Document x1peB2zZJRgrwN73X2OaNzvoJ

'V, sf;' worker* Yiuve been due to mesothelioma. The prob lem has assumed sufficient importance to hAve 0 warranted the establishment of Mesothelioma Ref erence Panels in a number of countries,- by the International Union Against Cancer, and the recent establishment of a Mesothelioma Registry in this country by the National Institute of Environmental Health ^Sciences of the U.S. Public Health Service. These experiences highlight one portion of the current spectrum of asbestos disease... It Is how recognised that direct occupational exposure to asirestos results in a hazard much more significant than formerly appreciated. In the last severs) years, however, additional problems have been rec ognized which add another dimension: the possi bility that the utilization of asbestos is associated with a much wider risk, perhaps one of the com munity at large. This is less well defined, much, less well documented, but because of 'H;potential'^ importance, of considerable concern. " '' *. The recognition of this potentially wider spec trum of asbestos disease has been based upon three germinal observations. The first was the publica tion in 1960 by Wagner and his colleagues of .47 . cases of mesothelioma in South Africa, all from the In*ul*tionworkrr employed in th'fc>ntroeOon Industry ' northwest Cape Province, an asbestos-rich area of h#v* had diuitnui health experience* w*n though their.-; . the country. Analysis of the cases showed that few - ^jj, ubecto*.-Up umji the p**t *v<riy*rtH vu- ..." ' had worked directly, with the mineral but that'46 -thought that/Umg' cancer from aibettoi wai ah' tnduitria! 1^,. .-. of the' 47 niay have had contact with. direct. They had lived in an area in which' asbestos .was mined, or had worked in an environment in which indirect, haphazard exposure was conceivable. In.striking contrast, there were no cases of meso thelioma in the rest of South Africa'reported.in the same perfod. and none in 10,000 consecutive autop-'-v'^-V sies of individuals with silicosis. This report un equivocally..raised the question -.of. whether asbestos-; associated mesothelioma was limited to direct occu- " TABU i;' .V .* ':'..jpatioha^js^pcjaur,; or, whether liou.ch Jess intimate i-fV?: : . cont&ct'rquld^i>roduce .the jiamer^u)jL^|;<s> it. . . .Obsatv i.dNt rebar ol Daothi imisi^iii^^-iln^^iliw^Xfsan i^^.^wTupt^al^ at^ analo-Zci^^.^ ie form' among'ftt' ' . * *j,- asbestos workers.; In our experience,'Indeed, {he1""-' Cooit of Dooih Doih majority of older asbestos workers may be expected -.-v-.-.-,.aho^f!these changes'whenX-rayed. It was, thero-`j ^aseaa&seaod iiocheo Peritoneal mutotheliofna .. . V .... w.iakbi>- -va-uw- nw 2.) calcification - in 490- of 6,512 individuals X-rayeo in .w'hne'^hV'iief-g'h'boriii.g..county/-#^?* > 7 had hone in 7,tbi. Kiviluoto astutely noted that the "" ''' ,. Cancer. A*fo*lo* . H*ar1 onlMAufotory dt*o* -. . -itvi '.'-.V.i" . rz-x m Ainll O-.1l1l.ier coute:* ol deat.h v. ift a Tlo|, oU COUM 6 *Baid upon U.S. morlolily dolo dimgaiding smoking habiu. United Stole* dolo not ovoilobli, but figure should be only lightly !* then 2 3. `United Slate* dale noi available., but thew are tore cautot of dcoth in general populotion .c-puntfyrn^iF^amaiien fenfi.shH 3lf2gues,: wW\' demohstratedthe presence of aslicstos fibers in the air in the vicinity of the mine and while this may not reflect the true explanation for Kiviluoto's find ings. the question of environmental contamination was strongly suggested. `The third observation was equally sobering. It had long been known that asbestos fibers, when March. )9G0 PQ6*00 0932 PRODUCED BY FORD HFM - 008372