Document ppa59Q51zm3w6vGE6NYyMYeN6

some knowledge of dust levels and fibre type) and confirmatory clinical findings of pulmonary fibrosis. Many workers who have been exposed to asbestos never de velop. any x-ray changes and only some develop asbestosis. It is not morally justified to suggest to a symptom-free, otherwise healthy individual that he or she is suffering from an incurable dust disease with a concomitant cancer risk, if there is not definite proof. If the disease is "definitely suspected" then the individual has a right to know, to cease exposure and to seek compensation. It is not yet known whether the improved methods of examination available permit the detection of the disease at a stage where fur ther progression can be prevented if exposure ceases. The disease is now almost certainly diagnosable at an earlier stage than 46 years ago in Merewether's time. The disease will probably pro gress in the more advanced cases even when exposure to asbestos dust has ceased. The British worker has changed his job habits and it is unusual to find him working in one firm or one job for as long as 20 years. Asbestosis is a preventable disease -- it now remains to prove whether lung cancer and mesothelioma are preventable by the same means. With regard to lung cancer the eradication of the cigarette habit will undoubtedly also lead to the eradication of this complication of asbestosis.1' In a large asbestos textile factory in Rochdale the prevalence of asbestosis has been reduced In 1975 to 0.77% among the current labour force compared with Merewether's finding of 26.2% in 1929. (Table). This reduction has been achieved by conscientious effort on the part of management to eliminate the disease. In recent years there has been a growing awareness among workers in industry of their role in the prevention of occupational disease and when enlightened management takes advantage of this new willingness to cooperate, then useful practical measures follow. Confrontation is not the way to better health. Elimination of occu pational disease depends upon joint consultation and sensible ap plication of the most reliable and practicable preventive measures, implementing legge's aphorism that unless and until the employer has done everything, and everything means a great deal, the work man, no matter how willing he may be to do so, cannot protect himself. The world cannot do without asbestos at the present time as it forms an essential component in many sophisticated engine^ production and everyday devices. Without asbestos, more f would undoubtedly be lost from the hazards of fire and most ki' of energy conservation, transportation and industry would'! unable to function effectively. References 1. The Asbestos Industry Regulations. (S.R. & O 1931 No. 11401, 2. Merewether ERA and Price CW: Report on Effects of Asbestos Dust' the Lungs and Dust Suppression in the Asbestos Industry. Part 1,. * currence of Pulmonary Fibrosis and other Pulmonary Affections in AsbbS Workers. H.M.S.O., London. 1930. 3. British Occupational Hygiene Society; Committee on Hygiene $ dards: Hygiene standards for chrysotile asbestos dust. Ann Occup , 11:47.1968. 4. Problems arising from the use of Asbestos. Memorandum of the S* Medical Inspector's Advisory Panel London: H.M.S.O., 1967. 5. Department of Employment 1974. Annual Report 1974. H.M. Chi spector of Factories: London. H.M.S.O. (Cmnd 63221. 6. International labour office meeting of experts on the internal classification of radiographs of the pneumoconioses. Occup Safety Hlth 1959. 7. UICC/Cincinnati classification of the radiographic appearance pneumoconioses. A co-operative study by the UICC committee. 58:57, 1970. 8. International Labour Office. International Classification of Radiog of Pneumoconioses. ILO U/C Classification 1971; 1972. 9. Bader ME. Bader RA, Teirstein AS et al: Pulmonary function and i graphic change? in 598 workers with varying duration of exposure asbestos. Ml. Sinai I Med 37:492. 1970. 10. Becklake MR. Fournier-Massey C. McDonald 1C et al: Lung func in relation to chest radiographic changes in Quebec asbestos workers.' Physiopalh Kesp 6:637-659, 1970. 11. Elmes PC: Incorrect diagnosis of asbestosis. Postgrad Med / 50:1 251. 1974. 12. The Asbestos Regulations. London: H.M.S.O.. (1969 No. 690).' 13. Department of Employment. Hygiene Standards for Air1; Asbestos Dust Concentration for Use with Asbestos Regulations. TechData Note 13 (Rev.I, 1969. 14. Amandus HE, Lapp NL, Jacobsen C, and Reger RB: Significanc irregular small opacities in radiographs of coalminers in the U.S.A. Brit :j dustr Med 13:13. 1976. 15. Berry C, Newhouse ML, and Turok M: Combined effect of ast exposure and smoking on mortality from lung cancer in factory worker* Lancet 2:476-479. 1972. 610 Asbestosis/Lewin ir