Document jNgOZv2zLLdzn0wQkjBn9dwJ5

FILE NAME Brakes BRK DATE 1995 DOC BRK261 DOCUMENT DESCRIPTION Journal Article - Index of Past Asbestos Exposure as Applied to Car and Bus Mechanics Pergamon Pergamon Ann occup Hyg Vol 39 No. 4 pp 441 454 1995 Elsevier Science Lid Copyright 1995 British Occupational Hygiene Society Printed in Great Britain rights reserved 0003-4878 AN INDEX OF PAST ASBESTOS EXPOSURE AS APPLIED TO CAR AND BUS MECHANICS Nils Plato G^ranTornling Christer Hogstedt and Staffan Krantz Department of Occupational Health Karolinska Hospital 17176 Stockholm Sweden Lung Research Unit Department of Medicine Karolinska Institute Stockholm Sweden Divisionof Occupational Medicine National Institute of Occupational Health Solna Sweden and Division of Aerosol Science National Institute of Occupational Health Solna Sweden ' | | Recened in final form 26 September 1994 Abstract to describe historic fibre exposure from containing friction ways Different materials were studied and compared for a group of 103 car and bus mechanics with more than 20 years employment and 15 years of asbestos exposure A model was constructed to calculate asbestos from friction materials including duration intensity and exposure last cyueamrulTathievemodel is a ceoxpmobsiunraetion of an additive and a multiplicative model where an asbestos index was constructed that takes both near field and far field exposure into consideration The model was performed based upon data from the international literature and quantitative asbestos measurements 1976 1988 in Swedish car repair workshops The fibres were counted by contrast microscopy with fibre length > 5 mand aspect ratio 3 The mechanics fibre exposure at 398 repair criteria workshops during a period of 48 years were calculated using the model The mean cumulative was estimated to be 2.6 ml ' year The annual cumulative exposure exposure was highest for truck exposure mechanics the early 1960s The car mechanics had a weighted average fibre exposure range of 11 41 mlflmean 0.21 ml in 1965 compared to 0.003 0.08 f mlflmean 0.021 fml in 1985. In order to validate the model the mechanics fibre exposure estimated using the model were compared with representative asbestos exposure measurements for car mechanics during the 1960s and the 1970s correlation coefficient = 0.69 Five lung physiological variables FVC TLC FEV TL and CV were used to study exposure response relationships None of the exposure parameters suggested any significant relationship between exposure and decrease in lung function INTRODUCTION | exposure Asbestos exposure can cause a variety of lung disorders Lung cancer is an effect of high asbestos exposure levels in the past Selikoff and Lee 1978 while other diseases may be the result of more recent exposures Therefore it is important to characterize asbestos exposure over long periods Information on cancer and other diseases from studies of level asbestos exposures is inadequate Car mechanics are generally regarded as a low exposed group no increased risk of lung cancer was found Hansen 1989 Mesotheliomas have been observed R^delspergeret al 1986 Woitowitz and R^delsperger1994 but there is no support for any increased risk for car mechanics or garage workers McDonald and McDonald 1980 Teta et al 1993 J^/rvholmand Brisman 1988 Wong 1992 Lung function data have not been studied systematically demonstrated with well described exposures High levels of asbestos exposure can cause lung fibrosis Selik and Lee 1978 is however unknown if low dose exposure can result in fibrosis Murphy et al 1972 changes in small airways owing to asbestos i i el Author to whom correspondence should be addressed 441 442 N. Plato et al exposure but the level of asbestos exposure that may cause airway effects has not been satisfactorily described The aim of this study was to construct a model to estimate the cumulative asbestos exposure from friction materials to apply the model to one type of employment car mechanics with low asbestos exposure at different working places and finally to compare the model with other types of exposure and determine its relationship to lung function variables This study is an expansion of a recently published study Dahlqvist et al 1992 as bus mechanics have been included to increase the exposure range Friction materials in clutches and brakes for vehicles have contained about 30-70 asbestos fibres since 1930 Kauppinen and Korhonen 1987 During repair and changing of friction linings there can be exposure to asbestos fibres worn from the linings This has been demonstrated in several studies Hatch 1970 Lorimer et al 1976 Knight and Hickish 1970 Rohl et al 1976 Kauppinen and Korhonen 1987 In the middle of the 1980s approximately 25000 workers were employed as car and bus mechanics in Sweden and thus exposed to asbestos fibres Asbestos brakes linings were introduced in the beginning of the 1980s Different methods can be used to describe past exposure depending on the data sources available quantitative or quantitative models have been used Stewart and Herrick 1991 but no model exists which could fit closely Swedish car mechanics Asbestos exposures during different job activities have been studied but the exposure pattern over longer periods has not been adequately investigated for car mechanics STUDY SUBJECTS AND METHODS Study group A study group was selected from the local health records of the Local Vehicle Health Service in Stockholm and the local bus transportation company Lung function examinations and individual exposure assessments were made The criteria for selection were male older than 40 years and more than 20 years employment as car and bus mechanics Those who had been involved in spray painting or body repair activities or had asbestos exposure from other sources were excluded Ninety car and eight bus mechanics fulfilled the selection criteria Smoking data were collected by interview Dahlqvist et al 1992 The subjects were classified as smokers smokers and smokers groups and the amount smoked was expressed in years Twentysix were smokers 39 had never been exposed to diesel exhausts and just five were free from both diesel and tobacco exposure The car mechanics had worked at 386 different repair workshops and the bus mechanics at 12 bus repair workshops The workplaces represented a wide range from small fashioned car repair workshops to large recently constructed repair workshops with good ventilation Until 1975 most of them had used compressed air for cleaning the brake shoes During the observation period 1938 198t6he mechanics had worked at an average of four workplaces range 1-14 workplaces The mean employment time was 29 years 20-48 years Reference equations for lung function were derived from a control group of 83 suburban bus drivers without asbestos exposure who were investigated in the same way Dahlqvist et al 1992 Twenty of them were smokers | | | i : ' | Past asbestos exposure index for car and bus mechanics 443 Exposure assessment The exposure was estimated by the following procedure 1 construct a model to describe cumulative asbestos exposure by using an asbestos index and estimate the cumulative asbestos by the model 2 cumulative exposure was compared to other ways of describing exposure employment duration and exposure duration 3 the model was applied to the 103 car and bus mechanics and exposure estimates correlated with lung function data Employment duration is often used as a simple estimate of exposure if no other data are available The information concerning employment time was collected from company records and also checked by questionnaires obtained from the study subjects Exposure duration time was calculated with additional information from question- naires and interviews described in the Appendix e.g. job activities and location With the information about more specified activities for we could exclude employment periods with no asbestos exposure Model construction The model was designed to calculate asbestos exposure from work with friction materials such as dust from clutches and break shoes It has been described in detail in Swedish Plato et al 1991 and is more briefly summarized in the Appendix By reviewing the international literature a set of parameters that influence the asbestos exposure of car and bus mechanics was selected The magnitude of the multipliers associated with those variables was estimated and chosen from a large series of past measurements covering representative values for different work activities technical equipment ventilation technical standard and workshop sizes The derivation is discussed in more detail in Table Al of the Appendix The coefficients were used in an equation that takes task activity as well as background exposure general shop exposure into consideration The model was created as a combination of an additive and a multiplicative model Table A2 in the Appendix and makes calculation of cumulative exposure possible The equation in the model expresses the quantative exposure in an asbestos index Asbestos index general shop exposur+e task activity exposure for each mechanic for each year summed for all years of employment as a vehicle mechanic i Model validation validton validation The model was validated using representative Swedish measurements in car and bus repair shops for the period 1976-1988 The fibre measurement criteria using phase- contrast optical microscopy were length > 5 ...mdiameter < ...mand aspect ratio reports T3 en including 23 h measurements personal sampling at different car repair shops were selected from the data bank of industrial measurements at the Swedish National Board of Occupational Health to validate the efficiency of the model These investigation reports were selected because they contained sufficient information on work activity production rate and other information needed to choose coefficients in the model Many reports in the databank did not contain adequate information and could not be used The coefficients and equations in the Appendix were applied for those 23 measurements Asbestos indices AI were calculated and plotted against the measured fibre level in the transformed curve Fig ) i i 444 N. Plato et al y = 0.03 + 0.01 1x r = 0.69 0.20 0.18 0.16 0.14- ml 0.12 0.10 fibres 0.08 0.06 0.04 0.02 0 =. { I i | j 5 10 15 20 25 Al Fig 1. Transformation curve Comparison between the constructed asbestos index AI and asbestos fibre level from 23 historic h measurements The calculated asbestos index was related to asbestos fibre level by the statistically significant regression line 0.029 x shown in Fig3. The correlation coefficient was 0.69 for all observations 23 This demonstrates that a quantitative relationship exists between f ml and the AI It also shows that the exposure was generally low Application The model was used to characterize the exposures of 103 car and bus mechanics Each subject answered a questionnaire which asked about the repair shops where they had worked job activities and employment time The administered questionnaire was expanded with a standardized personal interview Two industrial hygienists asked 38 additional questions for each workplace in a subject's work history The questions included the following topics room conditions 11 questions treatment of brake shoes eight questions work activities involved with repair 13 questions and activities of the bystanders six questions The people interviewed also had to estimate the duration of work to replace brake shoe linings number of changes from year to year grinding of brake lining time and end year for use of compressed air and use of respiratory protection For each decade they also estimated the general condition of the work area and dustiness from different work operations using a level ranking scale with the existing condition as the reference point The aim of the personal interview was to collect information that could have influenced early exposure such as work activities that generate high exposure peaks and also the possibilty of dispersing the fibre in dusts found in brake drums and clutch housings The Al was calculated by using Equation A1 in Table A2 of the Appendix Work activity and task frequencies during the whole working life of the mechanics were taken into consideration for each individual By use of the validation curve Fig ) the Al could be converted to approximate f ml year Annual and cumulative asbestos exposure values were estimated for each of the 103 mechanics who participated in the medical investigation Cumulative exposure during their total times as mechanics was expressed as mean and range for the whole group weighted average exposure was calculated as a weighted mean exposure for each individual Past asbestos exposure index for car and bus mechanics 445 Lung function function The mechanicsmechanics and unexposed controls underwent examination using lung function tests tests by Dahlqvist et al 1992 Dynamic spirometry was used to measure vital capacity VC, N and forced volume in 1 s FEV . N = 103 static spirometry was used to measure measure total lung capacity TLC N 103 nitrogen breath wash was used to measure measure closing volume in per cent of vital capacity CV N = 92 and carbon monoxide single single breath wash was used to measure transfer factor TLC N = 90 equations Reference for calculation of predictive values for the lung function variables were derivedderived from 83 asbestos exposed suburban traffic bus drivers Smoking years , age and height were studied as potential confounding variables Exposure response response analysis Regression Regresion analyses were done to examine the relationship between the cumulative asbestos exposure exposure and effects on lung function Dependent variables were observed values divided divided by predicted values for FEV TLC VC and CV Independent variables were were length of employment cumulative exposure and exposure duration Student's test was used for significance tests in the regression analyses RESULTS Exposure The mean mean employment time was 29 years range 20-48 years and mean exposure time 26 years years range 14-48 years normal distribution 0.98 Shapiro Wilk statistic The The correlation between employment time and exposure time was 0.92 The distribution of cumulative exposures for the car and bus mechanics 103 persons as calculated with the model using their employment at 398 repair workshops during 48 years is shown in Fig The mean was 2.6 year range 0.1-11.6 30 25 20 Frequency Frequency Frequency Frequency 15 Frequency Frequency Frequency { 10 5y| | |0 j 1 1 L L | -1 2 5 8 11 14 | Cumulative asbestos exposure fibres ml *,,year Fig 2. Distribution of cumulative asbestos exposure for 103 vehicle mechanics Mean cumulative | exposure year normal distribution W 0.98 SAS 446 N. Plato et al fml fml * year The annual mean exposure had a range between 0.01 and 0.46 f ml since 1938. The weighted average for all car mechanics over the period was 0.09 fml fml The annual asbestos exposure decreased during the 1960s and 1970s Fig 2 This decrease was more pronounced for cars from 0.10 to 0.02 f ml than for trucks 0.12f 0.12f ml mainly because of wise changes to disc brakes that generate lower exposure in small cars During the period 1938 198t6he mean asbestos fibre exposure was 3.5 times higher for those who had been working with trucks compared to those who had only been working with cars and the bus mechanics had a 1.6 times higher asbestos exposure than the car mechanics in 1984 Fig 3 In 1964 the car mechanics had an exposure 0.04 mlfl,, 0.170.4f0.17f mlfl,,mean 0.10 f mlflcompared to 0.18-0.46 f mlflm,,ean 0.36 f mlfl,, for the truck mechanics Most of the mechanics started their career with truck repair activities that generate higher exposure levels The Swedish truck mechanics worked more hours per weck with friction materials than the bus mechanics The annual asbestos exposure for bus mechanics was lower than for truck mechanics Fig 3 The variation in annual asbestos exposure levels for the 95 car mechanics showed that occupation is a poor way to characterize exposure and the correlation coefficient was only 0.41 The regression line for cumulative asbestos exposure vs employment time was y = 0.79 x3 shown in Fig 4. Consequently long employment time or exposure duration does not necessarily mean high cumulative asbestos exposure Exposure relationship for lung function The exposed group had a significant decrease in TL with 12.5 0.01 Table , but the decrease was not significantly correlated to either cumulative asbestos exposure or employment time Table 2. No other lung function variable was significantly decreased or correlated with exposure level Tables 1 and 2 The unexposed population had on average a normal lung function compared to reference values Dahlqvist et al 1992 0.45 0.40 0.35 ml ,,0.30- fibres 0.25 level 0.20 0.15 Asbetos 0.10 ---- ---- Cars ee Mixed 0.05 0 1944 L 1949 1954 J 1959 I 1964 Year L 1969 1974 1974 ! 1979 a) 1984 Fig 3. Calculated annual mean asbestos exposure levels f ml ) for different vehicle mechanics N= 103 Past asbestos exposure index for car and bus mechanics 447 12 a ) year year * fibres 8F fibres fibres fibres exposure 4 exposure exposure exposure exposure exposure 4F Cumulative Cumulative Cumulative Cumulative 2r Cumlative Cumulative 0 " 2 a a s s s os s aa Se a] _ = Bs a . Lad) ase ae s a" oil ' as oR ae i a. = a:| # I L } 10 20 30 40 50 Employment time year Fig 4. Correlation Correlation employment time vs cumulative asbestos exposure for 103 vehicle mechanics = -0.793 0.41 Table 1. Mean and standard deviation for observed O values of five lung function variables for 103 car and bus mechanics Predicted values from 83 asbestos exposed bus driver Value N O SD TL TLC FVC 90 87 * 23.8 103 100.7 11.2 103 99.2 12.0 CV 92 FEV 103 946 99.9 19.2 12.8 0.01 DISCUSSION A model was developed to estimate past exposure from asbestos friction materials for Swedish vehicle mechanics The model was based on estimations of multipliers for different exposureexposure variables derived from the worker's task activities and background activities in the workshop The constructed model was applied on interview data from 103 mechanics The mean cumulative asbestos exposure for this population was 2.6 { ml year year Despite the perception that car and bus mechanics constitute a homogeneoushomogeneous group the variation in exposure was wide 0.1-11.6 f ml year Annual asbestos exposure exposure estimates showed a three times higher mean exposure in 1964 compared toto 1984. A statistically significant % decrease in mean TL was observed for the exposed group compared to the asbestos exposed control group However no exposureresponse relationship was observed between either cumulative asbestos exposure or employment time and any ofthe lung function variables TL TLC FEV VC CV or VC 448 N. Plato et al Table 2. Regression coefficients for lung function variables vs asbestos exposure Exposure Correlation +2 N coefficient % Intercept a Slope b Cumulative exposure CV TL FVC TLC FEV Years of employment CV TL FVC TLC FEV 91 89 102 102 102 91 89 102 102 102 0.106 -0.001 -0.079 0.138 0.138 --0.055 0.093 -0.016 --0.057 -0.082 0.030 1.12 0.02 0.62 1.92 0.31 0.86 0.03 0.32 0.68 0.09 91.8 87.9 100.5 102.9 100.9 86.6 89.3 102.4 105.0 98.1 1.08 -0.16 -0.48 -0.78 -0.36 -0.36 0.28 -0.06 -0.11 -0.15 0.06 0.05 ** 0.01 The following text will discuss the quality of the exposure assessment including the fibre analysis the compatibility with studies from other countries and the relationship with the lung function variables Qualitative vs quantitative exposure assessment For most mechanics employment time data from company records correlated closely to the exposure time from interviews or questionnaires correlation coefficient 0.92 Some mechanics had been electricians car conditioners or worked in other asbestos exposed tasks for example supervisors Their job title in the company records however was still car mechanic which partly explains why the correlation was not perfect Job title combined with job activities might give a higher correlation The variability in exposure between different car mechanics is due to the product of a large variety to working activities working methods and shops The annual mean asbestos exposure ofthe 95 car mechanics was 0.09 f ml range 0.01-0.46 fmlfl1 fmlfl1) To use occupational titles alone to describe exposure would produce large misclassifica- tions with a maximum factor 45 45 between the highest and the lowest exposure in the job title The variation was also large for cumulative exposure 0.1-11.6 f ml * year Employment time or time in exposed work correlated weakly in this study with cumulative exposure r 0.41 see Fig 4. Duration of exposure close to employment time was 14-48 years which means that differences in exposure can be explained by employment time by a factor of only 3. The exposure was high in the past and has diminished owing to improved technology and ventilation The fact that the workshops have improved favours those who have worked only during the last 20 years The correlation between cumulative exposure and exposure time has been poor in several studies Blair and Stewart 1990 Smith 1992 Additional questions can be asked during data collection to reduce misclassification of exposure From the magnitude of coefficients in the exposure model Table A1 in the Appendix it is theoretically possible to have AI range by a factor of 120 using Equation A1 with either all lowest coefficients or all with highest value To get more precise exposure information the interviewer can ask for type of vehicle and thereby Past asbestos exposure index for car and bus mechanics 449 reduce the theoreticaltheoretical variability by a factor of 40. By putting more precise questions about working working methods the distribution is decreased to 13 and questions about repair shops conditions conditions will reduce it by a factor of4.Work activities after 1975 give a general reduction by a factor of 1.5 Each factor type of vehicle type of brakes etc. in direct questions reducereduce the variability by a third Cumulative exposure assessment is time and resource consuming consuming which can be reduced by using a systematic questionnaire technique Aditional Additional information can be obtained by interviews and is important to reduce misclassification misclassification Validation the model vs historic measurements Errors of might have occurred when estimating the value for each variable in the historic exposure exposure equation The correlation in the validation was 0.69 between asbestos index and measured asbestos levels A reason for this relatively low value is imprecision in low levels of asbestos It would have been advantageous to have measurements from the 1950s and the 1960s for validation of the larger values of the coefficients in the model but such data were not available Another reason can be poor choices for the multipliers or variability in the actual effects of the factors One important source of error can be differences in fibre counting techniques between laboratories The fact that the same laboratory did most of the fibre counting diminished the error in the calibration curve We think that the correlation was good in spite of the usual systematic and and and random errors in industrial hygiene sampling strategy and fibre counting All fibres areare not asbestos fibres The debris debris from brake shoes and clutch linings contains a large number of fibres with length < mPlato et al 1991 These short fibres may not have the same biological activity activity as the long fibres Brake dust at workplaces has been characterized by size and chemicalchemical contents Jacko and DuCharme 1973 Qualitative analyses by transmission electron microscopy suggest that brake dust mainly contains short fibres length < r m that are also so thin that they are invisible with optical microscopy In a study by Rohl Rohl et al 1976 84 ofthe fibres were shorter than 0.4 mWilliams and Muhlbaier ( 1982 observed that 99.9 of the original mass of asbestos fibres were broken down at high temperature to fibrous magnesium silicates during the brake process Rohl Rohl et al 1976 observed that only % of the fibres in the debris met the definition of asbestos fibres The morphology of asbestos may be changed during the temperature increase in the brake process Davis and Coniam 1973 At 650 the asbestos configuration configuration is transferred to forsterite Koshi et al 1969 which is fibrogenic in lung tissue tissue Hayashi 1974 Sakabe et al 1971 Woitowitz Woitowitz and R^delsperger 1991 concluded from animal experiments that exposure to dust from worn brake linings seems to be less hazardous than from unused { asbestos ' I In this study asbestos was defined as the airborne fibres released from friction materials brake pads and shoes clutch linings with length > 5 ...mand aspect ratio 23 23 Friction materials brake shoes pads clutch linings contain 30-70 chrysotile asbestos The fibre counting was performed by contrast optical microscopy PCOM Qualitative analysis of fibre composition needs scanning electron micro- scopy SEM with an energy dispersive detector The fibre calculations in the | Past asbestos exposure index for car and bus mechanics 449 reduce the theoretical variability by a factor of 40. By putting more precise questions about working methods the distribution is decreased to 13 and questions about repair shops conditions will reduce it by a factor of 4. Work activities after 1975 give a general reduction bya factor of 1.5 Each factor type of vehicle type of brakes etc. in direct questions reduce the variability by a third Cumulative exposure assessment is time and resource consuming which can be reduced by using a systematic questionnaire technique Additional information can be obtained by interviews and is important to reduce misclassification Validation ofthe model vs historic measurements Errors might have occurred when estimating the value for each variable in the historic exposure equation The correlation in the validation was 0.69 between asbestos index and measured asbestos levels A reason for this relatively low value is imprecision in low levels of asbestos It would have been advantageous to have measurements from the 1950s and the 1960s for validation of the larger values of the coefficients in the model but such data were not available Another reason can be poor choices for the multipliers or variability in the actual effects of the factors One important source of error can be differences in fibre counting techniques between laboratories The fact that the same laboratory did most of the fibre counting diminished the error in the calibration curve We think that the correlation was good in spite of the usual systematic and random errors in industrial hygiene sampling strategy and fibre counting All fibres are not asbestos fibres The debris from brake shoes and clutch linings contains a large number of fibres with length < mPlato et al 1991 These short fibres may not have the same biological activity as the long fibres Brake dust at workplaces has been characterized by size and chemical contents Jacko and DuCharme 1973 Qualitative analyses by transmission electron microscopy suggest that brake dust mainly contains short fibres length < ...mthat are also so thin that they are invisible with optical microscopy In a study by Rohl et al 1976 84 ofthe fibres were shorter than 0.4 mWilliams and Muhlbaier 1982 observed that 99.9 of the original mass of asbestos fibres were broken down at high temperature to fibrous magnesium silicates during the brake process Rohl et al 1976 observed that only % of the fibres in the debris met the definition of asbestos fibres The morphology of asbestos may be changed during the temperature increase in the brake process Davis and Coniam 1973 At 650 the asbestos configuration is transferred to forsterite Koshi et al 1969 which is fibrogenic in lung tissue Hayashi 1974 Sakabe et al 1971 Woitowitz and R^delsperger 1991 concluded from animal experiments that cxposure to dust from worn brake linings seems to be less hazardous than from unused asbestos In this study asbestos was defined as the airborne fibres released from friction materials brake pads and shoes clutch linings with length > 5 ...mand aspect ratio Fricti on materials brake shoes pads clutch linings contain 30-70 chrysotile asbestos The fibre counting was performed by contrast optical microscopy PCOM Qualitative analysis of fibre composition needs scanning electron microscopy SEM with an energy dispersive detector The fibre calculations in the Past asbestos exposure index for car and bus mechanics 451 would not be correlated with the fibre exposures Such exposures might have affected Dahlqvist all mechanics but probably not the bus drivers control group et al 1992 found a exposure relationship for cumulative asbestos exposure and CV based on 50 of the car mechanics When the group was increased to include both car and bus mechanics 103 the significance disappeared CONCLUSIONS -It was possible to make a model for estimation of past asbestos exposure and to validate it This approach may be useful in other applications -The car and bus mechanics had relatively low overall asbestos exposure at least during more recent years It had been higher in the past but even the truck mechanics were exposed at a low level compared to most asbestos exposed groups _No significant effects on lung function were demonstrated from these low levels in this study Acknowledgements - This work was carried out with financial support of the Swedish Work Environment Fund The authors would like to thank Professor Thomas Smith Ph.D. Harvard School of Public Health Boston for support on methods and principal discussions We also thank Irena Cynkier Ph.D. then at the Department of Occupational Health Karolinska Hospital for help during data collection and interview and finally Monica Dahlqvist Ph.D. then at the Department of Occupational Health Karolinska Hospital for performance of the pulmonary function examinations and the later data analysis i REFERENCES Bentley M. Z. 1970 Control of the use of asbestos containing friction materials Ann occup Hyg 13,31 32 Blair A. and Stewart P. 1990 Correlation between different measures of occupational exposure to formaldehyde Am J. Epidemiol 131 510--516 Dodgson.J Cherrie J. and Dodgson.J 1986 Past exposures to airborne fibres and other potential risk factors on the European manmade mineral fibres production industry Scand J. Wk Environ Hith 12 Suppl 1. 26--33 Dahlqvist M Alexandersson R. and Hedenstierna G. 1992 Lung function and exposure to asbestos among vehicle mechanics Am J. ind Med 22 59 68 Davis and Coniam S. W. 1973 Experimental studies on the effect of heated chrysolite asbestos and automobile brake lining dust injected into the body cavities of micc Expl molec Puth 19 339 353 Esmen N. A. 1979 Retrospective industrial hygiene surveys Am ind Hyg Ass J. 40 58 65 Hansen E 1989 1989 Mortality of auto mechanics A ten year follow Scand J. Wk Environ Hith 15 43-46 Hatch D 19701970 Possible alternatives to asbestos as a friction material Ann occup Hyg 13 25 29 Hayashi H. 1974 1974 Cytotoxicity of heated chrysotile Environ Hlth Perspect 9 267 270 Jacko and and DuCharme R. T. 1973 Brake emission measurements from brake and clutch linings from selected mobile mobile sources U.S. Environment Protection Agency Report 1973 68-04-0020 J^/rvholmB. and and Brisman J. 1988 Asbestos associated tumours in car mechanics Br J. ind Med 45 645 646 Kauppinen T. and Korhonen K. 1987 Exposure to asbestos during brake maintenance of automotive vehicles by different methods Am ind Hvg Ass J. 48 499-504 Knight K. and Hickish E. 1970 Exposure to asbestos during brake maintenance Ann occup Hyy 13 17-20 Knight K. and Hickish E. 1979 Investigation into alternative forms of control for dust generated during the cleaning of brake assemblies and drums Ann occup Hyg 13 37 39 Koshi K. Hayashi Hayashi and Sakabe H. 1969 Biological and mineralogical studies on serpentine minerals in heat treated state Ind Hith 7 66-85 Krantz S. 1976 1976 Asbestos exposure at community bus repair shops Report for National Institute of Occupational Ocupational Health Solna Sweden in Swedish Past asbestos exposure index for car and bus mechanics 451 would not be correlated with the fibre exposures Such exposures might have affected all mechanics but probably not the bus drivers control group Dahlqvist et al 1992 found a exposure relationship for cumulative asbestos exposure and CV based on 50 of the car mechanics When the group was increased to include both car and bus mechanics 103 the significance disappeared CONCLUSIONS --- was possible to make a model for estimation of past asbestos exposure and to validate it This approach may be useful in other applications -The car and bus mechanics hada relatively low overall asbestos exposure at least during more recent years It had been higher in the past but even the truck mechanics were exposed at a low level compared to most asbestos exposed groups -No significant effects on lung function were demonstrated from these low levels in this study Acknowledgements - This work was carried out with financial support of the Swedish Work Environment Fund The authors would like to thank Professor Thomas Smith Ph.D. Harvard School of Public Health Boston for his support on methods and principal discussions We also thank Irena Cynkier Ph.D. then at the Department of Occupational Health Karolinska Hospital for help during data collection and interview and finally Monica Dahlqvist Ph.D. then at the Department of Occupational Health Karolinska Hospital for performance of the pulmonary function examinations and the later data analysis REFERENCES Bentley M. Z. 1970 Control of the use of asbestos containing friction materials Ann occup Hyg 13,31 32 Blair A. and Stewart P. 1990 Correlation between different measures of occupational exposure to formaldehyde Am J. Epidemiol 131 510--516 Cherrie J. and Dodgson J. 1986 Past exposures to airborne fibres and other potential risk factors on the European manmade minera fibres production industry Scand J. Wk Environ Hlth 12 Suppl , 26 33 Dahlqvist M Alexandersson R. and Hedenstierna G. 1992 Lung function and exposure to asbestos among vehicle mechanics Am J. ind Med 22 59. 68 Davis and Coniam S. W. 1973 Experimental studies on the effect of heated chrysolite asbestos and automobile brake lining dust injected into the body cavities of mice Expl molec Path 19 339 353 Esmen N. A. 1979 Retrospective industrial hygiene surveys Am ind Hyg Ass J. 40 58 65 Hansen E. 1989 Mortality of auto mechanics A ten year follow Scand J. Wk Environ Hlth 15 43 46 Hatch D. 1970 Possible alternatives to asbestos as a friction material Ann occup Hyg 13 25 29 Hayashi H. 1974 Cytotoxicity of heated chrysotile Environ Hlth Perspect 9 267 270 Jacko M. G. and DuCharme R. T. 1973 Brake emission measurements from brake and clutch linings from selected mobile sources U.S. Environment Protection Agency Report 1973 68-04-0020 J^/rvholmB. and Brisman J. 1988 Asbestos associated tumours in car mechanics Br J. ind Med 45 645 646 Kauppinen T. and Korhonen K. 1987 Exposure to asbestos during brake maintenance of automotive vehicles by different methods Am ind Hyg Ass J. 48 499-504 Knight K. L. and Hickish D. E. 1970 Exposure to asbestos during brake maintenance Ann occup Hyg 13 17-20 Knight K. L. and Hickish D. E. 1979 Investigation into alternative forms of control for dust generated during the cleaning of brake assemblies and drums Ann occup Hyg 13 37 39 Koshi K. Hayashi H. and Sakabe H. 1969 Biological and mineralogical studies on serpentine mineralisn heat treated state Ind Hlth 7 66-85 Krantz S. 1976 Asbestos exposure at community bus repair shops Report for National Institute of Occupational Health Solna Sweden in Swedish Past asbestos exposure index for car and bus mechanics 453 parameter were estimated from data in a number of internationally published reports Bentley 1970 Hatch 1970 Knight and and Hickish 1970 1979 Lorimer et al 1976 Rohl et al 1977 R^delspergeret al 1986 Kauppinen and Korhonen 1987 The exposure matrix is based on the principle that was applied by Marsh 1987 after a method developed by Esmen 1979 The exposure vectors have been estimated from a geometric ranking ranking scale illustrated in Table Al The extremes for each variable were first selected with geometric steps because no direct data were available The choice of the size of the coefficients is explained below Type of vehicle vehicle K,range 13 13 A truck has about three times bigger brake lining surface compared to a car and thus generates generates three time more fibres Rohl et al 1976 Coefficient 2 was selected for cars and trucks due to a larger influence of truck fibres Rooms ( range 1 3 1 T3 he variability of exposure in the workrooms in this study has been estimated to a factor of3 from the best to the worse condition Riala et al 1984 carlier applied a factor of 5 to unventilated rooms compared compared to ventilation by open windows during painting operation The respirable asbestos distribution pattern pattern is equivalent to that of vapours Nicholson 1982 The worst rooms were ventilated by opening garage doors during the summer and were given a coefficient of 3 Working activities activities K range 1/3 1/3 A factor of 3 has been applied in order to separate the best and the worst working activities as a mean for 8 h activity Compressed air and machinery grinding give the highest exposure The exposure shows a large variation between drum and disc brakes depending on the longer working time spent spent with drum brakes Kauppinen and Korhonen 1987 Rohl et al 1977 Hatch 1970 Knight and Hickish Hickish 1979 Lorimer et al 1976 Nicholson 1982 Working frequency frequency K range 1.8 3.0 The frequency of different working operations drum or disc brakes has been been estimated to have a coefficient of 3. This was estimated from the mean value from different studies where drum brakes and disc brakes were evaluated during equivalent cleaning techniques Table A1 Coefficient table for the exposure matrix Variable 1. General shop Type of vehicle K ) Repair shop rooms A | 2. Task activities Work activities k Frequence of work K Other factors K Multiplier coefficient Comment 3.0 Work with truck or bus 2.0 Work with truck and car 1.0 Work with just passenger car 3.0 Small bad conditions no ventilation 2.4 Small bad conditions poor ventilation 8 Normal mechanical ventilation medium 1.3 Good condition big size good ventilation 10 Big size excellent condition and ventilation 3.0 Compressed air blowing drilling riveting grinding with no exhaust 26 Compressed air blowing grinding with separate exhaust 22 Brushing drilling riveting grinding without separate exhaust 17 Brushing grinding with separate exhaust 13 Brushing water spray 10 Water spray ) No activity with fibre material 3.0 Daily drum brake activity 18 Daily disc brake or low frequence drum brakes 10 Low frequence disc brakes 15 Work as vehicle mechanic before 1975 10 Work as vehicle mechanic after 1975 Notes 1 Subjectjob job activities changed across time K and Kand the employer shop changed Shops changed changed across time K,K and K as they expanded and changed the type of vehicle and repair work they would would do 454 N. Plato et al Many of the subjects reported very high dust generation during short periods of work on clutch removal During the braking operation on a car nearly 80 of the asbestos fibres and the debris will leave the brake drum and go out into the environment whereas the dust from clutch activity stays within the transmission The clutch often has a total friction surface and amount of debris comparable to the brake linings in the car Other factors K,range 1.0 1.5Information on the asbestos dust hazard was widely disseminated around 1975 and the introduction of new asbestos regulation rules generally improved the working conditions resulting in a general decrease of % compared to the conditions before that period The use of a face mask repairatory protection has an exposure reduction factor of 0.3 for activities where a mask respirator was worn Torney and Barnhart 1976 However face masks were not used during the period of interest so were not included in the model With the coefficients in Table Al and the ranking scale all the exposure situations can be classified for each The ranking scale is geometric in order to give a similar distribution between the coefficients This method was used because measurements were missing for many historical exposure situations Step 3. The model takes into consideration that the mechanic is both primarily exposed by his own work task activity and exposed from field air contaminants general workshop exposure Equation A1 is constructed from the model by Dodgson and Cherrie by using multipliers Cherrie and Dodgson 1986 Literature studies Rohl et al 1977 indicate that the background level has an influence on the total exposure To include task activity as well as background exposure a combination of additive and multiplicative model was constructed shown in Table A2 The asbestos exposure has been expressed in the relative unit asbestos index AI The equation could then be used for each mechanic for annual exposure calculation The AI has to be converted into mlfl,, f mlfl,,by using a transformation curve That curve was created using 18 Swedish reports By using information in the reports the coefficients were estimated and the AI were calculated Table A2 Equation for calculation of asbestos index AI by using the matrix in Table A1 Model asbestos index Al = general sh-otap sk activity Variables for general shop exposure FE Variables for task activity exposure NE for each car mechanics for each year summed over all years with work as a vehicle mechanic and year AI K * K, K K, start year AI Note Al calculated based on each subject's personal work history and of the shops where she worked rN 3oF