Document BRkyrNJoyR84axX7wYQMbnRgX
FILE NAME Dental Asbestos DEN
DATE 1977
DOC DEN103
DOCUMENT DESCRIPTION US Army Research Report - Asbestos A Subtle Carcinogen in the Dental Lab
A045 027
UNCLASSIFIED
ARMY INST OF DENTAL RESEARCH WASHINGTON DC DC ASBESTOS A SUBTLE CARCINOGEN IN THE DENTAL
SEP 77 DE CUTRI EF EG F HH UST ET JN JN BRADY
LABORATORY
SEM
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TECEI CV CLASSIFICATION OF THIS PAGE When Data Entered
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REPORT DOCUMENTATION PAGE
1. REPOR NUMBER
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READ INSTRUCTIONS
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JENT'S CATALOG NUMBER
A. " fand Subtitia
i Asbestos A Subtle
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Laboratory SEM and
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Carcinogen in the Dental
Microprobe Study .
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5. TYPE OF REPORT A PERIOD COVERED
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8. CONTRACT OR GRANT ) NUMBER
PERFORMING ORGANIZATION NAME AND ADDRESS
10.
PROGR
ROJECT TASK
WalterUS Army Institute of Dental Research
Walter Reed Army Medical Center
Washington D.C.
20012
11. CONTROLLING OFFICE NAME AND ADDRESS
US Army Medical Research & Development EQDA SGRD
Washington
61102A61102A 38161102B
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12. REPORT DATA
Comman17 1d17117 Sep 1877
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154. DECLADSECLASSIFICIATIONFDIECCLASASITFIICAOTINON SCHEDULE
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17. DISTRIBUTION DISTRIBUTION STATEMENT of the abstract mtoreidn Block 20 if different from Report
18. SUPPLEMENTARY NOTES
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19. KEY WORDS Continue on reverse sida il necessary and Identify by block number
| Asbestos chyrsotile carcinogen S.E.M. microprobe dental hazard t ~=
20. ABSTRACT CER om reverse side ff Iden ant d Ii dentt ityy by b ockParticles of debris emanating
an asbestos containing dental laboratory material were characterized with the scanning electron microscope and ray microprobe The dimensions and com-
position of these particles suggest their potential to behave as subtle carcino-
gens With almost daily use of dust producing asbestos in the dental laboratorylaboratory
improper handling of this substance could be hazardous to the health of denpersonnel It is recommended that high standards of personal and laboratory giene be employed in the handling of asbestos
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ASBESTOS A SUBTLE CARCINOGEN IN THE DENTAL LABORATORY
SEM AND MICROPROBE STUDY
Duane E. Cutright D.D.S. Ph.D.*
Eugene F. Huget D.D.S. M.S John M. Brady D.D.S. M.S ***
U.S. Army Institute of Dental Research Walter Reed Army Medical Center Washington D.C. 20012
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Commercial materials and equipment are identified in this report to specify
the investigative procedure Such identification does not imply recommenda-
tion or endorsement or that the materials and equipment are necessarily the
best available for the purpose
* + ***
Commander U.S. Army Institute of Dental Research Chief Division of Dental Materials Chief Department of Biophysics
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Risks encountered in dental practice have become foci of a number of studies Dangers associated with the inhalation of particulate matter bac-
teria viruses enamel dentin calculus and amalgam from microbial aerosols
produced during the use of speed rotary instruments have been addressed Also investigations have been conducted to establish and to define acceptable
limits for operating room levels of mercury vapor3-5 and of nitrous oxide 6-8
Recently concern has been shown for asbestos fibers which emanate from the powder component of some periodontal dressings as well as from liners for
casting rings and crucibles 9-10 The present study was conducted to sample
and to characterize particulate debris encountered in the use of asbestos in the dental laboratory
MATERIAL AND METHODS
A. A three segment of inch wide ring liner was torn from a
roll of asbestos by each of two laboratory workers Particulate matter remaining on the thumbs and index fingers of the test subjects was removed with the use of acetate tape Additionally the sites from which debris had been
removed were resampled after the workers washed and dried their hands
Two three strips of the asbestos were beated in a burnout furnace
at 1,300 for 45 minutes The strips were cooled to room temperature in open air and torn by two volunteers Sampling of particulate matter from the thumbs and index fingers of these individuals was accomplished as de
scribed above
B. Samples of debris were collected on acetate tape from a bench top upon which 20 phosphate investment molds had been broken from asbestoslined metal casting rings Additional particles were removed from a wall
* Material supplied with Ceramigold Investment Whip Corp. Louisville
KY 40217 ;
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against which the bench was located from the muffle of a furnace from
casting machine and from a drawer in which a roll of liner had been
stored
The sampling tapes were sealed to aluminum stubs The debris taining side of each tape was coated with gold and palladium or carbon
and examined with the use of a scanning electron microscope Photomicrographs of the collected matter were analyzed for determination of shape size and distribution of particulate components Elemental constituents
of selected carbon coated particles were determined by dispersive ray microanalysis #
RESULTS
A. Material collected from thumbs and index fingers Scanning elec-
tron microscopic examination showed aggregates of relatively straight parallel fibers and single randomly dispersed fibers Figure 1 The fibers though fragmented did not exhibit axial cleavage Diameters of the linear particles ranged from 0.10 to 1.0 ...m Generally fiber length exceeded 200 um Morphological differences between the particles broken from unheated and heated strips of the test material were not detected
Dispersive ray analysis of selected particles revealed that magnesium and silicon were the predominant constituents of the test material However small amounts of iron were also detected as well as sulfur and calcium Figure
2 Approximate elemental composition of the fiber was as follows magnesium 45 silicon 40 sulfur % calcium % and iron % Heating at a conventional mold burnout temperature did not alter the elemental composition of the woven
fibers
+ Scanning Electron Microscope model 1000 Advanced Metals Research Corporation Burlington MA 01803
# Energy Dispersive Ray Analyzer model 707A with EDIT II Software
EDAX International Prairie View IL 60089
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Fibers were not detected in the particulate matter removed from the
digits of washed hands Occasional small spheroidal and plate parti-
cles found in one sample exhibited a broad range titanium silicon chlorine
potassium calcium and iron of elemental constituents
B. Material collected from laboratory bench storage drawer wall furnace and casting machine Samples of debris removed from the laboratory bench and wall contained fragmented slender particles Figure 3 Particles
storage drawer Analysis revealed that these filamentous particles were com-
posed of magnesium silicon sulfur calcium and iron in the
relative
concentration as found on the finger tips Particles detected within the
muffle of the furnace were not fibrous ration of length to diameter less
than 3 to ) Constituents of these particles included silicon phosphorous
calcium and sulfur
DISCUSSION
Asbestos is a term used to identify any one of several minerals which
can be crushed into fibers However a particular mineral substance known
as chrysolite is the principle source of commercial asbestos Chrysolite
is a hydrated silicate of magnesium the approximate composition of which is
37 to 44 percent silicon dioxide 39 to 44 percent magnesoixuidme 12 to 15
percent water and 1 to 6 percent iron oxide Analytical data suggest that the fibrous material examined in this study is chrysolite Compositional features
of the nonfibrous particles removed from the fingers of washed hands and from
the furnace muffle infer the presence of debris from refractory investment
materials The occupational risk associated with asbestos exposure has been well
documented In man exposure to asbestos dust is associated with an in-
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creased incidence of tumors of the lung and with pleural and peritoneal
mesothelioma.18 Asbestos fibers are subtle carcinogens that do not produce
an obvious exposure relationship Usually a long latency precedes the onset of fibrogenic or carcinogenic activity and the effects of repeated
exposures over long periods of time are cumulativ1e9
The threshold limit value TLV below which asbestos would not affect adversely the health of man is not known The current eight time weighted
TLV for asbestos is 2 fibers per cubic centimeter of air however this
limit has not been evaluated with regard to its effectiveness in the prevention of asbestos disease Additionally the mechanisms by which fibrous materials produce malignant disease are uncertain It has been shown however that the degree of carcinogenicity is related to fiber size rather
than to composition.21 composition.21 Data from animal experiments have indicated that
durable fibers less than 3 um in diameter and more than 20 min length present the greatest hazard and the fibers described in this report fall within this
range of size
Since it has been shown that cigarette smoking increases the risk of lung cancer in asbestos workers it should be discouraged especially within
the working area
ale The actual risk incurred in the use of dust producing asbestos in dental laboratories is unknown However the potential for inhalation or ingestion of
Ve
asbestos particles by dental laboratory workers would appear to be greater than that of members of the general population Figure 4 The need for rigorous standards of personal and laboratory hygiene in the handling of asbestos is obvious Hand washing for example as shown in this study effectively removes the material from fingertips In view of these results reported here and in conformity with correct occupational health practices the following protective measures are suggested in dental clinics
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1. Inform all office and laboratory personnel of the potential danger
of asbestos
2. Confine the storage and use of asbestos to a small area of the laboratory or to a small isolated working chamber
3. Isolate operatories and other offices from the dental laboratory
4 Insure the wearing of face masks and surgical gloves when asbestos or containing debris is handled
5. Encourage cutting in lieu of tearing of asbestos 6. Prevent smoking and eating in the dental laboratory 7. Prevent the transmission of asbestos waste by sewage lines and air exhaust systems to preclude its discharge within the community environment
(
SUMMARY
particles of debris emanating from an asbestos containing dental labora-
tory material were characterized with the scanning electron microscope and
ray microprobe The dimensions and composition of these particles suggest their potential to behave as subtle carcinogens With almost daily use of dust producing asbestos in the dental laboratory the improper handling of
this substance could be hazardous to the health of dental personnel It is recommendtheadt high standards of laboarndalt aboorar toy ry hygiene be employed in the handoflai sben stg os
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REFERENCES
1
Travaglini E.A Larato D.C and Martin A. Dissemination of
organism droplets by speed dental drills J Prosthet Dent
132 Feb 1966
2.
Micik R.E Miller R.L Mazzarella M.A and Ryge G. Studies on
dental procedures J Dent Res 48:49 Feb 1969
3 Battistone G.C Hefferren J.J Miller R.A and Outright D.E. Mercury its relation to the dentist's health and dental practice charac-
teristics JADA 1182 Jun 1976
4
Mantyla D.G. and Wright O.D. Mercury toxicity in the dental office
a neglected problem JADA 1189 Jun 1976
5.
Eames W.B Gaspar J.D and Mohler H.C. The mercury enigma in
dentistry JADA 1199 Jun 1976
6.
Linde H.W and Bruce D.L. Occupational exposure of anesthetists
to halothane nitrous oxide and radiation Anesthesiology 363 Apr 1969
7
Johnson E.G. Harmful pollution by anesthetic gases Lancet 824
\
Oct 1972
|
8 Nikki P. Are anesthetic gases harmful to operating room staff Ann
|
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Clin Res 247 Oct 1972
9.
Burnett G. Substitute for asbestos in casting rings Br Dent J
|
171 Sept 1976
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10. Council on Dental Therapeutics and Council on Dental Materials and
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Devices Hazards of asbestos in dentistry JADA 777 Apr 1976
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11 Berg D. Inorganic insulating materials In Standard Handbook for
Electrical Engineers ed 10. New York McGray Book Co. 1968
p 355
12 Enterline P.E. Type of asbestos and respiratory cancer in the asbestos industry Arch Environ Health 312 Nov 1973 13. Selikoff I.J.1 and Nicholson W.J. Asbestos air pollution Arch
Environ Health 25 Jul 1972
14. Weill H. and others Radiographic and physiologic patterns among workers engaged in manufacture of asbestos cement products J Occupational
Med 248 Mar 1973
15 Doll R. Mortality from lung cancer in asbestos workers Br J Industr Med 12:81 Apr 1955 16. Cordova J.F Tesluk .; and Knudtson K.P. Asbestosis and carcinoma of the lung Cancer 1181 Dec 1962 17 Huper W.C. Occupational and nonoccupational exposure to asbestos
Ann NY Acad Sci 184 Dec 1965
18. Stanton M.F and Wrench C. Mechanisms of mesothelioma induction with asbestos and fibrous glass J Natl Cancer Inst 797 Mar 1972 19. Thomson J.C. Asbestos and the urban dweller Ann NY Acad Sci 196
Dec 1965
20. Nicholson W.J. Asbestos - the TLV approach Ann NY Acad Sci 271
Dec 1976
21 Stanton M.F. Fiber carcinogenesis is asbestos the only hazard J Natl
Cancer Inst 633 Mar 1974
22. Berry G. Combined effect of asbestos exposure and smoking on mortality from lung cancer in factory workers Lancet 476 Sep 1972
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FIGFU ORR FIE GURS ES
Figure 1
Typical scanning electron photomicrographs of particulate matter removed from thumbs and index fingers of laboratory workers A Aggregates from dry unheated ring liner Initial magnification was X50 B Aggregates from heated ring liner Initial magnification was X50 C Particles of dry unheated ring liner Initial magnification was X5,000 D Particles of heated ring liner Initial magnification was X5,000
Figure 2
Dispersive ray analysis of a single fiber component of an asbestos casting ring liner
Figure 3
Typical scanning electron photomicrographs of debris from laboratory bench top and laboratory wall A field of bench top debris Initial magnification was X50 B field of wall debris Initial magnification was X50 C Linear component of bench top debris Initial magnification was X5,000 D Bundle of linear components of wall debris Initial magnification was X5,000
Figure 4
Fragmented debris from laboratory asbestos in storage drawer
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