Document QgmDqrZ8dKQQg4O0kreLqNxz8
FILE NAME Brakes BRK
DATE 1965
DOC BRK023
DOCUMENT DESCRIPTION Journal Article - Annals of the New York Academy of Sciences - Occupational and Nonoccupational Exposures to Asbestos
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SECTION IV HUMAN EXPOSURE TO ASBESTOS COMMUNITY STUDIES
188 i
OCCUPATIONAL AND NONOCCUPATIONAL
TO ASBESTOS
EXPOSURES
W. C. Hueper
National Cancer Institute Bethesda Md
cNpne
Numerous reports by many investigators from various
lish the fact that an
countries estab-
of
occupational or nonoccupational inhalation of dust
different chemical and physical types of asbestos
ment of asbestosis of the
results in the develop-
lungs which depending upon the type of
ure may be designated as an
expos-
occupational neighborhood or household
pneumoconiosis Since 1935 an increasing amount of
and pathologic evidence moreover incriminates
epidemiologic clinical
this health hazard as one
of the environmental sources of cancers of the lung TABLE
recently also of
1 and more
mesotheliomas of the pleura and peritoneum although some commercially interested parties and their medical
tectors still prefer for their
guardians and pro-
of these
own reasons and motives to deny the existence
dangerous and usually fatal sequelae of a
asbestos dust The obvious
respiratory contact with
fallacy of such allegations is well demonstrated
by the remarkable and progressive rise in the number of cases of asbestosis
and of cancers of the lung pleura and peritoneum
reported from various
countries during the past two decades It is shown also by the increase 1 TTAABBLLEE TABLE
of publications noting the first observations on the
and asbestos
occurrence of asbestosis
cancers from several countries during the past decade
TABLE
mark Sweden Belgium Finland Japan Both
Den-
occupational diseases
are definitely not as rare and in fact have become less
in
,
as has been claimed by several industrial parties so recent times $ 1
There was for instance an estimated total of about 700
t
tosis in Germany in 1946
cases of asbes-
2
among a total of approximately 8,000 employees
of the asbestos industry Wegelius found 125 cases of asbestosis of the >
lung roentgenologic examination of 476 asbestos workers of one com- $a >
pany in Finland Of 132 asbestos workers examined
&
?
cent showed
by B^hme29 per
.
u
radiologic evidence of asbestosis The morbidity rate of as- .:
bestosis in members of this worker group rose moreover with the duration
of employment being five per cent in workers exposed to asbestos for less "
than three years 56 per cent for those
79
employed for five to ten years and
$
per cent for those with over 10 years exposure A similar
i
rate of 80 per cent
morbidity
among English asbestos workers with over 20
of employment was reported by Merewether and Price in 1930. Nyeoarros
noted an asbestosis attack rate of 65 per cent in 167 asbestos workers 4
studied roentgenologically It is remarkable that no large observations
on the incidence morbidity and mortality rates of asbestosis and asbestos
cancers have been published from the giant American asbestos industry i
184
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eC EAL.
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Dyers ity erssbestosis pte
est nce
ABLE
inhalation
decade from
ak
EXPOSURES
-
c
IUNITy PSy rUps
L
EXPOstnry
lessper ** diseases increase
housebea
Md. ;
;
US Countries oats,
Inhalation of dew
i
ults jn the devel ye
the type of time
hood or housebess
lemiologic, clinieas
ta
ow
Pelee")
oo, amd)
3
al
*a
Country
Number
Country
Number
Ss
<loe
wt et
Sex
Sex
USA Blo
on 1
| Plane}
al
lame Asbextotics
Qa
Age
faleos paves
Reported
om
period
period period
azard as cry
BLED), andmm toneum, althuugs uardians and pro
leny the CXistence tory Contact ws vell demonstrates
ases of asbestos.4 ted from Varieus
by the Ipcrease
nce of asbestoars
St decade (Des. a;
ti diseases
in recent times,
casesS of of asbes. 3,000 employees sbestosis of the
2rs of one com.
:
per rme, !27!9 29
ity rate of as-
h the duration
bestos for Jes
eynears, and
2):
lar morbidity
over 20 yean
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186
Annals New York Academy of Sciences
|;4 ireRnAI 2R0oeduseS0sAamiUhandebs To It is an axiom of sound public health practice that protective and pre-
ventive control measures to be rational and effective against environmental
health hazards must be based on adequate information on the sources and
oF
of the causative agent involved and on the population
qh
types of exposure
of an en-
et:
affected For such an assessment of the potential scope
Cer
vgirroounpmsental health hazard of occupational and nonoccupational implica- >
it is necessary to determine the distribution pattern of the agent
cae
tfiroonms the site of its original occurrence and production through the sites +1
and types of its subsequent industrial and commercial uses to the homes
of the ultimate consumers It is moreover essential to ascertain the various Oo
into which the causative agent might be incorporated
types of products
be used It is important
Brea
and the purposes for which such products might
ee
furthermore to investigate the existence and degree of environmental pol-
ane
tar
lution of the plant area as well as of the plant vicinity and the zones along wee ta
the routes of transportation of such materials When some or all of such 4
data have become available a sound factual basis is provided for a com-
Ce
investigation of the workers employed in mines and
acRdhacuaned petent epidemiologic using and handling the causative agent and of the
Wer
factories producing
and associated
iets
members of various trades and occupations having primary
contact with it as well as of members of the general population sustaining Graruilt
same an incidental exposure to it Past experiences have shown that only through oie
J
i %
wl r es ' a
ahaa eins
Mevas
pAL
ey
+
y s is
G
Me
~&
ren
such comprehensive and painstaking epidemiologic procedures are any
1
Mc
worthwhile factual data on the existence and scope of occupational and G
ETE related environmental health hazards obtained The continued insistence
of some industrial parties that reliable decisions on such aspects can be ; v ERe
OR based on what is called deceptively sound clinical impression often :
merely reflects an objectionable desire to escape from an unpleasant situa- SBF
tion into a wishful dreamland in which profits are properly protected ' Soe, e
wer against just compensation claims
EE of the sources and types of occupational and non-
A brief presentation to asbestos and of the various occupational and
OR
occupational exposures
TS
nonoccupational population groups having such contacts therefore may
Be
foundation for the subsequent discussions of the biologic
ffuunrcntiisohnaalpraonpderanatomic effects associated with and produced by the in- coaeery
halation of asbestos dust The immediate importance of such data is indi- th
the fact that the world production of asbestos has increased from
radi
DerOesRA c5a0t0edtobnys in 1880 to 330,000 tons in 1925 to 446,000 metric tons in 1938
to over 2,000,000 tons in 1958 and that it is still rising FIGURE 1 The
PAP country is Canada while the principal consuming country
main producing
should have the largest
is the United States of America which consequently
aS
number of individuals exposed for occupational and nonocuppational nonocuppational reasons
A
to an inhalation of asbestos dust from an increasing number of sources tie ae
Mr and from a growing number and variety of products
waiterpe
utate ei
1B)
oy
at
,
7
3,is SPS
: Mae aere
~
ee pat
ie
ee
Hueper Exposures to Asbestos
-
187
cective and pre
t environmental
the sources and
the population
scope of an ea
ational implica
-n of the agent rough the sit es to the homes Eain the various be incorporated It is important ironmental p the zones alon e or all of such ded for a com-
d in mines and
ent and of the
and associated
LD PRODUCTION ASBESTOS IN WETRIC TONS
2,000,000
ee 100,000
600,000
100,000e1400,000
4200,000 02000
600,000 ee
400,000
200,000 A
1900
I
1910
i
1920
Latent period 20 years
.
NUMBER OF ASBESTOSIS CANCERS OF LUNG REPORTED *
7
|
|
I
i
|
1950
YEARS
tion sustaining
at only throug
FIGURE 1. World production of asbestos and asbestosis carcinoma of the lung
dures are any
cupational and
nued insistence aspects can l ression often
pleasant situa erly protected
Since of the different types of asbestos chrysotile represents approximately 95 per cent of the total asbestos produced contact with this type of asbestos furnishes the chief cause of asbestos pneumoconiosis and cancer in most countries and especially in the U.S.A. which mainly produces imports processes and uses chrysotile.- Contact with other types of asbestos particularly amosite and croeidolite is of comparatively minor and regional importance for occupational reasons because these varieties of asbestos are
ional and non-
cupational and
therefore may of the biologi ced by the inh data is indi-
mainly mined in South Africa and preferably consumed in Great Britain and represent only a relatively small fraction of the total amount of asbestos produced and used The exposure data to be given apply therefore mainly to chrysotile although according to Lanza all three types of asbestos dicit the same kinds of biologic reactions
OCCUPATIONAL ACTIVITIES PROCESSES AND PRODUCTS
increased from : tons in 1938 IGURE 11. Th aming country ave the largest ational reaseSTA ber of sources
WITH ASBESTOS HAZARDS
PE
JEP
Asbestosis and asbestos cancer hazards related to an inhalatory exposure
to asbestos exist not only for asbestos workers proper engaged in the direct
and regular production processing handling and using of asbestos
Laining materials but also for the large number of individuals who may
ustain such contacts on an incidental basis Such persons may be em-
oyed permanently or temporarily in or near operations where asbestos
and asbestos products are produced or handled and where they inhale
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188
Annals New York Academy of Sciences
.
TABLE 2 ASBESTOS
Sites of asbestos cancers
Exposure stigmata
Recognized Lung
Chronic fibrosing pneumonia involving first
lower lobes asbestosis asbestos bodies in sputum asbestos warts of skin fingers
Compounds of economic importance
Chrysotile amphibole amosite crocidolite tremolite containing magne-
sium aluminum calcium iron silica
Operations and products with contact to asbestos for producers
processers users consumers residents
Asbestos rock mining loading shipping crushing milling asbestos spinning weaving mixing cutting pressing molding plastering cementing spraying of steel construction undercoating of automobiles insulating pipes etc. clothes cloths sheets blankets curtains brake linings linings yarns cords ropes twines ribbons artificial snow filler in rubber goods plastics and roof coatings filter cloths filter pads filter paper artificial wood tiles shingles cardboards wall boards partitions panels paper clutch facings clapboard
pipe coverings pipes insulation blocks insulation jackets gaskets pump pack-
ings electric wire insulation structural heat insulation facings of acoustical
building materials catalyst supports in sulfuric acid production putties
Population groups with occupational and environmental
exposure to asbestos
Occupational groups
Nonoccupational groups
Asbestos rock miners loaders truckers crushers millers asbestos spinners weavers electrical appliance and wire manufacturers masons carpenters heating equipment workers rubber workers shingle and tile manufacturers building material manufacturers filtering material manufacturers molders of asbestos
products asbestos makers putty manufacturers asbestos cement makers asbestos paper cardboard and brake producers asbestos felt insulation workers asbestos sound insulation workers asbestos insulators pipe coverers asbestos tube wrappers asbestos cork insulation workers construction workers
cc onstro uction n s constrt uctionruction
automobile makers garage attendants
garage attendants
Residents in vicinity of asbestos processing and textile mills inhaling plant effluents polluted with asbestos
dust and individuals living and working along roads on which asbestos is trucked inhabitants of houses with
asbestos insulation
therefore air po engineers mecha sonnel truckers yard workers au
The total num
suspected and po
run between 50,0 asbestos in mem their relative lia also show distinc of about 50,000 a England and sev must be consider the actual scope c
numerous occupa utilization of asti industrial health
Miners sorter ularly in underg containing asbes
rock and for the
and deliver it to rocks comminua fibers from the a
4
deal of dust and
technologic preca employed in thes
and escaping fro
tion of the intra
thereby create n ployed in the yar hazard endangeri
ity of such plan
Reports on the oc
miners and mille
and South Africa
hazards associate |
As | |
The greatest q
of a variety of |
J
cement proper fi!
| | |
bate
oe
ee eee
eee
ne
wee
dares
bein
Sciences
stigmata
eumonia involving first
_s asbestos bodies in of skin fingers
ance
molite containing magne-
os for producers
idents
, milling asbestos spinering cementing spray-s insulating pipes etc. gs yarns cords ropes , plastics and roof coatial wood tiles shingles lutch facings clapboard ets gaskets pump packon facings of acoustical production putties
vironmental
upational groups in vicinity of asbestos
nd textile mills inhaling s polluted with asbestos viduals living and work-
ids on which asbestos is bitants of houses with lation
Hueper Exposures to Asbestos
189
therefore air polluted with asbestos dust repairmen maintenance men engineers mechanics laboratory technicians office workers medical personnel truckers railroad workers yardmen construction workers ship-
yard workers automobile plant and garage employees 18-23
The total number of individuals in the United States having manifest
suspected and possible but often unsuspected contact with asbestos should run between 50,000 and 100,000 The duration and degree of exposure to
asbestos in members of this group however must vary considerably and
their relative liability to asbestosis and asbestos cancer consequently will
also show distinct differences The recent estimate as to the total number
of about 50,000 asbestos workers employed in the United States Canada
England and several other European countries made by Braun and Truan
must be considered an optimistic understatement which tends to minimize
the actual scope of the health hazard associated with work in asbestos The
numerous occupations and products associated with the production and
rene utilization of asbestos provide a vivid illustration of the wide scope of the industrial health problem related to this mineral TABLE 2
gO
CAT Asbestos Ore Mining and Milling
ADI
Miners sorters or dressers of asbestos ore in open pit mines but partic-
HA
ularly in underground mines are exposed to the inhalation of rock dust
td
containing asbestos Similar exposures exist for the loaders of the mined
rock and for the truckers and railroad personnel who haul the material
and deliver it to the crushing mill The crushing and screening of asbestos
rocks comminuation carried out in the mills for separating the asbestos
fibers from the adherent rock is associated with the production of a great
deal of dust and thus entails a heavy exposure to asbestos unless stringent
technologic precautionary measures are taken for protecting the workers
employed in these mills The amount of dust produced in these operations
and escaping from the mill buildings can moreover cause a marked pollu-
tion of the intraplant and periplant environment with asbestos dust and
thereby create not only an intraplant asbestosis hazard for workers em-
ployed in the yard and offices located on the premises but also a periplant
hazard endangering individual and animals working and living in the vicin-
ity of such plants industrial neighborhood and household hazard
Reports on the occurrence of asbestosis and asbestos cancer among asbestos
miners and millers which are on record from Canada the United States
and South Africa demonstrate the existence of the typical health
hazards associated with these occupations in asbestos
Asbestos Cement Production and Consumption The greatest quantity of asbestos of all grades is used in the manufacture of a variety of asbestos cement and plaster products such as asbestos cement proper which may be applied like ordinary mortar or plaster or
4
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190
Annals New York Academy of Sciences
which may be sprayed on walls insulating material for the covering of
pipes boilers cables conduits and ducts siding shingles roofing shingles tiles flat and corrugated sheets wallboard clapboard and automobile un-
dercoating The production processing and commercial use of these
materials often entail for workers engaged in such activities a distinct
exposure to containing dust Reports in the more recent medical
literature attest to the existence of distinct occupational health hazards from such exposures by noting the occurrence of asbestosis and asbestos
cancers in asbestos cement and plaster makers mixers and sprayers in-
laggers and coverers especially sulators
pipe
those employed in shipyards
and masons.1,40,41,2,4,8 The circumstances under which asbestos
cement products are used in the human economy make it likely that they may create asbestos health hazards of an associated type for other workers
as well as in homes where asbestos insulating is used
Manufacture of Asbestos Textiles
Asbestos alone or in combination with other vegetable or animal fibers and synthetic plastics is employed extensively in the manufacture of
threads yarns wicks cords ropes tapes cloths sheets blankets and similar products which in turn are used widely in industry automobile aircraft as friction materials brake linings fireproof safety clothing curtains life jackets and similar articles clutch facings lagging cloths and
gaskets During the preparation of the asbestos fibers and in the fabrica-
tion process of textiles from asbestos carding stripping mixing bobbing spinning and weaving the workers become exposed to asbestos dust released into the air although the absolute amounts of this have greatly been reduced during recent years by proper technologic measures in modern textile plants Whether the introduction of such protective procedures has succeeded in totally eliminating asbestotic hazards for the workers
employed in such plants however remains to be seen because of the often
relatively long latent period which may elapse before asbestosis may be-
come symptomatically manifest even after workers have left such hazard-
ous operations Exposure conditions in the asbestos textile industry
until rather recent times definitely demonstrate that asbestos textile work-
ers
spinners
spinners carders weavers carders weavers
subject distinct asbestosis
were subject to a distinct asbestosis and
asbestos cancer hazard 1 58,12,13,53,54,59-72,33,73,74,20,75,76 58,12,13,53,54,59-72,33,73,74,20,75,76 58,12,13,53,54,59-72,3,73,74,20,75,76 58,12,13,53,54,59-72,3,73,74,20,75,76 58,12,13,53,54,59-72,3,73,74,20,75,76 58,123,5 4,59-72,37,420,756 58,12,13,53,54,59-72,3,73,74,20,75,76
Periplant hazards for the population living in the vicinity of such plants may ensue if the effluents of exhaustive ventilation equipment are released into the environmental air without previous removal of their asbestos
constituents
Miscellaneous Asbestos Products
Asbestos is being made into floor tiles by blending it with other mate-
rials such as asphalt plastics and similar chemicals It is used for seals
packing circuit i
Seliko
not all
exposur
pneumo
often c
;
health E
i
of many
ognized ;
quately i|
Prote | Prote :
Asbes
course o
L
a compli
compens
countrie
ain ***
: Great B
i
condition
United S
from eac
and the le
was deni
Carolina
this decis
provision
;
i
against th
still leave
;
1 Th ; during th
:
asbestos
I of them
employed |
processed
environme |
The 2
|
the past tw '
on the occu ,
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a
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1.
NUKEISNUKA EISARR IAY INUKA EISAY RIAY
,,KKIN NUKEISARIAY
,,KKINDR
WES
POLARITINGASOWASARE POLARITINGASOWASSARE POLARITINGASOWAS ARE
IRISTELUSKILS ST^ NARGITEMSST^ NARGITEMS USULCHALETOWY P^s pro^ NG ZAZ3.2700WAVELLINS ZAZ3.2700WAVELLINS ZA3.270WAVELINS ZAZ3.2700WAVELLINS VIVULGTEN LASTE KALIYEMWUALI
KALIYEMWUALI KALIYEMWUALI
ek le nee entre Pe tee ee ab
A
he
Hueper Exposures to Asbestos
191
overing of g shingles
mobile un e of thre
a distinct
nt medical th hazard d asbestin
rayers in
shipyards
h asbestow that ther
er workers
packing material for pumps and joints for making paper filter material
circuit breakers molds and many other articles whose total number Selikoff et al have estimated to run at about 3,000 different items While not all contacts with asbestos and asbestos products are associated with exposures to asbestos dust and thus may result in the development of
pneumoconiosis and cancers of the lungs pleura and peritoneum or less
often of asbestos warts of the skin there can be little doubt that such
health hazards are connected with the production processing and handling of many of them Their existence however may often not be known rec-
intedaliochae! ognized and appreciated by members of the medical profession not adequately familiar with industrial practices and products
edantahad Protection of Asbestos Workers by Workmen's Compensation Laws Asbestos workers of several countries acquiring as the result and in the
course of their regular.employment asbestosis of the lung with or without
a complicating respiratory cancer are covered by provisions of workmen's
mal fiber
compensation laws These occupational diseases must moreover in some
facture of
Aw
countries be reported to governmental agencies Germany Great Brit-
kets and -
.2.8.06.07.20 It seems however that this type of protection applies in
obile airhing curloths and
e fabrica
Great Britain to only some types of occupations but not to others The
enh
conditions on this matter differ distinctly in the different states of the
er
Nin United States where each state has its own compensation acts differing
as
from each other to a considerable degree concerning the type of coverage
, bobbing s dust re-
ha
and the length of the mandatory clause Compensability of asbestosis
gri
Me
was denied for instance in North Carolina in 1937 in a suit against the
ve greatly
in modern
Carolina Asbestos Company by the Industrial Commission In an appeal this decision was confirmed by the Supreme Court of North Carolina Legal
procedure
provisions furnishing presumably adequate protection of asbestos workers
e workers
against the health hazards peculiar to their occupation at the present time
the often
still leave much to be desired in many states
s may be ch hazard industry tile work stosis and
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- asbestos
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CONCLUSIONS
a
1 The enormous rise in the production and industrial use of asbestos
during the past 50 years has resulted in markedly widened exposure to
i
asbestos dust for a greatly increased number and variety of workers Some
I
of them moreover sustain such contacts incidentally either when being
employed in various capacities in operations where asbestos products are
i
processed used or handled or when working in plant areas in which an
environmental pollution of the air with asbestos exists
| 2 The harmful effects of such growing exposures to asbestos during the past two decades are reflected not only in a growing number of reports
F
on the occurrence of asbestosis and asbestos cancer in a variety of asbestos
;
workers but also in the fact that such reports originate from a rising
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number of countries in some of which such observations were made only recently for the first time
3 Information on the number and variety of exposed workers and on the occurrence and incidence of asbestosis and of asbestos cancers
among them is most fragmentary in all countries especially in the United States and Canada one being the principal consumer of asbestos and the other the chief producer of this mineral It is for this reason regrettable that the original plan of having a recent epidemiologic survey on these aspects of asbestos production in Canadian mines and mills to be undertaken under the aegis of the National Cancer Institute of Canada was not adhered to and that this study was carried out as an dominated venture which yielded highly controversial negative results."0
4 The principal worker groups exposed to respiratory contact with asbestos are employed in the asbestos mining and milling industries in the production and commercial use of asbestos cement and plaster and their numerous secondary products in the production and application of asbestos for insulating purposes and in the processing of asbestos and its manu-
facture into textiles
5 Because in many countries and states the workmen's compensation
laws are defective the protection of asbestos workers against occupational health hazards related to respiratory and cutaneous contact with asbestos is inadequate
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35. CARTIE
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se 10
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37. SLEGGS
OMT Afric 38. DESMET
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39. ISSELBA
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tions were made only
exposed workers an of asbestos cancer
pecially in the United r of asbestos and th
is reason regrettati ogic survey on these nd mills to be under te of Canada was not
: dominated results 0.84-89,63,91 iratory contact with ing industries in the nd plaster and their pplication of asbestos
bestos and its manu
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41. 42 43.
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J.
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Ill
pulnionary
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bei Asbestos
cinoma Ain
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