Document G5LYDvOeNrODzX73geVeBDe6v

itvl A -Ci s- PROGRAMME I. r~ WORLD SYMPOSIOM ON ASBESTOS MAY 24, 25, 26, 27, 1982 Mount-Royal Hotel MONTREAL Quebec, Canada **v 3f2 j/ u*. Sponsored by: *** the Government of Canada the Government of Quebec the Commission of the European Communities vr i CAP CO JEN 0011049 Programme Biographical notes and abstracts MAY 25 Ballroom, 9th floor 8:30am Opening remarks DCINNIGAN, Jacques (Canada) Secretary General ofthe Symposium 8:35am Introductory Presentation Asbestos -- A Controversial Issue ATHERLEY, Gordon (Canada) President and Chief Executive Officer Canadian Centre for Occupational Health and Safety, Hamilton, Ontario Dr. Atherley was professor of Occupational Medicine and Director of the Environmental, Occupational Health and Safety Unit at the Department of Preventive Medicine and Biostatiitics of the University of Toronto before he took on his present appointment as President and Chief Executive Officer of the Canadian Centre for Occupational Health and Safety, In Hamilton. Author of numerous scientific papers and of a book on occupational health and safety. Dr. Atherley has served In various consultant and advisory capacities in the Industry, gov ernment and private sectors, In the U.K. and Canada. Abstract Asbestos is a controversial material: on the one hand, there are the undoubted harmful effects on health arising out of human exposure to asbestos, especially In the workplace, alt of which leads some people to urge that asbestos should be extin guished from industrial, commercial, and domestic use. On the other hand, there are the social consequences of such a policy measured in terms of toss ofjobs at a time of serious world-wide unemployment, the loss of prosperity of countries and regions with asbestos as a natural resource, end the possibiity that the substitutes for asbestos might be themselves dangerous or relatively expensive In terms of the energy costs Involved In their production. Whether asbestos should be counted out totally or allowed to continue to participate In the economies of the nations reflects an issue which, because of its fundamentally social, political, and economic nature, rests with the decision-makers of the communities and nations and definitely not with the Interna tional scientific community, as Is represented at the sym posium. Nevertheless, the decision-makers cannot properly consider the Issue let alone decide It, without scientific infor mation having the qualities of trustworthiness, comprehensive ness, comprehensibility, relevance, and usefulness. In his presentation. Dr. Cordon Atherley wOt examine these qualities relative to the social, political, and economic Issue of asbestos with the Intention of highlighting tire ethical standards Imposed by principled science on scientists seeking to assist the decision-makers to decide this difficult Issue. 16 CAP CO JEN 0011050 SESSION I 8:55am Asbestos: The Medical Data TRCIHACIT, Ren< (France), Chairman Director Centre de Recherches Toxicologiques Faculty des Sciences Pharmaceutiques et Biologiques de Paris "Professor Truhaut, who.ts a Doctor of Science, has dcdtceted . ' his career to university teaching and to research. HU scientific contribution, centered on the problem! of analytical or biologfcat toxicology, including problems of chemical carcinogenesis, numbers more than 400 original articles published in French and foreign periodicals, and over300 general papers. Profes sor Truhaut is a member of several Flench and foreign scien tific academia* and has acted as espert. In France and within the major international health organiiatioos, in the field of tonctty risks resulting from chemical pollution, the environ ment and the workplace. 9:00am Asbestos-Related Diseases: An Overall Review SELJKOFF, Irving (Clnited States) Director Environmental Sciences Laboratory Mount Sinai School of Medicine, New York Dr. Satikolf is Professor of Medicine and of Community Medicine and Director ofthe Environmental Sciences Laborat ory of the Mount Sinai School of Medicine in' New York. Editorin-Chlef of the American Journal of Industrial Medicine and of Environmental Research, Dr. Selikoff Is weB known for his research and numerous contributions in the field of environ ment) medicine. Past President of the American College of Toxicology, past President and currently Governor of the New York Academy of Sciences, he is a member of the National Cancer Advisory Board of the National Cancer Institute. Abstract Should the use of asbestos be continued? The fact that the Symposium Is addressing this question Is a measure of our past inadequacies. When a death of asbestosls was observed In 1900 and recorded In 1906, it could not have been widely known.'But ft would have been difficult to overlook the serious potential of the dust when the careful clinical studies and surveys In the decade alter 1924 found that asbestosls was common among exposed workers, and that deaths could occur. Despite this understanding, the 1930s, 1940's, 1950's went by with few precautions In trades in which there was asbestos exposure. Nor did accumulating scientific knowledge concerning the cancer potential of asbestos Increase protective measures until the 1960's and 70`s. There will be debate concerning the dimensions ofthe disease legacy we now face as the result of our years of failure -- exactfy how much lung cancer or mesothelioma or gastroin testinal cancer or cancer of the larynx or other cancers, or asbestosis--In shipyards, the construction Industry, transport mines, factories, chemical facilities and refineries, power plants. Insulation work or other trades. We will be asked whether levels of 10,000 or2,000,000 fibers per cubic meter of air (0j012.0 ^ml) will protect people In the future, and we wffi not be able to answer confidently because few measurements were made years ago to correlate with cancer experience since. Stitt, we'll be able to give the key answer--that there is a "doseresponse" for ail asbestos disease--the more asbestos, the more risk, the less asbestos, the less risk. But this discussion will not be able to answer the critical ques- 17 CAPCO JEN 0011051 bon _ should asbestos be continued? --If evidence win not be available that tt can be safely used, that there wO be vigor ous insistence on aH feasible safety measures; not minimal controls but maximum capabilities. Would this prevent aH asbestos disease? No --- but It would avoid all that now can be avoided. To do less than we can will likely prove unacceptable. Even this, however, will be incomplete. Succor and help are needed for those exposed in the past Surveillance and care must be offered to the victims of past mistakes. Asbestos research should Include Improved medical management as well as industrial and commercial measures. Again, we can do 9:30am Epidemiological Evidence: Exposure-Response, Fibre Type and Industrial Process MCDONALD, John Corbett (Canada) Professor and Head of the Institute of Occupational Health and Safety McGill University, Montrial Or. McDonald studied medicine at the University of London, at the London School of Hygiene and Tropical Medicine and at the Harvard University School of Public Health. In addition to his membership in various committees, advisory groups or commissions concerned wtth problems of public health In general. Or. McDonald's main professional activities and research publications have evolved around epidemiology and occupational health and safety, either teaching or directing research and laboratories. Abstract Since at least the 1964 New York Conference It has been suggested that fibre type and Industrial process Influence the nature.end incidence of disease resulting from asbestos expo sure. The 20-30 major epidemiological Purveys in the last IS yean have tended to support the view a) that, other things being equal, the risks of asbestos and lung cancer are consid erably greater for Insulation work and textile manufacture than In the cement or friction-products Industries or in mining and milting and b) that malignant mesothelioma has been usually associated uSth'amphiboIe and seldom with pure chrysotile exposure/Ther* has been much debate on the evidence -- inevitably Imperfect--for both these contentions and on the extent to whidi other factors--exposure levels In particular-- have Indeed been comparable. While it Is dear that in expert-. mental animals, fibres of different type but similar dimensions have much the same pathogenicity, various Industrial proces ses could have a major effect on fibre-site distributions, and human anatomical considerations and life span could well explain differences between experimental and epidemiological findings. Unfortunately It b precisely In these areas of reliability of exposure measurements, of quantity, quality and duration, that the epidemiological studies have, for good reasons, been most deficient The available data wilt be reviewed In some detail and both the Interpretation and Implications discussed. 10:00am The Meaning of a "Threshold", Considerations Applying to Carcinogens in General HIGG1NSON, John (United States) Senior Scientist Universities Associated for Research and Educa tion in Pathology Inc, Bethesda, Matyiand Dr. Higglnson holds a degree In Medicine from the University of Dublin. For many years and up until recently, he was Direc tor of the International Agency for Research on Cancer (IARC. Lyon). His major research interests have been the study of 18 CAPCO JEN 0011052 health and dilease in different environments and their relation to diet culture and socio-economic factors. Author and coauthor of numerous scientific publications he has served in research councils and Institutes, study groups and committees in many countries and in many International health organizedons. Abstract Thebackground to the controversy that surrounds the term "threshold" in carcinogenesis wH be discussed, h b dependent ore 1) Uncertainty as to.the definition of "carcinogen" in view of rec'ent recognition of the eompleiaties of multistage car-^-^-r.. ctoogenesb; 2) Recognition that there are many different " ' mecharrisms by which exogenous stimuli may produce cancer; 3) Lack of rational or biological methods for extrapolation from animals or in vitro models to man of carcinogenic potency of chemicais; 4) inability to prove the negative from either eplderoiofogical studies or by exnpotation from animals. Thus the term non-carcinogen h almost impossible to define, `and 5) The widespread view that even a single molecule of an initiator may produce cancer. The impOeations of recent research on the theoretical existenceof a threshold tor a carcinogenic-producing stimulus wifi be discussed and the possibility that both initiators and promoters may be without effect for practical purposes under certain circumstances, k will be suggested that the term "carcinogen" be used in a highly limited sense since certain factors whJch induce cancer are dearly not carcinogens in the widely understood sense. 10:20am Carcinogenic Aspects of Asbestos SCHMAEHL, Dietrich F.K. (Federal Republic of Germany) Director _ Institute of Toxicologyand Chemotherapy German Cancer Research Institute, Heidelberg Dr. Schmaeh! is Professor ofMedicine at the University of Heidelberg and. since 1964, Director of the institute of Toxicology and Chemotherapy, at the German Cancer Research institute, in Heidelberg. He Is a member of numerous national and international commissions. Chairman of the commission "Studies on the carcinogenic risk of humans from air pollution" of the German Ministry of the interior and Chair man of the Research.Councfi on Smoking and Health. He is editor and coeditor of several scientificJournals and has also published extensively in his field of research. Abstract Human inhalation of dust containing asbestos fibres enhances the risk of bronchial carcinoma and the risk of mesothelioma of the pleura and the peritoneum, k seems possible that tumor occurrence may also be induced in other organs, in the case of asbestos, the pathogenesis of cancer is still unknown despite animal experiments and In-vitro studies, although there exists some knowledge indicating epigenetic mechanisms of oncogenesis. However, it b not known whether there are identical, similar or different processes responsible for the development of bronchial carcinoma and mesothelioma. For the Interpretation of risk extrapolations there should be some consideration of the fact that asbestos differs funda mentally and substantially in two ways from those carcinogens for which so far extrapolation models have been worked out. 1. In all probability, there b no gertotoxic mechanism of action. 2. There b a cumulative effect for a certain portion of fibres. So far, there b no evidence that in the case of epigenetic car cinogens, extrapolation models can accurately predict the effects of small doses from those of large doses, whereas for genotoxic carcinogens thb has been repeatedly proved 19 . CAPCO JEN 0011053  through animat experiments. For a number of epigenetic car cinogens, some probable threshold values for the carcinogenetic effects could be established by way of animal experiments and studies of the mode of action. PANEL 1 10:40am ' Is There a Practicable No-Effect Level for Asbestos? _____ r... . . .. TRUHAUt, Rerii (France)^ Chairman " SELIKOFF, Irving (United States); McDONALD, John Corbett (Canada); H1GGINSON, John (United States); SCHMAEHL,- Dietrich F.K. (Federat Republic of Germany) MALTONL Cesare (Italy) Professor Institute of Oncology of Bologna Dr. Maltonl b Professor of General Pathology and Experimental Oncology and has been directing the Bologna Centre for Pre vention and Detection of Tumours and Oncological Research since Bs foundation. His Interests center on problems of environmental and occupational cancers (particularly those associated with Industrial agents), the natural history of tumours, arid the early detection of cancers and cancer pre cursors through targe mass screening. The results of hb research and scientific activities have been repotted in more than 220 publications. WEILL, Hans (United States) Professor of Medicine Tulane University, New Orleans i. Dr. Weill obtained hb M.D. degree from the Tulane University School of Medicine where he b now Professor of Medicine. He b also Director of the Specialized Center of Research on Fh brotic and Immunologic Reactions to the Occupational Envi ronment of the National Heart Lung and Blood Institute, and Chief of the Pulmonary Diseases Section of the Tulane Medical Center. Dr. Weill has published abundantly !n the field of pul monary diseases associated with occupational and environ j mental situations such as exposure to silica, asbestos, cotton and coal dusts, air pollutants and Irritant gazes. Dr. WellI. who has filled several consultant assignments, was a member of the Task Force on Pathology Standards for Asbestos of the US. National Institute of Occupational Safety and Health (NIOSH). I { WOITOWITZ, HansJoachim (Federal Republic of Germany) Professor and Head of the Institute and Polyclinic of Occupational and Social Medicine University of Giessen Dr. Woitowitz studied medicine at the universities of Marburg and Cologne. He was assbtant physician at the Medical Univer sity Clinic of the University of Cologne and at the Institute and Polyclinic of Occupational and Social Medicine of the Univer sity of Eriangen-Nuremberg and, then. Head of the Institute and Polyclinic of Occupational and Social Medicine of the Uni versity of Giessen. He has published numerous scientific papers in hb field of research which comprises clinic and epidemiology of occupational diseases, carcinogenic risks and pathophysiology. I I 12:00noon Lunch 20 CAP CO JEN 0011054 SESSJON U 2:00pm Asbestos: Protection In the Workplace SAMUELS. Sheldon (United States), Chairman Director Health, Safety and Environment American Federation of Labor and Congress of Industrial Organizations . Mr. Samuels was educated at the University of Chicago and trained in environmental health while with the New York State Health Department and the US. Public Health Service. He has taught at the State University of New York, the University of Cincinnati, and (currently) at the Mount Sinai School of Medidne, and has lectured In 11 countries on behalf of the Departments oT State and Labor. Mr. Samuels helped to found the Workers' Institute for Safety and Health of which be was Acting Director until October 1980. He Is a member of the National Cancer Advisory Board, a Contributing Editor of the American Journal of Industrial Medicine and the author of 36 scientific studies. 2:05pm Problems and Progress In Engineering of Work place Environment Control in Primaty and Secondaiy Industries; Work Practices; Packaging. Waste Disposal, etc REITZE, William B. (United States) ' Chief Environmental Scientist and Vice-President Johns-Manvilte Sales Corporation U- Mr. Reitxe's undergraduate and graduate work was in biological and health sciences, specializing in neuroanatomy and physiology at the Columbia University Medical SchooL He has published numerous papers In the fields of toxicology, phar macology, air pollution and industrial hygiene. Mr. ReJtze spent several years w'th the New Jersey State Department of Health In the Air Pollution Control Division prior to Joining Johns-Mari val* where he has served in various health-related functions. His present responsibilities include industrial hygiene, safety, community air pollution, water pollution, solid waste disposal medical program, and biostatistics and epidemiology. Abstract This presentation will deal briefly with the history of dust con trol measures used In the asbestos mines', mills and manufac turing plants. It wil! also discuss the present types of dust collectors used In these settings. Included In the presentation will be discussion of other non-engineering methods used to reduce dust when shipping or handling asbestos. And. finally, methods of controlling asbestos dust on construction sites where asbestos-containing materials are installed will be discussed. CAP CO JEN 0011055 2:20pm Monitoring the Workplace: Problems and Progress. State-of-the-Art (Automatic Counting Methods) and International Efforts for Standardi sation of Methods. ROBOCK, Klaus (Federal Republic of Germany) Professor Asbest-Institut furArbeits- und CJmweltschutz Dr. Robock is the Director of the Asbestos Institute for Occu pational and Environmental Safety end Health in the Federal Republic of Germany. He b also Chairman of the Dust Mea surement Advisory Fane) of the Asbestos International Associa tion and Lecturer at the Institute for Hygiene and Occupational Health, University of Essen. In 1976, he was awarded the Frent-Koebch fbize for hb research in the field of sSicosis. Hb particular Interests are in the area Of dust measurement con trol and biological effects. He has many publications to his credit and has received International recognition for his work on dust problems. Abstract' Objectives for measuring concentrations of respirable asbestos fibres at Workplaces are: 1) to control engineering measures for technical dust suppression; 2) to comply with statutory threshofcl Emit values; 3) to assess dose-response relationships In epidemiological Investigations for various asbestos-related diseases with respect to person-related dust exposure. Description ofthe development of techniques in measuring asbestos fibre concentrations (thermal precipitator, midgetimpinger, gravimetric methods, membrane filter method). Factors which explain differences of measuring asbestos fibre concentrations are: 1) the change from previously applied r- methods to the membrane fiber method and Its fibre counting: 2} the use of different sampling strategies; 3) the different application for evaluation of membrane filters; 4) the use of electron microscope versus the use of light microscope. Demand to Internationally standardize the measuring methods for the determination of asbestos fibre concentrations. This will be the only basis to compare situations at workplaces and the epidemiological-findings derived thereof, between various countries. An aide to achieve international comparability b pro vided by the RTM1 "Reference Method for the Determination of Airborne Asbestos Fibre Concentrations at Workplaces by Light Microscopy" of the Asbestos International Association, which b worked out in detail for the first time. By applying this Reference Method it Is feasible to make the results of other methods, previously applied, comparable. State of the art regarding the application of a new technology to eliminate counting errors--automatic evaluation of mem brane filter samples by means of image analysing systems. 2:35pm Asbestos disease with Maintenance and Repair LJL1S, Ruth (United States) Associate Professor Department of Community Medicine Mount Sinai School of Medicine, New York After a teaching and research career in occupational medicine at the University of Bucharest Dr. Uis Joined In 1972 die Department of Community Medicine, Division of Environmen tal Medicine, of the Mount Sinai School of Medicine, where she b currently Associate Professor. Dr. Uis has authored and coauthored many scientific publications In the field of heahh problems associated with asbestos exposure. 22 CAP CO JEN 0011056 Abstract Advene health effects associated with asbestos exposure are well documented for occupational groups directly exposed to asbestos -- asbestos miners, asbestos textBe'workers. Insula* ton workers. However, the health hazards due to asbestos have not ber tmpletefy ascertained for those workers who are Indirectly exposed In Industries where asbestos Insulation was used extensively. Potential asbestos hazards were evaluated In maintenance workers in a large chemical plant and In a group of oil refinery ' workers. .......__ .___ In both groups, pleural abnormalities were more prevalent (28 and 25 percent respectively) than were the slight parenchymal changes observed (24 and 23 percent, respectively). These findings indicate that radiological evidence of asbestosis is to be found with significant prevalence In chemical plant malrttenance workers and In oi refinery workers. The risk of develop ing severe disabling pUmonaty fibrosis seems to be unlikely, sine* few of the cases had small irregular opacities graded 2/1 or higher. The risk of lung cancer and/or roesotheSoma In these workers has yet to be assessed. Although epidemiologic data on Incidence of mesothelioma associated with this pattern of asbestos exposure are not yet available an Increasing number of cases are being observed. > Prevention of exposure from such and similar sources Is presently receiving increased attention. 2:50pm Estimates of Occupational Mortality from Past and Projected Exposure to Asbestos NICHOLSON, William J. (United States) Associate Professor Department of Community Medicine Mount Sinat School of Medicine, New York Dr. Nicholson received hb PhD. in Physics from the University of Washington in Seattle. After a few years as Senior Staff Member at the Watson Laboratory of Columbia University, he Joined the staff of the Department of Community Medicine at the Mount SinaT School of Medicine, where he is currently Associate Professor. Dr. Nicholson has participated in numer ous studies in the field of environmental and occupational problems associated with airborne chemical and particulate Irritants, and has authored and co-authored publications In the field of exposure to vinyl chloride, asbestos and other mineral dusts. Abstract Not available at printing time. 3:05pm Problems of Medical Surveillance COOPER. Clark (United States) Consultant in Occupational Health, San Francisco Dr. Cooper obtained his degree In Medicine from the University of Virginia, and holds a Master's degree in Public Health from the Harvard School of Public Health. After serving for some years ki tire (IS. Public Health Service, he was successively Research Physician, Professor of Occupational Health In Resi dence and Lecturer at the School of Public Health at the Uni versity of California (Berkeley), and b now an Independent consultant In occupational health. Member of and consultant In many (IS. state and federal committees on environmental and occupational health. Dr. Cooper has published numerous studies In the field of pulmonary diseases In the mining, smelting and refining industry. CAP CO JEN 0011057 Abstract The purpose of asbestos-oriented medical surveillance should be to prevent disease or to minimize its progression and the development of complications. The author will review a program of periodic examination of insulating workers in the western United States, jointly sponsored by management and labor since 1968. Problems to be discussed include: 1) clear definition of objectives; 2) optimum content; 3) fre quency, 4) quatity control; 5) communication with workers, employers, family, and government; 6) confidentiality of infor mation; 7) Inappropriate governmental regulations; and, gj jhe relative.Ineffectiveness of intervention.' .` Indirect medical, psychologic,' and epidemiologic benefits will also be described. SESSION III 3:20pm Rights and Responsibilities: Perspectives front Science, Industry, Labour and Government BEAUDRY, Ren6 (Canada), Chairman Juge en chef adjoint Tribunal du Travail du Quebec Judge Beaudry, who b licenced In Law from the University of MontrfaL specialised in labour taw practice for several years before becoming a magistrate in 1970. He b a judge of the Qudbec Provincial Court and Associate Chief Justice of the Tribunal of Labour. As a specialist in occupational health and safety legislation, he has taught in this field at McGill University and at the University of MontrfaL and has also participated in numerous seminars and conferences. From June 1975 to October 1976 he presided the Study Committee on salubrity In the asbestos industry which wes set up by the Quabee government and, more recently, the Inquiry Commission into the Balmoral mine tragedy and on safety conditions In under ground mines. Scientific Viewpoint PE.TO, Julian (United Kingdom) Epidemiologist Imperial Cancer Research Fund Oxford University Mr. Peto, who holds a Master of Science degree in Statistics and O.R. from the Imperial College in London, b currently statistician at the Imperial Cancer Research Fund's Cancer Epidemiology and Clinical Trials Unit, at Oxford University. He has published important contributions in the Reids of risk assessment and of industrial hygiene standards, and has reported weH researched data in the area of dose-response relationships for asbestos-related diseases! Abstract The only proper role of the scientist b to provfde the estimates of risk on which decision-maldng Is based, and to prevent misrepresentation of these data. Science cannot and should not take any position on the discussion of rights or respon sibilities, except to insist that factual claims are well founded. This ban Important rote, as government, labour and man agement have all at various times exaggerated the security or danger of asbestos exposure. A scientist who holds strong views on what level of risk b acceptable, what price should be paid to achieve R. and how regulations should be imple mented will however be perceived, probably correctly, as too biased to fulfill this role satisfactorily. 24 CAP CO JEN 0011058 3:40pm Industoy's Viewpoint VAN DER REST, Etienne (Belgium) Chairman of the Governing Council Asbestos International Association A dv2 engineer from the Catholic University of Louvain. Mr. van der Rest has been successively Managing Director, Vice-Presi' dent end Chairman of SA Etefnit. in Belgium, and sits on the Board of Directors of several companies in Belgium. France, England and the Netherlands. He is Chairman of the Govern ing Council of the Asbestos international Association and of the Belgian Federation of Asbestos-Cement Industries. Abstract The international asbestos Industry recognises that It Is dealing with a product which. Eke other raw materials, can present risks to the health ff Rs handling and use are not properly controlled. From the industi/s point of view, however, ft would not be sensible for society to be deprived of the exceptional qualities offered by asbestos, especially since asbestos, if used properly, can be made safe for both workers and users. Laws and regu lations currently governing the use of the fibre and asbestosbased products ensure the protection of workers and users. In countries where there are stai no suitable laws or regulations, the.Asbestos Internationa! Association itself is encouraging qdhierence to rigorous standards for dust-emission levels and senakidng users to safe methods of asbestos use. Adherence to safety standards and reliance on sound technology will ensure that asbestos can continue to be of great value in many applications, such as automobile safety, conduit systems, 'housing and a wide variety of other uses.' 3:55pm Labour's Viewpoint MAZZOCHJ, Anthony (United States) International Representative . OtL Chemical and Atomic Workers International Union Abstract Not available at printing time. 4:15pm Government's Viewpoint MARTONIK, John F. Jr. (United States) Deputy Director Directorate of Heatth Standards Programs United States Department of Labor Mr. Martonlk who holds a Master of Science degree in Industri al Hygiene from the University of Pittsburgh, started his career, in the (IS. Mining Enforcement and Safety Administration where he developed industrial hygiene inspection techniques for non-coal mines and recommended methods for controlling dust In underground coal mines. Since 1976. he has held vari ous positions in the US. Occupational Safety and Health Administration (OSHA), where he Is currently Deputy Director of Health Standards Programs, Involved with the development end implementation of occupational health enforcement programs. Abstract OSHA has the responsibility under the OSHAct for promulgat ing standards for toxic materials and enforcing those stan dards. OSHA's existing Asbestos standard promulgated in 25 CAPCO JEN 0011059 1972 provides fora permissible exposure limit of 2 fibers/cc, using engineering controls when feasible, respirator programs, medical surveillance, monitoring, and hygiene practices. Since this standard was based upon asbestos' noryrarcinogenlc effects. OSHA wilt reevaluate it based upon recent information to determine whether the standard is adequate for the protec tion of worker health. During its reconsideration, OSHA will determine whether a significant risk of materia) impairment exists to workers exposed to asbestos. If a new standard is needed OSHA will determine whether the remedies prescribed - reduce the risk and If the remedies prescribed are feasible and cost effective. OSHA wili do this on an industry by industry - basis. PANEL2 4:30pm Are Workers Exposed to Excessive Risk? BEAUDRY, Ren6 (Canada), Chairman NICHOLSON. William J. (United States); COOPER, W. Clark (United States); PETO, Julian (United Kingdom); VAN DER REST, Etienne (Belgium); MAZZOCHI, Anthony (United States); MARTON1K, John F. Jr. (United States) STUMPHIUS, Jan (Netherlands) Managing Director National Aerospace Medical Centre Dr. Stumphlus holds a Doctorate In Medicine and certificates In X-ray thorax reading, in occupational health, in radiation protection and in aviation medicine. In 1970, he received the Burger Award for hls scientific work in occupational health. A member of numerous associations, commissions and advisoty committees on occupational health, on asbestos and other mineral fibres, he is the current Managing Director of the National Aerospace Centre in the Netherlands and a member of the Permanent Commission and International Association on Occupational Health. 26 CAP CO JEN 0011060 MAY 26 Ballroom, 9tb floor SESSION IV 9:00am Asbestos and Substitutes OTT, Heinrich (CEQ, Chairman Principal Scientific Officer . ..........- -- Directorate General for Science, Research arid " Development Commission of the European Communities Dr. Ott studied chemistry and physics at the LudwigMarimiliins University in Munich, where he received the degree Of "Oiplom-Chemiker" and his PhD. degree In Science. He was employed for time in the pharmaceutical Industry in Germany and then joined the Commission of the Euro pean' Communities es Scientific Officer, working at the Joint Research Centre at bpra (Italy), where be did research in toxicology and radiobiology, in 1973 he was transferred to the Brussels headquarters of the Commission of the European Communities. Within the Environmental Research Programme of the European CommunSies he assumes responsibilities as principal scientific officer for contract research in toxicology and asbestos, and research coordination. Evolution In the CIses of Asbestos PENNEY, Wilfred (United Kingdom) Director General Asbestos .Information Centre Ltd, London in addition to a long experience in asbestos-related industries, Mr. Penney was a member of the Environmental Control Committee of the Asbestosis Research Council, UK, and is currently Chairman of the Asbestos Working Patty of the Con federation of British Industry and Director General of the Asbestos Information Centre in London. Abstract A look at the evolution of the use of asbestos outlined by the growth of chrysotile asbestos consumption in the UK. While the existence of asbestos was known for thousands of years, science made It serve mankind from 1873. Several applica tions were introduced through the industrial revolution and growth continued during the Depression years. Producton soared after the Depression as the economy picked up. From 1940 to 1945, production was directed to essential uses and the war effort, and war equipment and its demands nourished future growth. Post-War development further increased con sumption of asbestos, particularly asbestos-cement products. From'1950 to 1960, there was continued progress, with the introduction of new products, new designs, new uses and new production methods. Increasing competition from alternative materials end the first rumblings of unease on the health aspects of asbestos brought about a temporary recession between 1960 end 1970. These trends continued In the next decade and volumes were reduced after a peak In 1973. Following an explosion of anti asbestos campaigns, high risk areas and products were with drawn and prohibitions and controls started to be introduced. Today, marketing efforts are aimed at promoting products that will remain and new uses. 27 CAPCO JEN 0011061 t t 9:25am The Feasibility of Substitution PYE, Andrew M. {United Kingdom) Associate Editor Design Engineering Morgan-Grampian Limited, London Mr. Pye graduated from the University of Cambridge with a degree In metallurgy an'd.materiab science. Joining the Fulmer' Research Institute, a consultancy arid contract research orga- ~ . nfzation specializing In materials technology, he worked on several projects. Including a study of substitute materials for asbestos, a subject on which he has written a number of pap ers. Subsequently becoming editor of the Fulmer Materials Optimizer, a four-volume materials selection and Information system, he joined Morgan-Grampian In 1980, as associate editor of Design Engineering. Britain's leading journal for engineering designers writing principally about recent developments pertaining to engineering materials. ; ( J "f Abstract This paper is primarily concerned with the potential for the replacement of asbestos In industrial engineering applications which comprise industrial textiles, millboard, high temperature Insulation, Jointings and seals (induding gaskets), friction materials, bearings, electrical Insulation and fibre-reinforced plastic composites. k is recognised that construction industry applications, such as asbestos-cement, insulation boards and sprayed insulation comprise a significant proportion of historical asbestos usage; thus, for completeness, guidance is given on the state-of-theart substitution potential and sources of further reference. It is emphasised that the substitution of asbestos containing mat;rials wM not be by a single, universal product; rather, eech application must be considered individually. The resultant ero sion of the supply infrastructure of the user industries evidently leads to cost penalties associated with the use of many substi tutes and the dilemma of compromise between performance end cost This is most apparent with the most arduous of applications. The costs of research and development into new materials end of the acquisition of new or modified processing machinery have. In some cases, to be borne by the user industries. This paper will not consider the possibDity of associated health hazards which may conceivably arise from the use of certain substitute materials, which subject will be dealt with by other speakers. 9:45am 9:45am J. Socio-Economic Impact of Asbestos Use (Cost-Benefit Analysis) with Special Reference to Developing Countries VENKATARAMAN, Nagaswarni (India) Managing Director Hindustan Ferodo Limited Mr. Venkataraman. who holds a B.Sc. degree In Engineering (Electrical and Mechanical), has had a lengthy experience with the asbestos industry In India, dating back to 1955 when he Joined Asbestos Cement Ltd. As a member of the Indian Stan dard Institution, he was responsible for drafting most of the specifications for asbestos-cement products now manufac tured In India. At Hindustan Ferodo Ltd, which he joined In 19S4, Mr. Venkataraman was successively Works Director and Sales Director before being appointed in 1973 to his present position of Managing Director. 28 1 CAPCO JEN 0011062 Abstract Asbestos, with Its unique combination of physical and chemi cal properties, plays a vital role In the growth of key sectors of developing countries. Upwards cf SOX of the asbestos Is used as a 'construction materiar for the reinforcement of cement and goes a long way In helping to achieve national goals of providing low cost domestic/industrial shelters, water supply and drainage to urban/rural areas as well as aiding irrigation for agriculture. The balance of asbestos Is used tn'the equally important industrial applications of friction/beerfng materia!,- -jointings,"peckIng'and seals, thermal and electrical Insuiatidris~ and tire protection. The outlook for asbestos In these countries must be viewed in the context of economies still reding under the impact of large foreign trade deficits resulting from the oil price hikes of the 1970i on one hand, and the need to commit their limited resources to essential nation building activities on the ether. To be acceptable as a "substitute* for asbestos under these circumstances, a material must have the required combination of mechanical and thermal properties In conjunction with a high ehemicql inertness and resistance to biodegradation, k should also be available in substantially large quantities at a significantly low material cost, with guarantees of freedom from health Hazards. Present day substitutes fail Into two major categories; man made mineral fibres (including glass) and organic fibres. Their costs range from a few times to tens of times the cost of asbestos. Their manufacture is energy Intensive. All of them are generally accepted as having a respirable component Although limited studies on hazard assessment for the man made mineral fibres have not yet proven them to pose a human cancer risk, the Implications from animat studies, where artificial implantation of fine fibres has resulted in the induction of tumors, cannot be Ignored. Adequate studies on the hazard assessment of the organic fibre substitutes are stm awaited. -~ lO.-OOam USHEWOKUNZE. Christopher M. (Zimbabwe) Secretaiy for Mines Ministry of Mines Mr. Ushewokunze completed his university education in the United Kingdom where he received a Master of Law degree from the University of London. He has lectured in law at the United Nations Institute for Namibia and at the University of Zambia. Among his research activities, has been a major study on the mining legal framework of Namibia. Mr. Ushewokunze has acted as legal consultant to the UNCTAD Zimbabwe Proj ect, where he reported on legal aspects of land tenure, mineral production and manufacturing industry in Zimbabwe. He has a number of publications to his credit Professionally, he is a Barrister at Law and Is currently Permanent Secretary at the Ministry of Mines in Zimbabwe. Abstract Asbestos, particularly the chrysolite variety, ofwhich Zimbabwe is a major world producer, has Important applications In developing countries. These fall into two broad categories: asbestos-cement construction products and the manufacture of sophisticated insulated materials. Asbestos-cement materials do not rust, corrode or suffer natural decay; they do not require maintenance or subsequent treatment as painting. They are therefore extensively used In housing and industrial building construction, on the one hand and In piping for water supply and sewage disposal, on the other. The social and economic impact In a country like Zimbabwe commences at the mining and blending stages--where over 11 000 persons are directly employed, the export earnings producing valuable foreign currency, and through to the man- 29 CAPCO JEN 0011063 ufacturing of the different type* of product*. In *0 cases asbestos has and is contributing to the improvement of Evinr conditions of.whote social communities In Zimbabwe and among third world populations. Hazards associated with asbestos use. In Its manufactured form appear to be outweighed by economic advantages. How ever, fittie research appears to have been carried out in third world countries on the harm, if any, likely to occur to end-users of manufactured asbestos materials. 10:15am Substitution -- A trade Onion View LEVINSON, Charles (ICEF) Secretary General International Federation of Chemical, Energy and General Workers' Onions (ICEF), Geneva Mr. Levinson holds a doctorate from the University of Paris. Throughout his career in the labour movement, hie has held important posts within a number of International organizations. He Is currently Secretary General of the international Federa tion of Chemical, Energy and General Workers" Unions (ICEF), as wD as Vice-President of the Supervisory Board of DuPont de Nemours In Germany. He has published several works on trade unionism and industry and, as editor for the ICEF, bulle tins and reviews on the chemicals, rubber, paper, energy and pharmaceutical industries end on occupational health. Abstract The story ofAsbestos is fortunately unique In the evolving annals of industrial disasters. Hopefully, Its final chapter to now being written. Already recognised as hazardous to the health of slaves in the papyrus records of ancient Egypt In the era of ptholemy. Asbestos has exerted an enormous human and social price for Its special heat-resistant, friction and reinforcing properties. There to perhaps no other single industrial resource which has had such extensive and intensive consequences on health. The long latency period between exposure and detectable injury for asbestosis, lung cancer end mesothelioma has been paralleled by an equivalent dormancy In respect of scientific acknowledgement of the evidence of hazard and the applica tion of corrective measures in industry. Debate and disagree ment over the issue. In large measure engendered by pressure from economic Interests, has seriously obstructed the implementation of objective, medically-based policy. Even allowing for difficulties in establishing absolute standards which are not susceptible to legitimate query, Asbestos policy has consistently tended to reflect the hesitations of the "unproven"" statistics rather than the much larger area of the "probable". Despite the overwhelming statistical and clinical data pointing to the hazards of Asbestos, ft Is not these hazards which have become the basis of policy. Political, economic and industrial considerations have been allowed to divert action Into longer term compromises. Public health and social responsibility no longer take the center stage es policy objec tives as attempts are made to optimize or to offset profits, investments,job losses and related considerations. These distorted policy aims have led to a serious. Irresponsible and probably malignant Asbestos Policy. The time has come to return the discussion to the health and social predominants. Asbestos must be phased out of industry where possible. Sub stitutes are already available In a wide range of applications. Phasing out Asbestos through substitution on the basis of the best technological, scientific and industrial procedures avail able must become the focus of policy. 30 CAP CO JEN 0011064 In the Interim, Immediate attempt* must be enjoined, by regu lation if necessary, to set emergency threshold levels, to fix product safety standards according to the binding properties of new produc" and processes, and to launch public information campaigns putting out that the material is relatively safe or constitutes an acceptable cost-risk if handled intelligently. 10:35am Health Hazards of Substitutes WAGNER, John Christopher (United Kingdom) Pathologist Pneumoconiosis Unit Medical Research Council, Penarth, Wales Doctor of Medicine from the University of Witwatersrand (South Africa), Dr. Wagner pursued a distinguished career as a Research Medical Officer at die South African Pneumoconiosis Research Unit beforeJoining, in 1962, the Medical Research Council's Pneumoconiosis Unit in Penarth (Wales), where he Is 'member of the Scientific Staff. He is a member of the EEC Panel for Pathology of Asbestos!* and Mesothelioma and has been actively involved in several committees, projects and symposia' related to that field. Dr. Wagner is the author and co author of over a hundred scientific publications. His most recent studies relate to the general area of pneumoconiosis and carcinogenesis associated with exposure to mineral dusts. Abstract This paper b wrongly tided; the subject b "Possible Risks of Substitutes" as so for no evidence of hazard to man has been established. However, by considering certain environmental situations and the-findings from experimental studies It b possible to draw up guidelines which should reduce these potential hazards. The fibrous minerab that have Keen considered as substitutes cah be categorized into the following three groups: a) man made mineral fibres; b) non-commercial asbestos fibres; c) othef naturally occurring fibrous minerals, including the zeolites and the fibrous days. If it b accepted that the biological effects of all these fibres depended upon their lengths and diameters, then the fact that the erfonke fibre In Karain can Initiate mesotheliomas could have been predicted once its measurements were known. Thb has now been confirmed experimentally. Using a crystalline and vitreous classification, the differing effects of intrapleural implantation and Inhalation can be explained. In implanta tion, the fibres are deposited directly into the pleural cavity, whereas, following inhalation, the fibres have to pass a series of natural barriers. Although crystalline and amorphous (vitreous) fibres may appear similar at the time of adminbtration and thus act In the same manner if Injected, after passing the normal barriers in the respiratory tract the crystalline fibres may split up into thousands of smaller fibres, white the vitreous fibres may have disintegrated into non-fibrous particles and, therefore, become inactive. I 31 CAP CO JEN 0011065 10:55am PANEL3 Should Asbestos be Replaced? OTT, Heinrich (CEC), Chairman PENNEY, Wilfred (United Kingdom); PYE, Andrew M. (United Kingdom); VENKATARAMAN, Nagaswami (India); USHEWOKUNZE, Christopher M. (Zimbabwe); LEVINSON. Charles (ICEF); WAGNER, John Christopher (United Kingdom) BLUZAT, Roger (France) Consultant & ia Direction de ia Recherche Saint-Gobain-Pont-&-Mousson Professor Btuzat is e Doctor of Science. He b a Research Associate at the University of Paris-Sud and acts as a consul tant for the Research Department of Salnt-Goboin-Ponth-Mousson. VELASQUEZ, Joseph (United States) Workers Institute for Safely and Health Washington, D.C | : j | .i 12:00noon Lunch 1:30pm SESSION V Risks Associated with Ron-Occupational Exposure HICKMAN, John Roy (Canada), Chairman Director Bureau of Chemical Hazards Department of National Health and Welfare Mr. Hickman b the Director of the Bureau of Chemical Hazards in the Environments) Health Directorate of the Canadian Department of National Health and Welfare. He received hb Master of Science degree in Pharmacology and Medical Biochemistry at the University of Birmingham, Since Joining the Department of National Health and Welfare, he has heid a number of senior positions related to toxicology and environ mental health. Over the years, he has also acted as adviser end consultant on food Irradiation and drinking water quality for international organizations such as the International Atomic Energy Agency, the World Health Organization, the Organiza tion for Economic Co-operation and Development, and the Food and Agriculture Organization. 1 1:35pm Levels of Exposure of the General Population from Natural Sources ROSS, Malcolm (United States) Research Mineralogist United States Geological Survey Mr. Ross holds a Master's degree in Physical Chemistry and a PhD. degree in Geology. Hb professional activities relate to mineralogy, petrology and crystal chemistry of uranium miner als, day minerals, talcs, micas, chain silicates especially amphiboles and pyroxenes, and lunar minerab. He specializes in the use of x-ray and electron diffraction equipment tn crystal structure analysb, and b presently engaged In assessing the 32 CAPCO JEN 0011066 .. _ r " relationships between human exposure to mineral particulates and the incidence of disease, particularly in regard to fibrous minerals. He has written numerous papers and abstracts in the fields of mineralogy, petrology, crystal structure analysis and environmental science. Abstract An examination will be made of the Important commercial asbestos mining localities of the world with particular emphasis on the most common asbestos minerals: ehrysotile, crocidolite and amosite._The less common asbestos minerals, anthophyfDte/tremolite"and eeb'noiite, have been mined sporadically, the only major production being the mining of anthophyiiite in Finland. Dust levels at the commercial asbestos mines and milts have beeen very high until recently. The best measure ments of dust levels were done in the towns of Thetford Mines and Absestos in the Province of Quebec. The sampling data give good evidence of the levels necessary to protect the miner end miller as well a* the other residents who were non-oceupationaUy exposed to ehrysotile asbestos. There Is a much larger question as to what the dust levels were In amosfte and crocidolite mines and at what levels the amostte and croddotfte miners are protected. An examination will also be made of other hard-rock mining operations such as the mining of gold, iron ore, talc, vermtailite, copper, woHastonite, zeolites and chromite. The gangue minerals associated with the ores from which these com modities are extracted often Include minerals that are similar to or Identical to commercial asbestos, as well as other minerals considered by some to be asbestos-like. Some asbestos min erals, particularly ehrysotile, appear as natural background In many, water supplies and in some geographic areas such as Colinga, California. The detection or lack of detection of-asbestos-related diseases In various mining and residential populations reviewed give a good idea of risks associated with occupational as well as nonoccupational exposure to the various asbestos dust 1:55pm Levels of Exposure of the General Population horn Industrial Activities (Demolition and Wastes) and Buildings LANTING, R. W. (Netherlands) Senior Scientist TNO Research Institute for Environmental Hygiene Mr. Lanting graduated horn the State University of Leiden with a Master's degree in Structural Geology end Geophysics. His main professional activities have been In the field of metrology of air pollutants and air pollution by particles, especially fibres. He participated in several international studies aimed at the harmonization and standardization of measurement methods and wrote several publications on measurement techniques for gaseous air pollutants. Mr. Lenting is a consultant for the European Commission DG11 in matters of air pollution by the asbestos-processing industries and is responsible for the analytical section of the Atmospheric Pollution Division of the TOO Research institute for Environmental Hygiene. Abstract Contamination of the environment by asbestos fibres con tinues from the point of extraction of the fibre, through the manufacturing process and the product use to the moment of ultimate disposal as waste. Owing to its persistence In the environment, asbestos fibres can be detected virtually everywhere In the atmosphere. An inventory and quantification of the most important emission sources resulting from the technical use of asbestos is pre- 33 CAPCO JEN 0011067 tented. Estimates of these emissions indicate that the con* trlbution of the manufacturing Industries to the levels of asbestos fibres In the general environment Is only smaD com pared to the emission occurring durine the lifetime of the asbestos-containing product These emissions are caused by processes like finishing opera tions in the consumer industries, wear and weathering of finished products, renovation and demolition of structures containing asbestos, transportation and disposal of waste. Renovation, demolition and waste disposal are typical opera-.r"-Uvr-JiJMBons where through unawareness of the presence of asbestos --' fibres high exposure levels can be expected for the nearby' population. From the total quantity of asbestos still present In structures and Installations, H may be expected that the operations men tioned wfll remain a significant source of environmental pollu tion fora long time. Concentration Weis measured WO be discussed and com pared with other industrial activities. In the European countries, roughly 60< of the asbestos con sumed is used in the construction of buildings. Sprayed asbestos has been applied very frequently prior to the prohibi tion of these operations enforced in most countries now. This material, mainly used in public buildings and offices may become a significant pollution problem for the occupants of such places. High exposure levels have been found In schools and swimming pools where much activity occurs. Especially children, through their long life spaa run a greater risk of being affected by carcinogens with a long latent period. How ever, no firm conclusions can be drawn yet from the present data on levels of exposures. 2:15pm 2:15pm 235pm Levels of Exposure of the General Population from Consumer Products PREUSS, Peter W. (United-States) Associate Executive Director for Health Sciences United States Consumer Product Safety Commission Dr. Preuss holds a Ph.D. degree in Botany and Biochemistry from Columbia University. As Associate Executive Director for Health Sciences in the Consumer Product Safety Commission, he has the responsibility for the implementation of the Chemi cal Hararda Program which focuses mainly on the assessment of exposure, hazards and risks associated with chemicals in consumer products. Other functions include the supervision of the Health Sciences Laboratory, compliance testing of safety packaging and health support to all other hazard programs of the Commission. Dr. Preuss is also the CPSC representative on the National Cancer Advisory Board and Chairman's alter nate to the Executive Committee of the national Toxicology Program. Abstract not available at printing time FELBERMAYER, Wolfgang (Austria) Head of the Institute for Environmental Protection and Clean Air Abstract not available at printing time 34 CAP CO JEN 0011068 r 2:55pm 255pm Health Effects on the General Population DOBBERT1N, Sigobrt (Federal Republic of Germany) Environmental Agency Ministry of the Interior Dr. Dobbertin studied veterinary medicine with special Interest in microbiology. After graduation, he was employed at the Institute for Food Sciences and received his certificate as a_ Veterinarian for Hygiene of Food, tn 1975, he Joined the Environmental Agency, an Office of the Ministry of the interior. He heads the section responsible for the "Effects of PoButants on Man". His particular Interest is the problems of carcinogenetic substances in the environment. Abstract Iri the presentation the fallowing bets are summarised: 1) The environmental pollution with asbestos Is increasing tn the most Industrialized countries; 2) Scientific basis Cor the existence of a threshold value is not available for asbestos or other car cinogens; 3) These two aspects allow the conclusion: There U an esbestoxaused tumor risk for the general population. The difficulties in risk extrapolation end risk assessment are described and some points of view ate discussed about the existence of threshold values. Furthermore critical aspects to the problem of mesothelioma and the causes are made In the presentation. The necessity of more influence of preventive medicine in environmental protection policy is emphasized and rt least a selection of agreements between industry and gov ernment in the Federal Republic of Germany is reported. ENTERLINE. Philip E. (United States) Professor of Biostatistics University of Pittsburgh,.- Professor Enterline holds a PivD. degree in Demography and b currently Professor of Biostatistics at the University of Pittsburgh. He has served In a number.of positions in the CIS. Public Health Service, where he was at one time Chief of the Morbidity and Health Statistics Branch, and later Chief of the Biometrics end Social Studies Branch, Occupational Health. Dr. Erteriine has published many scientific publications In the general Reid of occupational disease hazards and in the esti mation of health risks among coal fibrous glass, asbestos, chemical and refinety workers. Abstract - Aside from exposures to asbestos In occupational settings there b good evidence that nearly everyone in the general population has exposures from the environment. This b a review of the evidence for such exposures, the magnitude of these exposures and the most flkdy effects on cancer inci dence. For malignant mesotheliomas direct evidence of a gen eral population effect is used while for other cancers effects are extrapolated from dose-response data In occupational saltings. The evidence for these dose-response relationships is reviewed, along with several mathematical models used to describe these data. Estimates are made of the proportion of cancer attributed to asbestos exposures In the population, classified by the nature of these asbestos exposures. . 35 CAPCO JEN OOI1069 3:25pm SIEM1ATYCKJ. Jack (Canada) Recherches Bio-Mdica!es Institut Armand-Frappier, Montreal Dr. Siemlatycki holds a Master of Science degree In Statistics and a Ph.D. degree in Epidemiology from McGill University. After completion of a post-doctoral fellowship at the Interna tional Agency for Research on Cancer in Lyon (IARC), Dr. Siemiatycki joined the staff of Montreal's Institut Armand-Frapvpier where he to currently Associate Professor of Epidemiology. His main areas of research and publications are in the field of epidemiological methodology, especially in the assessment of occupational risk factors. Abstract While risks to health among asbestos-exposed workers Is welldocumented, there to concern that non-occupational expo sures may also cany excess risks. The populations residing in the asbestos-mining towns of Asbestos and Thetford Mines are thought to behighly exposed to air- and water-borne asbestos. A study based on death certificates was undertaken to com pare mortality rates from selected causes In these towns with those in coniparable-sized towns of Quebec not so exposed. In the period 1966-77, males In the asbestos-mining areas experienced excess rates of respiratory cancer (SMR-15). G! tract cancer (SMR-1.1) and other respiratory diseases (SMR-1.3), whereas females experienced SMRs below 1.0 for alt causes examined except G! tract cancer (SMR-1.1). Few of the females residing in these towns but many o.f the males had been occupationally exposed to asbestos. Since the decedent's occupation to not recorded on death cer tificates, It was not possible to determine whether the apparent excesses among males can simply be explained by the fact that a substantial number were occupationally exposed. This w3l be discussed. 3:40pm Family Contact Exposure ANDERSON, Henty A. (United States) Chief, Section of Environmental and Chronic Disease Epidemiology State of Wisconsin Division of Health Mar a distinguished research and teaching career in the Department of Community Medicine and the Environmental Sciences Laboratory of the Mount SinaT School of Medicine in New York. Dr. Anderson, who holds a M.D. degree from the University of Wisconsin Medical School is currently Chief. Sec tion of Environmental Epidemiology of the State of Wiscon sin Division of Health. He has published the results of many scientific studies in the field of health problems related to exposure to various airborne irritants, especially in dairy farmers, asbestos and chemical workers. Abstract Environmental asbestos pollution from industrial sources was not anticipated to pose any significant health hazard to the general public. Beginning with Wagner's report in 1960 and later Newhouse's report in 1964, it became apparent that a health hazard could occur in the neighborhoods of esbestos factories and in the households of asbestos workers. Over 50 pleural and peritoneal mesotheliomas have been reported among household contacts of asbestos exposed workers. Radiographic evidence of parenchymal and pleural fibrosis and calcification have also been reported with a greater prevalence among such environmentally asbestos exposed populations. Beginning in 1973, the Environmental Sciences Laboratory of the Mount SinaT School of Medicine in New York began a clini cal and mortality survey of all household contacts of 1,664 36 CAP CO JEN 0011070 worker* employed for varying periods of time from 1941-54 in a factory producing amostte asbestos products. Concurrent with the clinical surveillance program, a comparison group of 326 Individuals was selected, matched for sex, age and geo graphic area of residence. Clinical examinations and chut x-rays are available on 771 of the household contacts of the asbestos factory workers. Overall 35X of the household contacts had one or more radiographic abnormalities associated with asbestos exposure compared to 5* of the comparison group. The presence of radiographic abnormalities in the study cohort was statistically '--;c^7'signiTrcantlyas`sociatedwithclintcal.abnprmaBtfesj^>serred.__ .. "T- duration of Indexworkers employment and length of time since onset of first household exposure, k is essential that clinicians become aware ofthe possible sig nificance of radiographic evidence of parenchymal or pleural fibrosis in the absence of an occupational asbestos exposure and seek possible environmental exposure. The Individual should be notified of the existence of the abnormality. PANEL 4 3:55pm Is the General Population at Risk from Cancer Due to Asbestos Exposure? HICKMAN, John Roy (Canada), Chairman ROSS, Malcolm (United States); LANTING, R.W. (Netherlands); PREUSS, Peter W. (United States); FELBERMAYER, Wolfgang (Austria); DOBBERT1N, Sigobrt (Federal Republic of Germany); ENTERUNE, Philip E. (United States); S1EM1ATYCKI, Jack (Canada); ANDERSON. Henry A. (United States). FISCHER, M. (Federal Republic of Germany) Institute for Water, Soil and /ur Hygiene Federal Office of Health, Berlin Dr. Fischer holds a PhD. degree In Physics from the Freie Uni versity of Berlin. He has done research on the theory of electro magnetic waves and plasmas, and on systems theory of resource problems (environment, energy end raw materials). Since 1978, he has been at the Institute for Water, Soil and Air Hygiene In Berlin to build up a new sub-section (n human ecology. His present activities are centered around the risk assessment of cancerogeneous substances in the environment and the development of minimization strategies. HIGGINS, Ian T.T. (United States) Professor of Epidemiology School of Public Health University of Michigan Dr. Higgins is Professor of Epidemiology and Professor of Environmental and Industrial Health at the School of Public Health of the University of Michigan. His vast expertise and numerous publications in the field of occupational and environmental studies are mainly related to the epidemiology and pathology of respiratory diseases. Over the years. Dr. Hig gins has acted as consultant and expert on numerous national committees; having served on the Sub-Committee on Epidemiology of the Safe Drinking Water Committee of the National Academy of Sciences he is currently a member of the Epidemiological Task Force for Health Effects Studies of the Environmental Protection Agency, as well as of the Committee on Toxicology of the National Academy of Sciences. 37 CAP CO JEN 0011071 NECJBERGER, Manfred (Austria) Associate Director Institute of Environmental Hygiene University of Vienna Or. Neuberger b a specialist In Internal Medicine and Hygiene. He b Associate Professor of Hygiene and Preventive Medi cine and Associate Director of the Institute of Environmental . Hygiene of the University of Vienna. His mainjnterests tie -.w#h epidemiologic arid experimental air pollution research, 'occupational and environmental toxicology'and prevention programs. Dr. Neuberger acts as a consultant for the Aus trian Workmen's Compensation Insurance. He has several scientific publications to his credit, notably a book on new approaches to risk estimation of air pollutants. I 38 CAP CO JEN 0011072 MAY 27 Ballroom, 9th floor SESSION VJ 8:30am The Direction ofResearch: Present and Future HARINGTON, John Sullivan (South Africa), Chairman- .... . . Head of the Cancer Research Department National Cancer Association of South Africa Dr. Harington obtained his Ph-D. degree from the London School of Hygiene and Tropical Medicine, and was awarded the degree of Doctor of Science (02c.) by the University of London for his published work on the biological effects of silica dust'and asbestos fibres, his studies on experimental car cinogenesis and In the field of epidemiological and aedologlcal aspects of human cancer. Dr. Harington Is currently Head of the Cancer Research Department of the National Oncer Association of South Africa. His studies have centered on the physicochemical aspects of mineral fibres and the relation ships with their biological activity. 8:35am Physico-Chemical Modification of Asbestos in End-Use Products DERUYTTERE, Andr6 (Belgium) Head of the Physical Metallurgy Section University of Leuven Dr. Deruyttere graduated In OvU Metallurgical Engineering from the University of Leuven and received his Ph.D. (Metallur gy) from the University of Sheffield, UK. He Is Head of the Physical Metallurgy Section at the University of Leuven, where he has also occupied the position of Dean of the Faculty of Applied Sciences, Chairman of the Department of Metallurgy and`member of the University's Board of Directors. He partici pates in many scientific commissions and societies; among others, he is a member of the Commission fo, Metallurgy and Applied Chemistry of the Belgian National Foundation for Sci entific Research, Vice-Chairman of the National Committee for Planning and Control of the Steel industry and a member of the Commission for Applied Research of the National Council for Scientific Policy. Dr. Deruyttere has received a number of prestigious scientific awards and has over 70 publications to his credit Abstract The modem techniques which are available in materials research laboratories permit a thorough study of the charac teristics and properties of asbestos-cement dust and a com parison with virgin asbestos dust This is illustrated by an Investigation which, although limited in scope and time, shows that interesting and worthwiie conclu sions can be reached. The results of this investigation have already been published, but It may be justified to expose them again to the very broad audience of a World Symposium, in the hope that others will be encouraged to continue and expand the work so as to reach more complete and more definitive conclusions. Total dust samples produced by machining commercial asbestos-cement products have been collected at the machines in the production plant The granulometry of the samples has been determined. The composition of the 39 CAP CO JEN 0011073 granulometric fractions has been analyzed by X-ray diffraction. The asbestos content is smaller In the fine than In the coarse dust fractions. Microscopic examination has shown that only about I OX-of the particles of respirable size are "optically pure" asbestos fibres. An examination with scanning and transmis sion electron microscopes equipped with X-ray spectrometers has shown that even the optically pure fibres In asbestosCement dust are usually covered with small calcium containing particles. However, dust from autoclaved products contains more non-coated fibres. The dissolution kinetics and the absorption of carcinogens from tobacco smoke show that asbestos-cement dust behaves more like cement than like . .. pure asbestos. Therefore the general conclusion can be drawn that results obtained from studies on pure asbestos should not be automatically applied to asbestos-cement dust, because it is clear that there are notable differences between the two kinds of dust. 8:50am Modification of Asbestos Fibres: Biological Considerations DUNNIGAN, Jacques (Canada) Directeurginiral Institut de recherche et de dve)oppement sur i'amiante, Sherbrooke, Quebec Or. Dunnigan was successively Assistant Vice-Dean for Research and Director of the Research Programme on Asbes tos at the Gnivetsify of Sherbrooke, before he took on his present appointment as Director General of IRDA. A member of many advisory research committees for the Governments of Canada and Quebec, and the author of many publications. Dr. Dunnigan's current research activities are In the field of the mechanism of action of fibrous particles at the cellular level Abstract Proposed in the early seventies, "Stanton's hypothesis" stated that the biological effects of asbestos fibres depend on dimen sion and durability rather than physicochemical properties. Since then, an overwhelming body of data published by many scientists from laboratories around the world, which are reviewed today. Indicate that chemical surface properties are now considered an Important determinant In the mechanism of action of fibrous materials. Including asbestos, at the cellular level If indeed surface chemistry of fibrous materials Is an all Important factor of ceD toxicity and resulting pathogenicity, it follows that 1) Fibrous particles which may be released from finished products, may well be physico-chemically different from the original fibres. These "modified" fibres may then dis play altered biological properties. This phenomenon should be taken Into account in the process of regulation-making in the use of composite finished products containing fibrous materi als; 2) Regulations concerning the use of finished products are not scientifically supported, if arrived at by extrapolation of biological anchor epidemiological data obtained after exposure to pure, unmodified fibres; 3} Efforts to chemically modify asbestos fibres In view of altering the biological anchor technological properties should be pursued. 40 CAPCO JEN 0011074 9:05am Surface Characteristics and Biological Properties of Minerals LANGER, Arthur M. (United SU--i) Environmental Sciences Laboratory Mount SinaT School of Medicine, New York Dr. Longer holds a Ph.D. degree in Mineralogy from Columbia University. He is currently Associate Director .of the Environ* mental Sciences Laboratory and Head of the Physical SciencesSection of the Environmental Sciences Laboratory at the Mount Sinai School of Medidne in Mew York. An expert In the physico-chemical aspects of mineral dusts and the relation ships with their biological reactivity. Dr. Linger has acted as consultant on several national and international commitees and has also co-authored many publications in the general Retd of asbestos characterisation and measurement Abstract Mot available at printing time 9:20am Prospects for New Methods of Analysis and Measurement of Fibres in Environmental Samples CHATFIELD, Eric J. (Canada) Head of the Electron Optical Laboratory Ontario Research Foundation Dr. Chatfiefd obtained his Ph,D. in Colloid Science from Cam bridge University In the United Kingdom. From 1958 to 1968 he was on the scientific staff at the Atomic Weapons Research Establishment Aldermaston. where he performed studies on mixed alkali metal-plutonium aerosols. Since 1968 he has been Head of the Electron Optical Laboratory of the Depart ment of Applied Physics at the Ontario Research Foundation, where measurements of asbestos In air and water have formed a large part of his activities. He-has numerous technical pre sentations and publications to his credit Abstract Routine measurements of asbestos fibre concentrations in the workplace are made by collection of the airborne dust on membrane filters which are examined by phase contrast micro scopy (PCM). This technique is not specific for the detection of asbestos fibres, but the assumption is made that all particles which have aspect ratios greater than 3:1 are asbestos, in the general environment, the assumption cannot be made that all elongated particles encountered in either air or water samples are asbestos, since asbestos usually forms a minor proportion of the total number of such particles. The requirement for identification of the fibres therefore leads to the use of trans mission electron microscopy (TEM) for measurements of asbestos In environments outside of the workplace. Both the phase contrast optica) and the transmission electron micro scopy techniques are based on manual fibre counting, and are therefore subject to the limitations of counting statistics and operator subjectivity. Consequently, inter-laboratory compari sons have usually yielded variable results over a wide range of values. In the search for more accurate and reliable methods for measurement of asbestos fibre concentrations at the levels normally encountered, two new techniques have been investi gated. For workplace atmosphere samples, a scanning elec tron microscope (SEM) has been Interfaced with a computer to perform automatic fibre counting. The system applies con stant criteria for the enumeration of ell fibres, including the Individual fibres within fibre aggregates. The system also 41 CAP CO JEN 0011075 determines the chemical composition of each fibre so that non-asbestos particles can be rejected from the fibre count Magnetic alignment of asbestos fibres, first reported by Timbrail, forms the basis of the second approach to the measure ment problem. A new system has been constructed which is capable of detecting 0.2 ng of chiysoUe and 1 ng of crocidoBte. The fibres are suspended In a Squid which is placed In a rotating magnetic field. Measurements are then made of the intensity of light scattered by the suspension. Since the system Is not based on fibre counting, precise measurements are possible In short periods of time. 9:35am Critical Appraisal of in vitro and in vivo Assessment of Biological Effects of Fibrous Materials BIGNOM, Jean (France) Service de Fneumologie tCentre Hospitalier Intercommuna! University of Paris Val de Marne Professor Bignon holds a Doctorate In Medicine and a Doctor- ' ate In Science (Histology) from the University of Paris. He Is Professor of Respiratory and Environmental Pathology and of Occupational Medicine at the GeteS Faculty of Medidne. Dr. Bignon fs also Director of the Laboratoire de recherches sur les affections respiratotres et environnement (research laborat ory on respiratory diseases and toe environment), and Scien tific Director of the Laboratoire deludes des particules inhatees de la DASS (laboratory of characterization of inhaled particles). He participates as an expert In numerous working groups and commissions, including within the Commission of the Euro pean Communities (Toideology. Environment, Asbestos). i Abstract During the past ten years, several laboratories have developed different test systems in order to evaluate the biological responses Induced by mineral dusts end particularly by asbestos. 1.Short term In ultra systems will be reviewed critically. The biological significance of each type of tests (hemolysis, enzymes release by macrophages, effects on proliferative cells In culture, mutagenesis tests on mammalian cells...) will be discussed in relation to Inflammation, mutagenesis or cancerogenests. Different in vitro responses are observed accord ing to /tore types, the signifleance of which will be discussed in relation to the physico-chemical characteristics of the fibres. 2. Animal experiments represent the reference method for studying the fibrogenic and cancerogenic effects of different types of fibres. Inhalation exposure seems the most suitable method for extrapolating an adverse effect to human beings. However simpler methods, such as Intrapleural or Intraperitoneal injection of mineral dusts, are useful for testing the biological properties of modified asbestos and new types of asbestiform fibres or synthetic fibres, of which only smallamounts are available. The animal data are necessary in order to validate the in vitro results. 3. Other experimental methods have to be investigated in order to study the synergism between asbestos fibres and other carcinogens (radiation, tobacco, benzo-a-pyrene) and to shorten the duration of animal experiments (by using to vivotn vitro methods for Instance). 42 CAP CO JEN 0011076 E.. - PANEL5 9:55am Questions and comments from the floor HAR1NGTON, John Sullivan (South Africa). Chairman DERUYTTERE, Andrd (Belgium): DUNNIGAN, Jacques (Canada); LANCER, Arthur M. (United States); CHATF1ELD, Eric J. (Canada); B1GNON, Jean (France); MALTON1, Cesare (Italy) BECK. Ernst Gehrard (Federal Republic of Germany) Director of the institute of Hygiene Giessen University Professor Beck b Director of the Hygiene Institute end Medical Ecology Centre, at the Ju$tus-Ueblg University in Giessen. Hb numerous research publications relate to the genera) fields of environmental hygiene and ceO toxicology, especially on the subject of the biological effects of airborne mineral particles. RILEY, George W. (Canada) Research Manager Mineral Processing Laboratory, CANMET Energy. Mines and Resources Canada Mr. Riley is a Mining Engineering graduate from the Camborne School of Mines (UJC). Prior to joining the Canadian Depart ment of Energy. Mines and Resources In 1964, he was Involved for 10 years with the asbestos industry, particularly in the area of processing. As Manager of the Mineral Processing Laboratory he is concerned with the. processing, utilization, properties, characterization, identification end evaluation of metallic and non-mttaliic minerals, mineral wastes, ceramics and construction materials of mineral origin. Mr. Riley is active in many technical committees, including the Canadian Advboty Committees for the International Standards Organization, and is Coordinator of the Canada/EC Asbestos Fibre Definition and Fibre Measurement Techniques Program. SEBAST1EN, Patrick (France) Materials Engineer Laboratoire deludes des particules inhales, Paris Dr. Sdbastien has been specializing for 10 years in the metrol ogy of inorganic particles (including asbestos) In relation with the study of their effects on health. His doctoral thesis in engineering was on the theme of The Biometry of inhaled Par ticles. From 1972 until April 1982, he has worked in Paris at the Laboratoire rfltudes des particules inhaiies (laboratory for the study of inhaled particles) and is now with the institute of Occupational Health and Safety at McGill University. 10:30am Resistance and Immunological Status In the Pathology Related to Asbestos Exposure KAGAN, Elliott (United States) Associate Professor of Pathology Department of Pathology Georgetown University Dr. Kagan holds a degree in Medicine from the University of Witwatersrand (South Africa). He was for four years Head of the Department of Immunology at the National Research Institute for Occupational Diseases of the South African Medical 43 -4- CAPCO JEN 0011077 Research Council. He then joined the staff of the American National Red Cross Blood Program and later taught pathology . at the School of Medicine at the Georgetown University Medical Center In Washington. He Is currently Director of the Hematologic tmmunopathology Division at the Georgetown University Hospital Dr. Kagan's research activities are centered primarily on immunological aspects of occupational lung disorders. Abstract The fibrogenic and carcinogenic properties of asbestos fibers _. _ .. are now wed recognized, yet there is still considerable debate -- .regarding the mechanisms whereby asbestos evokes Ks biological effects. There is a body of evidence which indicates that constitutional factors may determine an individual's sus ceptibility to asbestos-related disease. Among these host determinant factors, the Immune system may play a pivotal role. Striking manifestations of immune derangement have been described in asbestos workers. These include: a) defec tive expression of cell-mediated immunity (cutaneous anergy, impairment of lymphoproiiferative responses and oflym- phokine generation}; b) decreased numbers of circulating T lymphocytes; c) hyperactive B cell function (elevated Immunoglobulin levels and an Increased frequency of non- organ-specific autoantibodies}. These abnormalities may results horn a loss of suppressor cell Immunoregulatoiy Influ ences as a consequence of asbestos exposure. Since many facets of immunological function are genetically modulated by Immune response (Ir) genes residing within the major his- tocompatibflity compter, Immunogenetic studies should prove useful probes of host susceptibility status in different categories of asbestos-exposed populations. The use of sophisticated , immunological probes to detect persons "at risk" of devetop ing asbestos-related cancers has tremendous advantages for both labor and industry. Such studies could provide a "ray-of- hope" for the earliest detection of disease in asbestos workers. Tb* potential cost benefit to industry could be substantial in terms of the prevention of tost worker-hours and the circum - vention of compensation claims. 10:50am Tissue Burden Studies POOLEY, Frederick David (United Kingdom) Reader in Mineral Processing Department of Mineral Exploitation University College, Cardiff, Wales Dr. Pooiey holds a PhD. degree In Mineral Engineering from the University of Wales. He Is currently a Reader in Mineral Processing-at the-Department of Mineral Exploitation, University College in Cardiff-'Aiso, he is the author and co-author of studies on the identification and quantification of mineral fibres in airborne dusts and biological tissues. Abstract Collection of information concerning the fibrous minerat eontent of tissue pamples is extremely important as epidemiological, pathological and biological studies can be more readily interpreted with the knowledge of the mineral types, fibre numbers and sizes contained in such samples. In arty study of tissue for its asbestos mineral content, facilities for observing, identifying and quantifying the various minerat fibre* must be available. There are many studies recorded in the literature which although well tntenttoned were performed with inadequate preparation methods and analytical facilities. The results obtained were therefore limited and often mis leading. sometimes adding confusion rather than clarity on the subject of asbestos-related diseases. The sophistication of studies of lung tissue has been closely linked over the past 15 years with improvements and devel opments in analytical equipment and methods. It is now } i ! 44 CAP CO JEN OOI1078 generally accepted that reliable results of asbestos burdens In lung tissue can only be obtained using the most modem designs of analytical transmission electron microscopes. There are very few studies reported In the literature which have been produced employing such equipment, and In many the num ber of tissue specimens examined have not been sufficient to allow any general conclusions to be drawn. Future studies will no doubt be involved with confirmation of the data on fibre types and levels In tissues that have already been obtained, while further studies of selected cases to . -^5=-~'--amtne factors such"as fibre translocation will be performed, it is probable that the mineral matter In tissues other than fibres win also be quantified as this has been an entirely neglected area. 11:1 Oam Epidemiologic Significance of Asbestos Fibres In Lung Tissue MCDONALD. Alison A (Canada) Directeur de programme Institut de recherche en santd et en sScuriti du travail, Montreal Or. Alison McDonald is a medical graduate from the University of London and did post graduate studies at the London School of Hygiene and Tropical Medicine. She has tong been on the staff of McGill University. She was Professor In the Department of Epidemiology and Health when, for a brief period (19781981). she joined the St-Mary's Hospital Medical School In London, as Professor and Head of the Department of Epidemiology. Dr. McDonald is currently Program Director at the Institut de Recherche en SantA et SAcuritA du Travail (a research Institute on occupational safety and health). In MontrAaL Abstract Advances In electron microscopy have enabled investigators to identify the physico-chemical nature and dimensions of single mineral fibres, and to estimate the numbers present in a given dry weight of tissue. Although mainly restricted to studies post mortem, this technique is dearly of great potential value in estimating, for epidemiological purposes, past exposure* to inspired mineral fibres. Earlier studies of coated fibres (ferruginous bodies) have not contributed much to our understanding of asbestos-related disease, because coating varies with mineral type and length of fibre, end not only asbestos fibres are coated. Some correlation between uncoated asbestos fibre counts made with the light microscope and lesser degrees of asbeslosis has been reported. However, the proportion of light-visible fibres varies between IX and 10X of those seen by electron microscope. Recently, electron-microscopic analyses of lung tissue have been made in a single laboratory of two substantial case-con trol series of malignant mesothelioma: one from North Ameri ca and the other from the United Kingdom. Both series gave simitar results: the quantity of chrysotiie fibres was similar In cases and controls, but much larger quantities of amosite and crocidolite fibres were found In cases than In controls. The Interpretation of these findings depends on the retention and movement within the lungs of inspired asbestos fibres, and on physical end chemical changes which may occur. Expert- mental and epidemiological studies suggest that chrysotiie fibre bundles tend to divide longitudinally Into smaller bundles or Into separate fibrils. The latter fragment Into shorter fibrils and are then found In greater quantity In peripheral rather than central areas of the lungs. In addition, leaching of chiysotile appears to occur whereas amphibole fibres seem to remain unchanged. Further study of the behaviour of asbestos fibres in the lungs and other tissues b urgently required. 45 CAP CO JEN 0011079 POCCH1ARI, Francesco (Italy) Director General Istituto Superiore ci Sanity Professor Pocchlari, who holds university degrees In Chemistry and Pharmacy, was Involved for many years In research at the Laboratory of Biological Chemistry of the Istituto Superiore di SanitA and is currently Director General of this Institute. He is also an active member of many national and international committees and working groups in public health, including die European Medical Research Councils where he Is the rep resentative from Italy. Professor Pocchiari is also currently Vice? President of the European Science Foundation. TRINK, Claude Emmanuel (France) Ing6nieur des mines Service de TEnvironnement Industrie! Ministire de I'Environnement A graduate of the co!e Polytechnique and a Mining Engineer, Mr. Trink has been since 1977 Assistant to the Chief of the industrial Environmental Services at the Directorate for Pollu tion Prevention of the French Ministry of the Environment 4:30pm Closing Remarks DCiNNIGAN, Jacques (Canada) Secretary Qeneral ofthe Symposium 52 CAPCO JEN 0011086 Available Copies of Speeches at the World Symposium on Asbestos (May 24-27, 1982) 1. ATHERLEY, Gordon 2. CHATFIELD, Eric J. 3. COOPER, W. Clark 4. DERUYTTERE, Andre 5. DOBBERTIN, Sigobrt 6. DUNNIGAN, Jacques 7. DUPERE, Jean 8. ENTERLINE, Philip E. 9. FELBERMAYER, Wolfang 10. FOURNIER, Etienne 11. GORSUCH, Anne M. 12. 'GRAY, Herb 13. HIGGINSON, John 14. KAGAN, Elliott 15. LANTING, R. W. 16. MARTONIK, Jr., John F. 17. NEUBERGER, Manfred 18. NICHOLSON, William J. 19. PENNEY, Wilfred 20. PREUSS, Peter W. 21. PYE, Andrew M. 22. REITZE, William B. 23. ROBOCK, Klaus 24. 25. ROSS, Malcom SCHMAEHL, Dietrich F. K. CAP CO JEN 0011047 Speakers - WSA (May 24-27, 1982) 26. SELIKOFF, Irving J. 27. SIEMIATICKI, Jack 28. SIMPSON, William J. 29. USHEWOKUNZE, Christopher M. 30. van der REST, Etienne 31. VENKATARAMAN, Nagaswami 32. WAGNER, John C. -2- CAPCO JEN 0011048