Document 65dOdQNyz2bn9d4mrBo7orq83

January 21, 1972 Mr. E. W. Holman Pittsburgh Corning Corporation Gateway 3 The attached is an EPA position statement on asbestos made at a public hearing in Hew York on January 18, 1972. LBG: lc Attachment Lee B. Grant, M.D. Medical Director 001333 ( HE-LT J 't'-r'-'l '> .? "'V-.0-O' rcH-rwinj SCJtille:.*. is u brie' Sultry -jr ;r<..*r aspect; o' the `.'-ecology of ssbtscjs rm,ch establish it rs a recaseous a;.r.' poi iutsr.t. A h^Zaroo^s air ^cl "utant is defined dv section I'd o*` the Cn??*' Air Act of \i70 as oi-e: . "to vnic.h no a*"b''rMt air quality sti-.oai'o -;s apoli^ujie *ho wrvtn in the j.ioqment cf tr.e Aiiirrstrjtor ^y cause, or co:i`.riout= to. an increase ir. f.-orc'ity cr an inc,-*se In seriojs irreversible, or 'rceoacitating reversible illness."^ Toe diseases rfiicn o.e been related to the inhalation of asbestos by hunmns include asu-rstosis and i;Vi!iqn*nc tumors of the lung, pleura and per;cooeuri. 0^ these, asbestosis was the first to be associated with exposure to asbestos. Asbestosis is a nor*-**!-.grant lung disease which results in an x-ray pattern of diffuse interstitial fibrosis and physiologic changes consistent with a restrictive lung 2 * -disorder. . The disease is often lethal tn severe cases. However, prolonged exposure to asbestos concentrations far above those likely /. ~to be found in comnunlty air is-required to produce clinically sig- ... nificant (i.e. incapacitating) asbestosis.. ". An association between asbestos exposure and carcinoma of the - lung was first firoly established by epidemiologic evidence reported in 1947. The data indicated that bronchogenic carcinoma was present -r in 13.2 percent of 235 persons known to have died with asbestosis. -In the years since 1947, numerous other studies have confined this Si# n'p yeyV-iJ-- ""'W** * ^ w ec. . ".y ^ ^ *.*..'*Tm :' s` , -001334 ^ f-.ts*T. K*v -~ . ,i relationship bet*<rn asc^stos closure and lung cancel.4- 1 7 One Study ` showed that a;: rstrs ~r: -.Sio tc.-v* a<' S2 ti.Ts as iikely to de velop lung cancer as non-c^-rsco-j workers wno do :>oc sp--*.^ (Should exposures in the general population e^rsdcn thole in occupational f(tuitions a considerable increase in ncrtality end awrbidicy of lung cancer could be produced.) However, whether nono^copaticna': exposures to asbestos pliy i role In the development of bronchogenic carcinoma has not been adequately studied. The Panel on Asbestos cf the National teademy of Sciences has evaluated the existing literature on asbestos. According to their review the only tuwor issoclited with nor.occupation-il asbestos exposure Is diffuse mesothelioma. Hesotbeliomlas, primary malignant tumors of the pleura and peritoneum, however, are serious. In 1960 Wagner et al. 18 reported 33 cases of pleural mesothelioma from South Africa. A history of asbestos exposure was established for all but one patient. Only 17 of these r* 'm * were occupationally exposed. The remaining patients lived In the vicinity of an asbestos line or had household contacts with miners. Htnerous other reports linking mesothlal malignancies to asbestos exposure' have been published since 1960.8*9,10iU'1?,Z7 This argues strongly for a causal association. Thus several types of exposure to asbestos have been associated with mesotheliomas Including: 1) occupational exposure to asbestos, 2) employment or resi dence near an asbestos Industry,-3) household contact with an asbestos worker, and 4) no known exposure. For example, Hewhouse and Thompson :;;V - ' " - 2- >.- :' -V"** ; 0dl335 a series of 83 patirnts whose a* s a the 1 iotas were diagnosed ' _ at the London Hospital between 1917 and 19o4. The authors were able i to obtain full occupational and residential histories for 76 patients in the series. They found that 31 (40.82) had occupational exposures to asbestos, 9 (11.82) lived in the sane house as an asbestos worker, 11 (14.52) had no history of occupational or household exposure but . lived within half a wile of an asbestos factory and 25 (32.92) had i no known exposure. Of the 25 with no known exposure, four were found to have asbestos bodies in their lungs. Corresponding percentages for a group of Batched control subjects were: occupational exposure * 10.52, household exposure - 1.32, neighborhood exposure - 6.62,' end no exposure - 81.62. These findings strongly implicate asbestos as a causal factor In this disease. Hany case reports of mesothelioma Include persons who Have worked In the shipbuilding and construction Industries at jobs that do > 28 not Involve direct contact with asbestos. Thus, It Is apparent that indirect occupational as well as nonoccupatlonal exposure to asbestos ay contribute to the development of aesothelioma. Accurate characteri zation of previous asbestos exposure in Individuals who subsequently `develop e so the! ion is difficult because of the prolonged latent^period between exposure and the onset of disease. The prognosis of wallgnant esothelIotms Is extremely poor. In one large series of aallgnant jt 1 - ----- esotheliomas the average duration of life following the onset of * symptoms was only 16.4 onths.' t ' .* - ' - * 001336: "Because of tre :? z.;n sericus effects of uncontrolled inhalation of asbestos mirsr-ls in Industry and uncertainty as to the shape, and character of the dose-response curve in man, it would be highly Imprudent to perr.it additional contamination of the public environ ment with asbestos. Continued use at minimal risk to the public requires that the major sources of man-made asbestos emission into the atmosphere be defined and controlled. In the absence of such controls, local fiber concentrations might at times approach those in occupational sites. Analytic methods and epidemiologic data are not yet adequate for the development of an ambient air standard, but emission controls are needed and appear to be feasible.* * *? -rr i. V." - i. 4 -- 001337 Asbestos References 1. The Clean Air Act. Crvironmental Protection Auency, Washington, D. C. December, 197C. p. 15. 2. Asbestos. Report of the Comm, on Biological Effects of Atmospheric ' Pollutants, Div. of Pedical Sciences, national Research Council, National Academy of Sciences, Washington, D. C. 1971. p. 4. 3. Ibid, p. 5. P 4. Buchanan, V. D. Asbestosis and primary Intrathoracic neoplasms. Ann. N. Y. Acad. Sci. 132: 507-518, 1955. 5. Dunn, J. E., Jr. and J. M. Weir. A prospective study of mortality of several occupational groups. Special emphasis on lung cancer. Arch. Environ. Health 17: 71-76, 1968. 6. Enterline, P. E. Mortality among asbestos products workers in the United States. Ann. N. Y. Acad. Sci. 132: 156-165, 1965. 7. Enterline, P. E. and M. A. Kendrick. Asbestos-dust exposures at various levels and mortality. Arch. Environ. Health 15: 181-186, 1967. , 8. Hammond, E. C., I. J. Selikoff, and J. Churg. Neoplasia among insulation workers in the United States with special reference to intra abdominal neoplasia. Ann. N. Y. Acad. Sci. 132: 519-525, 1965. 9. Jacob, 6. and K. Anspach. Pulmonary'neoplasia among Dresden asbestos workers. Ann. N. Y. Acad. Sci. 132 : 536-548, 1965. 10. JCleinfleld, N.,'J. Messite, and 0. Kooywan. Mortality experience _ in a group of asbestos workers. Arch. Environ. Health 15: 177*180, 11. Knox, J. F., R. S. Doll, and I. D. Hill. Cohort analysis of changes . In incidence of bronchial carcinoma in a textile asbestos factory Ann. N. T. Acad. Sci. .132: 526-535, 1965. ....... - 12. lleban, J. Malignancies In asbestos workers. Arch. Environ. . Health 73 : 619-621, 1966. / 13. ' Mancuso, T. E. and A. A. El-Attar. Mortality pattern in a cohort 'of asbestos workers. J. Occup. Med.* 9: 147-162, 1967. . .~ 14. -Selikoff, I.'J.; J. Churg, and E.'C. Hanhond.-.Asbestos exposure and neoplasia. J.A.K.A. 188: 22-26, 1964. 00133S. f 15. Sel i I. J., E. C. Iljnarnd, sr.d J. r.i.org. Achestos e a.k * sntc<ing and neoplasia. J.A.M.A. 2f:i: lv6-112, 126-'. ) 16. Vigiliani, E. C., G. Mott-rj, and P. Maranzans. Association of pulmonary tirrjrs with asbestos ir. Piedmont and Lombardy, Am. N. Y. Acad. Sci. 132: 558-574, 1965. 17. Wright, G. W. Asbestos and Health in 1959. Aroer. Rev. Resp.Dis. 100: 467-479, 1969. 18.* Wagner, J. C., C. A. Sleggs and P. Karchard. Oiffuse Pleural Mesothelioma and Asbestos Exposure in the Northwestern Cape Province. Brit. J. Ind. Med. 17: 260-271, 1960. 19. Borow, M., A. Conston, L. L. Livornese, and H. Schalet. Meso- . thelioma and its association with asbestosis. O.A.M.A. 201: . 587r591, 1967. .. 20. Elmes, P. C., W. T. E. McCaughey, and 0. L. Vade. Diffuse meso thelioma of the pleura and asbestos. Brit. Hed. J. 1: 350-353, 1965. 21. Elmes, P. C.,-and 0. L. Wade. Relationship between exposure to asbestos and pleural malignancy In Belfast. Ann. N. Y. Acad. Sci. 132: 549-557, 1965. 22. HcEwen, J., A. Finlayson, A. Malr, and A. A. H. Gibson. Mesothelioma . In Scotland, Brit. Med. J. 4: 575-578, 1970. .23. Newhouse, M. L. and H. Thompson. Epidemiology of mesothelial tumors in the London area. Ann. N. T. Acad. Sci, 132: 579-588, 1965. 24. Owen, W. G. Diffuse mesothelioma and exposure to asbestos dust *^ -----^,.-10 the Merseyside area. Brit. Med^ 2: 214-218, 1964. -- 25. Slikoff, I. J., J. Churg, and E. C. Hanrond. Relation between exposure to asbestos and mesothelioma. New England J. Med. 272: - - = - ` 560-565, 1965.. 26.' Hewhouse, M. L. and H. Thompson. Mesothelioma of pleura and peritoneum following exposure to asbestos In the London area. Brit.. J. Ind. Med. 22: 261-269, 1965. - 27. -..lleben, J. and H. Plstawka. Mesothelioma and Asbestos Exposure. ...Arch. Environ. Health 14: 559-563, 1967. ' 28* " Asbestos." op. c1t.;"p. 49.' '29. Ibid. p. 31/ r' : 001339' Or