Patterns of asbestosis in New Jersey.

Hospital discharge data from New Jersey were used to identify cases of asbestosis for the 8 years 1979-1986. Multiple admissions were deleted so that each individual was counted once at the time of his/her first hospitalization with an asbestosis diagnosis. White males had the highest age-adjusted average annual discharge rate of 19.3 cases/100,000 population, followed by black males (12.3 cases/100,000) and white females (1.2 cases/100,000). The discharge rate was positively associated with age in each race/sex category. The relationship between rates for black males and white males depended on age: under 65 years, the rates were almost equal, and at 65 years and older, the white rates were nearly twice the black rates. There were two areas of the state where the rates were highest: the north-central and southwest regions. These two areas represent manufacturing and shipbuilding applications of asbestos, respectively. During the years 1979-1986, the annual percentage increase in asbestosis rates was 20% for white males, 17% for black males, and 8% for white females. Continued surveillance will reveal when the rates for asbestosis stop increasing.     

Asbestos disease in sheet metal workers: proportional mortality update

This paper, updating the findings of an earlier study, provides additional evidence that sheet metal workers in the construction trades are at increased risk for asbestos-related disease. A proportional analysis of cause of death among 331 New York sheet metal workers found a significantly elevated PMR for lung cancer (PMR = 186). In addition, there were six deaths attributable to mesothelioma (three classified as lung cancer deaths) and three death certificates mentioned asbestosis or pulmonary fibrosis, although none of these three deaths were attributed to these diseases.     

Prophylaxis of asbestos-induced diseases: studies and perspectives

In recent years, implementation of dust-suppressing measures in USSR asbestos mills has led to significant decrease in dust levels. New cases of asbestosis and asbestotuberculosis in annual medical examinations have not been detected. For prevention of possible future incidence of these diseases, we plan to concentrate efforts on the medical selection of new employees, taking into account not only dust exposure, but also other ascertained risk factors (social, demographic, and biological, especially genetic). It seems to us that the grounds for complete prohibition of asbestos are insufficient. Substitution with alternative materials is discussed.     

Assessment of mortality in the construction industry in the United States, 1984–1986

Construction, one of the larger industries in the United States, employs 7.6 million workers, many in skilled trades occupations. Previously published data about potential worksite exposures and mortality of construction site workers are limited. We analyzed occupation and industry codes on death certificates from 19 U.S. states to evaluate mortality risks among men and women usually employed in construction occupations. Proportionate mortality ratios (PMRs) for cancer and several other chronic diseases were significantly elevated among 61,682 white male construction workers who died between 1984 and 1986. Men younger than age 65, who were probably still employed immediately prior to death, had significantly elevated PMRs for cancer, asbestos-related diseases, mental disorders, alcohol-related disease, digestive diseases, falls, poisonings, traumatic fatalities that are usually work-related, and homicides. Elevated PMRs for many of the same causes were observed to a lesser degree for black men and white women whose usual industry was construction. In addition, women experienced excess cancer of the connective tissue and suicide mortality. Various skilled construction trades had elevated PMRs for specific sites, such as bone cancer and melanoma in brickma-sons, stomach cancer in roofers and brickmasons, kidney and bone cancer in concrete/terrazzo finishers, nasal cancer in plumbers, pulmonary tuberculosis in laborers, scrotal cancer and aplastic anemia in electricians, acute myeloid leukemia in boilermakers, rectal cancer and multiple sclerosis in electrical power installers, and lung cancer in structural metal workers. Using a standard population of blue collar workers did not result in fewer elevated PMRs for construction workers. Despite lifestyle differences and other limitations of the study, the large numbers of excess deaths observed in this study indicate the need for preventive action for construction workers. © 1995 Wiley-Liss, Inc.     

石棉肺的病理学-对诊断标准的更新——美国病理医师学会和肺部病理协会组建的国际石棉委员会的报告

石棉肺是由于过量吸入石棉纤维而导致的肺弥漫性纤维化病变。其病理特征为特定型肺纤维化伴随肺内多量石棉沉着的表现,临床上疾病发展较慢,从开始接尘到出现症状,典型的潜伏期可长达20年以上。本文重点摘译介绍美国病理医师学会和肺部病理协会所组建的国际石棉委员会于2010年制定的＂新石棉肺病理诊断标准＂（以下简称＂新标准＂）,主要从历史背景、石棉矿物学、石棉肺的诊断三个方面进行阐述,该＂新标准＂最重要的更新点为石棉小体的作用和石棉纤维分析的作用。（1）石棉小体的作用：肺泡腔内或者纤维灶中出现石棉小体在组织学上被认为是石棉吸入的证据。石棉小体与其他含铁小体的区别之处为石棉小体相对较细且具有半透明的轴心。在5μm厚的常规切片中,石棉小体数如果≥2个/cm2,同时伴有特定类型的肺纤维化时,就可以确诊为石棉肺。当石棉小体数量很少时也不能直接排除石棉肺的诊断,而是需要对肺消化物进行石棉纤维的定量分析。（2）石棉纤维分析的作用：用于石棉纤维定量分析的材料,通常为肺消化物或者支气管肺泡灌洗液。用来观察的工具常为光学显微镜、扫描电镜或者透射电镜。然而无论使用何种技术,其结果的准确性都取决于各个实验室对技术的选择和结果分析等的熟练程度。测量结果必须和该实验室制定的参考范围作比较。不仅如此,石棉肺还需要与其它肺纤维化疾病相鉴别,尤其是需要与特发性肺纤维化及呼吸性细支气管炎相鉴别。与特发性肺纤维化相鉴别,石棉肺与特发性肺纤维化均表现为胸膜基底部的间质性纤维化,其鉴别之处有三：一是石棉肺纤维化几乎不伴感染,而特发性肺纤维化则与之相反;二是石棉肺疾病发展速度较慢,极少出现成纤维细胞,而特发性肺纤维化却以成纤维细胞灶为特征;三是石棉肺通常伴有脏层胸膜的轻度纤维化,而此现象在特发性肺纤维化中则较少见。与呼吸性细支气管炎相鉴别：石棉肺病灶常始于呼吸性细支气管附近,逐渐向外扩展并侵及周围越来越多的肺腺泡,直至这些独立的纤维灶相连,形成典型的弥漫性纤维化病变,尽管疾病早期很难与吸烟者及混合粉尘性尘肺患者所发生的腺泡中央型肺纤维化相区别,但是,其与呼吸性细支气管炎的鉴别点是石棉肺的纤维化不会局限于细支气管壁。     

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.     

An algorithm for matching anonymous hospital discharge records used in occupational disease surveillance: anonymous record matching algorithm.

The expense of collecting primary data, coupled with limited authority to mandate reporting, requires alternative methods of implementing an occupational disease registry in Illinois. One alternative data source for surveillance of some occupational diseases is hospital discharge records. Because these records lack personal identifiers, it has been impossible historically to match records belonging to the same individual and obtain reliable case estimates. To circumvent this difficulty, an algorithm has been developed to match anonymous hospital discharge records collected from all Illinois hospitals. The algorithm was based on the assumption that specific combinations of occupational disease code, sex, zip code, and date of birth would identify an individual to whom multiple hospitalizations belong. Matching with the algorithm reduced the 1986 case estimates from 597 to 499 for all cases of coal workers' pneumoconiosis, asbestosis, and silicosis.