Document BEEp2kL8wwmqymqo0D0KJxwm

.` .*-?*!**--i-* *- *I>>-*,*1~*--e,-\**r;**-/'*, *s.**.:: '''* . -- ,;.v>. . *-?: INDUSTRIAL HEALTH NEWS LITERATURE ABSTRACTS MEDICAL ENGINEERING CHEMICAL - w,- TOXICOLOGICAL JUNE, 1968 (Vol. 32, No. 6) INDUSTRIAL HYGIENE FOUNDATION 4400 FIFTH AVENUE PITTSBURGH, PA. 15213 5 51 Pulmonary Function ir. 3acasse Worker's Lur.: Disease. A . K. Pierce et al. .Am. Rev. P.esp. Dis. 561 -570 .'April. 1 -or!. Seven previously well m.er. workir.c ir. a fiberbcard plant developed signs and symptoms of ac-j-. bagasse worker's lur.g durir.c a ten-wee!-: period. Two of these patients had open lur.g bioosie* to confirm the diagnosis. Pulmonary functions were measured from 2. 5 weeks to 26 months after the onset of symptoms. All patients had a restrictive lung defect due to a reduced in spiratory capacity: partial airway obstruction was r.ot a feature of the illness. All patients had a severe reduction in the transfer coefficient of the lur.c for carbon monoxide at the outset this was primarily due to a reduction in membrane diffusing capacity, whereas the volume o: blood in the pulmonary capillaries was more nearly normal. Although pulmonary functions returned toward normal, the total lung capacity, inspiratory capacity, vital capacity, forced expiratory volume, transfer coefficient of the lung for CO. and membrane diffusing capacity remained significantly abnormal more than one year after the onset. Three patients were treated with adrenocorticosteroids and -) were not. There was no significant difference betwe*- the treated and the untreated patients in the rate of objective improvement or in the extent of residual impairment of pulmonary functions. These data suggest that steroids do not hasten the resolution of a granulomatous infiltrate nor do they make resolution more complete. There are 28 references. -- Authors' summary. 552 Metal and Mineral Concentrations ir. Lungs of Bituminous Coal Miners. J. V. Crable. eta!. Am. Ind. Hyg. Assn. J. 29. 106-110 (March-April, 1968). Lung and pulmonary lymph node samples from 26 West Virginia bituminous coal miners nave - analyzed for total dust, coal, and free silica. In addition, beryllium, cobalt, manganese. r.U- titanium, and vanadium were determined by the quantitative spectrographic methods; lead was determined by the L'SPHS dithizone method; and copper, iron, magnesium, and zinc were deter mined by atomic absorption spectrophotometric methods. The summarized results of the rr.ir-'- analyses from this study and the authors' previous study are presented. The concentration and mean values for eleven elemental constituents are compared with normal values reporter Tipton and Shafer and Cholak. There are 9 references. -- Authors' summart 553 Tissue Response to Intraperitoneal Asbestos With Preliminary Report of Acute Toxicitv of -612-1 Treated Asbestos in Mice. J. Jagatic, et al. Environ. Research_l_, 217-230 (Nov..1ih Intraperitoneal asbestos not only produced fibrosis, but a special and peculiar type of fibrt= r which was proliferative, granulomatous and invasive, and histologically similar to mesothe- although morphologic evidence of actual malignancy was not obtained. Further, asbestos " exposed to high temperature produced a high degree of toxicity in experimental animals: t"'-- resulted in a 60ro mortality rate. -- Authors Editor's Note: Although the authors of this 14-page article insist that the fibrous ir.flam..--* tissue resulting from intraperitoneally injected asbestos is histologically similar to meso>and that it is "invasive", they gave no evidence in support of these opinions. The 22 il!us-r`! that are included in this report, support neither the claim of similarity to mesothelioma ^ of "invasiveness" of the inflammatory tissue. 5 54 Asbestos--A Hazard to the Community. C. Gold and J. Cuthbert. Public Health(London) 80, 261-270 (Sept. 1966). During a recent study of pulmonary fibrosis in a Southeast Glasgow clinic. 21 proved ca3 possible cases of lung pathology associated with exposure to asbestos have come :0."' patient with suspected asbestosis should have, ir. addition to x-rays, an examination bodies in the sputum, lung function tests, and open lur.g biopsy, since asbestosts has * in patients with normal or borderline x-rays by the lung function test and most relia--- ^ biopsy. It is also important to take a complete occupational history in cases o: obscu ^ ^ fibrosis, since asbestosis or pr leural tumors mav' occur manv' tears after. a. suho_rtt-V the asbestos dust. Also, persons ir. occupations SUaIi rot associated wit:: ~e-- be endangered by working ir. close proximity with people who use asbestos, espec--*-spaces. Case histories are given and a table is presented showing the type o: aS-'c' _ . tion, length of exposure, ace, and period elapsed since eXDOsure of the 24 pane.--Since the use of asbestos has become more widespread ir. recent tears, it '-s reCO" 4 Iternative materials to asbestos should be used whenever possible. A proposal to mix 3 th tarmacadam for road use is viewed with concern. -- APCA Absts. ~ 'iios \ote: Regarding 5o4-56o. interested readers are referred to the Editorial in the May iE-rTTjp""and IHF Medical Series Bulletins No. 11 ar.d 12 which report progress and planning `b(jStos bioeffects research. -- R. T. P. deT. ..if" as j*.mioloay and Clinical Features of Asbestosis and Related Diseases. P. C. Eimes. ^Jtgraa- ` J. 42, 623-635 (Oct. 1966). -- 0nary fibrosis caused by asbestos dust has become less common since the introduction of ,uppresssion measures in 1932-33. However, in occupations where these safety measures observed, asbestosis is still a threat. Symptoms of asbestosis are breathlessness on ir*rtjoni productive cough, tightness in the chest, clubbing of fingers, warts, cyanosis, restricted movement, kyphosis, and fine rales heard over the lung bases. Changes in x-rays are citeconclusive, since they also occur with other forms of chronic diffuse fibrosis involving the "leura. N laboratory tests except lung biopsy are diagnostic of asbestosis but sputum examinand respiratory function tests help to support the diagnosis. Carcinoma of the lung result- from exposure to asbestos appears to be common in patients whose exposure to the dust was sufficiently long or intense to cause crippling fibrosis. The rapidly increasing number of ases of fatal mesothelioma of the pleura and peritoneum have been definitely traced to exposure *o asbestos dust. The degree of exposure in many cases is slight and there can be a long interval between exposure to the pollutant and the development of the tumor. Preventive measures re commended are restriction of use and greater precaution in the handling of all types of asbestos. Crocidolite fiber, in particular, should be eliminated from commercial use. -- APCA Absts. i.heatos--An Environmental Health Hazard. W. D. Norwood. P. A. Fuqua and T. F. Mancuso. 9 vnrthwest Med. 66. 821 (Sept., 1967). four Case Reports demonstrate asbestosis with pulmonary emphysema and cor pulmonale, as bestosis with lung cancer, mesothelioma, and rectal cancer. The occupational histories of workers as plumbers, boiler makers, carpenters, pipe fitters, steam fitters, mechanics, stationary engineers, undercoaters, foremen, maintenance electricians, builders, rubber workers, construction workers, cement workers, boiler repairers, sheet metal workers and laborers must all be elicited if diagnosticians hope to record the more than 3, 000 different exposures to asbestos. For the sake of workers and their dependents with industrial health compensation rights, the diagnostician must not be misled by recent occupational history nor overlook other work exposures within the lifetime of the patients. The obvious need for de creasing the exposure to asbestos by better occupational hygiene programs is recognized but no detailed criteria were presented. Considering the growing uses of asbestos, this occupational and environmental disease may get worse before it gets better. -- J. Occ. Med. Absts. Talc in Atmospheric Dusts. H. Windom. J. Griffin, and E. D. Goldberg. Environ. Sci. Tech. _1_. 923-926 (Nov. 1967). The mineral talc has been observed in dusts recovered directly from the atmosphere and in the solid mineral phases of rain and snow. The talc, where detected, attains levels of the order of a per cent by weight in the solid phases. This talc probably arises from agricultural activity where the mineral is used as a carrier and diluent for pesticides. The amounts of talc found in atmospheric dusts appear to reflect a local introduction rather than a generalized global fall outMeasurement of Asbestos Exposure. J. R. Lynch and H. E. Ayer. -- APCA Absts. J. Occ. Med. 10, 21-24 (Jan., i 968). As an outcome of an epidemiologic study, a safe level of exposure should be set in terms of a method of exposure measurement which meets the following criteria in the order given: (1) The environmental factor measured should be sufficiently relevant to the disease mechanism to correlate with health status ever. ir. environments where exposures to mixed dust occur. (2) The sensitivity of the method should be such as to measure levels well below the Threshold Limit Values (TLV). (31 The method should lend itself to an appropriate sampling strategy: e. g. , long-period personal samoles in the case o: asbestos. (41 The expense of conversion from existing methods should be reasonable. The impinger method of measuring asbestos exposure does not meet ar.v of the criteria -.veil with the exception of expense. Weight methods would be ^referred if there were an ar.alvtical breakthrough. At present fiber counts on membrane filters are the best method e stimatlr.i exoosure ts related to the risk a: asbestosis and the airborne fiber concentration as a factor ir. the risk a. lar.g cancer. There are - references. -- Cord from text. Industrial Hygiene Digest une. 1dpi 559 Industrial Hvgier.e for Insulation Workers. J. L. Balzer. J. Occ Med. _1_- 25-31 (Jan,, 19681. The asbestos worker is exposed to amosite and.chrysotile asbestos-containing materials, fibro : glass, cork, plastics, and adhesives. Working in industrial and commercial building protects and marine construction and repair, he is exposed to many other environmental hazards not created by his own trade. Although he works with asbestos-containing products 45^ of the time the over-all time-weighted average exposure to asbestos-containing materials is below the pre- sently recognized Threshold Limit Values (TLV) of 5 mppcf. The three work areas in which | dust levels were above the TLV (prefabrication, tearing out, and mixing) account for less thar 20% of his total work time. However, the incidence of radiographic changes indicative of j asbestosis is over 25% in our men with 20 years or more of work. This and other evidence suggest that the present TLV is too high. Incidence of asbestosis and the risk of malignancies in the asbestos worker can be reduced by local and general ventilation, substitution of materia.s changes in work habits and personal respiratory protection combined with education of the rr.r to reduce their own exposures to asbestos-containing dusts. There are 17 references. -- Author's summarv. 560 Asbestos as an Environmental Hazard. I. R. Tabershaw. J. Occ. Med. U), 32-37 (Jan., 1968). In summary, if one accepts the assumptions (1) that asbestos minerals increase the risk of iur: cancer in occupational groups. (2) that they lead to an unusual risk of mesothelioma of the pie--; and peritoneum in occupational groups and those living near asbestos plants, (3) that such maii:- nancies usually result from exposures 30 to 50 years earlier. (4) that the "asbestos bodies found in from 25 to 50% of lung smears from routine autopsies are probably due to asbestos ir. most cases, (5) that these "asbestos bodies" may result from recent exposures as well as thoJf many years earlier, (6) that world production and use of asbestos has increased from 500. 00 tons to 3, 500, 000 tons in 30 years, it is important to consider whether or not asbestos is a m.a' threat to public health. One is not yet justified in such a conclusion, in view of the fact that rr.of the world tonnage goes into uses that do not lead to air contamination; that asbestos is not act-*- indestructible; that the effects are dose-dependent: and that low doses probably lead to lover rates and longer latency. Nevertheless, there is need for epidemiologic studies directed to with intermediate exposures and for evaluation of the beneficial effects of cessation of smo*"- Another need is for experimental and industrial hygiene studies to determine the nature anc of exposure. Biologic studies centered on the meaning of the "asbestos body" are crucial tr understanding the clinicopathologic response. Strict control of industrial and neighborhood environments is essential, but it is premature to extrapolate from the effects of heavy expos- to minor and low level exposures. There are 15 references. -- Author's summ- 561 Research on Health Effects of Asbestos. L. J. Cralley, et al. J. Occ. Med. Hh 38-41 (Jan. ,1968). Asbestos is a general term applied to a group of fibrous crystalline hydrated silicate rr.'ner Although a number of different types of asbestos minerals exist, only four or five are o. commercial importance. Each differs somewhat from the others in chemical compos:tl'_ physical properties such as ability to withstand heat and chemical erosion, crystalline fiber dimension, and degree of fiber harshness and brittleness. It has been known since nineteen hundred's that excessive exposure to asbestos gives rise to the disabling pu m . disease "asbestosis." More recently, evidence has been developed that the incidence r piratory tract and other malignancies in asbestos workers is excessive. A major pr ^ - studying the health effects of asbestos is the long latent period of 20 or more years tr<- _ exposure to the onset of disease. Also in the mid-nineteen thirties and earlier. there dust control and the workers were often exposed to massive levels of dust from asbe--^ ^ ^ other associated materials in the manufacture of asbestos products. Thus, the cau- of the resultant disease are essentially unknown. Included in these potentia. sou. ` causative agents, either alone or in combination, are asbestos fibers themselves. _ associated with the fibers in the ores such as trace minerals and polycyclic aroma-- t v - ' materials added during processing such as metals, tars, and pitches, and conco.- exposures to tobacco smoke or other air pollutants. A strong supported lone-ter. r needed tc provide the information regarding the pathogenesis of asbestosis and <? ^ - that appear associated with the inhalation of asbestos dust. More precise data o. 20. ni June. 1968 . .^n-.ical character izatior. of the asbestos minerals which lead to their being inhaled and ,:-.c ir cr.e body, :r. their carrying with them other chemicals, in their migration, may open ...-us-?*-cted avenues of biological research. -- Cond. from text. , -o oathoioaical Studies of Pulmonarv Asbestosis. ca> n=-` -A--s---s-n--.------------4--:--5----4---6--5----(--A--u---g--.-,----1--9--6--7--)--.---------------------- ?. iicarr.ura. -vironmental conditions in asbestos factories in Osaka ar.d Nara were investigated. The e of the dust in the factories was studied by electron microscopy. The concentration of particles is tabulated for different plant operations in a Nara factory. The occurrence .^jtosis among the employees of these factories was studied by periodic x-ray examinations, jiough definite asbestosis could not be found in employees working less than 5 years, the " uency of detection of definite asbestosis increased in those working more than 5 years as \es- there was 21% in those employed between 5 and 10 years, 54% between 10 and 15 years. -f between 15 and 20 years, and 100% for those employed for over 20 years. The classification <-ray findings and the development of asbestosis are discussed. Case histories and photo- J-aphs of x-rays and lung sections are presented. -- APCA Absts. . ..-,,rViltoma and Its Association With Asbestosis. M. Borow, et al. pT^T'Med. Assn. 201. 587-591 (Aug. 21. 1967). `.'ithin a three-year period 17 cases of mesothelioma (9 of the pleura and 8 of the peritoneum) vere seen at a community hospital in New Jersey located near a major asbestos mill. The :-cidence of mesothelioma as well as asbestosis appears to be increasing. -- Am. Rev. Resp. Dis. Absts. Pulmonary Function Tests in Asbestos Workers. C. L. Leathart. --ans. Soc. Occ. Med. 13. 49-55 (April. 19o8). There are three ways in which puLmonary function tests may contribute to the management of -.vorKers exposed to asbestos; they may be used to confirm a diagnosis of asbestosis. to follow the progress of the disease, or to monitor unaffected workers at risk. The object of this paper is to consider how successfully these three parts are played. The typical physiological ab normalities are described, serial studies in cases of asbestosis are presented, and tentative conclusions are drawn from a small prospective study of asbestos workers who were free of disease when first seen. The findings from this investigation are summarized as follows: (1) Established asbestosis causes a loss of diffusing capacity, vital capacity and compliance. Pleural calcification by itself does not. (2) Progressive loss of function is seldom arrested when the patient is transferred to other work and most cases deteriorate. (3) Diffusing capacity ippears to be the best measurement for making an early diagnosis, but the diagnosis has been subsequently confirmed by other means in only four of the cases reported in the literature. (4) The development of crepitations at the lung bases sometimes precedes a significant drop in diffusing capacity and this may be a useful observation. (5) Finally, as a general conclusion, the function tests should not be interpreted in isolation nor be given undue respect. They should always be Considered in conjunction with clinical and radiographic examination. -- Cond. from text. Source and Identification of Respirable Fibers. L. J. Cralley, et al. Am. Ind. Hyg. Assn. J. 29, 129-1 35 (Viarch-April. 14681. Fibrous bodies with an iron-contair.ing coating have been found in the lungs of persons coming to autopsy in a number of urban hospitals, the number of fibrous bodies varying greatly with approximately 4 to 6T. of the persons examined showing numerous bodies. Because these find ings raise questions with regard to the possibility that asbestos is a factor in increased lung cancer, questions concerning the nature, source, ar.d significance o: these bodies are discussed in the light of research needed to find answers. There are l'5 references.- - Authors' abst. Pulmonary' Ferruginous Bodies. Development in Response to Filamentous Dusts and a Method of Isolation and Concentration, P. Gross, e: al. Arch. Pathol. 65. 539-546 (May. 1168). Feprir.ts available from Industrial Hygiene Foundation. 4400 Fifth Ave. . Pittsburgh. Pa. 15213. Formation of ferruginous bodies whouid not ne confused with pathogenicity. Failure to understand tr.is diffe rentiatiou may result in the erroneous ;er.e ralization that all fibrous dusts share the