Document OE862mpkGve2NZQY83JbVz0zj

40. COMPARATIVE EPIDEMIOLOGY OF MEN EXPOSED 42. MORTALITY EXPERIENCE OF AMOSITE ASBESTOS TO ASBESTOSAND MAN-MADE MINERAL FIBERS FACTORY WORKERS: DOSE-RESPONSE Goldsmith JR Epidemiology and Health Services Unit, Faculty of Health Sciences, Ben Gallon University of the Negev, Beer Sheva, Israel. Am 1 lad Med; 10(5-6):543-52 1986 RELATIONSHIPS 5 TO 40 YEARS AFTER ONSET OF SHORT-TERM WORK EXPOSURE Seidman H, Sclikoff IJ, Gclb SK American Cancer Society, New York. Comparative analyses are presented of selected studies of Am J Ind Med; 10(5-6):479-514 1986 long-term reactions to occupational exposures to asbestos and man-made mineral fibers (MMMF), with emphasis on studies with dose-response information and long enough period of follow-up to observe lung cancer excess, if it occurred. Uni form dose estimates based on average number of fibers per mil liliter were derived and tabulated with the corresponding standard mortality (or morbidity) ratio (SMR), crude probabili ty for each unfavorable outcome, and the likelihood that at A cohort of 820 men in a Paterson, New Jersey, amosite as bestos factory which began work during 1941-1945 was ob served from 5 to 40 years after start of work. Most of the cohort had limited duration of work experience (days, weeks, months), though some men worked for several years until the factory closed in 1954. With white males of New Jersey as the control population, Standardized Mortality Ratios (SMRs) of least as many deaths would have occurred as a result of the 500 are evident for the cohort for lung cancer and for nonin- expected numbers under Poisson assumptions. A dose-response fectious pulmonary diseases (including asbestosis), while being relationship was said to have been indicated when the crude almost 300 for total cancer and about 170 for all causes of probability increased monotonically with dose and/or the Pois son probability decreased and reached a value of less than 0.0S. Some arbitrary assumptions had to be made in estimation of the dose, and they may need to be corrected. Gravimetric dose estimates may have given different results. Studies selected for analysis included Quebec asbestos miners and asbestos cement workers exposed to asbestos, and pooled U.S. and European studies of MMMF workers, as well as a sample of cigarettesmoking fiberglass workers whose X-ray films were evaluated for fine nodular or irregular opacities. The lowest dose capable death. A statistically significant SMR of almost 200 is seen for colon-rectum cancer. Mesothelioma incidence initially shows a strong relationship with advancing time since onset erf1 exposure and then tails off. The main concern of the study is with doseresponse patterns. Response is measured by the mortality for relevant causes of death, while the direct asbestos dosage was measured in two ways. One way was the length of time worked in the factory and the other was the individual's accu mulated fiber exposure, calculated by multiplying the afore of showing either a statistically significant excess (single point mentioned length of time worked by the estimated fiber expo criterion-SP) or the median dose in an apparent dose-response sures associated with the particular job that the worker had in relationship with cause of death or radiological resuits is tabu tiie factory. Whichever measure of dosage is used, it was found lated. Radiological changes show a dose-response relationship that, in general, the lower the dose, the longer it took for ad for all types, with a median dose for asbestos of 2.8 fibers/ml. verse mortality to become evident9 and, also, the smaller the For fiberglass workers, the median dose of electron-microscopically detected fibers was two orders of magnitude less. For asbestos SP, exposures of 1.4 to 22 fibers/ml were associat magnitude o|that adverse'fhortality. '*i ed with increased lung cancer, while for mineral wool, the 43. ASBESTOS-RELATED MALIGNANCY minimal level with significant SP increase in lung cancer was t' an order of magnitude less. Based on fiber or particle counts, Antman KH man-made mineral fibers appear to be more potent than asbes _ Department of Medicine, Harvard Medical School, Boston, Massachu tos with regard to chronic pulmonary disease. setts. CRC Crit Rev Oncol Hemstol; 6(31:287-309 1986 41. MEDICAL SCREENING OF FORMER ASBESTOS Due to the known association with asbestos exposure, malig CEMENT WORKERS IN ISRAEL: A PILOT PROGRAM nant mesothelioma has assumed an importance out of%ropor- Tuch H, Tulcbinsky TH, Casper M, Kaaane H tion to its incidence in the American population (2.2 per mil lion). Patients present with chest pain, shortness of breath, or University of North Carolina, Chape! Hill, School of Medicine. ;) both. The initial chest X-ray generally reveals a large unilateral Am J Ind Mid; 10(5-6)471-8 1986 pleural effusion. A large piece of tissue obtained via open A pilot screening program for the evaluation of former as bestos-cement workers was carried out in the Chest Disease Clinic of the Acco Public Health Office (Ministry of Health), Israel. A total of 184 subjects were evaluated using medical and occupational questionnaires, clinical examinations, and pul monary function tests (forced expiratory volume, forced vital capacity). Thirty percent of individuals with more than 1 year of work experience had symptoms of breathlessness or cough. biopsy is usually required for histologic diagnosis. Investiga tional approaches include multiple needle biopsies obtained for electron microscopy, as well as for immunoperoxidase staining for keratin and CEA. The tumor characteristically remains lo calized until late in its course. The treatment of mesothelioma remains unsatisfactory. However, anecdotes report long-term disease-free survival after intensive treatment. Palliation with a response rate of up to 30% to various chemotherapeutic regi Individuals with 10 years or more of work experience showed mens has been reported by a number of investigators. (176 a high prevalence of rales and reduced pulmonary function, as Refs) compared to those with shorter work histories. These findings indicate the urgent need for active follow-up of Israeli ex-as bestos workers. A proposed screening and surveillance pro gram for this high-risk group is discussed with emphasis on follow-up, health education, and smoking cessation. 10 ENVIRONMENTAL AND OCCUPATIONAL CARCINOGENESIS 4 HWBUI0001972