Document NGNgo2Kov40m3VEzwgNLxk41w

FILE NAME Brakes BRK DATE 1979 DOC BRK072 DOCUMENT DESCRIPTION Journal Article - Survey of Asbestos Workers in the UK - NY Academy of Sciences 4, SURVEILLANCE OF HIGH GROUPS SURVEY OF ASBESTOS WORKERS THE PRESENT POSITION IN THE UNITED KINGDOM W. J. Smither Cape Industries Limited London WIY 4AB England The first study of a group of workers at high risk from asbestos exposure was that of Merewether and Price in 1929. Their report recommended the control of the disease by periodic medical examinations of the workers by which those unfitted by health reasons are prevented from entering the industry and cases of fibrosis and pulmonary tuberculosis are detected at the earliest possible moment The ultimate and only reliable test of the effectiveness of the preventive measures adopted by the industry will be found in the statistics derived from the records of periodic medical examinations of the workers . A scheme for initial and periodic medical examinations was proposed soon thereafter At that time workers at high risk were considered to be in special occupations designated as scheduled areas These areas were defined as breaking crushing disintegrating opening or grinding of asbestos and the mixing or sieving of asbestos or any mixture of asbestos and all processes involving manipulation of asbestos or incidental thereto all processes in the manufacture of asbestos textiles including preparatory and finishing processes the making of mattresses composed wholly or partly of asbestos and processes incidental thereto Persons in such employment were medically examined initially before the end of the second month of employment and periodically thereafter every two years or as directed by the Pneumoconiosis Board The latter is a governmental statutory body of medical experts in pneumoconiosis responsible for confirming diagnosis and assessing disability The members of this group form a Panel of experts who are responsible for initial and periodic medical examinations performed either in industrial locations or in regional offices The original arrangements given legal force in 1931 were updated in 1957.These regulations still apply Although the definition of scheduled areas has been more widely interpreted as the years have passed there were many workers in the asbestos industry who escaped the net As I pointed out at a conference of The New York Academy of Sciences in 1964 only % of workers in one factory fell within the strict definition of scheduled areas The major members of the asbestos manufacturing industry made early arrangements for the medical surveillance of a far greater number of their workers providing radiologic and clinical examinations for most workers in manufacturing processes Under various Acts of Parliament workers outside the scheduled occupations could claim compensation for asbestosis The Workmans Compensation Act used in 1930s and 1940s was superseded by the Industrial Injuries Act of 1948. Even these a statutes did not cover all workers exposed in the past who had claim to benefit so in 1966 the Pneumoconiosis Byssinosis and Miscellaneous Diseases Benefit Scheme plugged the gap As workers claims for benefit were upheld by confirmed diagnoses it became clear that more cases were arising in occupations outside the scheduled areas In other words many more workers were in high groups than the original investigators had believed 525 0330-0525 01.75 '1979 NYAS 526 Annals New York Academy of Sciences TABLE 1 PASI OCCUPATIONS AND PROCESSES THAT INVOLVE ONLY OCCASIONAL EXPOSURE TO ASBESTOS > Lagging and delagging Furnace insulation Heat and sound insulation Heat insulation Manufacture of filter papers and grinding of rollers Insulation wiring and preparation of insulation panels Used as a filler Incidential grinding in assembly of brake and clutch parts Repairs to brake and clutch parts Trimming of asbestos sheets and insulation boards Substitute for plywood Insulation Making of asbestos washers and gaskets Contractors performing work that involves use of asbestos may be found in Other asbestos exposures may occur in From Reference 7 Electricity generating steel Heavy engineering Loco building railway carriage building Boiler making Paper Electrical engineering Linoleum floor tiles rubber paints plastics adhesives roofing compounds Motor assembly Motor vehicle repair Building trade Furniture Scientific Light engineering Large building projects generating stations installation of plant dockyards dockyards shipbuilding ship repair Certain aircraft maintenance activities disposal of asbestos cement waste car body underseals asbestosasphalt mixes In the early 1960s Her Majesty's Factory Inspectorate undertook a survey to estimate the number of workers employed in processes that involved the use of asbestos or products with an asbestos content The survey indicated that at that time there were about 300 registered factories to which the current Asbestos Industry 1931 Regulations applied The estimate of persons employed in asbestos processes or otherwise at risk was approximately 12,000 The factories concerned were engaged in the manufacture of asbestos cement products asbestos textiles and asbestos friction materials including brake and clutch linings Many more factories used either asbestos or products that contained asbestos intermittently The former Asbestos Industry Regulations specifically excluded the application of those regulations to any factory where no person was employed in the use of asbestos for more than eight hours in any week In the survey referred to previously Her Majesty's Factory Inspectorate identified an additional 228 factories that could be considered to be included in that category TABLE 1 taken from Table 4 of the memorandum of the Senior Medical Inspector's Advisory Panel gives some indication ofthe wide variety of industries and processes in which the occasional use of asbestos may have been encountered Industrial experience teaches that workers exposed only occasionally to any hazard are much more likely to ignore protective measures than are workers familiar with the dangers despite the old adage that familiarity breeds contempt Occasionally exposed workers even today are more likely to forget that exposure dose is a product of concentration multiplied by time Smither Surveillance in the UK 527 because the latter is short they may well experience high levels of the former The number of roughly 1000 such workers in 1968 was stated to be regarded as a considerable underestimate The former Asbestos Industry Regulations did not apply to lagging and delagging or other insulating operations that employed asbestos Therefore no precise information of the numbers of insulation workers exposed to asbestos was available An estimate made by the Thermal Insulation Contractor's Association put the number at 7500 directly employed in insulation An additional 1000 insulators worked in Her Majesty's dockyards dockyards The numbers at high risk in 1968 were therefore estimated to be about 20,000 in the memorandum of the Senior Medical Inspectorate Advisory Panel Lower degrees of exposure risk in called occupational pursuits could not be estimated In 1964 McVittie reported to The New York Academy of Sciences that of 247 new cases of asbestosis diagnosed by four Pneumoconiosis Medical Panels 102 or 41 were engaged principally in insulation work These figures covered the years from 1955 to 1963. In the ensuing six years the same four Pneumoconiosis Medical Panels diagnosed 473 new cases reflecting the greater use of asbestos in the postwar years Of these new cases the proportion from insulation workers had risen to 51 TABLE 2 It was clear that the hopes of reduced incidence expressed in the Merewether and Price report had not been fulfilled There were three reasons The former regulations dealt with the existing position and were not extended to cover the uses of asbestos developed since 1931 The necessary statistics could not be obtained from the system of periodic medical examinations introduced Examinations covered a limited field of asbestos workers and there was no official record of the total number of exposed persons There was no standard method of measuring the workplace environment Expo- sure levels were highly speculative and were linked to broad occupational categories rather than particular processes The idea of personal monitoring had not even been conceived To compensate for the deficiencies of asbestos hazard control inherent in the former Asbestos Industry Regulations a new set of regulations came into force in 1970 throughout the United Kingdom The Asbestos Regulations of 1969 revoked the previous statutory regulations and imposed requirements for the safety and welfare of persons employed in factories and in other premises and places where processes are carried out that involve asbestos or any material composed wholly or partly of asbestos and capable of giving rise to asbestos dust For the regulations asbestos dust TABLE 2 NEW CASES OF ASBESTOSIS DIAGNOSED IN 1955-69 BY PNEUMOCONIOSIS MEDICAL PANELS IN Four United Kingdom Areas ANALYZED BY PRINCIPAL OCCUPATIONS Principal Occupation Opening disintegrating Insulation Textile Slab and pipe making Brake lining Miscellaneous Total Cases 1955-63 41 17 102 41 53 20 20 % 4% 27 % 247 100 Cases 1963-9 45 10 244 51 65 14 18 % 10 % 91 19 473 100 528 Annals New York Academy of Sciences TABLE 3 PRODUCTS That ContaINED ASBESTOS AND THEir Principal PAST USES Products that Contained Chrysotile or Amosite or a Mixture of Amosite and Chrysotile Building Shipbuilding and Construction Industries Approximate Asbestos Content % Asbestos Cement Corrugated sheets Flat sheets Moulded and extruded products Pipes density panels Asbestos Insulation Board Building applications Marine applications Sprayed asbestos insulation Roofing and external wall cladding in factories farm buildings garages External wall cladding in offices schools hospitals factories infill panels Rainwater pipes and gutterings flue pipes and fittings ventilation ducts and dust extractors cold water storage cisterns bulkheading for banks of waterways miscellaneous building components Pressure pipes for water main supplies pipes for sewerage and drainage cable conduits resistant partitions doors and ducting infill panels for curtain wall cladding systems resistant partitions and ceilings in schools hospitals office blocks shops warehouses multirise housing industrial drying and curing ovens molten metal moulds and troughing casting for fire protection of steel structures resistant bulkhead linings ceilings doors Treatment for structural fire protection thermal insulation acoustic correction anticorrosion and condensation control thermal insulation for industrial plant and equipment 10-12 10-12 12-15 12-15 25-40 25-40 25-40 50 Thermal Insulation Asbestos pipe sections Insulation of all types of pipework and hot 55 slabs and ancillaries surfaces Calcium silicate or Insulation of all types of pipework and hot magnesia pipe sections and slabs Asbestos cloth Asbestos mattresses Asbestos rope lagging Asbestos compositions setting cements surfaces Outer covering for thermal insulation Removable covers for locomotive fire boxes boilers Wrapping steam pipes as thermal insulation Protective finishes and coatings on thermal insulation 12-15 85-100 85-100 85-100 and setting 45 compositions Sprayed asbestos Thermal insulation of buildings plant and 50 machinery calcium silicate insulation material that contains up to 14 asbestos is white in color Other Products Asbestos millboard Asbestos based friction materials Automotive cylinder head gaskets ironing board pads interior panel lining for fireproof doors acoustic insulation for motor vehicle floors Brake linings and clutch facings for all types of vehicles factory equipment cranes 45-98 30-70 Smither Surveillance in the UK 529 Table 3 Continued Products that Contained Chrysotile or Amosite or a Mixture of Amostic and Chrysotile Approximate Asbestos Content % Building Shipbuilding and Construction Industries Asbestos paper for floor underlay Asbestos fiber temperature flexible insulation in electrical equipment as resistant barriers contact mountings air circuit brakers washers and spacers for terminal units Mechanical reinforcement in mouldings and in bituminous and fireproof paints reinforcement in electrical mouldings filtration purposes and packing of steam cocks filling for mattress insulation 70-95 100 Asbestos Textiles that Contained Chrysotile Asbestos Only Asbestos silver Asbestos roving Asbestos yarn Asbestos cloth Aluminized asbestos cloth Asbestos webbing Asbestos woven webbing Asbestos tape Asbestos tubing Covers for electrical conductors wire covering for many other electrical applications such as fireextinguishing and deicing circuits in aircraft Covers for resistances in electrical circuits heating elements operating up to 450 Weaving into electrical cable braiding patent glazing valve and tap packing cords for packing fireplace joints scaling switch boxes Thermal insulation as the outer cover wrap on steam pipes outer envelope for mattress insulation protective clothing fire blankets and curtains plastics reinforcement clothing for laundry clenders and presses filtration diaphragms for electrolytic cells Protective clothing finishing wrap on lagged piping and plant installations heat shields Wrapping of exhaust pipes and insulation of hot and cold pipes wrapping of electric cables lining of switchbox and fuse leads scaling joints in hot air ducts and smoke extraction systems wicking for oil lamps and heaters Brake fabrics and conveyor belung Wrapping for field and armature coils Insulation and induction coils and leads for switch gear 85-100 85-100 85-100 85-100 85-100 85-100 85-100 85-100 85-100 Products that Contained Crocidolite blue Asbestos blue asbestos fiber is no longer imported into the United Kingdom Bitumen battery Automotive industry boxes Blue reinforced Oil and acid applications plastics Blue asbestos yarn Acid- or resistant applications packings plaited packings and rolled cloth packings Blue asbestos cloth Flue curtains locomotive mattresses acid- and resistant covering for insulation Blue asbestos millboard = Acid- and resistant joints and gaskets 10-20 60 85-100 85-100 85-100 portable sampler worn planned account for variations variations work jesipayy sampling sampling strategy among factories the same industry group Asorrussogut among individuals variations existing categories categories seasonal variations workload workload si9ayo oy) diferences differences existing job and days ayq Jo fosTU0D Aq 4st Jo uononpay sdnou8 ysts-y3ry jo uoriuyap 4NO UL JOE] MAU B JapsuED IsnUL OM yeYL 1ApIAD S11 paurmsajapAyjeaausd st yy Aupiqndaosns TABLE TABLE 4 aiqrasnsraur ase a1ay1 yeyt 4e9]9 Ajauisrasout Sunuosaq si ASBESTOS SURVEY POPULATION POPULATION AT MAY 18 1977 Asruouynd jo iuatudoyaaap ayy MAY * Isulede ASBESTOS SURVEY POPULATION POPULATION POPULATION MAY UT TEL All stort qty Atparoad xouNdary sisosqy Males Males Females Females All All Aseuounnd medically least once once uaSiwe 1-yyey yim sigafqns ing pausiyuosud9q Jou sey medically least one ray 18,050 12,831 12,8311767 1342 1342 ., 19,817 19,817 14,173 ) stsoIsagse medically once awaiting awaiting asow Punog sf vaarue 280 TH sisixd2686 oF uon rayt awaiting e yeyt 3188 2406 sey 194 280 1114 se paounouoid the mortality study only 1019 717 95 ) 1114 763 17,662 pur population seajanuniud jo 22,257 22,257 15,954 15,954 1668 17,662 ) spuatied jo population Medical Advisory Advisory Service Report 1975-6 1975-6 yenpiarput jo wajqosd ayn Employment Employment Medical Medical Advisory parentheses Service Report 1975-6 ayt o1 asuodsas ur suoriete, ray Aoasns recording recording ay new entrants the films because has independently independently panel three yns gt recording the because ay1 satreaidrinuJro Auippe sayray iseadyi ut dnosd HSts-Y4y & pawoy sary ssdyows ApseajDweeoyiudis Aqy sy st 2p a8 fad stsorsaqse JO 22uapiout oq} UO os[e Inq eWoUTsIED stuaToysuOIg Jo soUaptouT the UO AjUO 1969 regulations regulations were concerned concerned mainly protecting the health the TOU 1969 regulations effectiveness concerned regulations regulations regulations and also derive the necessary necessary parequa that would determine the natural history asbestos asbestos exposure an ongoing ayy the control ofthe Employment Employment datsuaqut Advisory instituted Service of Department Department of Health Health Social Social Security aq 1am Aru gota Advisory three stages stages 94T I9AIMOLLTuryours Jo 1999 ay ULYUOD survey was ur ag osye of ILO reading reading serial rays of asbestos asbestos SY) I was feasibility ILO surveillance reading reading Pneumoconiosis Pneumoconiosis Medical Medical ayy over years ay1 mojag the Department Department Health Social Security asbestos workers certain certain major Atipiquou I began as prospective study asbestos Research Council and YI ssosse x jo of member member companies companies of the Asbestosi Asbestosis were employed employed Council st sjaagy the Dockyard Dockyard , where worksmedical officers workers employed to the 1969 Asbestos udaq ary III extended extended phase include factories workers workers installations installations installations that each employ a factories Regulations covers covers large number factories study May May 1977 24,313 (RruUatg workers The total number of workers in the study May was je1or 94) JO (Tb 1av) LL6E APW oUt pT tT pur gz6t isnny ul E97 pajeror droid Stuy ApnisAryerow qi ut Ayo papnjout oq wes asoyas9ys pur suotieunueNs Kes-x Jo/pur rotpaur ouyjoap awos shed-Sxurpnpout vorPunuexa peaipat 219;dutH09 241 pasayo st s9yJ0M Yara yInoyiv ApnisAuperow ayy ut papnyour ase quasaid30 ised Aoains ut ayy sEayom ty Ay popingas ase vOI}euIUtPXa Yoea 1e Sqof s499J0m 244 sionposd sorsaqsr jo asn pue von onpoud [eiisnput ut sqof papos 66 AUB OYE papsooaSst spEayeul J9YIO YIM S19qQq] Jo aInyxtUT JO saJdoqy jo asntxius soquyjo addy ayy, mupy auarkcyy {eLISNpUy 241 Aq patusoysad ase are ayy ut suaqy Solsaqse Jo suawasnsrous [rquatuuostAua dalIPjUasaiday AvI-x says JOLIO}UPOINISOd a7Is-|[Ny BR pur aseuvonsanbSuryows pue woiduhs Asonestdsas pirpurys & Jo yoraydtuos suotesidasysuaisissad Jo soussasd ayy soy uonpuntuExa routs & AsOsty aansodxa ue sasudutos pue [Pruuaiq si Adains ayy ut uoirurmexs frampat sy ies IN Ay) UY dDUrTTIZAING -uoyInUS to asbestos asbestos subject to to p TTYL survey survey population population 16,840 are still exposed exposed asbestos asbestos subject new SISxIOM M9] examinations examinations In this population group 11,214 were exposed before before the who suONE|NSay exposed came force and will offer group for enforced comparison Because Because wide q]] 9seyg regulations regulations were enforced possible thewide future voduoaaq levels is being monitored hygiene standards by studying possible and jo sa0ry mortaliy effectiveness workers included included hygiene survey standards exposures have always always been JT aseud on workers workers included included the survey whose exposures exposures have always oy) Jo pourg appropriate provide evidence of dose relationship relationship involved in OY SI9zJOM effects exposure provide asbestos asbestos dust There should alsaolso relationship opportunity oportunity to yp aseyg of individual individual susceptibility susceptibility susceptibility oyy revealed the survey in the future be studied studied by {roipayy methods individual investigation investigation investigation vary with ADAaNs concentration fiber sem Adains incidence and severity asbestosis asbestosis vary first the concentration concentration relationship fiber SoNSHES length exposure exposure and the time sincfeirst exposure exposure relationshirelaptionship relationship not OF SI99JOM however absolute absolute The documented carcinoma evidence also of incidence of ou siopres progresses under under present present conditions conditions oq 01 sey yoea ssnPoag stuT9y41 Jo Buipsooo3 pruy oy) pue progresses response response response the inhaled material material will will be revealed by the survey survey but Ayo} revealed intensive intensive investigation investigation investigation wnsny] antibodies studied the intensive antinuclear antibodies oy) Wot, factor asbestosis asbestosis exists reported " presence progresses suggested antigen found more confirmed asbeto subjects with antigen of antigen the more 210) frequently genetic predisposi- with ui papnyouy with Jo sipnsay HLA 27 antigen pounwexg tend have have advanced advanced advanced YIM fibrosis fibrosis have unex- pourweyay measureable measureable measureable degrees degrees susceptibility susceptibility susceptibility must consider workers workers and constant presence of suOItEIIPA brochures the workplace Work continues throughout throughout British IWPUsd}sAs Research Council discover discover indicators indicators susceptibility susceptibility asbestos related syiqey FIOM UI sUOTIEIIPA JOF JUNODTE O} pauurd useq sey AZaiers Suidwes ayy Suydues u139)-393u0 30) adryJo Zapjnoys prayay) UO WOM Jo}dUIPS afqriiod & Jo suPaUt Aq pusrpoved yioys soy auoz 8uryirasq arripawiuit ssoresado ayy Ul UayPT 9q OF 229m sajdiueg syusunsysut ajqrpeak Afwaiing Jo suondiosop pur wawaimsraut JO spoyjow JO suonrurldxa orep-oy-dn ard osye ing aur of awn wlozy pastaar oq TYFIW d10U PUPP FROIUOAT OUT, ISMP SOISAGSE,, IUYAP PyNOM saisO}DTy Jo s2o1Dadsuy sAisaley 27H Yor Uy) aauuEUT ay) UO suONoaJp[eFay you suoNsaTInsoes rey) ,,210N aoURpIND FB panss] arinoaxy A1ayeg pue yyeazy oy) vonsanpbany) oy somsue OL ( suonepndas pro ayt jo ursioniso issy ay1 pazamsue UoIUYyap sin ised 347 Ut posn syonpord snotseA Jo JUA}UOD soIsagse ay1 SISI| E JTAVL) Ise PINOS pouyaspe isnspoysaqse YoiymM Ut asninJyo 1Uasoid solsaqsJeo sasn qjP 22409 07 pauaisap alam suonrpndas ayy suossedpakoydua jo yiyray ayy 01 JafiurpasnPo 0} AYO] St BeYE FUDIKA UR YRS O1 SOIsaQsE sUTEIUOD 1PY) JO Jo SIsIsUOD RYT ISN sajoUap saouaing Jo Awwaproy yoA MaQy spruuy og the 4, abc Be= e | e 532 Annals New York Academy of Sciences diseases A fervent wish of every industrial physician concerned with preemployment examinations of asbestos workers would be granted by the success of such endeavors to identify individuals at high risk due to factors of susceptibility REFERENCES 1. MEREWETHER R. A. & C. W. PRICE 1930. Report on effect of asbestos dust on the lungs Her Majesty's Stationary Office London England 2. SILICOSIS AND ASBESTOSIS MEDICAL ARRANGEMENTS SCHEME 1931. Her Majesty's Stationary Office London England 3. THE NATIONAL INSURANCE INDUSTRIAL INJURIES PRESCRIBED DISEASES REGULA- TIONS 1959. Her Majesty's Stationary Office London England 4. SMITHER W. J. 1965. Secular changes in asbestosis in an asbestos factory Ann N.Y. Acad Sci 132/1 166 5 PNEUMOCONIOSIS BYSSINOSIS AND MISCELLaneous DiseasES BENEFIT SCHEME 1966 Her Majesty's Stationary Office London England i ASBESTOS 6 INDUSTRY REGULATIONS 1931. Her Majesty's Stationary Office London : England i 7. SENIOR MEDICAL INSPECTOR'S ADVISORY PANEL 1968. Problems arising from the use of ; asbestos Her Majesty's Stationary Office London England ' 8 MCVITTIE C. 1965. Asbestosis in Great Britain Ann N.Y. Acad Sci 132/1 128 9 THE ASBESTOS REGULATIONS 1969. Her Majesty's Stationary Office London England | 10 ASBESTOS HYGIENE STANDARDS AND MEASUREMENT OF AIRBORNE DUST CONCENTRA- TIONS AND HEALTH AND SAFETY EXECUTIVE GUIDANCE NOTE EH10 1976. Her Majes- : ty's Stationary Office London England i 11 HEALTH AND SAFETY EXECUTIVE EMPLOYMENT MEDICAL ADVISORY SERVICE REPORT 1975-6 Her Majesty's Stationary Office London England 12. SELIKOFF I. J. 1974. Epidemiology of intestinal cancer Environ Health Perspect 9 303 13. WARWICK M. & W. R. PARKES 1970. nuclear and rheumatoid factors in asbestosis Brit Med J. 3 492 14. MERCHANT J. A. C. A. KLONDA C. A. SOUTAR W. R. PARKES S. D. LAWLER & M. TURNER WARWICK 1975. The HLA system in asbestos workers Brit Med J. 1 189 15. MATEJ H. 1977. HLA antigens in asbestosis Arch Immunol Ther Exp Engl Transl 25 489 16. EVANS C. C. H. C. LEWINSOHN & J. M. EVANS 1977. Frequency of HLA antigens in asbestos workers with and without pulmonary fibrosis Brit Med J. 1 603 SU I shc namely exposed surveilla Ther usually ' fibrous v slate quaqua , amosite often and Amp Only a asbestifo that enc common primaril Beca it it is not reasonat asbestifc Asbe subsequ occupati worker exposure finally n nonexist Alth essential high some it synonym thing th source s the term foregoin reminds further conceal knowled be indivi The dec