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Merewether/Price -- 1930 -- Part I Preventive Measures ''The necessary preventive measures include, first, those directed specifically towards the suppression and control of the dust evolved in manufacturing processes, which are examined in Part II of this Report, and secondly, measures directed towards those employed in the industry. These latter include the control of the disease by periodical medical examination 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... Thev also include the education of the individual, as in other dangerous trades, to a sane appreciation of the risk, and to his personal responsibility in the prevention and suppression of dust." i ir> Year: 1930 Author: Merewether, E.R.A. Title: Report on Effects of Asbestos Dust on the Lung and Dust Suppression in the Asbestos-'Industry ` Published: His Majesty's Stationery Office, London "The emission of a visible dust cloud at a point where exhaust is applied is a clear indication of inadequacy." Page 34 4 Year: 1938 Author: Merewether, E.R.A. Title: Dusts and the Lungs Journal: Industrial Medicine TLV: "That is to say, that the dust particles which are invisible to the naked eye are the important ones: this leads us to the practical point that if a silica or an asbestos process produces Visible dust in the air, then the invisible dust is certainly in dangerous concentration." Year: 1942 Author: Cooke, Warren Title: The Occupational Disease Hazard Journal: Industrial Medicine Volume: 11 TLV: "In the case of the asbestos dust condition, our evaluation of the exposure should be based on the knowledge that the present toxic limit for asbestos is five million particles of dust per cubic foot of air. This is a very small concentration, so small in fact that the condition may look good even to a critical eye and still present an exposure greater than this low limit. In the case of asbestos dust, however, and this holds with even more certainty for dusts high in free silica content, the toxic limit is so low that the only safe procedure is to have recourse to actual dust determinations." Page 194 l.iv <4 Merewether/Price 1930 Study Report on Effects of Asbestos Dust on the Lungs, HMS Office Need to Warn Workers Health Risk from Insulation Product Use Asbestos-Related Disease May Result in Death Invisible Dust a Hazard 3 Cancer A. 1935 - Lynch and Smith B. 1938 -- Recognized officially in Germany C. 1942 -- Hueper Book D. 1944-JAMA editorial E. 1949 - JAMA editorial F. Private Research - Saranac Cancer - No Safe Level Known - Fibrosis and Cancer (Chrysolite) .r _ 4y I 1930 1932 1933 1933 1934 1934 1934 1935 Russall HsBsyatitoV Xllnaa Kllnan Xn*~~ Mood 6 G-'ayan Clark and Orinkar H.M. mtloMty Offiea, London, pp 5-34 ?! of Genfaranos Conoanilng Iffasts of Biwta I Upon tbs Rasplratary lyt-- (bald by tbs Industrial CmbImIoii of HiMMwia; Danoorat Printing. Madiasa, Via. pp 140, 213-210) Tubarel* 15:69-41 J. Induat. Hygt . 15:163-143 Brit. J. Radiol. 7}241-295 Industrial Caanlaalonar of Stats of Maw York; to: Bullatia 23:55 2I1343--1345 . 'Industrial Usd Inins,* Motional 1939 1939 1941 1942 V^l1944 lt45 Arnold, Baal and Osakaan Gustafson * Bellas 6 Angrist Hutsbinaan Carrstt 1946 1947 1947 1944 1949 1949 Flaissbar and Ibria 1. naavay 6 Xsnaaway Mallory, Castlsnaa and Pints Canapa . Canapa rranobiai 4 C uispa -I 19SO 1991 ... Frost Stoll, Bass 4 Angrist Brit. T. Tubsrc. 33:45-44 W193a9r lIaWtttAaUr utoM Qr. Need. Mod. 9:704-705 . yj T"** V\v*-- Hasting vJtftillatioa 41x57-115 Diraetsr of Daputy Tnspasfpr of raetoriso .' Haaltb Survsy Pips Covaring -Brit. J. Cxaasr 1:240-297 Nsw Eng. J. Msd. 236x407-412 Lavoros Madid . 2:14-20 Zaesbia 12:144-2.5 Mod. Uvoros 40:1 1-172 Abatoaot la Broil, ..dustr. lyg. 19../ 1x342-363 UgssAr. ^asgsr 112:1..4-1745 A.M.A. Arab. Intaraal. K4. 44:431-434 x* Railroad Knowledge of Preventive Measures June 10-11, 1940 Proceedings ofthe 20th Annual Meeting ofthe Medical and Surgical Section, Association ofAmerican Railroads, p.28. Chairman of committee on pneumoconiosis reporting on annual meeting of Air Hygiene Foundation in November 1939: Reported that Phillip Drinker gave a report at the annual meeting dealing with preventative engineering. He dealt extensively "with washing, cleansing and filtering of air; with toxic vapors and ventilation." Stated, ''The general work of the Air Hygiene Foundation of America, Inc. does not very closely interlock with that of the AAR, yet many details are brought out at their annual meetings which can be made of immense value to the Railroads." [emphasis added] ial Fygica* Ciqest - 19 Z .-vaucry, 19*5 ja act inhibit the bovclcpaoat it fi'crotic acdulus la th. tmchaobroocaial lyap: -tdcs or nice. The tissue it th.'sa codas, tacrcforc, re: = ts differently fre* ti lung tissue it rabbits. -- .mthur's ? *-^iributton tj tho Pi thesis :trf Pnmulntcoaauurrv B: ilicaals bv tiw Investigation sf --at. -aj iaaa- :ca .au I. Bcrthcim. SCV. ma. da :hilc. 4 (2ay. 1*42) The diagnosis of silicccis h_s been .cafirscd cy cuEoastrati..n it silica ia the ipuvea iao bicod tf 4C incivicuaij. Biiica ..hica iu conveyed tc the luagr sy m- caiacicn is tmaa up in gr..--tcr ?>rt by the iysphatics ai :a- rraniaacr is ex pectorated. iilicc interferes -itn too iyr.phc.tic oircuiatica, vrucucicg i ficrcu: prciircrttica ..aieb. eventually results in tne inclusion af tae particles :Cc.o- sulvcs. But before this secure :1c silica which xs lafealea pisses through tie t-c-a an my bo excreted la thu urine, lilies any sojaally be found. in tie else: but if the quantity is ices tats 3 =q. percent us dstcjaaaed ay tae ceiormetric netted, it is belief,:a te bo sf no clinic .1 significance. Quantities, froa 12 tc 2C ng. percent tre expressed as 1 pi-s,' fren 20 to 0 ag. percent 2 plus, :nd ' stcft =0 ag. percent 2 plus. Positive chemical resetleas for silica ia toe sp-u- :ji nay be obtained ia all eases ef silicccis. The positive reactions ia the deed, eerrespead to tic casu&ts af silica contained ia the sputum and positive chemical reactions ora found only in those individuals who have been exposed to silica-bearing dust. The specific chesieal reaction used is that described b7 1 barbnuser ead depeaos oa the reaction obtained *.ath nitrsnalybdonate of aoecnia. This aay be used equally oa the blood tad sputim sad is a acre certain test than, too spoctrographlc aotheds. -- la. Bar. Tuberc. Tbg_A^jtgj->j^. H.S. Alden and ~'.M. Hc^ell. Arch, D< md Syph., 49, 212 (Uny, 1944) The author describes corns or warts peculiar to asbestos wenccrs, first noticed by Berlitz ia 1930* Thoy have no relation to asbestos of the lungs. Oae charec- aristlc is that they appear end feel an if a foreign body -sere present, ncnc is ever found. It is probable, however, that oae id present in the very early stages. .-.sbestosJuf P'jjffiy-y Carclneaa. E.'.:. *odl*r. -cut. aad. iochschr., 39, c7- c7o (Aug. 0,1943) Soman. The author has colloctcd the published autopsy records oa asbestosis frea various countries and finds that there have been 14 instances of aalignent nisease of the lungs and pleura in 92 post-aertss cxoaiaatloas (16 pereeat). This is ia tsetse of the proportion of lung careinsaata m autopsies generally (2-6 percent). Car cinoma as a complication cf asbestosis occurred asst fraquaatly in oales between ec cod 41 and was generally in the part of the lung scat affected with asb&stcsis. IcVelcpaent of tha lesion wcs slot/ but corresponded with the length and intensity cf the exposure (12-42 years). There was often a loag interval between the e.s- bsttta cf ex^eure aad th* devlcpacat of the cancer, which, in the ruthor* s view,, zust now be regarded as cn occupational cancer. -- Bull. Byg. ' ' 2Xia Biseoaes zaa. Butbo a "c'w Protective Crcoa. J.C. Cov.niag, L.H. Ohaart cad 1.J. Btcidcsa.. Arch, -cr -bit. .no ayph.. 40. 456 (June, 1944) . lr, ihuustrics where w.rxars arc oxrcscd, to dcaatclogic irritants, sad where it .s impracticable to wear gloves, ,rjtective crcuas help to aiaiaiso cutzawus ir ritations. Many uratective cr.jas or* en the aurkst under trade aa*i. aad sf: id . TABLE 6 .N N H MAun-occupational sbestos Exposure istories obtained in Cases of esothelioma U/I.C9 h lb l 3STo "Safe" vel of Exposur Excessive cancer risks have been demonstrated at all fiber concentrations studied to date. Evaluation of all available human data provides no evidence for a threshold or for a "safe" level of asbestos exposure. NIOSH (1980), Workplace Exposure to Asbestos, 2. 59. Asbes tos Causes Mesothelioma Short or Indirect: Exposures Health risks are associated with even brief proximity to airborne asbestos fibers in many different work places. Most of the shipyard workers studied did not work directly with asbestos, but were exposed to airborne asbestos during application and ripout of insulation by pipecoverers and insulators. Finding asbestosis signs in 11.3 percent of their wives is fresh evidence of the pervasiveness of asbestos as an occupational hazard carried home by workers. Kilbum, et al (1985), Asbestos disease in family contacts of shipyard workers, (cross sectional study of living workers and their families). Ctirysotile Causes Alesottielioma -- Animal Studies. Number of" Rats with Lung Cancer or Adesotheliomas After Exposure to Various Forms of Asbestos Through Inhalation Form of Asbestos Amosite Anthophyllite Crocidolite Chrysotile (Canadian) Chrysotile (Rhodesian) None (Control Group) Number of animals 146 1 45 141 137 144 1 26 Adeno Squamous-cell Mesotheliomas carcinomas carcinomas 561 882 794 11 6 4 19 Ni 0 000 Wagner et al. The effects of the inhalation of asbestos in rats. (1974) (in 29). Chrysotile Causes Mesothelioma Animal Studies [Experiments in which animals were exposed to asbestos by intrapleural inoculation and by inhalation] These experiments produced some surprising results, in particular, although the crocidolite sample had produced more mesotheliomas than did the chrysotile after intrapleural injection, after inhalation, the sample of chrysotile from Canada produced as many mesotheliomas as did crocidolite; this was in spite of the fact that the retention of chrysotile dust in the lungs was very much less than that of crocidolite. This experiment has cast some doubt on the epidemiologic evidence that crocidolite is much more hazardous than chrysotile as far as mesotheliomas are concerned. Wagner, et al. Carcinogenesis and mineral fibers (1980). (46) Chrysotile Causes Mesotheliom 25 cases of mesothelioma (two peritoneal) with only chrysotile in the lung. Rogers, et al. Relationship between lung asbestos fiber type and concentration and relative risk of mesothelioma (1991) [Australia] 31. Causes Mesotheliom [82 cases of mesothelioma of residents of the town of IVianville, New Jersey, who had never worked at the abets products manufacturing plant located there]. These data indicate that residents of Aianville had an extremely elevated risk of developing mesothelioma. . . This study suggests a major community impact by a facility using primarily chrysotile fibers. Berry, Mesothelioma Incidence and Community Asbestos Exposure (1996) (New Jersey Dept. Of Public Health) 69. Chrysotile Causes Aiesotheliom In the German Federal State of Saxony-Anhalt, approximately - . . 843 asbestos induced mesotheliomas . . . were recorded in the period from 1960 to 1990. A considerable percentage of the mesotheliomas are solely due to exposure to chrysotile asbestos. Sturm, et ai., 1991. Use of asbestos, health risks and induced occupational diseases in the former East Germany. 20. Chrysotile Causes Mesothelioma Examination of all pertinent studies makes it clear that chrysotile asbestos is similar in potency to amphibole asbestos. Since asbestos is the major cause of mesothelioma, and chrysotile constitutes 95% of all asbestos used world wide, it can be concluded that chrysotile asbestos is the main cause of pleural mesothelioma in humans. Smith & Wright, 1996. Chrysotile Asbestos is the main cause of pleural mesothelioma. 40. Asbestos Causes Mesothelioma Population Studied 1. Quebec Mines Conclusion: Tremolite = Crocidolite for mesothelioma 2. Corsica Household Exposure as a child; Slight eleuation of lung tremolite leuels; Tremolite = Crocidolite for mesothelioma 3 Neui Caledonia Childhood enuironmental exposure to tremolite causes mesothelioma 4. Rural Greece Enuironmental exposure to tremolite; All mesothelioma uictims employed in agriculture. 5. Cyprus Miners' wiues and enuironmental exposures to chrysotile and tremolite 6. Montana Tremolite potent cause of mesothelioma in uermiculite processors 7. Rnimals 70% of rats exposed to small fraction of tremolite fibers get mesothelioma 1. McDonald (1997) 2. Churg (1986) 3. Luce (1994) 4. Sichletidisetal (1992); Constaritanopolous (1987); Langer (1987) 5. McConnochie (1989) 6. Amandus (1988); McDonald (1984); McDonald (1987) 7. Davis (1991) U.S. Government Conclusion: QSHA Mesotheliomas are Attributable to Asbestos Mesothelioma (cancer of the lining of the pleural and peritoneal cavities) occurs almost exclusively in asbestos exposed persons. Mesothelioma has been conclusively shown to result from asbestos exposure. Malignant mesothelioma of the pleura and peritoneum are extremely rare in persons not exposed to asbestos. OSHA (1984), Federal Register 14118. 61. Conclusion:__NIQSH Causes Mesothelioma Our review of both the toxicologic and epidemiologic literature strongly supports the view that occupational exposure to chrysotile asbestos is associated with an increased risk of both lung cancer and mesothelioma. Stayner, et al (1996), Occupational Exposure to Chrysotile Asbestos and Cancer Risk: A Review of the Amphibole Hypothesis. Risk Assessment Program, and Office of the Director, NIOSH. 15 Zl Conclusion: NIQSH 1980 Causes Mesothelioma Animal studies demonstrate that all commercial forms and several non-commercial forms of asbestos produce . ,, . mesothelioma. Chrysotile is as likely as crocidolite and other amphiboles to induce mesotheliomas . . . Human occupational exposures to all commercial asbestos fiber types, both individually and in various combinations, have been associated with high rates of. . . mesothelioma. Excessive cancer risks have been demonstrated at all fiber concentrations studied to date. Evaluation of all available human data provides no evidence for a threshold or for a "safe" level of asbestos exposure. NIOSH (1980), Workplace Exposure to Asbestos, 2. ' 59. rnmcnt Conclusion: QSHA Chrysotile Causes Mesothelioma In summary, there is evidence that all commercial asbestos fiber types., except for axithophyllite, cause asbestosis, mesothelioma and lung cancer in humans. OSHA, 1983 (Federal Register, 51115) 60. U.S. Govrnmnt Conclusion: HHS 1994 Causes Mesothelioma Occupational exposure to chrysotile, amosite, anthophylite, and mixtures containing crocidolite has resulted in a high incidence of lung carcinomas. Mesotheliomas have been observed after occupational exposure to crocidolite, amosite, and chrysotile asbestos. . . . Mesotheliomas have occurred in individuals living in the neighborhood of asbestos factories and mines and in people living with asbestos workers. Seventh Annual Report on Carcinogens, 1994 U.S. Dept, of Health and Human Services Public Health Service 21. World Health Causes Mesothelioma Epidemiologic studies., mainly on occupational groups, have established that all types of asbestos fibers are associated with . . . primary malignant tumors of the pleura . . . (mesothelioma). World Health Organization, Environmental Health Criteria 53, Asbestos and Other Natural Mineral Fibers. (1986) 54. C/3 C/5 U o Q < C/3 35 ~h yW ZE OZ S3 <td s >4 a S H O c/3 W S .2 T<3u 0uo)o f. . 03 O <*u. c<Su Co -^C> UQcJi C/3 T--3 oJ 2 _C gO .2 <-> 13 j= OC/3 wa) <D 03 cw .2 ts WO =e r2 3 S~ C/3 .>u. =3 2 J.I c <V S--I Cl O -CC/3 &u). > 03 UOCJ wco D o <Cu CO 4> q, <D Early Mesothelioma Deaths in Railroad "Workers This is illustrated with the following case, a machinist who retired in 1943 and died in 1946 (age 69) with a pleural endothelioma, with prior emplogment in 1916 with [the railroad] at the same facility. "The post mortem-examination showed that ------- was suffering from a malignant tumor which had its origins in the walls lining the lung surface and the inside of the chest wall. This had started in the left chest and had progressed to inuolue the cells and lining of the abdominal organs (peritoneum) and to a lesser extent the sac surrounding the heart and the lining of the right lung. It became clear that the tumor had extended through the chest wall in the front into the tissue which we had cut into on Tuesday morning which was indeed part of the tumor. This is a uery unusual type of cancer since it had spread so widely it of course was unapproachable by any type of treatment. LUe regret that we were unable to establish the diagnosis during life." [Signed bu Medical Director-Internist of railroad company R. (This information was obtained by chance from the uictim's family).] [This information was neuer published] Source: Mancuso, Relative Risk of Mesothelioma Among Railroad Machinists Exposed to Chrysotile, Am J,, Ind Med (1988) Railroad Workers: Mesothelioma and Asbestosis from Asbestos Exposure Year Study Findings 1960 Wagner et al. "Diffuse 2 case reports of diffuse pleural Pleural Mesothelioma mesothelioma in locomotive boiler and Asbestos Exposure workers on railways in South Africa. in the North Western Cape Province," BJIM 17:260. 1967 Lieben and Pistawka, Authors report 1 case of mesothelioma in "Mesothelioma and a boiler maker in a railroad yard where he asbestos exposure," worked on insulation of steam engines for Arch Env Health 25 years. 14:559-563 1977 Webster et al. 3 case reports of mesothelioma and 1 case "Pneumoconiosis in of asbestosis found in men who worked non-mining industries on the railways (in heavy engineering on the Witwatersrand," workshops) in survey of 287 patients. SA Medical J 51:262 264. 1978 Cochrane and Webster, Authors report 16 cases of mesothelioma "Mesothelioma in in men who worked in locomotive relation to asbestos workshops: 12 worked in asbestos fibre exposure," SA insulation of boilers, 2 in ship engine Medical Journal, 279 room repairs, and 2 as welders in other 281 workshops using asbestos cloth insulation, gloves and rods. 1979 Mostert and Meintjes, Authors report 4 asbestosis cases and 2 "Asbestosis and mesothelioma cases on the Rhodesia Mesothelioma on the railways. Mesothelioma was found in a Rhodesia Railways," locomotive driver and a locomotive Cent Afr J Med storeman. Asbestosis occurred in a 25(4):72-74 plumber, a fitter, and 2 boilermakers. 2*1 Railroad Workers: Mesothelioma and Asbestosis from Asbestos Exposure Year Study 1981 Charpin et al. "Manifestations thoraciques de l'amiante et genetique," Rev. fr. Mai. Resp. 9:55-59 1983 Mancuso, "Mesothelioma among Machinists in Railroad and Other Industries," AJIM 4:501-513 1983 1983 Sepulveda and Merchant, " Roentgenographic evidence of asbestos exposure in a select population of railroad workers," AJIM 4:631 639 1985 Oliver et al. " Asbestosrelated Disease in Railroad Workers" Am Rev Respir Dis 1985 ________ 131:499-504 Findings Authors report bilateral pleural plaques and calcification at the same site on the axillary and diaphragmatic surfaces in a set of twins who worked as laggers with the French railroad (SNCF). 9 mesotheliomas out of 29 cancer deaths in cohort of 197 railroad machinists. In another survey of machinists, 42 mesotheliomas and 2 cancers of the pleura were found. Among machinists in other industries, 16 mesotheliomas and 6 cancers of the pleura were identified. In a survey of 266 current and former railroad workers, roentgenographic evidence of asbestosis was found in 6 workers, while 20% had one or more pleural changes. 31% of workers with abnormal pleurae had localized pleural thickening alone (plaques). Roentgenographic evidence of pneumoconiosis was found in 8 persons. Pleural plaques occurred in 22.9% of 377 railroad workers. Reduced single breath DLco (12.4%), crackles (18.4%), and dyspnea (49.6%) were significantly associated with asbestos exposure. Railroad Workers: Mesothelioma and Asbestosis from Asbestos Exposure Year Study 1986 Magnani et al. "Uno studio dicoorte degli addetti ad una officina di grandi riparazioni (OGR) delle ferrovie dello stato," Med. Lav 77:154-161 1986 Schenker et al. "A Population-based Case-Control Study of Mesothelioma Deaths among U.S. Railroad Workers", Am Rev Respir Dis 1986 134:461-465. 1987 Lundorf et al. "Radiological evaluation of early pleural and pulmonary changes in light asbestos exposure" Eur i ] J Res Dis 70:145-149 1987 Huncharek, " Asbestosrelated mesothelioma risk among railroad workers," Am Rev Resp Dis 135:983-984 Findings Authors report 1 mesothelioma in a worker of the Foligno Repair Shop of the Italian Railways, where the main operations were and are locomotive repair. 80% of mesothelioma cases had either regular or intermittent asbestos exposure. Railroad workers with regular asbestos exposure had an odds ratio of 21.4 (95% lower confidence limit of 8.7) for mesothelioma. Those with intermittent exposure had a nonsignificant odds ratio of 2.3. Case-control study of 209 workers from railway maintenance and repair shop showed 119 with pleural or pulmonary changes; authors found a significant (pO.OOl, x2) dose response correlation between asbestos exposure and pleural thickening, and between asbestos exposure and pulmonary function. Recent review of 37 autopsy confirmed cases of diffuse pleural mesothelioma included 4 who worked on railroads. 2 had unspecified job titles and the other 2 were a brake repair worker and a machinist. Z1-5 Railroad Workers: Mesothelioma and Asbestosis from Asbestos Exposure Year Study 1988 Mancuso, "Relative risk of mesothelioma among railroad machinists exposed to chrysotile" AJIM 13:639-657. 1988 Oliver et af "Asbestosrelated pleural plaques and lung function" AJIM 14:649-656 1988 Hjortsberg et al. "Railroad workers with pleural plaques: I. Spirometric and nitrogen washout investigation on smoking and nonsmoking asbestosexposed workers" AJIM 14:635-641 1988. Findings Among the 156 deaths of a cohort of 181, 14 (35%) of all cancers were mesotheliomas and 11 were lung cancers. One mesothelioma occurred for every 13 machinists hired in 1920-1929. Asbestos cancer risk is higher than previously thought. Morbidity study of 383 railroad workers showed 22.6% had pleural plaques; plaques were associated with decrement of 4.3 percentage points for FVC and 2.1 for FEVi. Authors found correlation between asbestos-related pleural plaques and decrement in lung function. Out of 500 asbestos-exposed railroad workers, the authors found 148 to have significant pleural abnormalities, with 87 having asbestos-induced pleural plaques. An additional 9 subjects had slight parenchymal changes (ILO classification 1/1). Railroad Workers: Mesothelioma and Asbestosis from Asbestos Exposure Year Study Findings 1988 Hjortsberg et al. Increased volume of trapped gas (VTG) ''Railroad workers with was found in 87 asbestos-exposed railroad pleural plaques: II. repair shop workers. All examined Small airway subjects had pleural plaques. Authors dysfunction among suggest VTG is an indication of structural asbestos-exposed changes in small airways such as workers" AJIM peribronchial fibrosis. Subjects with 14:643-647 peripheral airway dysfunction may develop a more pronounced restrictive lung disorder. 1991 Mancuso, Mancuso found 15 cases of mesothelioma "Mesotheliomas and 11 of lung cancer in 181 railroad among Railroad machinists hired from 1920-1929. Workers in the United States," Annals New York Academy of Sciences, 1990 1991 Maltoni et al. Maltoni reported 83 cases of "Mesotheliomas due to mesothelioma; 78 of which were Asbestos Used in machinists. Mesotheliomas were found in Railroads in Italy," machinists, rolling-stock machinists, other Annals New York personnel, and family members of Academy of Sciences, workers. 1990 1991 Ruttner, Ruttner found 40 of 205 autopsied "Mesothelioma in mesothelioma patients were railroad Swiss Railroad workers who had received direct and Workers," Annals NY passive exposure to asbestos in the Academy of Sciences workplace. 1990 " 5 W-5* Railroad Workers: Mesothelioma and Asbestosis from Asbestos Exposure Year Study 1994 Nokso-Koivisto, "Past exposure to asbestos and combustion products and incidence of cancer among Finnish locomotive drivers" OEM 51:330 334 Findings Cohort study of 8391 locomotive drivers found an incidence ratio of4.05 (95% Cl of 1.75-7.97) for mesothelioma between 1953-1991. After 30 years of follow-up, incidence ratio was 5.04 (95% Cl of 2.18 9.93). 6 Articles Which Refer to Risk to Bystanders Author Hoffman Oliver Merewecher and Price Merewether Stewart, et al. Merewether Merewether Page International Labor Organization Dreessen, et al. Hueper Knox (Secretary of the Navy) Hutchinson Hueper Wyers Weiss Isselbacher, et al. McLawghlin Cttfhbert Year 1918 192? 1930 1930 1932 1933 1934 1937 1938 1938 1942 1943 1944 1946 1949 1953 1953 1955 1964 Journal US Department of Labor; US Bureau of Labor Statistics; Bulletin No. 231. Title '1 Mortality from Respiratory Diseases 1 in Dusty Trades. j 9 Journal oflndustrial Hygiene; Vol. 9. Pulmonary Asbestosis in its Clinical 1 H. M. Stationery Office Journal oflndustrial Hygiene; Vol. Aspects Report on Effects of Asbestos Dost "l1 on the Lungs and Dust Suppression 1 in the Asbestos Industry ;i The Occurrence of Pulmonary j 12; No. 6. Fibrosis and Other Affections in J Asbestos Workers i The Journal of Pathology and On the Occurrence of Clumps of ! Bacteriology; Vol. 35. Asbestosis Bodies in the Sputum of j Asbestos Workers | Tubercle A Memorandum on Asbestosis j Tubercle 1 A Memorandum on Asbestosis ! Public Health Report; Vol. 52. Encyclopaedia of Hygiene, Pathology and Social Welfare; Occupation and Health Supplement A Study of Dust control n'-diods in ii an Asbestos Fabricating PI- Asbestos ii 11 j Public Health Bulletin No. 241 A Study of Asbestosis ir. the { Asbestos Textile Factory | Cancers of the Respiratory System j Minimum Requirements for Safety and Industrial Health in Contract *I Shipyards Heating and Ventilation; Vol. 41; Dust as an Industrial Health Hazard No. 6. JAMA Industrial Management and Occupational Cancer The Postgraduate Medical Journal; Vol. 25. Number 290. Medmnische; No. 3. Asbestosis _____________________________________ 1 Cancer of the pleura with lung asbestosis in vivo morphologically ascertained. American Journal of Medicine Asbestosis and Bronchogenic Carcinoma The Dust Diseases in Great Britain Munch, med. Wschr; Vol. 109 The Community Hazards of rj | UAsbestos ./ / Knowledge of Risk to Bystanders Author: Oliver ^ Year: 1927 Journal: Journal of Industrial Hygiene; Vol. 9. Title: Pulmonary Asbestosis in its Clinical Aspects Comments: P. 484: "In a British factory the dustiest process is 'hand beating' of the finished mattresses which are used for covering and protecting the internal machinery of automobiles. This work should only be undertaken in a room separated from the main parts of the factory, with open windows at one end and strong down drafts at the other; but even with this precaution men working therein shoujxTwear masks." ~ ~ 1' -v 11 31 Knowledge of Risk to Bystanders Author: Merewether Year: 1933 (December) Journal: Tubercle Title: A Memorandum on Asbestosis Comments: P. 115: "The majority of spinners have either worked for a period in more dusty processes or have been or are exposed to dust generated in neighbouring more dusty processes. Also those employed at ring spinning, which is definitely a dusty process, and more so than flyer spinning, braiding and plaiting, are included in group (iii). The evil effects of exposure to high concentrations of asbestos oust for even a year or two has been already commented on. These factors have operated to increase the incidence of asbestosis amongst spinners, and in consequence the true incidence rates for this group are even less than those given in Table IV, and particularly so in the earlier years of employment." Knowledge of Risk to Bystanders Author: Owen WG Reference: Diffuse Mesothelioma and Exposure to Asbestos Dust in the Merseyside Area. Brit Med J 2:214-218 Date: 1964 Comments: `Two female patients had spent many years as sorters of used sacking, being employed by different firms of sackware manufacturers. Old sacks submitted for repair contained traces of their previous contents and usually were extremely dusty." (p. 214) "Case 7 ... In this case there was no history of direct contact with asbestos. From 1945 onwards the patient had worked as a Jgg^jiveiTjpr a firm of ship repairers and fitters. His loads consisted mainly of machine components, but he had carried powdered asbestos on a number of occasions. This material had always been contained in sealed bags, andjiederygdjiandlingj^ hdjasm^fll loading and unloading being carried out by other workmeF." (p. 217) CB&Q KNOWLEDGE OF RISK TO BVSTRNDER LETTER TO J.P. MORRIS, C.H. LONGMAN, D.B. MOSS, C.L. EMERSON, R.R. MASON, T.P. BALL FROM ARMSTRONG CHINN DATED: JANUARY 5, 1937 CB&Q CONNECTION: D.B. MOSS fl discussion mas had concerning the best methods of protecting workers from asbestosis and silicosis. The men handling Rsbestos ... are not the only ones exposed to the danger of these diseases, as the dusts they make in doing their work creates a danger to others that mau be working in the uicinitg." ... "Certain of the railroads represented haue already studied the question of danger from these diseases, and haue put out specific instructions to reduce the hazard." 31 RAILROAD KNOWLEDGE OF RISK TO BVSTHNDERS MEMO TO MESSRS. R.UJ. ANDERSON, ET RL. FROM C.L. EMERSON DATED: NOUEMBER 27, 1936 It is also suggested that the remoual of lagging [asbestos insulation], insofar as practical, be done in locations where employees engaged in other work may not be in close connection with it." "In should be understood that an employee so affected need not haue been actually engaged in the particular occupation but if his work inuolues contact the liability is the same as if he were actually so occupied." Mesothelioma Caused by Asbestos Railroad Exposures Table 6: Italian Cases of Mesothelioma Following Asbestos Exposure in Workplace, Not Due to Job Assignment Case No. 1 Job Military radar operator traveling on railroad rolling stock Source of Exposure rolling stock polluted with asbestos 2 Post office derk traveling on railroad rolling stock rolling stock polluted with asbestos 3 Sleeping car attendant traveling rolling stock polluted on railroad rolling stock with asbestos Site pleura pleura pleura Table 7: Italian Cases of Mesothelioma following familiar Exposure Due to Contact With Occupationally Polluted Members of the Family. Case No. 2 6 Kinship Daughter Daughter Job assignment of exposed family member Site Switchman in railroad pleura Engine driver in railroad pleura Maltoni, The Long-Lasting Legacy of Industrial Carcinogens: The Lesson of Asbestos (1995) 49. CB&Q KNOWLEDGE OF RSBESTOS HEALTH HAZARD LETTER TO J.P. MORRIS, C.H. LONGMAN, D.B. MOSS, C.L. EMERSON, T.P. BALL, R.fl. MASON FROM ARMSTRONG CHINN DATED: MRV 27, 1937 CB&Q CONNECTION: D.B. MOSS Minutes of meeting of the Railroad Engineering and Shop Committee of Mag 24. Discusses the bulletins prepared by the committee covering rules and instructions to be follouied in preventing occupational diseases. The committee completed the series of health bulletins to be sent by the General Managers' Association to "all railroads in Illinois... These bulletins couer the Tour major hazards on the railroads. namely, Silicosis, Rsbestosis. Lead Poisoning and RnthracoSilicosis, and mill be all that mill be issued for the present. There are other hazards, such as Arsenic Poisoning, Carbon- Monoxide Poisoning, Skin Diseases, etc., but these are minor hazards compared to the first four. Later, if found desirable, bulletins mill be issued on these lesser hazards." Railroad Knowledge of Asbestos Health Hazard November 28, 1936 Letterfrom Armstrong Chinn to members ofRailroad Engineering and Shop Committee ofthe AAR, including Dr. D.B. Moss ofChicago, Burlington & Quincy Railroad and C.L. Emerson ofChicago, Milwaukee, St. Paul & Pacific Railroad, p. 2 "In the meantime, as our first work, we are to give consideration to and recommend what action seems immediately advisable to protect the railroads from the following occupational diseases: 1 .Asbestosis, from handling asbestos materials, such as boiler lagging. Will you please give consideration to these matters, and be prepared to report at the next meeting of the committee...?" Railroad Knowledge of Asbestosis June 15-16, 1939 Proceedings ofthe 19th Annual Meeting ofthe Medical and Surgical Section, Association ofAmerican Railroads, p. 45. Report by Dr. A.W. Ide, Northern Pacific Railway (Refers to a report read on pneumoconiosis at last meeting, 18th Annual): Defines pneumoconiosis to mean "disease of lungs caused by inhalation of dust." It includes Silicosis, Anthracosis, Asbestosis and other kindred conditions. The report refers to silicosis as "insidious, very definitely a compensation disease, and incurable." [emphasis added] CB&Q Knowledge of Asbestos Health Risk Krobl and Hennessey of CB&Q answered the roll oil Association of Railway Claim Agents Meeting Date: May 16-18, 1934 ..Asbestos, which is a silicate, produces a disorder resembling silicosis. The determination of air conditions as to whether they are dangerous or not to the inhaler, can only be done by actual sampling followed by dust counting and size measurements. One may be lulled to a sense of security by assuming that what appears to the eye as reasonably clear air is free from particles of dangerous size... Citation No. 25. Proceedings of Conference Concerning Effects of Dust Upon the Respiratory System, Ind. Commission of Wisconsin, 1932." - Includes a case of asbestosis in insulation workers. CB&Q Knowledge of Asbestos Health Risk Llovd and Hennessey of CB&O answered the roll call Association of Railway Claim Agents Meeting Date: May 26-28, 1937 "We have also to deal with silico-anthracosis, silico-siderosis, silicatosis, and possibly "siliconosis", and assuredly with asbestosis which is really a form of silicatosis." Railroad Knowledge of Asbestos Health Hazard October 5, 1937 Letterfrom Alton ChiefEngineer Armstrong Chinn to C.M. House. "In connection with the Illinois Occupational Diseases Act, the New York Central developed a soaking vat for block lagging, which they have used at their Gibson Locomotive Shop with considerable success. The purpose of this is to reduce the asbestos dust hazard. I attach one blueprint of the tank used on the New York Central." [emphasis added] Railroad Knowledge of Preventive Measures 1937 Memorandum ofItems Investigated on the Alton Railroad in Connection with the Illinois Occupational Diseases Act. p. 2 Quote: "Handling Asbestos: Asbestos grinder - Located in separate building outside shop. Man is equipped with approved hose mask. Removing lagging from locomotives Carpenters doing this work were instructed to wear type A dust respirators - spray lagging before handling - and to handle carefully to avoid raising unnecessary dust. This work should be done at night when the minimum number of men are in the shop." SO Railroad Knowledge of Preventive Measures April 27, 1938 Letterfrom Armstrong Chinn to H.B. Voorhees "... furnishing masks, respirators and equipment as recommended in the several bulletins put out by the Railroad Engineering and Shop Committee will not eliminate the railroads' liability under the Occupational Diseases Act to those employees who may, in spite of all precautions, contract industrial diseases. The furnishing of this equipment will, however, greatly reduce the likelihood of employees contracting diseases for which we would be liable under the Occupational Diseases Act, and for that reason we should take all reasonable precautions to reduce our liability." [emphasis added] Railroad Knowledge of Preventive Measures October 5, 1937 Letterfrom Alton ChiefEngineer Armstrong Chinn to C.M. House. "In connection with the Illinois Occupational Diseases Act, the New York Central developed a soaking vat for block lagging, which they have used at their Gibson Locomotive Shop with considerable success. The purpose of this is to reduce the asbestos dust hazard. I attach one blueprint of the tank used on the New York Central." [emphasis added] Railroad: Personal Protection Essential Date: June 7-8, 1937 Description: Proceedings of the 17th Annual Meeting of the Medical and Surgical Section, Association of American Railroads p. 21: [T]he basic principle remains unchanged - ventilation by a method best adapted to meeting the condition solved. We have for consideration: ... (3) Personal protection: Control of hazard by means of protective equipment furnished [to] the individual employee, provided the device is effective and the employee can be depended upon to wear it continuously at work." [emphasis added] Railroad Knowledge of Preventive Measures March 18, 1937 Revision ofrecommendations covering rules and instructionsfor prevention ofasbestosis "1. Respirators should be furnished by the Company and they should be worn at all times by employees handling asbestos. Attention is called to some of the specific instances where respirators are required: Loading or unloading shipments of asbestos. Mixing asbestos. Removing lagging from boilers. Removing lagging from pipes. Breaking up or grinding asbestos. 2. Before removing lagging from a boiler, either locomotive or stationary, asbestos must be sprayed with water sufficiently to lay the dust. 3. Removal of lagging from locomotive boilers should be done when there is the least number of men working in the vicinity, and all such men should be protected by wearing approved respirators. 4. Grinding asbestos causes excessive dust. Where such operations are performed and facilities are equipped with exhaust systems, employes [sic] should also be required to wear approved respirators. When exhaust systems are not provided, employees so engaged should be required to wear air masks or helmets with clean dry air furnished from an outside source." 5. Each employee required to wear a respirator should be furnished one for his individual use or one that has been sterilized if previously used by any other person. 6. To insure maximum protection from respirators, only those that have the approval of the U.S. Bureau of Mines should be furnished. 7. Foremen should make periodical checks to see that respirators fit properly, and to note that they are in good condition. 8. Foremen should be held responsible for seeing that respirators are worn in accordance with instructions. 9. It is suggested that the above recommendations be communicated directly to the foremen involved. Publicity on the above might suggest the making of claims." Railroad Knowledge of Preventive Measures June 7-8, 1937 Proceedings ofthe 17th Annual Meeting ofthe Medical and Surgical Section, Association ofAmerican Railroads, p. 19-21 Remarks made by Chairman D.B. Moss on occupational disease: " Prevention of occupational disease is of great[er] importance, more humane and less expensive than the palliative of paying compensation after the disease has developed. Silica, asbestos and lead are the principal substances generating toxic dusts to which railway employees may be exposed. It is obvious that avoidance of great exposure to toxic dusts and other poisonous substances used in or generated by manufacturing processes and of unfavorable working conditions, is the first essential in preventing and controlling occupational diseases. ... Silicosis and asbestosis are strictly dust diseases, and can be contracted only by breathing silica or asbestos dust... Prevention and control, therefore, consists of protecting the employee against exposure by the means best adapted to preventing the generation and dispersion of these harmful dusts." [emphasis added] & Railroad Knowledge of Preventive Measures June 26-2 7, 1933 Proceedings ofthe 13th Annual Meeting ofthe Medical and Surgical Section, Association ofAmerican Railroads, p. 72: 'The subject of dust as an industrial hazard has been presented for consideration by the committee. The subject cannot be considered as inherently a railroad problem; however, it may arise in connection with various lines of work, and when it does so, presents a problem which demands attention. At present the best recommendation that can be offered is that dust pathology of the lungs may be prevented by plentiful use of water to wet down the dust at the point of origin, or by forced ventilation to remove dust particles. In the event that neither of these is practicable, respirators should be made available to employees who are required to work in the presence of the dust." [emphasis added] 0. \V Railroad Knowledge of Preventive Measures January 21, 1937 Circular No. GMA-2602: Letterfrom S. H. Schneider, Secretary of General Managers' Association of Chicago, to H.B. Voorhies, GMA President and President of Baltimore and Ohio Chicago Terminal Railroad. Cover letter for the distribution of the Railroad Engineering and Shop Committee's recommendations regarding the prevention of Silicosis and asbestos safety to all members of the GMA - Chicago, as well as to all non-member lines in the state of Illinois. 51 Railroad Knowledge of Preventive Measures February 15, 1937 Alton Railroad memorandum from C.M. House regarding Illinois Occupational Disease Act of1936 Cover letter for official company recommendations "covering rules and instructions to be observed by employees handling asbestos": " [The recommendations are] for the information of the supervision who will see that the employees wear respirators while performing the work enumerated therein and in accordance with instructions contained therein." [emphasis added] Railroad: Preventing Asbestos Exposure Essential Date: June 7-8, 1937 Description: Proceedings of the 17th Annual Meeting of the Medical and Surgical Section, Association of American Railroads p. 20-21: "It is obvious that avoidance of great exposure to toxic dusts and other poisonous substances used in or generated by manufacturing process and of unfavorable working conditions, is the first essential in preventing and controlling occupational diseases." [emphasis added] Railroad Knowledge of Preventive Measures January 14, 1938 Letterfrom R. W. Senijfto C.M. House Seniff provides a listing of foremen he has given instruction to regarding General Managers Association recommendations for preventing "possible hazards of asbestosis, silicosis and lead poisoning." Also includes circulars for consultation when purchasing respirators "to make sure the proper type for the work involved is secured." Railroad Duty April 27, 1938 Letterfrom Armstrong Chinn to H.B. Voorhees "... furnishing masks, respirators and equipment as recommended in the several bulletins put out by the Railroad Engineering and Shop Committee will not eliminate the railroads' liability under the Occupational Diseases Act to those employees who may, in spite of all precautions, contract industrial diseases. The furnishing of this equipment will, however, greatly reduce the likelihood of employees contracting diseases for which we would be liable under the Occupational Diseases Act, and for that reason we should take all reasonable precautions to reduce our liability." [emphasis added] CB&Q Duty to Inform Workers of Risk Association of Railway Claim Agents Meeting Date: May 16-18, 1934 "It is our job to make men safety minded and make them want to be safe; make them train themselves so that they will do their jobs in a safe way. A good Claim Agent, in addition to settling the claim for the injury, has it in his power to influence that man to be safe under similar conditions in the future. Many do this, and many men will do it, if they are encouraged to do it." 62- The Illinois Occupational Diseases Act: Railroad Duty Date: June 7-8, 1937 Description: Proceedings of the 17th Annual Meeting of the Medical and Surgical Section, Association of American Railroads p. 18: "The Illinois Occupational Diseases Act was approved March 16, 1936, to take effect October 1, 1936. Accompanying this Act were two others - the Health and Safety Act, and the Grinding, Polishing and Buffing Act.... Section 3 provides that it shall be the duty of every employer under this Act to provide reasonable protection to the lives, health, and safety of all persons employed by such employer." [emphasis added] 63 Railroad Duty to Employees Date: October 19, 1937 Description: Letter from C.M. House to H.B. Voorhees "When a complete set of these prints is available I will then delegate one man, preferably chemical engineer Seniff, to visit each engine-house, shop and car department and thoroughly familiarize the supervision and each employee performing the work that might involve asbestosis, silicosis or lead poisoning, after which I will give you my final report and recommendations in the event it is found that we should do something more in the way of providing additional protection for the employees performing the various classes of work which subject them to the hazards of silica, asbestos or lead dust, and expect to have the entire matter completed within the next thirty days." [emphasis added] CB&Q RESPONSE TO KNOWLEDGE LETTER TO ALL MEMBER LINES--GENERAL MANAGERS' ASSOCIATION OF CHICAGO and NON-MEMBER LINES--IN THE STATE OF ILLINOIS, MR. H.B. UORHEES FROM S.H. SCHNEIDER DATED: JANUARV 21, 1937 CB&Q CONNECTION: SENT TO ALL MEMBER LINES General Managers Association letter to all railroads in Illinois, enclosing suggested recommendations ... "for safeguarding emplogees handling asbestos." Attention is directed to the last paragraph of the recommendation, which says don't tell the workers whu we are instituting the safeguards, and don't post them in written form "where any nublicitu mau become attached to them." and result in claims being made. CB & Q Workers Exposed to Asbestos No Protection Given Tony Caruso 3/16/83 Began with CB & Q in Denver in 1942. Machinist. Locomotive boilers covered with asbestos. No protection from dust. Not told about asbestos hazards. Lyle Appleyard 1/16/83 Began with CB & Q in Denver in 1941. Machinist. Locomotive boilers covered with asbestos. No protection from dust. Not told about asbestos hazards. No Exhaust ventilation. C. D. Jewell 3/16/83 Began with CB & Q in Denver in 1942. Machinist. Locomotive boilers covered with asbestos. No protection from dust. Not told about asbestos hazards. No exhaust ventilation. Harold Dreith 3/16/83 Began with CB & Q in Denver in 1943. Machinist. Locomotive boilers covered with asbestos. No protection from dust. Not told about asbestos hazards until 1970. John Vessa 3/16/83 Began with CB & Q in Denver in 1941. Machinist. Locomotive boilers covered with asbestos. No protection from dust. Not told about asbestos hazards. Only ventilation was windows. (These workers were all employed by the Burlington Northern at the time they provided testimony). Risk to Railroad Carmen Year Study Carmen Risk 1983 Sepulveda and Merchant, Reports carmen with pleural "Roentgenographic and parenchymal asbestos evidence of asbestos disease. exposure in a select population of railroad workers," AJIM 4:631-639 1991 Ruttner, "Mesothelioma in 40 cases of mesothelioma in Swiss Railroad Workers," coach construction and repair Annals NY Academy of (Table 3). Sciences 1991 1978 Cochrane and Webster, 2 cases of mesothelioma in "Mesothelioma in relation railroad welders exposed to to asbestos fibre asbestos cloth, gloves, and exposure," SA Medical rods. Journal, 279-281 1987 Garshick et al. Past "The car repair shops were Exposure to asbestos usually separate from the among active railroad locomotive repair facilities. workers," AJIM 12:399 Exposure to asbestos was 406 possible during insulation and steam pipe repair [Johns- Manville, 19231." 1986 Schenker et al. "A "Other sources of potential Population-based Case- asbestos exposure included Control Study of work with lagging around Mesothelioma Deaths steam cranes, passenger and among U.S. Railroad refrigerator car insulation..." Workers", Am Rev Respir Dis 1986 134:461-465. 1 ASBESTOS INSULATION IN UJALLS AND CEILINGS OF ARILAOHD CARS sfT#eo of/ttrr/f//*? c&u/ftrr ///si/l^t/ojy to jrsrt 3#rers. Half Section of Steel Passenger Car showing application of _ Johns-ManvUle Ceilinite Fireproof Insulation 1/ 1, * ** ' * L * /* , ASBESTOS INSULATION ON PRSSENGER CAR STEAM LINES ASBESTOS INSULATION ON PRSSENGEA CAA STEAM LINES ASBESTOS INSULATION ON PASSENGEA CAA STEAM LINES I ` r,-,*V . ; * <* y.v ;V;,/vvv-'... 1%