Document regLbY6XRaQjwoyeZyQD4LKpe
FILE NAME: Asbestos Textile Product Use (ATPU) DATE: 1982
DOC#: ATPU018
DOCUMENT DESCRIPTION: Journal Article - Asbestos Fibres Released from Thermic Cloths-A True Occupational Hazard
G IO RN ALE ITA LIA N O Di
/MEDICINA DEL LADRO
PAVIA, M A G G IO 1982 VOLUME 4 N. 3
Unit operativa metalmeccanica, del sottoprogetto finalizzato del Cpnsiglio Nazionale delle Ricerche Prevenzione della patologia da ambiente di lavor - Censimento dei rischi nell'industria metalmeccanica.......................................... ;.......................... pag. I li
Maron G., Pretti A. - Industriai noise data management.................................................. pag. 113 Loi A.M., Paggiaro P.L., Serretti N., Franco F., Viegi G., Begliomini E. - Asbestos
fibres released from thermic cloths: a true occupational hazard............................... pag. 117 Pozzoli L., Seghizzi P., Cassina G.P., Beni L., Domp M., Pogna R. - Esposizione ad
anilina a basse concentrazioni: dosimetria individuale e monitoraggio biologico.... pag. 121 Petronio F. - Sulla gravit del danno infortunistico in un cantiere navale..................... pag. 129 Meloni M., Carta P., Casciu G., Casula D. - Volumetria radiologica polmonare e funzio
ne ventilatoria nell'enfisema conclamato in corso di indagini epidemiologiche........ pag. 133 Biscaldi G.P., Calligaro A., Pavesi L., Robustelli della Cuna G. - Reattivit e aspetti
morfologici e ultrastrutturali dei linfociti nella impregnazione saturnina................. pag. 137 Sarto F., Scapinelli R., Cominato I., Impellizeri G. - Aberrazioni cromosomiche nei
lavoratori del rad ar...................................................................................................... pag. 141 Pardi F., Ambrosino N., Bachini P., Loi A.M., Paggiaro P.L., Siclari C., Baschieri L.
Valutazione clinica e strumentale della malattia da strumenti vibranti: uno studio su 50 soggetti................................................................................................................ pag. 145 Menegozzo M., Costigliela A. - Patologia da isocianati e soggettivit operaia.................. pag. 151 Recensioni e convegni............................................................................................................. pag. 157
:o
Asbestos fibres released from thermic cloths: a true occupational hazard
Anna Maria Loi, Pier Luigi Paggiaro, Nadi Serretti, Fabrizio Franco, Giovanni Viegi, Enrico Begliomini.
Loi AM, Paggiaro PL, Serretti N, Franco F, Viegi G, Begliomini E. Occupational exposure to asbestos fibres liberated from thermic cloths.
GItal Med Lav 1982; 4: 117-120. The authors point out the possibility jat asbestosis can be detected or almost suspected in workers exposed io asbestos fibres released from thermic curtains or clothes in various industrial environments. They report the case of seven workers of a me tallurgie plant; these workers had been exposed to a such kind of risk and showed, from 10 to 23 years later, a radiological appearance of in terstitial fibrosis with a sligth or moderate respiratory impairment.
There are several reports that some overalls and
thermic curtains of industrial use can release asbestos fi
bres in the environment (1,3). Their concentration in the
air varies from 0.3 to 26 fibres/ml, depending on the
kind of tissues and from working conditions. However,
asbestosis cannot easily be detected at this level of-occu-
pational exposure.
We report here some results obtained in a routine
examination of a group of workers employed in a metal
lurgy plant in Massa (Italy). Ever since 1960 asbestos
^ u ta in ^ y re i^ ^
of the ..
'hiding -and to protect the welders. In 1976 they were.
^Substituted by similar clothes made up with vitrous wool.
When we began-the plant revision and medical examina
tion of the workers, we could not verify which kind of
asbestos had been employed, but we knew from the wor
kers examined that the environmental fibres were of whi
te colour and their mean concentration in the plant was
about 15 fibres/ml with a length above 5u.
Material, and methods
The factory production concerned handmanifactured articles of big size for the chemical and pefroichemical industry. Dust level was not available at the foment of medical examination (1979), which was our concern. The working men were 736 and they were em ployed in several jobs such as calendering, welding, grin ding and gathering, so that most evidence of occupatio nal risk was given to metallic fumes, noise and radiant heat.
This paper refers about clinical findings of a group of workers (49 men) that had been exposed to asbestos fi tes before the asbestos curtains and overalls were avoi-
^ nna Maria Loi, Pier Luigi Paggiaro: Institute o f Clinical Methodolo-
S"anri Occupation Medecme, Pisa.
L. i Serretti, Fabrizio Franco: Occupational Health Service. Massa.
I0vanni Viegi, Enrico Begliomini: Clinical Physiology Laboratory and Clinica Medica II, Pisa.
Fig. 1 -- Posteroanterior roentgenogram (a) and magnified view of the right lower lobe (b) of C.D. (case n. 3 of the Table). Interstitial reticula tion is evident in the lower lung fields. Hila appear slightly enlarged and increased in density, showing an irregular contour. C Kerley lines
are also present in the right mid-lower lung
O lini Med Lav 1982; 4:117,120
Fig. 2 -- Posteroanterior roentgenogram o f L.F. (case n. 5 o f the Ta
ble). This chest film reveals an interstitial design of reticular pattern in
both peripheral lung fields, more evident in the right zones, where somt
>
nodular shodows can be observed
A .M . Loi et a|
1) B.A. 2) B.R. 3) C.D. 4) 5 ) L.F. S .A . DY-A-
Fig. 3 (a) Fig. 3 (b)
Fig. 3 -- Posterosanterior roentgenogram (a) and magnified views of the right (b) and left (c) lower lung fields of S.A. (case n. 6 of the Table). Cardiac and hilar shadows appear moderately enlarged w ithu irregular and blurred contour. Interstitial network shows a reticular pattern in basal and peripheral regions in both sides. Some micronodular opacities are also evident. The right hemidiaphragm contour 1 slightly irregular and ill defined. A pleural thickening is present in both
sides near the costophrenic angle
ded. All 49 men underwent the following examinations:
CECA questionnaire for chronic bronchitis, chest radio
graph, medical examination, tests of ventilatory function
with a wedge spirometer.
Seven out of 49 men having a radiological appearan
ce of interstitial fibrosis were subsequently exam inated
for arterial blood gasanalysis and diffusion lung test by
means of CO transfert test (DLCOSb and DLCOss)- .
For one out of 7 men a chest radiograph of 3 years earlier ,
was also available.
i
Results and discussion
Chronic bronchitis, according with CECA question,
naire, was present in 11 out of 49 workers (22<7o). In
out of 49 men the questionnaire was positive for ot^
symptoms different from chronic bronchitis and in **
was neWgative-.-
p
Chest radiograph was normal in 27 workers, i1n ^
men there were various abnormalities as cardiom e.^
marked bronchovascular design, hilar enlargm ent
sema
TAB. I - Age, risk exposure and respiratory findings o f 7 workers with radiological appearance o f interstitial fibrosis
1) B-A:i b r 3) C.D.
4) G.P. ) -.F6) S.A. 7) V.A.
Age
Exp. time
VC
yr
yr
51
23
103
37
19
92
45
17
81
43
18
77
29
10
77
35
19
80
36
17
89
FEVi FEF25-75 % predicted
109
110
93
88
91
90
84
100
87
120
74
62
93
77
. predicted values from CECA and Morris et al.4 - Predicted values from Cotes and Hall5 for DLCOgg and Bates et al.8 for DLCOgg,
pOa mmHg
68
--
70 76 65 65 65
pCOi mmHg
37
--
36 39 35 35 38
PH
DLCOsb DLCOSg2
7o predicted
7.39
77
97
--
69
77
7.40
65
60
7.40
63
69
7.41
74
78
7.41
70
71
7.43
67
66
diac and hilar abnormalities were already present
Medical examination of the 49 workers gave a few
alterations. In several workers (5 out of 49) fine basilar
rales were present and in 15 pleural frictions were also
found.
In Table I are reported the results of ventilatory
function, blood gasanalysis and diffusion test of the 7
men with a radiological appearance of interstitial fibro
sis. We can see that VC was slightly reduced in 2; pOa
was abnormally low in 6, one worker did not undergo the
examination. Diffusion lung test was alterated in all 7
men with the DLCOsb and in 6 men with DLCOss* was
considered.
The mean age of the workers was 39.5 years (range:
29-51 years) and all had an exposure time of 10 or more
years. '
These data of respiratory impairment and radiologi
cal appearance of interstitial involvement suggested that
asbestosis can be detected or almost suspected in many
industrial exposures, even when the risk is neglected in
the course of routine environmental survey.
--
be easily detected in many industrial environments and we think that it may represent a true risk of pneumoco niosis.
Loi AM, Paggiaro PL, Serretti N, Franco F, Viegi G, Begiiomini. Fibre di asbesto liberate da teli termici : un vero rischio professionale. G 'tei Med Lav 1982; 4 : 117 - 120. Gli autori riferiscono la possibilit di ri scontrare o almeno di sospettare la presenza di asbestosi in lavraSmi esposti a fibre di asbesto che si liberano da coperture o indumenti ter mici utilizzati in vari settori industriali. Si riportano i casi di sette lavo ratori di un impianto metallurgico che erano stati esposti in passato ad un rischio di questo tipo e che, 10-23 anni pi tardi mostravano una fi brosi interstiziale radiologicamente evidente, accompagnata da una lie ve compromissione della funzione respiratoria.
b!<- - -- Posteroanterior roentgenogram of V.A. (case n. 7 of the Ta7 s'- Here also an interstitial network of reticular pattern is present. In `'0!n lung peripheral zones micronodular opacities are evident with a
pin head" aspect. Hila appear increased in size and density
^physema. Chest films of the 7 workers with an inter nal involvement of the lung are reported in Fig. 1-5.
REFERENCES
1. Bamber HA, Butterworth R. Asbestos hazard from protective clo thing. Ann Occup Hyg 1970; 13: 77-80.
2. Gibbs GW. Fibre release from asbestos garnments. Ann Occup Hyg 1975; 18; 143-149.
3. Riediger MG. Vtements de protection en amiante; dgagement de poussires lors de la fabrication et de 'emploi. Cahiers de Notes Documentaires 1979; 96: 425-433.
G lial Med Lav 1982;4:117-120
A.M. Loi et a;
4. Morris JF, Koski A, Johnson LC. Spirometrie standard for healthy
in adults. In: Normal values for respiratory function in
non smoking adults. Am Rev Resp Dis 1971; 103: 57-67.
Panminerva Medica, 1969; 327-343.
aR'
5. Cotes JE, Hall AM. The transfer factor for the lung; normal values 6. Bseaatsees. DWVB, MSaaucnkdleemrs PCTo,, C1h9r7i!s;ti9e3R-9V4.. Respiratory function in Ul'
Richiesta estratti: Dott. Pier Luigi Paggiaro, Istituto di Metodologia Clinica del Lavoro - Via Roma, 67 56100 Pisa Accettato il 12 giugno 1981