section 3: Disease Recognition :iij 11. What are the signs and symptoms of asbestosis?......... 5 12. Does asbestosis lead to lung cancer?............................. 5 13. What are the symptoms of lung cancer?...................... 5 14. How is lung cancer diagnosed? ...................................... 6 15. What is mesothelioma?................................................... 6 !!!{ 16. How is mesothelioma detected and diagnosed?............ 6 Section 4: Control of Exposure j:, 1.7. How can a worker protect himself in the workplace? . 7 j i; 18. What else should a worker do if exposed?.................... 7 ;:j! _ Section 5: Treatment i! 19. What can be done to treat asbestos-related diseases?.. 8 !j Section 6: Federal Efforts " 20. Which Federal agencies are concerned with the effects of exposure?.................................................................... 9 21. What are some current Federal agency activities on this problem?.................................................................. 9 Section 7: Other Sources of Information 22. Where can a worker go for more information?........... 10 Quick Guide to the Answers Suggested References ASARCO ALV 0003730 Section Is Risks in the Workplace 1. Who may be at risk of developing asbestos-related diseases? Workers in many occupations, particularly in asbestos mining and processing, shipyards, construction, and workers in automo tive brake lining repair commonly are exposed to asbestos, and may inhale or perhaps swallow dusts contaminated with concen trations of this substance. Risks of disease due to asbestos exposure have not been de fined clearly for all occupational groups known to have significant exposure. Firm scientific data are available only for heavily ex posed workers employed in asbestos mining, manufacture and in sulation. Over the past several years, evidence has accumulated that asbestos insulation workers previously employed in shipyards and elsewhere are experiencing asbestosis, a progressive and dis abling lung disease, and markedly increased rates of cancer. Work ers who manufactured the asbestos insulation materials used in shipyards also have increased asbestos-related disease. There is evidence that the problem may be more widespread than previously believed. Workers from a variety of trades who have been employed in shipyards, presumably in or near areas con taminated by asbestos dust, are now beginning to show signs of X-ray abnormalities in the lungs typical of asbestos exposure. These include painters, electricians, carpenters, machinists, boiler makers, and welders who may not realize they were exposed. Large numbers of persons worked around asbestos in shipyards during and since World War II. During the peak war years, 194044, an estimated 4.5 million persons worked in shipyards in the United States, and even those not directly exposed to asbestos dust may have a higher risk of asbestos-related disease. In the last 15 years, the number of shipyard workers has stabilized to an annual workforce of approximately 200,000. Because of the high turnover in jobs during the war and afterward, no one really knows how many people experienced significant asbestos exposure in their work in the shipyards. The total number of workers exposed to asbestos since the beginning of World War II, including shipyard workers, is esti mated at between 8 and 11 million. asarco alv 0003731 2. What diseases may be caused by asbestos? Asbestos can cause asbestosis and certain forms of cancer. Among some groups of workers who were heavily exposed to asbestos, as much as 20-25 percent of all deaths are due to lung cancer. This rate is much higher than would be expected from the effects of cigarette smoking alone. In the general adult population, about 4*5 percent of all deaths are due to lung cancer. In addition, asbestos workers are at increased risk of mesothelioma, an other* wise uncommon type of cancer not associated with smoking and rarely observed in the general population. Above-average rates of cancers of the digestive system (esophagus, stomach, colon, rec tum) have been found in groups of asbestos workers. Cancers of a number of other body sites also are thought to be associated with occupational exposure to asbestos, but these are less common. 3. What is the role of cigarette smoking? Asbestos and cigarette smoking together produce more lung cancer than either factor acting.alone. For example,.investigators at the Mt. Sinai School of Medicine in New York City, together with epidemiologists at the American Cancer Society, have found that asbestos workers who smoke have a risk of lung cancer 5 times that of smokers in the general population. Cigarette smoking also increases the risk of other types of cancer and disabling lung diseases (emphysema, bronchitis). Some information suggests that quitting smoking can reduce this extremely high risk in asbestos workers. Although nonsmoking asbestos workers have more lung cancer than nonsmokers in general, they do not experience the extremely high risk of lung cancer of asbestos workers who smoke. However, they still are at increased risk of other asbestos-induced diseases, including asbestosis, mesothelioma and gastrointestinal cancers. 4. Are there other work-related exposures that may aggravate risk? There are other work-related exposuns that are associated with respiratory disease and cancer. Workers should be aware that some of these exposures may aggravate respiratory a!'~ients. Addi tional information on medical problems associated with occupa tional exposures may be obtained from the Clearinghouse for Occupational Safety and Health Information, 4667 Columbia Parkway, Cincinnati, Ohio 45226. I I i !!'!! I 2 ASARCO ALV 0003732 5. How does asbestos cause disease? The answer is not known. Asbestos fibers too fine to be seen by the human eye become airborne during various industrial processes and are inhaled and subsequently may be swallowed. Scientists believe the most harmful fibers are so fine that an elec tron microscope is needed to see them. Because of their size and shape, asbestos fibers can penetrate body tissues. Because of their durability, they remain in the body for many years after entry. 6. How much asbestos exposure is hazardous? The answer is not known. In the case of asbestosis and lung cancer, the risk increases with increasing amount of exposure. Asbestos-induced disease is not likely to appear until 15 to 35 or more years after first exposure. The time between first exposure and the appearance of disease appears related both to the amount and duration of exposure: more intense exposure sometimes re sults in asbestos-related disease within 15 years. However, one study of workers in an asbestos plant showed that some workers who were exposed only a month or two have developed asbestosrelated diseases many years later. Typically, the first 10 to 15 years after initial exposure are free of signs or symptoms. Early X-ray changes may appear in lung tissue after 10 to 15 years, but may not be accompanied by other significant symptoms. Some investigators have reported evidence of impaired lung function in workers with less than 10 years of exposure to asbestos.' Section 2: Mature of Asbestos 7. What is asbestos? Asbestos is the common name for a group of natural minerals that occur as masses of compact or relatively long, silky fibers. Six fibrous minerals, members of a family called silicates, are recognized as asbestos: chrysotile (white asbestos), actinolite, amosite (brown asbestos), anthophyllite, crocidolite (blue asbes tos) and tremolite. Commercially, chrysotile is the most important form of asbes tos, with most chrysotile used in the United States being imported from Canada. All forms have a tendency to break into a dust of tiny fibers that can float in the air and be inhaled or swallowed. 3 ASARCO ALV 0003733 8. How much is used? Asbestos has been used in small amounts for thousands of years. Modern industrial use in the United States dates from about 1880, when mining of the Quebec chrysotile deposits began. Gradual increases in production and use occurred during the next 50 years, followed by accelerated use more recently. From 197075, the amount of asbestos fiber used in the United States aver aged some 800,000 tons annually, according to the U.S. Bureau of Mines. Amosite from South Africa has been used in the U.S. in smaller quantities in industries such as shipbuilding. 9. How is it used? Asbestos has about 3,000 different uses, with about two-thirds being used in the construction industry in building products, insu lation, friction materials and textiles. Manufactured products have included reinforced asbestos cement sheets and pipes, patching and taping compounds, floor and ceiling tiles, as well as paints, coatings and sealants containing asbestos as reinforcing fillers, pipe linings and fillers for various liquids. Friction products include clutch facings and brake linings for automobiles, railroad cars, airplanes, and industrial machinery. A variety of other uses are known, including theater curtains, fire proof "blankets," filtration materials, and until recently, artificial ashes in false fireplaces and dry-wall patching compounds. Once incorporated into manufactured items, the hazard result ing from asbestos is less serious, as long as the substance is not dis rupted in any way. However, the fibers are nearly indestructible. A potential health risk arises whenever asbestos fibers are set free, resulting in asbestos dust. 10. How has asbestos been used in shipyards? Asbestos has been used extensively in shipyards to cover pipes and surfaces in new construction, repair and refitting. Major sources of exposure to asbestos in shipyards have been in fabrica tion of asbestos materials (such as pipe-coverings), their installa tion, and their removal during repair and refitting work. Asbestos has been included in insulation materials such as boards, mattresses, and cloth for engines, hulls, and decks; cover ing of ventilation and water pipes; coatings for cables and electric wires, wall boards and tiles; and putties, caulks, paints, joint fillers, and cement products. It may also be present in construction materials such as gaskets, rings, tape, tubing, twine, webbing, washers and coated electric wires. 4 l!!!!' k. ASARCO ALV 0003734 Asbestos exposure in shipbuilding probably is now far less than it was in the past, due largely to improvements in engineering and industrial hygiene methods and the introduction of other insu lation materials into construction. Section 3: Disease Recognition 11. What are the signs and symptoms of asbestosis? Asbestosis is a chronic lung disease whose signs and symptoms result from permanent changes in lung tissue due to asbestos expo sure. The earliest and most prominent sign is shortness of breath on exertion. It rarely becomes apparent until at least a decade after first exposure. The disease process usually has to be rather advanced to produce shortness of breath, however. A dry, crackling sound (rales), coming from the lungs during inhalation, is the most characteristic physical sign of asbestosis. Clubbing of the fingers is sometimes found, usually late in the disease. A bluish discoloration of the skin and the lining of the mouth and of the tongue also may occur in the later stages of the disease. A physical exam with X-rays will show diffuse scarring of the lungs as asbestosis develops, and lung function tests will show impairment of the maximum volume of air a worker can inhale. 12. Does asbestosis lead to lung cancer? Scientists do not believe asbestosis necessarily leads to lung 'i cancer, but the presence of this disease does indicate that a worker received considerable asbestos exposure and has a greater risk of developing asbestos-associated cancers than an unexposed person. Both types of disease can be caused by the same environ l .1 mental agent, and the development of each may be independent of the other. 13. What are the symptoms of lung cancer? A cough, or a change in cough habit, is found in most lung cancer patients. Chest pain is the second most common symptom. It usually is felt as a persistent ache unrelated to cough and is commonly experienced on the side on which the tumor is located. Blood-streaked sputum, coughed up from the lungs, is the initial symptom of a small percent of lung cancers. i ii r jl! < . 1: { ! * i;- if." L. r 5 i I ASARCO ALV* 0003735 14. How is lung cancer diagnosed? Initial diagnosis is by chest X-ray examination. Confirmation is by means of medical procedures such as sputum cytology, or biopsy by means of fiberoptic bronchoscopy, mediastinoscopy or by thoracotomy.* 15. What is mesothelioma? Mesothelioma is an extremely rare cancer in the general popu lation, but is more common among asbestos workers. It affects the pleura, a membrane lining the chest cavity, or the peritoneum, a similar membrane lining the abdominal cavity. A large proportion of mesothelioma cases can be traced to prior asbestos exposure. Only 120 cases of mesothelioma of the pleura and peritoneum were reported in the National Cancer Institute's Third National Cancer Survey of 1969-71, compared to 24,049 cases of lung can cer. The nine areas surveyed represented approximately 10 percent of the United States population. There is some indication from recent scientific reports that mesothelioma is becoming a more common diagnosis. 16. How is mesothelioma detected and diagnosed? The most common first symptoms may be shortness of breath or pain in the wall of the chest, aggravated by deep breathing; or abdominal pain, which may vary from vague discomfort to severe spasms. These spasms are sometimes located in the upper right region of the abdomen. Occasionally, this pain is accompanied by a need to urinate or defecate. Although chest X-ray is of some help in diagnosing mesothelioma when it occurs in the lining of the lung, precise diagnosis of this unusual cancer is difficult and requires an exploratory operation of the chest or abdomen, de pending on the patient's symptoms, to provide tissue for micro scopic examination. / i 11" I i; ______________ *More information is available in a brochure, "Progress against Cancer of the Lung," available from the Office of Cancer Communications, National Cancer Institute, Bethcsda, Maryland 20014. Living with Lung Cancer, a book in paperback form for patients, also may be helpful, and is available at nominal cost from Schmidt Printing, Inc., P.O. Box 6006, Rochester, Minnesota 65901. 6 r * ' E L ASARCO ALV 0003736 Section 4: Control of Exposure 17. How can a worker protect himself in the workplace? He can take steps to make sure his employer is aware of and following the asbestos exposure and related industrial exposures regulations of the Occupational Safety and Health Administration (OSHA). First, he can request a copy of the Standard on Worker Exposure to Asbestos from the Office of Information, OSHA, Washington, D.C. 20210 or from regional offices in Boston, New York, Philadelphia, Atlanta, Chicago, Kansas City (Mo.), Dallas, Denver, San Francisco and Seattle. After studying the standard, a worker may wish to discuss apparent shortcomings with his employer or union representative to try to get them corrected. He also may initiate a complaint of workplace hazards with OSHA for investigation. A booklet, Good Practices Manual for Insulation Installers, also is available and may be ordered from the Clearinghouse for Oc ;upational Safety and Health Information, National Institute for Occupational Safety and Health.* This publication describes recommended procedures for working with asbestos. Recommended practices for demolition operations have been published by the EPA. "Sprayed Asbestos-Containing Materials in Buildings: A Guidance Document" is available from the Stand ards Development Branch, U. Environmental Protection Agency, Research Triangle Park, N.C. 27711. 18. What else should a worker do if exposed? First, if still working around asbestos, he should take immedi ate steps to avoid additional exposure. Second, if he hasn't smoked cigarettes he should never start. If he has, he should quit. This will reduce the risk of lung cancer, no matter how many years he has smoked. He should also be alert to other potential health hazards in the workplace. Third, he should get regular health check-ups. His doctor should be made aware of his occupational history (for example, that he once worked in a shipyard), and provide a physical exami nation that includes a chest X-ray, a lung function test, a rectal examination, and possibly a sputum analysis. Sputum cytology, the examination of cells in deep cough sputum samples, is a proce dure still under study as a diagnostic method for lung cancer and is not widely available. However, it has shown some usefulness in studies of asbestos workers as an aid in identifying exposure. *Address is in question #4. 7 i !vl l i. IM j; . L. t Ii ar ASARCO ALV 0003737 Lung cancer, mesothelioma, asbestosis and other serious com plications of asbestos exposure are late results of asbestos-induced disease. Early X-ray changes often precede these serious conse quences. Absence of X-ray change is no guarantee of future safety. Some workers have had enough asbestos exposure to cause meso thelioma without showing earlier X-ray changes. However, in gen eral, absence of X-ray change many years after initial exposure provides evidence of limited exposure. Section 5: Treatment 19. What can be done to treat asbestos-related diseases? Asbestosis: Most deaths from asbestosis are due to super imposed respiratory infections such as pneumonia and bronchitis, rather than to direct effects of the disease itself. These infections usually can be treated, but it is important to get medical attention early. Lung and Esophageal Cancer: Treatment of these cancers de pends on the type and amount of tissue affected. Lung cancer may be treated by surgery, drugs, radiation, or combinations of these treatments. Esophageal cancer is treated most often with radia tion. As with most cancers, the treatment must be tailored to the individual patient. Cancer of the Colon and Rectum: Surgery is curative in many cases and early diagnosis increases the likelihood of cure. Methods are available to improve the frequency of early diagnosis. Mesothelioma of the Pleura or Peritoneum: Effective treat ment is not yet available. Research is underway in the United States, Great Britain, and France to improve the treatment. Cancer of the Stomach: Detection has been improved by de velopment of the flexible gastroscope and gastric camera. Treat ment is usually by surgery. New treatment regimens using drugs are improving the outlook for patients with this cancer. Cancers of the Kidney, Larynx, and Oropharynx: Physician awareness of the possibility of occurrence improves chances for early diagnosis. These cancers often can be treated effectively by surgery and/or radiation therapy. 8 asarco alv 0003738 Section 6: Federal Efforts 20. What Federal agencies are concerned with the effects of asbestos exposure? The National Cancer Institute (NCI) and National Institute of Environmental Health Sciences (NIEHS) are conducting or spon soring research on the health hazards of asbestos. The National Institute for Occupational Safety and Health (NIOSH) also is re sponsible for research on the documentation of hazards, and operates an information service to answer workers' questions j about occupational safety.* The Occupational Safety and Health Administration (OSHA) ! regulates worker exposures. This Agency is part of the U.S. De li partment of Labor. The Environmental Protection Agency (EPA) j! is charged with monitoring levels of asbestos in air and water. The ; Food and Drug Administration (FDA), a part of the U.S. Departj ment of Health, Education and Welfare, is concerned with asbestos j contamination of foods, drugs, and cosmetics, such as might occur during the manufacturing process. The Consumer Product Safety Commission (CPSC) recently has banned the use of asbestos as artificial ash for ceramic logs in I gas-burning fireplaces, consumer clothing made of asbestos, and j! the manufacture of dry-wall patching compounds containing ) asbestos. : 21. What are some current Federal activities on this problem? An Asbestos Subcommittee of the Armed Forces Epidemiol ogy Board has been established and currently is reviewing pro grams which might be recommended to the Secretary of Defense concerning asbestos-related disease among civilian employees of the Armed Forces, as well as veterans and men and women cur- II rently in service. At the request of this Subcommittee, additional j | information is being gathered to assess the health risks of shipyard workers in various U.S. locations. Investigators of the Environmental Sciences Laboratory, Mount Sinai School of Medicine of the City University of New York and the American Cancer Society, are collaborating in a number of studies of shipyard workers, funded partly by the National Institute of Environmental Health Sciences, Research Tri angle Park, North Carolina. NIEHS also is sponsoring a study, with partial support from the EPA, in rodents on ingestion of asbestos minerals. *Address is in question #4. 9 r. :'f :i- illl*; ill: i ii' \ I- - r Mi . . ;: L r ASARCO ALV 0003739 The National Cancer Institute (NCI) has planned an analysis of respiratory cancer in several shipbuilding areas along the east coast of the United States. Currently, NCI is completing an interview analysis of lung cancer cases and controls along the southeastern Atlantic seacoast where elevated lung cancer death rates were found in a nationwide study of geographic cancer patterns. An educational program for physicians and the public is being developed by DHEW in cooperation with the voluntary health agencies, concerned unions, and the asbestos industry. Section 7: Other Sources of Information 22. Where can a worker go for more information? (a) Sixteen Cancer Information Service (CIS) offices provide toll-free telephone sources of information. These offices can help with a variety of questions about cancer, including causes, preven tion, detection, diagnosis, treatment, rehabilitation assistance, i, medical facilities available in a particular region, home-care assis tance programs, financial assistance for cancer care, emotional I* counseling services, and patient referrals. These offices also can provide information about local smoking cessation clinics. CIS offices do not diagnose cancer or recommend treatment for individual cases. They do provide facts, understanding and rapid access to the latest information on cancer and local re sources. The locations of the CIS offices are indicated at the back of this brochure. (b) Workers may wish to contact their international unions or the Industrial Union or Metal Trades Departments of the AFL- CIO, 815-16th Street, N.W., Washington, D.C. 20006 for specific sources of medical help, information on asbestos co^'rol, and insurance matters. (c) Individuals who once worked in the Navy shipyards may wish to contact the Department of Defense, Public r rrespon- dence. Directorate for Management, Washington, D.C. 20301. (d) Inquiries concerning environmental exposures such as those occurring during building demolition, or other air and water concerns may be answered by the Public Information Center, 10 If;- [ ASARCO ALV 0003740 PM-215, U.S. Environmental Protection Agency, 401 M Street, S.W., Washington, D.C. 20460. (e) The Consumer Product Safety Commission (CPSC) oper ates a "hot-line" for answering questions about potential hazards of commercial products: (800) 638-2666, except Maryland resi dents, who should call (800) 492-2937. (f) For information on current Federal regulations concern ing the workplace, workers may contact the Occupational Safety and Health Administration, Office of Information, Washington, D.C. 20210. (g) The National Cancer Institute will answer questions about health risks associated with asbestos exposures. Write to Asbestos, National Cancer Institute, Bethesda, Maryland 20014. (h) For specific information on how to quit smoking, a worker may contact the Office on Smoking and Health, Room 622E Humphrey Building, 200 Independence Avenue, S.W., Wash ington, D.C.20201. (i) Compensation: Individuals who suffer asbestos-related diseases as a result of employment may have a right to assistance under a worker compensation law. Those who were exposed to asbestos during the course of Federal employment may be covered by the Federal Employee Compensation Act. Those presently employed in shipyards by private employers may be covered under the Longshoremen and Harbor Workers Compensation Act. For information about eligibility for these two compensation pro grams, contact the Office of Workers Compensation Programs of the Department of Labor, Employment Standards Administration, 200 Constitution Avenue, N.W., Room S3524, Washington, D.C. 20210. Former or retired military personnel should contact the Veterans Administration for information. Those exposed while working for private employers should contact their state worker compensation programs in the state where last exposure occurred. Worker compensation laws and the benefits they provide vary widely. If compensation is offered in a particular state, the law generally will provide some benefits for medical care expenses, permanent disability, and care of survivors to those who can demonstrate their eligibility. 11 ASARCO AL\/ 000374-1 I t I (j) Workers may be interested in ordering a new publication, Cancer and the Worker, for $2.00 from the New York Academy of Sciences, 2 East 63rd Street, New York, New York 10021. This book was written to inform workers and plant managers about what we know--and do not know--about cancer risks in the work place. It is based on a March 1975 symposium on "Occupational Carcinogenesis" sponsored by the Academy. (k) Other information on how to quit smoking, lung diseases, ' and cancer is provided by local offices of the American Lung Association and the American Cancer Society. These organizations have local offices throughout the United States that may be identi fied from the telephone book. 1I i 8li. I JK I \ i 12 j . J E_ r ASARCO ALV 0003742 i i!i 1 ' Cancer Information Services: CALIFORNIA LAC-USC Cancer Center From Area Codes (213), (714) and (805): 1-800-252-9066 Rest of California: (213)226-2374 COLORADO Colorado Regional Cancer Center 1-800-332-1850 CONNECTICUT Yale University Comprehensive Cancer Center 1-800-922-0824 DELAWARE Fox Chase Cancer Center 800-523-3586 DISTRICT OF COLUMBIA (Includes suburban Maryland and Northern Virginia) Cancer Communications for Metropolitan Washington (202) 232-2833 FLORIDA Comprehensive Cancer Center for the State of Florida Florida: 1-800-432-5953 Dade County: (305) 547-6920 ILLINOIS Illinois Cancer Council Illinois: 800-972-0586 Chicago: (312) 346-9813 MAINE Maine Cancer Information Service 1-800-225-7034 MARYLAND The Johns Hopkins Oncology Center 800-492-1444 MASSACHUSETTS Massachusetts Cancer Information Service 1-600-952-7420 MINNESOTA Minnesota Cancer Council 1-800-582-5262 MONTANA Montana Cancer Information Service 1-800-525-0231 NEW JERSEY Fox Chase Cancer Center 800-523-3586 NEW MEXICO New Mexico Cancer Information Service 1-800-525-0231 NEW YORK Roswell Park Memorial Institute New York State: 1-800-462-7255 Erie County: (716) 845-4400 NEW YORK CITY Memorial Sloan-Kettering Cancer Center (212) 794-7982 NORTH CAROLINA Duke Comprehensive Cancer Center North Carolina: 800-672-0943 Durham County: (919) 286-2266 PENNSYLVANIA Fox Chase Cancer Center 800-822-3963 TEXAS M.D. Anderson Hospital and Tumor Institute Texas: 1-800-392-2040 Houston: (713) 792-3245 WASHINGTON Fred Hutchinson Cancer Research Center Washington: 1-800-562-2875 Seattle Metro: (206) 284-7263 WISCONSIN Wisconsin Clinical Cancer Center Universitv of Wisconsin 800-362-8038 WYOMING Wvoming Cancer Inform: tion Service 1-800-525-0231 Other States: 800-638-6694 13 p 1 : i'' i i. i Uf.. j I1!: ! ' i ; i I i L ASARCO ALV 000374-3 F Quick Guide to the Answers 1 Question # Air (see Environmental Protection Agency) i Building demolition (see also Environmental Protection 17 Agency) Compensation 22(i) Construction use 9 Consumer products (see also Consumer Product Safety Commission) 9 Examinations 18 Latency 5,6 Medical help 18, 22 Occupational risks 1*6 Other sources (for referrals) American Cancer Society American Lung Association Cancer Information Service Clearinghouse for Occupational Safety and Health Information Consumer Product Safety Commission Environmental Protection Agency National Cancer Institute Occupational Safety and Health Administration Office on Smoking and Health Unions U.S. Navy (Department of Defense) 22(k) 22(k) 22(a) 4 22(e) 22(d) 22(g) 17, 22(f) 22(h) 22(b) 22(c) Prevention 3,18 illiL-.,-. 1 Publications Cancer and the Worker 22(j) 14 ASARCO ALV 000374-4- Good Practices Manual for Insulation Installers Living With Lung Cancer Sprayed Asbestos-Containing Materials in Buildings: A Guidance Document Standard on Worker Exposure to Asbestos 17 14 17 17 Research Shipyard use Signs, symptoms, and diagnosis Asbestosis Lung Cancer Mesothelioma Other Cancers Smoking Treatment Asbestosis Lung Cancer Mesothelioma Other Cancers 21 1,10 11,18 13,14,18 15,16,18 19 2,3,18 19 Water (see Environmental Protection Agency) Workplace controls 10,17, 20 Workplace exposures 1,4,6 15 ASARCO ALV 000374.5 Suggested References Becklake, M. R. Asbestos-related diseases of the lung and other organs: Their epidemiology and implications for clinical prac tice. American Review of Respiratory Disease, Volume 14:114227,1976. Clifton, R. A. Asbestos-1977: Mineral Commodity Profiles, MCP-6. U5. Department of the Interior, Bureau of Mines, September, 1977. Single copies available without charge from Publications Distribution Branch, Bureau of Mines, 4800 Forbes Avenue, Pittsburgh, Pa. 15213. IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Man: Asbestos. Vol. 14,1977,108 pp. A publica tion of the World Health Organization. May be ordered from the Q Corporation, 49 Sheridan Avenue, Albany, New York 12210. Key, M. M., Henschel, A. F., Butler, J., Ligo, R. N., Tabershaw, I. R. Occupational Diseases: A Guide to Their Recognition. U.S. Department of Health, Education, and Welfare, Public Health Service, Center for Disease Control, National Institute for Occu pational Safety and Health, June 1977,608 pp. For sale by the Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. National Institute for Occupational Safety and Health. Current Intelligence Bulletin 5. Asbestos: Asbestos exposure during servicing of motor vehicle brake and clutch assemblies: August 8, 1975, IN: NIOSH Current Intelligence Bulletin Reprints. U.S. Department of Health, Education, and Welfare, DHEW (NIOSH) Publication No. 78-127,1978. Selikoff, I., Hammond, E. C. Asbestos-associated disease in United States shipyards. Ca-A Cancer Journal for Clinicians, Vol. 28, No. 2, March/April 1978. |T Iit-` liL-- j. 16 U.S. GOVERNMENT HUNTING OFFICE: 1979 O-- jaj.97* ASARCO ALV 000374-6