Document o1O2yjoRpJnGZdEkLdwjwmkX

FILE NAME: Visible Dust (VDT) DATE: 1965 Jan DOC#: VDT019 DOCUMENT DESCRIPTION: Memo with Report (mu) (gP) fcflCQiCAt, HEALTH DIV.SiGti 1 new VC"x JA N 1 51965 j January CHS ERS GCA JR 1^9 ( AL l Hs s - LC-i. tbae-toa. Ln the Petroleum Industry To Kembara Central Gcmmittea on Medicine and Health, and Technical Advisors Gentlement At th request of the Chairman, Conaiitae on Industrial Hygiena, ambers of the Medical and Health Cousnittca are being asked to contribute information regarding their environmental- health experience with the use of asbestos in th patrols industry. -This Inquiry is prompted by reports of `episaaielagie studies wfcieb revealed manifold carcinogenic effects among bnildlng trades workers handling asbestos insulating material. Ta preserve the confidential nature of any information developed by a contributing company, Sr. Carl A. San (Environmental Health Institute, the University of Oklahoma Medical Center, Oklahoma City, Oklahoma) has agreed to serve as a "third party* and postal center. Those who would prefer not to send the informtion to aa directly can mail it to Dr. Hau who will remove all identifying marks including the postmark and relay it on to me. The information will he collated and presented to the Caanaittee at its next spring meeting if possible., Along with this information the report will include a review of the published information on the subject of asbestos eposura *ad it physiological effects. I Unless two or aors companies can offer some definite data or informa tion, the Survey report will consist of a review of the literature In the hope that it will stimulate future investigations among member companies. Vary truly yours, LERrbgm cc: G, S. CoUinga, M.D. T. E. Han, H. D. Paul D. Halley K. O. Mattocks H, 7, Headricks Lucian E. Eeqea Wfl-TEX OUJHtiJ l :c c o c f- D. D B B B B B sj B / e -6 Attachment III THE HEALTH OF HEFZKERZKBI APPLHNG ASBESTOS 2NSULATTGH . (A Preliminary Audit) % a ^ ' Eocent reports describing a high incidence of pulmonary neoplasms . bong oobostos workers has focused attention on the health of refinery craftsman engaged in'insulation activities. To obtain information relative to the exper ience or. petroleum eompanlos with the health of their lnsulatoro, nembora of the ' Medical and Health Committee vere polled, inviting them to contribute personal information on this subject to a common pool. Assurances were offered that the identity of the donor and source of information would not be revealed to preserve their confidentiality.' Before presenting an analysis of the available information on petroleum company experience, a brief history of asbestos as an Industrial health hazard is appropriate. ' Historical -- For 50 years or longer asbestosis has been recognized in the United States as a form of pneumonoconiools resulting from exposure to asbestoi dust. However, it -was not until Joint medical and environmental studies wore con ducted by official health agencies in the mills of Pennsylvania and Horth Carolina _about 30 years ago that the relationship between dust concentration, particle size . years of exposure and definitive chest x-ray markings was established. The lung field markings vere also shown to correlate well with certain subjective reactions related to pulmonary function. x Important foots concerning the physical character of the dusts associate with asbestosis were revealed in these studies. Although asbestos fibers, ranging in median length from 7-16 minrons, were found in the air, these long fibers were relatively few in number. The bulk of suspended dust ranged from shout 0.5-3 microns in length and varied in concentration f r o m little as 1 or 2 million particles per cubic foot of air (mppcf) to 20 or more mppcf, depending on the " mechanical operation Involved. The correlations also showed that after 15 or more years of exposure the disease reached shout the same degree of advancement, as evidenced by chest x-ray markings, regardless of dust intensity. In these etudlea there seemed to be so evidence of pulmonary or other thoracic neoplasms and no suggestion of such findings. Subsequently, reports of the occurrence of lung cancer and other malignancies associated with asbestos employment began to appear in the literature. Although the number of such cases appeared large, soma investigators felt that the observations did not establish an increased incidence of cancer end that the association was unproved. Kany "1, [ c 0 c *1 1 0 B B B I I B , \ - . ' ' E-T Attachment III valid weaknesses wore shown to exist in tho roports claiming lung cancer as a opccific industrial hazard of asbestos workers. L'ovcver, in 1963 a report pub lished by Solikoff, Churg and-Ba=ohd.-(tho latter or tho cigorotto famo) dcscrib a significant incidence .of lung cancer and other pleural tumors as veil as cance of tho stomach, colon and rectum among asbestos insulators in tho construction industry These insulators woro exposed to a varioty of materials including fibrous Lass, cork and hair felts which contain no asbestos; other insulating materials, such as magnesia, calcium silicate Insulating block and insulation - - cements containing 10-15 percent asbestos; No free silica was present and asbos appears to bo tho only biologically active material in the exposure. This repor seamed to bo free of tho statistical weaknesses and other valid criticisms of tb earlier reports. Sinco tho date of that report at loast 3 additional publicatio; by other investigators confirm in part, if not all, the findings of Solikoff and his associates. An important finding in these reports is that these cancers are found some 20-40 yoars after Initial exposure to asbestos, frequently after roil meat from active esploymant. Susaarv of Findings - The response to the poll of the Nodical and Heal Committee members regarding this potential problem was nominal for this typo of inquiry. Twelve replies representing nino companies were received Of this numt about 3 companies had made vhat appears to bo a careful examination of their heal records and at least two other companies are engaged or are about to begin both environmental as well as medical surveys of asbestos insulators. A point of special interest is that not all insulating materials used in a refinery consist of or contain asbostos Considerable quantities of glass wool or rode wool, as well as magnesia, are also used as insulation. Those materials are similar in composition to those reported by Solikoff and associates. One company reports that among a group~of about 40 insulators there was one case of bronchogenic carcinoma after soma 16 years of exposure and one case of adenocarcinoma of tho rectum after some 20 yoars of exposure. Two other employees have had lung biopsies'performed; one with 25 yoars of exposure show lag a single asbestos bodyin the specimen and the other with 20 yoars of service with fibrous thickening of the avoolar septa but no asbestos bodies in the speed There was no significant pathology In these specimens. In another cospany one plant reports a suspected case of asbestosis which occurred same 10 years ago, but the outcome of the case is lost to antiquit; At another plant of tho samo company one insulator had a lover lobectomy and it was suspected that the fibrosis was caused by asbestos. A biopsy disproved this ABS-003991 The sticky- note shown below was written by Barry Castleman and attached to the page immediately following along the right margin at the spot marked on the next page with an X . 5m / E-8 Attachment III allegation. X-ray examinations of 7 additional insulators at this plant, each of vhon has had 18 or core yoars of exposure,_*ovealed no significant findings* At still another plant roentgenography of all the insulators rovodod broncho ' vascular markings which was not apparent among other refinery people. No eigniil- cance was attached to these markings by the contributing physician. A third company reported examination of insulators at 11 their plant ^ The majority have less than 15 years service and their chest x-ray files and 6th tosts appear normal. Two employees with taro tha# 15 years service are reported * to hava & bronchitis. . All other reporting companies state that their insulators appear healt and that there have been no unusual illnossos among the group. No results of any dust surveys ware reportod although ono or two companies state that the inhalatio exposure to asbestos is insignificant. It is pertinent to point out that the so-called KAC for asbestos dust is 5 eppef and that some investigators consider this value to be too high. It is equally important to point out that dust con centrations below about 5 mppcf of air are generally Invisible to the naked eye oven to that of the experienced observer. Conclusion - She data obtained to date from the Medical and Health Committee is inadequate to resolve the question as to the degree of hazard which - ashestoa poses to refinery insulators. This is so because the total number of reilnexy insulators (about 150) covered by the contributing companies* reports . is insufficient for reliable statistical treatment and it is uncertain in every case that the morbidity end mortality records of retired refinery insulators or former refinery insulators have been included in the reports. Since the usual ''diagnostic examinations ere frequently inadequate to detect certain cancers in thair early stages, the disease may not be revealed until it has progressed to advanced stages late in life. TO obtain an adequate population sample of refinery insulators for statistical reliability and comparison with published data# at least 500 employee* should be covered in the survey. Sines there are only a relatively few insulator* of long tenure in any one plant, the survey would require the full cooperation of at least 10 companies to obtain meaningful results. As a matter of interest, Salikoff reports that the expected mortality from lung and plneral cancers over a 20 year period in a population of 500-600 persona is shout 6 and for the same length of time, the expected mortality from neoplasms of the stomach, colon sad rectum is about 9 for the same size population. ` 3 ABS-00399' , / _ * E-9 Attachment III casea on some personal observations of Insulating activities., it is - sr opinion that the inhalation exposure to asbestos among refinery insulators . ' *' . . * "1 1s neither w'<rv<r"i*1 nor gnj t*t'nn*- ad I "urge theKedical and Health Coamittoi . to continue studying this potential health problem. - ' . * . ^ V ` < ABS-003.QO 4 I E-10 Attachment III X* "A Study of Asbestosis In tho Asbestos Textile Industry" - Public Health Bulletin #241, August 1938, U S. Covorniaent Printing Office. 2. Braun, B.C. and Truan, T. D. - "An Epideaiological Study of Lung Cancer in Asbestos Miners" - ABA Archives of Industrial Health, Vol. 17 (June) 1953. 3 Salikoff, Cburg and Hamaond - "Asbestos Exposure and Neoplasia" - JAHA Vol. 188, No. 1, 1984* 4 ELwood, P.C. and Cochrane, A.L. * "A Follov-up Study of Workers from an Asbestos Factory" - British Journal of Industrial M edicine, Vol. 21, No. 4 1964. 5 Butra, T.R. and Camay, J.B. - "Asbeatois and Pulsonaxy Carcinoma" - Archiv . of Environmantal Health - Vol. 10, No. 3, 1965. 6. Williams, W.F. -- *Asbestosiaand Lung Cncer" -- Archive# of thvironmental Health - Vol. 10, No. 1, 1965. . 7. Asbesto8ls Spspoeium - New York Acadeagr of Scienoes - Suoa&er of 1964. -i-. r ^S-004000 The sticky- note shown below was written by Barry Castleman and attached to the page immediately following along the right margin at the spot marked on the next page with an X. i .y N t r' . ij. . - . TABIZ 2 - Page 2. . .'? ... Precanceroua .Lesions .. . . -, . ... . . . . . Etiologie Age H - BONES AND BONE MARROW: Benzol and derivativ Blood dyscrasias: Hyperplastic, hypoplastic, aplastic, radioactive substan I1 - ' * . or hemolytic anemia. .Thrombocytopenic radiation. . purpura with spleen not markedly en larged. Transitory leukopenia, mono i: cytosis. LUNGS: ` : Pneumoconioses : Bituninoaia, asbestoaia, "lipoid" Asbestos, arsenic, ti r. Chronic Pneumonia : pneumonia, chronic chemical pneu monia., arsenical dermatosis, chromate ulcer of hands, perforated nasal septum (chromate, arsenic). oil, mist, chrome st -- chrome pigments, nit carbonyl. ? .... - .i *> r. Many of these pre-cancerous manifestations regress spontaneouslyJTrom expose to the causative agent ceases, however, aone of them are followed by or transformed is malignant growths. It is advised, therefore, to examine certain workers periodically such reactions when they are known to be exposed to these carcinogenic agents, and vhe warning signals appear the worker should be removed from bis environment. x Q 0 11 Q 003348 CARTER