Document ZJaDz4e0DeEZqLBawKLk9g9KZ

FILE NAME Insurance Industry INS DATE 1957 DOC INS045 DOCUMENT DESCRIPTION Published Conference Presentation - The Asbestos Industry Health Experiences Among Asbestos Workers it ae owt . poe 139 _ . 1957-3 1957-3 1957-3 ff ss . te | ay . . . - ar - CEMNT ASTESTOR 187 Sor ISS Jo EXPERIENCES CEMENT HEALTH EXPERIENCES AMONG ASTESTOR WORKERS WORKERS : Lo . . HOME OFFICE LIFE UNDERWRITERS ABC N : N mo ' ! |a | . THE ASBESTOS INDUSTRY- - mo | zar the king of Babylon They from ( CERTAIN HEALTH HEALTH EXPERIENCES EXPERIENCES AMONG ASBESTOS WWoorrkkeresrs . | | emerged the fire com- pletely unharmed and archeologists today lend us to believe that they were protected from the flame DY NENNETH W. SMITH M.D. AND HUGH JACKSON 98 CU fiber Thus by a blanket of woven . . asbestos mineral : : . ; aoe ie used for we can see that the has been |. | i centuries In this presentation I shall try to outline certain health . many but it was not until 1927 | definite occupational experiences which we have seen in asbestos s. | years that a . pulmonary pulmonary asociated inhalation workers not only 7 = 0d was associated with the of fi this | in my own company but in many other associated companies ' 7 While asbestosis is a well 6 As previously the is | industry indicated there recognized occupational discase + 1] 11ses the fiber when mixed with | for are relatively few people in the working populations of - : +> Ty other established fact that when materials established fiber mixed | the United States and Canada who are exposed to asbestos - " or asbestos is | diatomaceous other potentially potential y toxic dust and actually very few ever develop the disease It * earth or dusts the vy resulting will be shown that the lives of the asbestos workers are not | The shortened by their occupation and also that st | 7 pulmonary changes from the inhalation of these mixtures are not typical of asbestosis ray pattern is ' clinical the patient iy trades does not predispose the individual to othweorrk in these * the course of is changed or the . | ep diseases of monocrupational nature , pulmonary susceptibility to intercurrent infection fa increased or de- The word asbestos is err Greasen |^ brous generally used to describe several Dry ee | making magnesium silicates which ha in making diagnosis diagnosis a diagnosis of occupational pulmonary wy their chemical are entirely different in wy discase , is highly important to obtain ee | composition and in their physical a tional propertics There are several types of these fibers The most history not only the job title but also are the chrysatile amosite and crocidolite important of raw materials used in the particular job so Deposits of these various types of fibers are found throughout the world The silicosis or the mixed pneumonoconioses can be We believe that there are fewer than | argest deposits are in eastern Canada and Africa a 15,000 | Those asbestos fibers are highly resistant to heat and United States and Canada who are employed today in mines some are resistant to acids They have great tensile and mills where their potential exposure is orly to rabestes In industry | large surface areas Because of these strength and _ fiber this _ the various mining milling milling miling manu- their filamented properties as well as un . facturing operations create some dusts which \ structure the industrial use of these fibers | throughout the world is increasing The textile industry has cg, being inhaled If asbestos fibers from ten to fifty mirrorscapable in Le c 4a ,e ok _ length are inhaled used these fibers for generations to produce blankets clothing ot , over continuously and in sufficient quantities Fos hreads ropes tapes braided tubing and filters : '. a period of many years a typical pulmonary Abroste In recent years however there has been an develop It has been demonstrated that this fibrosia of asbestos in the insulation building and friictnicorneasing use due to the chemical but rather to the mechanical action trades In addition the fiber can be found in material hingles hingles wallboard < hihingles ngles pipe covering floor tiles brake linings and brake The fibers are deposited in the terminal bronchioles bronchioles bronchioles bronchioles | blockblocks s cements puttics and extensively in plastics lungs Then the tissue reacts coating the fiber and Historically the material has been used for . what is known as the asbestos body This appears lung Those who are biblical students will recall that minantyheytehairrsd ay defense mechanism of the . hapter of Daniel the three men Shadrach Meshach and . Many individuals who have these asbestos bodies in Abednego were thrown into the fiery furnace by Nebuchadnez- sputum have had only intermittent exposures and have absolutely no evidence of the disease Proceedings - Home Office Life Underwriters + : disease . So more appropriate to use the term asbestos bodies ; ; Association 1957 ene : > - ' >-' HOME OFFICE LIYE UNDERWRITERS AGOCIATION 1 a signifying signifying signifying than asbestosis signifying i bodies an exposure to the fiber - but not necessarily indicating disease .- the inhaled Ifincreasing quantities of fiber are continually the tissue reaction progresses and a generalized diffuse fibrosis oa : | } cts : & : or appears the lower lobes of the lungs scarring throughout additional exposure this fibtosis may spread to the other lobes of resultingin respiratory embarrassment : : lungs respiratory the and eventuallycardiac failure immale Pe - immale pulmonary inhalation The fibrosis resulting from prolonged a of the fiber will produce a very typical ray pattern which {i does not resemble that produced by any of the otherknown 1 d used toxic dusts The ray picture should never be to i i estimate the presence or extent of an impaired pulmonary function or disability Many cases with Xray evidence of . 1 ' advanced asbestosis have been known to carry on their work and live very comfortable lives for several years years ~- There's no typical clinical picture of asbestosis The disease =: ok ae . Soe | isis very slow and insidious in its onset and very slowly slow 5, | gressive with continued inhalation of the fiber pro- The textbook cyanosis asbestosis . signs of and clubbing of the fingers are virtually non- x stent in the cases of we see today will An ray survey was made of 708 employees working an Jk ' * joo | u _ ob 5 . asbestos mill where the ore was dried crushed and separated in Operations employees through graded packed and then shipped requiredrequired the employees to rotate in this plant various jobs so that it was impossible to relate any ray changes to a particular particular job or to a specified dust concentration At the particularsame time it could be assumed that all members of the group - hadhadbeen exposed to varying concentrations of the dust . . wpe, . oye of of asbestosis asbestosis Sixty than ten years cent nine per service of this gro a had more of 703 only Of the original group of had developed X diagnosed ray evidence whichwhich could be positively positively as asbestosis These men exhibited various stages of pulmonary ment All stages pulmonary involve- were working steadily at theirjobs with no signs of disability Itis of interest to note here that none of the exposure men developed ray evidence of asbestosis with under twenty years of . Medical literature has given considerable attention to occupational pulmonary disease but very litle been reported on the occurrence of nonoccupational disease among employees in the dustydusty trades respiratory a aa In order to determine the incidence incidence of nonoccupational i disease in a group of 1,561 men and women | in the working industry working industry it was decidedto study study the claims asbestos for stekness and accident insurance All employeesemployees survey group in theplan participated by pendent insurance company Indemnification operated Indemnification made after the nature of theillness had been cert ing physician , The includie ncluded claimsclaims submitted over a five study for such illnesses as the common coldcold sinusitis pharyngitia asthma sinusitis such gripegrippe bronchitis pneumonia pational pulmonary diseases such from report | and Occu Occu pleurisy asbestosis pleurisy as asbestosis excluded the Of the 1,561 employees in the approximately employe s aproximatelyapproximately equal numbers in > (ol . occupations Of all claims filed for The rays of these were divided into three \ employees groups essentially normal those with exaggerated markings esentialy disease of asbesto- with any but not typicalof employees studied Eis Of the 708 and those definite oar . 649 or 91 per cent had .. + normal rays Thisis ofinterest because 204 of the em- > actually a showed worked i ployes ployees or 20 per cent of the total had more than ten years of service Two men over forty years in varying dust concentrations with absolutely no evidence . ii of any increased markings in their rays ms f 45 45 per cent were for employees who had dust only did this survey show that the incidence . in each the year was approximately the same ey period group but it also establishedestablished that there was no appreciable ' difference in the duration of illness in either Also 7 clinical observations group for many years given the impression impression had uo duasdtusyty occupatiinoitnself would not predisappoerssoen to more nonoccupational respiratory disease than would dust job . 1 : Fifi of the 708 employees showed some increase of "OST TT all peribronchial markings although none had any evidenco - Animal experiments and clinical that asbestosis does not predispose observations chowa observations observations have chowa person to the develop- WORKERS CERTAIN HEALTH EXPERIENCES AMONG ASBESTOS 101 _ pulmonary tuberculosis aggravate ment of nor does it a aggravate an apparently healed tuberculous lesion In two isolated one- industry towns in the Province of Quebec where asbestos was - + \ mined and processed the incidence of tuberculosis over a , period of many years was no greater than that of other isolated population towns with comparable comparable LL4 In tuberculosis trade addition the incidence of but without a dusty trade tuberculosis among asbestos these workers was lower than that the general population in ot mining towns . Conflicting conofpiirmnions difficult to extremely and different reports makeit extremely ordeny conclusively the causal relationship often * of asbestosis carcinoma of thelungs Too ~ a common conclusion is drawn from observations and experiences with of different racial groups living in diferent different parts the world under variable economic conditions and working in socio MI diverse occupational exposures To these variables I'd like * types to add the fact that there are various of asbestos thaesbestosis limited fibers which may have different actions on the lungs The Canadian experience with has been : to the chrysotile fiber The majority of industrial processes there in the United States use this fiber but recentlyrecntly has been ~ recently some in the use of amosite and crocidolite On the increase other hand the British and other European Industries use Therefoqrueantities the greater quantities of theharsher Gbers amosite and crocidolite , relationship in trying to clarify causal relationship of relationship asbestosis in cancer many variable facts should be clearly identified especially the type of fiber used and whether or (AAT not other dusts such as silica or diatomite were present in to the or atmosphere 7+ ate industrial environmental to _ To amplify this point I'd like like to take a few moments to 4M, ee : fibers comonly describe thethree types of asbestos most commonly : . of African 2 used today An electron micrograph the South African blue or of crocidolite fiber wouldshow thatitis composed many short 7 sharp spicules which are rather brittle _ -y. Amosite fiberis brownish yellow in appearance and found in Africa and Australia Seen under the electron microscope at the same magnification as the fibers would appear sharp and they above longerless actually are less brittle than the . crocidolite se os . ; HOME OFFICE LIFE UNDERWRITES ASSOCIATION Crude chrysotile fiber found chiefly in Canada is greenish-grenish- whitein appearance Electron micrographs show that this fiber is soft and long reasonable I think crocidolite amosite and brittle fibers such ascroidolite damage much more extensive t . as ume and could cause- to the lung than could could the long soft silky chrysotile fiber Therefore I think it is unfair to | European compare the experience of some of the operations ~ European with our North American operations using different typestypes of ; fibers with different actions Le To amplify my statement that there aredifferent occupa- -2 tional diseases having ray pictures and different different would like clinical patterns I would like to describe the rayray appear- ances of some of these diseases The ray in asbestosis bilateral in both lower lung fields obliterated completely or patterns of other pneumonoconioses In silicosis the ray reveals bilateral and appears in all Conglomerate Conglomerate shadows can appear fields The homogeneous or ground asbestosis is not seen here ; conglomerate conglomerate seenin asbestosiaasbestosia infiltration which is apex to the various the various appearance . pneumonconiosi The ray of diatomite pneumonoconiosis can exaggeration of all linear markings granular pattern andfrequfnt requent ly the apices iTnhe ray pictures resulting ture of dusts never follow not typical of either of working environments a coal of silica and asbestosand _ Thus you couldhave many or diatomite and silicasilica : ray shadows changing from finefine granular infltrationsto homogeneous and later to coalescent shadows in the same individualindividual . Several years ago anyone who installed insulation materials was called an asbestos worker because robertes robertes was practicallypractically the only material purpose robets Today however synthetic ^...bers clays there are mineral fibers nesia and a host of other synthetic ^...bers cement mag- substances used in the CERTAIN HEALTH AMONG WORKERS WORKERS EXPERIENCES ASDESTOS ont . ' - majority . The majority of these materials are relatively non- trades * and it is obviously incorrect to label insulation the toxic ; medical installer today as an asbestos worker asbestos medical literature today incidence articles asbestosis : There are numerous articles in the reporting the asbestosis or and lung The conclusions of the 4 -. asbestos workers | among cancer should not be acceptedaccepted implicitly unless the report authors that the called asbestos was exposed worker that _ clearly indicates ipa exposed to asbestos fibers and not to a mixture of dusts a onlyOne the group I am reporting has retirement company in whichhas been in effect for sixteen They have a years tpoltaanl enrollmentenrollment of slightly over 21,000 people but of course slightly . this figure has varied slightlsylightly through the years Since they _ * started to asbestos fibers just about 100 years ago the use employees following review of the plan will include _ pension fiber period who had an to the over a long have exposure employees 1,185 who of 27 ces time In the past there were 1,185 _ sixteen years retired underthe provisions of the pensionpension _ ; plan The average plan length of for this group was 24 years Although employment specifically wo we are unable to determine specificaly how many of these had is extensive exposures asbestos faisbbeesrtoist is ruesaesdonianblneeatrolyasaslul moef that the majority since _ asbestos had 1,155 the product lines Of the 1,155 there were 186 who retired for disability of Only of thesehad reaching before the age 65. 6 . , ait ce . : employment with potential - N potential asbestosis : long incidence ~ This low based on would seem to indicate that the asbestos trade is . exposure not as hazardous ne may have been indicatedin the past _, mo. ee ote Cr 104 HOME OF LE UNDERWRITERS ASSOCIATION 40s wy Frequently adequate that pneumonoconioses other Conflictive medical opinions crist concerning asbestosis ' . adequate occupational histories are not ob 2 er tained so pneumonoconioses are incorrectly . ~ called asbestosis asbestosis - : fibera the of not the life [ 4. Exposure to asbestos . does shorten the . worker . _ wets CP aL. , Inhalation to Inhalation of asbestasbestos os does does not predprediispose spose tthhee worker to 5. Inhalation not other pulmonary diseases which willshorten hislife os industry controlled of | 6. The asbestos has the exposure so that . ; the incidence of asbestosis is very low low : . uO , : 4 oe . a Smith | Chairman LawSON Thank 7 Smith much you very much Dr. for . Dave splendi rtehaptort on |poe any proceDerd. printedcare || being with us It was a very interesting paper . ne - Do of you gentlemen have any questionsquestions to [3 would like ask of Smith while you have him available If not we will to close Cartwright I think gave us a splendid on az i \ The paper of which you ~ p01. | : taconite this morning covers it in much more detail and presumably have a copy covers has an excellent bibliography if to further you investigate We greatly appreciate apreciate what Dave Morris thanks ever . And thanks to you has donefor us so much for moderating the fi Barney Leon Paul : . panel Chet Hovey and Jack Wilson Shea before wo If thereis nothing further to come before the meeting wo stand adjourneduntiluntil 1058. have been asked by the secre- me please tary if you will your badges on the a , table asyou go out . i Thank you all very much !! 5 | The meeting adjourned at 12:10 o'clock + a occupational pulmonary is recognized disease Asbestosis recognized 1. develop slow and insidious in its onset It takes many years of to it does not progress after exposure . y exposure develop and there is | until it is far little disabilitydisability censes very 3 advanced tte : workers dust 2. There are relativelry elatively few exposed onlyonly to this . in industry today