Document M4nko8r4JpORBEy2v15MKxxYa

J1 INDUSTRIAL HEALTH NEWS LITERATURE ABSTRACTS MEDICAL ENGINEERING CHEMICAL ... TOXICOLOGICAL ' -f legal'^ r'r'` JUNE, 1968 (Vol. 32, No. 6) INDUSTRIAL HYGIENE FOUNDATION 4400 FIFTH AVENUE PITTSBURGH, PA. IS213 5 51 Pulmonary Fur.cticr in Sa.:s.s = r ? Lure Am. ?>ev. P.esp. Eis. 5c!-57` .'.-.pri'.. 1 -c'`. A. V.. fierce et al. Seven previously 'veil :r.er. wcrkir.:: :r. a fiberbcarb piar.t developed signs and symptoms of ac-- bagasse worker's lung during a ten-week period. Two o:' these patients had open lung bioosie-- to confirm the diagnosis. Pulmonarv functions were measured from 2. 5 weeks to 26 months after the onset of symptoms. All patients had a restrictive lune defect due to a reduced in spiratory capacity: partial airway obstruction was not a feature of the illness. All patients had a severe reduction in the transfer coefficient of the lur.e for carbon monoxide at the outse- this was primarily due to a reduction in membrane diffusing capacity, whereas the volume of blood in the pulmonary capillaries was more nearly normal. Although pulmonary functions returned toward normal, the total lung capacitv, ir.soiratory capacity, vital capacity, forced expiratory volume, transfer coefficient of tie lur.e tor CO. and membrane diffusine capacitv remained significantly abnormal more than one year after the onset. Three patients were treated with adrenocorticosteroids and -1 were not. There was no significant difference betwe*- the treated and the untreated patients in the rate of objective improvement or in the extent of residual impairment of pulmonary functions. These data suggest that steroids do not hasten the resolution of a granulomatous infiltrate nor do they make resolution more complete. The.-r are 28 references. -- Authors' summary . 552 Metal and Mineral Concentrations ir. Lungs of Bituminous Coal Miners. J. V. Crable, et al. Am. Ind. Hyg. Assn. J. 29. 1 06-1 i 0 (March-April, 1968). Lung and pulmonary lymph node samples from 26 West Virginia bituminous coal miners hate ... analyzed for total dust, coal, and free silica. In addition, beryllium, cobalt, manganese, rut- titanium, and vanadium were determined by the quantitative spectrographic methods; lead was determined by the USPHS dithizone method: and copper, iron, magnesium, and zinc were de:ft- mined by atomic absorption spectrophotometric methods. The summarized results of the mir-' analyses from this study and the authors' previous study are presented. The concentration rv. and mean values for eleven elemental constituents are compared with normal values reporter ' Tipton and Shafer and Cholak. There are 9 references. -- Authors' summarv 553 Tissue Response to Intraperitoneal Asbestos With Preliminary Report of Acute Toxicity of Treated Asbestos in Mice. J. Jagatic, et al. Environ. Research_l_> 217-230 (Nov., HoTi Intraperitoneal asbestos not only produced fibrosis, but a special and peculiar type of fibre: which was proliferative, granulomatous and invasive, and histologically similar to mesotr.e.. although morphologic evidence of actual malignancy was not obtained. Further, asbestos exposed to high temperature produced a high degree of toxicity in experimental animals: tr.:: resulted in a 60F- mortality rate. -- Authors Editor's Note: Although the authors of this l-4-page article insist that the fibrous truUm- " tissue resulting from intraperitonealiv injected asbestos is histologically similar to mesoi and that it is "invasive", they gave no evidence in support of these opinions. The 22 iHu=-`" that are included in this report, support neither the claim of similarity to mesothelioma ^ of "invasiveness"' of the inflammatory tissue. -* r- 554 Asbestos--A Hazard to the Community. C. Gold and J. Cuthbert. Public Health(London) 80, 261-270 (Sept. , 1966). During a recent study of pulmonary fibrosis in a Southeast Glasgow clinic. 21 proved -a- 3 possible cases of lung pathology associated with exposure to asbestos have come :o patient with suspected asbestosis should have, ir. addition to x-rays, an examination bodies ir. the sputum, lung function tests, ar.d open lung biopsy, since asbestosis in patients with normal or borderline x-ravs bv the lur.a function test and most re-ia - biopsy. It is also important to take a complete occupational history in cases o: .. fibrosis, since asbestosis or pleural tumors may occur many rears after a short . the asbestos dust. Also, persons in occupat:or.s usual.associated v.-it.t r.ea-- be endangered by workir.c ir. close proximitv with people who use asbestos, espe<--^ _ spaces. Case histories are giver, and a table is presented shoovina the type o: a:> . tior., length of exoosure. aae, and period elapsed since exposure of the 24 natter-- - . Since the use of asbestos has become more widespread in recent years, it is reco..- June, 1968 iternative materials to asbestos should be used whenever possible. A proposal to mix _,sii!>le tarmacadam for road use is viewed with concern. -- APCA Absts. jWtoS v* t - . ^ \ote.. Re^garding 554-566, interested readers are referred to the Editorial in the May and IHF Medical Seriess Bulletins Xo. ar.d 12 write report progress and planning !i"%\sbestoa bioeffects research. -- R. T. P.' deT. - a-miologv and Clinical Features of Asbestosis and Related Diseases. P. C. Elmes. \ted. J. 42, 623-635 (Oct. 1Q66). p^Ttgtad- ` -- onary fibrosis caused by asbestos dust has become less common since the introduction of ^ppresssion measures in 1932-33. However, in occupations where these safety measures :'* observed, asbestosis is still a threat. Symptoms of asbestosis are breathlessness on ^Vtion* productive cough, tightness in the chest, clubbing of fingers, warts, cyanosis, restricted e.<esr t movement, kyphosis, and fine rales heard over the lung bases. Changes in x-rays are conclusive, since they also occur with other forms of chronic diffuse fibrosis involving the "'eura- X laboratory tests except lung biopsy are diagnostic of asbestosis but sputum examin ation anc* respiratory function tests heLp to support the diagnosis. Carcinoma of the lung result- a from exposure to asbestos appears to be common in patients whose exposure to the dust was !nJUff{ciently long or intense to cause crippling fibrosis. The rapidly increasing number of tsei of fatal mesothelioma of the pleura and peritoneum have been definitely traced to exposure o asbestos dust. The degree of exposure in many cases is slight and there can be a long interval between exposure to the pollutant and the development of the tumor. Preventive measures re commended are restrictionofuse and greater precaution in the handling of all types of asbestos. rocidolite fiber, in particular, should be eliminated from commercial use. -- APCA Absts. asbestos--An Environmental Health Hazard. W. D. Norwood, P. A. Fuqua and T. F. Mancuso. v'nrthwcst Med. 66, 821 (Sept., 1967). Four Case Reports demonstrate asbestosis with pulmonary emphysema and cor pulmonale, as bestosis with lung cancer, mesothelioma, and rectal cancer. The occupational histories of workers as plumbers, boiler makers, carpenters, pipe fitters, steam fitters, mechanics, stationary engineers, undercoaters, foremen, maintenance electricians, builders, rubber workers, construction workers, cement workers, boiler repairers, sheet metal workers and laborers must all be elicited if diagnosticians hope to record the more than 3, 000 different exposures to asbestos. For the sake of workers and their dependents with industrial health compensation rights, the diagnostician must not be misled by recent occupational history nor overlook other work exposures within the lifetime of the patients. The obvious need for de creasing the exposure to asbestos by better occupational hygiene programs is recognized but no detailed criteria were presented. Considering the growing uses of asbestos, this occupational and environmental disease may get worse before it gets better. -- J. Occ. Med. Absts. Talc in Atmospheric Dusts. H. Windom, J. Griffin, and E. D. Goldberg. Environ. Sci. Tech. _L_, 923-926 (Nov. 1967). The mineral talc has been observed in dusts recovered directly from the atmosphere and in the solid mineral phases o: rain and snow. The talc, where detected, attains levels of the order of a per cent by weight in the solid phases. This talc probably arises from agricultural activity where the mineral is used as a carrier and dlLuent for pesticides. The amounts of talc found in atmospheric dusts appear to reflect a local introduction rather than a generalized global faLL- ut. Measurement of Asbestos Exposure, J. R. Lynch and H. E. Ayer. --APCA Absts. S. Occ. Med. 19, 21-24 (Jar.., 563). As an outcome of an epidemiologic study, a safe level of exposure should be set in terms of a method of exposure measurement which meets the foLlowir.g criteria in the order given: (11 The environmental factor measured should be sufficiently relevant to the disease mechanism to correlate with health status ever. ir. environments where exposures to mixed dust occur. (21 -he sensitivity of the method should be such as to measure levels well below the Threshold Limit alues fTLVl. (31 The method should lend itself to an appropriate sampling strategy: e. g. . tong-period persona! samples in the case of asbestos. (41 The expense of conversion from existing methods should be reasonable. The impinger method of measuring asbestos exposure toes not meet ar.v of the cr-lterta well with the -rxceptior. o: exoense. V,'eight methods would be oreterred if there were ar. ar.alvtica. hreaktr.r 'ugh. At present :iher counts on membrane filters *re the best method -sr.matlr.s exposure \s re.ated to the ns.-; asbestosis ar.d the atro'rr.e ttber concentration as a taotor tr. the risk . ..mg oar.cer. "There are : references. -- Co.od fr om text. .r.nusmal Hvaiene Digest une. 33Q Industrial Hvgier.e tor Insulation V.'orkers. J. L. Baizer. J. Occ Med. 1 0. 2 5 - 3 i (Jar.., 13681. The asbestos worker is exposed to amosite and. chr ysotile asbestos-containing materials, f-b.-0 glass, cork, plastics, and adhesives. Working in industrial and commercial building proiec:, and marine construction and repair, he is exposed to many other environmental hazards not created by his own trade. .Although he works with asbestos-containing products AS3"- of the tir-e the over-all time-weighted average exposure to asbestos-containing materials is below the presentiy recognized Threshold Limit Values (TLV) of 5 mppcf. The three work areas in which dust levels were above the TLV (prefabrication, tearing out, and mixing) account for less tha20% of his total work time. However, the incidence of radiographic changes indicative of asbestosis is over 25% in our men with 20 years or more of work. This and other evidence suggest that the present TLV is too high. Incidence of asbestosis and the risk of malignancies in the asbestos worker can be reduced by local and general ventilation, substitution of materia.; changes in work habits and personal respiratory protection combined with education of the me: to reduce their own exposures to asbestos-containing dusts. There are 17 references. -- Author's summary. ! ; j > 560- Asbestos as an Environmental Hazard. I. R. Tabershaw. J. Occ. Med. H), 32-37 (Jan., 1 968). In summary, if one accepts the assumptions (1) that asbestos minerals increase the risk of iur: cancer in occupational groups, (2) that they lead to an unusual risk of mesothelioma of the pie-': and peritoneum in occupational groups and those living near asbestos plants, (3) that such mar.:nancies usually result from exposures 30 to 50 years earlier, (4) that the "asbestos bodies found in from 25 to 50% of lung smears from routine autopsies are probably due to asbestos ir. most cases, (5) that these "asbestos bodies" may result from recent exposures as well as thosf many years earlier, (6) that world production and use of asbestos has increased from 500. 00 tons to 3, 500, 000 tons in 30 years, it is important to consider whether or not asbestos is a z.i' ' threat to public health. One is not yet justified in such a conclusion, in view of the fact that trof the world tonnage goes into uses that do not lead to air contamination: that asbestos is not ac:-a. J indestructible; that the effects are dose-dependent; and that low doses probably lead to lowr.* rates and longer latency. Nevertheless, there is need for epidemiologic studies directed to i with intermediate exposures and for evaluation of the beneficial effects of cessation of srr.o,w- Another need is for experimental and industrial hygiene studies to determine the nature anct'-- of exposure. Biologic studies centered on the meaning of the "asbestos body" are crucial tc understanding the clinicopathologic response. Strict control of industrial and neighborhooc ^ environments is essential, but it is premature to extrapolate from the effects of heavy expo5- to minor and low level exposures. There are 15 references. -- Author's surnma. , : 561 Research on Health Effects of Asbestos. L. J. Cralley, et al. J. Occ. Med. 10, 38-41 (Jan. ,1968). j | Asbestos is a general term applied to a group of fibrous crystalline hydrated silicate rr.t--e Although a number of different types of asbestos minerals exist, only four or five are o- ^ commercial importance. Each differs somewhat from the others in chemical compos'-"0" physical properties such as ability to withstand heat and chemical erosion, crystalline ,e -J fiber dimension, and degree of fiber harshness and brittleness. It has been known since^a. nineteen hundred's that excessive exposure to asbestos gives rise to the disabling pulmo-^ disease "asbestosis." More recently, evidence has been developed that the inciaence ^,fr7. piratory tract and other malignancies in asbestos workers is excessive. A major pr studying the health effects of asbestos is the long latent period of 20 or more years exposure to the onset of disease. Also in the rr.id-p.ir.eteen thirties ana earlier. `r';er^._ s- dust control and the workers were often exposed to massive levels of dust :rom aSoe' ? 3. other associated materials ir. the manufacture of asbestos products. Thus, me caa'_ of the resultant disease are essentially unknown. Included in these potential sourcecausative agents, either alone or in combination, are asbestos fibers themse;ve = associated with the fibers in the ores such as trace minerals and polycyclic arort.a^- ^ _ materials added during" o* rocessingS such as metals, tars, and Ditches, and, .......r.,.a...*.T.T..'.. 5,'*" exoosures to tobacco smoke or other air pollutants. A strong sunoortea long-^-- .... .needed tc provide the information regarding the pathogenesis of asbestosis an- ^ . that aonear associated with the inhalation of asbestos dust. More orecise data -- June, 1 363 cation of :he asbestos minerals which lead to their being inhaled and their carry!: .g with them other chemicals, in their migration. may open of biological research. -- Cond. from text. Studies of Pul tonary Asbestosis. 453-4o5 (Aug. i ?67'. a. -iror.mental conditions in asbestos factories ir. Osaka and X'ara were investigated. The 'e dust in the factories was studied by electron microscopy. The concentration of ,,(ied particles is tabulated for different plant operations in a Xara factory. The occurrence ^''oestosis among the employees of these factories was studied by periodic x-ray examinations. \ough definite asbestosis could not be found in employees working less than 5 years, the cv- 0f detection of definite asbestosis increased in those working more than 5 years as re ... there was 21% in those employed between 5 and 10 years, 54% between 10 and 15 years, iJ.!rbetween 15 and 20 years, and 100% for those employed for over 20 years. The classification ' ray findings and the development of asbestosis are discussed. Case histories and photo- J"aohs of x-rays and lung sections are presented. -- APCA Absts. sothelioma and Its Association With Asbestosis. M. Borow, et al. ^GT~Med. Assn, 201, 587-591 (Aug. 21, 1967). >'ithin a three-year period 17 cases of mesothelioma (9 of the pleura and 8 of the peritoneum) ,e seen at a community hospital in Mew Jersey located near a major asbestos mill. The -cIdence of mesothelioma as well as asbestosis appears to be increasing. -- Am. Rev. Resp. Dis. Absts. n.draor.arv Function Tests in Asbestos Workers, G. L. Leathart. Soc. Occ. Med. 13, 49-35 (April, 1 Po3). There are three ways in which pulmonary function tests may contribute to the management of workers exposed to asbestos; they may be used to confirm a diagnosis of asbestosis, to follow the progress of the disease, or to monitor unaffected workers at risk. The object of this paper is to consider how successfully these three parts are played. The typical physiological ab normalities are described, serial studies in cases of asbestosis are presented, and tentative conclusions are drawn from a small prospective study of asbestos workers who were free of disease when first seen. The findings from this investigation are summarized as follows; (1) Established asbestosis causes a loss of diffusing capacity, vitaL capacity and compliance. Pleural calcification by itself does not. (2) Progressive loss of function is seldom arrested when the patient is transferred to other work and most cases deteriorate. (3) Diffusing capacity ippears to be the best measurement for making an early diagnosis, but the diagnosis has been subsequently confirmed by other means in only four of the cases reported in the literature. (4) The development of crepitations at the lung bases sometimes precedes a significant drop in diffusing capacity and this may be a useful observation. (5) Finally, as a general conclusion, :he function tests should not be interpreted in isolation nor be given undue respect. They should always be Considered in conjunction with clinical and radiographic examination. -- Cond. from text. Source and Identification of Respirable Fibers. L. J. Craliey, et al. i ll Am. Ir.d. Kyg. Assn. J. 19, 129-1 35 (March-April, 1^681. Tibrous bodies with an iron-containing coating have been found in the lungs of persons coming to autopsy in a number of urban hospitals, the number of fibrous bodies varying greatly with approximately 4 to 6% of the persons examined showing numerous bodies. 3ecause these find ings raise questions with regard to the possibilicv that asbestos is a factor in increased lung cancer, questions concerning the nature, source, and significance o: these bodies are discussed m trie light of research needed to find answers. There are 1 3 references.-- Authors' a'ost. Pulmonary Ferruginous Sodies. Development Isolation and Concentration. ?. Gross, e: al Reprints available from Industrial Hygiene F y . Resoor.se to Filamentous Dusts and a Method o; Arch. Pathol. 55. 539-546 (May. 1568). iation. 4400 Fifth Ave. . Pittsburgh, Pa. I 521 3 - ormatior. of ferruginous bodies wrould ret oe confused with pathogenicity. Failure to understand '-"is diffe rentiation may result in the erroneous cer.era'.lzation that all fibrous dusts share the i 1 \ !