Document M4nkd0J38MOO1zYjxopG55Lkz

Pergamon >ruf. Htti.. m. *R. N<. 4, fkt 4 tjx, |<rt4 Elyntf Scwwvc t<rJ Cop; rtfhi * IW Bnth OciwfoiM'iui M|Knc S*vt Printed m G((U Sot-jia AH \gtvt- revived UD)> 4.VS ti 5* |i . ottl 0003-4878(94)E0032-U MESOTHELIOMA AMONG CAR MECHANICS?* H.-J. Wostowitz and K. Rodeisperoer (KictUcd 30 Nacmbtr I99J and infinalform IS Ftiraary 1994) Paper read at the Workshop on Health Risks Associated with Chrysolile Asbestos, held in Jersey, Channel Islands, 14-17 November 1993. No Astt. In .1991 and 1992 preliminary information was given on an on-going case-control study of mesothelioma, which tip to that time involved 175 cases, of whom 14 were car mechanics (Wonowrrz and Rodelsperger, 1991, 1992). This study has now been . finished (Worrowrrzet at., 1994) and the final results relating to car mechanics can be repotted. Of the original 14 cases four had to be rejected, since the panel of pathologists finally classified them only as "possible mesothelioma". Ultimately out of 324 cases of 1 mesothelioma 16 were classified as motor vehicle mechanics (according to code 42! "JCraftfahtzeug-Instandsetzer"--"motor vehicle repair worker"--of the German Federal Statistical Office). They were compared with 16 mechanics among 3 (5 hospital controls and 12mechanics among 182 population controls (sec Table l|. The hospital controls' were patients who had undergone lung resection for reasons other than mesothelioma, in mosf.instances because of lung cancer. Evaluation of the occupational histories of cases and controls showed that one of the mesothelioma cases and one of the hospital controls worked with locomotive engines and a second case worked with trams. A third mesothelioma patient worked in automobile production where he was exclusively involved in fitting windscreens. Among the population controls who had worked with cars one had only painted cars and another hadproduced car spare parts. The motor mechanics began their employment in that capacity between 1925 and 1972, the.median date being 1949 for both groups of patients and 1946 for the population controls. The duration of relevant employment was longer for controls than for cases, with median values of 5, 5.5 and 4 years, respectively. Seven of the mesothelioma cases, nine of the. hospital controls and three of the population controls said that they had done brake repair work. In all three groups there were some individuals'who had substantial asbestos exposure in other types of employment (e.g. in a power plant or in theship-building industry). Only four of the mesothelioma cases, two of the hospital controls and five of the population controls had no history of asbestos exposure. Three of these four mesothelioma cases, and also two of the five *Supported by the German Federal Ministry of Science and Technology. Project No. 01 HK 076 A6. Mesothelioma among car mechanics? 637 ospital controls and two of the five population controls, stated (hat they had been igaged in brake repairs. Lung tissue analysis was available for two of the mesothelioma cases and for one of hospital controls (Rodelsperger et al.. 1993, see Table 2). For mesothelioma Table Z Luno tissue asalysis.of mesothelioma cases and hospital controls. ENGAGED AS.MOTOR VEHICLE MECHANICS. THE ANALYTICAL SENSITIVITY IS DEFINED AS CONCENTRATION PER FIBRE .' No. Status Lung dust fibre concentration t^5 /tm x I05 f g-' (dry| Analytical Other -sensitivity Chrysotile Amphibole minerals I Case 2 Case J Control 22 25 0 0 1.630 0 282 0 0 0 n font No. I. no fibres longer than 5 ptm were found. Since 1972 he had worked for ears as a car mechanic and was engaged in brake repair work during this time. There s no~ suggestion of any other asbestos exposure. For mesothelioma patient No. 2 characteristic amphibole fibres longer than 5 pm XxOoDbserved. He had worked as a car mechanic for only I year in 1940 and had been a aalffe pilot from 1941 to' 1945; he had no known asbestos exposure from other iyyment. cbntrol patient No. 3 had numerous long chrysotile fibres but no amphibole fibres, had worked as car mechanic from 1934 to 1939. From 1945 to 1950 he was a oner of war in Russia where he had to arc-weld steel structures and to install glass e insulation. Subsequently he is assumed to have had no further occupational osure to asbestos. CONCLUSIONS rtt>ni -these results, there is no evidence that car mechanics are exposed to an 3ISKxt.mfc.ormesothelioma even if they do brake repairs, but asbestos exposure in ffi^tiEl'oyFinent'itsi'; a%itnp0rtant confounding factor, so that if there is a jtftelioma tfiskTornidiftames but it were small it would not be detectable. The nee of fibres in the lung tissue analysis for one of the mesothelioma cases--despite mployment For 8 years as a car mechanic, repairing brakes--does not exclude the bilityrthat, decades before, chrysotile fibres were active at the large! cells. On the : hand; it is doubtful that (he-amphibole and chrysotile fibres, in the lung tissue of >thcr patients, can be related So their employment as car mechanics. the discussion of the issues raised in this and the other allied papers see 07-425.] :. ,. REFERENCES SPERGEIC K-.WoiTOWirZ. H.-J.. BrCocel. B.. Arhelcer. R.. Romer.W., Pohlabeln. H. and Iockjel. H. I1993) Fail-KonuolFSludie an Mesotheliompaiienlen zum Cehalt anorganischcr Fasem im This does not mean that other mechanics were not engaged in brake service. HWBUI0010231 636 H.-J. W<HTwr7. and K. Rouelspf.rce* A ) iOl 1 o i $s c *I ? "H J HWBUI0010232 Mesothelioma among car mechanics? 6J7 hospital controls and two of the five population controls, stated that they had been engaged in brake, repairs. Lung tissue analysis was available for two of the mesothelioma cases and for one of the hospital controls (Rodelsperger et ai. 1993. see Table 2). For mesothelioma Table 2. Lose nsset analysis or mesothelioma cases and hospital controls. ENGAGED AS MOTOR VEHICLE MECHANICS. THE ANALYTICAL SENSITIVITY IS DEFINED AS CONCENTRATION PER FIBRE No. Status Lung dust fibre concentration LzSpm x 10'fg"' (dryl Analytical Other sensitivity Cbrysotile Amphibote minerals i - Case 2 Case 3 Contro! 22 tt 25 0 0 1.620 0 282 0 0 0 76 patient No. 1 no fibres longer than 5 pm were found. Since 1972 he had worked for 8 years as a car mechanic and was engaged in brake repair work during this time. There was no'suggestion of any other asbestos exposure. For mesothelioma patient No. 2 characteristic amphibole fibres longer than 5 pm were observed. Me had worked as a car mechanic for only 1 year in I940and had beena Luftwaffe pilot from 1941 to. 1945; he had no known asbestos exposure from other employment. Control patient No. 3 had numerous long chrysotile fibres but no amphibole fibres. He had worked as car mechanic from 1934 to 1939. From 1945 to 1950 he was a prisoner of war in Russia where he had to arc-weld steel structures and to install glass fibre insulation. Subsequently he is assumed to have had no further occupational exposure to asbestos. CONCLUSIONS From these results there is no evidence that car mechanics are exposed to an increased risk of mesothelioma even if they do brake repairs, but asbestos exposure in other employment is an important confounding factor, so that if there is a mesothelioma risk for car mechanics but it were small it would not be detectable. The absence of fibres in the lung tissue analysis for one of the mesothelioma cases--despite bis employment for 8 years as a car mechanic, repairing brakes--does not exclude the possibility'that, decades before, chrysolite fibres were active at the target cells. On the other hand, it is doubtful that the.amphibole and chrysotile fibres, in the lung tissue of two other patients, can be related to their employment as car mechanics. [For the discussion of the issues raised in this and the other allied papers see pp- 407-425.] REFERENCES RSoeisyerger. K.. WniTowtTZ. H.-J.. BrCtkel. B.. Arhelger. R._ Romer. W.. Pohlabeln. H. and JCckel. K-H. II99J) Fati-Koniroll-Studie an Mesothtliompaticnten zuro Gehalt anorganischcr Fascrn ira 6.1ft H.-l. Wnmtwirr. and K. ROtKlsmoEft Lunecnstaub. V'ortnig atifdcm KoMoquium Faserfurmsge Sluubc: 'orsthrifteo. Wirkungeit. Messung. Mindcrung. Kornmission Rcinhaltimg tier Luft in VOI unti DIN Futda. 7 9 September 199). YOU fkrtchtc \WS. pp. 253 267. VDI-Vcrtag. Dusieldorf. WmrmviTZ. H.-J. and RnofAst'ERCtEtt. K. i I9SM} Chrvsotile asbestos am) mesothelioma. [Letter to the Editor.) Am. J. htJ. .tW. 19. 551 553. WotTnwirz. H.-i. and RfmF.uw*iUi-R. K. tl992lChrysoule asbestos. mesothelioma and garage methanics: 'Response to Dr Wong. .4m. J. inMeJ. 21. 455 455. WlMTOWir/.. H.-J.. HtLURIMLG-.CAtAVKFZOS. A-BemsHacser. K. H.. Rowelspreccr. K - ItVKtt. K.-H. */ *tl. 11994} Mul(izcn(nhc und mufttdtsttplinarc Untcrsuchungcn tur Analyse von Rtsiko- und hinnuOfaVtoren dcs diflbsen maligiten Mesothelioma. Schriftcnrcihc dcr Bundcsansialt Tor Arbeitssehotz. WrtschjCts\flag NW. Bremerfoven. HWBUI0010234 6JK . . H.-J. WojTOWny.and K. ROuCisreMSER . Lungenstaub. Vortcug auf4cm Kvllot^uium Fasicrfovmtge Slaubc: Vwschrifveu. V/iibn^cn. Messong, MinJerung. Komnmsron Rcinhultung dcr Luft in Vof und DIN Fulda. 7 9 September 1993. VDf* Berkhie 1075. pp. 253 367, VDt-Vcrlag. Dusseldorf. WcHTvviT7_ H.-J. and Rooels^Eroer. K. |I99I| Chiysotik asbestos and mesothelioma. (Letter to the Ediior.f .-Inf. J. id. Xfed. 19, 551 553. Wfnwwirz. H.-J. afMTRfioEtarFJttjEiu K. 11992 iChrysolile asbestos, mesothelioma and garage mechanics: Response to Dr Wong. .4m. J. hiJ. MvJ. 21* 453 455. Wt)m)W|TZ.H.-)..HlLlERIMLG..CALAVKEZ(IS. A.. BERGHAL'SF.K. K. H..RftoLSPREGER. K JficMi. K.-H. et tiL (1994) MultUenlnsche und mutlidisziphniirc Umerrsuchungen r Analyse von Risiko- und F.iniluQfekiorcn dcs dilTuscn malignen Mesotheltoms. SchriftcnnHhc dcr Bunifcsaiwali fur Arbeitsschutau Wirtschaftsvedig NW. Brcmcrhuien. HWBUI0010235