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ST0095385 PLAINTIFFS EXHIBIT DOW 42 DOU 02773 Biologic Effects of Atmospheric Pollutants ST 0095386 ASBESTOS THE NEED FOR AND FE \SIBIUTY OF AIR POLLUTION CONTROLS Committee on Biologic Effects of A tmospheric Pollutants DIVISION 01 MEDICAL SCIENCES NATIONAL RESEARCH COUNCIL NATIONAL ACADEMY OF SCIENCES Washington, d.c. 1971 02774 qOU V l U I i lir 'Imls rrpmtrit liririu skjs un.lrrtakru tiu.lrr (In- arms .| Mir Nalinii.il Ki m ik I* I mm. il Miih Hu i \|sii-" approval nt Hi.' i ...vi-riunk' Hn.ml >>l Hu- NK( Su. I. ppins.il tn.Ik .ilril Hut tlir H. aril i onu.li'inl tli.it tin- pr.'lilmi is nl n.ilmn;il sivmlu ,in. Hi it Wii. i.l.iiiiui tin- ptnhlt-m ri'i|uiri'i| siu-ntilii nr In linii.il smnprlrnir. and tli.it thr rv'.nii.rs.it NK( skcto partii ul.ifls suituhlc lu thr . mnliii t .it ihr protect I h- ni'titnli.in.il iimIhIKh-' ,.j NKC were thi n iIim lurcfil in Hu- t.>ll.mimr manner lIk' members >! tlir study i ninunttiT sierr selei |.-i| (nr their inilisulu.il m tn.I.irlv i mn !''ti'tii r .mil niili'iiii'nl skitti till'- nsiili-i.ituiii l< Ihr li.il.iin . .mil lirr.iitlli ill.. i{iliiii--. KopouMt'itils Inf all ,1'pv. t' <t Hit' ii'fxnt tf't' with tlir studs nimmittrr, tn s linin 'iiKrir appfri lalmu i\ expressed \ltluuieli thv rrpnrl' nl mif siuilv i "ttiimtin's .itr in it sutiniitti'il Inf .ipprns.tl it. \. jiti'Mix membership mu thr C mm. il. r.u h rrpnrt is irvirsn il I's a sn nml irfmip m .. irnti'ts a.. *ilitj* r.' pmn ilurrs rst.iHli.linl .mil 'iimulmeil hs tlir Ai ailrins's Rrpmt .1fti'su i* f iitmttiv Su, h iriirsk. ,ifr inlrn.lr.1 In .Irti rm.n, . utlrf .ilu, sk hr I hr r thr m urn s'lmi- amt t. ti Saul points m i u-ss h.isr hr. ri .nl.Irrs.nl anil is llrlh.'i thr rrpnriril Mini uiit' .>? lush'fis .mil rr. nimnriul itimn .iimi Irmn thr .is.iii.ihlr il.it.i .mil inlormalinn I ti'lnhiiii.ui . t thr rrpnrt is |., iiniltril mils .illrr ..ihsl.i. Infs . mnplrlinn n! Hit' trsirss ptiK.'S I hr s* i irk nn a In. h thi' puhlis jtinn is hj'rd ss i' ivflnrt'inl piirsii.ict in t nfitf.u t Nn t .'A 'n-4 ' u ith ihr I nsifnnmrrit it Pp.tri i...ri Aituu s ISHN tiarA;/i/i 'mm Pnmnp and Pubh'hmj: < in tic National Vadims nl Srirnu's 2IHI ( .institution Asrnur, N W Washinrlnn. IX ''MIX First prrtri'. (h i.iher !`7| Sfsnn.t ptirtim* Ihuemher ia7| Lihrars nl t onjue" < jialny ( jd Ntntiher 'H I'') *r. Prinfri! in th*- t 'ruled St Mrs *! Amrlti a PANEL ON w n akk rooiM- k . School California. Berkeley. Cham I I wls J < KM I I Y Bureau Division ot epidemiology a Health Service. Cincinnati. Hi NJAMlN (i I I K R IS. JK School of Public Health. B< i'M;i rikoss. Industrial Hy; Pennsylvania III M AS A HOI ADAY. Os I jke City, Utah IK VISfi i si I.IKOI I-. Pnvn Sinai Hospital. New York. (;i ok(.i w wkk.ii i . Medi II ispital. Cleveland '>hio S-\MU 1 1' Hl< kv Departn Michigan Medical Center. / l i> h<> \ /. i k . Division ot Council. Washington. D C COMMITT! OF ATMOJ AR 1 MKk H IH'Bois. Depa Medicine. University of Po VISION W H \CI)N Colleg University of Wisconsin. V A\ \si H M 1 Jl k . Depar School of Hygiene ami Pu University. Baltimore. Mat W i l \KK i :*Oi`l k Sehoo ( aliform.i. Berkeley 0277S DOW ST0095381 ST0095388 PANEL ON ASBESTOS w iI f ool'i k. School of Public Health. University of California. Berkeley, ('hairman \ t wis J R M I.I-Y. Bureau of Occupational Health and Safety. Division of Epidemiology and Special Services, U. S. Public Health Service, Cincinnati. Ohio HI sjamin o EERRts.jR . Department of Physiology, Harvard Schcxd of Public Health. Boston. Massachusetts I'M'l cross. Industrial Hygiene foundation, Inc.. Pittsburgh Pennsylvania I'TNi'w \ HO LAI) A Y. Occupational Health field Station. Salt l-ako City. Utah ik vt\<; j si I.IKOI'I-. Environmental Sciences Liboratoiy. Mount Sinai Hospital. New York, New York <;i ur<;i w WRKiH Y Medical Research Department. St. Luke's Hospital. Cleveland. Ohio swirt i. i' lilt ks. Department of Pathology. University of Michigan Medical Center. Ann Arbor, Associate Editor I i> boa/. JR.. Division of Medical Sciences, National Research Council, Washington. D. C.. StaffOfficer COMMITTEE ON BIOLOGIC EFFECTS OF ATMOSPHERIC POLLUTANTS AK l HU R B DUBOIS. Department of Physiology. School of Medicine. University of Pennsylvania. Philadelphia. Chairman vis i os w. bacon. College of Applied Science and Engineering. University of Wisconsin. Milwaukee assa m ha h f Jl-R. Department of Environmental Medicine. School of Hygiene and Public Health. The Johns Hopkins University. Baltimore. Maryland w ci.ark COOPER. School of Public Health. University of California. Berkeley m ,, ASHI STOS \n k i * \ i ( k \ (ir.itlu.iio School ot Public Health. University of Ihn-i'm-jh. Pittsburgh. Pennsylvania in k i k \ m i) i) i s \i \ s School ol Public Health. University ol Mk Mi-.mii. A.in \rbor ! i ) \ (.n i H i k (. |intitule <l I \pcrimcnt.il Patholouy ami I o\i. !>'.. Mh.nn Medical t ollccc. Albany. New York f \ i n ii\mm<>m> Department ol Physiology and Pharmacology. i liege ,,| Veterinary Medkine. University of Minnesota. St. Paul \ M i I t i* n k k s. Department of'Pathology. University of Malucan Medical ('enter. Ann Arbor \ b tun i, t \ ||| s Department of Radiation Biology and Bio* pin sics. University of Rochester Medical Center. Rochester. New V ork \ i*k \ ii \m M i li ii M i i i) Department ol Chronic Diseases. School of Hygiene and Public Health. Ihe Johns Hopkins University. Baltimore. Maryland f \ i l Ml ii K Biomedical Compulation Paulines. University of < Inumo. ( Imago. Illinois f\Miss mils ik Department of Chemistry. University of < .ditornia. Riverside mordos. j sioi'bs Haskell Laboratory, b. I du Pont de Nemours and Company. Newark. Delaware " 'lit ms i .\vi ok. Department of Horticulture. University of ( aliform.i. Riverside [\kusi \v J vii.siti Department of Pharmacology and To\ivolog\. Cmverstly of Rochester Medical Center. Rochester. New York l i> ho v/ JR .. Division of Medical Seiencvs. National Research Council. Washington. D. C.. f-'.wcutiw Dircemr Pre This document was devcl Pollution Control Admmi Control Ottive upon the I Agency in December !'*" set lorlh in a well-orgam/ turn on asbestos as an air health effects, measuretne siatc*of*lho-art document full*, all that is now know The report is the rest11 Asbestos, chaired In Dr \ ol the parent Committee ants. Division ol Medical f Members ol the Panel <m produced a lepori that. at which the sponsor ropiest cussed in the report is adc Much vredil i"i the u.u given to Ihe I diior <i the (irossblaii 0?777 oow ST0095389 ST0095390 Preface This document was devclojvd .it the request ot the National Air Pollution Control Administration. which became the Air Pollution Control Office upon the formation ot the I nvironmental Protection Agency in December I`>70. The request was for a report that would set forth in a wcll-organi/ed fashion the currently available informa tion on asbestos as an air pollutant, with special attention to sources, health effects, measurements, ami feasibility of control. It is not a state-of-the-art document and. therefore. does not attempt to cover fully all that is now known about asbestos. The report is the result of the dedicated efforts of the Panel on Asbestos, chaired by Dr. W. Clark Cooper and formed umkr the acuis of the parent Committee on Hiologic Hfecls of .Atmospheric Pollut ants. Division of Medical Sciences. National Research Council. I he Members of the Panel on Asbestos arc to be commended for ha\ ine produced a report that, although brief, covers the salient points on which the sponsor requested sound scientific opinion, l ach item dis cussed in the report is adequately documented ip the bibliography. Much credit for the clarity of expression in this report must be given to the lulitor of the Division of Medical Sciences. Mr. Norman (irosshlait. v DOW 02778 ST009539I VI \si sms fliis report (I) summarizes the evidence rcpardin*! the pathm'emcitv ill asbestos mi man anti animals. ( 2) suinmari/r\ the evidence ot luiman nonoccupational exposure In asbestos. (*t evaluates the evidence rveardinu a health risk associated with various decrees ami Iv pcs ul e\ post i re. < 4 t identifies xnurv es of environmental anil.iini nation by ashestos. ami (5) <'tiers reeommentlations concern m si ilie need lor and teasibility of control measures. Charles L Dunham ('hjirnuni. Division o| Mcdual Sai'iie. Cot 1 Intiod'.Khon 2 l*atiioeenivit> <>i .. I'\ idt :ky ol Mum |- \posures to Asb 4 | .lunation ot Riv I \ pi `sines to .\sh 5 Sour., es "l -\shesi 0 PniKiples oi ( oi-. Kcwai. h Needs s ( oneiii"' *us .nut Relet'-'Kes DOW 02779 Contents ST0095392 1 Introduction 2 Pathogenicity of Asbestos 3 Evidence of Human Nonoccupational hxposures to Asbestos 4 F.slimation of Risk in Nonoccupational 1-xposures to Asbestos 5 Source* of Asbestos Fibers in Ambient Air b Principles of Control 7 Research Needs H Conclusions and Recommendations References vii I 3 II lb -0 24 30 32 DOU 02780 ST0095393 1 Introduction The naturally occurring fibrous silicates classified as "asbestos** have become almost indispensable in modern technology.h,*i:4J4> The world's annual production has grown from a few thousand tons in I`>00 to over 3 million tons in 19bK.120 Annual consumption in the United States averaged nearly 800.000 tons during the period 196519(>9.120 The potential of asbestos as a hazard to health has been the subject of a number of reviews in recent ycars.3:'49'60'l31',3#,',45,47l6'' Although it has been known for a half-century that persons who inhaled large amounts of asbestos dust in the course of their work sometimes developed disabling or fatal fibrosis of the lungs, it has been only within the last three decades that other serious effects, such as cancer, have been associated with occupational exposures. Recently, the likelihood of exposure of the public at large to asbes tos has been recognized and has led to a demand for more rigorous control of asbestos emissions into the atmosphere. "Asbestos** is a generic term for a number of hydrated silicates that, when crushed or processed, separate into flexible fibers made up of fibrils.44 Although there are many asbestos minerals, only six are of commercial importance: Chrysotile. a tubular serpentine mineral, accounts for 9 S'* of the world's production: the others. DOW 02781 ST0095394 \Mtl Sins i:* .ntipn. .u h!*ol:k- .IK' .Hill 'MV I "V fill .III! I|< iphl III lc. J| elll' ill |. 1 Ik- -I'fvsf." muk'J.iK til t U t III 11 K'lI llk-l.illk ek'llk'lit il xontcnl i.itiv`v*t Utvi h.iiik-4'iv !li-\iliilit\ <>i h.it'.lmov leg'll.- Mr.-nMh Mjj'.j.e .iful .w'lv-i .iUiiI'uU'n Tfi.j I .Kiel inni.' i!i. iiu1unUi.i1 um'n .nut ih-u .ilku l then u'N|>ii.il'ilii\. ilepo-niion. lek-tHu tf.imliH .lUnli jlk) I'lnlii.iik l.'.k Iivi/V I fie elkk (n "I IiIv/n . Ilk- prnpcriu-N ol llu Will) l!)l IliMItlx i >1 il:' iliu nit: inimnu'. imlim .iv\|uitvd inmi III.' i! '. jn k'iI on 11iv mii .iv . Ilk'll ,u inn. PA I HOI.INK mi I Ik' J'K< k . Il < >1 MU)' iiklml. fi -i11H i!n'i' : .nut m.k v. i .il I \ |v : pel lion.' im N. .il Nl >' .11.xI il l':- r leu .' v x . pl >-i I 'i unt u.!!. ,'-l .i Kf,.. ..... f . . i. . . . ST 0095395 2 i Pathogenicity of Asbestos The effects of fibers in biologic systems may result not only from the properties of the fibers themselves, but also from contamination with inorganic or organic substances that occur naturally or are added during mining, milling, processing, shipping, or use. Contaminants acquired from the atmosphere or in the respiratory tract may be carried on the surface of fibers, f ibers may act as cofaclors; eon* versely. their action may be modified by other cofactors. PATHOGENICITY IN MAN The proven or suspected effects of asbestos minerals on human health include nonmalignant changes, such as pulmonary and pleural fibrosis, and several types of malignancy, notably of the lung, pleura, and peritoneum. Nearly all the positive evidence of an association between asbestos and human disease has come from occupational groups. With few exceptions, these have consisted of workers engaged in the mining and mining of asbestos, the manufacture of asbestos-containing pro* ducts tsuch as textiles and construction materials), and the application anu 'emoval of asbestos-containing insulating materials. DOW 02783 Asbestusis ASM SIDS Ashestosis. or .slvsl'tic pneumoconiosis. was the titn! vle.iilv ii-in<-n strated adverse cited ot asbestos in man It is ehar;u leu/rd In a p.d tetri ot roentgenograpliic changes in the lung consistent with diltnsc interstitial hbrovs ol variable degree and at times with fibrosis and vakil iu I ion ot the pleuia clinical changes that include true laics, in gcr Juhbmg. and shoitness of breath, each ot whicli may he absent m an individual c.ise. ami physiologic changes consistent with a icsti k tivc lung disorder. I tic Inst published mention ot a vase, in a man who had walked tor 10 \ejrs m the carding room ol an asbestos iachny , was b\ II Montague Murray m t`h)7.1,w Cooke reported a second case m I'Od'" and in l`J2" piovtiled a more detailed description/' m wlm.li the term "ashestosis'' was first used. In I`MO. Meiewcthei'"4 reviewed the s;dlent Icattires ot the disease and the environmental exposures "t workers. nuUiding data derived trom an epidemiologic study reported in more detail by Mcrewether and Price.,0< This led l<> the promulga tion of regulations for environmental and medical control in the knited Kingdom, which became effective in I`M2.1 Cases were tirst re ported in the United States m t^and guidelines lor accept able dust concentrations were proposed by Dreesscn i t ul. m l*Mb. *' Industrial expenvmce indicates that pulmonary fibrosis sufficient to interlerc with respiratory or cardiovascular function can be pre vented by reducing asbestos dust concentrations to levels that are si ill far above any likely to be encountered m community air. Pleura! Calcification Calcified pleural plaques occur frequently in workers exposed to usbcstos.<,','JMo;,,07,,r' When multiple or hda.eral. they are re garde i by sonic as almost diagnostic of asbestos-related disease.4' *' In asbestos workers, calcified plaques rarely appear until 20 years after tirst exposure and do not necessarily correlate with parenchymal fibrosis.'*" ( alcilication appears to .lifter m frequency m different occupationally exposed groups, bxit studies are inadequate to verity or explain such differences. Hromlmgcnu t .iiokuiiu Nh k'.llllU s i >| |l|"!' If 'V ' ! palll< >giu 'liK urn Pi mi i! . i! conii.isl wjih the u-u.il!. :.! I'ctiph'-ta! pnm.iiv sil. ' n All cdl 1\ pcs ,|H lepie'Cl.l. . I he (list suggestion fh.if i. ancer >1 the lung w as described squaiifii- . ell u vvitli ashcsiosis le-pit' "ib hrinly supported l-\ epid: McrcwctJiei. ( Imi luspe> i. ported *1 nistjiu . - ,, .n, his depaitjnetil t<> h.iv Io . I`Mb.'"r llos ii-.niuie.i \..\y I *' I li.KX f | hi pels.'-, the same pel i"d 1 il-n ne i" ings in l ,2ns Uines I r* an w tor pneumov"iu.>Mv It. I ashestosis, J "" i *I w ; i* ' 11 i wait '"n.') i ot p i. however, in a Ik*\pii.tl to w been rclciro thus thei a- m I'M-'." .ilk. i .uuk /me : had worked h* at least 'o . tilled as dusty . *m> hided ' curreil unluated .i risk m population. Other si ud ies` - * 111.1 III I4.s,| '4. |<v|i I. f i( pal ion.ll exp> 'Mile I" I'l 'I o| bnmc In Kjeiiu !< . t X cm es III Ihe derm 1 " gloups. piol-jl k : I i I : MevUhell.il l nmois I'l 1111.II V III.lit............ ' 1 leg.ltd d a- ' si ane ev. i. . |n . o . DOW 02784 ST 0095396 ST0095397 Bronchogenic Carcinoma S> 1 U\lt UlOs ol l'r< >lk III igcllh V .IK lili'!!' I ISM >v l.l U 11 W 1I11 ast k s I H. p.iiink'iu utK >Mk . I'liin.iiv mU'n .ik- in 111\* l>>w t lull. n. 1:1 t outlast M till tile llsllallv Illl'llCl I f * ' P k l u V >'l lippcl )<)'> lull" US JViiplictaJ pnni.n > sites ,n i- . mi nil'ii in aslvsft <s ielated Inm* > m i Ml i c tt iv pcs ui c i cptesculcd m itn'sl m i n-s. I he hod suggestion that asbestos might be unsallv icl.itcd l> cancer ol lho long was made tn l*MS by I yiivh and Smith.who JommIviI squamous cell v au mottia in a Son 111 < atolnu textile wot V ct with asbcstosis. Dcsptc other iv dated leporls. an assov i.ition v\.i\ nnl firmly \upjn>rted by epidemiologic evidence until D*47. when Merewother ( hiel hispev toi o| I ,k lot ha m the t'uled kingdom, ported .' I instances ol . .nicer ot he hint' hi s pel sons km * n In his department to have died with ashcstosis between Ihjl md I'Mk.1"* This constituted an MKidemvot I . compared with l. 42'i tlD (>.KX4 m persons eertitied as having had silicosis during the same period. (Hoync in W5D1' reported on the pathologm lind iiijis :n l .205 limes from workers w hose eases were being ev a In a ted tor pneumoconiosis. hi I *2 asbestos wotkers, he tound IJl with asbestosis. I 7 ol whom, or 14.1)' , had eaneei "t I lie lung. . mu pared w itli 55 u>.4r - r ot 7*><i persons who had silic is. I he studs was.lone, however, in a hospital to which suspected tumor patients would ' ivc been reterred; thus, there may have been an oveiednnate ot itsk. Doll tn (U55.M alter analy/mg the causes of death among Itis tnenwho had worked toi at least '() v eats in areas ol asbestos lev t lie plants do* lined as dusty, eon* luded that the IX eases ot lungt.iikei tluto. eurred indicated a risk about 10 times that m the genetal mate population. Other siudies*1 1 *1 * *-'*; '* * * **'".......................- ....... m.i .i4vi'4. icv.i<.i.i..4 |);jU, ^,,|iinined an association between no a pjlroiul exposure to asbestos and a higher-lhan-espected in> nlenee ot bronehogenic cancer. Some siudtes1' have deinoiistr Med dittcr- eiKes m the degi CO o| risk among dilTcienl occupationally exposed groups, probably related to d se. as w ell as to < ntiei t.u tors Mevjfhclfal Tumors Primary malignant tuiuois ! the pleura and peritoneum have been regarded as exceedingly rare by most pathologists, until recent \>\Us some even |ucsli*ned their exists nee. I here are still dtllercu* es <*1 DOW 02785 ASHIMOV opinion as to diagnostic criteria. Therefore, statistics on prev alence or incidence in one geographic area cannot he safely compared with those Jrom another. Adherence to strict diagnostic criteria, in cluding an autopsy complete enough to rule out other primary tumors that could metastasi/e to or involve serosal surfaces, is a difficult constraint on a retrospective series. It was after !`h>0 that serious consideration was first given to asbestos as an ctiologic factor in mcsothelial malignancies. In that year. Wagner <7 at,M reported 33 eases of pleural mesothelioma in a part of South Africa important for erocidolitc mining. For all but two ot the patients, the authors discovered likely asbestos contacts two decades or more earlier. However, only 17 of these had had oc cupational exposure. The remainder had lived near mines or had had household contacts. Although mesothelioma had previously been attributed hy some to asbestos exposures, k*7m.i#.$.im no evidence of a strong association had been developed. Additional information supporting a relationship between asbestos and malignant mesothelioma has accumulated since 1%0.9,,J,W,,,7'4U An outstanding fcV.drc has been the long period, commonly over 30 years, between the first exposutc to asbestos and the appearance of a tumor, as emphasized in reports hy Wagner'*" and Selikoff and Hammond.1'3 Other Neoplasia Associations between asbestos exposures and malignancies of the gastrointestinal tract and of other sites have been reported, but the d3ta are still inconclusive.*J'S9,,*,9,'n3 Mutagenic Effects Evidence of a mutagenic effect of asbestos has not been reported. PATHOGENICITY IN LOWER ANIMALS A comprehensive review of information derived from experimental work in animals entails consideration not only of the variables re lated tti the type and dimensions of the asbestos fibers and of adsorbed nr concurrently administered eontiunimmts. hut aim of the species and strain ot animals, the route of administration, and the Pathogenicity of As- time and dosage lac perimental models if man. but many tsola dated. The studies c and those dealing w: Experimental Asbes Asbcstotic pulmona in various species ot pjgs^9.4s...s7 ham the studies, the dtsi man, c.g.. it was mi but to do so it was asbestos dust and h posurc. (In contras lower cumulative e has been asked wh> confined to fibers . answered. Experimental Neo Lung cancer from in rats5" and in m used different met lung cancer in the has an increased o chromium, and cc whose lung cleara cancer rate of am. Canter of the p in rats and hamstt most common ty dust introduced i lation of results t The studies of mesotheliomas o* amosite. or chr\ s evidence of migr. DOUJ 02786 fifiCSfiOOiS Pathogenicity of Asbestos 7 turn* ami dosage factors. I'hcrc are at present no satisfactory ex* pcntncnt.il models to duplicate prolonged inhalation of asbestos by man. but many isolated segments of the problems have been eluci* dated. I ho studies are best divided into those dealing with asbestosis uiut those dealing with neoplasia. Experimental Asbestosis Ashestotie pulmonary fibrosis has been produced experimentally in various species of animals, including rats.4**5*'156,157 guinea pigs.;9,45,4`M51 hamsters.55 rabbits,'5' and monkeys.151 in many of the studies, the disease resembled early ashestotie development in man, e.g.. it was multifocal. Diffuse fibrosis has also been produced,*57 but to do so it was necessary to use very high concentrations of asbestos dust and long periods of exposure or observation after ex posure. tin contrast, experimental silicosis can be produced with lower cumulative exposure.) In the course of the investigations, it has been asked whether the fibrogcnicity of asbestos dust is mostly confined to fibers longer than 5 pm;45*'54 the question remains un answered. Experimental Neoplasia Lung cancer from chrysotilc dust has been produced experimentally in rats58 and in mouse lung implants.159 Other investigators who used different methods for introducing the dust'42 did not find lung cancer in the animals they studied. That some asbestos dust has an increased content of trace metals - particularly nickel, chromium, and cohalt may explain these differing experiences. Rats whose lung clearance had been artificially impaired had twice the lung cancer rate of animals with normal clearance.5* Cancer of the pleural surface (mesothelioma) has been reported in rats and hamsters that received intrapleural injections of the three most common types of asbestos.,3*US9,"M> The amounts of asbestos dust introduced into the thoracic cavity were very large, and trans lation of results to human inhalation of asbestos is uncertain. The studies of Roe et which involved pleural and peritoneal mesotheliomas of mice after subcutaneous injections of crocidolitc. amosite, or chrysotile. are of particular interest because they yielded evidence of migration of fibers. DOW 02787 XSHI SHIS Yiiut.iIK Occurring I tlects m I owcr Animals l heie is no cwdciiu't li.it cl lev Is m domestic or wild a nit mils are mipoit.mt .0 >.nU-iM lor controlling aslvslos emissions. S. hosier lias ik-Miilvtl pulmon.u\ aslvslosis (without the development hI asbestos bodies) m .1 ihn* ih.t lived }or nearly )0 years as a ratcatcher to .: \ >uh>n asbestos factory.1*7 Webster lias demonstrated fibrosis in donkeys. baboons. ami wild rodents in Si*ulh Africa.1'" and Kivitn-li> has Jest rihcd the finding o| anlhophyihte asbestos in the lungs >t .1 i.'U m an anlhoph\ Ihle prodm me area ol I'mland.'" SI I DibS IS VIlKO I heie have been limited studies ol the effects of asbestos in biologic ss stems in mm l-or example. M.icNahaml I lirinyt<>n'r* demonstrated m l`n-.7 that ashes: >s would hcmoly/c sheep erythrocytes This lias been confirmed by olher\.,:`'*,> Cbrysotile differs from amosite. innnlolite. ami jnttiophy Ihle in the conditions under which it is hcniolx he. I\tn//i t / <jf n'' demonstrated in l`>h.x that both crocidolitc and Jir\ softie were cy fofuxic for guinea pie macrophages in culture, i he asitviis .>t ihe tormer was greater. the cytotoxicity *>| neither was inhih'ted by polyvine Ipyridme V-o\ide. a macromolecular chemical that ts etfeelivc m preventing the cytotoxic damage caused by crystal line sills a in experimental conditions. Although the foregoing type's of study have no known relation to tihrogcnic or caieinogenie effects in fun. they proside systems that may prove useful in determining mechanisms o| actum and approaches fo prophylactic or tfierapeuuV measures. INHL kNt t OF MAJOR VARIABLES ON PA I HOt.fcNK t I Y 'Mien considering tin influence* of type of jsK-smv fiber si/c. and cofactors on biologic lects. it is necessary to emphjsi/e that a.! hiwm attribute may inlliunee n-spnatuhly. iteposilnm. ictcnlion' clearance, translocation, and biologic reactivity in differing ways Although some in vitro and laboratory studies yield different responses to different types ol asbestos, the results do not justify draw mu lirm u'iv. hisinnx as to the relative pathogenicity of the Pathogenicity ul Asbestos dittcrcnt Ivpes Nor !> .-pin sm.li ditII'H'i'u's AH iIm- produce asbestosis Jn on!;, ol malienaiicies hemi <l< t-rn single asbestos |\pe \Mier- as in the chrysotde peohini there are possible >-xpl.niain hestos type I be high mcul< Western Cape area > Souih crocidolitc is unusually ha/, rare in the Transvaal. w her-though SehkolI </ (// 1 *' tn workers whose exposures h. site. Sluis-f remc 1and W> ot mesothelioma high in .hy and McDonald </ .// did mining ami -milling areas .t All epidemiologic studies pathogenicity among types quantitative d.H.i on cumut. the presence <>! eol.u t'-fs | graded as lo relative risk wit l iber si/e is critically imp position, retention, ami ele. probably an impott.mi dele logic action. I ittle is know the human body. including gastrointestinal tract. I lie a largely on tlieir diameter. 1 garded as being m the resp* position, longer libers app.ir Until recently , mosi wi fibers delectable by the - p finitely 0.5 pm diameter an microscopic d-.Mi todmiqu Ihe variables that must tv . contain many I M-si/cd tim demonstrated."*1" There t permits the assigning ol rei range, ciunpared with tibei relative risks associated wo ST0095400 DOW 02788 I'athogonieitv t Asbestos u dU'Cient l\pvs \m do I'J'lili'TtlH * I* `l1 IV st I III ICS COIK'llIMVl'Iy support uv.li dincieincs Ml iln* commercially used lornis of asbestos .;m pi* iime asbcstosis. It* only telahvclv lew- studies lias the modcruc vt m.iltenaiuKs boon determined m primps will* exposures to a Ntni'lo asbestos type Where Iboro .iro data that suggest ;i lower risk. ,iv in tl*o ihrvsoiitc-producing areas ot CaniuLt'*''^ ami Italy.1'4 there aro possible explanations lor the dillcrcncc other than as bestos f\po The high incidence of mesothWial tumors in the North Western Cape area of South Africa has led to the suggestion that i.roeKloltte is untistialk hazardous. but mesotheliomas have been ure m the Transvaal, where croculolite is also produced .J'M<T Al- tluMii'h Selikoil ci a! T'1 lomut main mesotheliomas in insulation wotkois whose exposures had been largely to ehrysotile and amo- site. Sluts-Cretnei1 ,T and Webster"'-' have not lound the incidence of mesothelioma high in areas where amosjte was mined and milled, and McDonald </ a! I"a du) not report an excess m the ehrysotile- nititins and -milling areas of Canada AH epidemiologic studies that appear to indicate ditferences in pathoeemcily among types ot asbestos are flawed by their lack of quantitative data on cumulative exposures, fiber characteristics, and 1 lie pi csciu e it cotactors The dd lerent types, therefore, cannot be graded as to relatixe risk w ith respect to either asbestosis or neoplasia. I iber si/e iscnticallv important in determining respirability. de position. retention, and clearance from the pulmonary tract and is probable an important determinant of the site and nature of bio logic action. I.title is known about the movement of libers within the human bod>. including their potential tor entry through the gastrointestinal tract. The aerodynamic properties of tibers depend largely on their diameter: libers below .V5 pm in diameter are re garded as heme in the respirable range.f iber length affects de position. longer libers apparently having treater hbrogemc eltocts,41 I'ntil recently, most work and speculation have involved only tihers detectable by the optical or light tmeroseope (I \D. approxi- m.itclv l) 5 pm diameter and larger. I he application ot election microscopic techniques*'* has enlarged our horizohs as to the variables that must be considered Tissues and air samples may contain man\ I M-si/ed hbrils for every IM-st/ed libet that can be dcmonstiated.,',*M< There is. however, no body ot knowledge that permits the assigning of relative risk factors to libers m the TM range, compared with libers in the I M range It is possible that the relative risks associated with libers ot ddletcnl sizes .ire dilfercnt 0278^ 0ow ST009540 I l<> ASMS I OS tor nonmalignaiit jihI malignant changes. I he evidence tiiai bundles ot hbrds may he broken clown within the body to individual fibrils ic important.,4* A number of investigators have postulated that a probable role of asbestos fibers in producing disease is to carry toxic or oncogenic substances to vulnerable sites. Studies bearing on this have included analysis of various types of asbestos to determine the contaminants present, with special emphasis on metals2*-27 and polycyclic hydro* carbons:4'-*1''*4 studies of the elution of contaminants in biologic materials:2* and the concurrent exposure of animals to asbestos and to other materials.10* The present consensus is that contaminants are present, but a special pathogenetic role is still speculative. The work of Sctiknff </ a! 1,4 strongly suggests a synergism of cigarette smoking and asbestos exposure in the increased risk of lung cancer in insulation workers. It is not known whether this is because of reduced clearance of asbestos, transportation of cigarette-smoke carcinogens by asbestos fibers, or the promotion by one factor of cancer initiated by another. CO o o 03 c_n 4T O ro Evid Non> Exp* Direct and indirect evidence ing directly with asbestos m is of several types. For exa; strated in the lung* of perso a few geographic areas, path ing a reaction to asbestos (e found in populations with r Asbestos fibers have been d FIBERS IN LUNG TISSUE Structures that appear to K tcrial were described in hint In 1929. Cooke1!* described with pulmonary fibrosis. St as "ashestosis bodies.*' Hcca hihit them a few months afi that they were evidence of i term "asbestos body" came DOW 02790 3 Evidence of Human Nonoccupational Exposures to Asbestos Direct and indirect evidence that persons other than those work* ing directly with asbestos minerals arc being exposed to asbestos is of several types. For example, asbestos fibers can be demon strated in the lungs of persons not occupationally exposed, in a few geographic areas, pathologic changes regarded as represent ing a reaction to asbestos (c.g., pleural calcification) have been found in populations with no history of occupational exposure. Asbestos fibers have been demonstrated in ambient air. FIBERS IN LUNG TISSUE Structures that appear to be fibers coated with a pigmented ma terial were described in lung tissue as early as 1907 by Marchand In 1929, Cooke14 described such "curious bodies'* in association with pulmonary fibrosis. Stewart and Haddow10 referred to them as "asbestosis bodies.** Because those who work with asbestos ex hibit them a few months after starting work, it was recognized that they were evidence of exposure, hut not of asbestosis. The term "asbestos body*' came to be the preferred designation. U DOW 02699 fST00 95 3 0 VSHI SIOS W jv Itu t -sited IiKis weie lound mi persons known to haw i ii > | `>t 11< rn.dk exp' 'm'i! In asbestos. the itK'til il > u| I In.- tvnli.il til*, i wa-. 'hUIoiii <|tnsh< >ued. .it 1111 n il* Ii limn limv I" liinv smiilai d-* vst it l"iniit m pci sons with no know n exposme to asbestos M nnnan*"' in Mimni.ili/vil 1`* lepofts published between and in which these olivi.l' weie associated with ex- I'osiu. fi- yiaplutv. mal. hornblende. tulilc. dialumaceous v.irth, .ail'i'iuinluni, ami talc (m which taw trviimhtv asbestos ini^hl liaw kvu invokedt. I lie demonstration by t boss and m-workers'4''' that -tlivJ hlviN may produce such bodies in experimental animals indicates tlial they result Irom a nonspecific reaction to any sparingly o'lul-lv Jil''.is i<11> iei' body. as had lust been su.cecsted In Cooke it CO* " I licit is tlnisamplv lust 11 u a I ii 'ii lm ahumlmiiii}! "asbestos t v .Is ' ,i% .-Jsiuiiv Icun.m I'H'V lumiiir1 sn^jleskd the term ' iiiiiivi.il lihvt I'.'tk, " and. in I'Niti, tifoss'' ivcnuiiKiiilvd "lei i ,iei ' :' hods i ii.>ms.-ii < i .it m I `to v w t rv Ihv t list to show Ilia I these v .Hcd liK'is were present in a hi-h propoition o| hnif*s obtained by I 'uiuu .i.itivpss |hey lound that 4 o| lmi)! sme.ns in SOU f.isv v .tiiVv autopsies m < ape I own showed wbal were called "asIV'T' > n-'dies " Kepoits Irom mjny othei aieasltave confirmed a hieh [r. taleiKt m I tines oh tamed m similar autopsy series. * `f ' ' " t 'in Ilian it if '1,1 i nl et red that, it a sutlicient volume f ate U'vi\ ssei .-x.mmud m v.kIi ease, ncatk alt persons would he toniiit to haw s'.ivll hodies. their study ot |(H) luilijs in Ihltslniich eon iHin.ul Ho m s'lecestio.i Ideutihvatioii ot the tine tiheis has proud to he a lormidahle it vlmiv.tl task '* U it (tout libcr-by -liher a naly sis. all that tan K saul is dial fated tiheis lewmtslui)! those in asbestos workers ait pi-serit m most persons m nrhan eetileis Shippiii)! the coathi)! and analy/ntL* the tores by various techniques tan sometimes ilemon- shaie that the tores ai\ asbestos, hut the process is tedious and >|ten MlmHi'1 IslW Atl' iition is now heuty directed toward study. not ot the terrujnus hiulies .done. htU ol the total liher content of the limes. whether such tiheis are mated or uncoated. In a study ol .t.(XH) eonweuln e autopsies m New York City. I utijjcr ft <//.** haw lound Ih in. tin loaf.d "p I it all v tisihle hlvrs m two thirds the 1.44`Huny: sped mens it. whit It touted tiheis were demoustuted and in one fourth ot tli"s in wlii. h malt'd lilvis were not dt immst taletl. I wenly-eijjht v use. uint saiuplis o| luii)! tissue 11urn the same senes examined l-.videncc of Human Nonotv hy electron nucrosmpy wen tthers M looley ft of "* has I vulence is theielore stro s,irids nr millions ot libers. S GO ami other types ot asbestos most persons not ocswpatini O ol libers are relatively small, o occupationally exposed.1 ,J 1 NO live techniques, measuring b< cn GO to define a gradient t accur deuce <>t disease, on the onexposure, on the other Although there appears nin many Imnian Junes. there asbestos.**-0 Some are | rol>. and plant products, such js p vilremis} libers have aiso^hee human hint's. "Calc, often usecontain a siemticanl amount Inloimalion is sparse mtu with mcreasme use ol ashest it .mi dillereikes between nit Haimnond1 *' compared huiu* loiind no siynilit.ml itKfe.i'v boilies. This suyeested that ii York City between |lH4 and nous bodies i.ad not been m>. Chantzdlyun Um,<: reports a bodies in samples ot Junes In !*{>. 105b. 10bb. Pl bURAL CAUTI ICATIO' THE GENERAL POPULATI- Meurman.,M1 m l*>bS. revtev pleural calcification and asln slronjily stiyecsted an assou. mmoccupationul exposures i Kiviluoto7'' reported t.duiK deteeted tlurui).' mass roentee OUJ 0^700 ST0 0 9 5 3 1 2 fvntcmc of Human Nonoccupational Exposures to Asbestos I.) **\ JvAhim microscopy were i'omul to contain IM-si/ed chiysotilc ribus''4 Poolcy c/ u/ "" have reported similar findings. Ivnteruv is iheietore strong that most human lungs harbor tlmu vu.ds or millions ot libers. Some ot these are chrysolite asbestos, ut.d t*iher ty jh*s ol asbestos minerals are probably there also In most j*ersons not occupdtionally exposed to asbestos, the numbers t nbefs are relatively small, compared'with the numbers louml m the owupahonally exposed.1 '* I lie systematic application ol quantita tive tcduiKptcs, measuring both coated .md uncoated fibers, is needed todetme a gradient ol accunu.lated libers lor correlation with inci* deiue ot disease, on the oik *' *. and history ol environmental espoMire. on the other. Ahhmigh there appears no doubt that asbestos fibers are present a. many human limps, there are sources ot airborne hhcis other than .iNbestos Some are probably derived from the burning of leaves jiu! plant pioduvts. such as paper, wood, and coal. Man-made (mostly vitteous) fibers have also been identified in the sediment isolated from human lungs laic, often used generously as a dusting powder, may t<Mluin j significant amount of tfcmolitc asbestos fibers. Intoi maiion is sparse concerning possible increase ol fibers in lungs with iiu Fc.tsing use of asbestos and concerning tile existence of sign if* K.mt dti'. icnces between urban and rural populations. Selikofl and llaittiK <..!' compared lung tissues obtained in 1934 and I9(>7 and tound no significant increase in the proportion containing ferruginous bodies. I his suggested that, despite increasing ise of asbestos in New York City between 1934 and 1967, fibers of a type producing ferrugi nous bodies had not been increasing at a corresponding rate. However. ( lung-1 ly tin Uni15* reports an increase over each decade in asbestos bodies in samples of lungs from persons who died in London in 193b. 194b, 1956, 1 %6. PLEURAL CALCIFICATION IN THE GENERAL POPULATION Meurman.1"7 in 1968, reviewed critically the literature related to pleura! calcification and asbestos exposure. A number of studies stiongly suggested an association between pleura! calcification and nonoccupationa! exposures to asbestos. Lor example, in I960. Kiviluoto7" reported calcifications in 9'7, of the adult population delected during mass roentgenographie surveys in a Finnish commune DOW 02701 u ESKIMOS in whuh there was .in jNhestos mine and null. the frequency was low tor the remainder ol the linmsh population. K.iumo11'' enlarged on tlK'H* observations m !*<*(>. reporting th.it. ot n.U,2(M chest films t.iken in ! inland he tween I *><() and !.$!(> showed p!etir;il cal cification. I.2.>2 i . the letter were among 4.1.4M films t.iken m 10 communes m whuh there were .mthophylhte mines. Rock .mil soil m such areas also contain much aslvstos. so that the demonstration that airborne anthophyllite could he ilemonstrateil over 25 km from the mines is not necessarily relevant. Anspach4 reported that, ol 244 suhtects with pleural calcification found in a chest roentgenographte survey m Dresden. 177 had either worked in or lived near an asbestos factory, /olov <7 ill 170 described a 5. !'' prevalence of pleural calci fication in a rural population in Bulgaria and suggested that the most likely cause was asbestos m the soil. However. Mromck,72 Marsova.'"' and Rousutid Sludeny,12* reporting on a high prevalence of pleural plaques in a rural district of Czechoslovakia, have been unable to demonstrate a soutce of asbestos exposure. I he consensus at present is tlut calcification alone may not invariably he considered an index of asbestos exposure in the general population, although it may prompt a search for an environmental source of asbestos. MEASUREMENT OF AIRBORNE ASBESTOS A more direct method of obtaining evidence on the likelihood of exposure of the general population would he the sampling of air to determine the presence and amount of respirable asbestos fibers. [ here are. however, many uncertainties as to the best methods of sampling, identifying, and quantitating airborne asbestos and inter preting data so obtained.Limited information has been derived from measuring fibers on sampling sites; for example. Laamanen et al*2 showed asbestos fallout diminishing rapidly be yond I km from an anthophyllite quarry, but still detectable at 27 km. Counts of asbestos libers collected on membrane filters by high-volume air sampling and estimated by light microscopic tech niques similar to those used in industrial hygiene have shown small numbers of fibers in a few urban sites.10,1'' Such results, although showing numbers of libers detectable by the light microscope that were low by occupational health experience, have been too few and variable to be used with confidence. Alternative methods that are l.vidciue o( Human Nonm-tupai currently under development u and mass ol libers in the l \1 m. measurable concentrations >1 air "* Such enviromueMt.il t stages ami provide lew slues t.i Irom this type ol exposure I*, .o ST0095313 Evidence of Human Nonoccupational Exposures to Asbestos 1S currently under development, including estimations of the number and muss of fiber* in the LM and the EM si/e ranges, have shown measurable concentrations of asbestos in many samples of ambient atr.'^'t w Such environmental measurements are in their earliest stages and provide few clues to the extent or significance of the risk from this type of exposure to asbestos or to other mineral fibers. ST0095314 DOW 02703 Estimation of Risk in Nonoccupational Exposures to Asbestos Industrial experience has shown thjl prolonged inhalation ot ashcsi->x can increase the risk of neoplastic disease, Examination ot lung tissiu has made it apparent that a much larger proportion of the gcnoial pub lic has inhaled and retained asbestos fibers titan had formerly been realized, tn tact, most urban dwellers have some such fibers m their lungv Can these facts be related'.' Does the general public as well as persons working near occupational sources, living in the household' of asbestos workers, living in the neighborhoods of asbestos plants, or having occasional random exposures have a dctectably increased r/sk of malignancy or other disease because of airborne asbestos' The limited information available to answer these questions comes either from direct epidemiologic studies of groups with various levels of nonoccupational exposure or by extrapolation from the experience of industrial populations with direct or indirect asbestos exposures EPIDEMIOLOGIC STUDIES RELATED TO NONOtTUPAllOS M EXPOSURES Two general indices of asbestos exposure are availahle lor use in direct epidemiologic studies of groups not known to he occtipa l(> Estimation ol Risk in Som C/> --H O o lO cn GO cn Initially exposed !> ,r.t>esi-> member's place ol work and latent periods ol aslvstos i. each person's whole liletmu each memlvr's lung conieni direct epidemiologic stmlic' questions at issue. I he only studies ilia! ap[ men! ot malignancies in jki involvingdiffuse mcsothelf has been the subject ol spec the mesotheliomas reported attributed to household am producing area Although t been described as suhslauti. 7u patients with mesotheh Id17 to ldf>4. Ot these. ' jsbestos. d ( 11i Ii.kJ j r. < 14.5'.* i had neither ol tin.mile of an asbestos ijclorv Corresponding percentages (paticnis-m the same hoxpii and X l h'Stumpluus and the community near the >l of 21 me `humus repoi |do7 had been in workers < tos workers. Raimio"-' l<> peritoneal malignancies in cations attributed to aufho chest survey films. In a h i Uorow<7a/.i: j)) huI two asbestos mill, although the drawn came trom an area t virons. Lichen and Pistawi theliomas reported in I'eni K lived or worked close i< hers of families that mclu of exposure could be obi. able random exposures \ on U'S fatal malignant m ( anuda between 1 dSd .mk DOW 02704 ST 0 0 9 5 3 16 1 %um.iiioii ol Risk lit NoiiKToputi<mnl Lxposures to Asbestos 17 *Hv c\|oscd to asbestos I Ik* hrst is based on knowlcdpc ol each rubci '' place ol work amt place ol residence; because ol the lonp o. i jvikkK tl asbestos-related disease. this knowledpc must covet . h person s whole hlelimc. I ho second is a quantitative estimate ol h member's bmp content ol asbestos lilvrs t here are low such liiov i cptdcmioiopic studios. amt lho> aro inadequate lo answer the I lo-iions al issue. I ho otdv studies that appear to implieato asbestos in the develop- '. ?ii o! malignancies m [vrsons not occupationally exposed are those a -Kme diiluse mesothelioma, a tumor I hat is uncommon and that i Kvn the suhiect ol special atlention m recent years. Many ot Miv ru.-sotlieliomas reported hy Wagner vt ui in Soulh Africa were niubutcd to household and neighborhood exposures m a cToeulohlc- ci siiume area. Although nom .cupalional. these exposures have Kvn described as substantial.,,,M Nowhouse ami Thompson*11 studied patients with mesothelioma diagnosed m London Hospital front '>1* ft ()| these. .*1 <40X'.> had occupational exposures to .inK-sIox. *f 111 X . | hail a relative who worked with asbestos. 11 'It' i had neither ol those backproumls but had lived within a halt- "dv *! an axhesios taclory. and -5 <52.7',' t had no known contacts. lu-qvmdrnp percent.-res tor a proup ot matched control subjects n -iie-tis m ihe same hospital lor other diea -csi were 10.5, 1.5. o b. eid * I > Stumplmis and Mevcr14 reported no mesotheliomas in ih.- tnummlx ne.n the shipyard ill I hishmp < Holland 1. althouph I 7 i I nestUheliom.is reported m the province ol /eelaiut in l`M- had been m workets m that card, but not m insulation or ashes- 1 ' is ukeis Ratmio"'' Sound no excess of pulmnnarV. pleural, or ntorie.d m.dipn.mcies m the areas of lunland where pleural calcili- ti'-ms attributed to anthophylhte were present in h-`t of routine he't surxev tilins. In j senes of I 7 mesotheliomas collected by H- tow /all but two were in persons who hail worked in an asbestos mill, although the autopsy series from which the cases were drawn came from an area that included inhabitants of the mill's en* v*rns. l ichen and l*istawkaM found that, of 42 persons with mesi>* fhehomas reported in Pennsylvania. 10 had worked in asbestos plants. ^ lived or worked close to an asbestos industry, and 3 were mem* : ot families that included asbestos workers; in II. no history l opoxure could he obtained, and the rmiaming 10 had question- d'lr t.indom exposures. McDonald <7 al'"* collected information u lbs tat.il nuhpnatit mesotheliomas known to pathologists in i ida Ih tween 1`tvt.iml I`Un I he> continued an association DOW 02705 I.\ ANMStOS with (Kktip.ition.il exposure to asbestos luit concluded (hut (he ex cess w.o in tin- ntamil acfure and industrial application ol asbestos, rather tlum m numtu1. or milling, it ts apparent that no quantitative conclusions were possible I'ront these simlies. which present serums methodologic problems to the epidemiologist. They surest a risk in household contacts aiul in resilience m the immediate neighborhood of an asbestos plant. I'here appear to be different levels ol risk in dif ferent types of occupational exposures, anil some of these may be re jected m corresponding household and neighborhood experience. In no analysis of causes of death in a large population has there been quantitative estimation of the lung content of ferruginous bodies and bare asbestos fibers, to determine whether a detectable gradient of disease can be correlated with asbestos content. The series so fur studied have been too small, and methods too variable, to permit any conclusions as to the importance of small fiber numbers in the lung. EXTRAPOLATION TROM OCCUPATIONAL EXPERIENCE Another source of evidence of the relative risks associated with in haling moderate or small numbers ol asbestos libers is the experience of persons who have had occupational exposures below those known to be definitely hazardous. The maximal airborne fiber concentra tions recommended for prevention of usbestosis are much higher than any likely to be encountered in nonoccupational situations. |-or ex ample. one recommended standard would limit the average concen tration of airborne chrysotile to 2.000 libers per liter as determined by light-field count.'4 Another that has been proposed would limit average concentrations of fibers to 5.0(H) libers per liter.2 Occupationrelated asbestosis can be effectively controlled with airborne fiber con centrations much higher than are likely to be encountered in nonoccupational situations. It is important to determine whether workers whose exposures have been reduced to levels that prevent or greatly delay asbestosis. us well as others whose exposures are indirect, have a lower risk of lung cancer than those with higher and more direct exposures. Workers who began employment in a British textile null after l`M.\ when implementation of the Asbestos Industry Regulations of PM I reduced (hut did not abolish! dust exposures, were reported in l*Kx to show no excess of neoplasms.*1 T he long latent periods of asbestos-related lung cancer and mesothelioma, which would prolv GO Estimation of Risk in No; O ably he even longer at l<v o draw final conclusion as NO cios. Nevertheless. rcdiR\ cn Another indication ut red co wilh lower exposure is m lhal. although there were respiratory disease among previously in .. I omlon as among those who had low recently reported the m>r chrysotile mine* and mills lung cancer among the 2.all could be explained by been maximally exposed, miners and millers are con creasing accumulated do\a Vlosi senes ol cas: rep' who have worked m the o in trades not involvin Mini as plumbers, electricians, j ginous hodics in their l ing Dunn and Weir.H in a stui revealed an excess ol ileall found no excess lung canci groups they studied were o likely to have had exposur gradient of effect within tl studies of groups with indi One cannot extrapolate one hand, those who arc di in their employment to. on have had moderate or sligh evidence to suggest a grad.e indirect occupational, to la of winch dust concentratio most community air. T his exposure that wiibnot be a* those levels are is not know in the general population s neighborhood exposures h though there may be lerrug DOW 02706 I -tmutinu <l Risk in SimiKiii|>iiii(m:il Ixposures to Asbestos l`> 1,1 v Iv ex cn longer ,it l*\vci dose levels, arc such 1 hat it is loo soon to ! iu iin.il.iinclusions as to the eventual incidence ol those malignan* ' \e\ei Iholoss, lotimvii exposure seems lo he having .in eltect. Vi*thci uulu.ilion ol reduced incidence or delayed onset ol disease .mili lower exposure is in the observations ol NewhuUsc.*11 who lound that, .illhough there were more deaths trom lung cancer nut chronic -.i 'I'ii.iIoia disease .unoni! those who had heavy exposures many years :m. \iouv|\ m ,i I ondon asbestos-products plant, tins was not true aion.j those who had low or moderate exposures. McDonald e/ ul upends reported the mortality e\|vrience ol men who worked in . In \ sonic mines and mills ot t.hichcc. There was a .light excess ol l imu v.Huei among the 2.4^? deaths in workers born 1 XUO- I `>20. but !l > <l*e explained by the excess that oeeurred m those who had ** vn maximally excised. I Ins suggests that, insofar as ehrysotde mneis .nnl millers are concerned*, the risk drops oil rapidly with deK-.isme accumulated dosage. Most series ol ease reports ol mesothelioma include some persons \xho have worked in the construction or shipbuilding industries, but in trades not involving ditcct contact with asbestos.1"* Such persons as plumbers, electricians, and metal workers often have more ferruunions bodies m their lungs than do white-collar workers.1 M Although Dunn and Weir.u m a study of occupational groups in California that levealed an excess of deaths from lung cancer m insulation workers, lound no excess lung cancer deaths m other construction trades, the groups they sludied were diluted with many persons who were un likely to have had exposures. Nevertheless, there may lx* a definable uradicni of el tee t within the construction trades. More thorough studies of groups with indirect exposures are certainly needed. Due cannot extrapolate from Ihe mortality experience of, on the one hand, those who arc directly and indirectly exposed to asbestos m their employment to. on the other hand, the general public, who luxe had moderate or slight exposures from ambient air. There ts exidencc to suggest a gradient of effect from direct occupational, to indued occupational, lo family and neighhoihood situations in all "t w hich dust concentrations arc probably high by comparison with most community air. This suggests that there arc levels ol asbestos exposure that will not he associated with any detectable risk. What those levels are is not known, but there is no evidence that persons :n the general population without occupational, household, or neighborhood exposures have any increased risk of neoplasm, even though there may lx* ferruginous bodies or fibers m their lungs. DOW 02707 ST00953 18 5 Sources of Asbestos Fibers in Ambient Air Precise information is not available on tonnages, numbers of fibers, fiber si/es and varieties, atmospheric dispersion, and ultimate fate of the asbestos emitted into ambient air. Although there are no reliable data to justify extrapolation from the more completely studied tu. upational exposure experience, information regarding actual and po tential sources of emissions of asbestos fibers is of value both for directing future studies and for understanding the steps that might be taken now to safeguard the health of the public. NATURAL SOURCES OF AIRBORNE ASBESTOS FIBERS Several varieties of asbestos ore and counterpart rock (containing f M-si/ed asbestos fibers) occur as outcroppings or are just below the surface of the earth throughout the world. Asbestos fibers can become airborne from these formations during road-building, con struction. and tilling of the soil, as well as by landslides, erosion, and weathering. Talc, mined and used extensively in the United States, exists in fihrous. as well as platy. form. Like asbestos ore and rock, talc exists on or close to the earth's surface and is subject to dissent- 20 Sources ! Asbestos Fibers i CO ""* o o so CH co m. VO mating forces. Such nalura. i|uantihes used as a diluent a background liber concentrai thought that studies ot liber' will permit comparison^ of u and Ihvreny provide definite dons nl natural and indusin.. MINIM. AND MILLING OF Mmingand milling <t ashesU emissions. In the United St. to a tew mines in California. I ihcrsare emitted during ren the ore body for open-pit mu mg and ore-breaking. Waste posed to wind and to disturb; during drying, crushing, grind collectors and air-cleaning dc\ dust provide^ a potential sour transportation of m A I ransportatum of asbestos 01 containing products and nj'i importance. Movement of as! trucks contributes to the over asbestos fiber, usually in bag' reused, either in the asbestos i a source of fibers. Occasional spilled during handling. Snml of products. Transporting ast* vehicles through urban areas c MANUFACTURE OF PRODl Industries that must provide v measures for the protection ol DOU 02708 s..iiti N ut \sIh*\Iis Filters in Ambient Air iiii: li'ikvs. Sikh naturally niuiiung talc, ;i\ well as the large >:>ritK\ used as a diluent anil earner lor pesticides. ean add to the . ki'i.mmi td'ei concentration in the amhient h is it*.n:*ht that studies o| fibers in glacial and polar lee now under way a'H jvniiit comparisons of roeent deposition with those in the past r -l theieln provide definite information on the relative contrihu* >>t n.itni.d ami industrial sources. MINIM. AND MILLING OF ASBESTOS Mu.me .uul inillme ot asbestos constitute another source of asbestos v*iis. in the United States, such activity is presently confined i ` i tew mines m California. Vermont. Arizona, and North Carolina. I ilnrs .ue emitted during removal of overburden and preparation of Hu me body tor open-pit mining. Further release occurs during drillme .md orc-hrcjking. Waste dumps from mining and milling are ex* p-*sed to wind and to disturbance by bulldozing. Fibers arc emitted t ome di\ mg. crushing, grinding, and screening of the ore. If dust .--hector' and air-cleaning devices are used, disposal of the collected dii't prov ides a potential source ol fiber emission. IK WSPORTATION OF MATERIALS CONTAINING ASBESTOS li.iii'i'ort.itioii of asbestos ore. milled asbestos fiber, and asbestos* -ut.iming products and wastes is an emission source of varying impoitjiivc. Movement of asbestos ore from mine to mill in open ti t. ks contributes to the overall emission. The shipment of milled i-K'tos liber, usually in bags, can result in emissions. If bags are .i'cd. either in the asbestos industry or elsewhere, they will become ** %-nice of fibers. Occasionally, bags are broken and asbestos is filed during handling. Similar emissions occur during the shipment >t products. Transporting asbestos-containing solid wastes in open v hu 1-n through urban areas can be a more important emission source. M WE \CTURE of produc ts containing asbestos >1 i'tite> that must provide ventilation and other dust-control i .I'.ikN tot the protvetum of workers may emit asbestos fibers DOW 02709 ST0095320 VSBISTOS mb* the surrounding environment unless effective air cleaning is applied to effluents. Fibers removed by ventilation ami filtering dcsues ami not reintroduced into the production process and asbestov containing waste products of the manufacturing process ultimately are disused of outside the plant. USF. OF PKODUtTS CONTAINING ASBESTOS Many products, at times unknown to the user, contain asbestos of one kind or another. There are great variations among such products with respect to the chances of liber release during the use of the pro* duct. The likelihood depends predominantly on the ease with which the fibers can he dislodged by the application of energy and on the dedegree to which the applieation of energy actually destroys the fibers during the use of the product. Almost all the asbestos fiber used in the United States for manufacturing products becomes tightly bound within the products and usually undergoes little actual abrasion or wear before being discarded. Asbestos cement products (accounting for most of the asbestos used in the United States), shingles, and floor tiles are in this category. Some asbestos-containing products, such as hrakclinings, are subjected to great friction; their rate of wear is con siderable, and at times they are almost completely worn away. In the case of hrakclinings. the application of energy is so intense and the heat created so great that most ehrysotile libers are destroyed by be ing converted to another substance, which is nonfibrous.6S,6',,KK Nevertheless, an appreciable percentage < 1 - 3 a ) remains as fibrous asbestos. In some products lor example, asbestos cloth, paper, and sprayed tireproofing materials- asbestos fibers are not tightly bound or mixed with another materia) that holds them in place. Fiber release from these products occurs primarily during application and removal. The spray fireproofing of buildings with asbestos-containing materi als is a case in point. This operation can be a serious source of emis sion. in that it usually occurs in densely populated areas. Talc is mined and milled and used in greater quantities than is as bestos in the United States. Because it contains asbestos fibers, its uses will add to the total number of fibers (including nonasbestos fibers) emitted. The use of talc in dispensing pesticides over wide areas of the country and its use in cosmetics are two examples of how this materia! may act as a source of asbestos and other fibers. Sources of Asbestos Fib DEMOLITION For years, asbestos has l some forms of msulatioi than 2(f/* of the total: b of asbestos. When a bui. are open to the ambient family residential structi insulation. Demolition < have been fireproofed w. be an emission source m SOLID-WASTE DISPOS, Solid wastes produced di products, use of such pr<. sources. These waste ma gard to their potential as posal often'resull in com. municipal wastes in open source. ST009532l DOW 02710 ST0095322 s..uft*N t AsIh*>i*>n libers in AmhieiM Air |>! MOI || ION I vv-.trs. jsIhMos has been incorporated m building materials. In . nk torniNol insulation ami wallhourd. (he amount present is less tii.ut '(f of the total. hut other materials consist mostly or entirely x'\ asbestos. When a building is demolished, areas of loosened asbestos ,ii. open to the ambient air and libers are emitted. In general, single* la:ml> residential structures contain only small amounts of asbestos insulation. Demolition of industrial and commercial buildings that have been fireproofed with asbestos*eontaining materials will prove to he an emission source in the future, requiring control measures. SOLID HASTE DISPOSAL Solid wastes produced during manufacture of asbestos-containing products, use of such products, and demolition can be emission sources. Vhese waste materials are usually disposed of without re gard to their potential as emission sources. Alternate methods of dis posal often result in commingling of asbestos-containing wastes with municipal wastes in open dumps and thus create a long-term emission source. DOW 02711 6 Principles of Control The natural background level of asbestos libers is difficult to quantify or modify. The major sources of local ambien'-air contamination with asbestos are industrial processing and use of products containing asbestos. It is feasible to identify the sources of emission, select those to which presently available control procedures can be applied, and point out areas that need further study and development of new methods of control. NATURAL SOURCES OF AIRBORNE ASBESTOS FIBERS Natural sources of asbestos fibers have been identified in many areas of the United States. It is assumed thy* /missions of fibers from these reservoirs through erosion and wind make up a natural background of asbestos in ambient air. Few data are available on the magnitude of the contamination from natural sources, geographic variation, and seasonal variation. It is desirable to have information on the natural background, because it would assist in evaluating the effects of control measures and permit some estimates of the lower limits of contamina tion that might be achieved in different areas of the country. 24 MIMN(. Oh ASHESIOS I lie sUmljrd !eilmii|ue' loi mines. it not aluady in u-.e ways wt u|Vn pits should lv truckloads of ore should be oo ported, handling of ore shun -H lv moistened to reduce wim o treated with dust-suppressiw o kjO cn CO MILLING Of ASHESIOS po co An in-plant dusl-coiitro} pro* nulls includes exhaust veiiti).: .in-cleaning equipment, isola' housekeeping and iiiaiiilen.ni MANUFACTURE Of PROD I he elements of dust control ore also apply I`> the inamilai is important that a Just-eonti tor which it is usc'd and that r Only persons especially frame !v used to develop and mstitu USE OF PRODUCTS CONTA An important emission source taimng asbestos. This coristitu used. But tile asbestos in sonn is m cementitious products or carried on in urban areas, whei mated air. and control of dust is difficult. The most eflcctive appioael public lo asbestos imin this ><> tion and release .it its origin dn DOW 02712 ST 0095324 25 minim; ok asbestos I liv mmlurJ le climques for dust control In underground or open-pit Mines it not already in use, can he applied in asbestos mines. Roadvk.*\ 111 ojkmi pits should he treated with dust-suppressive agents; i*ikkl>ids ot ore should be covered with tarpaulins while being tranv ported, handling of ore should be minimized, ore storage piles should t>c .noiNtened to reduce wind erosion; and waste dumps should be treated with dust-suppressive agents. MILLING OK ASBESTOS An m-plant dust-control program lor protecting workers in asbestos mills includes exhaust ventilation with efficient dust-collecting and air-cleaning equipment, isolation, enclosure, wet methods, and good housekeeping and maintenance. MANUFACTURE OF PRODUCTS CONTAINING ASBESTOS Hie elements of dust control recommended lor the milling of asbestos ore also apply to the manufacture of asbestos-containing products. It is important that a dust-control system be specific to the operation lor winch it is used anu that it be tested to ensure its effectiveness, t M\'> persons especially trained and experienced in dust control should be used to develop and institute dust-control procedures. USE OF PRODUCTS CONTAINING ASBESTOS An important emission source is the use of insulating materials con taining asbestos. This constitutes only a small fraction of the asbestos used. But the asbestos in some insulating materials is not bound as it is m cementitious products or tiles; construction activities usually are carried on in urban areas, where many people are exposed to contam inated ,ur; and control of dust during construction, although feasible, is difficult. I he most effective approach in reducing exposures of the* general public to asbestos from this source involves controlling dust produc tion ,md release at its origin during construction work. The generation DOW 02713 ST0095325 ASBKSIOS ot Just should be reduced by changing material-handling methods, work practices, and cleanup procedures. Local exhaust systems should be used lor dust collection it points ot generation; for example, dust collectors for band saws are available, and hand-powered tools sup plied with exhaust systems are being made. Much developmental work is needed to produce portable air-moving and air-cleaning systems for use in tunnels, crawl spaces, and other confined areas. This subject has been neglected by industrial hygienists and ventilation engineers, and no satisfactory equipment is available. DEMOLITION AND WASTE DISPOSAL Demolition and waste disposal are likely to be emission sources if appreciable amounts of asbestos are used in construction, unless opera tional procedures are strictly controlled. Isolation, enclosure, and wetting down are useful. Caution must be observed not to demolish during high winds and to keep sludge from drying out and becoming airborne later through natural forces and from being introduced into sources of drinking water. MEASUREMENT OF AIRBORNE ASBESTOS An important consideration in the development of a strategy for con trol is whether there are methods for measuring airborne concentra tions of asbestos that are sufficiently sensitive, specific, and reproduc ible. Present methods of sampling, identifying, and measuring airborne asbestos are not entirely satisfactory, especially if one is dealing with low concentrations and unidentified or mixed sources. Only within recent years have methods for determining concentrations of fibers for industrial hygiene purposes been standardized;14'*5 they use samples collected on membrane filters in which libers are counted with phase-contrast illumination. Electron microscopic methods give a much more complete indication of the total fiber content of the air; but when the need for fiber identification is included, they are tedi ous and expensive for routine use.1,66,1 ^ The relative biologic signi ficance of different sizes of fibers is not known, nor is the relative importance of fiber numbers and fiber mass. There appear to be no published data on the efficiency of air-cleaning equipment as related to fibers of different sizes. Principles of Control In pile ol the JiMicuMk . llie jppioxnnalc eoncciilr.iln. major types ol .islvslos It i\ measurements to a single me11 the critical variables hi tenio < oilier uncertainties, it is noi > ambient air quality standards. DOW 02714 ST0095326 Principles ol Control In \pik* of the difficulties. U is povsiblc to sample air. determine the approximate concentration of airborne fillers. and identity the mjior types of asbestos. It is not desirable to limit environmental measurements to a sinjtle method until there is a clearer definition of the vMticjl variables in terms of health. Because of methodoto^u and other uncertainties, it is not yet feasible to base control on numerical ambient .nr quality standards. DOW 02715 7 Research Needs Research Needs { onventionai I.M and l-.M mcthoi. in selected occupational and voini More epidemiologic studies are dillcront exposure ranges should t household, and neighborhood exp thehoma are needed to determine increasing and to determine the et large series ol routine autopsies sn whether causes ol' death can be re. lungs and other organs. Ail the ab< exposure is to he established with. $T 0095327 Two recent ^eports^<,*, have discussed in some detail the ~.ianv kinds ot research needed to answer pressing questions concerning the eltects o! jsbeslc.s on health and the degree and nature of necessary controls. Inxestigations along the following lines should bo given high priority. Study of the mechanism of action of the asbestos minerals should continue, with particular attention to carcinogenic effects. It is important to learn more about the influence of asbestos type and fiber si/e on respirability. deposition, retention, translocation, and effects at the tissue, cellular, and molecular levels, with and without cofactors. It is especially important that the role of fibers smaller than the l.M size range he clarified. Methods of sampling, identifying, and quantitating airborne ashes* tos need continued development. Coordination with studies in ani mals and man ts essential to ensure that environmental data will be biologically relevant. Similarly, methods for identifying and quanti tating asbestos in biologic tissue need development and application. Quantitative methods for measuring airborne asbestos should' he applied widely to determine the natural background and the concen tration and distribution of fibers in the air near various sources. 2H DO14 02716 K. *?h Ne*its ?<> i -iit.'ii.tl l M and I M methods should ho applied simultaneously - t\t occupational M\\1 community situations. V. > y. pideuuologic studios are needed Populations m several ,1 o i m ranees should be studied. including occupational, arul neighborhood exposures, Special studies ul nwso* i.-hu .tie needed to determine whether the incidence has been asiue and lo determine the current pattern o}' distribution. A wniMii routine autopsies should he studied to determine !i. thet causes ol death can he related lo amounts of asbestos in the ' and other organs. All the above are urgent if a range ot safe M'. vuie t\ lo he established with confidence. ST0095328 DOW 02717 Conclusions and Recommendations CO -H O O NO ccon ro co PATHOGENICITY OF ASBESTOS MINERALS Any of the commercially used asbestos minerals, when inhaled in sut* ficient numbers, as in uncontrolled occupational exposures, can cause disabling tibrosis of the lungs. An association between occupational ex posures to asbestos and bronchogenic carcinoma has been established, but the dose-response relation and the role of cofactors have not been defined. Evidence of a causal association between some but not all ex posures to asbestos fibers and diffuse malignant mesotheliomas of the pleura and peritoneum is substantial, but evidence of such a relation with other tumors is inconclusive. Although the different types of as bestos differ in some of their biologic effects, no type can be regarded as free ot hazard. The hypothesis that asbestos fibers act as coiactors or carriers of carcinogens is attractive, but as yeI unproved. EVIDENCE OF HUMAN NONOCCUPATIONAL EXPOSURES TO ASBESTOS The demonstration of ferruginous bodies, similar to those found in asbestos workers, in a large proportion of randomly selected lung specimens in many parts of the world is presumptive evidence that .to Conclusions ami Kocmnm jvr'<-:is with im <Kitip.iii< .ishcstos. Proof lias ^ome i Jirvsotilc asbestos libers have been too limited to >1 Iviion ot libers m the er.v have been demonstrated ./ those in industry, but dat. ESTIMATION OF RISK I EXPOSURES TO ASBES7 The most important quest tior.al exposures to asbest* malignancies. Industrial ex hood ot significant ashestr major potential tor risk up tionjl contacts, household neighborhood ot an asbest o poorly defined. The apj> groups, however, suggests x without detectable risk It arborne asbestos libers wi ab'c ctlects on health. At f numbers ot libers found in attect health or longevity. NEED FOR AND FEASIB Asbestos is too important i tial use to he stopped. Hut. uncontrolled inhalation of tainty as to the shape and v it would nc highly imprude the public environment w it the public requires that the sion into the atmosphere hi such controls, local tiber co in occupational sites. AnaK vet adequate for the dcwlo emission controls are noede OOUi 0271& ST 0095330 i ..n. liiMnns and Recommendations M ' wiih no occupational c<>mt ,k t m.iy h.tve inhaled .uul rcl.iincd - ' honi has come in some areas with positive identification oi 1 'it.- asbestos libers An.dvses ot comimunt\ air tor asbestos 1 m. i-i ii too limited to tleiine the sources, concentrations, and Uistrii- .i libers m the environment I he liber concentrations that ti . I'cen demoOsUuted m ambient air are small, compared with * indii'M \. but data are inadequate tor detmitive comparisons. fxilM \ MON Of RISK IN HUMAN NONO( < UPATIONAL tXPOslRtS TO ASBESTOS iiv m<M important quotum in the case ot persons with nonnecupaexposures to asbestos is whether there is an increased risk ot iv. iica iikics Industrial experience indicates that there is no hkeh* b--tl oi Mendicant asbestosis m mmocuipational exposures. The i**r potential tor risk appears to lie m those with indirect occupai ! .oui.icts, household contacts, or residence in the immediate 'viehborhood ol an asbestos -source, and even there, the actu.il risk ' ;v--n\ detmed. Hie appearance ol a giadicnl of effect in such -i ps. howevet. Mi)!^csts that there are levels of inhaled asbestos without detectable risk. It is not known what range ot respirable .iub>tne asbestos tibers will ultimately be Immd to have no vneusuT.:bie diesis on health. At present, there is no evidence that the small ?:-.::*icrs >t fibers tound in most members ot the general population < health or longevity MH FOR AND FEASIBILITY OF CONTROLS \sN-s|ov is ion important in our technology and economy for its csscnti.il use t" he stopped. But. because of the known serious effects of u\-'utr>lled mhulalum of asbestos minerals m industry and unccri :iut;. as to the shape and character ot the dose-response curve in man, " ,v mid be highly imprudent to permit additional contamination of mi I'nhiis environment with asbestos. Continued use at minimal risk to M|. ruhlk requires that the major sources ol man-made asbestos cmisx' " udo rhe atmosphere be detmed and controlled. In the absence ol h o'tiirols. local litier concentrations might at times approach those v up.iiional sites. Analytic methods and epidemiologic data are not ` i-.lcquate lor the development of an ambient air standard, but Mi'ii controls are needed and appear to be feasible DOW 2?19 References 1. Alcocer. A. F... J. Murchio, and P. K. Muviiei. Asbc tos Content of Some Urban Ait Samples. AIHL Report 90 (revised), Berkeley: State of California Department of Public Health, |970. 12 pp. 2. American Conference of Governmental Industrial Hygienists. Threshold Limit Values of Airborne Contaminants and Intended Changes Adopted by ACtilH for 1970. Cincinnati: American Conference of Governmental Industrial Hygienists. 1970. 27 pp. 3. Anvilvel. L.. and W. M. Thurlbeck. The incidence of asbestos bodies in the lungs at random necrospsies in Montreal. Can. Med. Assoc, J. 95:1179IIH2.1966. 4. Anspach. M. Sind Plcuraverkaikungen pathognomomsch fur cine Asbcstose ' Int. Arch. Gewerbepath. Gewerbehyg. 19 108-120, 1962. 5. Anton. H. C. Multiple pleural plagues. Brit. J. Radiol 40:685-690, |9o7. 6. Anton. H. C. Multiple pleural plaques. Part II. Brit. J. Radiol. 41:541-348. 1969. 7. Asbestos Industry Regulations, 19.1], Statutory Rules and Orders, 1931. No. 1140. London: H. M. Stationery Office, 1931. 4 pp. 8. Ashcroft. T. Asbestos bodies in routine necropsies on Tyneside. A patho logical and social study, Brtt. Med J. > '6)4-618. 1968. 9. Ash ift, T., and A. (i. Heppleston. Mesothelioma and asbestos on Tyn* de: A pathological and social study, pp. 177-179. In H. A. Shapiro. !;d. Pneumoconiosis. Proceedings of the International Conference. Johannes burg, Cape Town: Oxford University Press. 1970. to. Balm. J. L.. W. <*. Cooper, and D. F. Fowler. Fibrous lined air transmission 32 References OO --H O o vn cn CO CO sWCIIlS A II ,ISV SslIU Ill < ! I Health. I in press i I i. K-insci. G. M. J s I .mi<l urinary bladder m ilvssiulis workers .inti iron >/. nui iv 12 K>-fi'W. M., A ( ins!)>n. I I its association will, .isIhsIom I i. Braun. 1). and I. I). I rn.t asbestos miners A.St.A. Ar. 14. British ()kiii|>.iti'-i)al llyeiivi asbestos dust. A nn. < hi ap. 1 Biishartan, W, D. Ashesiosis S. Y. Asad. Set. 1 <2 507-s Ir. Byroiii, J. A. A. H<dg\*>. buildings incori<ijtmg ashe- Oscup. Hyg. 12 I 41 -14 * I' I 7. ( au na. I).. K. S. I > it ten. aini autopsy. J.A.M.A. I'<2 371- i *. Churg. J.. S. H. Rosen, ami 5. mevilhelioina associated wit 1965. i u. Cooke. W. 1-. A sliest os dusi . Med. J. 2.578-580. 1929. 20. Cooke. W. I-.. Fibrosis nl ths- Bm. Med. J. 2 147. W24. 21. ( ooke. W. F. Pulmonary ash 22. Cooper. W. C. Asbestos as a 15 285-296. 1967. 23. Cooper. W. ( .. and J. 1 . ba posures in the insulating itad lerenccon Biological Wlcvis 24. Cordova. J. K. H lesluk.an oi t he lu ng. ( a ncer 15 11*1- 25. Crallcy.l.. J..W. C. C.H.fx-r, health etlsvlsol astieslos. J, 26. Crailey. 1.. J.. K. G. Keenan Chjracteri/ation and *lub;!i Amer. Ind. Hyg. Awn, J. 2,J 27. Crailey, L. J.. R. G. Rot*nun. manufacture of jsbestos tes 28:452-461. 1967. 28. Crailey. L. J.. R. G. Keenan, of respirable fibers, Amer, in 29. Davis, J. M. G. l!estf<>n-iii;.r animals. Ann. N. Y. \sjd. 30. Dickc.1. h..and B. Saylor. ! lungs at necropsy. |)is. ( best 31. Doll, R. Mortality from lung Med. 12.81-86. I`*55. DOW 02720 ST0095332 Retvi.-iucs .U !:' \n isn smhciii i! llu n i-Hwiontiirtii.il c Meets. Arc li. I immii. I >tih. nn prrs>I l n-ii l. M .J S I .mills, and M J.SivwjM. On'iipational c.mccr .it the .-in.ns M.nlili'l m ilyi'slitlls upciJtlvcs jnd ol the lun)* ill asbestos IcltUc s .ik. in .iii.t ii.m *iv miners. A liter. J. ( Im. Path. 2 A I 2r>-l .V, ! l( '(>* M.. V < .Mixii.n. i . 1 I ivorncsc. and N. Sclulct. Mi-s.iUivli.imj and I' i.ill-hi si till jsIsvsliiNis. j.A.M A. 201 Ax7-$u I. I*iri7. Hii.in M <...iml I.D. I nun. An v|'iiivminiii|!iv'jl sliitly nl'luii|! vjnivr in .-' . n|..s mitu-is. N.M.A. An li. Ind. Ilv.illh I 7 b.t4-<5.C I`l5x. ! i H'n .-.li o. v<i[>.iik is.iI llynu-n.- Sis iviy, Hygiene standards tor chrysotilc inI.. s|.>\ iliisl Atm. < In up Myn, II 47^s`i, | Mh.Ii.m.hi. W. I) Asln-si.isis jmJ pr m.iry miralhorucic ncopljsms. Ann. \ V \i.nl. Sii. I tj 507-M*. I'lhS. '> H.i -m.J l'.. A. A. Hodgson, and S. Holmes. A dust survey earned nul in '-mi.Inn's nisi.i|Hii.nin^ jslH-siiivhjsvd nulvfijl m their construction. Ann. .. up. ||>g. 12 141-145 |ur,g. i i iiiiu.l).. k.S. I uitvn. jml I', tiross. Asbestos bodies m hunun lungs at n.t..ps>. j.\.m \. i`: wi-.n.t. i*j(,s. i lime. J.. S. II Ri-si n. ami S. MH>licn. Histological characteristics ol m. m>ilull.iin.i .iss.isutvil with dshcelos. Ann. N. V. AcjiI. Ssi. I .>2 M4-<22. i'H.s, l i < .-k s. VA. I. Asbestos dust jihI i iu- s urn ms bodies lourui in asbcstosis. Brit. Mi-il. J. s7x-5xt), | ;o i "kv, HI, l ihfosis i>l thv lungs due l<> the inhalation of asbestos dust. Hut Mod. J. J 147. I '*J4 .'I. t ....kv, H. I . Pulmonary ashestosis. Brit. Med. J. 2:1024-1025. 1*>27. t -`.'ixr. W c. Asbestos js a hazard to health. Arch. 1-nvtron. Health 1' >5-2'. |>r,7. t .>jvf. W. ( and J. 1 . Bal/cr ( valuation and sontrol ol asbestos ext-.-sims m the insulating trade. Presented at (he 2nd International Con* t. ren. e <>n Biological Mlecls ol Asbestiis, Dresden. April 22-25. I'JbX. 'i i ..r.losj, J. I.. H. lesluk, and K. P. Knudtxon. Ashestosisand carcinoma i the lung. < anevr 15 11X1-11x7. |`)62. . t ialley. 1.. J.. W. ( . Cooper. W. S. 1 ainhart, and M. (\ Brown. Research on irulth etlectsol asbestis. J.Ovcup. Med. I0;.?X-41, IV6X. > t rallcy. I. J.. R. <;. Keenan. R. K Kupvl. R. K Kmxcr.and J. R. Lynch. harjilen/dtinn and s>lubility t*f metals associated with asbestos fibers. \"ur. Ind. Myg. Assoc. J. 2'*:5f><*-57.(. l^bx. - \ < r.illcy. I.. J,. R. (i. Keenan, and J. R. Lynch, l-.xposure to metals in the m.muljiiure ol asbestos textile products. Amcr. Ind. Hyg. Assoc. J. 'h 452-4hI. |`f>7. . v t r.illcy. I . J.. R. (i. Keenan, and W, S. Lainhart. Source and identification I respirable hhers. Anter. Ind. Hyg. Assoc, J. 2^ 12*4--1 -'5. I*>6X. Davis. J. M. (. Ilcelron-niicruscope studies of ashestosis m man and mimals. Ann. N. Y. Acad. Set. I H:***-\ 11. I`<>5. Mu ke !. |.. and B. Njyior. Prevalence of "asbestos" bodies in human tunes at necropsy. Dis. Chest 56.122-125. I4f>u. I*-.n r. Mortality from lung cancer in asbestos workers. Brit. 2. Ind. Med. 12 M-H6. |U55. DOW 02721 'Mil S I i .s I >' . W i s.. . \ i .,1 n. -id. tt'iM ini ts. i . I M I I >: \ i-, > 11 'A 0>.i I I I Iv M. 11 % I. I...I , Hill 'll I'l . 1 >111HI 1 1 1................ 1; M H it \ ; ' i" hi. 'hull ..11 1.. .11 ' lit! . .1 ... H' 1:d `Hal f tupv Sp. i.it . mpti i ! 'ii lui'l" . -Hu i l V 1.. 1 -s.' ,, II Plh 1 1 d I-" .s 1 11. I'll. 1 1 ll Hill 1! \l Hmi < . H. I'l . ' ................... "i .. .1. . . !. -.) I..11.0V, .1 p.-.s, l. 1 i> is Am. I ) r 11 11 - Ik licit 1 u. 1 < 1 .s 1 .IV. II. 1 I. II llnl 1 K 1 1 III ll. | i|. Hu t t|. 'll list ll l.\ III. t s 1'.. , H. ilih Si 111. h .i - mini' l il I. hi . -1 .asl'i si. i S llll-l > Ill ill.' Illl'l in. ' ill V. 1 I- . up Iiu nit. l'd 1. 1 ........... V ' H I I M. 1 .|ll-lu \ lll'l ( > 1 . VA .<!. . | ip 1 ii a- in.'. a ii 1 till pli m a .Hilt tsl>, s|. 1 S Blit AS. I. J. 1 ISO ls(. ! H.V ... , ; It.ms 1`. ` . .Ulit < t. 1 . VV uk . Ks'l.f1 lulistu; ' 111 (Vii'v'li VV s' A 111.1 pll Hl.ll HI.(ill'll llll \ in Hi Mast II 'l**Pi N^ Ann. S A Aid S. ! 1 c k t> | ill...., i r and A 1 . I ..ilil ini'.. A lull. a. up stuiH ..1 M Iki IS J r i;, .*sbt s|. s I.K 1 n\. Bui J. Iml. M. d. .'1 Hi 11 Hi'. I'ti l. >' i nl.'t Iiu.'. |' 1 . Mutl.i Ills a in. mi' ,i` tlfsl. >s pi .dm Is w.. , K . 1 . in 1 >u 1 I..I M id s \ 11 Cl. \ A . \. a.I S, i 1 1:1 Stl- It. V I'lt.v 4( V t nf>i i nir I*, I and M. \ Hi It i. k \\|irs|. is ilusl j>i ismrs it i ii ' f. V. I s ,|>lll HI. Ift.illl l . \t i ll. 1 MV ! I .11, | il-.lil l| 1 S I X | 1 X(. i 'll. 11. I ||'| l III || J |( nut W . Si ml lii'I I'll ll IIH .tl III nil 11,1 s III I l.1 \ Imt.Mid. :t Ml .) i'Jtul. JI li l I' It S.. J. < . S!> i ,iinl I . * . W .il in-1. I \ |`i isuii' In .isln si irn si-t Ilf. im.i i>| ' In- I'lrur.i. Util. Mi il. J. I I - I .1 C't, 4'. I i.-st I J.iniiin and l\ l k immtii: AUdU-c. \skvst..sis'*ilk pli u .i i iii .ill.'ii .ini.iiu! iiisiiil.iiim' <*<ifk''is I Mul. Hull t Jo.' 'u4. 44. I Ijf.llli I I . I< llf> si it ill asbestos .is .(Il llitl II Jj n| 111 u.*`I .If till Irr !i. .tiiiin.il Iissin-s, \mr. Ke\. lubiii.lv r,.'-'' no. luJl. 4' I i.ifitiiii. I . I.util I). | . ( imiiniHfcs S| ul K s mi i*\pet ilium .il (iih'ii u k- 'fill "fs. A |. Jnll.ll.il Ii `11 n| jsl'isl. is .{ ll si Its il li'i I | >i >1! ,111111.111 I ii i . ill. ms nil. i I n Hi J. Iinl. I Is ! 1 i i.s-.v | h | | 4 | u l; 4t. I .a/e K. I In' pin six .il .uni tin >lii ill.ii si i in i in, >1 .islii-sl-is \nn S *1 A. Hi. Si i. I _M- HI | i(.s_ 4'. .Inv/i l (. Mi'Htiil jn.l l'. I`ik n 111, Xshi'sii.s Ii. ..hi's in l In ihim". mil.it'll .mi s . .1 M i' in Mill, l j'i it' i 'X 4-S. Cull's t AA Si'lllr ('>'hli'iils .I'SI I. t.ilii) IS l| ll I til' si 11| Ji'. . | islirslus n {"Ki-ilit li'iii t*.>js Anut.lnd U>c. \ss.ii J. tOJSx.JoJ |*** 4'). I ills. Ill J ( . Hi .lit ll tl.l/.Hils "t asl'i sti'S K\1 i'll! si mill's I'll I*.S I ml I 'i'l flints U 1 ll S 111,111. ll III I,'. | III!' pit,4. I I.Mls S*H < K i l*|' Mill ' 'It. il,,vm S K. I'liiiiiiiin i inn is|s A liisti ili i. ,| | sit rv i \ .,t iifiiopsi mu- Iti I .M|S i .isrs l .mil | X | It-H 14, I'lSl. * l tm'ijjll. J Itllli'h riMjl ill,ijhi.isis ill lilt' (l.Hli,ill.. .| ask. sd-sis. \i.n \ \ A. III. S, I. I tj >,X- l?: pit,A. i.ftiMItl J. .(Ill) X , < .1 jfljlll. ( H .trial) Jill I I ,||||| .isl'i'sli IS I Ii'.in Ii I *1 ' 1`tfn ' Ki'ItTOJUVS < ,li .ss. j*. J llJjS s (ll- . Illf . j I'lllll. I`/S |`lli(.. * lilt 1-t A 4 1 id iss, J'. i , J < talk v inii li'.liVpf, it K ll > . Ainil Iml J ` ^ I.fi.ss. I*. .iTid K. J . i*. i|c I lidnHt-ssiwncss nf the [miiiu 00 --H o o S7. k> cn CO Sx. CO oo I id hi. HimIIIi I A * t.diss. I'.. K. !. 1*. ili irmi:. tvinij'mnus Isi.ilivs Ui-sii-i. ii'd .( method of iv.IjIih'I ,, pit.X. (.KISS. I*.. K. I . I', 'll- Id'.Ill" li.'sd.s lil'i ls I'lit.iniii ("s. A7x, J <*70. t il * iv. i\. K. I . I* m i i-vil!.' I s |Xfnmnl ji .is)'.-si i is, s i I piilniun.il y iJfji. isji s ii v In 15 <4 t-.t-sA. Pit. \ <1. ILmmniiJ. I . < . 1. ]. Ss'U' wi.ixors m I hr l ruti'il Slj'i- ni'ii|iljM.i. Ann. S. V v.n:. 111!, H.tiiJy. il. i . Asln-sius h-i.i!- I'ttiS. 'I. II.HilllMlHI. i. S ( llfllllwl stl I t: t j --47. |W,5. I-'. II at ini'll >n. J. S. Oisiifd-ni i- surisiamcs in jshfM'tx. Sjiui tl.l. lianniitun, J. S.. and I . j. ( . Iihi-rs and Iheir naliifj) mis. '.4. llurmylun. J. S.. ami M. Sn:r I hi* fluiiunH'if ,i 4 hfn^p>rf su-.tin. Mill. J nvid'n, llulil t,5. Ibtfh. D. I'l'ssihii' jJiiTruliv. Ossup. My*, i ^ iw"i Hirltvitintfs't. k. I .. < . 'A , Mv iVvclupini-m .'I a Kjpnl s.i Ashcsius m Amhn-ni Air !- Columbus Ball fib- Mi'ji,..:u Hi'mlrv.S.U. I In- i'folii|>\ n. v. Asad. Nu. i i:-::. <>s. llukisfi. li. t .. ami k. 1. km tfnanio. Ann. On up. ll,,*. i 1,4. Hull, I*, i .. j. Mills, mil <>. t!Uini'4-piK. J. Patti. Hail. 7|j tiouuluno. O H Ihcp.ith ilifir ass.nuiion willi .istn-si!| Hourihanc. 0. O H . I 1 f"1* piniral plaques .is an null \ iai and pjtholo^iial tf.iluifs dojty But Mod J I I'li.* 0272? Ki-in 1*11\ on ' I' I -l'* ' |"> 'Nlllp (.!> H--W .ill IN lllll.tll .lllll'll'lll .III ' \l.ll f . !. I-'N llcttcl to Htc cdltol) ' I J . I llllc V . <11111 R, 1.1' tic 1 11 1 llli' " Asl'Csl* in" It. It) ICS | lit 11 n'l't. il Ml v. An vt. li-tl. Hyj* Assoc. J. Jx s4 l -54 J. I 'hJ. -nn I*. .4nJ R, t . 1\ de I tcville. I X|Himu'titjl .inIhnIomn SltulivN on itic cicNMwtu" the pulmonary tthrosis t jusct! i>% thrvNoiilciliiNi. Att.il. i ,m: . -ii. IK alt h I 5 t, tb-r.41 ' ' " I* K . 1.1'. til' 1 fell!tv, l.. J. ( f jllev . Jllil J . M, t i. !)JV IN. I'll!Iltotl.it y !.' .ciih'iin tKitliv' IVvi'loptiicnl iti response to li!jtiu'ti(<iuN UiinIn ..! i mi-llvd o! iNoljtloi) and concentration. \ftli. I'jlh. XS S t`J 54i. *(,N, I' . K I. I*, tie t lev tile. 41 id M. S. 11 jlll'f . Asl'CSt i IN vet NUN tillII4V r't'I.N * 11`x'l N ClttJlIllt IOV.OPK xlltcfltl. Atcfl, Illvitod. Health JO >7|- '\ W'll. " ' .! 'N P.. R. I. P tic 1 :c' tile, I*, H. I old M, Kjni luk, .mi! M. A. Hjhv jk. I t !'> I'Mvtil.il .inI'cnIonin 1 lie ileveltiptnetM ol Iuup c uric er mi rats with .m! n o it., i v deposits ot vhry *t ilc asbestos dust. Auli. I nviroti. Ilejlth .4 ; *i< i t.7. !I.oi.hi-mil. I . ( .. !. J. NchkoJ|, jtui J, Churi*. SeopIjNM anion*: insulation ti -ikt m the 1 tilled Mates with njh'i ial fcletenei' to mtu abdominal ;i!jni,i. \mi, V Y. Acad. Sa. 1.1 J ' I't.t S ]'in5. i' ll.ti.lv '!. 1 . Won|on teljlet! disease. Amcr. J. Med. Sci. J>0 .tXt'.Cvr ST 0095334 ! n.itinc'oii. J. S. ( hemic j! studies ot asbestos, \nti, N. Y. Ai.td Sei ; . t .4 ' Wmn, f I j 111. c1 11. J, S. Oo urieiue ol oi)n cont.nnm*: 1 4-hcn/py retie jnd re!j ted 'tihN'.iikCN in asbestos. Njtufv 1*.n 45-4V ll,>J. ;. iljmip'oii, J. S.. jnd I-. J. C. Roc. SiuJicn ot carcinogenesis ot asbestos tiKrs and their natural miv Ann. V Y. Aud. Su. 15 J:4.W-45U. I`>t.>. -. Hj!ui)M"n. J. S.. jtid M. Smith. Studies ot hydrocarbons on mineral dusts Mi. elution ot * 4 licn/.pyrcne .md oils trom asbestos jnd coal dusts by si.-.im. Arch. I'nvin.n. Health X 45.*--15X, |9h4. .n. Hatch. !>. Possible alternative!! to asbestos a> a Ifietion materia!. Ann. u.iup. 1 * :5-:i. 1 *>7o. Ile'te'tini.'er. R. !., C, W, Melton, am) W. M. Henry. Interim Report on licielopmcn' ol j Rapid Survey Metliod ol Sampling jnd Analysts lor Wie-tos in Ambient Aif to National Center lor Air Pollution Control. ' .'lumbijs BaMelle Memoiul Institute, I**7!). J4 pp. . !tenufs. N. M. J he geology. occurrences. jnd riuior uses ol asbestos. Ann. v n. Acad. su. i.*m:-::. im.s. x. Hick.ish. U. K. and K. L. KntKht. Exposure to asbestos during brake main* i< lance. Ann. (Kcup. Hyjt. U.17-JI. I`>70. !fot p. f-., Mills, and 0. K. Younjj. fxpentnc*ntj! asbestusrs in the jsuinea-pijt. J. Path. Bad. 9J:185-195. !9h<>. 0 Hour 1 hjMe, !). O'B. I'he pathology of mesotheliomata and an analysis ot itie 11 association with asbestos exposure 1 horax 1 *> J<*K- J7x, 1 `>n4. 1 !! 'iiriliane. !>. O'B.. 1.. Lessor', and P C. Rn harilson. Hyaline and cati died I'b'iirjl pljijucs as an index o! exposure to jsbestos A stin!y ol radioing!- .jl and pathological features of Hit? cases with j consideration ot epnfemii'-ey But Med. J I 10r.9-!074. J-tr.r. " <* VMHMOS Mi - >m. V. I l .o iv .. iti' m uli-i.. i u . I,.n > i. i > -i. j.l, .** l li in Mu inil,11hl.mIs <! I hi1 vi sli i n si-, |ii-n ..I i lit -i iin i J11li.n i i. i'i, ,ii k,,/|,| li.UrJi -40' -4 I X I /*..* mil iv.lii > Iict k i . M k! jus. nut U l 11.iii!s \ 1 > --.i. nl -ii. %. )!i till . J|| III*>111.1 Kvpo! I i| ollc .1 <111i|'Mi ! . .1 in I 1i ii w I -I l|, .ii.itljMi-lifot.iiuiv AmiciJ Mi-.I ! ' '.'I l''; ' Ijsott Jtlil M AnspJsU I'ulm-ill.ilN lu .;'l.i .i.i .uti-niy ) lit \.l, ti i.Im .In. Willin'!' \llll S V \i.lll Si I I sill ' Is I'll.'. s J ji i iK( i jiii | H |l. -li 111' I l'i'( 11 .ini ii'l. i 11 mill M' itiili'l iii ili'ii It-. t sttyv*kicl'ss's ki Xslvslnsv -\iils (,, < ii'"*i M'i-Iis i' M ID > [OSS *'i ki'ji. I I AslH'sliisl' .illi! jl'tli illiln.ll lit i|i!.imiis l.iriiil '*11 t*|i kniijii K < jiuI J K 1 > ri. h t ti :u hi tin ' j i in -I. ii 11 ii in, iiKniit it . ir. iti .mi! jiijK 'is n! J11 '*! s \mv't !ii,| fl.y \ \ -.-' i J 'I s s ,* s'*' |'i?n s kis :hii 'ii'. H PVumI i j!i i! it ji i' in .is ,i r - -t ii1 i'i !( >1- u si)'i- ! in-in i,, ii [i.i liniijl I'liilvmii jiil Iiophs!t 11 v .['`>i sit im \,i.i K.i'!ii'l Siippl 1*4 I I '".{I ** kli'IMlilil . M . .1 Missile. JIli! <> k. " 'i HI.Hi \1. -i l.ilil t i \ |'i i nil. i' in .i `fiiiiji .is!ii's|ns w.-rks'is Aiiii ! tivinni IliJMi !s ! '' IMI !'i,7 si) knn\. } J- . K X ! ) 111. jiuI [ I > Mil! < . iii. j i ,iu.ii\ ms . .I i (i.uijvs in nit i- delin' !I*f I HKfll.il iJKMIoNIJ III 1 !i'\!|li .I'1 i si - ' I .It I -1 > Ah II N ^ Asjtl Ssi I ?,,* I )-s x! kno\. J I . S 1 Ii 11 UK's K f )i ill .in J I !) Hill M. n i j!hs hum hi ttyuiui'i '(III lit lun i Jllst'S j Mil 1||(! Wi 1| in'I s ill .111 .1 sl-1'I. s 11'\ ! ill- |ji ! 1| y Mill J Iml \,i'l[ *s *'*.4-50.4 !'**.X. X I.JJ MIJ Ill'll. A . I Niifo Jill! V K Jill". 1 <Misi : s.i 111 Ills .111 .|! rilosplli'l K .III pollution i.ftiscd lv .ishcst,is Aim N V \.,i.! S. i H_* .`4'!-J4s !'i*is x.4 l jn>:vr A M.V HjJcii l.< Hjmni-.iiil jn,l t J Si.- hk J f !non.\inii JiIkts. iniludirii! itirysiitili'. im Itin^s .ii .nj!n|sy I'K-hiniiijiy tcpott I'rc- scnti'ii jI I hud Inter n.ilionjl S> in;ssi:m mi hitulcil l'.n' u !cs ! uinl.in. Si'plcitiK'i J.'. l`*Tl) X4 I .jrttKT . \. M I J kl' Ilk ill I. .1 Mil A Sjstte 1 llllvillU ,|4'ia!,i\ 111 t!lv lun^s ol persons hi New Vink ( its Aii !i ! *t\ir Hi'.ilrh 54x- M I X' IckIu'I I' I'nnuti'i Ik-ik/cltciilumm ti" K.hk!.'v!'.s livi As'k-sIhsv \nh (icwcfiicpjMi. (icwcilii'iiyj* 14 4x.?*.4oJ. !'*54 x/i Ili'hi'II.J MjIi^M.IIK li's IM jsIk-'Ius w 1'I ki'l ' \ltli t IIV 111 HI Mejllll I 5 fi I 1. ! or,*, X7 I ichen. J.. jrnl H I'tsf.iwkj Mesotlteliiitn.i -mil .isK-stiis esposiiic \iilt Inviiori Hcjlth !4 ssh-s/.I. 1`if.? xx lyiKh.J K Brjkc !imnndcii>mpiisuiitM'i*'!U'ts l \w I'nlUr. I .HiUnl Assov. I-S x24-Xjl> I'Jf.X X`* 1 yr>i!i. i. K., M I' \>cf, jiiit I 1 J> iliiisihi I Ik mii'iit I.i'i.msliips ol sslcsli'ii jsIk'si.is exposure iuJkcs Amici (list H>si ! <1 s'is-i,(J4 tn'o `*1 lyiufi.K M ,mJ ft A Smitli Pniiiiiiti.ils ,isiu ,i.isjs Ml i .m ni.iiii.i n| lunjj in jslivsto-silisiisis A huh i i jiiu'I 14 s*. i4 !'*is Ki h-ri'iu im GO --H O O kD cn CO CO cn M . \ ,r . . -i ii- i ! '. . - M ., f I 'i . : i.i. I I.. \. i, i . . <> ' M hi ii > I I i ' \ ' i I........... A Ik - I'I ' > M H.i, H II I I I, A Ifll l .! I . I \! II Ii HI I I I li.nl . !u (,, h Vtii ... i !i li i'i < "* - - ; > M < 1111-11, s VV V.tl S *1 \ ' M< iih'Ij . U -In -1 ml Ml., ' M ll.llll.l \ 1 |.i l.':ii .1 h's ' .lli i't lI l 111 1 Mt Ilull.il.l 1 l .1 '1 ( I K----lit f M I .l-r. - ioi .'I 1 Jin-lif. Null t 'ii ,i '. 11 i M. I wi n I \ I ri-! i, \ 111 V..II.III.I Oil! M I I 1 Ml VlM Ii- I 4 \ * .- . I 4X | HI,' : H ; i`.'Tl'W I'I lilt I K \ \ I' ' Ki p.iit .! ii,, * !,. 11, )- i II M Ntjn i'i!., i'i .'II Mel i'w cl Ii.i f 14 \ Ii,. pilltll' in.HS .j 11 - - 11 n HI 1 > ' >'* - Js - I -r ill in- Mi-ii-wi'tlui I K \ .iii.l' I >llsl oil thi- l 't'li! .1. I t'H' ' I -'Mill HI M Si 111 -'ll li * *!' ! oil Mt in in.im | < I \ i- i i * -1 Jillop'S USI' V * Poll vit 111-' Mi'll! 111.ill | * ' I'I-III li! , |u . 1 ns non Kv ` -o 1' > " ' ID.N loo MiU.-i W. I V.--I. 1s hi ' 'ii/. ,|., | jn i. ,i .... - Vi.ul s. ( I ; !-........ ; Mills K <. Cut-'. 1. I'< I |- ill I lo Mmi is M M si . ,t PI' I * I 's In k i i ; t- >i ln.ln-lM.il I Ir . i - I . . I Keletem e* n ST0095336 Mi, S.ib t* and I S tl.mn^ixi Ilnnu.iv 11. .n i ivii\ nt .isIh-nI.,, .md I tic I Hiincl.lt dil'l' SitUlc J I 4 V'.'s't 1*11.' Mm, l I and t J I >uMi-i Mil h- ,,li ! >/ v mim i>l ii In,11 hc.ilt I, ",,lic> I he *i t ,ip|i!.i.n h wtlh ul rctcii-in v i>. ,m .ishcsios .......... m\ \ih I muon Health >. .'to-.'.'n l'.i M .u, u"> I I .mil \ ri At tji M,.11I r v I'.iiK'in hi ,i v>>Iimi i <ii r, cvi.i, worker, J thiiip Mi-,I ' IJ'-tn.' !`*r./ I Wtriri K H ) J trnh .in<1 M I * lltl.t Jw l,|ll'll mii ti .i,l,,*,t>i,is < .in ,-t ! ,t > V.it, *uit,t J t i-tn-i , u-< niuiidi, In-I'lyini-tiik'iit.illi-in ,l, i I ,ni(*i-n Vctli Ih-nt.. he t*e, I'.ith I' '.'s I'Mr M,ii>. ,\.i D RcrH.ie /m M :; ; *>. i .1 \ >n,4 ,li-t I'k'iiijvcik.ilkuiiycn / 1 tiheik * M, < .tUC'lCS M ! I I I III-* !.l I"! dl.iytl,,,". "I ill! fuse IIK-miI (u-ll.ll I mill it, \lll* \ S Nl.tll s,. I .* 1,1) ; *.| i l`,S M.t .Miyhcv \\ I t <) ! W.i.li- ,irut I* t t-tiues I \|nimiiIn .isln-siiis fu,r .fii.f iiifii'.,- plcur.it mi-Mif?n-fii,tn.is Rrif Med J I l't7 ('/<.' * M. IKin.il,! \ I) \ M.i-iv- O \ II < M, Donald I tn.fcttn.d* *V> <'! i*' ii'i.it \ in.ilicn.ini iiii-s.i (n-li.d * mu, ns in 1 .i.*,l.i -iiivi-t >i! 4 ;' 1 ) ;l) M*I>- *i.t. J i A I) M,|),rn.ilil (. ty (hIi'in S Sn-niutsiki ,tn,i * I K---m , i v m i In- i !u>n,>i ik- aslH-si*,\ Hum-, .uni nnlK ) i.iui-'v, \ivli I nin-,'1 Hi'jd'i 21 ',7'-iMi. r*.'I ''i M, t wen. J . \ ] ;;i!.i ,ii. \ M.m iml A \ M **itvni Mcm>i hehortia in S, [lam! Km Mi-il J 4 s"*< , ?.s 1 *7n. \l, ViiHi- J < A,In 'l->M'm (ne.il Hriijm Ann N Y Acad Sci Mj t,,*s- > 5s ! >,* Metewelher I R \ AsI'vnI-im . jin! urcinum.i M ihe tuny liiAnnu.il Ki-(ift - it tin-1 lin-l Inspector ,'i 1 ,iiinfn-s !! i Hi- N i*jr I `'47 t, mdoii J} M Sfjjjouerv Ulliiv. W4`) ?') pp '>>. Mi-n-tti'ilii't. I R A I he uinifri-ncc nt pulttionjiy nhrosis and olhet pulmonary jMectmns in jsheslos workers 5 tin! Hv| I ^ 1 *>H-2?-, ' Pl.J'i'. ]`/.5(l i" Miii-vri'tln-f I- R A.jiuIC W I'*kc Ki-pur! n (lie {lli'i'lN i' AsIh-\Ih\ !><in! ,n l!u* t.unjss jn,l !>iis( Sujipti-'Mon in tin- A\hi-\Ui\ Industry l.,*ii!m tf M S'.itii'TK-f> Oltiic. I'l'0 *4 p| '"> Min*man. I t). AM'vstos Inulii-s and pleural pl.n|u.-s in a l-mtusli scru-s >>l jut-ipsy ias'N. Ai ia I'ai h. M icr< Si jnd (Suppl.) I x I -1 -107. I `inn. Mi'mmjn. { . <) Pti'uraf tif*rocli itic pf.uiucs and exposure. Environ Ri-v ' M)-4/. 1 ')f,X Milli-r. t ., W |- Smith, and S W. Berliner I fsts lor c1tM ot asbestos *> bcn/i>! j I pyrene i jrcinotstfm-Ms in the n-sptMlory tract Ann S. Y. \,.|J Si i 1 .5: 4X*I -S0(J. ' V|JK R fi i'ulmonary aslicstosis Report <>! ,i case. Minn. Med I A 4**5-- 4'`) |').t(). 1 '* Murray. It M. Statement before the com nut tee in the minutes of evidence. PP Id7-I2K. In Report il the Departmental Committee.on ConnH*ns.itn*n l**f Industria) Disease larndim. H. M. Statm/>ery Ottive. I'tt)7 askisms Ml New house M I \ \linlv **l Hu* m.iil.ilHv > 'm .in .iil i.ut.>is Hut J 1ml Mo! tul I'N.i tlj New house M i .and H fftoiups.m f'pi.feinn >( ipl <>l uu-soltii-lial'uin-irs in the ! otidon jicj. Ann N ^ V ad V i I <' ! `biA II' New M l . j itJ II Mi'.inpvn Memt het" nu ot pleut.i .mJ pen., ttt neum following exposure to ashes'iix m the l on,l<m area Mm J l?i<l Me.I .`*.1 W l< ttiMu**- ilii'Xnltii-l............ -in.t -x |ioii|.- to i .best, . dust hi 1 hi Vcim'\m>!oiw Mnl Mol 3 2!4 .'!* !`>i.4 ts l >wen. W Ci Mesothehal ium.>i\ jiuI espoone to asbestos dust \nn \ V Aud Si I l.<2 |`*IO Mi* Parj//i. 1 .H Petnis. ( * Se,, hi. and ! ( Vijili.itii S'iiiIu-mhi ih ii/m s y tot.'SK lly ot jsbesl dlist Mi'i! ! 4V< ili' S'' s <i! -5 7<>. I ''I,* It? |\>!lui k . A . and M t S;ile 1'u ,iK'!ni' .I'tvsios liodres in li.isalhing smears Israel 3 Moil Sii 4 22 *-22n. W'\ ll.s P,,le\. I l> . P I) Oldham ( -It (in, jtul J t Wane Mu*, vrliuti *t asbestos in tissues. pp I Ok- 1 i In II A Shapiro. I d Pneum<iio,,,i,Ms Pron-edme, of f.'ie inlet tut hnt.tl t .mt,>.<>, e I >'>. Cape I own Oxford fuisersity Press. !*? 11 > Kjimio. V < Ksunenec *! unusual pleui.il . .ili ilu j'l.in i*t ! inland Stiidu-s >n atmospheric pollution iJum-i! '*> asbestos Ann Med. Ini Penn '5 iSuppl. 4`> l-nl. I`rn> I2t). Reading,C l . Asbestos, pp. Ix4-I`l In I1 S l>epjr?ment ot the Interior Bureau ot Mines Minerals Yejjhook !'"< Vol l-ll Washington. If ( C S. (os ern tnenl Printing Otlice. 1*>71. 121 R jih. S A Measurement of airborne asbestos dust by instruments measuring different parameters Ann N Y Ae.nl Sei. 152 M)r.-,t|C_ |>u,c J 22 Roberts, (i. H Asbestos bodies in lungs jl necropsy 3 t tin Path 20 s?tM? ?. 12* Roe. I- J tR. I Carter. M A Walters and J S HjrmgMn lhetjilio logical etfeels ot subcutaneous mieet i,ins ot jsluslos fiber s in mike Migration of fibres io submesothchal tissues anil mdu lum ot rtiesuihelio mala Ini 3 t afuer 2 njs-t. 5* ! *<r.7 124 Rosjto. i) V Asbestos Its Induslrij! Applisations. Sew York Remtiol.l Pub! Corp . I `5'J. 2! 4 pp. 125. Rous. V , and 3 Studeny Aetiology o! plcuiat plaques thorax 2$ 27o2*4. t*7() 12b Sshnit/er. R j . and Pundsaek. I- I Asltestos hemolysis. Pnviron Res t : -! 1. ! u70. 127 Sehuster. S H. Pulmonary ashesiosis in a dog. 3. Path. Bast 14 75 1-757. !2k Sccehi II. C . and A Re//onreo Hemolsne avttvity ot asbestos dust. Med Livoro 5`> 1-5. lvr,K. J2*C SelikoM. I 3 The oeturrenee ot pleurjl ealeitieatuin among asbestos insula non workers Ann. N Y Acad. Set. !.l2 ts|-.b>7. |r*5. 1J0 Sehkoff. J. J., J. ('burg, and H. Hammond Asbestos ex|v>\ufv and neo plasia 3 A M.A. IXX;22-2<>. I'hi4. t-51. Selikotf. I. J.. J. Churg. and h. C. Hammond. Relation lyrtween exposure f* asbestos and mesothelioma. New Kng 3 Med. 272 5(.i).Ari5, I*Hi5 ir i- i 1 , i i . i. c i'-, 1 ... - r |. Ill I , II ' ! I i II \ i r a h it . . 1.1 .11 I I | l|, I,.in > 1 j............. I \ M \ :r I t t II . 00 .' .i,i. i. 1 -I l'i . tin . .1., . i l'i . i- o o VO cn co co I .- > " i ; I , -. < . .: i I I W I .,* i. . Pi . i.l. I ,i : I, M 1. .1 1C- .1 I, < ,i,i , \ I... ' .................... k \ .1 1 H. * I / 1 . o s. ...II, W I I Mill. , \< I | ,l . ' i 1 - . \\ i s ,,ii. A } lt,.| | ' -'"i" >1 a il *i , > i . p. ....... . .. l . 1 S -I- I W 11 l'i. Il:, "1,1. .1 K I .,1" ' 'l | ';s it S m I I t' 1 il , *,-t- i I .il il. >i, U * , ' | r .1. | 1 Si I..I. I, *. I p 111 , 1 A II ,' . .-! -1.* . |1 *i I I .. \ M- is .11 I \f ml \ . Hill .- pill. ., II 1 , .<>, 1 .SI | ,'iin. I i,i, . ,|.l ., ml -i ., t M . if'tMi' 1 , ri I f H \t. i II up its e il i - j s,,nis. , H i y c \ri,. i ' tv VI ,1. P .,. K ill 11-ti '.ill. "t ,| \ |. p .Im>. . bi. - ,,L A ,i:,.1 I < I,.,; . S'-, i \ -.- I 1 I* il li " .................... ! ' I ibel sltaw IK Vsi . 1 .s , i.l ;' i | .,,,i ,N p* Ih'-ii ui It, ||i, p.ii ti.,ai . ['l- ui t in,I ' i:i.in-,, i,. p|- i i 'i Pi ,..trie' 1 ' lb-' I nli i n O ` ipi- I .m it \l,.i ! I r.. i ,-i s, . I t|onis,,n J | , w M t. 1 fit \i li Pii'i SI J-' J. : 1 ' 1 ft, K't K - mod,-mi mil.||, || | s \> 't W*l l*S lilnliul IlMU'Kx l .mil poi.* i it I In,I Ml.I >s lust m ttu Nin| Inn jr- .t i i:r>.- f.s [in h.*sjl Inn*: (!< fit'll** iiint *wn Ovtu.l finljn-J Vtii.iir* I i nn *t itio i*t*t> I) i l imonr Path >ii I ho jrrUi" |i'< m*>* >t uiONnb,li' iik Konlml.l |l-. ir W - - UM bsi l i M 1 t . Di'illl ir m.l 'i ti * |st .ir- Ri'li'fU'HVN V) s.-lik..;i I I in>) | t llnimntit.l \nI, .In* IuhIu'n m Mu' Sow A.uk II'nI Hi. .n i\ i\*- |irt n.>i iiiiiv |i| *io. 1i)S Inti A Sh.iI ll t'u ii'H' n 'in-ims (*i 11 iviinu's ni i |u- Intornai f*n.ii ( on lor on, o. J< liu linos- Inn v' I 'ti' <.,,v 1'ivi i K ! it il I mvoiMl \ fions. I `f70 soiik.'M | I .tii.| I i Il.i'litii itiii I nvifiinnii'iUal I'l'nli'intiilii^y III t >'nmMo11\ ill,, r> i%i it..Hii,. ui'iiInm.i! oitvir.>nnioniai unIvnIon ox fuNuro \'||.-' I PnMi, Millit) S- U.nS. ||.1>*I, rn* t'l Srlik i'll lilt ll.iiuinon.i .in,l J ( luuj! N'.bosiiiN oxpoMiro. siiinkinji. m.l n.-.>ii.iM.i I \ M \ ;ui |or*. 11 2. t`mx ' s.-lik.-li | | j ( ft nnni"ii,l in,( / <'(iur>r Modality oxivnorKO'.*1 i-' .i.. iumiI.i' i, in w. k i-tv i'*4 l -1p|* |nH '\ Mupif". I >1 fin'llm<>, >ui>ixis I'i'i, ,'i'ilin|i\ ill iIn* 1 nlortuimii.ii < ',*nloron,v. Inhan- *i"%l*irf j* I '<> ' ( ,,jv |i **fi 0*1.if,I tumors;! y J'roNv. J071) I - Si likiiii.l I Vk 1 Si,"i-...n. .mo 1) M l unjror ANhcsIos air pollution in hi * in ur i* 1'i' v,'iiiril it i In* Anton, .m Mi'tln .ii AsNooulion Air Pollution Mi'ili, .il k <*< ,;. h t hiIc'iein ,'. Sow l J/loun'. ()rl'>l'i'r V f `J7(J - Mm- * :'-iin`i < K Aslvsi. isis i i Si >ui!i Min an onIh-nIon minors Invimn K.* : :i ` : 1 * I'Wii i > S'iiiiii\\ i 1 Miili'i It J 1 I*.i\s,'i, .nnt l I) HulH'ii 1 osl* [,*r oafvino- o-mi.ii* -! ,'!v i,.* Ann S A Ao.nl S, i i 4M.-4XX I'ftvA 1 'siintii a | unit-A ,i/,!i Imln, i mn .'I , .n, inoin.is Ifoiit nmiiNO lon>> II i'1'pi ii,'.l ,, ii li is I'i'i. Amor Asm*, t'aiuor Kos 10*4. t *<># i il'Ot i 1 i i lo n. 'i'i'i W it fninii.ivitv ix|*i'\i,i\|N \ 1,'iHni ,*t .i ,-.i\o .inl .i rovicw Amor. K, * I tit--. ' ` n .M MM. I'* <0 Ml split s .null f l oini'nolior Aslx'sios niinorals m moJorn loohn'ilouy I mifii Hi-* : u.f.-.'os. ' > si.mi'Mi \1 I l< itl.i. k**,il. ami 1- Millfi ixponmonul pulnn*n.iry n iri'i.i, 'I.'sin w it I) .ist'i'xiiis Anu'l ln.1 Hvn Annuo J 10-^.lA-244. I IM S|i-.ii', M I an.| \ li.iiKl.iu l),'nitnNiraiin ol ho ps'culur h-ntioN of l>uinn>n.iiy astvsi.isis i ''.in|,i'\1unis IkhIion" i in nnuorui ohlainoil lung pnnvtim* .ml in itn-'fiiiii.n I fail) liaol *2 P'. 14 1 si'tiiipfiiuN J ami f it Woyi \nI*onIun hmlK's jo,t moNoihoimnu Ann n,iiif Mvjt 11 ,*h t _*? i-jf.x i In Sullivan K J . .nnt H MIijiunnhI.in i'u'limin.ity Air Pollution Survoy .*1 Asliosl'iN \ ( ili'i iitii' Kovii'w SAIT.-V fuhiuation Al'll) K ili ti'lt Sali.-ntl An f.iiltiiiim i .mliul AilimniNlr.iiion. lli. Sn/iiii A .unit < tinij* Mi u. (mi'ami .{,* otuffin-ni uMfio aNboslu* hmly N ii,.'* I f ,lli nV ' in | 'K,'* il' iii<ii.ti.i,v I R AnI'.-.i.in is an onvirunmoni.ii ha/.ifit J 0,,up Moil i in If' l nii in i' in...... ,n i <; in,' p.iiii.,!.*i!ii at itiaitm'Nis .*t m.tli|tn.inl moNoiholtom., ,*l ................... . I'.',i.,ii.'imi> p|< Mu mi inti > Stiapu** t,l I'noum.K.tmo f i .. ilu.iix . .11 In- liiloi u.iI n >n.il I . IIIrl,'ll. o. Jiiliallllt'Nlii,i|l I 'Mt'f < apo l.niu imvoiNiU fross l'f7o 11|..in,..ii | (, ami W M (.i a vox Ji AshostoN .in an urban air oonl.iisn- ii mi \i Ii full * I 4n.n 4i. J |'if,i* ........... . I i. K <> * K.im liul.i. ami K K Mu, I l.in.ilil AnIwIun a* a ill- "In It III Ivin iii/.il'l V \ 11 M.'.l I 1' ' N I I'ti.l DOW 02727 ST0095338 4<l aski sms l-l i' ' ) mil'i ill A I !* ml'.il rd-iH hltmus .JmsIs Ann VY Ai.nl Su I ; *n' i 1 : 1-n.s I in I II SI inl\ >| | lie m , nl.11 l it'nil ill ,1'lnslii' hixlii's m iun><s m | ..nil' Hi ri in rn.i, Uni Mi ll J * ' l.\ .'> i. I: j l': I'jiiln.in M l> I' iiinss .mil K i I' ilr I icvilli* Icfim'iii'nis hmiu's in linm.iii lungs 1`trs.ik'in i* al i.mi.I.mu jiii*-jisti's Ai.h I miii.n IUmIiIi i : > * i;; i`n.s l'4 Vii'li.im I t I M.u.in/.ui.i. ,n>l H I'vims I |'>i.W'i)ii.>liii!i. .il .. mis . ! .ishi'sins Mm km s iii ik ii i lift n I r.ily Mi'il I .ivui.. s`i I'H.S, I'' Vt^ili.mi I i < Mi>11in.i. .iii.I I' M,n.in/.in.i Ass.ii i.ilmii |>iiluii.iui\ iiiiin >i s ss nli ,isl>t`sii isis in I'll .I in. "iii .mil I iinih.iiiK Ann N. A ,\s .nl Ss i | :s s.s ' '4. | `,s I s>. \ iss.iI I \ J I M Ihjik.iti .inil I' < I'r ill I-\ivriiin'iil.il simlii-s I'1 .nhi sl.iMs \ \l \ Ar.li ImiHsu Oiiuj* Mi'il 5 1-41. |K I W ii'ii.i i i Xshi'stiisisin i\jn 11 nii-iii.il .iinm.i|slli.i I liiilMi'il I I I 'h. < I" V\ ICJU'I I I I |'lill'lllh>li>i!V "I .llllllsc Hli'S.illll'Il.ll IlllllMls Isiill'l.il- I l'l in... i.iii.iii in >iu si nit ii s in s->nt It \it n .i .in.l i In' I 'mi ril k iiii!i)i ini A im \ A \i .III V I | i J s -s.s S I'll.s I s'* Vi ifiii i 1 \ I s |n'l Min til.11 pi uliii I ii ill nl UK's. >1 lii'li,>I l iiiik mf i > .1 I lit' I'lcui.i In imi'l.iiiijiiim <! ihisii >n l.ilu ii.iti .iniin.ils Vn urc 1 '<<> | mi. rsi. .: inip U.riMK't. I < .mil i Hrm Ati's..Hn li"in.i'm i il' inll'ivs mu mm nl.iinm \mi|i ishi'si.i* Hut J c.tnn'1 i '`i* *>v | | l>'l AA.is'lli'l 1 <1 A Mi'Ci's .Hlii 1' M.ifi ll.ill'l lillliisv pU'uf-il ms's, il hill. .Ml.i nut I'.hfsi. is in |i. isuii- hi I In in .i: h ,s|i-t n ( .ijk' l*r. iv mi f Hill J In.l M-'.l I ' 'ml I ('|,| | l>.` 'A.hsi,-t I \ ili.'ii.n i-\pi.sin.- in S. mill Alin.i |'l* In II A 'sit,i in in ...............ii ii isis JV n fi'ilirttfs .il ihf 1 nli'in.i inm.iM `*nlt'iin. >' I `tunni'sl'iiii: I'H.'i < .ijv lnssii i) v I * H 1 I'lini'isils 1'ioss. |`i7ii I'-' \\,lisi.. | \slv ,|. .sis in ii.hi I'MU'iiiiirnl.ii .iiiini.il' ni Smilh Alfii.i S.iiiit,' I ' <iln | `in I Ini AV'-.Hti II \\ \shis|,isi' iill.l 1 lim.'1'lllili'hs i>t-i||Svl| Mi\l W< n lli''ls.In |.` s -s .s I 1 1 *'' AAi'iss \ 1`li'in.ilii i'hs hi* i i Hiiui'ii.isltfsliisi' in nvn m.'I jUi.tl.i^isi h >*t'si, In ti li.i. Ali'ili/ilii'i Ii.' < 'I l 'M I'isl VAhiiI. mi. H . i i .i 1111 n, jiiil I l IISK.H1 \m U\|tl\.i 1 |1 (mlill'rit; Iii. m il iin is j'hi'i i. <lijsis I' I*-' AA >ikni>' l *ii nip .ni AsIh'sIhs jml < jiii.i K-jti.M .uni MMnnimn.l-il nms iin w tikmp jjr.tuj* . .iimni'tl unt|i*f llir .IIH|>;. m U' (.i',^'i.,iiii. il l'ilh.ili>)*v ( i mi mil lie hi (lit* Inli't n.ilnm.tl 1 `im.ii AimiiisI ( ..iki-i An Ii i nvinm lli'.itlli II |`M>A Ins AAii^in <t WAslnslos jml hi'.tlih hi I** Ann't Kos Kisp Un I'll! Jl," . tl.'l | *l|t'l Ini AAi.fs It \shtsi-.sis i'listjnut AAi-,$ 1 '<nt! f.i\ I**l'* I i' /.mis * | H-"iiiIk.n .hkI I H ii' nli'n l*l-itr 11 ishi'si..si. in .ijni.nil>n >1 v >i W11 I nut .ii K'-s i '>' ]'*.' OOW 027^0 ST0095339