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OCR for page 237
Appendix A
ASBESTOS EXPOSURE AND NEIMAN DISEASE. HAILS OBSERVATIONS
AND STUDIES F ROM 1898 TO 1979
Disease or
Benchmark Contribution to the Field References
-
Bronchitis ""bestos fiber lohalation in the workplace Anterson, 1898
Phthisis injurious to the bronchial tubes and lungs.' (see Greenberg,
Clinical latency mitigates against establishing 1982)
a stronger association between work with asbestos
fiber and disease, because sick workers leave
industry. No mortality data.
Pulmonary Death due to pulmonary fibrosis (in an asbestos Murray, 1907
fibrosis textile worker without tuberculosis). Autopsy (see Greenberg,
showed fibrosed lungs and presence of "spicules 1982)
of asbestos in pulmonary tissues. When the
worker wan alive, this sputum contained what
was thought to be asbestos spicules." Fibrosis
wan believed to be induced by dust. Different
work areas had a range of dust conditions.
Asbestonis Complete histological and gross pathological Cooke, 1924
description of asbestos. Author originated
term anbestosis and cited experimental pathology
studies indicating that asbestos dust causes
fibrosis in the lungs of guinea pigs.
Asbestosis First major reviews of asbentosis. Detailed Cooke, 1927;
clinical, radiological, and pathological McDonald, 1927;
description. Cooke noted the presence of Oliver, 192?
"curious bodies' in pulmonary tissues of
asbestotics. Asbestoals attack rate high
for testlle workers opining Canadian
chrysotile.
A~bestoals "Curious bodies" probably some form of coated Cooke, 1929
fiber. Author recommended the term "asbestosis
body . "
. . .
Asbestosis Re~lew of asbestosis in Great Britain and other Merewether, 1930
parts of the world. Relationship between
asbestosis and tuberculosis discussed.
Latency also discussed. Author suggested
different fores of fiber may have different
biological acti~rl~les.
237
Hi
.
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l
238
Appendix ~ (cont. )
Disease or
8ench-szk Contribution to the Field References
l
Asbestosis Authors suggested, on the ba8i8 of S7 cases they Wood and Glo~e,
had seen, tat tuberculosis increases severity 1931
of scarring in asbestotico.
Asbesto~is "Constitutional factored may be important in
determining who among the work force is
-susceptible to asbestosis."
Asbestoals German government lasses dictum forbidding
all those under the age of 18 from employment
in the asbestos industry. Germans followed
Brltlah Home Office.
Asbestosis
Pleural
asbestosis
Author dlacussed the different physical and
chealcal propertlen of the various asbestos
types used in co~erce (e.g., size, shape,
"others-) and their poselble role in determining
the occurrence of disease and the types and
patterns of lesions obeer~red. Different kinds
and intensities of exposures in industry also
described. Geographic differences in occur-
rence of disease may be related to fiber types
and/or genetic factors. Role of mineral
contao`~nants unknown.
Gerbis, 1932
Gerbia, 1932
Glove, 1932
Asbe~tosi ~Mortality data suggested asbestos workers have Merewether,
shortened life espectanciea. Greater attack 1933, 1934
rate in mills may be related to the "ability of
the fiber to split longitudinally into fibrils
creating respirable dust."
Asbestosis
Lang cancer
Primary lung cancer found at autopsy in two Gloyne, 1935
female textile workers with asbe~tosis.
Asbesto- Primary lung cancer in Den employed in textile Lynch and
silicosis plants in South Carolina. Lungs fibrosed. Smith, 1935
Lung cancer
Lung cancer Author found that the length of elapsed time
and latency frog' the start of asbestos work until the
"bestosis tine of death was 15 to 21 years in all als
of the cases Anon to him. In fire of the
sis cases, the tumors developed in the lower
lobes of the lung, whereas in the general
population lung cancer was most colon in
the upper lobes. It was well recognized
that the more extensive fibroals in asbestosis
was also fount in the lower lobes of the lung.
Nordma~,
1938
Asbestosis and Among 943 cases of fatal sillcosis in Great Wilson, 1939
1uJlg cancer Britain in 1938, 23 lung cancers occurred
attack rate (2.41~. tong 103 cases of fatal asbestosis
for all prior years, 12 lung cancers were
found (11.61~. Attack rates appeared to be
different, although true incidence was unknown.
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. ~
;~
239
PPBJDIX ~(cons .
Disease or
Benchmark Contributlon to the Field References
Asbestosis Comparison of autopsy series in general popula- Wedler, 1943
Long cancer tlon with 92 asbestotics. Fourteen malignancies
Mcsothe- in asbestotlcs (16Z), compared with approslmately
lions (?)a 2: in the "unexposed" general population. Metas
Other tases to pleura, peritoneum, and pericardium.
cancers (?) Histology much like "sarcoman.-
Asbestosis Prevalence of lung cancer aeon" asbestotlce Barrett, 1948
Lung cancer increases with age: 25-34, 4.83; 35-44, 5.63;
45-54, 18.9%; 55-64, 25.61; 65 and older, 23.51.
Latency, dose, and aging not separated as
factors in this pattern.
Lung cancer
Other cancers
and other
sites
Paeumoconlosis Compared mortality experience in different
'dusty trades" in Great Britain. Age at death
for seven silica-exposed groups ranges from 44
to 63 years (lowest in pottery industry).
Asbestos trades averaged 36 years (39 for males,
34 for females. Approximately 14: of asbestotice
died with lung cancer. Author noted "strikingly"
different attack rates in males and females:
19.6: for males, 9.7: for females. Neoplasms at
other sites twice as high in asbestotlcs as
compared to other pneumoconlosis groups (about
6:, compared to 3%~.
Gloyne, 1951
Lung cancer, This study provided evidence linking certain Brealow et al.,
occupation, occupations (including those involving asbestos 1954
and ciga- exposure) with lung cancer. The study also
rette offered additional evidence associating
smoking cigarette smoking with lung cancer.
A~bestosis
Lung cancer
Mesothelioma
5
. i,
Cohort study of testlle workers at a plant
in Great Britain. Incidence data indicated
a standardlsed mortality ratio (SMR) of almost
14; 11 observed, 0.8 expected for lung cancer in
workers employed before Protective standards"
of the Asbestos Regulations Act of 1931.
Author cautioned that smaller risk in workers
employed after 1931 may be an artifact; they
may have not yet reached "risk" period because
of their short elapsed lime after onset of
exposure. ~ endothelioo`e was obeer~red in a
worker.
~ l~ indicates the tlsease was not diagnosed by Dame.
Doll, 1955
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240
APPENDIX ~ (cont.)
Disease or
Benchmark Contrlbution to the Field
, . Iteferences
Pleural peso- Thlrty-t~ree cases of pleural aesothelio~a Wagner et al.,
thello~a reported among alders and Fillers of crocido- 1960
Envirocaental lite in the Northwest Cape Pro~loce, South
esothelio~a Africa. Along the cases were area residents
with no known occupational exposure. Histo
logical evidence of asbestosis was not
present in all cases.
Pleural plaques Pleural fibrosis and calcification--stigmata Ki~riluoto,
Environmental Connally associated with fibrous dust insult-- 1960
stigmata were found in a population ll~lag in a region
of Finland where anthophyllite asbestos was mined
and milled. ambient asbestos pollution was
implicated.
Asbestosis Abdominal tumors found in asbestotics durlag Keal, 1960
Abdominal autopsy. Ovarian cancers in women and general
tumors carcinomatosis (no primary) in men.
Mesothelioma ~ ? ~
Asbestos bodies Asbestos bodies were found in pulmonary tissues Thomson et al.,
and exposure in 261 of 500 consecutive autopsies conducted in 1963
the general population of Capetown, South Africa.
Use of asbestos by society was questioned in view
of the known cancer hazard.
Asbestosis Morbidity and mortality data for insulation Selikoff
Lung cancer workers showed excess cancer and asbestoals et al., 1964
Mesothelioma accounting for most decreased life expectancy.
(pleural and Mallgnancies included lung cancer and pleural
peritoneal) eesothelio~a. Ihere was also peritoneal
Gastrointesti- mesothelioma and an excess of gastrointestinal
nal (GI) cancer.
cancer
Peritoneal Peritoneal aesothelio~a seen in crocidolite- Entiknap and
mesothelioma esposed workers. Other intrsabdoo~inal tumors Smither, 1964
Other cancer may have been present as well.
(GI)
Mesothelio~a Records in an east-end London hospital showed
that a large proportion of the aesotheliomas
that occurred were in nonoccupationally
esposed persons: residents living within a
half mile of an asbestos plant ant families
of workers.
Mesothelio~
Bystander
occupational
exposure
Newhouse and
Thompson, 1965
Mesothelio~a observed in shipyard workers whose Harries, 1968
Jobs were not asbestos-related. Most aeso-
thelio~as occurred in bystander populations.
Importance of fugitive dust raised.
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i
.
241
APPENDIX ~ (cont.)
Disease or
Benchmark Contributlon to the Field
Lung cancer
and cigarette
smoking
Pleura
asbestosi~
Pu1mor~ ry
asbestosis
Household
exposures
Eat rapulmonary
cancers
Multiple cancer
in single
hos to
Fiber dose,
latency,
rink
References
_
Stridence suggested that cigarette - Poking
as"atos workers had a greatly increased
risk of developing lung cancer as compared
to nonsmoking worlmates. The risk appeared
to be multiplicati~re--the product of both
smoking and asbestos risks.
Radiographic and clinical surrey of 678
individuals cohabiting with asbestos workers.
Thirty-fire percent (239) of them
had pleural or pulmonary asbestosis.
Questions raised concerning dust on clothing
as the vector of the fiber. (In a follows
up study published in 1979, the authors
stated that they were ascertaining causes of
death among a larger population of house-
hold members. Of 550 decedents traced, five
deaths were due to pleural mesothelioma.)
SMRs showed slight excesses of cancer of the
larynx, buccal cavity, brain, skin, kidney,
pancreas, and prostate among 2,271 deaths
(168,000 man-years of observation) in a cohort
of 17,800 insulation workers in the United
States and Canada. Authors reported that 2.1:
of the deaths involved multiple primary cancers
and that occult malignancies were present at
time of death.
Short-term (l-month) intense exposure to
amosite fiber increased lung cancer risk.
Latency period inversely related to dose.
Selikoff _ al.,
1968
Anderson et al.,
1976, 1979
Selikoff et al.,
1979
Seidman_ al.,
1979
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242
REFERENCES
Anderson, A. M. IB98. Obeer~rations published in H.M. Chief Inspector of
Factories and Workshops, Report for the year IB98.
Anderson, H. A., R . Lilis , S . M. Daum , A. S . Fischbein., and ~ . J.
Selikoff. 1976. Household contact asbestos neoplastic risk. Ann.
N. Y. Acad. Sci . 271:311.
Anderson, H. A., R. Lilis, S. M. Daum, and I. J. Selikoff. 1979.
Asbestosis among household contacts of asbestos factory workers.
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Barnett, G. P. 1948. Annual Report of the Chief Inspector of Factories
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Brealow, L., L. Hoaglin, G. Rasmussen, and H. Abrams. 1954. Occupatione
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Cooke, W. E. 1924. Fibrosis of the lungs due to the inhalation of
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Cooke, W. E. 1929. Asbestos dust and the curious bodies found in
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Doll, R. 1955. Mortality from lung cancer in asbestos workers. Br.
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Entiknap, J. B., and W. J. Smither. 1964. Peritoneal tumors in
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GIoyne, S. R. 1935. Two cases of squamous carcinoma of the lung
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GloyDe, S. R. 1951. Pne~oconiosis. A histological survey of
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Greenberg, M. 1983. Classical airdromes in occupational medicine:
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Ki~riluoto, R. 1960. Pleural calcification as a roentgenologic
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Keal, E. E. 1960. Asbestos and abdominal neoplasms. Lancet
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Lynch, K. M., and W. A. Smith. 1935. Pulmonary asbestosis III.
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McDonald, S. 1927. Histology of pulmonary asbe~tosis: A review. Br.
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Ilerewether, E. R. A. 1933, 1934. A memorandum on asbestosis.
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at.
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;1
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243
Murray, J. M. 1907. Report of the Committee on Compensation for
Industrial Diseases. Minutes of Evidence.
Newhouse, M. L., and H. Thompson. 1965. Mesothelloma of pleura and
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Selikoff, I. J., J. Churg, and E. C. Hammond. 1964.
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~ bestos exposure
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Wedler, H. W. 1943. Asbestose und Lunge~kreba. Deut. Med. Woch.
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Wood, W. B., and S. R. Gloyne.
by pulmonary tuberculosis.
1931. Pulmonary asbestosis complicated
Lancet II:954-956.
Representative terms from entire chapter:
pulmonary asbestosis
