Inferences on the kinetics of asbestos deposition and clearance among chrysotile miners and millers

BACKGROUND: The health effects of asbestos are intimately related to the fate of inhaled fibers in the lungs. The kinetics of asbestos fibers have been studied primarily in rodents. The objective of this study was to explore the application of these kinetic models to human autopsy data. METHODS: We analyzed the asbestos fiber content of the lungs of 72 Quebec chrysotile miners and millers and 49 control subjects using analytical transmission electron microscopy. Statistical methods included standard multivariate linear regression and locally weighted regression methods. RESULTS: The lung burdens of asbestos bodies and chrysotile and tremolite fibers were correlated, as were the concentrations of short, medium, and long fibers of each asbestos variety. There were significant associations between the duration of occupational exposure and the burdens of chrysotile and tremolite. The concentration of chrysotile decreased with the time since last exposure but the concentration of tremolite did not. The clearance rate varied inversely with the length of chrysotile fibers. For fibers greater than 10 mu in length the clearance half-time was estimated to be 8 years. CONCLUSIONS: The patterns in our data are compatible with both of the hypotheses suggested from rodent experiments; the existence of a long-term sequestration compartment and overload of clearance mechanisms in this compartment.     

Radiographic changes in a group of chrysotile miners and millers exposed to low asbestos dust concentrations

Radiographic changes in 342 Quebec asbestos miners exposed to low levels of asbestos dust for an average period of 20 years were studied. Their estimated cumulative exposure ranged from 7 fibres per cubic centimeter X years (f-y/cc) to 300 f-y/cc. Of these workers, 2.1% showed a small opacity score of 1/0 or more and 2.7% showed pleural changes. No linear relationship could be established between small opacity score and any index of exposure to asbestos. Pleural changes were related to age. A referent group of office workers within the same mining industry showed a prevalence of 2.1% (1/48) for small irregular opacities 1/0 or more, and for pleural changes.     

Radiographic changes in a group of chrysotile miners and millers exposed to low asbestos dust concentrations.

Radiographic changes in 342 Quebec asbestos miners exposed to low levels of asbestos dust for an average period of 20 years were studied. Their estimated cumulative exposure ranged from 7 fibres per cubic centimeter X years (f-y/cc) to 300 f-y/cc. Of these workers, 2.1% showed a small opacity score of 1/0 or more and 2.7% showed pleural changes. No linear relationship could be established between small opacity score and any index of exposure to asbestos. Pleural changes were related to age. A referent group of office workers within the same mining industry showed a prevalence of 2.1% (1/48) for small irregular opacities 1/0 or more, and for pleural changes.     

Chrysotile asbestos and health in Zimbabwe: II. Health status survey of active miners and millers.

As part of the effort to establish industrial practice and public policy regarding asbestos in Zimbabwe, we have conducted a cross-sectional study of the chrysotile mines and mills. A stratified random sample of workers with greater than 10 years of exposure has been evaluated by spirometry, chest radiographs, and employment history. The latter was converted to quantitative estimates of exposure dose, using a matrix based on measured and reconstructed fiber levels for each job and facility during the years of work. Based on these data, a clear dose-response between asbestos exposure and functional loss has been demonstrated, with mean losses from predicted of about 400-600 cc in vital capacity in the 10% of the population with heaviest exposures. Low-grade parenchymal radiographic abnormalities (ILO grade greater than or equal to 1/0) were evident in 8.7% of the total study group and were almost 10 times more common in those with more than 100 fibers/cc.years cumulative exposure than in those with 16 fibers/cc.years or less. Pleural disease was relatively rare, occurring in just under 10% of the study group, and was unrelated to exposure dose. Overall, these findings are compatible with results of similar studies in Quebec and Swaziland and suggest that similar control strategies are probably indicated.     

Magnetic lung measurements in relation to occupational exposure in asbestos miners and millers of Quebec

Fe₃O₄ particles (ferrimagnetic) are usually attached to asbestos fibers (nonferrimagnetic) in the chrysotile asbestos mining and milling industries; therefore, a magnetic measurement of Fe₃O₄ in the lungs of workers in these industries could help determine the amount of asbestos which has been inhaled and retained in their lungs. As a first assessment of this method, magnetic measurements were made of Fe₃O₄ in the lungs of 115 miners and millers in Quebec. These measurements at an industrial site were found to be feasible and practical; however, the amount of Fe₃O₄ seen in the lungs of those with welding exposure was large enough to mask the Fe₃O₄ contributed by asbestos, and this subgroup was considered separately. For the remainder (nonwelders), the amount of Fe₃O₄ was plotted against a total dust exposure index (asbestos and other dust) estimated for each worker. Although the correlation between these quantities was not high, it was statistically significant at the 1% level. Because retained asbestos is likely to increase with increasing exposure to total dust, this correlation suggests that a magnetic lung measurement of a chrysotile miner or a miller does reflect, to some extent, the amount of asbestos in his lung. There was considerable scatter in the data, partly due to individual variations in deposition and clearance, to which this method is sensitive. When the data of only the nonsmokers were plotted, the amount of Fe₃O₄ was greater than for the total group of nonwelders. This is consistent with previous findings that less dust is deeply deposited in the lungs of smokers, due to constriction of small airways.     

An update of a mortality study of talc miners and millers in Italy

BACKGROUND: While talc containing asbestiform fibers is considered a human carcinogen, only limited animal and human data are available on non-asbestiform talc. To provide further evaluation on the issue, we updated the analysis of an Italian cohort of talc miners and millers in Val Chisone; talc found here is free from asbestiform fibers. METHODS: The cohort was comprised of 1,795 men who had worked for at least 1 year in the mine and/or in the factory between 1946 and 1995. Vital status and death certificates were obtained from registration offices in the municipality of death or of birth. Employment, termination of employment, and detailed job history were obtained from personnel records at the plant. RESULTS: No excess was found for total cancer mortality, nor mortality for lung cancer. No case of mesothelioma was reported. There was a significant excess mortality from non-neoplastic respiratory diseases (SMR 228.2, 95% CI 190.2-271.5). Mortality excess for non-neoplastic respiratory diseases was mainly due to silicosis. CONCLUSIONS: This study provides additional support for an association between talc in mining and milling and non-neoplastic respiratory diseases, while showing no significant excess risk for lung cancer and mesothelioma. The results also provide additional information of interest to evaluate the potential association between silica and lung cancer.     

Evaluation of respiratory effects in miners and millers exposed to talc free of asbestos and silica.

Miners and millers of talc ore, free from asbestos and silica, were examined for respiratory effects. A study of 116 subjects included the modified British Medical Research Council respiratory symptom questionnaire, simple spirometry, chest radiography, and limited examination of the chest. A one-year follow-up evaluation was performed on 103 subjects. Of the 12 subjects whose chest radiographs showed small round or irregular opacities (perfusion 1/0 or greater), five had never smoked cigarettes. Pulmonary function values at the time of the initial study were less than predicted and the rates of loss of FEV1 and FVC greater than expected. These differences were in part attributed to cigarette smoking but were greater than predicted from that source alone. There was evidence of an exposure effect after adjusting for cigarette smoking and we conclude that these workers have been affected by their exposures. No clear interaction between smoking and exposure could be identified. Populations such as this will need to be studied for longer periods to determine what current dust levels are safe.     

Lung cancer from asbestos textured ceilings: a case study

Background: Asbestos was used in spray applied textured ceilings from 1945 to at least 1980. Exposure to asbestos and the probability of developing lung disease is high in individuals who lived with these types of ceilings in their home. Asbestos exposure and frequency of disease is even higher in an apartment suffering from flooding, maintenance, and/or multiple structural impacts.

Purpose: Our goal is to examine a case of lung cancer in a non-smoking individual exposed to asbestos from the damaged acoustic ceilings in her apartment.

Methods: The subject’s medical and occupational records were obtained and reviewed and a physical examination was performed. Exposure ratings were obtained from previous literature for discussion purposes.

Conclusion: Asbestos-textured ceilings are a possible source of asbestos exposure and there may be a risk of developing cancer in individuals exposed to ceiling deterioration.     

Malignant pleural and peritoneal mesotheliomas in former miners and millers of crocidolite at Wittenoom, Western Australia

Methods: A group of 6493 men and 415 women who had worked at the former Wittenoom crocidolite mine and mill at some time between 1943 and 1966 have been followed up throughout Australia and Italy to the end of 2000.

Results: The cumulative number of mesotheliomas up to 2000 was 235 in men (202 pleural, 33 peritoneal) and seven (all pleural) in women. There had been 231 deaths with mesothelioma (9% of known deaths).

Conclusions: The number of deaths in men with mesothelioma between 1987 and 2000 was at the low end of the predictions made earlier based on the number of cases to 1986. If this trend continues, it is predicted that about another 110 deaths with mesothelioma will occur in men by 2020.

     

Fibers in lung tissues of mesothelioma cases among miners and millers of the township of asbestos,quebec

Twenty cases of mesothelioma among miners of the township of Asbestos, Quebec, Canada, have been reported. To further explore the mineral characteristics of various fibrous material, we studied the fibrous inorganic content of postmortem lung tissues of 12 of 20 available cases. In each case, we measured concentrations of chrysotile, amosite, crocidolite, tremolite, talc-anthophyllite, and other fibrous minerals. The average diameter, length, and length-to-diameter ratio of each type of fiber were also calculated. For total fibers > 5 μm, we found > 1,000 asbestos fibers per mg tissue (f/mg) in all cases; tremolite was above 1,000 f/mg in 8 cases, chrysotile in 6 cases, crocidolite in 4 cases, and talc anthophyllite in 5 cases. Among cases with asbestos fibers, the tremolite count was highest in 7 cases, chrysotile in 3 cases, and crocidolite in 2 cases. The geometric mean concentrations of fibers ? 5 μm were in the following decreasing order: tremolite > crocidolite > chrysotile > other fibers > talc-anthophyllite > amosite. For total fibers < 5 μm, we found > 1,000 fibers per mg tissue (f/mg) in all cases; tremolite was above 1,000 f/mg in 12 cases, chrysotile in 8 cases, crocidolite in 7 cases, and talc-anthophyllite in 6 cases. Tremolite was highest in 8 cases, chrysotile in 2 cases, and crocidolite and amosite in 2 cases. The geometric mean concentrations of fibers < 5 μm were in the following decreasing order: tremolite > other fibers > chrysotile > crocidolite > talc-anthophyllite > amosite. We conclude, on the basis of the lung burden analyses of 12 mesothelioma cases from the Asbestos township of Quebec, that the imported amphibole (crocidolite and amosite) were the dominant fibers retained in the lung tissue in 2/12 cases. In 10/12 cases, fibers from the mine site (chrysotile and tremolite) were found at highest counts; tremolite was clearly the highest in 6, chrysotile in 2, and 2 cases had about the same counts for tremolite and chrysotile. If a relation of fiber burden-causality of mesothelioma is accepted, mesothelioma would be likely caused by amphibole contamination of the plant in 2/12 cases and by the mineral fibers (tremolite and chrysotile) from the mine site in the 10 other cases.     

Chrysotile asbestos and health in Zimbabwe: I. Analysis of miners and millers compensated for asbestos-related diseases since independence (1980)

Data on the health effects caused by locally mined chrysotile asbestos in Zimbabwe have been very limited. The prevailing local view has been that risk is minimal. In this report we critically reassess the cases of 51 individuals with asbestos exposure who have been compensated by the Central Pneumoconiosis Bureau since independence in 1980. Results demonstrate that the major health risks of exposure reported elsewhere--morbid asbestosis, nonmalignant pleural disease, malignant mesothelioma, and lung cancer--all occur in Zimbabwe, at least among workers in the asbestos mines and mills. It is concluded that further investigation and control measures in the industry are warranted.     

Lung cancer among Dutch coal miners: a case-control study

A case-control study was conducted in the southern part of The Netherlands to investigate the risk of lung cancer in coal miners; 381 age-matched pairs of primary lung cancer cases and controls, diagnosed between 1972 and 1988, were selected from the pathology department of the University Hospital in the region. Information about past employment in coal mines was obtained through the registers of the collaborative pension fund for Dutch miners. 20% of the cases were (at some time) employed in coal mining, compared with 21% of the controls (odds ratio 0.95; 95% confidence interval: 0.65-1.38). 9% of both cases and controls had an underground work history (odds ratio 0.96; 95% confidence interval: 0.56-1.65). The duration of underground coal mining did not differ substantially between cases and referents (average duration: respectively 117 and 108 months). No relation between specific histologic tumor cell types and coal mining could be demonstrated. The study gives no indication that workers in Dutch coal mines have an increased risk of developing lung malignancies.     

Respiratory health in chrysotile asbestos miners in British Columbia: a longitudinal study

A respiratory survey was undertaken in chrysotile asbestos miners in British Columbia consisting of a questionnaire, spirometry, chest radiography, and physical examination. The tests were performed in 1977 and again in 1983. The population groups studied included 63 "exposed" (working in the plant more than nine years), 52 "controls" (working in the plant less than five years), and 38 residents of the village at the minesite. A subset of 39 was identified with high exposure (worked in the mill more than five years). Measured levels of environmental particulates were similar over the entire period of operation of the plant (1.4 to 14.0 million particles per cubic foot and 0.7-88.0 fibres/cc in the mill; 0.2 to 2.7 mpcf and 0.6 to 9.3 f/cc in the mine). The exposed groups were more likely to report cough and breathlessness than the two other groups and were also more likely to have abnormal FVC and chest x ray films (the latter not significant, p greater than 0.05) and to be more likely to have a combination of these abnormalities. There was no trend to progression in the combination of abnormalities associated with exposure on follow up. The heavily exposed group showed a significantly worse trend in FVC. This adverse trend was confined to those with initial abnormalities. Tobacco smoking did not increase the trend to progression in this group.     

The hemolytic activity of chrysotile asbestos fibers: a freeze-fracture study

Short asbestos fibers isolated by a sedimentation procedure have a strong hemolytic activity. In the presence of ferritin particles, hemolysis by chrysotile fibers is inhibited at least during the first 10 min. Freeze-fracture studies show that after 20 sec or 2 min of contact between the fibers and the RBC membrane, the intramembranous particles remain randomly distributed over the whole surface of the P-face. On the E-face of the asbestos-treated red blood cell membranes, the number of intramembranous particles is significantly reduced. With the transmission electron microscopy, it is not possible to resolve the trilaminar structure of the ghost membrane around the deeply buried asbestos fibers. It is postulated that the membrane defects brought about by asbestos are caused by the adsorption of one membrane constituent, possibly phospholipids, on the chrysotile fibers.     

Comparative epidemiology of men exposed to asbestos and man-made mineral fibers

Comparative analyses are presented of selected studies of long-term reactions to occupational exposures to asbestos and man-made mineral fibers (MMMF), with emphasis on studies with dose-response information and long enough period of follow-up to observe lung cancer excess, if it occurred. Uniform dose estimates based on average number of fibers per milliliter were derived and tabulated with the corresponding standard mortality (or morbidity) ratio (SMR), crude probability for each unfavorable outcome, and the likelihood that at least as many deaths would have occurred as a result of the expected numbers under Poisson assumptions. A dose-response relationship was said to have been indicated when the crude probability increased monotonically with dose and/or the Poisson probability decreased and reached a value of less than 0.05. Some arbitrary assumptions had to be made in estimation of the dose, and they may need to be corrected. Gravimetric dose estimates may have given different results. Studies selected for analysis included Quebec asbestos miners and asbestos cement workers exposed to asbestos, and pooled U.S. and European studies of MMMF workers, as well as a sample of cigarette-smoking fiberglass workers whose X-ray films were evaluated for fine nodular or irregular opacities. The lowest dose capable of showing either a statistically significant excess (single point criterion--SP) or the median dose in an apparent dose-response relationship with cause of death or radiological results is tabulated. Radiological changes show a dose-response relationship for all types, with a median dose for asbestos of 2.8 fibers/ml. For fiberglass workers, the median dose of electron-microscopically detected fibers was two orders of magnitude less. For asbestos SP, exposures of 1.4 to 22 fibers/ml were associated with increased lung cancer, while for mineral wool, the minimal level with significant SP increase in lung cancer was an order of magnitude less. Based on fiber or particle counts, man-made mineral fibers appear to be more potent than asbestos with regard to chronic pulmonary disease.     

Respiratory health in chrysotile asbestos miners in British Columbia: a longitudinal study.

A respiratory survey was undertaken in chrysotile asbestos miners in British Columbia consisting of a questionnaire, spirometry, chest radiography, and physical examination. The tests were performed in 1977 and again in 1983. The population groups studied included 63 "exposed" (working in the plant more than nine years), 52 "controls" (working in the plant less than five years), and 38 residents of the village at the minesite. A subset of 39 was identified with high exposure (worked in the mill more than five years). Measured levels of environmental particulates were similar over the entire period of operation of the plant (1.4 to 14.0 million particles per cubic foot and 0.7-88.0 fibres/cc in the mill; 0.2 to 2.7 mpcf and 0.6 to 9.3 f/cc in the mine). The exposed groups were more likely to report cough and breathlessness than the two other groups and were also more likely to have abnormal FVC and chest x ray films (the latter not significant, p greater than 0.05) and to be more likely to have a combination of these abnormalities. There was no trend to progression in the combination of abnormalities associated with exposure on follow up. The heavily exposed group showed a significantly worse trend in FVC. This adverse trend was confined to those with initial abnormalities. Tobacco smoking did not increase the trend to progression in this group.     

Lung functions in phosphate miners in Jordan: a pilot study

Phosphate mining and processing is a major industry in Jordan. In this study of 56 workers in this industry, there was significant occurrence of cough, chronic bronchitis, and abnormal spirometry among smokers (p less than 0.1). There was no correlation between the spirometry, A-aDO2, and chest x-ray changes in this occupational group. Smoking was noted to be more detrimental to these workers than was their occupational exposure. Many parameters must be examined when evaluating this pneumoconiosis.     

Environmental measurements of total dust and fiber concentration in manufacturer and user of man-made mineral fibers.

Man-made mineral fibers (MMMF), most of which are referred to as man-made vitreous fibers (MMVF), are mostly amorphous silicates manufactured from glass, rock, or other minerals. Analysis for MMMF have been restricted largely to the measurement of total airborne mass concentrations, but more recently to the determination of airborne fiber levels by phase contrast optical microscopy. In Korea, many small factories are related with manufacturing and using MMMF without any special evaluation of environmental measurements. Though MMMF are known as the substitute of asbestos and their toxicity are regarded as very low, MMMF do not totally excluded from the respiratory and/or skin diseases now. Therefore, we evaluated the environments of many workplaces with total dust and fiber concentration. Most dust and fiber concentrations were below threshold limit value (TLV) at various industries and working processes. However, these data showed a slight relationship between total dust and fiber concentration.