Document ByB5JdMMg64rDRLJvpBME7EJw

' MORANDUM DEPARTMENT OP HEALTH, EDUCATION', AND WELFARE PUUUC HP.AI.TM wiLYirv. c^.Nff K row r^srASh * NATIONAL INSTntfTJ. K.n OCCLTATIONat iAlTTY ASO IM.aLTM : itortoa Corn, Ph.D. ----- --.....DATE; 0C 1 5 1976 Assistant Secretary of Labor ------ -- ----- ----- . Occupational Safety and Health Administration Department of Labor : Director, National Institute for * Occupational Safety and Health . s. Evaluation of Data on Health Effects of Asbestos closure and Revised . * Escscasndad Numerical Environmental r< ` According to your request, 1TI0SK has evaluated available data concerning the health effects of exposure to asbestos. The general conclusion of this study is that all forms of asbestos, both commercial and nca- . . commercial, are carcinogenic. All have the capacity to induce pleural * and peritoneal mesotheliomas and/or- lung cancer in nan. In addition, f all forms of asbestos have been found to cause asbestesis in nan* JttOSH has proposed new environaental limits which are* ^sed on this study. These recommend that no worker be exposed to an airborne concentration c asbestos in excess of 100,000 fibers over 5 us in length per cubic meter on an 8-hour time--weighted average basis. In addition, the proposed ' standard states that no worker should be exposed to peak concentrations in excess of 200,000 such fibers per cubic meter of air based on LS-minuca ' sampling periods. Currently, it is not possible to establish a safe exposure ' level for a carcinogen. Therefore, recoemended exposure values are based on the lowest concentration at which asbestos fibers can be monitored reliably using phase-contrast fiber counting procedures. After a thorough 'review and evaluation of all available sampling and analysis nctheds, NIQS2 feels that phase-contrast microscopy is the only generally available and practical technique for routine monitoring, although electron microscopic methods arc available on a limited scale for sore precise research studies. The recommended Tt?A standard of 200,000 fibers over 5 ua in length per cubic . meter of air is intended to (1) protect against the neucareinogcnia effects of asbestos and (2) materially reduce the risk of asbestos-induced cancer. Because it,_is not possible yet to specify a safe exposure level for the cnA'cinogenic'activity of asbestos, only a. ban oa its use esu ensure complete protection against this mineral's carcinogenic effect. - .w Therefore, emphasis should be placed on prohibiting the occupational usc of asbestos in other chan completely closed operat iouj*. and on substituting other products whenever possible*. Ashent os should bo replaced, where technically feasible, by snbctiLutets with the lowest possible chrouic ^ tonicities. .* ` l " r^C-^Qjy i Korean Corn, PU.D 2* The present indications aw ch.it concentrations of asbestos fibers of 100,000 per cubit secr-r will occur rarely is Che asbestos-processing industry. Asbestos-cantainis;; ?ireprr.of in;; and naecheie linings of air-ducts and pleats::* alrh3unh~th<*y are possible* sources of asbestos fiber, probably aru not cajac polluters of air within buildings. This report addresses .on!*/ the health effects of exposure to asbestos and the proposed cnvisouawnral Unit* iriOSH intends, however, to address' formally, as soon as possibly, the ocher provisions of the standard outlined in CSKA's Notice of Proposed Kulesakiag dated October 9, 1975, and further cosaer.cs will be brought to your attention. John F. Finhiea, M.D. %/  ;, . '*.*. . . '**.rv ***. **.' .? v. " *% o fe-swiimiiON and Update of Information on tfe Health Effects of Rjeuc Health Ssiyice '\ . - < .* . * . . Center foe Disease Control 0, ' fknaNAL Institute for Occupational Safety and Health Daos-SERy 1975 . - . - In a study of 232 former insulation plant employees, Selikotf (1976a) * .reported positive x-ray findings, among individuals, having1 exposures to ' asbestos known to be a*s.short as one day* More recently, Anderson et al ' (1976) reported x-ray findings consistent with asbestosis in household and . . j -' . . .family members having no known exposure to*asbestos other than residing with a known asbestos worker.* These two studies demonstrate the presence. of asbestos disease in the absence of continuing new exposures. . . ' Wagoner at al. (1973) demonstrated a significantly increased risk of ^death for nonmalignant respiratory disease and for diseases of the heart, . which in part were secondary to pulmonary disease, among"a cohort of workers in a major manufacturing complex using predominately chrysotile. Among . . those workers observed 20 or more years after onset of employment, a four-fold . .' ** * . % ' increased risk of death due to nonmalignant respiratory disease was . . ' ' observed* Further evaluation of these deaths revealed the majority occurred' within 1 year after termination of employment and at an average age of 53.8 years. . *'-. *' Newhouse (1969) reported an.increased risk of'death from nonmalignant respiratory disease in rale asbestos textile and insulation workers with low to moderate exposure. . . . Enterline and Henderson (1973) reported that for all ages, only 18 deaths occurred due to asbestosis in several asbestos plants studied from 1941 to 1753. -It is of significance, however, to note that the state of Mew Jersey a.lonje^ in the years 1969-1S70, had awarded workmen's compensation for . asbestosis to 455 workers from one of the plants in the .study. (Heymann. 1971; Serraino. 1970) - . . Selikoff (1975a) reported a significant excess'of deaths due to asbestosis amona A rtVnttn It * McDonald, A.0,,, & McDonald, J.C. (1976)' Epidemiologic studies of the . illnesses due to asbestos in Canada. Rev. fr. Mai. Re$p..4:25 (Supp 2) 70) Kogan, F.M.* Guselnifccva, tf.A. Gulevsfcaya, M.R. (1972) The cancer . mortality rate, among'workers in the asbestos industry of the Urals. * . Gig., i.- Sanit. 37-29 - / * . . 71) Interline, P.E,, I Henderson, Y.. (1973) Type of asbestos and respira* tory .cancers in the asbestos industry. Arch. Envir. Health. 27:312 72) * Borow, rt.* . J Conston, .A,, . Livemese, L. c l. 5 Schalet, N. . (1973) Mesothelioma following exposure to asbestos: A . ^ review of 72 cases. Chest, Vol. 64 5:541*46 . -**. ' * ' * 73) Gillanr, J.D., Dement, J.M.; Lenten-, R.A., Wagoner, J.JC., Archer,' V.E., & Blejer, H.P. (1976) Mortality patterns among hard rock gold miners, exposed to an asbestifonn mineral. `.Ann. N.Y. Acad. Sci. 271:345-352. 74) . Seidman, H., Lilts, R., and Selikoff, I- (1976) Short-term asbestos exposure and delayed cancer risk* Third International Symposium. * Detect. Prevent. Cancer, New York, 26, April - 1 May, 1976 ' ' ` .. * - . ' 75) .Meurman, L., Kiviluoto, R_ & Hakama, M. (1974) Mortality and morbidity ' among the working population of anthophyllite asbestos miners in Finland. Brit. J. Industr. Med. 31:705 . \ ' - 76) Kiviluoto,. R. (I960) Pleural calcification as a roentgenologic sign of, non-occupational endemic anthophyllita-asbestosis. Acta Radiol. . (Stockh.), Suppl 195:1 ... . ' . 77) Meurman,.L.* (1966) ArOestos bodies and pleural plaques-in a Finnish series of autopsy cases. Acta. Path. Microbiol. Scand. Suppl 131:1 * 78) \Selifcoff, I.J. (1974) ; Epidemiology of gastrointestinal cancer. * .Environm- Health. Perspect. 9:299 _* - ... 79) Mancuso, T.F. & El Attar, A.A. (1967) Mortality pattern in a cohort - of asbestos workers. A study based on employment experience. . 4. Gccup. Med. 9:147 ^ . .; , -. 80) Newhpuse, M.L. (1973) Cancer among workers in the asbestos textile * industry. In: Bogovski, P., Gilson, 4.C.t Timbrel!, Y., and Wagner, J,C., c'ds.. Proceedings of the. Conference on BicTooical Effects rf .Asbestos, Lyon, pp 203 * . ^ 3!) McDonald, 4.C., 8ecklafce, H.ft., Gibbs, G.M., McDonald, A.D. ^ _ Rossiter, C.E. (1974) The health of chrysotile asbestos mine and mill - workers of Quebec. Arch. Environm. Health 23:61 * /% 1 dencrar population. Wo mesotheliomas were found, but Kogan ```c tfi* *,,-* ' .. .. ^ f that this might'be explained by the insufficient experience-of ri*<J .'**' ' ' . ' . s*p^jologis'ts with this rare type of cancer in that geographical area. ' * * Also* the numbers^ of people in the study populations were not reported.' Wagoner et ail (1973) reported on the cancer risk among a cohort of - : ' 2 . . * r - * .' .. , . workers in a major manufacturing.complex,utilizing predominately chrysotile * -asbestos in textile, friction and packaging products. An excess of . ' - .* . *T ' . . . . *' respiratory cancer occurred among asbestos workers in each duratfcn-of- . ' -` j- - -* - * employment category down to and including 1-9 years. They observed a * * ' * ** * ' v statistically significant-standard mortality ratio of 122 for all ' ` . , .. .. a * .*** * . . malignant neoplasms and 244 for malignant neoplasms of the respiratory. - ' *.*# . system. The asbestos workers in this study were located in an area of ' * . * *. - . ` - predonrinately Anrish butch population .with known low frequencies of snaking. ' . *' . : . . - * t The authors, nevertheless., used the general white male U.5. population as. - ~* . * ' a control groups which would tend to underestimate the degree of risk. . ' . Enterline and Henderson (1973) found that for retired men viho had . worked as .production or maintenance-employees in the asbestos industry and *--? * ` ' .* . who had reached; S5 years of age, those who had been exposed only to -' chrysotile had":a respiratory cancer risk 2-4 times than that expected. Among men within the asbestos cement industry exposed only to chrysotile, * <3 r * * * a one-'to four^fold excess of respiratory cancer was found. Of S02 deaths, ** . . only one mesothelioma had been*recorded in the several plants investigated. v--In cnntrzsisub^equent investigation by Borow et al (1973) found 70 cases of mesothelioma from only one of these plants. The.discrepancy was due to "aiethodoVogical variations, for example Enterline and Henderson (1973) had limited their investigation to men of 55 or over, while.many of the - mesothelioma cases reported by Borow et al (1973) had died before that age.