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FILE NAME Brakes BRK DATE 2012 DOC BRK219 DOCUMENT DESCRIPTION Journal Article - Report of a Recent Brake Through in the Fiber Mesothelioma Dialogue Inhalation Toxicology 2012 24 136 137 '2012 Informa Healthcare USA Inc. ISSN 0895-8378 print 1091-7691 online DOI 08958378.2011.643932 08958378.2011.643932 LETTER TO THE EDITOR Report of a recent brake through in the fiber mesothelioma dialogue informa healthcare 01/2812 on University Mcmaster by only informaheltc. use personal For from Downlade Toxiclogy Inhaltion Marsh et al concluded that elevated lung levels of tremolite in the lungs of brake workers with elevated levels of amphiboles arose from concurrent exposures to commercial amphibole and chrysotile asbestos in occupational settings other than brake repair work Then based on this finding they conclude that the weight of the scientific evidence does not support a role for occupational exposure to brake dust and other friction products in the development of mesothelioma Marsh 2011 These statements are incorrect The authors assume that occupational settings where brake work is conducted is free of amphibole exposure This is not true Commercial amphiboles were used to manufacture many friction components Victor used crocidolite in gaskets until at least 1963 Borg Warner used crocidolite in transmission friction plates Ford hygienists were aware of the use of amosite in brakes Maremont used crocidolite during the Canadian asbestos strike and Borg Warner admitted that it used crocidolite in brakes in one set of sworn interrogatories and denied this in another set of interrogatory answers Hickish 1968 Warner 1992 and 1996 Warner 2006 Sherr 2011 Egilman 2011 Automobile mechanics who worked on brakes would typically work with these products Thus it is incorrect to assume that brake workers acquired elevated lung amphibole levels from anywhere but automobiles absent evidence that a patient had exposure to amphiboles at some other occupation Working with automobiles can be the source of amphibole lung levels and explains the results in this paper The authors argue that chrysotile brakes can not be linked to mesothelioma because brake work never results in chrysotile lung burdens sufficient to cause mesothe- lioma However this is not true Dr. Roggli found elevated levels of chrysotile in the lungs of two workers with pulmonary fibrosis whose only asbestos exposure was as a consequence of the work with asbestos brakes Case 1 1983 and Case 2 1994 Roggli 2011 Dr. Roggli explained that he has failed to publish these cases because the patients did not suffer from mesothelioma Roggli 2011 However this is irrelevant as the authors theory is based on the general proposition that working with brakes never results in elevated lung chrysotile levels Any brake worker with elevated levels is a Black Swan case that disproves the authors theory For example even absent lung fiber data Dr. Roggli has opined that a particular brake worker's mesothelioma was idiopathic because he has not seen any brake workers who had background levels of asbestos in their lungs without a corresponding elevated level of commercial amphibole fibers Roggli 2011 Dr Roggli's methodology has been thoroughly critiqued elsewhere Egilman 2009 In recent testimony Dr. Roggli agreed with our inter- pretation of the importance of these results He con- firmed that mechanics exposures can lead to levels of chrysotile and commercial amphiboles that cause increased fiber burden in their lung tissue and he would have attributed causation to their exposures had they had mesothelioma Roggli 2011 Report of a recent brake through in the fiber mesothelioma dialogue Asbestos Total Commercial Patient bodies fibers amphiboles Chrysotile Tremolite Silicate phylite Case Case 0 10 0 6 1 1 Case Case 0 10 0 6 1 1 Actino 222 222 Total uncoated fibers 42,800 21,800 commercial asbestos fibers 8500 7000 Addressfor Correspondence Dr. David Egilman MD MPH 8 North Main Street Attleboro MA 02703 USA mail degilman@egilman.com Received 15 November 2011 accepted 21 November 2011 RIGHTS 01/2812 on University Mcmaster by only informaheltc. use personal For from Downlade Toxiclogy Inhaltion Declaration of interest Dr. Egilman serves as a consultant in asbestos litigation at the request of asbestos manufacturing companies and injured people David Egilman Department ofFamily Medicine Brown University Providence RI USA References Warner Corporation's answers to Plaintiffs master interrogatories and requests for production propounded to defendant In reply All asbestos personal injury or death cases filed or to be filed in Dallas County Texas June 1992 Interrogatory response no 6E and Warner Corporation's responses to Plaintiffs master interrogatories and request for production to defendants In reply All asbestos filed or to be filed in Cameron County Texas January 27 1996. Interrogatory response no 6E Letter to the Editor 137 Warner Amended responses to interrogatories regarding Borg- Warner's ofcrocidolite transmission parts In reply All asbestos litigation filed by SimmonsCooper LLC Plaintiffs - A.W. Chesterton et al defendants In the Circuit Court Third Judicial Circuit Madison County IL Interrogatory response no 2 March 31 2006 Egilman D. 2009. Fiber types asbestos potency and environmental causation a peer review of published work and legal and regulatory scientific testimony Int J Occup Environ Health 202-228 Egilman Available at http://egilman.com/browse.php?display=list& Asbestos 2011 Hickish DE Knight KL Report 41/68 1968. Exposure to asbestos during the servicing of brakes of passenger cars Marsh GM Youk AO Roggli VL 2011. Asbestos fiber concentrations in the lungs of brake repair workers commercial amphiboles levels are predictive of chrysotile levels Inhal Toxicol 681 688 Roggli VL Data count sheets as discussed in Roggli VL Deposition testimony Keitha Durham vs General Electric et al No. CI- 09756 Jefferson Circuit Court Division Eleven October 24 2011 pp 150-168 pp 179 18p0 140 pp 180-181 and p 169 Sherr Jonathan H. Deposition testimony as Corporate Designee of Maremont Corporation Edward Neff et al vs American Honda Motor Company Inc. et al Case Number 09-000185 In the Circuit Court for Baltimore City May 6 2011 '2012 Informa Healthcare USA Inc. RIGHTS dy