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An
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U.S. Department
of
Health,
Education,
and
*
Welfare
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Public
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. National .
Institutes
of
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This report was prepared under Contract NO-1-55176 by the
Stanford Research Institute International, Menlo Park, California,
for the Division of Cancer Control and Rehabilitation, National
Cancer Institute, as an informational and educational resource.
Acceptance of the report does not signify that the contents
necessarily reflect the official views or policies of the National
Cancer Institute, nor does mention of trade names or commercial
products constitute endorsement or recommendation for use.

mmmmmjumrn

-i'~j-“^-ljj....-

asbestos:
An
Information
Resource

Prevention
Branch
Division
of
Cancer
Control
and
Rehabilitation

Richard J. Levine, M.D.
Editor

National
Cancer
Institute
Bethesda,
Maryland
US.
Department
of
Health,
Education,
and
Welfare
Public
Health
Service
National
Institutes
of
Health
DHEW Publication Number
(NIH) 79-1681

87297398

May 1978

ACKNOWLEDGMENTS

SRI International (formerly Stanford Research Institute) acknowledges the
invaluable advice and assistance of the following individuals during the
preparation of this monograph on asbestos:
Henry Anderson, M.D.
Department of Environmental Medicine
Mount Sinai School of Medicine
New York, New York
Robert E. Baumann, Ph.D.
Professor of Engineering
Iowa State University
Ames, Iowa
Arnold Brown, M.D., Chairman
Department of Pathology and Anatomy
The Mayo Clinic
Rochester, Minnesota
Jean Spencer Felton, M.D.
Long Beach Naval Shipyard
Long Beach, California
Graham W. Gibbs, Ph.D., Director
Occupational Health and Safety Unit
Institute for Mineral Industry Research
McGill University
Montreal, Quebec, Canada
Philippe Shubik, M.D., Director
Eppley Institute for Research in Cancer
Omaha, Nebraska
Acknowledged also are the many contributions from the staffs of SRI's
Center for Occupational and Environmental Safety and Health, Center for
Resource and Environmental Systems Studies, Biorganic Chemical Department,
Minerals and Metals Center, and Center for Research on Stress and Health.

87297399

'-t-

CONTENTS

LIST OF ILLUSTRATIONS......................................................................................................

ix

LIST OF TABLES....................................................................................................................

ix

FOREWORD...................................................................................................................................

xi

ACKNOWLEDGMENTS....................................................................................................................

xiii

I

INTRODUCTION ...............................................................................................................

1

II PRODUCTION AND USE OF ASBESTOS FIBERS ANDPRODUCTS ..........................

9

U.S. Consumption of Asbestos Fibers
.....................................................
U.S. Production and Producers of Asbestos Fibers .........................
End Uses of Asbestos............................................................................................
Handling of Fiber and Products During Their Production ...

9
11
13
15

Mining...............................................................................................................
Milling...............................................................................................................
Transportation
............................................................................................
Manufacture of Asbestos-Containing Products .........................

15
17
18
19

III

BIOLOGICAL EFFECTS OF ASBESTOS FIBERS

................................................

21

Disposition of Fibers in the Body..........................................................

21

Inhaled Asbestos
Ingested Asbestos
Injected Asbestos
"Asbestos Bodies"

.......................................................................................
.......................................................................................
.......................................................................................
.......................................................................................

Carcinogenic Effects--Human Studies

21
22
23
23
23

Evidence of Lung Cancer.........................................................................
Evidence of Mesothelioma
....................................................................
Laryngeal Cancer
.......................................................................................
Digestive System Cancer .........................................................................
Other Cancers.................................................................................................
Association of Effects with Fiber Type..................................
Dose-Response Relationship
...............................................................
The Cancer Latency Period ....................................................................
Incidence of Cancer and Age at First Exposure
to Asbestos.................................................................................................
Smoking and Asbestos-Related Cancer ..........................................
Cancer from Incidental OccupationalExposure
.......................
Disease in Workers' Households
......................................................
Cancer in the Neighborhood of Asbestos Facilities ...

24
25
25
26
26
26
27
29

iii

29
30
31
32
32

87297400

.....................................................

Ill

IV

BIOLOGICAL EFFECTS OF ASBESTOS FIBERS (Continued)
Carcinogenic Effects--Animal Studies ......................................................
Noncarcinogenic Effects of Asbestos
......................................................

32
34

Asbestosis.............................................................................................■ •
Asbestos Pleural Effusion ....................................................................
Pleural Calcification, Diffuse Fibrosis,
and Plaques.................................................................................................
Asbestos Warts
.............................................................................................
Animal Studies--Evidence of Noncarcinogenic Effects . .

34
37

OCCUPATIONAL EXPOSURES .........................................................................................

41

Exposures in Mining and Milling
................................................................
Exposures in the Asbestos Products Industries
.............................

42
42

Friction Products ........................................................................................
Asbestos Paper
.............................................................................................
Asbestos-Reinforced Plastics
...........................................................
Asbestos-Cement Pipe and Sheet......................................................
Floor Tile......................................................................................................
Asbestos Textiles ........................................................................................

43
45
45
45
46
46

Exposures in the Utilization of Asbestos-Containing Products

47

Insulation Trades ........................................................................................
Brake and Clutch Repair.........................................................................
Installation of Floor Tile, Roofing, and Siding ....
Use of Spackling, Patching, and Taping Compounds
...
Wearing Asbestos Garments ....................................................................

47
48
48
49
49

V NONOCCUPATIONAL EMISSIONS AND EXPOSURES

37
38
38

...............................................

51

Asbestos Emissions from Natural Sources
............................................
Asbestos Emissions from Human-Created Sources
..............................
Redistribution and Fate of Asbestos in the Environment ...

51
51
52

Redistribution by Air.............................................................................
Redistribution by Water .........................................................................
The Ultimate Fate of Asbestos Fibers.......................................

52
54
54

Exposure to Airborne Asbestos

....................................................................

55

Exposure from Ambient Air....................................................................
Exposures from Asbestos Mining, Milling,
and Product Manufacture ....................................................................
Exposure from Transportation of Materials
Containing Asbestos ..............................................................................
Exposure from Asbestos Manufactured Products
....................
Exposures from Disposal of Asbestos Products
and Wastes
........ ...........................................................
Exposures of Asbestos Workers' Families ..................................

55

iv

57
58
61
62
62
64

87297401

Exposure to Asbestos in Drinking Water .................................................
Exposure to Asbestos in Foods and Drugs
............................................

56

VI

CONTROL OF THE ASBESTOS HAZARD—PHYSICAL CONTROL ....................

67

Engineering Measures

.......................................................................................

67

Enclosure......................................................................................................
Exhaust Ventilation ..............................................................................
Isolation......................................................................................................
Plant Design............................................................................................
Treatment of Asbestos .........................................................................
Substitution
............................................................................................

68
68
69
70
72
72

Administrative Measures

..............................................................................

75

Limiting the Number of Employees Exposed
.........................
Limiting the Duration of Exposure for Any Given
Person......................................................................................................
Restrictions on Smoking and Eating
.......................................
Smoking Cessation Programs
...........................................................

75
75
76
77

Work Practices, Including Housekeeping and Use of Personal
Protective Equipment ...................................................................................

77

Housekeeping
............................................................................................
Personal Protective Equipment ......................................................

78
78

Control in Specific Manufacturing and Consuming Indus­
tries
...................................................................................................... ...

80

Asbestos Textile Production ..........................................................
Asbestos Paper
.......................................................................................
Asbestos-Cement Pipe and Sheet.................................................
Automotive Brake and Clutch Repair
.......................................
Construction
............................................................................................
Demolition and Rip-out of Asbestos-Containing
Insulation............................................................................................
Control of Emissions to the General Environment

80
81
81
81
81
82

....................

83

Air Pollution Control .........................................................................
Water Pollution Control ....................................................................
Waste Water Treatment Processes .................................................
Control of Asbestos Fibers in Potable Water
Supplies.................................................................................................
Waste Disposal.......................................................................................
Identification
.......................................................................................
Separation.................................................................................................
Secure Transport
..................................................................................
Secure Ultimate Disposal
...............................................................

83
83
84

Control During Transportation

87

87297402

v

...............................................................

85
86
86
87
87
87

VII CONTROL OF THE ASBESTOS HAZARD—MEDICAL MANAGEMENT ....

89

Composition of the Workforce..........................................................

89

Lung Cancer........................................................................................
Mesothelioma
............................................................................................
Asbestosis.......................................................................................

90
90
92

Early Detection and Treatment of Asbestos-Related
Diseases......................................................................................................

92

Lung Cancer........................................................................................
92
Laryngeal Cancer
...................................................................................
Mesothelioma
............................................................................................
Cancers of the Alimentary Tract .................................................
Asbestosis........................................................................................
97
VIII

CONTROL OF THE ASBESTOS HAZARD—EDUCATION

....................................

Goals of Education...................................................................................
Modes of Education—The Written and the Spoken Word
.
The Educators............................................................................................

99
99

. .

100
101

Physicians........................................................................................
101
Nurses.................................................................................................
101
Health Educators (Communication Specialists)
....
Industrial Hygienists .........................................................................
Union Health and Safety Specialists .......................................
Industrial Safety and Other Training Specialists
. .
Science/Medical Writers ....................................................................
Target Groups for Education

96
96
96

102
102
102
102
103

....................................................................

103

Managerial and Supervisory Personnel
..................................
Workers in the Asbestos, as Well as Other, Trades . .
Retirees and Other Former Workers ............................................
Workers' Families
..............................................................................
Occupational Health Professionals........................ J . . .

103
104
104
104
104

Assessment of Education's Value

..........................................................

105

A

ASBESTOS-RELATED AND -ASSOCIATED MINERALS ........................................

A-l

B

FEDERAL REGULATIONS OF OCCUPATIONAL EXPOSURE

...............................

B-l

C

MONITORING AND MEASURING ASBESTOS CONTAMINATION ..........................

C-l

D

ANIMAL STUDIES RELATED TO CARCINOGENIC EFFECTS
OF FIBERS................................................................................................................

D-l

AIR AND DRINKING WATER ASBESTOS CONCENTRATIONS
FROM SOME PUBLISHED SOURCES....................................................................

E-l

APPENDICES

vi

87297403

E

SMOKING CESSATION PROGRAMS

..........................................................................

G

SOURCES OF EDUCATIONAL MATERIALS

............................................................

G-l

H

REFERENCES.................................................................................................................

H-l

vil

F-l

t '0 t ’ 6 6 Z £ 8

F

ILLUSTRATIONS

1
2

3

Distribution of Ultrabasic and Metamorphic Rock
Formations in the United States ...............................................................

4

Disposals and Emissions of Asbestos from Asbestos
Production, Manufacturing, and Consumption in the
United States ..........................................................................................................

53

Locker Room, Shower Arrangement ...............................................................

71

TABLES

1

Apparent U.S. Consumption of Asbestos Fiber ..................................

10

2

Operating and Nonoperating Asbestos Mines and Mills
in the United States.......................................................................................

12

3

Selected Asbestos Products and Their End Uses ..............................

14

4

Major U.S. End Uses of Asbestos Fiber, By Type& Grade

.

16

5

Deaths from Respiratory Cancer by Cumulative Dust
Exposure....................................................................................................................

28

Exposure to Airborne Asbestos in Selected Asbestos
Product Manufacturing Industries
..........................................................

44

Medical Examinations for Asbestos-Exposed Workers ....................

93

6
7

ix

.

FOREWORD

There is increasing realization that asbestos may be present across
the entire spectrum of human exposure--in our air, water, food, drugs,
cosmetics; in our homes and, most importantly, in our workplaces.
There
is also developing awareness that several types of cancer may be the con­
sequence of exposure to this material, especially for certain segments
of the population.
Recognizing our responsibility to transfer information to the scien­
tific community and the public, the Division of Cancer Control and Rehabil­
itation, National Cancer Institute, is making available this document on
asbestos and cancer.
Several of the more important objectives of the
document are to:
(1) present both current and historical evidence of the
carcinogenic potential of asbestos; (2) examine potential exposure of the
public; (3) describe current intervention and control technology; and
(4) discuss the possible prevention roles of various individuals and
groups in the community.
Dissemination of information is a fundamental
prerequisite to the formulation and implementation of action programs
for effective cancer control and prevention at the federal, state, and
local levels.
This document represents work of individuals in many different
research fields, and the contributions of all these individuals are
acknowledged.
The comments of many scientists in the federal government and private
sector are greatly appreciated.
Particular thanks must be given to Dr.
Herman Kraybill and the Interagency Collaborative Group on Environmental
Carcinogenesis for their comments and to Drs. Irving Selikoff, Mearl
Stanton, Paul Kotin, Elizabeth K. Weisburger, and Kenneth Bridbord for
their review and suggestions.
Dr. Winfred F.
Cancer Institute.

Malone served as Project Officer for the National

Diane J. Fink, M.D., Director
Division of Cancer Control
and Rehabilitation
National Cancer Institute

xi

ACKNOWLEDGMENTS

SRI International (formerly Stanford Research Institute) acknowledges the
invaluable advice and assistance of the following individuals during the
preparation of this monograph on asbestos:
Henry Anderson, M.D.
Department of Environmental Medicine
Mount Sinai School of Medicine
New York, New York
Robert E. Baumann, Ph.D.
Professor of Engineering
Iowa State University
Ames, Iowa
Arnold Brown, M.D., Chairman
Department of Pathology and Anatomy
The Mayo Clinic
Rochester, Minnesota
Jean Spencer Felton, M.D.
Long Beach Naval Shipyard
Long Beach, California
Graham W. Gibbs, Ph.D., Director
Occupational Health and Safety Unit
Institute for Mineral Industry Research
McGill University
Montreal, Quebec, Canada
Philippe Shubik, M.D., Director
Eppley Institute for Research in Cancer
Omaha, Nebraska
Acknowledged also are the many contributions from the staffs of SRI's
Center for Occupational and Environmental Safety and Health, Center for
Resource and Environmental Systems Studies, Biorganic Chemical Department,
Minerals and Metals Center, and Center for Research on Stress and Health.

87297407

xiii

Chapter I
INTRODUCTION

Because of their unique combination of resistance to heat and chem­
ical attack, high tensile strength, and flexibility, fibrous asbestos
minerals have long been used by man.
The early Greek geographer,
Pausanias, speaks of golden lamps made about 430 B.C. with incombust­
ible wicks of "Carpathian flax." The Romans used asbestos as cremation
clothes to conserve the ashes of deceased persons of rank.
The French
emperor, Charlemagne, had a tablecloth of asbestos and is reputed to
have impressed his enemies by passing it through fire to clean it.
Today, asbestos is found in thousands of commercial products
including heat-resistant textiles, reinforced cement, special filters
for industrial chemicals, thermal insulation, floor tiles, gaskets, and
brake linings.
More than 725,000 metric tons (800,000 short tons) of
asbestos have been consumed in the United States alone in producing these
products in each of several recent years.
As a consequence of man's
utilization of asbestos, coupled with the natural occurrence of the min­
eral, asbestos fibers are found in the air we breathe, the food we eat,
and the water we drink.

A Hazard to Human Health
The fact that asbestos is a hazard to man's health was recognized
quite early.
In the first century, both Pliny the Elder, the Roman
naturalist, and Strabo, the Greek geographer, wrote of a sickness of
the lungs in slaves whose occupation was the weaving of asbestos into
cloth.
However, the association of asbestos with chronic respiratory
disease had to be rediscovered in the modern era.
A series of case
reports was followed by an epidemiologic study published in London in
1930,1 52 years after large-scale mining of asbestos had begun with the
opening of a mine at Thetford, Quebec, Canada. The cancer-producing
potential of asbestos was not established until 1949, when a report was
published describing an excess of cancer of the lung and pleura among
individuals dying from asbestosis.^
It is now clear that among asbestos workers, there is, in addition
to the risk of asbestosis, a greatly increased risk of death from lung
cancer and from pleural and peritoneal mesothelioma, malignancies that
are seldom found in the general population.Moreover, asbestos has
been linked with gastro-intestinal, oropharyngeal, and laryngeal cancer.
According to the U.S. Public Health Service, one million persons
now living in the United States either work or have worked in the

1

asbestos product manufacturing industry.
This figure does not include
those employed in mining and milling asbestos; those whose work may
involve installation, modification, or repair of asbestos products;
persons exposed indirectly to asbestos in the course of their work such
as at shipyards or in the construction industry; persons living in the
neighborhood of an asbestos product factory; or consumer users of asbestos
materials.

What is "Asbestos?"
To the mineralogist, asbestos is the generic name for a group of
naturally occurring hydrated mineral silicates of the amphibole or
serpentine series that are characterized by fibers or bundles of fine
single crystal fibrils.
Naturally occurring asbestos fibers typically
have length-to-width ratios of the order of 100 and higher.
Included in this definition are the following minerals:
•

Chrysotile

•

Crocidolite

•

Amosite, and

•

The fibrous varieties of anthophyllite, tremolite, and
actinolite.*

All of these minerals may occur in a nonfibrous form, in which case
they are not classified as asbestos.
Commercially, chrysotile is the
form of asbestos used most.
Crocidolite, amosite, and anthophyllite
also have some commercial significance.
It is important to note that identification of asbestos fibers is
relatively simple with macroscopic samples that clearly show the fibrous
nature and other unique characteristics of these minerals.
Positive
identification is based on morphology, crystallographic structure,
color, hardness, optical properties, and appearance. However, in the
case of microscopic samples, positive identification becomes increasingly
difficult, even when special microanalytical techniques are used.
The identification of asbestos is complex because many of the min­
erals that are chemically almost identical to different varieties of
asbestos (e.g., grunerite to amosite, serpentine to chrysotile) exhibit

2

87297409

Crocidolite, amosite, anthophyllite, tremolite, and actinolite are
derived from the amphibole series and may be referred to as
"amphiboles."

M

perfect prismatic cleavage (the ability to break along well-defined
crystallographic planes), so that physical degradation often leads to
the formation of minute cleavage fragments that are chemically as well
as physically indistinguishable from asbestos fibers.
Recent compre­
hensive studies at the U.S. Bureau of Mines have concluded that there is
currently no absolute way to distinguish between finely divided asbestos
and certain other minerals of similar composition.^ Some minerals other
than asbestos that may exhibit fibrous structure are listed in Appen­
dix A.
On the other hand, recent biological studies suggest that, in
terms of carcinogenic activity, mineral shape and size may be more
important than chemical nature.^ The question of asbestos carcino­
genicity can, therefore, be viewed as part of a broader issue—i.e.,
tissue modification caused by mineral fibers.

Occurrence of Asbestos
All forms of asbestos develop through several stages of geologic
processes (paragenesis) from parent rocks that are transformed into
asbestos.
Parent rocks of asbestos minerals include basic constituents
normally found in ultramafic, dolomitic, or limestone rocks.
Transfor­
mation may occur under localized conditions of temperature and pressure
which lead to recrystallization of other in-situ minerals (metamorphism).
It may occur as a result of the action of hot mineral solutions that
can dissolve or otherwise alter some minerals to form others (hydrother­
mal processes).
In all of the commercial asbestos deposits, the geologic conditions
have been favorable to the development of fibers of sufficient quality
and concentration to warrant their extraction.
(The same conditions
may operate in other mineral deposits but yield asbestos fibers that are
too disseminated or scarce to be of commercial interest.)
Minerals and rocks that can contain asbestos are listed in Appen­
dix A.
A favorable mineral association is not a sufficient condition
for the formation of asbestos—it will form only if special structural
and other geologic conditions are met.
If asbestos presence is, in
fact, established, the minerals and rocks listed in Appendix A would be
significant sources of contamination for humans, since they include
important raw materials for industry and are mined in commercial quan­
tities, worldwide.
The areas of the United Stated having basic geologic constituents
associated with the formation of asbestos are shown in Figure 1. Again,
this graphic does not necessarily depict actual asbestos occurrence but.

87297411

3

ZW L&ZL&

NOTE:

In Hawaii, the type of mineral alteration that
could lead to asbestos formation it quite restric­
ted (to the vicinity of the Koolau and Molokai
volcanoes on the itland of Oahu).
Ultramafic rockt, mafic plutonic rocks, and similar basic
intrusives.

|^)

Areas of extensive high-rank (severe) metamorphism.

E3

Inferred ultrabasic intrusives.

SOURCES: ‘Tectonic Map of North America." U.S. Geological Survey; SRI International

FIGURE 1

DISTRIBUTION OF ULTRABASIC AND METAMORPHIC ROCK FORMATIONS IN THE UNITED STATES

rather, is an overview of the areas that are more likely than others
to provide the geologic setting associated with formation of asbestos.
Although deposits of asbestos may be found throughout the United
States, asbestos is commercially mined and milled at only five loca­
tions, in the states of California, Arizona, and Vermont.
(Most of the
asbestos consumed in the United States is imported, nearly all of it
from Canada.)
In addition to commercial mining and milling of asbestos,
human-created occurrences of asbestos fiber may result from the mining
and milling of mineral ores associated with asbestos; from the inadver­
tent disturbance of asbestos deposits by activities such as farming and
road building; from the transportation of asbestos ore, milled fiber,
products, and wastes; from the manufacture, use, repair, and demolition
of asbestos-containing products; and from the disposal of asbestos
wastes. All are discussed in succeeding chapters of this monograph.

Regulation of Asbestos-Fiber Emissions
A recommendation for limiting exposure to asbestos in U.S. industry
was made in 1938 by the U.S. Public Health Service.8 The recommended
limit, an airborne concentration of less than 5 million particles per
cubic foot, was formally recognized in 1964—as a guideline issued by
the Bureau of Labor Standards.
No legal regulations were established
until passage of the Occupational Safety and Health Act of 1970 and
establishment of the Occupational Safety and Health Administration
(OSHA).

Occupational Exposure
OSHA regulations apply directly to all private employers, including
federal government contractors, but not to federal, state, or local
government agencies.
Federal agencies are required to establish their
own occupational safety and health programs consistent with the stand­
ards of the Act and subsequent OSHA regulations.
States are encouraged
by the Act to develop programs and regulations, for private employers,
that are at least as effective as OSHA regulations and can, under these
conditions, assume responsibility for enforcing standards—at the time
of this writing, 24 states have programs of their own.9 The current
OSHA limit on occupational exposure to asbestos fibers is an 8-hour
time-weighted average of 2 fibers per milliliter, no longer than 5
micrometers, with a length-to-width ratio of at least 3:1, detected by
a method using phase-contrast (optical) microscopy.

87297413

The permissible levels of occupational exposure to asbestos con­
tained in all federal regulations (and one proposal) are summarized in
tabular form in Appendix B.
Also, the provisions of these regula­
tions for method of compliance, monitoring, medical surveillance, edu­
cation, and the keeping of records are summarized there.

5

j

Emissions to Air and Water, Disposal of Solid Waste, Transportation

A national air emission standard for asbestos, first published in
1973,10 requires either the institution of specified air-cleaning meth­
ods or else no visible emissions (except water) to be released to the
outside air.
The standard applies to the milling of asbestos (but not
to adjacent storage depots); manufacturing or processing of specified
products; renovating or demolishing certain buildings (but not ships)
containing more than a specified amount of friable asbestos insulation;
and to wastes containing commercial asbestos or products of asbestos
mining and milling.
Friable or spray-on insulating materials, except
when applied to equipment or machinery, must contain no commercial
asbestos; however, spray-on paints, decorative materials, and weather­
proofing are not regulated.
Under the terms of guidelines and standards promulgated in 1974
and 1975, certain asbestos-manufacturing operations were to achieve, by
July 1, 1977, wastewater effluent limitations requiring application of
the best practicable control technology currently available; and by
July 1, 1983, except for operations involving solvent recovery, there
is to be no discharge of wastewater pollutants to navigable waters.H
Federal agencies are directed by two Executive Orders to monitor,
evaluate, and control their activities so as to protect and enhance
the quality of the environment and to conform to air and water quality
standards of the Clean Air Act and the Federal Water Pollution Control
Act.

Food, Drugs, Consumer Products
The Food and Drug Administration (FDA) has reviewed several com­
mercial practices that may result in asbestos contamination of food and
drugs and, in January of 1976, revoked approval for use in foods of
sodium chloride (salt) produced by the electrolytic diaphragm process.^
In the absence of more-reliable data on background concentrations of
asbestos in water and the contribution of asbestos filters to levels
of asbestos found in ingestible products, the FDA has not regulated
the use of asbestos filters for filtering edible foods, beverages, and
nonparenteral drugs.13 The agency has, however, enacted regulations to
limit asbestos and other fibrous materials in parenteral drugs.1^ The
FDA has approved (1) the use of asbestos as a component of various
types of food-contact articles in which contamination of food is not

6

wmmmmm

likely to occur, and (2) the use of talc, in which asbestos is a possible
impurity, in cosmetics.*
The Consumer Product Safety Commission has banned general-use
garments containing asbestos.
The use of asbestos in special garments
such as fire-fighting suits is permitted, but only if they are con­
structed so that asbestos fibers will not become airborne under normal
conditions of use.l^t

Constraints on Monitoring and Measuring Asbestos Levels
As will be brought out later in this monograph, it is simply not
known what attributes of asbestos it is that constitute a health
hazard—size, shape, mass, type etc.—nor is it known what amount is
hazardous or over what period of time.
The U.S. federal occupational
standards are, perforce, an attempt to optimize what is known about
the health hazard with the technical and economic practicalities of
measuring the substance.
For example, by using phase-contrast optical
microscopy, rather than the higher resolution electron microscopy, it
is not possible to count all the fibers and not always possible to even
distinguish between asbestos and other fibers (as noted previously);
electron microscopy, on the other hand, is time-consuming and expen­
sive.
The difficulties of measuring and identifying are of such pro­
portions that there are extreme variations in the measurement of a
sample, both within a laboratory and among laboratories.
As a consequence, the reader should always bear in mind the pos­
sible grossness of measurements referred to throughout this document,
even when they are expressed in terms that bespeak of precision—e.g.,
the decimal point.
At the same time, the fact remains that asbestos is
a human carcinogen and that, as such, is a suitable subject for treat­
ment in this document, the prime purpose of which is helping man control
cancer.
The constraint on monitoring and measuring asbestos is such,
nevertheless, that it is the subject of more extensive treatment in
Appendix C of this document.

^Full attainment of the desired result of regulation inevitably requires
adequate means of enforcement.
Legal powers of enforcement as well as
de facto enforcement practices differ widely among the various govern­
ment agencies having statutory authority.
See Reference 17 for an ex­
ample of divergence of enforcement practice in just one regulatory agency
from what is required by law.
7

87297416

Talc is listed as a "generally recognized as safe" (GRAS) substance
for use in paper, paperboard, and cotton food packaging materials; as
an anticaking agent for forms used in molding various food shapes and
in chewing gum base; and to coat polished nonenriched rice, as a free­
flow agent, and as a vehicle for enrichment formulas.15 An FDA ruling
on talc as a direct food or drug additive has been deferred until an
acceptable analytic method can be developed.^

*****

Summarized in the next four chapters are:
production and uses of
asbestos fiber and fiber-containing products; the biological effects,
carcinogenic and noncarcinogenic, of exposure to asbestos; occupational
and nonoccupational exposures and exposure levels.
In the final three
chapters, strategies and programs for the control of the health hazard
represented by human exposure to asbestos are set forth.

8

Chapter II
PRODUCTION AND USE OF ASBESTOS FIBERS AND PRODUCTS

Although some exposure of humans to asbestos fibers in air and
water is always possible as a result of the weathering of asbestoscontaining rock, it is man's large-scale commercialization of the mineral
that has engendered greater health risk.
In this chapter, the major
facets of such commercialization in the United States are reviewed—
consumption and production volumes; categories of manufactured goods;
and processes for mining, milling, transporting, and manufacturing
asbestos and asbestos-containing products.*

U.S. Consumption of Asbestos Fibers
During the five years ending in 1975 the amount of asbestos fiber
apparently consumed^ in the United States averaged some 800,000 tons
annually, although between 1974 and 1975 apparent consumption declined
27Z from 856,000 to 629,000 tons.t It is expected that consumption will
have recovered to about 820,000 tons in 1976.
The sharp decline between
1974 and 1975 reflects not only a market affected by a sharp recession,
but also a substantial interruption of supply associated with work
stoppages, a landslide at a major mine, and a serious fire at an asbestos
mill in Quebec, Canada.
The estimated U.S. apparent consumption of
asbestos fiber for the 1971-75 period is shown in Table 1.
It can be seen in Table 1 that most of the asbestos fiber used in
the United States is imported (about 90%).
Nearly all of this imported
asbestos is chrysotile fiber that comes from Canada (96.5% in 1974). The

This chapter includes information obtained through a special survey of
industry carried out in the Fall of 1976 by the Mineral and Metals
Center, SRI International.
^""Apparent" consumption—i.e., production plus imports, plus net ship­
ments from government stockpiles if any, less exports.
Apparent con­
sumption figures do not take into account any changes in inventory
levels of manufacturers and therefore differ from "actual" consumption
figures (an example of which is found in Table 4 in this chapter).

accordance with industry practice.

9

87297419

^Volumes in this chapter are expressed in short tons (2,000 pounds) in

Table 1
APPARENT U.S. CONSUMPTION OF ASBESTOS FIBER
(Thousands of Short Tons)

1971

1972

1973

1974

1975

Production

131

132

150

113

100

Imports

681

736

792

776

575

Stockpile releases

10

13

7

29

4

Exports

54

59

66

62

50

768

822

883

856

629

Apparent consumption

Source:

U.S. Bureau of Mines, Commodity Data Summaries, 1976.

Republic of South Africa accounted for some 3% of the U.S. imports in
1974 (crocidolite and amosite fibers), and a number of countries sup­
plied the remainder.
A substantial portion of Canadian output is pro­
duced there by U.S. companies that manufacture asbestos products.
It should be noted that in addition to importing both crude and
milled fibers, the United States imports products manufactured from
asbestos.
In 1974, for example, the value of products exported from
Canada to the United States was as shown below:^

¥
i

*.(

Canadian Dollars
(millions)

*

i

Brake linings and clutch facings

$0.9

lVf

Building materials

3.7

it

Other products

3.2

Total

$7.8

However, the value of imported products is not large compared with U.S.
domestic shipments, which, for example, totalled $742.6 million in
1972.2

10

87297420

The U.S. Bureau of Mines has estimated that U.S. demand for asbes­
tos in the year 2000 will range between 1.0 million and 1.8 million
tons.^ It is also possible, however, that substitution of other

materials for asbestos could result in a lower level of demand.
substitution could occur for a number of reasons such as:
•

More rapid price increases for asbestos than for its
competitive products.

•

Health and safety considerations.

•

Lack of availability (an industry expert has estimated
that by 1980 supply could fall short of potential world
demand by about 500,000 tons, or about 10% of world
demand).

This

U.S. Production and Producers of Asbestos Fibers
The volume and value at the mines of asbestos fiber production in
the United States during recent years is shown in the tabulation that
follows:
Production
(Thousands of
Short Tons)

Value
Per
Ton

1971

131

$ 93

$12.2

1972

132

102

13.5

1973

150

121

18.2

1974

113

158

17.9

1975

100

182

18.2

Total Value
(Millions of
Dollars)

The decline in production volume from the all-time peak of 150,000 tons
in 1973 resulted primarily from the closing or reduction in output of
several mines such as GAF Corporation's Lowell Vermont mine (acquired
by the Vermont Asbestos Group), Pacific Asbestos Corporation's mine
near Copperopolis, California (later reopened by Calaveras Asbestos
Limited), and the Christie mine of Coalinga Asbestos Company, Inc., at
Coalinga, California
(a 15,000-ton-per-year mine that has remained
closed).
The average domestic production of only 125,000 tons annually
during the 1971-75 period is a relatively small fraction of the nearly
800,000 tons consumed annually in the United States during those years.
As a result of an increase in the production volume and average value
per ton In 1976, the value of U.S. asbestos fiber production could be
in the range of $25-30 million in 1976 (11-13% of the mine/mill value of
all asbestos likely to be consumed during the year).

11

87297421

U.S. asbestos mines and mills, their locations, output, and employ­
ment are shown in Table 2.
The current total mill capacity is on the

Table 2
OPERATINC AND NONOPERAT1NC ASBESTOS
MINES AND MILLS IN THE UNITED STATES

In Operation as of
Late 1976

Type of
Mining

Mine Name

Mine Location

Mill Location

Fiber Type

Annual
Production

Employment

Atlas Asbestos Corp.

Open pic

Santa Cruz

30 mi. NW of
Coalings

At mine

Short

30,000 tons

30

Under­
ground

El Dorado

32 mi. N of
Globe

Globe

Short and
spinning

3,000 tons

33

Union Carbide Corp.
(California)

Open pit

Santa Rita

Eastern
San Benito
County

King City
(55 mi. W of
mine)

Short

35,000 tons

68*

Vermont Asbestos Group
(Vermont)

Open pit

Lowell

Belvldere
Mountain

At mine (15 ml.
from Hyde Park)

Short to
medium and
spinning

40,000 tons

208

Calaveras Asbestos Ltd.
(California)

Open pit

Pacific
Asbestos

Copperopolis

At mine

Short to
medium

35,000 tons

175

(California)
Jaquays Mining Co.
(Arizona)

?■

Suspended Operations
Coalings Asbestos Co.
(Division of JohnsManvllle Corp.)
(California)

Open pit

30 mi. NW of
Coalings

At mine

Short

Asbestos Mfg. Co.
(Arizona)

Under­
ground

Near Globe

Globe

Short and
spinning

Metate Asbestos Co.
(Arizona)

Under­
ground

Near Globe

Globe

Short and
spinning

Powhatan Mining Co.
(North Carolina)

Open pit

Burnsville,
N.C.

Baltimore, Md.

(Anthophyllite)

SUU employment only—deposit is mined by independent contractor on an intermittent basis.
Source:

SRI--lndustry contacts and trade journals.

i

\

SHa-Jao

order of 143,000 Cons per year (all in the form of chrysotile fibers).
California mines and mills account for about 70% of total U.S. output.
It is difficult to predict changes in U.S. asbestos output because
such changes will be a function of costs, including environmental costs,
in the United States as compared with costs in Canada and other sources
of supply.
Neither current nor projected costs are published.

End Uses of Asbestos
The high tensile strength, flexibility, heat and chemical resis­
tance, and favorable frictional properties of asbestos fiber make it
adaptable to a large number of uses.
Depending on the length of fibers
and other characteristics, asbestos can be:
Carded, spun, or woven
Used as structural reinforcement of materials such
as cement, plastic and asphalt
Laid and pressed to form paper.
Some authorities, such as the U.S. Bureau of Mines, state that
there are more than 2,000 discrete uses of asbestos; others, such as the
Asbestos Information Association and Canada's Department of Energy,
Mines and Resources, suggest that there are upwards of 3,000 uses. A
selected few of the many applications are shown in Table 3.
The properties of asbestos fibers determine the uses to which the
fibers are put.
Properties of major importance are length distribution,
bundle diameter distribution, harshness, tensile strength, and surface
activity.
Other considerations include color and content of iron and
dust.
The relative-strength standard developed for chrysotile asbestos
by the mining industry in Quebec is a convenient basis for delineating
some major uses.
For example:
•

Long fibers (Groups 1 and 2 and 3) are used in textiles,
electrical insulation, filtration media, and maximumstrength asbestos cement products.

•

Medium length fibers (Groups 4, 5, 6) are used as rein­
forcing fillers in asbestos cement products, in friction
materials such as brake linings and clutch facings, in
paper, and in pipe covering.

13

87297423

No. 1 crude is 3/4 inch staple and longer (to nearly 6 inches). No. 2
crude is 3/8 to 3/4 inch staple.
Other groups are milled fibers.

r

Table 3
SELECTED ASBESTOS PRODUCTS AND THEIR END USES

Floor Tile
Office floors
Commercial floors
Residence floors

Gaskets and
Packings

Friction Products

Valve components
Flange components
Pump components
Tank sealing com­
ponents

Clutch/transmission
components
Brake components
Industrial friction
materials

Asbestos Textiles
Packing components
Gasket components
Roofing materials
Commercial/industrial dryer felts
Heat/fire protective clothing
Clutch/transmission components
Electrical wire and pipe insulation
Theater curtains and fireproof
draperies

Source:

Paints, Coatings
and Sealants
Automotive/Truck
body coatings
Roof coatings and
patching compounds

Asbestos Paper
Gas vapor ducts for corrosive compounds
Fireproof absorbent papers
Table pads and heat protective mats
Heat/fire protection components
Molten glass handling equipment
Insulation products
Gasket components
Underlayment for sheet flooring
Electric wire insulation
Filters for beverages
Appliance insulation
Roofing materials

Asbestos Information Association/North America.

AsbestosRe inforced
Plastics
Electric motor
components
Molded product
compounds for
high-strength/
weight uses

Asbestos
Cement Pipe
Chemical proccess piping
Water supply
piping
Conduits for
electric
wires

Asbestos Cement Sheet
Hoods, vents for corrosive
chemicals
Chemical tanks and vessel manu­
facturing
Portable construction buildings
Electrical switchboards and com­
ponents
Residential building materials
Molten metal handling equipment
Industrial building materials
Fire protection
Insulation products
Small appliance components
Electric motor components
Laboratory furniture
Cooling tower components

•

Short fibers (Groups 7, 8) are used as reinforcing filters
in plastics, floor tile, and asphalt and in paints and
oil-well drilling muds.

The consumption pattern for asbestos fiber in the United States is shown
in Table 4.
The construction industry—including new building, renova­
tion, and maintenance—accounts for an estimated 70%-80% of total U.S.
consumption.
The first four uses shown in Table 4, which are constructionindustry related, account for only 65% of the total use, but a portion
of some of the other uses is associated in various ways with the con­
struction industry.
Several other aspects of Table 4 are noteworthy:
•

Chrysotile fiber accounts for a very high proportion of
total asbestos use (94% in 1974).

•

About 98% of the crocidolite is used in the production of
asbestos cement pipe, because of (1) its hardness,
brittleness, and high tensile strength, which add to the
rigidity of the end product, and (2) its superior fil­
tration qualities, which enhance the drainage of water,
permitting the cement to dry more rapidly.

•

Asbestos cement pipe and sheets account for a large pro­
portion of total use (38% in 1974) .

•

A very large proportion of total asbestos use is accounted
for by the shorter-length fibers (Quebec Grade 7 chrysotile
alone accounted for nearly 40% of the total use in 1974).

The transportation industry uses about 14% of all the asbestos con­
sumed.
The applicance industry uses some 5%-6% of the total.^

Handling of Fiber and Products During Their Production
Producing the many asbestos-containing products that are used
involves mining asbestos ore; milling, or hand-separating, the fibers
from the ore and from each other; transporting both ore and fiber; and
manufacturing the products themselves.
These four general processes
are reviewed briefly in the sections that follow.

Mining
Most asbestos ore is mined in surface operations.
Of the five U.S.
mines in operation, four are surface mines and one is underground.*
Each operating mine is associated with a mill that processes the ore.

For a description of each mine and a discussion of the mining, milling,
and dust-control procedures, see National Environmental Research Center,
Characterization and Control of Asbestos Emissions from Open Sources,
North Carolina, September, 1974.
15

87297426

*

MAJOR U.S. F.ND USES OF ASBESTOS FIBER, BY TYPE AND GRADE
1974
(Short Tons)

Croup
3

Asbestos cement
pipe
Asbestos cement
sheet

_

_

Chrysotlle_________________________________________________
Total
Croup
Croup
Croup
Croup
7
8
Chrysotile
6
5

138,800

41,900

300

4,200

10,900

15,000

52,000

11,800

-

Amosite

Anthophyllite

Total
Asbestos

Percent
of
Total

36,400

1,100

200

222,900

26.4 X

-

4,300

-

94,800

11.2

-

-

-

153,500

18.1

-

1,700

-

8.9

-

-

28,800

3.4

Crocidolite

185,200
_

90,500

-

-

-

U>

oo”

-

153,500

Roofing products

-

-

3,7 00

11,100

12,700

46,300

-

73,800

Packing and
gaskets

100

1,900

7,500

7,500

1,400

10,300

_

28,700

_

100

900

100

3,400

2,800

_

7,300

-

1,800

-

9,100

1. 1

-

_

400

1,600

2,700

_

4,700

-

-

-

4,700

0.6

_

3,600

1,300

29,500

6,300

36.600

300

79,600

-

-

200

79,800

9.4

300

-

-

-

37,900

4.5

-

700

17,800

2.1

-

-

20,400

2.4

Insulation,
electrical
Friction
products
Coatings and
compounds

_

100

_

_

100

400

36,700

400

37,900

Plastics

400

1,000

900

800

-

7,500

6,300

16,900

Textiles

700

14,200

3,900

800

-

800

-

20,400

Paper

-

-

5,500

400

23,900

33,300

-

63,100

200

-

-

Other

-

300

1,100

-

2.300

32,700

-

36,400

400

50a

-

1,200

23,100

175,000

158,900

102,600

330,200

7,000

798,000

37,300

9,400

1,100

o.n

2.7

20.6

18.8

12.1

39.3

0.8

94.4

4.4

1.1

0.1

Total
Percentage of
Total

Source:

U.S. Bureau of Mines:

Mineral Yearbook (preprint),

1974.

200
-

1/1

Flooring products

49,000

Insulation,
thermal

©

Croup
4

oo

Croup
14 2

.

63,300

7.5

37,300

4.4

In three cases, the mine and mills are at the same location, but two
mines send their ore by truck to mills 32 and 53 miles away.
(See
Table 2.)
The methods used to mine asbestos ore in the United States
are described below.
Area strip mining, as practiced in the California operations,
entails removal of the ore by earth-moving equipment from shallow
deposits—in one instance without even the need for blasting.
Generally,
a shallow overburden with low concentrations of asbestos fiber must be
removed.
Open pit mining, as practiced in the Vermont operation, is
similar to area strip mining operations except that to follow the fiber
veins, the workings are much deeper.
Blasting and removal of ore occur
primarily on the sides of the pit along terraces that spiral down around
the sides of the pit toward the bottom.
Underground mining, as practiced in the Arizona operation,
entails following the veins of ore with shafts, galleries, and drifts,
using blasting and earth-moving equipment.
This operation is followed
by transporting ore to the surface, where it is processed further.
At the typical asbestos mine, coarse ore is crushed by a jaw
or gyratory crusher to a size that can be accommodated by the mill.
Oversize rock is separated by rotating cylindrical trommel screens and
is crushed in a secondary crusher, usually of a conical type.
The ore
streams are conveyed to driers—rotary kilns in larger installations—
where moisture in the ore (up to 30% by weight) is removed.
The dried
ore is then stored, with large amounts being held to allow for varia­
tions in fiber demand and mine production over time.
Prior to milling,
dried ore is conveyed to an additional crushing step.

Milling
Milling, done primarily by hammer mills (fiberizers) or crushers,
serves to free the fibers from the rock and separate the fibers from
each other.
In general, longer-length fibers in the final mix bring
higher prices.
Hence, it is desirable to hold the mechanical working
or fibers to a minimum since, although the fibers have very high ten­
sile strength, they are so fine that they are easily broken.
The most expensive grades of fiber are not mechanically milled at
all; rather, they are hand-separated ("cobbed") from the surrounding
rock into bundles of relatively long fibers with lengths of 3/4" or
more.
Such fiber is valued for manufacturing asbestos textiles.

87297428

The solution to the problem of maximizing the recovery of fibers
other than hand-cobbed, in all but one of the asbestos mills in the
United States, is to use mechanical means to free the fiber bundles from
the rock, but to use air aspiration systems to separate and convey the

fibers.
In these systems, the ore is shaken on progressively finer
screens through which small rocks and fiber bundles pass for further
treatment while larger rocks are retained for further crushing or for
conveyance to tailing dumps.
The fibers freed are removed by the flow
of air through powerful suction hoods.
Separated fibers are caught in
dry cyclones and conveyed to screens that separate them according to
size.
After sizing, the fibers are sent to bins for storage.
Subse­
quent operations include removing the fibers from the storage bins,
blending in fibers of different sizes to produce the desired final
shipping specification, and bagging for shipment.
The one exception to the air-aspiration milling system is found
in a California mill that processes the loose fiber ore by a wetseparation system.

Transportation
Conveyors and trucks are used at mine and mill sites to move ore
from mines to mills.
Asbestos fibers typically are shipped from the mills in 100-pound,
multiwall, paper or plastic bags.*
(One producer reports the use of a
stronger, woven, polyvinyl bag for some shipments.)
Bags are pressurepacked to reduce bulk, damage, and dust.
It is customary to tape rip­
ped or punctured bags when the damage is discovered; yet the fact that
the fibers are tightly packed may often prevent them from escaping even
if the damaged area is not repaired.
The technology is now available to
pack asbestos even more tightly—i.e., to form blocks with twice the
density of fiber shipped in conventional bags, a 100-pound block having
a volume of about one cubic foot.
Palletizing is used almost universally, with the bags glue-locked
to each other or shrink-wrapped to the pallet (wrapped with a film of
plastic which is then shrunk) to stabilize the load. Much of the asbes­
tos shipped is further unitized by being loaded into sealed railroad
boxcars or shipping containers.
Sometimes the asbestos is made into
pellets, which, rather than being packed in bags, are loaded on and off
railroad boxcars by gravity flow through pipes.
The majority of Canadian chrysotile fiber is shipped into the
United States in conventional sealed railroad boxcars in which the con­
tents are protected by inflated-rubber bags.
The modern damage-free
bulkhead cars are being used as they become available.
The cars are
routed directly from the Canadian mills to the U.S. manufacturing
plants.
Smaller proportions of chrysotile imports from Canada are
received in containers, either by rail or by ship via the Atlantic

18

87297429

Some manufacturers can add the bags, along with the fibers, to their
product mix without even opening them.

Ocean.
All fiber from South Africa, the source of all U.S. imports of
crocidolite, arrives by ship in containerized bags at Gulf Coast ports.
U.S. exports of fiber, virtually all of which are from California
and destined for Mexico, Central America, and the Far East, leave the
mills by both rail and truck.
Containerized ocean shipments leave from
ports such as Stockton, Sacramento, Oakland, and San Francisco.
Although
100-pound bags are by far the most widely used in the industry, one of
the California mills, for the convenience of its customers, ships all
of its fibers in bags weighing from 10 to 50 pounds.
One company plans
to shrink-wrap each paper bag individually, for added protection, since
some users buy in less-than-pallet lots. A representative of one of the
world's largest shippers of asbestos reports that about 2% of the bags
shipped sustain some damage.

Manufacture of Asbestos-Containing Products
Production processes used in th<» consumption of asbestos are high­
lighted below for selected products.
Asbestos cement products use the largest amount of asbestos
of any product category (about 317,000 tons, or 38% in 1974).
Specific
products include wallboard, pipe, shingles, and blocks.
Advantages of
the products over their nonasbestos counterparts are better tensile
strength, strength-to-weight ratio, strength under heat stress, resis­
tance to acid, and smoothness of finished surface (critical to ensure
laminar flow in pipe used for transport of liquids).
Asbestos fiber (primarily chrysotile, but also others to a
limited extent) is mixed, either wet or dry, with portland cement and
silica in proportions ranging from 10% to 70% of the total material.
If
the mixing is done dry, the mixture is generally metered in a flat layer
onto an open surface, where the requisite water is applied by over­
head spray.
The resulting layer, much thinner than the final product,
is then wound onto mandrels in a spiral mat (for pipe) until the requi­
site thickness is built up, or is layered flat (for wallboard or shingle
forms).
The same winding or layering process may be used for wet-mixed
products, or the mixture may be cast.
Finishing processes for the dried
cement products vary with performance requirements and type, and may
include grinding, drilling, sawing, or cutting.
Asbestos can be made into the full range of textile products—
from nonwoven lap and felt, through yarn and cord, to woven cloth, rope,
and tube.
The asbestos fibers required for textiles are significantly
different from those used for other asbestos products; they must be quite
k
For a more detailed discussion of the manufacture of asbestos-containing
products, see U.S. Environmental Protection Agency, "Development Docu­
ment for Effluent Limitations, Guidelines and Standards of Performance:
Asbestos Manufacturing," Washington, D.C., 1973.

long to be spinnable.
Spinnable fiber is sometimes obtained by textile
producers in hand-cobbed, "crude," form—i.e., as unopened, rock-free
fiber blocks or bundles—since, as noted previously, it is difficult to
protect fiber length during milling operations.
If the fibers are received as crude, they are opened in edge
(knife) mills into small bundles and then milled into extremely fine
flexible fibers.
The resultant fibers, as well as being more delicate
and breakable, are also more "floatable," leading to a greater emission
potential per unit weight.
Once the fibers have been adequately opened
and fluffed,
they may be blended with up to 20% of a cellulosic fiber
such as cotton, the specific material chosen depending upon the appli­
cation of the final product.
The subsequent processes, such as carding,
lapping, roving, spinning, and weaving or braiding (as required) are
all performed on equipment essentially identical to standard textile
machinery.
Asbestos is used in vinyl and asphalt floor tiles as a filler
and reinforcement to provide strength and stability without reducing
flexibility and compressibility.
Very short fibers are used, compris­
ing 8-30% of the total weight.
In the case of vinyl tile, for example,
polyvinyl chloride resin serves as the binder, limestone and other
materials are used as fillers, and pigments and chemical stabilizers
make up the rest of the typical mix.
The manufacturing process is
typically a 24-hour operation that includes weighing, mixing, heating to
about 150°C, decorating, calendering, cooling, waxing, stamping, inspec­
ting and packaging.
Friction products and gaskets typically contain 30-80% asbes­
tos, generally in some sort of organic binder.
In friction products,
the asbestos is used for its unique combination of strength, compaction
characteristics, friction properties, and stability at high temperatures.
Asbestos is used in these products in two different ways:
(1) the
asbestos, as loose fiber, is mixed with the binder; or (2) the asbestos,
as either matted or woven textile, is impregnated with the binder.
The
low total volume of the latter process is because it is used only in
special situations, generally in gaskets, where dimensional stability
and elasticity are of significance.
Asbestos paper has essentially the same properties as the
usual cellulose-based paper, except that it has superior thermal insula­
tion properties and fire resistance.
It is used primarily as building
paper (roofing and flooring) although it has been reported that the
above-mentioned qualities also find use in high-quality-bond document
papers.
Asbestos paper is made using the same processes as those used
for standard woodpulp papers, but the raw materials mix, by weight,
might be 70-90% asbestos fibers (typically short in length), china clay
and starch (or sodium silicate) as the binders, plus other constituents
that provide special properties.

87297431

20

Chapter III
BIOLOGICAL EFFECTS OF ASBESTOS FIBERS

As noted in the Introduction to this monograph, asbestos fibers are
known to cause cancer.
In this chapter, (1) a summary of what is known
about the disposition of these fibers in the body is followed by (2) a
description of the carcinogenic effects of the fibers, based on human
studies as well as animal experimentation; also included is (3) a dis­
cussion of the noncarcinogenic effects of asbestos fibers.

Disposition of Fibers in the Body
Technical difficulties associated with the assay of biological
tissues for asbestos have limited the amount of information available
about the disposition of asbestos.
Almost all data have come from
animal experiments in which asbestos was monitored by electron micro­
scopy or radiotracers. Asbestos fibers typically enter the body by
inhalation or ingestion.

Inhaled Asbestos
The disposition of asbestos fibers entering the respiratory tract
is not fully understood. Certainly some fibers are ultimately deposited
in the airways and lung tissue.
Some could also be expectorated or con­
veyed to the gastrointestinal tract by airway clearance mechanisms and
possibly some to the pleural and peritoneal cavities via lymphatic
drainage.

Longer fibers are screened more effectively by the nasal hairs.
Inside the upper respiratory tract, fibers are deposited through the
forces of gravitational sedimentation and impaction at points where the
air stream changes direction; and these depositions depend largely on

21

8

Of asbestos fibers found at autopsy in human lungs, a majority are
less than 5 pm in length;seldom do they exceed lengths of 200 pm or
diameters of 3.3 pm.3 One autopsy study of persons with occupational
exposure demonstrated that all asbestos fibers examined in the lung were
less than 0.5 pm in diameter.2 This preponderance of small fibers in
part reflects their ability to remain 'suspended in air for longer per­
iods than larger fibers, but it is also a function of their deposition
and clearance characteristics once they enter the respiratory tract.
It
is also possible that some fibers may be fragmented as the result of
biological activity within pulmonary tissues.

fiber diameters.3.4
in the small airways, especially at airway branch
points, the collision cross-sectional area, which is a function of fiber
length, is of greater importance.3 As a result of these obstacles, a
greater proportion of fibers reaching the gas-exchange surface of the
alveoli may be small, compared with fibers entering the upper respira­
tory tract.
Studies with mammalian cells in culture indicate that these shorter
fibers (usually less than 5 pm) may be engulfed by alveolar macrophages
and transported to lymphatic channels or the mucociliary blanket for
excretion.
Longer fibers may be only partially engulfed or may be
engulfed by several macrophages at once.*?
Data from autopsies of humans have suggested that some fibers may
enter alveolar lymphatic channels and be carried to hilar and mediastinal
lymph nodes.® Numerous fibers can be found in the pleura, a serous
membrane which covers the surface of the lungs, thoracic diaphragm, and
chest wall; how they gain access to the pleura is not known.
Generally,
the concentration of fibers in the pleura is less than in the lung it­
self, but in some areas of the pleura, fiber concentrations similar to
those within the lung tissue have been observed.9

Ingested Asbestos
Most asbestos fibers entering the gastrointestinal tract are prob­
ably excreted with the feces.
Although it has been reported in one
study that there is little evidence of asbestos fibers^ penetrating
the walls of the gastrointestinal tract, there have been animal studies
showing such penetration.
In a study reported in 1965, chrysotile
fibers were found in the lining of the colon in rats fed a diet contain­
ing a massive amount (6%) of chrysotile asbestos.H
In another study,
fibers of amosite asbestos suspended in saline, when placed into an
isolated segment of rat jejunum in vivo, were found penetrating and
within the jejunal wall.12 one recent study of rats fed 250-300 mg of
asbestos per week for a year did indicate that if penetration of the
gastrointestinal tract lining does indeed occur, the number of

GD
In an experiment with rats, about one-third of inhaled asbestos (crod
cidolite) was deposited on the surface of the respiratory tract.
Half
a
the amount deposited at inhalation was found immediately afterward in
the gastrointestinal tract, nose, pharynx, and larynx; clearance from
u
these latter respiratory tissues to the gastrointestinal tract was
u
practically complete within an hour.
Of the remaining crocidolite
deposited in the lungs, one-quarter had been evacuated at the end of
the month.5 In another study of rats exposed to amphibole asbestos for
six months, 41%-74% of the asbestos found in the lungs immediately after
exposure had been removed within 18 months.®

22

penetrating fibers would be very small (90% probability of less than
1500 fibers).13

Injected Asbestos
Asbestos injected into the bloodstream is rapidly removed and
deposited in various tissues, with highest concentrations observed in
lungs, liver, and spleen.1^13 Limited evidence suggests that asbestos
in the blood may be transported across the placenta of rats.1®
In mice, asbestos injected subcutaneously migrates along lymphatic
pathways from the injection sites.
Fibers accumulate in lymphoid tis­
sues, particularly in regional lymph nodes, and are usually contained
within macrophages.
Small numbers of fibers may be found in the spleen,
pleura, liver, kidneys, and brain.

"Asbestos Bodies"
Approximately 10% to 30% of the fibers retained by human lungs
(usually longer than 5 pm) become coated with mucopolysaccharide and
hemosiderin to form yellow-to-brown rod-shaped structures with clubbed
ends, often beaded along their length.1® These structures were first
called "asbestos bodies," but now they are frequently referred to by the
more general term, "ferruginous bodies," since identical structures may
result from the coating of fibers other than asbestos.
It has been
hypothesized that this coating, laid down by engulfing macrophages,
renders the fibers biologically less active.
It is thought that a certain balance is achieved between the forma­
tion of asbestos bodies and their dissolution or excretion.,20
Asbestos bodies found in the sputum are strong presumptive evidence
of asbestos exposure. Occupational exposure as brief as one day and as
long ago as ten years has been shown to produce sputa containing asbes­
tos bodies.20 Asbestos bodies in lung smears or tissue (unlike those
in sputum) are commonly found among residents of urban areas who may
never have been exposed to asbestos in the workplace.21-23
Asbestos bodies or fibers have been detected in extra-pulmonary
tissues of persons occupationally exposed to asbestos:
in tonsils,
thoracic and abdominal lymph nodes, pleura, peritoneum, liver, spleen,
pancreas, kidney, adrenals, and small intestine.
The numbers found
appear to be far fewer than in the lung.®»24

The many observations, both case reports and epidemiologic studies,
of cancerous effects among humans exposed to asbestos fibers could be

23

87297434

Carcinogenic Effects—Human Studies

».<-.-<r»

fWOJur;.*®

looked at from a number of points of view, but the ones used here are:
types of cancer; fiber type; dose-response relationship; latency; age at
first exposure; smoking; indirect occupational exposure; household expo­
sure; and residential exposure.
The section on human carcinogenic effects
is followed by a summary discussion of animal experiments and asbestosrelated cancer.
High rates of lung cancer have been observed in asbestos workers
exposed to all commercial asbestos types. Among some groups of asbestos
workers, approximately 20% of all deaths are caused by lung cancer where
the proportion of deaths expected from this cause would be only about
5%.25 Pleural and peritoneal mesotheliomas* are a frequent occurrence
among occupational groups exposed to chrysotile, crocidolite, and
amosite.
Estimates for certain occupational groups suggest that as many
as 8%-ll% of deaths may be due to mesothelioma, a relatively rare cause
of death in the general population.26
Some occupational groups exposed
to asbestos have, furthermore, demonstrated an excess of other cancers,
especially of the larynx and gastrointestinal tract.

;
5
f
;
J
.
i

,

Asbestos exposure leading to an excess of cancer may occur among
groups exposed indirectly, as in shipyard workers or in groups mining
other minerals that may contain asbestos as a contaminant.
Mesothelioma
also has occurred among persons living in the homes of asbestos workers
or in the vicinity of asbestos facilities.
Both cigarette smoking and occupational asbestos exposure individ­
ually increase the risk of lung cancer but, together, they act to pro­
duce a risk of lung cancer that exceeds the sum of their separate risks.

Evidence of Lung Cancer
The evidence that asbestos is a cause of lung cancer is over­
whelming.
Lung cancer was first linked with exposure to asbestos in
1935, when three cases of asbestosis and carcinoma of the lungs were
found at autopsy in asbestos textile workers.27,28 other case reports
followed.
In 1949 the Chief Inspector of Factories of England and
Wales examined 225 deaths from asbestosis or in which asbestosis had
been proved at autopsy.
Cancer of the lung or pleura was found in 31,
or 13.2%.
This was not characteristic of other pneumoconioses; among
6,884 deaths with silicosis at autopsy, for example, only 91, or 1.32%
had cancer of the lung or pleura.29
Further evidence implicating asbestos in the etiology of lung can­
cer came from a matched-pair case-control study published in 1954.
Upon classifying by 5 years or more employment in occupations

Mesothelioma is a term used to refer to a tumor made up of cells from
the pleura or peritoneum.
24

jc

m/mm w w

involving asbestos exposure (steam fitters, boilermakers and asbestos
workers), 10 patients with lung cancer but only one control had been
so employed.30
In a study reported one year later, 11 of 113 workers employed in
an asbestos textile factory in the United Kingdom for at least 20 years
were found to have died from lung cancer.
By applying to this group
age-specific mortality rates for lung cancer in the general population,
0.8 deaths would have been expected.
The ratio of observed to expected
deaths, therefore, was greater than 13.31 Continued study of workers at
this factory has shown a reduced risk of lung cancer, although still
two- to three-fold in excess, among workers first employed after 1933,
when regulations for control of asbestos exposure in the United Kingdom
had gone into effect.32,33 Numerous other studies have independently
confirmed an increased risk of lung cancer in various occupational groups
exposed to asbestos.25,34-39

Evidence of Mesothelioma
There is also overwhelming evidence that asbestos is a cause of
pleural and peritoneal mesothelioma.
Cases have been described in per­
sons with occupational and nonoccupational exposures.
The first case
report of a pleural neoplasm related to asbestos exposure appeared in
1933.^0 Additional cases were noted in the 1940s,41-43 an<j in 1954 a
peritoneal tumor was reported.44 However, it was not until 1960, with
the publication of a series of cases from South Africa, that the asso­
ciation between mesothelioma and asbestos exposure was generally recog­
nized.
Of 33 South African patients with mesothelioma, 32 gave a history
of occupational exposure to asbestos or residence in a crocidolite min­
ing area.45 Subsequently, a plethora of individual case reports, case
series, case-control studies, and studies of the mortality of occupa­
tional groups have related the occurrence of mesothelioma to a history
of exposure to asbestos.25,39,46-53 The rati0 Df pleural to peritoneal
tumors varies considerably in different studies, but peritoneal tumors
seem to be associated with heavier exposures and with asbestosis.54-56

Laryngeal Cancer
The evidence casually linking asbestos and laryngeal cancer is
highly suggestive.
In a study of 119 patients with squamous carcinoma
of the larynx ^nd age- and sex-matched controls, 33 with laryngeal cancer^^-btit only 3 controls, gave a history of occupational exposure to
asbestos.,58 This difference was striking, and the suggested increased
risk has since been confirmed by similar case-control studies,59 and
studies of occupational cohorts.60,61

87297437

.j'jusa

Digestive System Cancer
An excess risk of cancers of the digestive system attributable to
occupational asbestos exposure has been suggested by a number of epide­
miological studies.25,34,35,60,62-69
^ major problem with these
studies has been the inclusion of peritoneal mesothelioma cases among
all observed cases, making it difficult to document an increased risk of
any one digestive system cancer independent of that for mesothelioma.
In occupational cohort mortality studies where peritoneal mesothe­
liomas were separated from other cancers of the digestive system, excess
cancers of some sites have been observed.
Among 933 amosite asbestos
factory workers who were first employed between 1941 and 1945, there
were 11 deaths from stomach cancer by 1971 (vs. 4.58 expected); 15
deaths from cancer of the colon or rectum (vs. 7.05 expected), and none
from cancer of the esophagus (vs. only 1.23 expected).25 of 1.779
deaths through 1974 among a cohort of 17,800 insulation workers there
were observed 15 deaths from oropharyngeal cancer (vs. 7.87 expected);
14 deaths from cancer of the esophagus (vs. 5.35 expected); 18 from
stomach cancer (vs. 11.23 expected), and 47 from cancer of the colon or
rectum (vs. 28.63 expected).5,60 other studies of groups exposed to
asbestos examining the risk of these specific cancers after excluding
mesotheliomas are needed to further elucidate the role of asbestos in
cancers of the digestive system.

Other Cancers
Studies of women asbestos workers have suggested possible increases
in cancers of the ovary and uterine cervix. Among a group of female
English asbestos worker, 4 and possibly 6 deaths from ovarian cancer
were observed while only 2.1 had been expected.55
Investigators from
the Soviet Union have reported significantly increased rates of cervical
cancer among older female asbestos workers; however, the numbers of per­
sons in the study populations were not indicated.35 Findings in these
reports need confirmation elsewhere.

Association of Effects with Fiber Type* •
There are few studies of persons exposed to a single type of
asbestos, and the studies that are available often lack information
on potential confounding factors such as cumulative exposure, smoking
history, and physical characteristics of airborne fibers.
It is there­
fore exceedingly difficult to assign a scale of relative pathogenicity
to different types of asbestos.
For example:
•

Crocidolite mined in the Northern Cape Province of South
Africa and in Western Australia is frequently associated
with pleural mesotheliomas, whereas fewer cases have been
reported for crocidolite from the South African Transvaal.

It has been proposed that this apparent difference in risk
may relate to a difference in physical characteristics of
fibers from these areas—crocidolite fibers from the
Transvaal are thicker and longer.70
•

As asbestos proceeds from mine to mill to manufacturing
plant, it can become subdivided (and fractured), pro­
ducing fibers of smaller diameter and length, with pos­
sibly greater or smaller attendant biological risk.

•

Asbestos thought to be of one type may be "contaminated"
with asbestos of another type.
Lung tissue from men
employed in Canadian chrysotile mining has been observed
to contain tremolite and other amphiboles, often more
than the amount of chrysotile.71

All types of commercial asbestos have been related to high rates of
lung cancer in asbestos workers, and in occupational groups exposed to
chrysotile, crocidolite, and amosite, pleural and peritoneal mesothe­
liomas have been observed.72 Studies of anthophyllite miners in Finland
have shown a slight excess of lung cancer, but no mesotheliomas. ^6>37
The lack of mesotheliomas may be due to the small size of the cohort
studied; however, none has been reported from the communities in the
mining area.^
There is some information suggesting that chrysotile may not be as
hazardous as other types of asbestos.38,47,74-78 The mortality experi­
ence of a cohort of workers employed at an asbestos paper and millboard
manufacturing plant that used only chrysotile asbestos would seem to
bear this out.79
Pleural and peritoneal tumors, as well as excess lung cancer, have
been found in the mortality experience of workers who had mined and
milled New York State talc.80,81
This talc may contain large quanti­
ties of tremolite asbestos as well as smaller amounts of anthophyllite
and chrysotile.
In Italy, where the talc is reportedly uncontaminated,
mining and milling has not been associated with mesothelioma or excess
lung cancer.

Dose-Response Relationship

27

87297430

Evidence that the risk of developing cancer is related to the
degree of exposure to asbestos by some quantitative estimate strengthens
the basis for assuming asbestos to be of causal importance.
A precise
dose-response relationship is difficult to establish for any environ­
mental exposure and no less so for asbestos.
However, attempts have
been made for asbestos and there is some evidence suggesting that dose

as measured by severity of exposure and duration of employment relates
to rates of cancer in groups occupationally exposed to asbestos.
One study concluded that within an age cohort for which data were
most accurate there was an increasing mortality due to lung cancer with
increasing duration of employment.63 However, rates for individuals
employed the longest were lower than those in the category of next
greatest duration of employment; persons employed longest might more
likely be those whose occupational exposure to asbestos was less intense
or who were themselves less susceptible to cancer and respiratory dis­
eases (for example, persons who do not smoke).
An investigation of mortality among workers at an asbestos textile
factory in England found markedly reduced mortality from lung cancer,
and from other diseases in the presence of asbestosis, with reduction
in length of exposure before 1933.32 Moreover, the risk of lung cancer
and mesothelioma among workers at a Londom asbestos textile and insulat­
ing materials factory was independently found to be related to the
severity and duration of exposure.39,55,83
The respiratory cancer mortality (includes deaths due to pleural
mesothelioma in addition to cancers of the lung and larynx) of a group
of retired asbestos workers was categorized according to cumulative dust
exposure.
"Exposure" was the product of job-characteristic dust levels
in millions of particles per cubic foot (mppcf) and number of years on
the job, summed across all jobs held (thus giving cumulative exposure
in mppcf-years).
The result is shown in Table 5.
It can be seen that
there is a clear gradient of increasing Standard Mortality Ratio (SMR),
or ratio of observed to expected deaths x 100, with increasing cumula­
tive dust exposure.
Table 5
DEATHS FROM RESPIRATORY CANCER BY CUMULATIVE DUST EXPOSURE

Total Dust Exposure
(mppcf-yr)

Number of
Men

Respiratory Cancer Deaths
Observed
Expected
SMR

Under 125

533

15

9.0

166.7

125-249

305

12

4.8

250.0

250-499

328

17

5.2

326.9

500-749

126

9

1.8

500.0

750 and over

56

5

0.9

535.6

87297440

Source:

Chapter Reference 78.

28

The Cancer Latency Period
From all available evidence, the period between first exposure to
asbestos and death from lung cancer appears to be related to intensity
of exposure.84 Among workers at an English asbestos textile and insu­
lating materials factory, an excess mortality from lung cancer was
demonstrated following a latency of 15 years for those with heavier
exposures, whereas an excess did not appear until 25 years from onset
of exposure for those whose exposures were less intense.^9,61,83
Fifteen years is probably the minimum latency period for asbestosrelated lung cancer. An excess of lung cancer deaths first appeared
among a group of heavily exposed amosite asbestos workers 15 years after
onset of exposure,and in a large cohort of insulation workers fol­
lowed from 1967 through 1974 (135,000 person-years of observation), no
applicable increase in mortality from lung cancer was observed before
15 years had elapsed from onset of exposure.
The peak increase occurred
about 30-35 years after onset of exposure.25
In 85% of one series of mesothelioma cases, death occurred more
than 25 years after first exposure to asbestos, with a range of 3.5 to
53 years.Another investigator reported a mean latency period of 37
years,87 and among a large cohort of asbestos workers, most deaths from
pleural and peritoneal mesotheliomas occurred 30-35 years after first
exposure.25

Incidence of Cancer and Age at First Exposure to Asbestos
A characteristic of many cancers is a marked increase in incidence
with advancing age.
It is generally acknowledged that the higher inci­
dence of cancer in older persons is not necessarily because their tis­
sues are more predisposed to cancer, but because of the usually long
period between initial exposure and the appearance of diagnosable tum­
ors.®® In fact, with regard to susceptibility of body tissue to cancer,
it has been hypothesized, from experimental animal evidence, that the
tissues of younger people may be more susceptible to carcinogens but
that, conversely, older people may be more susceptible to cancer because
of a less efficient immune surveillance system.89
In a study of the relative incidence of lung cancer according to
age at first exposure to asbestos, data were obtained on 117 men who
were exposed for more than 20 years and who were followed for an average
of 13 additional years. A greater incidence of lung cancer was observed
■ among men first exposed at older ages.
For those first exposed under
age 25, the annual lung cancer incidence was 26% of the rate for all
ages; for first exposure between ages 25 and 29 it was 165%; at age 30+
it was 195%.
These incidence rates were corrected to account for varia­
tion in the duration of exposure, duration of survival after first
exposure, and for the fact that some lung cancers may have been due to

29

nonoccupational causes more common among older men.
The data suggested
that susceptibility to asbestos-related cancer may increase with
age.88,89
It seems unlikely, however, that age per se is a principal factor
in determining frequency of cancer, and it is not clear whether age
itself plays a part that is independent of exposure duration and time
elapsed since first exposure.

Smoking and Asbestos-Related Cancer
There is strong evidence that cigarette smoking alone is sufficient
to cause lung cancer.
Many studies attempting to examine the effect of
cigarette smoking on the increased risk of lung cancer observed in
groups exposed to asbestos have been deficient in one or more of these
respects:
•

Follow-up periods have been too short to allow accurate
computation of risk after the necessary 15-20 year latency.

•

Nonsmoking asbestos-exposed groups have been very small.

•

Smoking habits have not been completely ascertained.

•

Smoking-adjusted mortality rates from the general population
have not been used for comparison.

*i
;
>
v

;

A few studies have found that cigarette smoking was insufficient to
account for the increased risk of lung cancer among asbestos workers.
This has been generally accepted as evidence that asbestos can act
independently to cause lung cancer, a view that has been corroborated by
animal experiments and by some evidence suggesting an increased risk
among nonsmoking asbestos workers.62
An investigation of two groups of asbestos workers—one with a high
dust exposure and a high respiratory cancer mortality, the other with a
lever dust exposure and a lower respiratory cancer mortality—found that
their smoking habits were similar.?® This implies that high doses of
asbestos can account for higher mortality among smokers.
Another inves­
tigation, a case-control study of lung cancer patients, revealed an
enhanced risk of lung cancer with asbestos exposure, whatever the number
of cigarettes smoked.^2

87297442

In a study of the combined effects of asbestos exposure and smoking,
the smoking habits of 1,334 male and 482 female asbestos factory workers
were examined in relation to mortality from lung cancer over a 10-year
period. Among 955 smokers with severe asbestos exposure, 41 lung cancer
deaths were observed, while only 11.3 were expected for smokers from the
general population. Among 161 never-smoking asbestos workers with

severe asbestos exposure, 1.7* lung cancers deaths were observed, while
only 0.2 were expected for nonsmokers in the general population.
There
were approximately five times as many person-years of observation in the
smoking group compared with the nonsmoking group, but about 24 times as
many lung cancer deaths among the smokers.90
In another study, smoking histories were obtained from 11,657 of a
cohort of 17,800 insulators.
In 9,591 workers with a history of ciga­
rette smoking, 248 lung cancer deaths were observed, compared with 59.5
expected.
Among 609 workers who had smoked pipes and/or cigars, two
lung cancer deaths were observed and 1.24 were expected.
Of 1,457
workers who never smoked regularly, four lung cancer deaths were
observed, while 1.08 were expected.25 Expected deaths were based on
approximate smoking-specific U.S. death rates.
Further analyses of group data have been performed to examine how
cigarette smoking and asbestos might be acting together.91,92 On a
statistical basis it appears that these two independent causes of lung
cancer interact positively.
In the general population, cigarette smokers
have a 10-15-fold excess risk of lung cancer.
One study observed an
8-fold excess of lung cancer among smoking asbestos workers compared with
smokers in the general population, but the excess was 92-fold when com­
pared to the general population of nonsmokers.^2 This suggests that the
combined effect of smoking and asbestos exposure is greater than the
simple sum of their separate effects.
The relation of this statistical
interaction to the pathogenesis of lung cancer is uncertain.
However,
it seems clear that, due to the important enchancement of risk by one
cause complementing the other, the increased risk of lung cancer in
groups exposed to asbestos may be concentrated among those who also
smoke.
There is very little evidence that cigarette smoking increases the
frequency of developing pleural mesothelioma after asbestos exposure,
and no evidence exists that smoking increases the risk of peritoneal
mesothelioma.
Of 9,951 insulation workers with a history of cigarette
smoking, there were 23 deaths from pleural mesothelioma and 47 deaths
from peritoneal mesothelioma, with none expected.
Among 1,457 workers
who never smoked regularly, there were two deaths from pleural meso­
thelioma, eight deaths from peritoneal mesothelioma, and none expected.25

Cancer from Incidental Occupational Exposure

*This is an adjusted figure to compensate for missing smoking infor­
mation for the deceased.

<^46248

Persons who do not work with asbestos directly, but who may be
incidentally exposed to asbestos while working, may suffer excesses of
cancer.
A 10% random sample of shipyard workers, widely distributed

throughout the various trades, revealed that some had pleural plaques
and some had pulmonary fibrosis, and retrospective and prospective
cohort mortality studies have revealed a 2.5-fold excess risk of lung
cancer as well as a number of mesotheliomas among workers with pleural
plaques.
Even those without X-ray evidence of exposure to asbestos had a
slightly increased risk of lung cancer and a few mesotheliomas.
A study
of sheetmetal workers also revealed a small excess of lung cancer and
one mesothelioma.93-95

Disease in Workers' Households
There are presently 37 reported cases of mesothelioma in persons
whose presumed exposure to asbestos was limited to living in the homes
of asbestos workers.96 However, no comprehensive studies of the dis­
tribution of mesothelioma by age and sex among contacts of asbestos
workers in their homes have been conducted.
The majority of reported mesotheliomas related to household
exposure have been in women, perhaps because they are more likely to
be exposed to asbestos by washing the garments of asbestos workers.96,97
Thirty-five percent of examined family contacts of asbestos workers were
found to have radiological abnormalities characteristic of asbestotic
disease.72,96

Cancer in the Neighborhood of Asbestos Facilities
On the basis of numerous anecdotal reports, indirect assessments,
and case-control studies, there seems little doubt that both pleural and
peritoneal mesotheliomas may result from some types of residental expo­
sure to asbestos.45,48-50,74,86,98-103 However, there have been no
adequate population-based studies, and an accurate estimate of risk,
where occupational and household exposure are definitely excluded,
cannot be made.
On the basis of one case-control study of mesothelioma
patients, relative risk of mesothelioma was estimated at 2.1 for resi­
dentially exposed, and 4.3 for occupational exposed, persons.49
Two studies have been made of the possible effects of increased
asbestos contamination of drinking water in Duluth, Minnesota, due to
the disposal of taconite tailings into Lake Superior.
No carcinogenic
effects have been noted, but the period of observation was short rela­
tive to the probable latency period of environmentally-induced can­
cer. 104, 105

All commercial types of asbestos—chrysotile, crocidolite, amosite,
anthophyHite—have been found to be carcinogenic when tested in mice,
rats, hamsters, and rabbits.
A brief review of evidence derived from

32

87297444

Carcinogenic Effects—Animal Studies

experimental observations is presented below for its value in corrobo­
rating known human cancer risks, predicting other effects, and increas­
ing the plausibility of certain hypotheses on causal mechanisms.
A more
detailed treatment of these and other relevant studies in animals can be
found in Appendix D.
Intrapleural or intraperitoneal injection of asbestos has produced
sarcomas* and mesotheliomas.
Laboratory animals have not been known to
develop mesotheliomas spontaneously, so that finding even a single such
tumor in an experiment may be significant.
Rats and rabbits receiving
intrapleural injections of crocidolite developed pleural mesotheliomas,
as did rats receiving chrysotile.106 For both these fiber types the
carcinogenic response appeared to be dose-related in another study with
rats.107 Mesotheliomas have also been induced in rats by Russian
chrysotile!08 ancj in hamsters by various types of asbestos fibers.109
Peritoneal mesotheliomas were observed in rats following intra­
peritoneal injections of chrysotile and crocidolite but not amosite.106
Rats that received intraperitoneally chrysotile milled to 99% <3 pm also
developed peritoneal tumors.HO Mesotheliomas were induced in rats
inoculated with crocidoliteHl and in mice inoculated with chrysotile,
crocidolite, or glass fiber. H2
Lung carcinomas and pleural mesotheliomas have followed from the
inhalation of asbestos.
Rats exposed to various doses of chrysotile,
crocidolite, and amosite have developed malignant tumors of the lung
and of the mesothelium.106>H3-115 Among these studies, adenocarcinoma,
squamous cell carcinoma, and fibrosarcoma were reported.
Among groups
of rats that were exposed with varying durations to five different types
of asbestos fibers, all of which produce asbestosis, a dose-response
relationship for malignancies was suggested.6 In this study it was
observed that as little as one-day exposure was sufficient to produce
tumors.
Few data exist about the effects of asbestos administered orally.
One study found that oral administration of asbestos filter material
to rats led to an increased incidence of malignant tumors. H-6 Car­
cinomas of the lung, kidney, and liver, as well as reticulum-cell
sarcomas, were found.
The available evidence from animal studies relating asbestos type
to differences in carcinogenic potency is limited and inconsistent.
This may be due to the predominant influence of size and shape of fibers,
which may vary from one study to another for each asbestos type.
Min­
eral fibers other than asbestos, but of similar size, can produce meso­
theliomas in rats after intrapleural or intraperitoneal injection.>
H-7,118 Although the carcinogenic mechanism involving fibers has not

A sarcoma is a malignant tumor derived from mesodermal tissue.
33

been entirely elucidated, a reasonable hypothesis is that it may be
related to morphologic characteristics.
There are few studies in which fiber size alone has been varied and
adequately recorded (diameter as well as length).
Furthermore, the
preparation of fibers for experimental purposes may alter mineral
properties.119* However, smaller fibers are thought to be more active
in producing tumors.

Noncarcinogenic Effects of Asbestos
Noncarcinogenic effects of asbestos exposure were noted several
decades before the association between asbestos and cancer was recog­
nized.
In 1906, deaths among asbestos textile workers from penumoconiosis were reported in England and France.121,122 These were the first
reports in modern times of the diffuse interstitial fibrosis of the
lung associated with asbestos exposure—"asbestosis."

Asbestosis
Asbestosis, which is characterized by a diffuse interstitial fibro­
sis of the lung, is one of the many dust-related lung diseases that are
terminal pneumoconioses. However, unlike some of the other pneumo­
conioses, asbestosis does not predispose to the development of pulmon­
ary tuberculosis, nor does evidence suggest that it is causally related
to emphysema and chronic bronchitis.123

Clinical Findings
The signs and symptoms of asbestosis, listed below, are no
different from those for other forms of diffuse interstitial fibrosis;
there are no pathognomonic features.
Symptoms:
•

Breathlessness on exertion

•

Cough, usually dry, but may be productive

•

Chest tightness or pain

00
N
CT

9i

*
Ball milling of chrysotile, for example, can result in decreased
crystallinity and changes in interlayer branching and surface hydroxyl
configuration.
These alterations have been accompanied by decreased
hemolytic activity.120

34

Viii iiimii)iiM)iii

Signs:

•

Decrements in lung function (decrease in lung
volume and flows)

•

Radiographic abnormalities (chest)

•

Rales, basilar

•

Restricted chest motion

•

Clubbing of fingers

•

Cyanosis

•

Cor pulmonale (right ventricle hypertrophy)

•

Pleural effusion.

The earliest and most prominent clinical finding—breathless­
ness on exertion—rarely becomes apparent until after at least a decade
of exposure.
Thus, by the time this "early" clinical finding appears,
the underlying disease process is well under way.
As the disease pro­
gresses, breathlessness may be present even at rest.
The most characteristic physical sign exhibited by the patient
with asbestosis is the presence of dry, crackling sounds (rales), heard
on auscultation at the lung bases and in the axillae during inspiration.
As fibrosis progresses, rales become more widespread and occupy a greater
part of the inspiratory cycle.
Clubbing of the fingers is usually a late feature of asbes­
tosis and is not found consistently.
Cyanosis of the skin and mucous
membranes of the mouth and tongue may also occur in the later stages of
the disease.

Radiographic Abnormalities
Radiographic features of asbestosis are similar to those of
other forms of diffuse interstitial fibrosis of the lung, except for the
frequency of pleural changes, expecially pleural plaques (which should
always signal the possibility of asbestos exposure).
Radiographic
diagnosis of asbestosis is based on the presence of small, irregular,
or round opacities distributed prominently in the lower lung fields.
The earliest changes often occur bilaterally in the cosophrenic angles.
Short, horizontal, linear septal lines (Kerley B-lines), which are
believed to represent lymphatic obstruction,^ may also be present.
With time, the abnormal shadows gradually spread upward into the middle
and upper zones of the lung fields and become increasingly coarse and
blotchy.
In more advanced cases, a "honeycomb" pattern may be present.

87297447

35

and the outline of the diaphragm and heart may become blurred and
"shaggy."
Pleural changes are likely to be present as well, perhaps in
as many as 50% of the cases.

Pulmonary Function Changes
The interstitial fibrosis associated with asbestos exposure is
accompanied by changes in pulmonary function characteristically observed
with interstitial fibrosis from other causes as well.
Thus, while these
changes are not unique to pulmonary asbestosis, they provide useful
diagnostic information when interpreted together with other evidence
such as exposure history, signs and symptoms, and chest radiographic
findings.
Changes in pulmonary function considered most characteristic
of asbestosis are:
•

General reduction of lung volume, especially of
vital capacity (VC)

•

Decrease in pulmonary flow rates such as indicated by
forced expiratory volume in one second (FEV^ g)

•

Impaired alveolar-capillary diffusing capacity,
reflected by reduced oxygenation of the arterial
blood and increased alveolar-arterial PO2 gradient
(alveolar-capillary block syndrome).

Although it is usually claimed that airway obstruction is
rarely a major feature of asbestosis,123-125 one investigator has
pointed out that epidemiologic studies of lung function have been unable
to clarify the relationship between obstructive airway disease and
asbestos exposure.
She advised that, until further evidence becomes
available, "an open mind should be kept in this regard."54

Asbestosis and Cancer
On the basis of case reports, an association between asbes­
tosis and lung cancer was suspected as early as the 1930s.
More than
a decade later, two authors!26,127 reported that, among British asbestos
workers, carcinoma of the lung and pleura had been found in about 15% of
deaths either caused by asbestosis or in which asbestosis had been
proved present at autopsy.* By the period 1961-1963, figures from the
British Ministry of Labour showed that approximately 50% of patients
certified as suffering from asbestosis (in contrast to exposed to

36

87297448

It remained for another investigator
to show that the actual risk of
dying from lung cancer was increased on the order of 10-fold over the
general population for male asbestos workers employed for 20 years or
more between 1922 and 1953.

asbes tos) died of (or with) lung cancer.
Although carcinoma of the
lung is often found in the presence of asbestosis, there appears to be
no scientific evidence that the two lesions are interrelated, except
that they both may be classified as diseases that are causally associ­
ated with exposure to asbestos.
With regard to another asbestos-related cancer, two reviewers
of the subject have noted that mesothelioma of the pleura and peritoneum
has often been associated with even low levels of asbestos exposure for
brief periods in the remote past.54,123 There appears to be no regular
correlation between severity of asbestosis and occurrence of mesothe­
lioma.
In fact, it is unusual to find significant pulmonary interstitial
fibrosis (asbestosis) with pleural mesothelioma.
However, prominent
asbestosis is frequently observed in association with tumors of the
peritoneum,54,123 and peritoneal tumors generally appear to be associ­
ated with heavier asbestos exposure.45,130 One reviewer noted that this
appears to support the notion of retrograde lymphatic spread of asbestos
fibers from the lung to the abdominal lymphatics resulting from thoracic
lymphatic obstruction due to advanced pulmonary fibrosis.54

Asbestos Pleural Effusion
Benign pleural effusion, which usually occurs in the presence of
some degree of parenchymal asbestosis, is another clinical manifesta­
tion of disease due to asbestos exposure. Among a series of 57 patients
with asbestosis or asbestos exposure, 12, or 21%, were found to have
"asbestos pleural effusion"—i.e., a pleural effusion in an individual
with a history of occupational exposure to asbestos in the absence of
any other disease known to cause pleural effusion.131 a number of
individuals diagnosed as having had asbestos pleural effusion have sub­
sequently developed mesothelioma.132,133

Pleural Calcification, Diffuse Fibrosis, and Plaques
Asbestos-related plaques occur as discrete, elevated, grey-white
lesions on the inner surface of the rib cage and on the diaphragm.

The reason for this apparent increase in the percentage of deaths in
which asbestosis and lung cancer were found on autopsy is not clear.
One explanation may be that the cases described by earlier
authors!26,127 received much of their asbestos exposure in the early
quarter of the centruy, when it was likely that airborne concentra­
tions of asbestos were high. As a result, many of these cases may
have succumbed to asbestosis at an early age—before lung cancer, with
its long latent period, could develop.128,129
37

Microscopically, the plaques consist primarily of connective tissue,
often containing deposits of calcium.
They do not interfere with
pulmonary function to any significant extent, nor do they necessarily
indicate the presence of pulmonary fibrosis.
An association between pleural abnormalities and exposure to
asbestos—both occupational and nonoccupational—has been clearly demon­
strated. 54,123,134-139 Accordingly, their presence should always alert
the examiner to the possibility of asbestos exposure.
In this regard,
it may be 20 to 40 years after exposure to asbestos that pleural
calcifications appear radiographically.135
Although pleural plaques do not, themselves, appear to be precur­
sors of malignant disease, a retrospective death-certificate study of
408 shipyard workers with pleural plaques showed that the risk of
developing bronchial carcinomas was increased by a factor of 2.4.95
Three cases of mesothelioma also occurred in this series.
In a pro­
spective study from the same shipyard, 235 men with radiographic evi­
dence of pleural plaques were found to have a 2.4-fold increased risk of
bronchial carcinoma.
Among 70 deaths, 13 were due to mesothelioma,
an excess of obvious significance.94

Asbestos Warts
Asbestos warts, or corns, are of minor health significance, but
they are an indication of exposure to asbestos.
They are caused when
asbestos fibers penetrate the skin and are most often found on the hands
and forearms.140 The warts may have a pinpoint, black center and are
often tender to pressure.
Unless removed by excision, they may persist
for years.

Animal Studies—Evidence of Noncarcinogenic Effects
Exposure by inhalation to any of the four commercial asbestos types
may result in fibrosis of the lungs in animals as well as in humans.141
Under experimental conditions a fibrogenic response to inhaled asbestos
has been reported in rats, hamsters, guinea pigs, rabbits, and mon­
keys .142-144

38

87297450

Outside the laboratory, pulmonary fibrosis in the presence of fibers
and asbestos bodies has been demonstrated in baboons, donkeys, and wild
rodents living in the vicinity of crocidolite mines or mills.145
Pulmonary asbestosis has also been reported in a dog kept as a rat
catcher in a London asbestos factory.146 There are marked interspecies
differences in susceptibility to asbestosis.
Tissue reaction in rats,
rabbits, and monkeys is typically less severe than in hamsters and
guinea pigs.142>147

'|r

1
I

Subcutaneous injection of asbestos or injection into the pleural
or peritoneal cavities produces a fibrotic reaction.
Thickening of the
pleural, pericardial, and peritoneal membranes has been reported, with
formation of adhesions and granulomas as well as pulmonary and media­
stinal abscesses. ^
Neither shape nor chemical composition is sufficient to explain the
fibrosing effects of asbestos.
Fibrosis has been induced with a variety
of fibrosis as well as nonfibrosis mineral dusts.
Some investigators
feel that fibers are more fibrogenic than nonfibrous particulates and
that fibrogenic reaction increases with increasing fiber length.
How­
ever, the role of fiber length is difficult to evaluate without simul­
taneously taking into account possible effects of diameter and aspect
ratio (length/diameter).
On injection, chrysotile heated to 400°C caused fibrotic reaction
in the pleura of mice equivalent to that of unheated chrysotile, but
fibrosis production diminished as temperatures increased above 400°C
(at 600°C, 800°C, 1000°C).
Asbestos in dust from automobile brake
linings, which are subjected both to high temperature and mechanical
grinding, resembled chrysotile that had been heated to 800°C or more
and then ground.
Effects of asbestos that may be related to fibrogenesis have been
observed iji vivo in mammalian tissues as well as in cell culture.
Bio­
chemical changes, including stimulation of anaerobic metabolism, and
physical effects such as damage to cell membranes and chromosomes have
been noted.*150'158

*

Such observations may shed light on the mechanisms by which asbestos
induces fibrosis.
For example, it has been postulated that during
phagocytosis, asbestos causes damage to the membranes of macrophage
lysosomes, which are cell organelles that contain lytic enzymes.
Sub­
sequent intracellular release of these enzymes may injure or kill the
macrophages, resulting in release of a fibrogenesis-stimulating factor.15^
39

Chapter IV
OCCUPATIONAL EXPOSURES

There is little recent data in the published literature on expo­
sures to asbestos, and it is difficult to assess whether what has been
published is typical.
Furthermore:
•

Occupational asbestos concentrations are commonly
reported as optical-microscope-visible fibers per
milliliter greater than 5 pm long, and these may
account for only a small fraction of the total
electron-microscope-visible fibers

•

It is not known whether small differences in fiber
counts actually reflect differences in fiber levels
or, if they do, whether they indicate a change in the
risk of incurring asbestos-related diseases (see
Appendix C).

Nevertheless, quantitative air sampling data from representative occupa­
tions is provided in this chapter in an attempt to indicate the range of
exposures found in three workplace situations:
asbestos mining and
milling, production and processing of asbestos products, and utiliza­
tion of asbestos-containing products.
Fewer than 600 persons in the United States are employed in mining
and milling asbestos.* However, industries that manufacture asbestos
products or that make use of them provide jobs for millions.
These
industries may be categorized as primary, secondary, or consumer accord­
ing to whether they produce manufactured goods from raw asbestos fiber,
process asbestos manufactured products to make other products, or
utilize a finished product containing asbestos without additional modi­
fication.
Over 37,000 persons are employed in the manufacture of primary
asbestos products; 300,000 are employed in secondary asbestos industries;
and millions more work in the asbestos consumer industries—over 185,000

Many more may be exposed to asbestos as a contaminant during the
mining and milling of other minerals.

41

of them in shipyards and almost 2 million in automotive sales, service,
and repair.1

Exposures in Mining and Milling
Sources of asbestos exposure in mining and milling include blast­
ing, crushing, transporting, and drying ore; air-aspiration milling;
and disposing of waste.
Time-weighted-average (TWA) levels of fiber in
mining reported in 1973 ranged from 0.5 to 2.8 optical-microscope-visible
(o-m-v)* fibers per milliliter, with an average of 0.9.
Much higher
concentrations were found in milling, where exposures ranged from 6.0 to
12.1 fibers per milliliter.2
In addition to mining and milling of asbestos, the mining and mill­
ing of other mineral ores that may contain asbestos as an impurity is
a potential source of asbestos exposure.
For example, concentrations
of asbestiform fiber in one hard-rock gold mine were reported in 1976
to average 0.25 o-m-v fibers per milliliter, ranging up to 2.8,3 and
fiber counts of 8 to 260 per milliliter were recorded in a talc mining
and milling operation, according to a 1973 report.^

Exposures in the Asbestos Products Industries
For all segments of the primary industry, manufacturing begins with
fiber receiving and warehousing.
Levels of airborne fiber in these
areas have ranged from 0.2 to 2.5 o-m-v fibers per milliliter and are
typically about 1.0.+ Levels at the upper limit of the range reflect
damaged shipments, careless unloading or ineffective housekeeping.
The
most important factor influencing asbestos exposure at this step of
production is the condition of the bags in which asbestos is shipped.
Next, asbestos fibers are introduced into the process.
Bags of
asbestos are usually cut open and dumped manually, either into open
hoppers or into bag opening enclosures.
This activity can result in
relatively high exposures if hooding is inadequate or lacking.
Disposal
of the emptied bags may also add to airborne fiber levels.
In four of
the seven major primary industries, highest TWA exposures occur in fiber
introduction and have ranged from 0.3 to 10.0 o-m-v fibers per milli­
liter,
typically somewhat above 2 fibers.
Exposures in mixing and blending depend upon how dry the materials
are that are being mixed, the intensity of agitation, and the effective­
ness of ventilation.
Typical TWA values in the past have been

^Data in this section are from Chapter Reference 1 (published in March
1976).
42

87297453

Greater than 5 micrometers in length.

j.-

approximately 2.2 fibers per milliliter, with a range of 0.2 to 10.0
fibers per milliliter.
Sometimes asbestos is dumped directly from the
bags into mixing or blending tanks, augmenting the usual exposures found
at this step.
Once the asbestos fibers are engulfed by a medium that prevents
them from becoming airborne, exposures drop.
This may occur at the step
of mixing and blending—as in the production of floor tile, paper, and
cement pipe—or in a subsequent step.
Exposure levels in formulation operations have ranged from 0.2 to
22.0 fibers per milliliter, with an average level of 1.8 fibers per
milliliter.
This wide variety of exposures is due to the number of
different processes represented by that stage.
Finishing operations vary significantly from one type of industry
to another, but usually include machining (i.e., cutting, drilling,
grinding) the rough product to specification. The mechanical energy
imparted during machining causes asbestos fibers to break loose and
become airborne.
Average TWA levels of exposure in these operations
have ranged from 0.1 to 8.0 fibers per milliliter, with a mean of 1.6.
In the last two production steps—inspection, and storage and
shipping—asbestos exposures are usually the result of airborne dust
generated by other operations, which may drift through the plant to
these areas or adhere to the products themselves,- becoming airborne
during handling.
Exposures are typically less than 1 fiber per milli­
liter .
Exposure levels in the major asbestos industries are summarized in
Table 6 and are discussed below.^

Friction Products
Friction products may contain 30% to 80% asbestos, and TWA exposures
in the industry vary widely (0.1 to 15.0 o-m-v fibers per milliliter),
averaging 2 fibers per milliliter for most operations.
Greater concen­
trations may occur in preforming operations, ranging from 0.5 to 22.0
fibers per milliliter and typically about 4 fibers per milliliter.
The
elevated exposure levels found in these operations result from manual
handling of the dry preform mix (asbestos fibers and metal reinforcing
materials in an organic matrix), which is conveyed in open carts,
scooped by hand, weighed, and poured into a block mold for mechanical
pressing into the shape of the finished product.
Other operations that may yield high asbestos levels include fiber
introduction, mixing of the dry preform, and finishing.
During finish­
ing, the products are trimmed, drilled, sanded, ground, and sawed to
specification.
Exposures vary with work practices and equipment.
For
example, exposures at ventilated radial grinders are below 2 fibers per

43

Table 6
EXPOSURE TO AIRBORNE ASBESTOS IN SELECTED
ASBESTOS PRODUCT MANUFACTURING INDUSTRIES

Asbestos Concentrations
(Time-Weighted Average In Fibers/ml)a
Most Operations
Typical

Range

2

0.1-15.0

Operations with Highest Levels
Name of
Typical
Range
Operation(s)

Number of Employees
Production
Total
Workers

Friction Products
Primary
Secondary

4

0.5-22. 0

2.5-6.5

Forming or
Rolling

4,900

Fiber Introduct ion

1,100

Fiber Introductlon

900

7,300
34,500

Asbestos Paper
Primary
Secondary
AsbestosReinforced
Plastics
Primary

1

2

0.3-2.8

1.0-3. 5

1

Secondary
Cement Pipe

0.75-2.7

0.2-2.5

2

0.5-3.0

0-5-2.0

4,500
198,000

2,600
11,000

1.5

0.25-3.5

2

0.6-4.5

Finishing

1,600

2

0. 3-8. 7

3

0.9-8.4

Dry Mixing,
Sanding

600

2,400

Cement Sheet
Primary
Secondary
Floor Tile

1.0-6.0

1,300
24,000

1

0.5-4.3

4

0.9-4.3

Fiber Intro­
duction

2,900

4

0.25-10

4

2.0-10

Carding

2,400

6,700

Textile
Primary

Paints, Coatings
and Sealants

1

1.0-2.5

3,700
7,500

2.0-6.0

Secondary

2. 5 1.5-8.0

Fiber Introduction

350

3,000

aOptical-microscope -visible fibers, 5 pm long or longer.
Sources:

Daley AR, Zupko AJ, Hebb JL;
Technological feasibility and
economic impact of OSHA proposed revision to the asbestos
standard.
Roy F. Weston Environmental Consultants-Designers,
March 1976 (prepared for:
Asbestos Information Association
of North America).

87297455

44

milliliter, but chamfers and back.grinders may cause exposures of 5-8
fibers per milliliter.5 if the finished products have not been cleaned
of adherent particulates, exposures may be high during inspection (4-7
fibers per milliliter).

Asbestos Paper
Exposure levels in the asbestos paper industry vary with the
asbestos content of the manufactured product, which can range from 5%
to virtually 100%.
Typical TWA concentrations in the primary industry
average 1 o-m-v fiber per milliliter (range 1-3 fibers per milliliter)
except in fiber introduction and stock preparation (wet blending),
where concentrations typically average 1-3 fibers per milliliter and
range up to 10.
The lower concentrations are achieved in plants which
use disintegrating, pulpable bags, thus obviating bag opening, dumping,
and disposal.
Since papermaking is a wet process, little asbestos dust exposure
is realized after fiber introduction until the product is dried.
Expo­
sure concentrations may then be elevated somewhat by the manual handling
and mechanical modification (slitting, calendering, converting, etc.)
needed to prepare paper sheet according to specifications.

Asbestos-Reinforced Plastics
The asbestos content of reinforced plastic is relatively small,^
and reported exposures in both primary and secondary industries are
lower than in most other segments of the asbestos industry.
TWA concen­
trations during most operations range from 1.0 to 2.5 o-m-v fibers per
milliliter.
Fiber introduction, dry blending, and handling of the
blended mixture and preform are sources of moderate levels of exposure.
After the preform has been remelted, the asbestos is bound tightly in
the polymer matrix, reducing the potential for airborne release.
Fibers may still break free, however, during finishing.

Asbestos-Cement Pipe and Sheet
Asbestos-cement products may contain 10% to 70% asbestos.
Although
more asbestos is used in manufacturing asbestos-cement pipe and sheet
than any other primary asbestos products, relatively few workers are
employed in these branches of the industry (3,600 total, 2,200 in pro­
duction) . 1

45

87297456

In asbestos-cement pipe factories, TWA fiber levels range from
0.5 to 4.5 o-m-v fibers per milliliter, averaging about 1.5.
In the

manufacture of asbestos-cement sheet, some fiber-introduction and dry­
mixing operations may yield higher exposure levels (0.3 to 8.7 fibers per
milliliter) than in the manufacture of asbestos-cement pipe, because
fiber may be introduced directly into the dry mixer.
Once fibers are
engulfed by the cement mortar during wet mixing, there is little oppor­
tunity for them to become airborne until finishing.
Higher levels
(averaging above 2 fibers per milliliter) may be found during cutting
and machining in cement pipe factories ; and sheet trimming and sanding
present the highest levels of exposure in the asbestos-cement-sheet
process, generally about 2.5 and 3.0 fibers per milliliter, respectively.

Floor Tile
Asphalt or vinyl asbestos floor tile contains 8% to 30% asbestos.
Airborne TWA asbestos concentration ranges from 0.5 to 5 o-m-v fibers
per milliliter.
Typical concentrations are approximately 1 fiber per
milliliter, except for fiber introduction, where concentrations of 4
fibers per milliliter are common.
Once the asbestos is engulfed by the
agglomerated plastic during the later phases of mixing, the potential
for exposure is reduced significantly.

Asbestos Textiles
Levels of exposure in primary and secondary production of asbestos
textiles vary directly with the asbestos content of the manufactured
products but generally are higher than in any other asbestos industry
besides milling. A typical TWA concentration of airborne fiber—i.e.,
for most operations—in the primary textile industry is 4 o-m-v fibers
per milliliter (range 0.1 to 22.3 fibers per milliliter) except in the
carding operation, where the typical concentration exceeds 5 fibers per
milliliter (range 6.1 to 27.3).
High asbestos exposures in the asbestos
textile industry result from the processing of dry—or, at best, par­
tially damp—fibers, which are easily dispersed into the atmosphere.
During carding, the vigorous manipulation of the dry fibers to separate
and align them accounts for the particularly high concentrations observed
at this step—even in the face of intensive efforts to achieve effective
ventilation.
The liquid dispersion method of asbestos textile manufacture, in
which asbestos fibers are mixed in water with chemical dispersing agents,
results in much lower exposure levels (less than 1 fiber per milliliter)
than in conventional plants.6 Moreover, the use of asbestos textiles

00
fO

cn

made from dispersed yarns results in significantly lower asbestos
exposures to the user than from conventionally manufactured products.^

Exposures in the Utilization of Asbestos-Containing Products
With two notable exceptions, the insulation trades and clutch and
brake installation and repair, levels of exposures to workers in the
consumer industries are generally very low.
But although exposure
levels are low, the vast majority of workers in the asbestos consumer
industries, it is surmised, are less aware of the health hazards of
asbestos than are workers in the production industries and may not
utilize basic control methods to minimize risk.

Insulation Trades* •
Exposures in the insulation trades vary widely, but they include
the highest occupational exposures and control is difficult.
In the
•
early 1970's, there were approximately 36,000 insulation installers®
employed largely in insulating industrial equipment, commercial buildings,
and ships.
It is difficult to obtain characteristic exposure levels for
these workers due to the many different insulating materials and condi­
tions of work.
The asbestos content of materials in use ranges from 10% to almost
100%.
Asbestos substitutes are gaining in use as regulations over the
use of asbestos become increasingly more restrictive.
Jobs performed by insulation workers can be classified into six
categories:
•

Prefabrication:
materials are precut and shaped using
hand or power saws either on the job or at the con­
tractor's shop (10% of time).

•

Application: Materials are fitted, hammered, or carved
and attached to surfaces by wiring or gluing (40% of
time).
Some materials used to be sprayed applied, but
this practice has been virtually eliminated in recent years.

•

Finishing: Materials are coated with asbestos-containing
cement, resin, asbestos or cotton cloth, or petroleum
based sealer (30% of time).

•

"Rip-out":
Removal of old or unusable materials in the
process of reinsulating (10% of time).

Miscellaneous
(5% if time).

Cleaning up, transporting materials

87297458

Mixing: Mineral wool, asbestos, fiber glass, and cement
or glue are mixed in buckets or troughs separately or
in combination (5% of time).

i

Percent of time at each task is highly variable, of course, and intended
only as a rough guide.9
Highest concentrations encountered by insulation workers have
occurred during "rip-out" or removal of old asbestos insulations.
In a
1968 report on air samples collected on a ship during removal of
sprayed asbestos coatings, removal of 100%-asbestos lagging, and subse­
quent cleanup were said to average 248 o-m-v fibers per milliliter,
62-159 fibers per milliliter, and 353 fibers per milliliter, respec­
tively; in comparison, the application of pipe lagging containing 15%
asbestos resulted in exposures of 5-60 fibers per milliliter, and cut­
ting and drilling incombustible board prior to installation yielded
exposures of 0.7-4.5 fibers per milliliter.10 Levels of 30-100 o-m-v
fibers per milliliter have been reported ruing application of spray
asbestos insulation.H Nearby workers may be exposed to elevated
levels of asbestos as the result of the activities of insulators—
especially in shipbuilding, where work often goes on in enclosed poorly
ventilated spaces.

Brake and Clutch Repair
There are almost 2 million persons employed in automotive sales,
service and repair, of whom 900,000 are said to be frequently exposed
to asbestos from automotive brake and clutch repair.^
(Note that this
figure does not include persons who repair other kinds of brakes and
clutches.)
Asbestos exposures were determined for specific brake servicing
operations including blowing-out automobile brake drum assemblies,
grinding used truck brake linings, and bevelling new truck brake linings.
Average peak o-m-v asbestos air concentrations for these activities
based on sampling within 10 feet of the operator were 10.5, 3.75, and
37.3 fibers per milliliter, respectively.
In a similar study, mean concentrations found 3-5 feet, 5-10 feet,
and 10-20 feet from an operator blowing dust out of brake drums were
16.0, 3.3, and 2.6 fibers per milliliter.
Grinding truck brake shoes
gave average concentrations of 4 fibers per milliter, and bevelling
produced an average count of 37 fibers per milliliter.
Measurable con­
centrations (0.1 fibers per milliliter) were found at distances up to
75 feet from the blowing-out operation (14 minutes after), 60 feet from
grinding, and 30 feet from bevelling, indicating that other garage
employees besides those directly involved in brake and clutch repair
are at risk.13 Another study estimated the time-weighted average
exposure for brake mechanics to be 0.8 o-m-v fibers per milliliter.^

There is limited information relating to levels of exposure during
installation of asphalt or vinyl asbestos floor tile.
Because asbestos
48

87297459

Installation of Floor Tile, Roofing, and Siding

fibers are firmly imbedded in Che tiles, installation per se is unlikely
to be a source of important asbestos exposure.
It is accepted practice,
however, to sand old asphalt or vinyl tile floors before installing new
covering.
Conventional belt sanders with coarse grit are used to sand
the tiles, and, normally, 240 to 250 square feet of tile can be sanded
per hour.
One report states that levels of 1.2 and 1.3 o-m-v fibers
occurred during a simulation of normal sanding activities over a short­
term sampling period.15
it is likely that fiber levels fluctuate
significantly depending on the age and condition of the tile being
sanded, grade of sandpaper, speed of the sander, size of the workspace,
ambient humidity, and quality of ventilation.
Installing asbestos roofing and siding should result in exposures
of lesser magnitude since these operations are
performed outside.

Use of Spackling, Patching, and Taping Compounds
Asbestos may be a primary component of spackling, patching, and
taping compounds used in wallboard construction to finish joints and
repair damage, or it may be a contaminant of talc, limestone, or other
rock used as raw material.
Used mostly in the construction industry,
the compounds are also used by persons doing their own construction
and repair, and intermittent exposure to asbestos may occur during
mixing, application, and sanding (finishing).
To determine possible exposure during application, air samples were
collected at various jobs and sites.
Peak airborne asbestos concen­
trations measured during such operations as hand sanding, pole sanding,
mixing of dry spackle with water, and sweeping-up averaged 2.3 to 47.2
optical-microscope-visible fibers per milliliter.
All exceed the current OSHA occupational standard for an 8-hour
time-weighted-average (2 fibers per milliliter), and many exceed the
permissible ceiling (10 fibers per milliliter).

Wearing Asbestos Garments

Exposures from wearing fire-fighting helmets also have been mea­
sured.
A new helmet with an unlined asbestos cover, an identical older
helmet, and a helmet covered with aluminized asbestos cloth produced
breathing zone concentrations of 2.3, 1.4 and 0.0 o-m-v fibers per
milliliter, respectively.18

49

0 9 t^ < > Z £ 8

Tests of wearing asbestos garments have indicated that breathing
zone concentration can exceed 2 o-m-v fibers per milliliter.
At one
plant where hoods, coats, mittens, and leggings were worn, concentra­
tions of airborne asbestos fibers ranged from 9.9-26.2 fibers per milli­
liter, and the 8-hour time-weighted-average concentration was 4.7 fibers
per milliliter.1?

Chapter
NONOCCUPATIONAL

Persons
to

asbestos

created

not

employed

fibers

sources

that

such

Such

asbestos may

which

the air is

as

be

gets

such

from

the

able data are
ppssible

food,

Asbestos

of

Rock

tions

as

use of

As

at

an

would be

exposures.

in measuring

products.

it

data

the

C

and

in water

The

distribution of

in Figure

1.

If

can be

disturbed by

inadvertently by

construction,

emissions

and

this

rock

a

natural means,

such human

tilling

of

the

I

of

that

could

this

monograph,

formations

areas

of

in the

source

population density,
appear

such

interven­

soil.

In such
air and
ambient

chapter.

formations

in Chapter

such

high

in

from natural sources

eastern New York,

possibly

United

rock

are

the most

to be

southwestern Connecticut,

contain
the

Stated

looked

critical

eastern
and

and

geograph­
is

at

areas

Pennsylvania,

greater

shown

in
for
south­

Los

Angeles

to

asbestos

and

Francisco.

Asbestos

Emissions

Human-created
include
tos

rock

the primary

conjunction with

San

of

discussed

of
for

Sources

or

discussed

occurrence

asbestos was
ical

as

on

avail­

contamination.)

cases, free asbestos fiber may be deposited onto soil or enter
water,^ thereby contributing to levels of contamination in the
air

are

the

indication

(See Appendix

asbestos

further

there

However,

some

in

may be

expected,

fewer

least

exposed

from man-

office building

insulation—or

the

are

or

asbestos

in

contamination.

asbestos

landslides,

road building,

asbestos

provide

from Natural

contains
or

and

"nonoccupational"
to

occupations

example,

environment,

the difficulties

that

for

drugs.

environmental

Emissions

as weathering

and

reviewed here

general

discussion

the manufacture

occupational

EXPOSURES

from natural sources

inhaled—as,

exposures—termed

AND

in asbestos-related

originate

contaminated by

ingested with water,
one

V

EMISSIONS

the mining

materials

demolition

of

nonoccupational

and milling
products;

asbestos

gross

from asbestos

sources

of

of

asbestos;

and

annual

and milling,

exposures

the

the manufacture,

products;

estimates

mining

Sources

transportation

installation,

the disposal

emissions

asbes­

and

of wastes.

in

the

United

manufacturing,

use

of

51

of

use,

States

asbestos

87297461

Some

of

and

from Human-Created

products, and disposal of wastes have been made and are shown in Fig­
ure 2.
Although these estimates are uncertain, by at least an order
of magnitude, several important conclusions are indicated:
•

Asbestos is preponderantly disposed to land,
water.

least to

•

Most of the asbestos disposed to land is consumer waste,
which is more likely to be disposed to uncontrolled
waste dumps and handled by persons unaware of the
hazards.

•

Disposal to land is an important source of atmospheric
asbestos and, because of proximity to urban popula­
tions, may be even more significant to health than
the emissions to air that come from mining and milling.

Redistribution and Fate of Asbestos in the Environment
Because asbestos is exceptionally resistant to thermal and chemical
degradation, it persists in the environment and can be widely redis­
tributed by both natural forces and human means.
The magnitude of
this redistribution is governed by an extraordinarily complex set of
factors which include the height of the emission source, the rates of
air and water flow, fiber diameter, rain, thermal air inversions,
electrostatic forces, agglomeration of particles, and the density of
vehicular traffic on asbestos-containing landfill, to name only a few.

Redistribution by Air
If, for example, asbestos is emitted to air as part of a "large"
agglomerated particle, it will settle to earth relatively quickly and
thereby have a limited potential for environmental contamination; thus,
concern over the relatively large quantities of asbestos emitted to
air from mines is somewhat attenuated by knowledge that the mining
processes tend to produce relatively large particles.
At the same time,
however, an appreciable fraction of the large mass of asbestos dis­
charged by mills is in the form of free fibers that may remain in the
atmosphere for long periods of time, travel great distances, and expose
many people.
Studies of atmospheric pollution in the area surrounding
asbestos mines and mills in Finland showed small amounts of asbestos
dust as far away as 27 kilometers.2
A simplified calculation of "drift distance" for two sizes of
^
asbestos fibers was made for this monograph using the method of Cowherd
and a terminal settling velocity as determined according to Harris.^
Fibers were presumed to be injected at a height of 50 feet (15.2 meters)

87297462

52

into a constant crosswind of 10 mph (4.5 meters/second) with no net
effect of turbulence.
The locality was assumed to be rural with a
"roughness height" equivalent to that of a wheat field.
A small fiber,
one with a diameter of 0.1 micrometers and length of 10.0 micrometers,
under such conditions would drift 1120 kilometers; a large fiber, 1.0
micrometer in diameter and 50 micrometers long, would drift 13.3 kilom­
eters .

Redistribution by Water

Asbestos borne by water can also travel considerable distances.
Studies of Lake Superior, reported in 1974, indicate that asbestos
particles can move several hundred miles or more.5 Another report,
made in 1976, shows that high river flows in surrounding regions have
resulted in unusually high fiber counts in the Philadelphia and Atlanta
water supplies.6
Water samples taken from wells located in areas containing asbestos
rock have shown elevated concentrations of asbestos.
A well at Malvern,
Pennsylvania, drilled in a belt of serpentine rock, had an asbestos
content of up to 0.157 micrograms per liter, in contrast with a well at
Glendale, Arizona, in an area known not to have such rock, which had an
asbestos content of 0.023 micrograms per liter or less.7

The Ultimate Fate of Asbestos Fibers
Very little has been reported on the ultimate fate of asbestos
fibers once they are released to the environment.
While it is known
that fibers can be readily subdivided by mechanical means into fibrils
of submicron diameter, it has not been established if fibers are sub­
divided by natural means.
It does seem likely, however, that natural
forces such as erosion, grinding, abrasion, moisture, and temperature
gradients would cause their eventual subdivision.
All types of asbestos resist prolonged attack by strong alkalis.
However, it has long been known that hydroxyl groups of chrysotile,
in contrast with other asbestos types, will react with weak acids and
even water, causing magnesium and silicon to be released from the
crystal lattice.8-10
Generally, despite some degradation, it is felt
that the fibrous morphology is retained.8 Thus, to a limited extent,
chrysotile may undergo decomposition through reaction with water and
acid present in the environment.

54

87297464

Temperatures required for thermal decomposition of asbestos are
seldom attained in the natural environment.
With chrysotile, dehydra­
tion occurs at about 100°C, and full dehydroxylation is achieved at

800°C.8
higher

Thermal

decomposition

of

amphibole

asbestos

occurs

at

somewhat

temperatures.

Exposure to Airborne Asbestos
As one would expect, airborne asbestos can be found in the vicinity
of asbestos mines, mills, manufacturing facilities, and waste dumps.
But

elevated

braking

levels

vehicles,

been

used,

ated

them with

and

equipment.
asbestos
brakes

roofing

gravel
of

cars

or

or

of

paving,

asbestos,

inhaled

with

roads

asbestos

filters

Even

powdered

pdpier mach£ mixes,

have

These
because

to

may be

contain

of

they

contribute

to

is

also

treated

found
first

install

a

as
in

to

or
own

automobile

wires

airborne

for

asbestos

50%

of

containing

asbestos,

used

in U.S.

are widely
or more

a

or

total

review

of

used

high

and

levels

cigarettes

cigarettes).
in

elementary

asbestos.H

intermittent nature,

small

contaminant
the

as

their

their homes.

longer

person's

a

items

contamin­

body,

surfaced with asbestos-bearing

a one-time

permanence

is

who

systems,

containing

no

cumulative

source

of

exposures

which

the

Asbestos
this

(reportedly

found

exposures

of

asbestos,

been

plumbing

of

products have

clothing,

charged with water
paints

concentrations

spray

on

repair such

driveways

with

schools,

area

persons

the walls

humidifiers
powders,

by

and

possible

and

near

asbestos workers who have

or who

or

found

asbestos

the work

home heating
irons,

talcum

of

from

be

be

in which

and homes

may

situations
use

also may

flooring,

and waffle

the

fibers

brought

clutches,

Other
include

in

dust

Asbestos

and

toasters

of

in buildings

portion of

but,

inhaled

risk.

in

the ambient

exposure

air,

sources

and

that

follows.

Exposure

from Ambient Air

The large majority of the U.S. population does not live in areas
that have elevated levels of atmospheric asbestos due to asbestos min­
ing, milling, manufacturing, or construction.
Nor are most people
involved in part-time installation or repair of asbestos products.
Ambient air, therefore, constitutes the basic source of atmospheric
exposure for the population at large.

Appendix E

contains

data

from several

55

studies.

87297465

There is a paucity of atmospheric asbestos-concentration data,
due, in part, to the cost and difficulty of obtaining it. Moreover:
data have sometimes been reported as mass of asbestos per volume of air
(most often the case)* while sometimes as concentration of fibers;

usually
for

only

chrysotile

measuring,

widely.

The

and

asbestos

hence

the

Environmental

standardized measurement
substantially
will be

more

largely

has

been measured;

precision

of

the

Protection Agency

procedures,

but

data

are

accumulated,

unknown

for

most

and

the

procedures

measurements,
is

currently

until

these

are

atmospheric

have

implemented

asbestos

The scant data available for ambient levels of asbestos
include a reported range of 0.01-0.1 nanograms per cubic

and

levels
in

of

a

40-100

remote

Average
between 0.09
between

0 and

2,400

Fiber

readings

that

are

in

not

one

fibers

per

Exposures

Asbestos

fibers

ing,

as well as

occur

from ore

turbance by
the

ore

volume

released

air

piles

for

of

that

significant

the

asbestos

of

the

turing

plants.

A study

of

can

are

in

1974

of

fibers

the best
duced

A

the production

result

1974

vicinity

million
meters

length

to

in

field
of

survey

an

the

on

asbestos

the mill

exposed

In

this

during

min­

to wind due to
and

screening

connection,
to

the

ten

together with
in

removal

Other emissions

(seven

air,

dis­
of

large

tons
the

of

length

generates

must

air.

the

air

mill

at

tailings

that

at

a

fibers

a

Since

after

that

are

passage
not

of

outside

concentrations

of

asbestos

fibers

pile.18

No

per
data

1.5

fibers

generally

California,

through

reintro­

disposed

Coalinga,

than

for

considerable quantity

even

removed

to

and maintained,
greater

efficiency
98%.

used

and manufac­

using specific

operated,

for

fibers,

be

mills

baghouses

collection

atmosphere

to

control measure

streams

approximately

Fibers

electron-microscope-visible
from

a

and open-pit

ore.

grinding,

designed,

short

process

emissions

air

the

was

of

available baghouses.

into

and may

the

in

number

released

remove

are

over 99.99%

However,

an

can be

near

Product Manufacture

for strip

produced),17

showed

of

1.5 microns
enormous

and

engineering

efficiency

than

Bay,

is

electron-miscroscope-

remain suspended

have

there

per

emissions.

from effluent

length.18

that

fibers.

and when properly

less

fibers

Silver

locale

and milling

to

crushing,

filter materials,
in

Milling,

dumps

predominant

dust

micrometers

o-m-v)

at

the

150,000

in mining

fiber

fibers
for

airborne

collection

air

air-aspiration milling

ton

remove

a

of

(2.4

since

ore bodies

Drying,

release

every

are

of

and waste

potential

Baghouses

to

drilling blasting

air required for

process
time

are

bulldozers.
in

up

Mining,

preparation

during

result
of

cubic meter

cubic meter.16

from Asbestos

overburden and

study

typical,

taconite milling operation—ranged

of

per

California.

of

electron-microscope-visible

Minnesota—readings

visible

fibers

in rural
meter,12

reported concentrations of asbestos in urban air vary
and 70 nanograms per cubic meter!4>15 and, from one study,

meter.13

cubic

electron-microscope-visible

area

and

levels

geographical areas.

air

found

varied

developing

the

fibers

showed

cubic meter within
for

plant

in

100
500

farther distances

56

■ at

from the source are reported.
A 1974 EPA report showed atmospheric con­
centrations of 2 to 106 micrograms per cubic meter within about one
kilometer of the Vermont mine-mill complex.19
Average readings were
about 30 micrograms per cubic meter.
At another site, about 1.5 kilom­
eters from the plant, the readings were .012 to 0.180 micrograms per
cubic meter, with an average of about .096 micrograras per cubic meter.
In 1972, some atmospheric sampling was conducted at the asbestos
mill located near King City, California.20
One sampling station located
100 meters downwind of the source showed concentrations on the order of
100 million fibers per cubic meter, and, due to unusual wind conditions,
concentrations on the order of 10 million e-m-v fibers per cubic meter
were recorded at a station located 500 meters upwind from the source.
Another atmospheric sampling, conducted within 3 milometers of the mill
during August and November of 1974, showed concentrations of up to 1
million fibers per cubic meter downwind and 10,000 fibers per cubic
meter upwind.21 Elevated concentrations (4,500 fibers per cubic meter)
were found out to the farthest station (3 km).
These samples were
obtained with an 0.8 micron-pore-sized Nuclepore filter, whereas the 1972
samples were collected with a Millipore filter.
Hence, it would appear
that the Nuclepore filter failed to collect a substantial number of
fibers smaller than one micron and that the 1974 data may have under­
estimated the total number of fibers present.
The King City mill is
unique in that it uses a wet process; hence, it is believed that most
of the fibers in the atmosphere come from the ore pile and tailings dump.
Dispersion of asbestos emitted to the atmosphere depends upon fiber
length, topography, meteorological conditions, and the emission source
itself.
Wind speed and temperature stratification are important factors.
As asbestos travels in the atmosphere, gravity and rain remove it from
the atmosphere, and the process of agglomeration can be a significant
determinant of how many fibers will be present.
Because most of these
factors are different at each site, detailed estimates of asbestos con­
centration in the atmosphere at each site require individual, special­
ized, calculations.

Exposure from Transportation of Materials Containing Asbestos
Movement of asbestos ore from mine to mill in open trucks, often
over roads paved with mill tailings, may contribute to the overall con­
tamination of the environment.*
However, three of five mills operating

.! I
*

22

The national asbestos air emission standard
prohibits the surfacing
of roadways with wastes containing commercial asbestos or tailings from
asbestos mining and milling, except for temporary roadways in the area
of an ore deposit.
The use of wastes that may contain noncommercial
asbestos as a contaminant has not been regulated.

the United

States
short,

Shipment

of

milled

emissions when bags
pressure

packing

monograph.

If

elsewhere,

they

asbestos

is

Chapter

II)

fibers

but

perhaps,

transportation

taconite,

and

of

their

Exposure

are bound

flooring
the

and

in

for

air

energy,

fibers

are

exposure during

ducts.

However,

materials

that may be

there

automotive

friction materials

estimate human
some

asbestos

assuming
pounds
has

a

15%

grinding

asbestos

automotive
usually

some working

of

manufac­

A more

important

asbestos-

urban areas.

ores,

Yet,

are

such

by

as

Also,

talc

and

emissions.

and

and

the

sheet,

this

reduces

application of
tightly bound

example.

for human nonoccupational
use,

and

repair of

asbestos,

it would be next

for

information

spray

pro­

that use asbestos

exposure
and

atmos­

asbestos

products

data
and

pipe

the

from even

an

so many

used

it has

are used

in

been

each

product

type.

In

are presented

or
to

the
for

asbestos.

automotive brake

are actually

clutch

to

loss,

automobiles

they

50%

about

However,

58

not

since brakes

all

the U.S.

and,

similarly,

it

incorporated annually

are completely worn out,

are scrapped,

pads,

103 million

into brakes;

are

disk

chrysotile

118 million
in

approximately

incorporated

facings.25

that

produce brakes

4.5 million pounds

repaired before

linings,

concentration of

estimated

annually

and milling

been estimated that

into
are

of

asbestos

(see

considerably.

since most manufactured

friction products),

contain an average

by weight.24

of

or

Friction Materials

Friction materials

pounds

this

finished products where

contaminated with

to

facings

and

are

that

clutch

of

cars

reduced

asbestos-cement

linings

impossible

and

in

When milled

environmental

may be dislodged

paragraphs

Automotive

into

(e.g.,

opportunities

follow,

II

the shipment

through

in

result

industry

transporting of

result

installation,

since

can

railroad

doubt

in a matrix.

the

contamination.

automobile brake

there

bound

incorporated

sufficient

Clearly,

during

are

Manufactured Products

a matrix

materials;

pheric

may

roofing products,

possibilities

no

open vehicles

products

is

in

is

two

minimized by

in Chapter

in sealed

other asbestos-bearing

from Asbestos

Most asbestos
fibers

tightly

would be

are

contamination.23

transported

occur

in bags,

the asbestos

they would be negligible,

containing solid wastes
the

in

of

could

remaining

emissions

described

emission

the

55 miles).

usually

either

for

contain asbestos

emission source,

and

such

a source

and

(32

fiber,
but

reused,

potential

of

the mines,

unitization as

may become

the

at

distances

asbestos

are

pelletized

Emissions

located

are broken,

and

bags

tured products,
products

are

rural,

this

and

clutches

and since

automotive asbestos

89Vk6Z4*8

in

separated by

will be released to the atmosphere.
Hence, the estimate of how much
actually is worn away annually is 74 million pounds, but only a small
amount of which is released as fibrous material.25
Tests performed on brake linings have indicated that under con­
ditions of normal usage, considerable alteration of the asbestos occurs.
One study has reported that most of the dust collected from brake drums
is nonfibrous and is similar in appearance to thermally degraded asbes­
tos, and it was suggested that the temperature at the points of contact
of brake linings and drum actually reaches levels at which thermal degra­
dation of asbestos can occur.24
Three research studies of asbestos emissions from brake linings
give estimated percentages of free fiber at 1% or less, 0.3%, and less
than 0.02%, respectively.25,26,27
jn the first of these studies, it
was estimated that annually in the United States there are 239,340
pounds of asbestos fiber emissions from cars, buses, and trucks and
that, of this amount, 204,952 pounds drop out on the roadway; 7,655
pounds become airborne, and 26,733 pounds are retained within the brake
and clutch housings.*25 These atmospheric emissions are of greatest
concern in ubran areas near traffic routes with high volumes of braking
vehicles.
Electron and light microscopy were used in a recent study to
analyze the number and size of asbestos fibers collected from air at
four Los Angeles freeway loop sites and from upwind ambient air controls
within 200 feet of the freeway.13 Concentrations of chrysotile asbestos
at the four freeway sites were low, generally in the range of 0 to
12,000 electron-microscope-visible fibers per cubic meter, and they did
not differ significantly from concentrations of chrysotile in the matched
upwind ambient air samples (0 to 9,000 fibers per cubic meter).
Concen­
trations of amphibole asbestos did not differ between freeway or controls
(1200 fibers per cubic meter).
There was no correlation of asbestos
fiber concentrations in the freeway samples with number or speed of
motor vehicles passing by during the sampling periods, nor was there a
correlation with wind direction or velocity.

There

is

apparently

Emissions:

Selected Mobile
emissions
emission

an

error

in data used

Emission Measurement
Sources," March

should have been
figures

in

this

study

from

"Brake

from Brake and Clutch Linings

from

1973

Total

239,340

have been scaled

EPA

(NTIS

pounds

and,

up

59

#68-04-0020).
therefore,

accordingly

in

this

the other
monograph.

6 9 ir & 6 Z & 8

Measurements were also made of chrysotile and amphibole asbestos
at the San Francisco Bay Bridge toll plaza, and the concentrations there

were found to be 1,400 electron-microscope-visible fibers of both types
per cubic meter.
This compared with an average San Francisco Bay Area
atmospheric chrysotile concentration of 500 fibers per cubic meter.

Spray Asbestos
From 1958 through 1973, spray materials containing 10% to 30%
asbestos by weight were used extensively to fireproof girders, spandrels,
and decking of high-rise office buildings, and use of spray asbestos for
decorative and acoustical purposes dates from the mid-1930s.
Erosion of such spray materials alone may cause asbestos fibers to enter
building air, but the materials might also be damaged and dislodged—as,
for example, by workmen repairing fixtures inside the space between a
ceiling and the floor above.
In large office buildings, air is often
returned to the ventilation system through these spaces.
A recent study of public buildings in which asbestos sprays
had been used showed that there were elevated levels of asbestos within
the buildings, as compared with the air outside.
Also, the difference
between inside and outside air was greater in the case of fibroussprayed buildings than in the case of buildings sprayed with cementi­
tious asbestos.
Flaking of sprayed asbestos from ceilings has been reported
inside schools, libraries, dormitories, and warehouses. 19,29,30,31
Air concentrations may range from 0.02 optical-microscope-visible fibers
per milliliter under quiet conditions to 4.0 per milliliter during dry
dusting.
Prior to implementation of federal regulations on asbestoscontaining fireproofing materials,* data were obtained at various
building sites in lower Manhattan where such materials were being
sprayed.32 Generally, average atmospheric concentrations within onequarter mile of a construction site were at least twice the background
level.
Current spray materials that contain 1% asbestos or less may be

87297470
Spray-on materials used to insulate or fireproof structures, pipes,
and conduits must contain less than 1% asbestos on a dry-weight basis,
and, for the spray application of material containing more than 1%
asbestos used to insulate or fireproof machinery or equipment, no
visible emissions are permitted.22 Spray-on paints, decorative mate­
rials, and weatherproofing are not regulated.

60

,!s
4

expected

to

result

concentrations

in no

that

more

occurred

than

one-tenth of the

elevated

asbestos

air

previously.

*
Exposures

from Disposal

Solid wastes

produced

containing products
in

the

past,

these

regard

to

in

mingling

the

their

open dumps,

of

thus

by

air

etc.

control

that

is

from

waste

Products

the manufacture

materials

potential.

creating a

wastes

include

equipment

vented

to

(e.g.,

control

This

facturers

of

asbestos

item,

products.

into

the

sometimes

like

and

of without

disposal

the bags

If

product

sealed

nonasbestos

in

tailings;

in which
common

the bags

mix,

and

they

are

may

and

result

as

result
in

grinding,

the milled
almost

fiber

is

all manu­

shredded

and

or

Occasionally,
exposures

drilling,

asbestos

incinerated

in

dust,

collected

emptied

not

are

plastic bags.

wastes

to

such
waste

from sawing,

asbestos-containing waste

treated

asbestos-

source.

scrap;

an

landfill,

latter

the dust
devices);

is

to

of

disposed

process wastes

and mill

received,

be

use

emission sources,

their

long-term emission

from overspraying,

directly

often

Moreover,

shipping bags.

porated

and

can be

were

and Wastes

asbestos-containing wastes with municipal wastes

asbestos

waste

Asbestos

from demolition^'

emission

Industrial
slurries,

and

of

incor­

disposed
they

to

may

unknowing

handlers.23

Water may
particularly

become

polluted with

the

paper

in wet

cyclones

for

cleaning exhaust

waste

from such

processes

and

asbestos

in

cement

may

be

product
gases

directed

the water recirculated (the dried waste
dumped directly into convenient sewers,
case,
of

but

the

especially

in

the

environment with

The

results

products

of

and

that

it

in manufacturing,
and

from factories.
either

during

use

The slurry

into settling

ponds

and

disposed to land), or it may be
rivers, or lakes.33
in either
can

contribute

to

contamination

asbestos.

a survey

manufacturers

for wastes

latter,

fibers

industries,

show

13.4%

of waste
that

used

37%

disposal methods
of

97

landfills.

plants
(The

used by

surveyed

remainder

asbestos

used

dumps

reuse,

I
*See

also

Reference

^For years,
tion,

asbestos

cement sheet,

industrial

and

tion.)

and

source

of

roofing,

residences

incorporated
and

emit

contain

buildings

especially

can

been

floor

commercial buildings

When such

asbestos,

has

ships

and

ships.

in

the

Obviously,
future,

are

demolition will

such

in

as

of

part,

asbestos
areas

open

insula­

constructing

the most

are demolished,

requiring

61

used
(For

small amounts

from insulating materials,

fibers.

emissions

and

tiles

and

only

into material

to

of
the

continue

control measures.

insula­
loosened
ambient

to be

a

87297471

single-family

air

19.

-

sell,

store

standpoint

or wet-slurry
of

emissions

their wastes.)

are

Of

those wastes

greatest

that

are

concern

disposed

.... .

from

to

n
the

uncovered

dumps.

Asbestos

mills

generate vast

manufacturing waste
square meters
be

400,000

less

than

over

30%

(about

1%

asbestos

asbestos,

disposal

asbestos
wastes

3

also

disposed

to

land

generated by

buildings,

which

may

Three

fall

studies

contain

many

studies

all

of

as

other

of

conducted

that

atmospheric

waste disposal sites,

even

to

which

amounts

site may

contain

from

the Vermont mill,

to

for

asbestos

emissions

from

the majority

Most

of

these

demolition of

ships

and

of

notable

friable asbestos

of

and

insula­

products.

concentrations

in

air near

establishment of
it

is

concentrations

in urban areas,
10

levels.

after

large

constitute

3).

large

the

a

12,000

operations.

renovation

asbestos

often

effect

case of

published.13*19,34

occupational

into

the

(Figure

concentrations—perhaps

approach

that went

disposal

Mill waste may

the

asbestos

have been

background

in

asbestos

prior

1975,

tailings

are opportunities

those

dumps,

as

Whereas

area of

acres).

nonindustrial wastes,

wastes

of waste.

a surface

large mill
100

in some California

are

tion as well

a

(about

by weight,

there

of

quantities

site may have

acres),

square meters

Obviously,
the

disposal

to

are

1,000

(The

asbestos waste

EPA standards
apparent

in

the

from

the

vicinity

of

considerably higher
times

than

higher—and may

revised EPA asbestos

these data were

in

these

recorded may

help

standard
reduce

emissions.)35

Exposures

Families
jected

to

of Asbestos Workers'

of

other sources.
clothing or
pheric

persons

asbestos

Workers

on

similar

to

to be

in

the asbestos

that

augments

may bring asbestos

equipment such

concentrations

been reported

employed

contamination

Families

of

as

asbestos

in

concentrations

per

in

and mills and much higher than the 0.09
reported in some U.S. cities.*14,15

Exposure

to Asbestos

Drinking water
exposed

is

known

elevated

that

rates

of

of

cubic

asbestos

meter,28

vincinity
70

of

nanograms

from

their

skin

or

Atmos­

workmen

have

concentrations
asbestos

mines

per cubic meter

in Drinking Water

is

asbestos.

to

home on

one

of

the

possible routes

Contamination of

occupants

of households

asbestosis

and

by which humans

drinking water may be due

of

are
partly

asbestos workers have

mesothelioma.36

8729

*It

to

the

may be sub­

exposures

and automobiles.

the homes

100-500 nanograms

estimated

fibers

lunch boxes

industry

their

1
l

I
to

erosion

from natural

containing materials
viously

in

this

found

chapter

Environment").
of

directly

discharged

of

and

the United

other

asbestos-

States,

Fate

of

as

also

result

These wastes

be

effluents

on

systems,

land

and

may

or

they

may

subsequently

noted

Asbestos

contamination may

into water

disposed

serpentine

throughout

asbestos wastes.

or

of

("Redistribution and

Substantial

disposal

atmosphere

deposits

be

in

from

improper

that

released

join

pre­
the

are
to

the

the water

sys tem.

Another
and

potential

miles

of

asbestos-cement

and the pipes
erosion.'»38
other

provide
Gaskets

possible

The
are

contaminator

pumping of municipal water

in Appendix

are

from one source

over

receive
cal

for

represent

supply

the

used

to

carry water

variations

in determining

C.

Furthermore,

at

one

can

the piping

to

200,000

U.S.

consumers,
are

change

the

data on
from 9

ing

105 water supplies

in

dix

E.)

made

effort was

A study

of

asbestos

cement

pipes

of

an

asbestos

a

The

of

of

the

few

content

liters

degree

of water

analyses

that

of water

to which

grab

entire municipality's

the

sources,

asbestos

extracted

An

the
most

are

that
sam­

water

time could be questioned—some municipalities

from several

monograph,

ing water were

time.

characteristics

location and

this

are

"grab" samples—samples

their water

For

is

About

contaminators.*6

are

taken

drinking water

a source of asbestos fibers from leaching and
and insulation used in treatment and in pumps

available

ples

pipes

major difficulties

discussed

of

distribution systems.

the

and

seasonal

content

concentration

different

United

and

of

asbestos

published studies,

States.6»?>39-45

to select

climatologi­

of water.+

data

only

for

(See

in drink­

represent­
also Appen­

finished drinking

it

of

asbestos

tests

asbestos-cement

cant
to
t

pipe

of

action

also

counts

study

water
that

lished

in

solids

rainfalls

1974

are

in

found
in

at

increased
1978)

located

the

a

previously

report

the

an

from river

is

and

supply

increase
and

of

no

pipe

of

fiber

signifi­
exposed

supplemented by water

in

area.

showed higher

regions.)

amount

runoff

showed

chrysotile rock

that

the surrounding

Laboratory

sections

concentrations

and Atlanta water supplies

that

tap.7

on

asbestos-

micrograms

water.38

sources

in

the Duluth water

using

and 0.004

from asbestos-cement

agressive"

from other

is

followed by

resulting

0.074

of water

(February

"moderately

mentioned

flows

pended

solids

recent

in Philadelphia

river

liter

of

EPA37 and Johns-Manville?

also have shown
a

two water systems

during

Further,

mineralogical
is

most

periods
a study

nature of

fiber
of
pub­
sus­

evident when heavy

the amount

shore

(Recall

asbestos

of

erosion.39

suspended

87297473

high

reservoir

the

per

in

increases

chrysotile asbestos

of

In San Francisco,
from a

the

However,

release

the

average

respectively

conducted by

in water.

concentrations

revealed

-1

water—some

of

the

samples

were

taken

system;

others

studies

in which

The

cities

cities;
in

in

their

vidual
lion
did

in

liter

56

fibers,

of

the

(for

three

because

in

Foods

may

in

in

the

and

be

air

to

the water

supply

Also,

be

only

are

included.

representative

asbestos was

of

suspected

of

contamination

found
of

per

and

U.S.

to be

drugs

of

food

during

their

and

800

two

cities

in

indi­

micrograms

over

not

per

60).*

been well-established
the

content

agricultural
impurities

contaminated water
directly

possibilities,

the

only

indi­

130 mil­

of

drugs.

substantiate
in

(for

in

and

concentrations

range

have

from asbestos

are

detection

concerning

contaminated water

to

to be

Drugs

and

of

found

concentrations

liter

samples

regulations

Uptake

irrigation,

been

food
no

soil

deposition of

sprinkler

Fiber

asbestos

the

nonparenteral

pesticide vehicle.

ture has

or both were

limit

fibers

and

contaminated

and

lower

Mass

did

Foods

the FDA has
foods

fibers,

supplies.

40).

cities

contents

and

asbestos

as

in

stations.

between below-detectable

to Asbestos

asbestos

over

varied

only

Asbestos

well

taps

water

selected

amphibole

105 water

range

samples

date,

by

not

selected

varied between

samples

Exposure

a

were

electron-microscope-visible
the

from

drinking water.

samples

vidual

to

studies

some were

Chrysotile
present

taken

municipal

electron-microscope measurements were made

the

indeed,

were
at

them.

course

of

but
One

by

talc

plant

onto

no

phase

in

leafy

of

transportation has

as

roots,

as

surfaces

published

instance

from
used

litera­

accidental
been docu­

mented. 46

foods

in

adhesives,

rubber,

which

asbestos

juices,
been

their

The

and

lard,
to

syrups,

are

and

process
tonics,

authors

of

become

resins

filters

sugar,

employed

washes,

may

preparation

between

drinks.
liter

1.7

They

also

in wines

between

13.1

and

in processing

used may

cider,

one

study

12.2

wine,

Asbestos

condiments,

either

asbestos

Foods

liquors,

filters

from

filters,

packaging.47

include beer,

oil.48

found between

fibers

have

drinking water,

million
parts

million

1.1

and

per

liter

fibers

per

liter

and

11.7

reported between

24.0

and

asbestos

of

fruit
also

mouth­

1.8

of

fibers

million

and

Canadian beer,

in Canadian soft

million

the world.50
per

6.6

in U.S.

liter were

in

fibers

per

another study,

found

in

one

*
Some

authors

micrograms

reported

per

liter,

for

and vinegar.49

from various

and

from the use

vegetable

electron-microscope-visible
and

contaminated with
or

their data
and

some

as

fibers

per

reported both.

64

liter,

some

reported

l^ V ^ 6 Z 4 « 8

Processed
water used

_

U

*-

-

..

manufacturer's
between

3.3

Any
be

reported.

The

foods

blood

of

filters

logies.

Asbestos

nonparenteral

which

other

uses

processed
form

release

asbestos

10

been

April

no

under
ppb

used

1975,

in

may

be

used,

asbestos

as

capsules

and

as

been

market

conditions

the

processing of
in Chapter

parenteral

an

dentistry.53-55

directly
a

must

noted

however,

contain

or

and

food

data have

in

drugs

the

drugs

I,

the

and

bio­

manufacture

of

ingredients.

medicinal
and

contained

consumed with

test

as

filters

their

gin

asbestos.52

preparing

and

of

concentration

in

either

agent

that

than

also have

in medicine
foods,

of

processing

liter.51

use

may
of

the

their

drugs

manufacture

less

since

in
per

virtually

reported

But

disapproved

used

fibers

quantity

since

contained

plasma.

Talc,

the

FDA has

FDA has

the

million

speculative

Asbestos
and

the water

8.7

estimate

purely

certain

gin;

and

as

an

constituent

impurity,

tablets
Also,

ingredient
of

has

and has
talc
or

packaging

may

been

used

found
be

in

various

added

indirectly

as

materials.56-66

to
a

Chapter VI
CONTROL OF THE ASBESTOS HAZARDPHYSICAL CONTROL

Three program approaches for controlling the adverse health effects
of asbestos fibers in man's environment are presented in this and the
following two chapters.
These approaches are:
•

Physical control of human exposure to asbestos
fibers—i.e., reducing the contact between man and
the fibers

•

Medical surveillance—measures taken by physicians
and other health-care personnel in behalf of asbestosexposed persons

•

Education—ultimately, of course, of persons exposed
to asbestos fibers so that physical and medical con­
trol measures will be of maximum effectiveness, but
also education of persons who are in a position to
motivate those who are exposed, and other persons with
responsibilities for asbestos-control measures.

Reducing the extent of contact between asbestos fibers and man can
be accomplished by actions discussed in this chapter.
Such actions
include:
(1) engineering of the materials, processes, and facilities
for utilizing asbestos commercially; (2) administrative measures that
relate to the persons who might be exposed; (3) improvement of work
practices; (4) control of emissions and asbestos wastes; and (5) con­
trol during transportation of asbestos raw materials and products.
The
chapter includes a section on the application of control measures in
several specific manufacturing and consumer industries.

Engineering Measures
Control of airborne asbestos fiber by engineering methods is not
greatly different from the control of other solid particulate matter
having a similar aerodynamic size, though some special problems and
technologies may be involved.
Engineering control methods include:
•

Enclosure

•

Exhaust ventilation

•

Isolation

/

67

Plant

design

Treatment

of

asbestos

Substitution

of

alternative

materials.

Enclosure

Unless

borne by wind,

extremely

high

inches

the most.

at

fibers,
of

due

the

dust

to

short

their

generated by
must

machine

so

Hence,

that

an

enclosure

operations

for

are

Dusts
3.000

to

for

asbestos

carry

air

out

into

its

the

Because

However,

per minute

a

at

suf­

For many

at

special

of

function.

unit

dust.

few

asbestos

operation

for high-velocity
require

of

or hooding.

manual

asbestos

feet

parts

with

remove

negative

airborne
and

operation

per minute.

the

face

wheels

care

in

pressure,

fibers.

should be
of

The

of

or
design.

must be

design

and

other

pro­

of

accomplished by

air movement

shoes

or

to

4,500

feet

All

parts

of

open

slightly

air

lower

at

velocities

velocities

of well-divided

is

at

textile

restricted

in dust

systems

asbestos-cement

conveying

a

persons
important

pipe.

systems,

are

fibers

be

carried,

The higher

and where

larger

for machines
Most

from

used where

must

plants.

systems,

function well

ranging

at

that

pieces
cut

including

velocities

of

and
low-

of

per minute.

to

control

prevent

seams,

Another major

provision of

as

asbestos

negative pressure

carry
The

systems

space

carried,

4.000

should

200

critical

are used where

penumatic

the

to

concentrations

pressure

faces.

large

dust-control

material must be

and

of

of
of

of

control

enclosure

inflow
escape

in the principles

feet

the

joints

the

air—a

characteristics.

toward

otherwise

ventilation,

areas

asbestos

small

shape brake

may

Enclosures

very

system is

relatively

velocities

is

true

at

in

ventilation-system design.

5,500

in

particularly

start

impelled

distance

aerodynamic

good

continual

velocity

exhaust

such

as

a

even when

short

openings, to permit

adequate.

enclosed

of

a

operations

prevent

experienced

aspects

and

a

Ventilation

proper exhaust
who

to

involving

Adequate
vided

is

the machine

intake

is

Exhaust

behavior

often have

velocity

operations,

only

low mass

machine

particles,

travel

distance,

there must be

ficient

an

This

travel

enclosures
or

dust

velocities,

as well

as

air—the

the

amount

of

to

consideration

make-up
exceed

systems

leakage

ensure
in

should be maintained

dust

a

into

the

adequate

plant's

of make-up

of

exhausted.

collection

loose
at hood

air

introduced

A mechanical

air

87297477

68

under

from

ventilation system is

amount
air

plant

supply
and,

system,

in most

rather

cases,

than

"natural"

necessary

to

room ventilation,

achieve

the

is

necessary

preferred

ventilation

per­

formance .

Many

specifications

Industrial

Ventilation

Industrial

Hygienists.1

Even with
to

good

ventilation

engineering

determine
ing

a

that

the

to

design.

•

Static

•

Air

•

Supply,

•

Fan

Frequent

duct

system is

Such

contruction

design may

be

found

the American

Conference

of

Governmental

system

principles,

that

is

designed

and

built

in

according

periodic measurements must be made

adequately

measurement

balanced

and

performing

to

accord­

include:

pressure

flow
capture,

and

conveying velocities

performance.

measurements

variations

for

issued by

in

the

are

essential,

balance

and,

since

hence,

plugging and wear

efficiency

of

the

can

cause

system.

Isolation

"Dirty"
to

operations

minimize human

particularly

reduce

airborne

average

limit,

In

as

asbestos
thereby

industry
fibers.

and bagging

levels

and

below

necessitating

frequently

asbestos

enclosure have

the

two-fiber

isolated

operations,

mills,
not

such

been

able

isolation.

to

reducing

there

are

in

isolating asbestos-fiber-emitting operations

and

tion

not

so

likely

he

is

separated

that

present

is
if

operations
reduce

efficient

costs

for

to

(1)

an

relax his

levels

local

exposure
exhaust

a

employee working
adherence

from fellow
no

through

to

employees

hazard;

at

a

dusty

opera­

restrictive work

who

are working

also,

ventilation,

plant,

prac­

freely

at

isolation can

and

(3)

make

for more

housekeeping.

Unloading and
because of
shifting or
asbestos

them:

to

time-weighted-

addition

to

fiber

at

are

For some

advantages

access

(2)

asbestos

ventilation

restricting

tices

the asbestos
to

vibrating screens

engineering measures

other

in

exposure

dust

storage

from bags

careless

of
that

loading.

asbestos
are
Such

is

another

inevitably
bags

should be

rebagged—and vacuum-cleaned within

for

isolation

in-transit

repaired—or

the

the boxcar before being

87297478

69

candidate

perforated by

transferred to the warehouse.
Also, of course, careful unloading is
required to minimize bag breakage.
Bag-opening

stations,

should

be

isolated

area.

The

emptied

up within
clean,

the

bags

opening

sealed bag,

isolated,
mately

a

enclosed,

disposed

as

well

from other

of

themselves

station's
shredder,

central
in

as

being

operations

enclosed

in

should

be

a

tube

that

collection point

sealed

be mixed with other material

containers.
and

and

being

into

rolled

either

emptied bags

from which

into

compounding
by

put

conveys

(In some

submersed

ventilated,

or

"isolated"

ventilation hood
or

and

the mixing

they

are

industries,

a

to

an

ulti­

bags

the manufacturing

can
pro­

cess .)

Plant

Design

Not often is industry afforded the opportunity of designing and
constructing a plant to specifications that place such hazard control
measures as isolation and dust control at the forefront of priority.
As

a

rule,

receive

process

higher

efficiency,
flict with

An
entry

flow

product
design

ideal

efficiency,

priority.

locker

rooms,

street

clothes,

and

cost

for health

and

safety.

for

only

at

isolating

through

separated by
the

other

Interposing a shower bath
shower

the

end

quality

of

a

control,

enlightened management

quality,

design

can be made

But

a

for work
between

a shift more

do

dusty work

locker

shower

savings

and

not

cost

is

aware

clothes
two

and

area

is

that

one

protective
rooms

(See

Figure

con­

in which

rooms.

provided—one

locker

likely.

factors

necessarily

clothes-change

room should be

the

and

Two
for

equipment.

makes

taking

a

3.)

The contaminated change room should be under negative pressure,
with the exhaust air directed to a suitable collecting system.
Air flow
between the two locker rooms should be toward the contaminated room. If
connecting doors between change rooms and shower are self-closing and
well sealed, it may be possible to use the separating shower room as
an air lock.
Some
control

•

important

Engineering
by

•

other

considerations

in

designing

for

asbestos

fiber

are:

as

few

a

dusty

employees

operation
as

Including

a protected

work

so

area

visitors

that

can be

that it can be handled

observation

entry

kept

so

possible.

to

of

area next

supervisory

to

an

personnel

isolated
and

a minimum.
0D
•O
N
(£

V.

FIGURE 3

LOCKER ROOM, SHOWER ARRANGEMENT

•

Planning

the

enclosures,
by

drafts

with
and

•

layout
and

from

ledges

do

serve

There

various

are

to

One

friction

milling

in

the

and

present

there

through

rock

Use
enclosed

a

pillow

fluff-dried
is

needed

of

but

problem in

yarn.2
face
the

been

fiber

and

asbestos

Such

a

are

Treatment
These agents

packaged

tried

of

of

in

of

which

other

treatment
the

not

as

the

in

mining

and

United

States

that

to

dried

fibrous

material.
the

pumped

gravity
of

friction

not

a matrix with

anti-dusting
are

product.

required,

long
lengths.

present

to

the

less

of

products.

fibers

polymer

into

Its

products

require

should

useful where
are

at

unusable,

airborne
of

Dust

pneumatically
release

products

asbestos

col­
form,

finished

asbestos-containing

fibers

then

bagging

into shorter,

is

from

is

reduce

that

separated

pellet

application

liquids

is

It

These

asbestos

with

such

in

can be

however,

asbestos

used

reduce

and

the manufacture

of

of

to

Although

devices.

through

fibers

in

the

and

pelletized

is

in

loose

success.

to be bound

viscous

as

unloaded

little

be

asbestos

pelletizing

and

can

mill

extruded

coating,

are

wetting

flotation

for

asbestos

wetting.

tolerate moisture,

and

industry

characteristics

not

asbestos

the manufacture

textile

is

of

length

recent method

fibers

pipes,

loose

At this mill,

pelletizing breaks

shorter

A

doors

deflect

airborne

treating

series

cars

but with

textiles

asbestos

disturbed

industry.

pelletized asbestos,

railroad
has

a

one

and

and

The

where

filters

only

destination,

fibers,

not

Off-set
to

effective

that will

is

heavier

lected between

of

construction

processing.

is

help

that beams,

areas

products,

utilizes wet

it

is

doors.

currents.

the most

operations

of

control

and

entries

such

as

methods
of

manufacture

or

air

into hoods,

equipment

Asbestos

emissions.

At

airflow

settle.

of

applicable

right-angle

interiors

not

Treatment

fiber

that

exhaust

windows,

incoming

Constructing

can

fans,

indirect,
diffuse

so

other

in

the

asbestos

inherent

sur­

particularly when

other materials.

agents

applied

may

to

dry

be helpful.
asbestos

by

spraying or mixing.
The fibers are then dried at room temperature.
This procedure retains the performance criteria of untreated asbestos.-*

Substitution

Although

role

the use of
it

in reducing

is

asbestos

likely

that

is well

entrenched

substitution will

the health hazards

from asbestos.

72

in many

play
For

some

important
future

example,

one of

87297481

applications,

the

largest

that

asbestos

asbestos

not

users,

be

used

nance where suitable

Materials
asbestos

that

of

of

has

have

been

issued

overhaul,
have

investigated

as

an

"Instruction"

repair,

and

mainte­

been designated.

possible

alternatives

to

Steel wool

Rock wool

Kaolin wool

Slag wool

Exfoliated vermiculite

Silica

Cellulose

Potassium

Ceramics

Sintered metals

Carbon

strength,

cost.

that

Navy,

alternative materials

glass

alternative materials

lack

U.S.

construction,

include:

Fibrous

Few

the

in

heat

Moreover,

inhaled

essential

fibers

that

the

have

proved

resistance,

as

satisfactory

flexibility,

or

since

attention has

been drawn

other

than

asbestos

may

proposed

asbestos

toxicity

of

be

titanate

fibers

as

asbestos

durability,
to

due

to

or because

the possibility

carcinogenic,4
substitutes

it
be

is
evalu­

ated .

In
less

certain

industrial

toxic materials

quality

of

rubber,

plastics,

asbestos

might be

processes

where

asbestos

have been substituted with

the product.

This

has

and various
used

been

the

adhesives

in paints,

case

and

is

in

caulks,

as

effect

a binder,
on

the

the manufacture of

cements.

coatings,

used

little

Similarly,
sealants,

less

and

joint

fillers.

Satisfactory
reinforced

critical

insulating

resistance

Not
ducts
and
as
and

of

many

board,

roofing

thread have

underlayments,
fibers

and

high

but

of

and

asbestos
pipe

strength

for

asbestos

inertness,

are highly

of

For

and heat

in paper
and

flooring

these

pro­

electrical

valued—products

fine quality

application

the majority

a variety

economically.

coverings,

limited

felts.

in

Glass

roofing and

paper

such

electrical

products,

cloth,

floor­
asbes­

are still used.

of

the more successful

silica

glass

fibers,

asbestos

are

Soda-Lime-Silica Glass

processes

the

chemical

asbestos-latex

found
in

found

for

insulating materials.

duplicated

have been

felts,

have been developed
for

however,

resistance,

properties

tos

Two

cannot be

the heat

ing

and

applications,

insulating papers,
and

resins

replacements

insulating

felt,

substitutes

and

asbestos

in which

mill

asbestos

plastics

Soda-lime-silica

glass

involving

of

the use

viewed

«

-H. -> •

soda-lime-silica

Fibers

filaments,

platinum dies,

73

1

substitutes,

briefly below.

made by highly
are

refined

of high quality

and

Z8V/LGZLQ

of

uniform size.
Some are less than one-half micron in diameter and are
adaptable to highly specialized uses, such as weaving into fabrics.
Glass fibers will not burn, but they will soften and coalesce
at temperatures which vary according to the composition of the glass.
Their heat and moisture resistance is limited by the organic film
applied to them during manufacture to improve processing and to reduce
breakage during subsequent plying and weaving operations.
(Without
such a coating, the fibers are more brittle and self-abrasive.)
Hightemperature properties are impaired to some extent, but the fibers will
withstand temperatures up to 1,200°F.
Exposure of very fine glass fibers to water vapor results in
relatively rapid deterioration, making them less resistant than asbestos
to the effects of steam and moisture.
Attempts to use them in place of
asbestos in asbestos-cement products have been unsuccessful because of a
chemical reaction, between the glass and cement, that decomposes the
fibers.
Glass
ment,

such as

Their high
organic
trical
or

as

fibers

stoves

are

and

efficient

tensile strength,

fibers,

and

an optical

Glass

on

thermal

with

insulation

a plied

yarn,

Glass
advantage over
stronger,
and

but

chemical

yarns

and

As
has,

in

poor

abrasive

applied

fabrics
asbestos

they

are

action.

a

given

designed

to

fibers

has

piping

strand

combined

stability

conjunction with
shipboard

for

elec­

asbestos,

cable.

II

to

extend

continued

as

a

covering

It

is

woven

of

glass

because

in use

and

fabrics

they
to

asbestos.

are

colors

have

for

use

some

lighter and

flexure,

interwoven glass
and

equip­

corrosive.

during World War

resistant

of

of

compared with

them suitable

glass-asbestos

less

made

types

are not

on naval vessels.

each

products

generally

abrasion,

and

asbestos

as

theater

draperies.

for

asbestos

unsatisfactory

characteristics

to

in

in

conditions

in Navy

fibers

textile

substitute

Glass
superior

used

in many weights

High-Silica

are

or

Fabrics

fireproof

general,

is

cloth

textile

having one

are being made

curtains

thermal

alternative material

asbestos

insulators

where

resistance make

fiber

A glass-asbestos
the supply of

greater

electrical

insulation.

thermal

refrigerators,

Glass

of

in

friction

results,

equipment, glass fiber

chiefly

because

of

the

glass.

Fibers

approximating vitreous

soda-lime-silica

glass

fibers

silica
in

in composition

resistance

to

the

QD
nJ
N
ce

74

V-

QD
CJ

action

of

facture,
melting

water

vapor

however,
point

and

high

because

(a)

in

limiting
exposure

the number of

the workplace,

any
and

the

of

•

given
(d)

asbestos

and

•

"Plant

Reducing

complement

employees

are

difficult

viscous

at

to manu­
its

to a

the
and

duration
eating

in

to

excessive

airborne

concentra­

by:

contaminated

further on

minimum

limiting

of

include

Exposed

exposed

to

(b)

restricting smoking

engineering design;

Design"

engineering control

cessation programs.*

limited

access

to

exposed,

(c)

Employees

employees

involve

a

person,

of

may be

Restricting
also

They

extremely

Possible administrative measures

smoking

Number

The number of
tions

are

the workplace.

for

Limiting

is

Measures

Administrative measures

of

silica

(1,725°F).

Administrative

the hazard

temperature.

fused

the

areas

hence,

in

number

this

of

(this
also

measure

see

can

"Isolation"

chapter)

persons

handling

asbes tos

•

Conducting
where

the

particularly
number

Smaller numbers
and

effectively

that

is

only

noted

time-weighted

the

and

of

operations
the

at

shifts

a minimum.

employees

protected

for Any

the OSHA standard
than

during

is

are more

than

a

easily

larger

group

exposed.

Exposure

no more

plant

exposed
and

occasionally

previously,
of

in

controlled,

Duration

average

dusty

persons

continuously

trained,

casually

Limiting

As

of

of

2

Given Person

for

fibers,

asbestos

is

an

greater

than

5

8-hour

Another administrative measure, which has been used in the British dye­
stuffs industry in connection with cancer control,** would be to give
preference

to job

applicants who

are

of

an

exposed

is

asbestos-related

that

ployees'

the

risk

of

developing

lifetimes will

ure

may have

not

take

some basis

into account

aggravation of

to

asbestos-related.

considerations

somewhat

in

theory with

other

sible
be

be

ject

(because
to

the

of

same

the

The

regard

Moreover,

to lung

need

conditions
there are

to be

greater risk

not

other

explored.
to job

75

have

not

reasoning here
the

em­

while

this

cancer,

it

or

the pos­

even

meas­
does

normally considered
ethical

and

economic

Still another possible
applicants who

to smokers)—would

considerations.

and who

cancer during

However,

asbestos-related diseases

administrative measure—giving preference
smoke

age

asbestos.

reduced.

adverse health

that would

to

advanced

previously been occupationally

appear

to

do

not

be

sub­

*

micrometers in length per milliliter of air; also concentrations must
never exceed 10 fibers per milliliter. This means that during any single
shift, employees may be exposed to airborne asbestos levels above 2
fibers per milliliter so long as such excursions are compensated for by
equivalent reductions in exposure, except that in no instance can the
exposure exceed 10 fibers per milliliter.
As

an

example:

to

an

airborne

is

equivalent

are

subject

remaining
who

had

hour

2-fiber

zero

Or,

of

zero

for

was

exposed

to

a

level of

for

the

remain

on

fibers

level

exposure

using

in

or

and

unimportant

off

shift,

for

any

These

activities

should be
vide

a

It

is

such

clearly

noted

in
a

light

present

greater than 5
count of 50.7

Smoking

and

materials,
practice

of

and

those
5

as

they
The

employees
of

the

to

as

8-

an

air­

long

as

he

per milliliter

in a number

exposure

receives

no

there

is

in

Other

is

counted

are

are

alternation of
a

that

physiological

not

not

work;

is

assumptions

required

will

asbestos

length

zero

but

of

levels

associated with his

microns

payroll)

that

a

person­

factor.

Eating

a strong

corporate

stand

eating,

drinking,

or

to

a

a

change

explained

as

should be

smoking

designated,

decontamination

represents

frankly

(1)

present

for

restricted

established

hour,

deficient

that:

standpoint.

(increased

action

is

than

fibers

available

should be

after

If

pm having

fibers

the

safe work

contrast

on

toxic

against

only

is

economics

lished

followed.

toxicity

force

than

purposes,

submicron

1

by

half

exposed

fiber

the worker

greater

practical

the

Restrictions

visited

other

for

which

long

the day.

covered
first

could be

1

of

hours

shift.

assumed
(2)

be

the

than

averaging
is

fluctuate;

form a

that

For

it

8 hours,

remainder

during

the

4

as

a worker

of

not

(4)

sufficient work
and

effect,

per milliliter

at which,

response;

nel,

hours

for

for

the

no more

exposed

per milliliter,

per milliliter

7

constant,

exposures,
2

of

for

can be

fibers

shift would

example,

fibers

4

exposure

the

9

since,

of

exposure

of

remaining

a shift

exposure

four hours

received

Control

5

a

on

level

level

respects

(3)

to

to

day.

borne

employees
asbestos

a

clean

procedures
in policy,

step

on

being

estab­

the

job.

location

have been
the

taken

change
to

pro­

longer

than

environment.

a

recent

publication

length-to-diameter
microscopy)
in

account

industrial

pm in

length

that

ratio
for

settings

asbestos

greater

fibers

than

3

approximately
and

corresponds

that,

roughly

(using
2Z_ of

hence,
to

430x phase-

all

asbestos

every

fiber

an actual

fiber

i
'

76

Smoking Cessation Programs
Because
asbestos
in

its

in

own

cancer

been

a

lung

on

places*

rarely

of

and

smoking

since

however,
about

have been
state

could

is

be

campaigns
the

hazard

undertaken

It

to

around

health

significant

reduced.

improve

a

the various

governments

public-service media
smoking

and working

smoking

program might

brought

rates

federal

and

the hazards

cessation

smoking

of

tobacco
and

Unfortunately,

tried have

moves

of

cancer,

smoking

although

recent

public

lic

interaction

control measure.

that have

in

the

right,

cessation,
that

of

producing

possible
smoking

educate

efficacy

a

long-term

is

restrict
to

as

programs

of

the

pub­

cessation

programs.

Various
of

this

approaches

monograph with

available

options.

should be

undertaken,

care worker

Work

to

smoking

a view

If

it

is

the

cessation are

providing

decided

that

discussion

in selecting an

Practices,

to

Including

a

be

of

in Appendix

perspective

smoking

should

appropriate

discussed

a broad

cessation

help

to

of

E

the

program

the health­

program.

Housekeeping and

Use

of

Personal

Protective

Equipment

Changes
of

reducing

which

work

•

in work

practices

Mixing
than

•

practices

occupational
may

to

mortar boxes

in

or

fabrication

sent

the

or

•

Permitting power

•

Using
saws

cutting

Jettisoning

of

the ways

in

bags

rather

field

shops

for

from which

insulation

installation with minimal

sawing.

tools

single-point
or

cost-effective way

closed polyethylene

central

cutting

Some

buckets.

material

to

the most

include:

Maintaining
is

be

asbestos.

be modified

asbestos mortar

in

on-site

•

often may

exposure

to be

cutting

equipment

polyethylene

used

and

only

in

chipping

central

tools,

shops.

rather

than

using abrasion.
bags

into

the

product

mix when

possible.
•

Substituting vacuuming
equipment

•

Good

•

Use

of

restrict

19

(as

facilities,

and

discussed

protective

states have
smoking

in

the

passed

public

blowing off

of

machines

and

air.
in more detail below).

equipment

(also

a

23

total

places

restaurants.

77

of

of

discussed below).

antismoking ordinances

recreation,

waiting

rooms

of

87297486

1976,

that

personal

for

compressed

housekeeping

Since

health

with

Housekeeping
Good housekeeping
asbestos.
debris

should be

shift,

these bags

tained

therein,

Asbestos
plant

and

however,

deposited
Nor
to

picked

and

it

spread

on

remote

a

taped

in

shut,

ledges,

labeled

of

airborne

shavings,

bags.
as

to

At

or

the

other
end

the hazard

pipes,

are

and

Vacuum

overheads,

disturbed by

Sweeping

fibers

a satisfactory way
around.

plastic

equipment,

removed.

ledges,

levels

scrap,

of

a

con­

of.

fine

other
of

is

not

entrained

cleaning

the

inaccessible

is

since

the

other

or work

the way

into

cleaning,

and

drafts

to

remove

air and

surfaces.
it

tends

only

recommended method—

Protective Equipment

control measures
reduce

first.

If,

however,

event

creates

personal

ate,

respirators

they

should

previously

exposure

pected

permitted,

reducing

central vacuum system.

Personal

nificantly

to

rejects,

airborne when

be

the

as

placed

floors,

should

the dust

preferably

and

disposed

because

on

such

up

can become

is wet mopping

The

essential

should be

dust

surfaces

activity,
it,

is

Waste materials

discussed

asbestos

these measures
a

potential

protective

and

never

to

as

a

this

and

chapter

they

sufficient,

exposure greater

clothing must

replacement

for

can

must be
or

if

than

always be

an

unex­

To

reiter­

available,

engineering

sig­

employed

the maximum

equipment will be necessary.

protective

serve

are not

for

in

fibers,

but

control mea­

sures .

Respirators

Respirators
repair
in

of

exhaust

baghouses.

method

of

Also,

the

The

use

at

the

best,

devices
are

individual
he

is

the

use

present

to

include:

task,

hair,

such

disposition

always
or

form of

of

respirators
a

as

the

burden

Factors

and

pulmonary

toward wearing

The

type

of

man-powered—will be

some

of

during

asbestos

not

to be

the

respiration

and

a

the

cleaning or
collection bags
only

removal

taken

lightly,
of

be
ones

medical

cardiovascular

thermal

be made

as

considered
such

as

to whether

in

it

is

such

a

oxygen needs

conditions
disease;

however.

the wearer—and,

perform whatever work

that must

feasible
of

products.

is

glasses;

or

the

on

that

and

an

that
deter­
for

may be

psychological

respirator.

respirator needed—for
dictated by

the

78

W.

the

protection may be

physiologic/physical

beards,

during

shakedown

determination must

equipment

do.

necessary

exposures

application of

place

be

during manual

asbestos

a nuisance—a

can

assigned

mination

this

controlling

insulation or

Since

may

ductwork

example,

preceding

factors

powered versus
as well as

by

the

concentration

of

airborne

should

be

rechecked

always

process,

control,

fitting,

maintenance,

The
by

the

Z88.2-1969

and

"American

or

an

there

to

National

concentration

significant

Respirators

be

acceptable

Standards

(The
are

climate.)

cleaning

of

National

fiber.®

whenever

worksite,

elements

American

asbestos

fiber

changes

require

in

proper

effective.

respirator

Institute

Standards

of

program are

(New York)

Practices

for

set

in ANSI

forth

Standard

Respiratory

Protection."

Protective Clothing

Special
be worn by
exposure

clothing,

of

other

because

cal

finished

or

and

if

piece,

without

sures

over

pockets,

A head

cap

of

should

safety

as

they

not

worn

in
a

room and
a

a

is

but

should

to

adhere

to

they

potential

for

curtail

of

coveralls,

cannot

the
are

paper

they

compara­

exposure

can

suits
lead

garment

be

cloth

of

body movement,

coverall

are

chemi­
hard-

to heat
should be

one-

rolled

edges,

and with adequate

clo­

Coveralls

should

be

and

the

clean

each day

plant.

also

required,

and,

and

lightweight

Hard

hats

do

where

the

hats

in

the

form of

canvas

away

plant.

from the

and

and work

clinging

exhaust

afforded by

although

and

The

Either

"contaminated

filtered

them,

not

paper

prevent

are

the

required,

accu­
a

paper

them.

personal

clothes

locker"

restricted work area
remove

or

to

types

also needed.

clothes

room,

some

airtight,

the hair,

under

are

Street

leave

from

coverings,

shoes,

conditions"
kept

in

be worn

are

cuffs,

the

are satisfactory.

fibers

is

perforated by

clothes.

openings.
away

fibers

coveralls,

torn or

almost

covering

caps

Foot
or

causes

Moreover,

street

necessary

surgical-type

the workplace,

protect

protection

eliminate

are easily

never be worn

mulation

they

sparks.

worn

for

and

nonporous,

stress

must

build-up

Disposable paper

action,

outside
to

cotton-polyester material—cotton alone

inexpensive

laundry workers,

only

satisfactory basic

of

static

tenaciously.
tively

to be worn

persons.

The most
preferably made
used,

not

all asbestos workers—not

and

room.

effects

(See

enter

asbestos

fibers

by

Protective

the

using a

equipment

be

kept

equipment
VII-1.)

galoshes,
as

in

long

a

"clean

should be
When personnel

"contaminated

locker"

vacuum equipped with

should

be

removed

87297<j88

79

should

Figure

should

rubber

satisfactory

protective

they

system.

booties,

form is

.w~...

(respirators

last)

and

The

worker

should

the

"clean

conditions"

If

laundering

service,

rather

in writing of
clothing
sealed,

shower

the

in

and

the

put

"contaminated

on

his

locker"

personal

outer

room

lockers.

clothing

in

room.

of work

than

in

clothing

is

done by

an

plant,

the

laundry

service

the

asbestos

should be
and

deposited

then

hazard.

When

vacuum-cleaned,

clearly marked

collected

dampened,

"Asbestos

outside

for

packed

Contaminated

laundering

should

be

advised

laundering,

in

plastic

the

bags,

Clothing—Wet

Before

Handling."

Control

in

Specific Manufacturing

Following are

some

observations

specifically

to

tries

demolition and

and

to

several major

asbestos

exposure

tries

difficult—persons

is

outside

proper work practices,
protective

has

Consuming

on

asbestos

rip-out.

of

risk

be

exposure

milling
are

moreover,

Industries

control

manufacturing
Generally

mining,
at

and,

equipment may

Asbestos

and

as

and

it

relates

using

speaking,

indus­

control

and manufacturing

less

aware

engineering

of

the hazard

controls

of

indus­

and

and

of

personal

lacking.

Textile Production

Control

of

asbestos

presented

a

greater

exposure
problem

asbestos

products.

In

that was

originally

designed

part,

during

production of

than during

this

may be

for

due

processing

asbestos

the manufacture of
to

the

other,

use

of

less

textiles
other

machiner

toxic,

fibrous

materials.

Fiber
combing
by

preparation—which

and which generates

the mixing

Dust

of

from these

involves

heavy

asbestos with

fluffing,

concentrations

another material

operations must

be

controlled by

grading,
of

beating,

dust—is

such

as

cotton or

enclosures

and

followed

and

rayon.

venti­

lation.

Carding,
dry
to

twisting,

processes which,
enclose

eliminate
ture and

slightly
humidity,

spinning,
their

and ventilate,
excessive

humidity

exposures.

by

It

is

positive
and

and

general

usual

the

it

these

and braiding

arrangement,

appears

from

that

current

operations.

of

are

fibers

very

technology
Control

to

keep

the ventilated

to help maintain proper

rate of

air

change

is

of
to

frequent

cannot
tempera­

room at

temperature

often as

are

difficult

room ventilation have been used

practice

pressure

since

and

exposure

weaving,

physical

reduce
a

and
as

one

complete

before

change

Asbestos

dust

is

of

sheet

over

The

low-pressure,

the water
to

minutes,

paper-making
Drying

steamheated

is

it

is

necessary

process
usually

rollers,

which

high-exhaust-volume

vapor

and

to

remove

any

asbestos

to

recycle

the

air

transport

it

dust

involves wet
accomplished

gradually

hoods

away

that

from

that may

be

passing

remove

are

the

materials,
by

used

drying

released

the

the moisture.
to

collect

paper

during

also
the

dry­

operation.

Bulk
or

the

created.

wet

ing

6

Paper

Since much
little

serve

every

cleaning.

beams

are

packaging
is

a

dry

of

paper

products

operation,

but

effective dust-control measures

In

general,

ventilation
serve

the

rates;

use

and

of

the

by winding

local

exhausts

for

this

them
and

on

hydropulpers with

exposure

in

reels,

area hoods

operation.

pulpable bags;

control measures mentioned

to maintain asbestos

spools,

vented

paper making

proper

previously will

at

acceptable

levels.

Asbestos-Cement

Pipe

The

for

prime

manufacture

of

into which

dry

agitated

and

machined,
cement

point

asbestos

at

the

buffed,

at

Automotive

The
brakes

and

Brake drums
beveling

control
sheet

procedures

are

at

in which

the

stage where

the

finished

product

(The

in

the

designed

critical

Clutch

exposure

enclosures

to

is

sand,

Local

essential

is

cut,
and

exhaust
for

proper

Repair

asbestos

air and when brake

should be vacuumed

vat

points.

occurs when brake

operations will have

are

the

asbestos

addition of water,
interim stages.)

exposure

in

the mixing

and

packaged.

and

of

pipe and

introduced

exposure

Brake

clutches

with compressed

is

carefully
the

greatest

and

application

final

curtails dust

control

Sheet

asbestos-cement

ventilation with
dust

and

during
drums

linings

instead
to be

of

repair

are

of

automotive

cleaned

by blowing

are ground
blown out.

controlled

by

and

them

beveled.

Grinding

enclosure

and

and
exhaust

ventilation.

Construction

of

since

exposure
few

to

asbestos

operators

are

fibers

in building

sufficiently

81

localized

construction
to

permit

is

the

87297490

Control
difficult

use

of

enclosures

coupled with
excessive
sawing

or

exhaust

respiratory

exposure

to

or shaping of
of

sanding

finishing

asbestos

Generally,
does
are

not

the

require

securely

dust

and

recharging
by

tape,

in

the

installed

fibers

floor

control

product

on

the

the

as

or

spackling

or

floor

air

of

low

from

and

compounds;

and

tile.

and

since

or

a

on-site

mixing

roofing,

little

periphery

preventing

insulation;

tile,

and

of

necessary

procedures,

help maintain

into

room ventilation

means

during

such

taping,

application of

only

occur

products

extraordinary

General

the

no

siding

asbestos

dust

is

sanding wheel

levels

of

the work area

to

exposure
can be

fibers

created.
evacu­

and

controlled

careful housekeeping.

Much

of

the

substitituions
on using
hazard

exposure

for

asbestos

fibers

high.

and

less

potential

for

already

recent

in place

difficult,

years

to

•

is

exposure

and

during

years

come.

but,

and because

these

to

that

•

dust

can be

introduced,

ground
•

reduced

tools

so

that

and

if

not be

so much

to

reduce

surfaces
dust
the

soaking
to

rip-out
for

the

permit water

soaked

does

less

the hazard:

not

a

fine,

arise

by

from

surface.

possible,

by

sawing or

collecting devices

allowed

fall must

to

fall

in bags

not

be

to

the

for disposal.•

allowed

to

dry—

still wet.
exhaust

system should be

site.

exhaust

should

used

asbestos material

demolition and

punctured

be placed

a high-capacity

efforts

insulation

away.

removed while

the work

Where wetting

hazardous

that

thermal

considerably by

removed,

instead

of waste

during demolition of

potentially hazardous

fitted with dust

should

possible,

control

be

should

at

is

during

surfaces

absorbent

tearing

should be

employed
•

and

removed

but

the health

be

ventilation are not
directed

operations.

82

toward

possible,

isolating

the

87297491

If

of

should

than by

Slurries
they

•

control

the water upon

Materials

fibers

there

the

impingement

emphasis

of

Insulation

asbestos

spray

cutting with

•

of

low-pressure water

rather

awareness

following measures will help

dust

Insulation

as

been reduced by
further

contain asbestos have been

because

insulation—nonabsorbent
to be

asbestos

rip-out

operations will remain

The

Airborne

anticipated

has
and

of Asbestos-Containing

Insulating materials
in

industry

increases.

Rip-out

and buildings

is

the building

alternative materials

of

The
ships

in

asbestos-containing materials,

Demolition and

is

may

spackling,

fibers would

of

that

patching,

of

embedded

A vacuum device
ate

fibers
asbestos

application
and

ventilation.

protection are

Control of Emissions to the General Environment
Air

Pollution Control

Methods
similar

to

variations
ations

for

controlling

those
due

that

for

to

asbestos

controlling

the

special

tive

pressure,
adequately

careful

fibers

cleaning

of

control general

related activities,

use

Control

of water

they

of

are usually

conducted

the

air

in

air

air are

with

asbestos.

some

Since
under

the ventilating

air pollution.

are not

general

community

of

air-cleaning methods mentioned below may be

rip-out.

to

particulate matter,

characteristics

generate asbestos

will

emissions

any

However,

adequate

system

while

the

for many asbestos-

practical

for use

in

pollution

in

case

this

oper­
nega­

demolition
is

or

limited

to

sprays.

The most useful control method is fabric filtration, and design
parameters for successful systems have been published.9-12
The effi­
ciency

of

fabric

filter units

from 952

to 99.9%

removing

the

operation,

Wet
range

and

packaging

requiring

the

use

and may
and

the

size,

are

dry,

Because
when

require

fibers

disposed

collectors

design,

and

out

other

ical

to

power
than

the

air and

recently,

more:

a

little

information

the volumes

significant

recirculated,
plants

the

is

their

further use.

Because
parts

collectors

on

collected

equipment may be

no

same

depending

fibers

they have

proved

to be

for asbestos

attention was

are

required
they

to wear
econom­

less

effective

fibers—yielding,

directed

associated with asbestos manufacturing,

and

a

than
at

efficiency.

Until

large,

the

in

slurry

operate with

disposal.

shell,2 mechanical

are

the

container.

limiting

protective

precipitation has

Pollution Control

published

many

to move

collected

efficiency

for

and

maintain.

Water

waters

is

than

air-pollution-control means
70%

thereby

dry,
dusty

equipment.

Usually,

Although

collectors

can be a

suitable

actual

ranges

operate

Venturi-type collectors—

generally

the

personal
the

and

fibers

in a

expended.

collector

operate and

the best,

no

from

other

of

fractured,

are dry,

removed

Electrostatic
other

energy

disposal

problem.

(cyclones)

scrubbers,

them are

fibers

are

no

The

fibers

units

protective

scrubbers
90%.

the wet

many of

they

to

pollution

as wet

the

dynamic

asbestos

These

for

personal

a water

range

collect

them

pose

Mechanical
efficiency

of

from 50%

to

of weight.

filters

efficiency

filtered

used

the basis

collectors—wet

in

slurry

on

are

most

on such waters.

of wastes have been

amount

of

some

they

number

of

the waste
is

virtually

plants

in manufacturing

form of waste

can discharge

83

toward
there

relatively small.

process water

plants have

situated where

The

and

the

is not
Further­
operations

treatment,

and

process waste

*1

waters to municipal sewers.
Recently, however, increased concern over
asbestos fibers in the air has resulted in (1) conversion of some dry
processes into wet ones and (2) use of water sprays to control dust from
mining and from piles of tailings or gob (low-grade ore), thereby
increasing the potential for water pollution.

Waste Water Treatment Processes
The standard processes for removing suspended-solid wastes from
water have been found to be satisfactory for removing asbestos fibers:
•

Pretreatment—removal of oil, grease, and the larger
aggregates of solid matter.

•

Primary treatment—sedimentation and chlorination

•

Secondary treatment—biological processes such as
aerated lagoons

•

Tertiary treatment

i a

Tertiary treatment—sometimes referred to as "advanced waste
water treatment" or "physical-chemical treatment"—is required if the
effluent from secondary treatment is not considered satisfactory.^
The several means of removing suspended solids in tertiary
treatment including microstraining, diatomaceous earth filtration,
chemical clarification, and deep-bed, granular media filtration.
In microstraining, the waste water is strained through a woven
mesh screen on the surface of a rotary drum that revolves on its hori­
zontal axis.
As the drum rotates, the solids are strained out of the
water and to a position from which they are removed from the drum.
Diatomaceous earth filtration is a form of mechanical separa­
tion that utilizes diatomaceous earch, a finely powdered filter-aid that
is built up (coated) on a supporting medium, to trap solid material.
The fibers removed are mixed in with the filter medium, and both must
be disposed of.
In the chemical clarification process, chemicals such as
aluminum, iron, or calcium oxides are added to the water to coagulate
fine solids.
Coagulation is followed by a flocculation phase, in which
particulates are aggregated into larger dumps that will settle.
This
process if followed by sedimentation, in which the floes that have been
previously formed are allowed to settle to the bottom of a settling tank.
While some of the solid material will have been removed by sedimentation,
the material remaining must be removed by filtration, usually carried

U
■O
fO
CO
84
CO
CO

V

--•A. ■■'

out

in

media

beds
such

of
as

a

porous

sand

Control

The
been

it

is

ingested

asbestos

in

and

might

be

much

as

practiced
the

in most

number

of

systems

useful

as

a

asbestos

been

sand

used

in

filters.

the

(<20,000
shown

of

humans.

oral

plants.

fibers

the

of

has

not

to what

meantime,

asbestos

per

in

liter).

potable water

indicate

that

both

alum and

that

in

they

since

North

filtra­

could

fiber

prove

concentra-

can

polyelec­

be

sand

America,

show
to

simple

and

high

advantage,

plants

reduced

of

and

techniques

results

Even

effective

areas

removal

definite

in

consistently

partially

filtration

In

intake

Preliminary

be

fiber

of

supplies

established

concentrations

study

a

of

Supplies

water

to

one

is

combination

coagulation/filtration

could

to be

Water

been

optimize
This

majority

fibers

a

13

standard

interim measure

results

coagulation

with

of

water-treatment

low-cost

The
trolyte

possible.

or

garnet.

not

that

reducing asbestos

limits

have

has

harmful

as

modification

coal,

nation's

reduced

of

and

the
it

be

method

or

Potable

researchers

minor

sand
coal,

in

some

below-detectable

as

Fibers

conclusively,
asbestos

as

sand,

of

One

tion

Asbestos

of

such

or

opinion

involves

that

medium
coal,

the

should

as

of

extent

established

extent

and

used

filters
and

are

Europe

well.

During
gallons

drinking water
0.06

FTU

1974,

per minute

two

diatomite-filter

removed

source.

over

The

80%

of

turbidity

(Formazin Turbidity Units),

Removal of amphibole fiber seemed
of chrysotile fiber.H
The pilot
conclusions

applicable

to

the

pilot

amphibole
of

the

with

to be
plant

plants

operating

asbestos

fiber

finished water was

over

95%

of

the

at

10

from a
0.05

fiber

or

removed.

significantly better than that
study suggests the following

filtration

of

Lake

Superior Water

at

Duluth:•

•

Several
to

98%

viding
of

•

filter
removal
the best

either

operating
of

as

body

filter

aid

(or

feed

Hyflow Super

and

precoat,

equivalent

continuous

coagulant

the

filter

influent water.

The

operating data

filters

producing

very

feed

grade)
of

indicate

filtered water

difficult

to

operate

turbidity.

85

involve

Cel

that

and

under

in

95%

the

pro­
use

(or equivalent

or

alum-coated

as

precoat

Cat-Floe

significantly more

result

Conditions

B

C-512

plus

polymer

a
to

vacuum diatomite

expensive
that

as

a

means

they would be

conditions

of

high

87297494

of

are

can

fibers.

filtered water would

alum-coated

grade)

conditions

asbestiform

•

A

least-cost-design

plants
life

suggests

and

ceeded

of

water

It

The

is

against

if

turbidity

the

improper

final

hazard

air

or

Hence,

respect

a

cost

increases

of

were

20-year
or

ex­

30,000,000

5.56c

that

for

2.5-3.5

a

equalled

produce

study

plant

alternative

for

per

the

1000

best

pro­

filter-aid would
designed

for

a

FTU.

arising

At

each

step

the waste

asbestos

from

is

in

the handling of

to be

concentrated,

treated—hazards

asbestos-containing wastes
asbestos

desirable

solid waste

improper handling

products

and

to

general waste management

the

from

the solid
isolated,

dis­

the waste handlers

must be

their

is

and

treated with

the

production.

options,

in

order

of

are;18

Waste

reduction—by

substituting
more
•

the

about

otherwise

accorded

The most

•

at

in

associated with

disposal.

reused,

arise.

priority,

FTU

could

day

filtration

emissions

waste material—whether

same

1.9

time

price

of

of

several

designed

Disposal

for

may

the
per

of

plant

suggested

occur

greatest

of,

of

water

potential

posed

a

turbidity

5%

tection

Waste

a

only

gallons
gal.

for

analysis

that

separation

nonhazardous

•

Waste

•

Secure
that

in

aration,

(c)

amount

of

asbestos

and making

used,

the

process

and

concentration—segregating hazardous

wastes.

recovery—reusing
ultimate

precludes

The most
discussed

the

material,

efficient.

Waste
and

reducing

less-hazardous

important
the

disposal—disposal
future

to

landfill

in

a way

reentrainment.

aspects

paragraphs

secure

the material.

of

that

transport,

controlling

follow:

and

(d)

(a)

secure

asbestos

solid waste

identification,
ultimate

(b)

are

sep­

disposal.

Identification

Obviously,
solid waste
waste

stream

if

there

asbestos

issuing

has

from a

can be
not

no

been

control

measures

identified

as

plant—identification and

asbestos-containing materials

as

directed

part

of

then

the

at

asbestos

solid

tracking

necessary.

87297495

86

Separation*
The
that

waste

prevent
tities
are
of

source

should

exposures
of

dry

a

asbestos-containing waste

separated

to workers

slurry,

impervious
provided

during
the

separation.

most

For

generally

plastic

bags.

slurry

does

the

having been

from nonhazardous wastes,

asbestos wastes,

heavy-gauge,
as

of

be

holding

may

also

dry between

disposal.

care

small

satisfactory

Asbestos
not

identified,

taking

to

quan­

containers

be

disposed

collection

and

’

Secure Transport

Waste
out
or

producing
private)

aware

of

the

provide

is

disposed

will

likely

must

be

hazard

15

a

a

integrity

such

off

layer

to

as

to

the

or

of

a

or

tear
bins

must

Control

The
not

See

a

bags,

have

disposal

deep
or

of
is

if
60

an

of

be

(public
are

unless

site.
the

If

they
waste

facility

maintained.

and more-permanent

tight-fitting

asbestos waste
depositing

adequate

centimeters

from waste

may

petroleum-based

much

they

and

disposal

container must

plastic

it

care

as

agents;

is

that

in

nonasbestos-containing waste

dust-suppression
most

upon unless

employees

site with­

community

lids

Care
waste

that will

Disposal

Covering waste with

in

ultimate
plant,

deep

if

also be

a

or

vegetative

soil

needed

hence,

and

and

there

is

covered

earth

that

is

at

is

is

is
no

also

cover
it

(1)

at

in

the more

maintaining

the

an

site,

does

disposal

desirable

or

impermeable

planting vegetation
a

least

established

such vegetative

controlled by

sealing

considered

that

for maintaining

it

can be

site

cover

dust-suppression

(2) by wetting the waste with water
container before disposal.^

as

relied

disposal

that

transit.

disposal"

Emissions

require

be

the waste

or

Ultimate

only

of

of

rip

cans

during

maintained,

resinous

means

proper handling procedures,

conveyance
the premises

not

ultimate

cover.

ultimate

familiar with handling precautions.

centimeters

and

cannot

the
this

on

The

with

services
of

to

practice,

be

Secure

"secure

In

of

The

come

transported

and

closed

taken

containers

be

disposal

can

not

must

emissions.

not

site with

control method

cases.

During Transportation

transportation

significant

Chapter

IV,

source

of
of

asbestos
airborne

Occupational

ore

Exposure,

applications.

87

from mine

asbestos

for

to mill

fibers,

additional

is

generally

although private

details

and

mine-mill

roads

liberated when
by

tarring,

EPA

roadbeds.
matrix,*

be

paved
pass

sprinkling,

chemicals.

be

may

trucks

or

such

as

permit

asbestos

asbestos

tailings

Some

treating

regulations

Manufactured

with

by.

fibers

these

emissions

the

roads

with

no

visible

products

textiles

from which

of

or

can
be

be

reduced

dust-suppressing

emissions

not

spray

can

firmly

asbestos

from mine

embedded

in

materials,

or

mill

a
should

either:

•

Transported

and

stored

in

enclosed,

impermeable,

sealed

areas

•

Wetted
prevent

•

and

covered with

Appropriately
durable

packaged—packaging

enough

to withstand

normal handling,
that warn

aged

used

to

transport

not

be

used

Such

areas

Before

ulations

of

similar material

should

the

areas

asbestos

fiber

or

the
be

bears

the

to

easily

store

posted with
to

should be

to

signs

transport
removed

is

not

areas

used

appropriately

outlined

labels

earlier

appropriately

in

or

pack­

store

other

warning of

the

asbestos

or store

goods,

accum­

preferably

filter.

to

transport

packaged
this

or

should

store
follow

chapter.

U &L&ZL&

protective procedures

or

and

during

thoroughly,

near

in

not

transport

Personnel working
that

leakproof

puncture
visible

asbestos

time

a high-efficiency

asbestos

is

or

hazard.

same

are used

that

abrasion

a vacuum cleaner having

regulated
the

at

that

about

should

goods.

with

and

persons

Areas

hazard.

tarpaulin or

drying

Manufactured products
asbestos

cement,

expected

to

to warrant

containing

asphalt,

result

in

asbestos

plastics,

asbestos

air

and

firmly

the

concentrations

packaging.

88

embedded

like—may
that

not

in a matrix—
reasonably

are high

be

enough

Chapter

VII

CONTROL OF THE ASBESTOS

HAZARD-

MEDICAL MANAGEMENT

A means
can

be

ment

limiting,
related

examination

virtue

of

be hired
exposed
In

of

somehow

other
for

to

to

tos

exposure

jobs

these

or medical

and

screening

cancer have

Composition

The
persons
any

own

of

desired

tional

to

evidence
tude

of

tosis.

asbestos

of

Each

dealing with

net

with

disorders

removal

their

removal

they

necessarily
program.

predispos­
by

asbes­

from exposure

course.

Neverthe­

from asbestos

detection and

by
not

expo­

treatment

than marginally

of

beneficial.

not

hiring

certain high-risk

exposure

and

can be

put

limited,

inevitably,

industrial

these matters

effect

of

the

exposure

a

exposure,

are

effective

causal

problem

Summarized

to

into

by

effect

social

in

and

physician must

develop his

in

preemployment

employment

relation

to

role
is

of

is

individual

in

relation

asbestos

are some

is

average

less

to
most

cancer,

approach
risk of

than what

risks,

relatively higher.

greatest—lung

below

screening

combined

asbestos,

persons whose

to be most

the

diseases

that

be aggravated

that

limit

to be more

discovering

involving

include

asbestos

expected

proved

these

that

preemploy­

Those workers

to

so

early

maintain a workforce whose

disease,
it

likely

after

the

a

policy.

assemble and
oping

for

for

recommend

diseases,

enough

even

to

diseases

during

in a medical monitoring

successfully

situation will be

for

examination

were

yet

considerations.

program

early

risk

and

exposure.

conditions

programs

to which

jobs

particular

The

not

increased

possess

enrolled

progress

population,

recognize

the Workforce

extent
for

political

and

detected

may

to

asbestos-related

intervention may

sure,

is

asbestos

should be

can be

asbestosis

lung

they

involving

diseases,

less,

industrial

persons who have

hopefully,

ing

the

asbestos

attributes

asbestos

this way,

in

to

The approach

convincing

considerations

for

be

occupa­

would be

for which

and

mesothelioma,

to

it would

even without

those diseases

is

devel­

the magni­
and

applying

asbes­

control

8729749S

89

IKnirfiifliig.

over

the

certain

industrially
individuals

Lung

Lung
exposure
related

exposed

on

population by

medical

excluding

from

employment

grounds.

Cancer

cancer
and

is

today

disease.

the most
exacts

frequent

of

cancers

related

the heaviest mortality

Several

risk

factors

smoking

greatly

for

lung

of

any

to

asbestos

asbestos-

cancer have

been

identified:

•

Cigarette
cancer,
tant

•

•

and,

single

risk

of

offspring—has

magnitude

of

cigarette

smoking,

lung cancer

risk of

occupational

cancer

in

an

products;

it

is

from

lung

the most

and,

a

first-degree
shown

cancer

for

together,

exposure

to

to

impor­

the

both

general

factors

carcinogens

expected

to

relative—parents,

confer almost

enhance

the

carcinogens

coal

tar,

mustard

respiratory

gas;

disease may

radium;

increase

as

^

lung

lung

Include arsenic;

petroleum,

nickel;

the

risk of

Such

same

synergistic.

affecting

ethers;

chromium;

the

population

are

asbestos worker.

creosote;

Nonmalignant

in

been

lung

reasonably be

chloromethyl

the mortality

knowledge,

factor.

siblings,

Prior

Increases

on present

A history

also may

•

based

and by­

and

the

uranium.

risk of

lung

cancer.
Pulmonary fibrosis has been noted in association with
lung cancer in persons with scleroderma®and certain rare
hereditary diseases of the lung such as fibrocystic pulmonary
dysplasia^»6 and congenital cystic disease of the lung.? Several
reports

have

associated

chronic bronchitis,
smoking habits.®-**
broad
ables
most

an excess

convincing was

forced

the

cells

of

recently been

substantial
diseases

found

excess

laboratory

mortality

among nonsmoking

among never-smoking

indicate

that

measures

of

lung-cancer
and

the

Aryl hydrocarbon hydroxylase

risk

regardless

include

condition of
(AHH)

is

an

of

inducible

exfoliated
inducible

87297499

90

obstructive
controls.®^

individuals with asbes-

be at increased risk of lung cancer,
duration of asbestos exposure.*®

aryl hydrocarbon hydroxylase

in sputum.

a

of patients with lung cancer or chronic
disease when compared with neighborhood

Experiments with animals
tosis may
level and

of

respiratory

of lung cancer cases that was not present among
And significantly higher rates of impaired

expiration have

relatives
pulmonary

finding

to nonmalignant

blood relatives
case spouses.*®

Possible

lung cancer with

smoking categories and have neglected such important vari­
as duration of smoking and extent of inhalation.*^ Perhaps

attributed

levels

risk of

after taking into account differences in
However, such studies have often employed

enzyme
such

thought

as

are

to

be

responsible

found

in

tobacco

investigators

has

human

appear

tissues

bronchogenic

ing

to

Inducible

cigarette smokers

lung

that

be

cancer.

At

converting hydrocarbon

to

an

levels

higher

enzyme

those

present,

active

of

genetically

carcinoma have

controls.16,17
among

reported

for

smoke

form.

inducible AHH

regulated

levels

levels,

of

and

at

there

are

in

patients

activity

might

greatest

carcinogens
team of

activity

that

inducible

therefore,

individuals
however,

One

with

than

indicate

risk of

numerous

develop­

difficulties

with the assay technique even in the most experienced laboratories, and
the method is not ready for general use.18
Furthermore, the associa­
tion between levels of inducible AHH activity
been firmly established.^

Examination
assess

the

observed
ring

state

to

of

exfoliated

of

the human

develop

over several

after

a

years.

cells

found

and

in sputum has

tracheobronchial

series
These

of

gradual

changes

cancer has

tree.

yet

been used

Cancer

cytological

have been

not

has

changes

categorized

to

been
occur­

into

stages of regular squamous cell metaplasia, various degrees of a typical
squamous cell metaplasia, carcinoma in situ, and invasive carcinoma.^
The

more

severe

developing
to

lung

complement

time,

the

effects
tation

the

all

Persons

capable

with

jobs

any

risk
use

factors

this

risk

age,

and

for
of

of

reflect

cytologic

factors

is

the

likelihood

sputum

above since,

technique

cytopathology

squamous

asbestos

listed

factors,
of

greater

examination

cells must

accurate

the

reveals

atypical

involving

risk

of

of

the

Cytological

exfoliated

operating

examination

than moderate
for

of

the widespread

of laboratories
samples.22

sputum

cellular changes,

use of

condition

of
to

the

cancer.21

the

at

any

present

lung

cancer

cell metaplasia would

one

A great
is

the

interpretation of

severity

of
used

interrelated

latency.
at

can be

limi­
paucity

sputum

or whose

equal

to

best

not

or

greater

be hired

exposure.*

Mesothelioma

Little
cause

of

is

known about

mortality

susceptibility

in asbestos workers.

to mesothelioma,
Persons

an

who have had

important
an

91

87297500

The evidence that asbestos is causally related to laryngeal cancer is
highly suggestive, but not as overwhelming as it is for lung cancer and
mesothelioma.
Therefore, the exclusion from employment of individuals
with other risk factors for this disease would probably be less bene­
ficial.
It should be noted, however, that except for family history,
the risk factors identified for lung cancer generally apply to cancer
of the larynx.
Risk of laryngeal cancer has, in addition, been corre­
lated with alcohol consumption.23-25 This cancer is rare, and most
susceptible persons will have been screened from employment in efforts
to exclude persons with elevated risk of lung cancer.

asbestos-related
asbestos

pleural

exposure

effusion

should

be

may

be

at

great

risk,

26

and

further

prevented.

Asbes tosis

Exclusion
disease would
exposure

to

from

employment

likely

asbestos

is

a

mesothelioma, for which
of cigarette smoking,27
antigens,30
and

there

risk

is

to

questioning

Because
disability
piratory

In

general,
early,

oftentimes

the

it would

of

treatment
far

or

primary

protocol

for

most

susceptible

asbestosis,

than

have

for

are more

adverse

lung

of

or

established,31

to

further

in

individuals

with

be

prudent

to hire such

not

cancer

from medical

susceptible

effects

to

for which

suggested effects
and specific HL-A

not been

identifying

of

existing

of

Asbestos-Related

asbestos-related

from satisfactory.

severe

disability

programs
a

for

testing

or

asbestosis.

respiratory
chronic

persons

res­
for

jobs

to

prevent

in mind during

preemployment

tos workers is given

in

of

and

Table

Diseases

diseases,

Cure

is

supervenes

early

false sense

efforts

kept

for
who

Treatment

instilling

must be

for

exposure.

is

death

persons

factor,

asbestosis

potential

Furthermore,

risk

from more
This

the

asbestos

efforts.

for

no method

from asbestosis

Detection and

detected

necessary

individuals

disease,

involving

Early

of

those

efficient

it is not.
However, despite
immunological response,2°>29

factors
date

those

of

prove more

even when

rarely

despite

detection and

security,

which

possible,
of

treatment

run

may

disease by

controlling

the subsequent

discussion.

follow-up medical

and

the best

detract
exposures.
A

examinations

suggested
of

asbes­

7.

Lung Cancer

Screening
tionnaires

at

improving

the

programs
intervals
changes

delphia Pulmonary
rate

of

months
were

only
of

a

12%

more

A semiannual
Veterans

of

of

rely

on roetgenograms

six months

survival

from

Neoplasm Research
of

individuals

negative

detected

which

than

6

months

screening

Administration

as

lung

symptom
33

reported

5-year

tumors were
against

4%

a

ques­

unsuccessful

cancer.32,

program conducted

sputum
12%.21

and

notably

The

survival

detected within
in

in

Phila­

those whose

6
tumors

afterward.

domiciliaries

films, questionnaires, and
operative survival of only

been

Project

whose

roentgenogram,

have

and

among

residents

consisting of

of

stereoroentgen

cytology slides reported a 3-year post­
This study documented a considerable

87297501

92

Table 7
MEDICAL EXAMINATIONS FOR ASBESTOS-EXPOSED WORKERS
Preemployment
Questionnaire: medical history, family history, history of smoking* and consumption of
alcoholic beverages, occupational history
Physical Examination: concentrating on the oral cavity, chest, and abdomen and Including
a digital examination of the rectum
Spirometry:
including measurements of vital capacity, forced vital capacity, and forced
expiratory volume at one second
Chest X-ray:

posteroanterlor and lateral views (14 x 17 inches)

Sputum Cytology
Follow Up
Nonsmokers, Ex-Smokers, and Smokers Who do not Inhale
•

No More Than Mild Atypical Sputum Cytopathology:
ometry, chest X-ray, and sputum cytology

a yearly questionnaire, spir­

•

More Than Mild Atypical Sputum Cytopathology: a yearly questionnaire and spir­
ometry; chest X-ray and sputum cytology every 4 months

•

40 Years Old and Older, At Least 20 Years from Onset of Asbestos Exposure:
add
fecal occult-blood testing and an examination of the oral cavity every 6 months

Smokers Who Inhale
•

Less than 15 years from Onset of Asbestos Exposure:
-No more than mild atypical sputum cytopathology—a yearly questionnaire, spir­
ometry, chest X-ray, and sputum cytology
-More thqn mild atypical sputum cytopathology—a yearly questionnaire and spir­
ometry, chest X-ray and sputum cytology every 4 months

•

15-20 Years from Onset of Asbestos Exposure:
-No more than mild atypical sputum cytopathology—a yearly questionnaire and
spirometry; chest X-ray and sputum cytology every 6 months
-More than mild atypical sputum cytopathology—a yearly questionnaire and spir­
ometry; chest X-ray and sputum cytology every 4 months

•

More Than 20 Years from Onset of Asbestos Exposure:
-Less than 40 years old—a yearly questionnaire and spirometry; chest X-ray and
sputum cytology every 4 months
-40 years old and older—add fecal occult-blood testing and an examination of the
oral cavity every 6 months.

Since smoking is such an important risk factor, breath should be sniffed for tobacco
odor; and in situations where the reliability of smoking histories is in doubt, levels
of expired air carbon monoxide or serum thiocyanate may be used to distinguish cigarette
smokers from nonsmokers. ^
Sources:

Protocol modified from the Mt. Sinai School of Medicine, Environmental Sciences
Laboratory Pulmonary Surveillance Program for Asbestos Exposed Workers.

93

amount
of

inter-

and

intra-observer

sputum smears

of

and

chest

positive

and

suspect

sputum

the

screening

its

specificity.21,34,35

method

Currently,
the Mayo

Cancer

examinations,
months.

At

physicians

by

large

Foundation,

Kettering

examinations

and

at

the

each

check

chest

Clinic

In
ment
the

the presence of

contains
same

frankly

individual

localize

a

tumor

are

tion

is

to

rule

localization

is

not

follows

utilizing

set

achieved,

Initial

results
of

detected

vive

five

years

or more.

determine

thorough
upper

a meticulous

actual

tumors,

which are

and had

a better

cancers

(64%)

•

from

likely

of

lung

However,

rates

of

individuals

to

undergo

to

to

be

more

to

sputum specifrom

and

to
radio­

otolaryngologic

examina­

tract.

If

investigation
if

necessary by

chest

ultimately
ticipants
the

suggest

observation

that

no more

expected
is

needed

Roentgenographically

centrally

the

sur­
order

occult

were

generally

smaller

Most

newly

diagnosed

lung

X-ray

current

to
in

placed,

alone,

and

only

screen were

detection

not

if

the

death

of

and

13%

of

first noted

follow-up

as

pro­

a

it

for

to

becomes

lowering

screening

to be

failure

of

the morale

on,

the program.

94

but

is,

participant was

operated

or

unwillingness

necessary.38-40

program—that

a screening

screening because

resection

To

screen

also might
of

other

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they

medical

line managers

Their

be

asbestos-related

managers

and

Supervisory

the beginning

There

chances will be

and

asbestos

retirees

the materials

tive measures,

about

and

many

of

and miscellaneous

Managers

of

occupational health

evolves,

safety

employer

Managerial

as

are

in prevention

trade

at

general

to be apprised

and

Education

the

listed

familiar with

the worker.

the OSHA occupational

of

newspapers

made

of

toward both

risks

daily

to be

program,

relationship

indicated,

families,

large

education

Groups

union

on

of

plant

accurate,

Target

in

a

and

for

As

to

in-depth

avenue

instruction

the staffs

asked

surveillance

to be

good working

on

be

a medical

results,
If

might

is

of

helpers,

probably higher.

is hazardous,

problem as

disease.

mechanics'

they

they might

should be,

industrial hygiene

and

information

can absorb.

Because he

is

at

the

level

of management

closest

supervisor should be particularly

103

to

the worker,

effective

in

87297511

a well-informed

modifying the behavior of workers since he will be in a position to
motivate rather than commanding or invoking the sanction of regulat ions .

Workers

in

the

While workers
educational
asbestos

Asbestos,

in

efforts,

and who,

and

how

and

buildings,

it.

Well

asbestos

there

are

therefore,

to minimize

machinists,

the

as

as

trades

should be

painters,

shipfitters,

are

Trades

obvious

other workers who may

These workers

welders,

Other,

informed
include

of

and

the

to

asbestos

hazard

dismantle

carpenters,

automotive

of

exposed

those who

electricians,

machinists,

targets
be

brake

ships

marine

and

clutch

repairmen.

Retirees

Because
disease,

it

and

of
is

Other

the

long

who have

where.

The

asbestos worker
that

he

at

longer

Exit

lance.
in

contact

Wherever

plant

cannot be

risk

of

development

provide
to

of

longer has

an

stress

the

obtain

to

for

asbestos

and with

employment

else­

to depart with

the

that material

asbestos-related

need

education,

asbestos-related
retirees

contact with

opportunity

former

health

to

permitted

no

possible,

programs

asbestos

he

and

of

contact with

if

interviews

life-time

in manifestation

to maintain

left work with

misapprehension
no

delay

necessary

persons

is

Former Workers

diseases.

emphasize

the

need

continued medical

workers

smoking

should be

cessation,

for

surveil­

included

and medical

surveillance.

Workers'

In

addition

families
of

in

the

wives

to

learning

mates.

cessation

home
form

often

on
of

Occupational

employee-spouses

been

at

plant

the

fibers

automobiles,

it has

audiences,

reinforced by

the

importance

observed

and

informed

and
that

physician's
than
the

their

program

families.

Professionals

there

are

so many

levels

of

industry

finished

and

penetrating questions

good with mixed

strongly

Health

more

the

contamination by

lunchboxes,
Also,

disease,

about

substances,

combinations

(raw materials,

product manufacturing and

104

of

substances,

intermediate manufac­

distribution),

occupational

87297512

Because

be

informed

potential

samples.

astute,
is

the

be

equipment,

their

ask more

asbestos-related

should

about

souvenir ore

prevention will

turing,

and

clothing,

Communication

industries,

about

asbestos workers

who visit with

office

of

of

smoking

brought

Families

health

personnel

rently

in

use.

are
For

not

in

innumerable buildings

it

is

in

the

a

possible

project

to

in

may

through

manufactured

the

professional's

material’s

presence

Assessment

of

Every
a

which

the

health

Although

tested
they

are

that

parts

of

fiber

it

could

be

knowledge—
or

raw materials

hazard will

sharpen
the

an
as

not

be

possible,

there

education program might
a whole,

some workers

be

are

small

education

as

to

its

are means

worth.
by

judged.

retiring

groups

and

can be

segments

in which

follows:

in

engineering

without

giving

workers

could be

program

to

controls

great visibility
observed

determine
control

if

prior

there

devices

and

safe work practices—

to

the

check-off

to

and after

the

change

their

is

or

a

in

their

in

procedure,
educational
use

of

compliance with safe

practices.

Compliance

in medical

report

chest

for

after

proved

innumerable

knowledge

workers
ability,

in

for

daily

but

pulmonary

telephone

rate would

appropriate

cultural

results,

added

surveillance programs—workers

radiography or

compliance

post-tested

test

such

program should be validated

various

of

effects

the workplace.

after

Basic

demolition,

and he will seek out

and

and

of

is

suspicion,

informally before

only

not

inauguration

the

asbestos

employment,

work

•

of

the

other

Compliance

institution

or

personnel's

for

as

or

untoward

leaving

engineering

•

of

force

renovation

asbestos

on

cur­

insulation

company

faced with

health

substances

asbestos

Value* •

education

participated

•

of

a

of

asbestos-containing

evaluation may

a work

some workers

of

throughout

effectiveness
for

of

the

company's

index

Education's

rigorous

against

Information

the health

While

a

reworking

elsewhere.

during

suddenly be

ubiquity

plant without

all hazardous

possibility

personnel

personnel
the

the

removed

health

industry

Finally,
a

with

being

the

protect

inhalation.
present
i.e.,

that

asbestos

all-knowing about

example,

calls

indicate
to

target

retention of

and

notices,
success

there

information or

and

should be

least

im­

education.

can be

expected

Differences

anxiety
at

and
in

group—groups

common knowledge

often

testing

some

contact with asbestos.
differences

function

in

preof

reading

levels

will

influence

some

rough

indication

altered behavior.

87297513

105

wmjjtk

appendices

Appendix A

ASBESTOS-RELATED AND -ASSOCIATED MINERALS

Minerals
Mineral

Other Than

Asbestos

that May

Species

Morphological

Pyrophyllite

Sometimes
crystals
quartz

Vermiculite

Normally

Attapulgite

fibrous

Lepidolite

as

Minnesotaite
(a

Characteristics

radiating needlelike
kyanite,

and

In

from reef mines.

exhibits

a

flaky

have

crystallizes

structure,

been

but

reported.

in well-defined

fibrous

overgrowths

Commonly

or

granular when

present

on muscovite micas.

fibrous

rather

than platy.

in

form of

talc)

Sometimes occurs

Chamosite

Halloysite
(a

Structure

forms.

Normally

(a mica)

as

Fibrous

feldspars,

varieties

Commonly

clay)

occurs
in

veins

fibrous

(a

Exhibit

fibrous

crystals,

mentary

iron

minute

formations

characterized by
tals,

Holmquistite

similar

times

Richterite

displays

Commonly

(an amphibole)

The

first

three

are

found

in

graphic

have

important

elongated

in aggregates
an asbestiform

exhibits a
habit

fibrous

similar

considered an

to

impurity.

A-l

is

crys­

and

some­

texture.

crystallo­

asbestos.

industrial applications;

connection with commercial mineral

normally

and

tubular

to needles.

Commonly occurs

(an amphlbole)

sedi­

(ironstones)

Frequently occurs with kaolinite

clay)

they are

the

associated with

the others

operations,

where

Minerals and

Rocks

Possibly Associated With Asbestos

Uses

Mineral or Rock
Talc3

Ceramic

applications

porcelain);
and

Phlogopite

(whiteware,

extender

filler for

cosmetics,

packaging of

foods.

A member of

the mica

wall

tiles,

electrical

for paints and pigments;
and

family,

in

lubricant

the preparation and

used in a number of electric

and electronic applications, such as insulation
craft sparkplugs, and as a thermal insulator.'3
A common constituent of metamorphic rocks;

Chlorite

green coloration,

is used

due

in air­

to its

in construction for aesthetic

purposes.
Used in ceramics

Kaolinitic clays

(whitewares,

filler or extender

Bentonitic

industries;

in

and printability;
as a binder

filtering applications;

Fuller's earth)

pharmaceuticals,

Vermiculite

Used primarily

to

as a

and plastics

impart gloss,

opacity,

and in medications.

for iron ore pelletizing;

and a

filler

in

for paints,

cosmetics,

industry as an

insulator

and ceramics.

in the construction

is also employed

industries as a soil
A primary source of

Taconite and simi­

insulators);

paint,

the paper industry

(Montmorillonite,

but

thermal

the rubber,

brightness,

Drilling muds;

clays

in

in the agricultural and horticultural
conditioner.
iron for

the steel

industry.

lar metamorphic
iron deposits
Magnesite and

Used as a raw material

Brucite

fluxes,

for magnesia-containing refractories,

and miscellaneous chemicals

production of magnesium metal.
with magnesite and,
Marblec

as

such,

is used as a

Metamorphic carbonate rock used
applications in construction and

aAlso known as

and can be used in

the

Brucite is often associated
source of magnesia.

for polished stone and other
for sculpture

steatite or soapstone.

^Most phlogopite is

imported

into

country is resticted mostly

the United States.

to small,

noncommercial

Its occurrence in

this

deposits and as an impurity

in certain marbles.
cThe
that

term "marble" is sometimes used indiscriminately
can be polished and

so-called verde antique or serta green,
(serta

green)

is

to describe other rocks

that have a pleasing appearance;
some onyxs,

commonly a serpentine and is

such rocks

and slates.

therefore likely

include

the

Verde antique
to

include

chrysotile contaminants.
Sources:

W.A.

Deer,

N.W.

Hendry,

et

al.

"Rock-Forming Minerals," Longmans Green & Co.,

"The Geology,

York Academy of Sciences,
Malcolm Ross,

"Geology,

Perspectives,

9,

Robert L.

Bates,

Publications,

1974,

132,

Dec.

31,

1965.

Asbestos and Health,'1 Environmental Health
pp.

123-4.

"Geology of

Inc.,

1961

Occurrences and Major User of Asbestos," New

N.Y.,

the Industrial Rocks and Minerals," Dover

1969.
A-2

Appendix B
FEDERAL REGULATIONS OF OCCUPATIONAL EXPOSURE
Definitions and Airborne Levels

8-Hr TimeWeighted-

(1)

Occupational Safety

Scope

of

(Fibers/ml)

Definitions
Longer

Regulation

than 5p using the

Dept,

tion with phase

labor

10

5

membrane filter method
at 400-450x magnifica-

and Health Admin­
istration,

Ceiling

Average

Federal Organization8

c
2

contrast

illumination
(2)

Occupational Safety

(Proposal)

Same as OSHA regulation

and Health Admin­

Does

but adds:

istration

construction work

not apply to

0.5

5

Same as OSHA regulation

5

10

2

length to

diameter ratio of at
least

3:1;

maximum dia­

meter 5p

w
i

(3)

Mining Enforcement

Metal and non-

and Safety Admin­

metallic open pit
mines;

istration
Dept,

of

Interior

vel,

sand,

gra­

crushed stone

operations;

under­

ground mines
(4)

Bureau of Mines

Surface work areas

Longer than 5y;

Dept,

of underground and

width ratio at least 3:1

of Interior

surface coal mines

length/

in 20 randomly selected
fields using phase con­
trast microscopy at 400450x magnification

(5)

Executive Office

Head of each federal agency must maintain an occupational
program meeting requirements of

assure periodic inspections and prompt
ing conditions;

Secretary of Labor is

evaluate and assist each program,
a

Sources:

*|july 1972.
July 1976.

(1)

Code of Federal

(3)

CFR,

Title 30,

ecutive Order

Regulations
Parts 55.5,

#11807,

Feb.

3,

(CFR),
55.6,

1975.

Title 29,

55.7

(1975);

keep records as

(4)

1910.93a;
CFR,

prescribed by

to issue guidelines

and report to President

Part

1970;

abatement of unsafe or unhealthful work­

provide training programs;

Secretary of Labor.

safety and health

the Occupational Safety and Health Act of

(.2)

Title 30,

CFR,
Part

to agencies,

annually.

Title 29,
71.202

Part

(19J6);

1910.1001
(5)

Ex­

Appendix B (continued)
Summary of Provisions

•

Occupational Safety and Health,

Dept,

for Compliance

of Labor—Regulation

Methods of

Specified engineering methods:

Compliance

asbestos

Including local exhaust ventilation of all

fibers In excess of exposure

Personal protective equipment:

Special clothing:
levels

personnel rotation pre­

respiration selection procedures.

Whole body clothing,

exceeding limits.

when spraying,

producing

Respirators—when technically not feasible to reduce expo­

sure by engineering methods or work practice and in emergencies;
ferred to respirators;

tools

limits.

head and foot

Laundering by management.

demolishing,

coverings,

gloves for airborne

Personal protective equipment used

or removing asbestos insulation.

rooms and separate clothes lockers provided to prevent

(For excessive levels,

change

contamination of street clothes

from

work clothes.)
Work practices:

Wet wherever possible;

no asbestos

cement,

or similar material removed from container unless wetted,

mortar,

coating,

grout,

enclosed, ventilated;

plaster

waste which

may produce air levels above limits must be disposed of in closed containers.

Monitoring

(a

Personal and environmental air samples at
be foreseen to exceed limits.

to

least every

6 months if exposures may reasonably

Employees must be notified of excessive exposure and of

action taken.
Medical

Preplacement,

annual and termination chest X-ray

pulmonary function tests

Including FVC,

FEVi.o-

(PA,

14"xl7")> respiratory disease history

Physician determines

ability

to

tolerate

respirator.

•

Education

Caution signs,

Records

Exposure levels retain 3 years.

labels.

Occupational Safety and Health Administration,

Methods of
Compliance

Medical records retain 20 years.

Dept,

of Labor—Proposal

Specified engineering methods:

(Same as regulation.)

Personal protective equipment;

(Same as regulation.)

Special clothing;

Whole body clothing,

levels exceeding limits.

head and foot coverings,

Laundering By management.

when spraying, demolishing, or removing asbestos

9IS£624«8

gloves,

for airborne

Personal protective equipment used

insulation.

Regulated areas; Areas where exposures may exceed limits must restrict access to authorized
persons; maintain a daily roster of persons entering; prohibit eating, drinking, smoking, and

Appendix B (concluded)
Summary of

chewing nonfood Items.

Persons

entering area must wash hands,

drinking,

showers

shall be arranged to separate regulated and

Personal

smoking,

for Compliance

eating,

facilities

Monitoring

Provisions

for street

and

and must shower

clothes

and work clothes

twice

consecutively

ical ventilation every

history,

person at
of

uncontaminated

If

above

to

3 mos.

changed.

limit:

exposure.

of

Clothes

areas.

every

apart,

Measurements

Sputum cytology

required

Physician's written

for

opinion

prior

to

lockers

Separate

3 mos.

no need

of

to

and

storage

if below

limit.

sample unless

the effectiveness

employees 45 yrs old
if

increased risk of impairing health from asbestos

exposure or use

and forearms

of mechan­

3 mos.

tests—same.

with 10 or more yrs

face,

the workshlft.

shall be provided.

from 5 days

reason to believe exposure levels have

X-rays,

the end of

environmental air samples monthly

If under limit

Medical

at

any medical

exposure

and

or

older

condition may place

recommended

limitations

personal protective equipment,

t*
w

Education

Adds

training to include asbestos

of medical

Records

surveillance,

Exposure levels,

medical

whichever greater.
tain 3 yrs.

•

controls,

records,

All records

to be

engineering methods

(Does not apply

•

Executive Office
See page B-l.

6TS&6Z&8

limits

of respirators,

purpose

transferred to

Dept,

of

successor or OSHA if plant

to coal mines.)

or yrs

employed + 20,

changes

hands

or

re­
closes.

Interior

including wet methods,

the nature of

retain 40 yrs

and mechanical ventilation performance:

Respiratory protective devices when exceed exposure
when necessary by

use and

regulated area rosters:

Records of employee training

Mining Enforcement and Safety Administration,
Specified

exposures,

OSHA standard.

the work;

exhaust,
limits,

and dilution ventilation.

engineering methods

respirator selection and maintenance.

not

feasible,

or

Appendix C
MONITORING AND MEASURING ASBESTOS CONTAMINATION

Although
diseases
well

is

the

role

clear,

the

understood,

control

human

and

of

mechanisms

this

exposures

impedes

to

economic difficulties

of

of

not

this

asbestos

chapter—were

the

Which

a^tribute(s)

disease

and

which

therefore

The

asbestos

that

attributes

of

cause

is

of

must

cancer

and

other

causation

efforts

and,

two

to

asbestos
be

and

if

the

facets
it

is

the

that

and

been

and

period

implicated

subject

hazard

actually

accurately;

not

subsequently,

technical

of

over what

have

ar •

concentrations—the

measured

that

measure

As

other

hazardous,

asbestos

of

underlying disease

substance.

enough,

(1)

of

a

measuring asbestos

murky:

amount

as

causes

(2)

of

are

the

time.

in

various

last

four

*
hypotheses

on

asbestos

carcinogenesis

include:
1

•

Size

and

shape

•

Number of

•

Total

•

Type

•

Trace

metal

•

Trace

organic

of

individual

fibers

2
fibers
3
mass

of

asbestos

2
of

asbestos
4
content
content

6

•

Surface

charge

•

Surface

adsorptive

6
Because

of

attributes
indices

cancer

inordinate

based

Because
and,

on

of

and

type of

these

four are

suitable

trace metal

or organic

fallen

is

no

no

be

consensus

consensus

exposure

to

on

on

that which

fibers;

content

the

the

asbestos,

the

of

number of

have

attribute(s)

appropriate

permits

through measurement

individual

the most

detailed

first

fibers;

found at

the end of

C-l

this Appendix.

risk

and
character­

four variables—size

total

asbestos.

of

cause

indicator of

monitoring

the

out

that

"best"

it

References will be

not

mass

of

asbestos;

87237520

shape

"background",

the

In addition,

measuring method will

and

separating

monitoring situations.

therefore,

exposure

of

for routine

there

from environmental

ization of

difficulties

from nonasbestos

of exposure

hypotheses
favor.

the

characteristics

In

addition

to

the

limitations

just

established whether

the

time-course

of

significant

in

possibility

that

as

to

determining

determine

costs

must

be

of

may

these

environment;
those

in

air;

exposures

to

certain

according

to

the

The most
a

water,
used

or

for

in

risk.

important

average

fit

the
of

monitoring

the

individuals.
type

that

to

the

has

dose

not

yet

rate,

leaves

determine

of

the

been

is

open

peak

the

exposures

method

technical
of

circumstances:

asbestos

Also,
of

the

at

difficulties

measuring

occupational

concentrations

environment

is

or
This

because

discussed below,
to

it

exposures.

and

measurement

large

methods

versus

in water

versus

determining

chosen may

differ

concern.

and Methods

desirable

device

as

limitations,

fiber

Monitoring Devices

which

just

chosen judiciously

general
versus

be

measurement

exposure,

carcinogenic

time-weighted

Because of
and

it

mentioned,

means

could measure

a bulk

sample

continuous

of

monitoring in

directly

of

the

material.

monitoring,

is

not

general,

asbestos
Such

a

would

concentration

device,

available

be

one

in

in

air,

which might

for most

be

situations,

however.

Some

Limited-Application Monitoring Devices

Some

devices

for

measuring

general

particulate

contamination

8
fluids—based

upon

the

piezoelectric

light-scattering principles
tions

where

the

asbestos

10

—may

be

balance.

Beta-attenuation,

suitable

concentration is

of

9
or

for monitoring applica­

a known,

constant,

and

relatively

11
large

fraction of

appropriate
community
orders

air,

such

general
purposes

where

of magnitude

appropriate
loading

for

the

the

in surveys

ratio

and

the

as

total

greater
of

particulate

asbestos-pollution

particulate

than

the

industrial

size

of

contamination.

monitoring

loading will be

asbestos
sites,

They

loading.

where

airborne asbestos

the

fibers

12

are

not

in

several
Nor

are

they

asbestos/total
may

fluctuate

2
markedly.

sampling will

continuous
almost

monitoring is

generally not

always be necessary.

C-2

practicable,

87297521

and

Thus,

Monitoring by Membrane Filtration
The

major

membrane
air,

filtration.

stack

media,

it

after

some

gases,
can

The
which

method of

be

the

suspended

a

the

of

filter

the

for

the

be

asbestos

The
sampling

commonly used

fibers

to

12

is

a

material

is

fluid

step

It

in which

the

through

Although

is

also

first

of

to

this

in which

recommended

characteristics

asbestos

for

is

applicable

media.

to

With

solid

that

remain

fibers

trapped

the

be

possible,

(coarser)
smaller

collected

the

is

those manufactured by

change
the

for use

a mixed
the

however,

filter

material
on

asbestos

as

the

are high,

causing an

loading

to

entraps
(including

second

(finer)

some

concentration

filter

in

entrapped,

dual-filter method has

because

on

filtration,

the medium is

of other particulate material

to be

media

directly

single-step

in

asbestos.

pass

filter best-suited
for

method

and other

allowing much

applications

generally

collection

environmental

digestion procedure.

while

for analysis.

filter

for

concentration

particulate

asbestos)

use

liquids,

final

suspended

concentrations

cannot

a

dual-filter set-up

advantages
and

membrane
food

as

most

larger material

most

to

used

preliminary

together with
utilize

The

v.ater,

procedure

all

monitoring in

is

low

the method

increases,

increasing amount

of

first filter.

in most

environmental

cellulose-ester membrane

Millipore

Corporation),

with

filter

(similar

a

nominal

mean

pore size of 0.45 or 0.8 pm.

These filters will remove, from water,
13
99.92 of asbestos fibers present
and are estimated to be "...almost
14
1002

efficient..."

For

some

for

removal

applications,

of

the

asbestos

fibers

"Nuclepore"

from air.

membrane

filters manufactured

12
by General

Electric

are

most

appropriate.

for scanning electron microscopy of

They

are

collected samples

more

suitable

because

of

their

However, they are difficult to use in direct environmental monitoring,
because they have a high pressure drop at normal sampling rates and a

03

87297522

relatively flat surface and their relative stability in an electron beam.

tendency

to

develop

static

charges,which

makes

them

difficult

to

asbestos

is

handle

*
after

sampling.

Measuring Asbestos
It

is

roost

attended by
in

Chapter

exposure

probable

greater
III).

to

be

that

inhalation of

carcinogenic

Hence,

airborne

tion groups,

in Air

it

is

asbestos,

refined

so

risk

than

airborne
is

ingestion

most

important

as

function of

that

a

those

groups

that

present

time

at

(as

for

discussed
knowledge

various

greatest

risk

of

popula­

can be

ascer­

tained .

tics
of

The biologically

effective

concentration and

of

available

for

inhalation

(in

critical

parameters

to

the

the

particles

individual)

biologically

of

size,

disease.

man)

Suffice

are
it

the

effective

fiber number,
with

are

concentration will be

shape,

Deposition

complex and
to say

that

controlling variable
should be measured,

special

exposures.
asbestos

if

the diameter of

in deposition,
although

As

and

the
with

on

the

Stream

flow rates,

source

flow

rates

characteristics

The

water.

air,

As

to

of

is

breathing

measured.

complex
best

(deposition

in

this

individual

zone

The

function of

asbestos

length is

correlated
the

airways

monograph

fiber

is

important

of

(Chapter

III).

the principal

enough

that both

difficult in practice.

determine

are

there

all

the

studying

part

the

but

to

be

are

this

Research Laboratory has

asbestos

content

representative

seasonal

distribution of

Environmental

recently been

of

some

characteris­

in Water

thermal

of

this

results

may

type

the

be

discussed elsewhere in

sampling of water
care

and

characteristics

are

Measuring Asbestos
The

mass,

deposition

effects

asbestos

in

a

of
on

requires
potential

sources

given body

stratification,

sedimentation,

have

as may

an

effect,

distribution

question

effort,

of

a

of

water.

differing

(for drinking

Committee

of

the

measuring asbestos

the Athens

developed

of

water)

the

system.

Measurements Advisory
the

and

human

(Georgia)

in

EPA

has

drinking

Environmental

preliminary method

for

such

assessment.

*
For

discussions

References

14,

of membrane
20,

24,

25,

filtering that
and

26.

are much

more

thorough,

see

.

87297523

f

In part,

the guidelines given there include:

"It

is

beyond

instruction
waters

are

asbestos
are

This

of

for

scope

field

fibers,
and

size

a

conditions.

Sampling

required

a

these

If a

the

The sampling container
capable

rinsed

at

prior

a

least

two

water

required

is

filled.

It

When

bulk water

the

filter

is

the

and yet

critical,

a method

for

separation

such

generally

rice)

may be

filtration

of

to

any

be

with membrane

filters,

used

method

For
is

organic

fibers

of

the

particle
the

the

a water

should

be

horizontal

sizes.

vertical

objective
supply

is

taken,

distribution,

a clean polyethylene,

least one

liter.

the water

The

that

is

are

not

vessels

obtain

has

screw-capped

bottle

being

approximately one

two

been

samples

collected,
further

it

is

be

sampled
as

liter of

not

from one

for

should

suitable

be
location

filtered

through

analysis.

unresolved
in

preparing

that

may

be

exists.

foods

in measuring asbestos

solid or

semi-solid

contained.

Surface

easily by

liquid

issue

At

the

C-5

(e.g.

straightforward washing

and beverages,

often appropriate,

co-contamination of

food

present,

contamination

filter

simple

followed by
16

remove

These

to

for analysis.

Glass

relatively

techniques.

apply

Food

asbestos

suitable

measured

the

filter prepared

The

is

as

to

in

food

as well

of

to

sampling container should

Measuring Asbestos
most

samples

sample

the

sample

that

meteorological

according

of

A minimum of

desirable

and

place

local

set

shall be

and

the

sampling

Because

distribution of

as

of

matter.

pm or more.

representative

(Note:

containers.)

principles

depth depending upon

take

times with

sampling.

.1

as well

holding at

sampling

membrane

in

to

of

detailed

considerations

a vertical

composited

furnish

particulate

from

designed

to

general

some

of

vary with

vertical

samples

bottle

be

should

carefully

representing

type

temperature

analysis.

the

are

range

may

of

and

There

in water
there

procedure

sampling;

distribution will

the

this

special

distribution

of

of

applicable.

small,

range

the

surface.

no
on
and

filtration,

treatment

to

Analysis

of

The

most valid

asbestos
This

is

Samples—Some Technical

particularly

from air or water.

the

true
In

exposures

are

are

those

to

earlier,

some

Technical

asbestos

optical microscopy.
possible

(fibrous

glass

and
or

complete

based
of

general

the

fibers

the methods

of

can be

asbestos

or mineral wool),
(nylon,

fibers

natural organic

orlon,

etc.)

the majority of

area

such as
cannot

fibers.

(plant

be

the

such

requires

and

Electron diffraction pattern

•

Elemental

a priori,
be

with

filtrations—tend
difficult

to

ashing,

resolu­

for

this

than one

information

separately by

is

using

fluorescence and selected
the determination of

elemental

characteristics.

multiple

the

the

information:

compromises

are

sample-preparation methods

to subdivide

reconstruct

obtaining

X-ray

the analytical methods,

as

or

in most

for which more

identified

transmission electronic microscopy.
techniques

inorganic

composition

fiber must

"heroic"

not

and morphology

air and water,

crystallographic

relatively

following

•

Each

is

characterization and

Dimensions

ruled out

it

or animal),

Moreover,

•

community

phase-contrast

fibers will be below

electron diffraction capabilities,

With any of

for

fibers

microscopes,equipped

composition

of

such

simple matter.

electron

of

surveillance.

from amorphous

the

no

distributions

using electron microscopy

identification of

type

exposure

continuous monitoring

identified by

Complete
18

fiber

of

from electron microscopy,

for routine

without

distinguish

situations

samples

community

fiber-size

tion of the phase-contrast microscope.
-----------------------------------r-----------------------------------------------------------------17,

For

assessment

upon electron microscopy.

already known

justified

However,

to

synthetic organic
monitoring

be

where

Constraints

Constraints

Individual

always

methods

cases,

constant

may

for

for assessment

use of optical microscopy,

referred

Economic

analytical methods

contamination

asbestos

and

Many of

transfers

of

required,

because

especially

these methods—involving
liquid resuspensions,

fibers

into

fibrils.

original

size

distribution.

06

necessary

Thus,

it

is often

87297525

and

For

samples

the

size

in

the

distribution

because

only

a

Economic
The

few

required

small,

needed

require

technical

for

an annual

operating

cover

the

expenses

For
of
the

fiber

The

will

budget

expense

cost

complex,
may

present,

number and

for a

for

a

of

the

require

analysis

mass
a

and
of

costs

of

of

in

run

several weeks

the

is

may

low
be

to

and

their
per

several

continuous
operator

capital

of

and

unreliable

two

or

fringe

be

required.
a

scanning/trans­

benefits,

three

material

thousand

If

and

technicians.

is

the

dollars,

one

not

distributions

sample.

and

investment

sample—when only

size

monitoring

$100,000-$250,000,

installing

salaries,

particulate
and

a

$100,000 will

filter

dollars

for

range

purchasing and

other

in

experienced

the

nearly

and

fibers

may

be

membrane

few hundred

analyses

minimum initial

microscopist

an uncomplicated
is

fibers

seen.

skilled and

support.

mission electron microscope,
overhead

asbestos

distribution

complete

a highly

for new equipment

This will

size

fibers will be

equipment

extensive

concentration of

Constraints

program will

and

which

type

excessive—
may be

sample
and

the

is

obtained
more

sample

analysis.^

Some progress has been made in automating the counting and sizing of
fibers, from photomicrographs,

20 21
’

but these automated methods are based

only upon recognition of fibrous morphology and are therefore unsuitable
for evaluation of "mixed" exposure by fiber type.

Reproducibility of Measurements

tion,

Because

of

there

are

samples

of

the

difficulties

large

variations

air and water,

replicability

and

of

measuring asbestos-fiber

in

the measurement

both within and

duplicability

studies

among

are

contamina­

of asbestos

laboratories.

summarized

in
Several

below.

Although the attainment of an intralaboratory precision of -30Z in
18
analysis of water has been reported,
it is not uncommon for results
C-7

87297526

Asbestos in Water

from duplicate
laboratories

In

a

to

per

liter

In

another

showed

for

to

to

by

more

on

an

million

In another

five

study,

an

order

known

to

per

of

in

one

liter,

in

1976,

on Lake

liter.

laboratories

the

in

There

also

asbestos

is

million

coefficient

of

from about

to

50%

to

considerable

variability

especially

of

Sinai

the

one
group

of

the

two

also

shown

of

liter.

two
of

readings of

evaluated
samples

averages
million

100%.

of

for

fibers

(standard

per

deviation

22

state

replicate

in Table C-2,
authors

that

an

may

show

of

the

individual

be

ten

atmospheric

ambient

are
two

of

orders

analyses

of

differences
in which

value may be

air

in Table
of

C-l

magnitude

higher.

four
of

and

Environmental

given

consistently

study

of

both within

Department

Health

readings were

conducted

The

of

laboratories

laboratory's

magnitude.

reported

per

The

samples.

less

these

than

an

findings

accurate within

a

23
factor of

The
result

or

three

inaccuracy

from several

number of
tion

two

fibrils

in volume

bundles,

(4)

of

of

sample

in values

obtained

found

in

these

fibrils,

and

(5)

its

preparation and

mean.

in

given grid

the

from a

(1)

circumstances:

variability

low-level

a

(3)

(2)

incomplete

the

analysis.

C--8

analysis

statistical variation

squares,

amount

contamination of

specific

of

much

dispersal

material

sample

a

lost

at various

can

in

the

greater
of

87297527

order

Mount

California Department

between

results,

78.7

of

the

These

fibers

readings

showed

The

air,

by

Sinai

showed

analyzed

ambient

from measurements

Mount

each

in

in measurements

analyses

No

made

variation

duplicate

more.

fibers

Superior.

on

and

million

million

other

that

Data

Differences

were

from 1.6

ranged

concentrations,

Medicine

9

Air

laboratories.

samples

or

varied

average)

Asbestos

among

sites

The within-laboratory

divided by

"competent"

to

investigators

water

nine

7.5

the

laboratories

the

seven

laboratory

while

independent

liter.^

reported

different

1975,

contain

variation among and within nine
from five

in

magnitude.

analyses were

sample,

per

workers

below-detection-'imit

replicate

fibers

fibers

competent

reported

of

identical

4.0 million

29.

study

sample

where

by

than

readings

a water

case

laboratories

8.

vary

analyzed

reproducibility

laboratories

0.79

samples

varia­

chrysotile

during processing,
points

during

Table

DUPLICATE ANALYSIS

OF

Asbestos
Sample

Mount

Number

C-l

TEN AMBIENT AIR

Concentration

SAMPLES

(nanograms/meter

Calif.Dept,

Sinai

of

74-000-003

0.6

120.0

74-000-012

44.0

0.4

74-000-023

0.0

13.0

74-000-032

2.7

0.0

73-003-038

2.6

0.0

73-003-046

7.3 a

73-003-054

7.3

0.0

73-003-064

21.0

0.0

74-000-110

46.0

14.0

74-000-119

1.4

2.2

^ith

an annotation:

Source:

Reference

23

"Disregard,
(end

of

this

)

Healtl

<800.0

only

2 fibers observed."

Appendix).

87297528

C-9

j
HA

Table

REPLICATE ANALYSIS

C-2

OF

FOUR AMBIENT

AIR

SAMPLES

3
Asbestos
•Sample

Number

1st

Concentration
2nd

Analysis

(nanograms/meter

)

Average

Analysis

73-003-038

0.0

5.3

2.6

73-003-046

7.6

7.1

7.3

73-003-054

3.2

11.4

7.3

73-00^-064

12.0

30.0

21.0

Source:

Reference

Although
to

be

useful

coefficient
reported
be

a

the

23

(end

this

phase-contrast

for evaluation of
of

for

variation

trained

(for

and novice

Appendix).

microscopic

occupational
sampling and

technicians,

two-fold variation

experienced

of

between

24

it

be

been

demonstrated

exposures,

analysis)

(for

for

has

asbestos

should

results

microscopists

method

recognized

amosite,

and

important

to

that

samples)
a

there

for

fraction of
in using
each

in

a

It

sample

method will

by

Conversions
Fibers

fibers

this

type)

chrysotile.

the

vary

particular

Between

is

also

of

airborne asbestos

by

type

industrial

Counts

by

large

variations

of

asbestos

four-fold

process

Different Methods

recognize
that

and

may

from

25
variation

a

22% has been

of

reference

and

that

will be

also

L
the

visible

(within

being evaluated.

and

Between

Number

of

and Mass.

Because
possible

to

of

the

convert

counts

equivalent

electron

of

Indications

error.

acceptance of any
a study of

size

by

the

microscopic
of

constant

the

phase-contrast

counts,

error

factor

distributions

in measurements,

optical

generally

method

not

to
margins

introduced by uncritical

conversion may be

for airborne asbestos

C-10

is

except within very wide

that may be

for

it

found

in

exposures

in

(a)

872S7529

various

asbestos

microscopic
buildings.
apparent

applied

In

latter

the

can

counts

equated with

illustrated

were

of

fiber

(2)

and

methods

23

correlation,

Nor
be

processes

to

a

comparison of

samples

study,

of

air

optical

taken

variations

by

and

electron

from inside

factors

of

public

20-30,

and

no

found.

visible
levels

dust

particles by

determined

in another study which

by

the midget

impinger method

phase-contrast microscopy,

gives measurements

of

as

both methods

for

26
one

job

at

four

asbestos

increased with midget
plants,
order

it

is

clear

textile plants

impinger

that

the

counts;

limits

Within a
but

of

if

plant,

comparisons

uncertainty are

asbestos

levels

are made across

approximately an

of magnitude.

In

a

1974

tude between
plants

study,

fiber/mass

and mills,

•

•

fibers

important

The

ratios

making any

between number and

Some

there were differences

ratios of

general

environment,

universal

vary

ratios

results

monograph,

to

when

occupational

apply

uncertain

among plant
as
or

well

electron

fiber

a

levels

estimate

asbestos

a constant
at best.

magni­

processing

conversion

factor

26

to

emissions,

as

factors

needed,

of

of

can be drawn:
optical-microscope-

the workplace,

within each of
for

these

conversion of

microscope
factor of

results
50 has

and

fibers.

2% of

that

The

total

the

categories.

optical

micro­

exist.

In

this

been used

to

convert

from optical-microscope-visible

electron-microscope-visible
conservative

to

electron-microscope-visible

fibers

scope

attempt

conclusions

several orders

emission streams

and mass

visible

No

in

of

factor

fibers

is

are

based

to
on

a

optical-microscope-

visible .
• No

single

factor

for conversion of mass

emissions to fiber

emissions

the

to

exists.
•

Fiber/mass
general

ratios

environments,

environment.
per
data

differ markedly

The

and

number

nanogram might well
available

and

they
of

from

occupational

also differ markedly within

electron-microscope-visible

range

from 100-10,000.

for convenience

C-ll

sake,

1000

Based
fibers

on
per

the
each

fibers
the

observed

nanogram

•

has

been

used

in

and

250

fibers

this

monograph

per nanogram for

The monitoring method
but

•

must

depend

Because mass
type

and

upon

of

atmospheric

ambient

chosen will be

electron microscopy

asbestos

can be

fiber

size

means

and

that

that

these

indices

distribution
standard

fiber

can be

deviations

length

and

as

directly

be

a

for

near plants,

each

reference

calculated

fiber

size

application
method.

from asbestos

and number,

it

recorded whenever possible.

completely
of

levels

urban air.

different

electron-microscope-visible

recommended

ing

for

fiber

stated by

length

diameter vary

the

The

geometric

and diameter,

independently of

is

assum­

each other.

REFERENCES

1.

Stanton MF,
in

the rat

587-603,

2.

Gibbs

et

al:

Carcinogencity

in relation

to

fiber

of

fibrous

dimension.

GW,

Hwang CY:

36(6):459-466,

SRI

pleural

Cancer

response

Inst

58(3):

asbestos

fibers

1977.

Physical

parameters

of airborne

in various work environments—preliminary

3.

glass:

J Nat

findings.

Am Ind Hyg Assn J

1975.

International:

Personal

communication with

Nicholson WJ,

October

1976.

4.

Cralley
of

5.

7.

their

Gorski

JR:

FLC:

Studies

oils.

Stettler LE:

Sem GJ,

of

Tsurubayaski

Almich B,
of

Soloman M,

a portable

U.S.

K:

Dept.

NIOSH,

July

carcinogenesis

The

energetics

surface

for and
of

A new mass

Feasibility
Sciences,

sensor

3(11):791-800,

Carson GA:

Education

of

1967.

fibers

1965.

asbestos

minerals.

1974.

A

of

Controls

Washington,

of Asbestos
D.C.,

1971.

for respirable dust measure­

1975.

theoretical

direct-reading particulate mass

Health,

asbestos

Sci 132:439-450,

Need

the manufacture

of

National Academy

Am Ind Ifyg Assn J

in

Ann NY Acad

The

(Ed.):

to metals

28(5):452-461,

Cooper WC

Pollution.

Exposure

Am Ind Hyg Assn J

35(6):345-353,

ment.

9.

Roe

natural

CH,

Lynch

textile products.

Am Ind Hyg Assn J

Air

8.

Keenan RG,

Harrison JS,
and

6.

LJ,

asbestos

and Welfare,

and

laboratory

evaluation

concentration instrument.

Public Health Service,

CDC,

1975.

C-12

87297531

10.

Mercer,

TT:

Press,

11.

Harwood

CF:

Illinois

12.

13.

Aerosol

New York,

Asbestos

Institute

#71-8,

1971.

Spumey

K.R,

aerosol

in

Control

Assoc

Manalan

DA:

et

14.

Lynch

JR,

10(1):

al:

15.

Anderson

April

CH:

5,

GA,

Research

Ewell JB:

18.

on

Techniques

Chicago,

ITT

Research

The

analysis.

Beaman

File

concentration.

19.

20.

21.

22.

Pavlidis

T,

of

Jr.

October

23.

of

asbestos

at

Dorado

exposure.

J

Occup

1976

in

28,

the
Beach,

Med

food,

(Part

drugs

III).

Institute,

April

Proceedings

asbestos

181-186,

Quantiative

determination

Chem 48(1):

101-110,

constraints

The automatic

Society,

Taylor WF,

fiber

to

Nov.

the

asbestos

Perspect

Ann

counting of

The

in water.

microscop

1975.

identification

Joint Conf

8-11,

Carter RE:

concentration

of

evaluation.

3rd

of

SEM.

fiber

1976.

Environ Health

the

in

dust with electron

DM:

Presented at

the

1976.

Ann Occup Hyg 13(3):

dust

to

and biologicals.

for Particulate Matter Studies

and

Fibrous

1976.

Anal

Computer

AL,

for Determining

of electron microscopy

contaminants

Steiglitz K:

air samples.

amphibole

Inc.,

Application

asbestos

1973.

Brown,

Presented

July

Airborne

397-404,

IEEE

asbestos

Air Pollut

Laboratory,

fiber.

nition,

of

J

Environmental Protection Agency,

asbestos

in

filter.

Interim Procedure

U.S.

Approaches

I:

of

1976.

Drug Association,

fication

Harness

State

Document

filters.

membrane

Langer AM:
of

EO

and electron microscopy

identification of

microprobe

DR,

11

removal by

Scanning Electron Microscopy

FD:

Chicago,

Quality,

of Nuclepore

Measurement

Workshop

Pooley

Academic

1974.

problem of particulate

17.

Control.

Parenteral

A Preliminary

Athens,

PP,

Evaluation,

1968.

Environmental

McGrath

means

496-498,

the

Ayer HE:

Asbestos.

16.

The sampling
air by

26(5):

21-24,

Hazard

Air Pollution

Asbestos

Rico,

in

for Environmental

ambient

Spring meeting of
Puerto

Technology

1973.

on

9:

and quanti­
133-136,

1974.

Occup Hyg 16(4):

asbestos
Pattern

fibers
Recog­

1976.

reliability of measures
Environ

Res

12(2):

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1976.

Nicholson WJ,

et

al:

Asbestos

Buildings.

Research

Agency

#450/3-76/004,

Pub.

Triangle

Contamination of
Park,

Oct.

NC,

1975.

C-13

U.S.

the Air

in Public

Environmental Protection

24.

Leidel

NA,

Bayer

SG,

Evaluating Airborne
NIOSH,

25.

26.

27.

TN

84,

Zumwalde
Asbestos

Membrane
U.S.

Filter

Method

Public Health

for
Service,

1973.

Beckett

ST,

Attfield

MD:

counting

of

asbestos

fibers.

Ayer HE,

Lynch JF,

membrane

filter

techniques

plants.

Ann NY

Acad

Harwood

CF,

Control

Technology

Triangle

RD:

Fibers.

Siebert

Inter-laboratory

Fanney

Sci

P,
for

JH:
for

A comparison
evaluating

132:274-287,

Blazsak

TP:

NC,

U.S.

#650/2-74/008,

Oct

1974.

of

17(2):85-96,

of

air

impinger
samples

in

Assessment

of

Sources.

and
asbestos

Particle
Research

Environmental Protection Agency

Pub

87297533

C-14

the
1974.

1965.

Enclosed Asbestos

Park,

comparisons

Ann Occup Hyg

Appendix D

ANIMAL STUDIES

RELATED TO

CARCINOGENIC

EFFECTS

OF FIBERS

Inhalation

Mice

Hybrid mice
chrysotile dust
week
of

for

17

(AC/F^)
at

a

months

were

exposed

concentration of

and were

or

58/127),

than

a

commercial

150-500 mppcf

preparation of

40-60 hours

sacrificed after exposure.

multiple pulmonary adenomas* was

(45.7%,

to

in

controls

A high

observed

in

the

exposed

(36.0%,

or

80/222).

per
incidence

group

Rats

White

rats,

some

of

caustic,

to

chrysotile dust

of whom had

(reportedly

to

received

an

intratracheal application

impede mucociliary

30 hours

per week

for

clearance),

62 weeks

at

were

a mean

exposed

concentration

3
of

86 mg/m

malignanat

.

Of

thoracic

fibrosarcomas,
was

twice

among

72

as

and

rats

surviving

tumors

16 months

or more,

25

(adenocarcinomas,

squamous

cell

a mesothelioma).

great

among

caustic-treated

those who had not been

tumors

in

39

treated

caustic-treated and

Squamous

carcinomas

The

of

the

incidence of
survivors

(10/41

untreated

lung were

or

found

carcinomas,

animals with

(15/31

24%).

control

developed

or

There were

animals.

in 2

48%)

of

31

cancer

as
no

113

Charles

River

3
CD rats

surviving

exposure

16 hours

a week

two

rats

exposed

to

for

tumors
III

of

crocidolite at
No malignant
amosite,

but

5

a

concentration of

tumors were
of

40

49

observed

exposed

to

mg/m
among

chrysotile

pulmonary adenomas.

the

lung.

references—see Apendix H.

D-l

87297534

*Benign

years.

chrysotile or

developed multiple

+Chapter

to

Groups

of

69

Charles

River

CD

rats were

exposed

to

crocidolite,

3
amosite,

or

chrysotile

per week

for

two

years.

developed malignant
carcinoma).
cancers

at

Three

Two

the

carcinoma)

and

.
exposed

,,
115
chrysotile.

In

to

a

produced

similar
a

chrysotile
to

exposed

carcinoma,

a

carcinomas

(a

experiment,

incidence

of

and

amosite,

but

While mass

of

exposed
cell

to

exposure

14%

to

amosite

and

developed

in

of

the

16 hours

the

an

adeno­

thoracic

pleural meso­
a

papillary

two

years

groups
group

three

four

animals

to

among

the

a

and

six months

incidence among

and

developed

cell

concentrations

mg/m

crocidolite,

squamous

for

50

carcinomas

thoracic malignancies
a

about

fibrosarcoma,

pleural mesothelioma

5%

crocidolite.

group

(squamous

group

pulmonary
one

the

tumors

(a broncoalveolar

thelioma) .

concentrations

Among

lung
of

mean

exposed

to

exposed

types

of

asbestos

3
were
and

all about

50

mg/m

1105 million per

In

another

phyllite,

,

counts

of

cubic meter,

study,

respectively.

C/D Wistar

crocidolite,

and

optically visible

rats were

chrysotile

fibers were

54,

864,

114

exposed

(Canadian or

to

amosite,

Rhodesian)

antho-

at

a

con-

3
centration of

12

of

All

exposure.

removal

of

the

theliomas were
and
to

a

single

among

fiber

types

from

found

in

tumors

control

Forty
of

the

duration

of

produce

lung

and

ly

asbestosis

tumors.

In

each

of

observed

animals

relationship

As

carcinomas

account)

to

lung and pleura.

observed malignancies.

into

day

for

varying

lengths

which progressed after

Lung carcinomas

exposed

of

per

asbestosis,

mesothelioma was
percent

hours

and

the

pleural

four

meso­

fiber

types,

among animals

exposed

exposed

for

developed

No

cancers were

such

two

years

found

animals.^

increasing

more

7

produced

the dust.

groups

peritoneal

A dose-response
with

respirable dust

rats

crocidolite.

malignant

mg/m

among

between asbestos

exposure
little

as

animals with
among

an

one-day exposure was

of

lung

groups

cancer was

increasing

pleural mesotheliomas.

(taking severity

addition,

there was

and

asbestosis
tumors

exposed

D-2

length

than among

for only

one

incidence

sufficient

There was
and

noted—

to

significant­
of

survival

those without
day,

of

there were

87297535

significantly

more

lung

tumors

those without

asbestosis.

Intratracheal

Injection

among animals with asbestosis

than among

6

Rats

White
3.5
of

rats

received

mg chrysotile
19

developed

1,

2,

in aqueous

pulmonary

3,

4,

or

6

intratrachael

suspension.

Among

adenocarcinomas.

injections

16-month

Two of

of

survivors,

these had

3

received
113

4

intratracheal

0.14

injections,

one had

3

injections

After administration

of

mg benzo(a)pyrene

carcinogen

intervals,

or

a

mg

No

injection of

epidermoid

mesotheliomas were
28 months.

(a

single

lung papillomas,

2

and

noted

tumors

chrysotile alone

in

in

of

2 mg

injections.

chrysotile

cigarette

smoke)

2 mg chrysotile and

carcinomas,

in

19

49

rats

rats

at

given 3

administered

containing
monthly

5 mg benzo(a)pyrene,

reticulosarcomas,

6/21 and 6/11 animals,

occured
or

in

6

received

and

pleural

respectively,

monthly
a

single

within

injections
dose

of

of

108
5 mg benzo(a)pyrene.

Hamsters

Eight
pulmonary
dose
No

of

pulmonary adenomas,
carcinomas

4.5

Among

34

tracheobronchial

developed among

benzo(a)pyrene

tumors were

9

observed

and

in

17

12

31

mg

LVG/LAK hamsters

chrysotile over

animals

receiving benzo(a)pyrene

papillomas,

administered

alone,

9

a

6

and

receiving a

period

of

12 weeks.

chrysotile alone.

tracheobronchial papillomas

161

1 pulmonary carcinoma were

and

The

effect

subcutaneous
in

of

intratracheal

administration of

Syrian golden hamsters.

tube

twice weekly
injected

42

One

rag).

for

20 weeks

one

the start

after

for

dose

studied

administered per

gastric

for

(NDEA)

or

3.5 mg aqueous

12 weeks

(total dose,

in polyglucin suspension was

6 weeks

(total

of NDEA treatment.

D-3

or

was

60 mg),

once a week

asbestos

once weekly

NDEA was

(total

subcutaneously

mg chrysotile

asbestos with oral

nitrosodiethylamine

Aqueous

intratracheally
month

instillation of

dose,
After

6 mg),

injected

beginning

8-10 months

of

21/52

87297536

NDEA was

reported.

and

14/51 animals

the

groups

tively.
or

developed

receiving

Among

asbestos

Intrapleural

asbestos

control

alone,

benign

groups

only

1/50,

and

and malignant
oral

NDEA or

pulmonary

tumors

subcutaneous

NDEA,

receiving oral NDEA,
3/47,

and

0/50

subcutaneous

among
respec­

NDEA,

developed pulmonary

tumors.

162

Injection

Mice

Two of

75 BALB/c mice

crocidolite

In aqueous

tumors were

observed

receiving

intrapleural

suspension developed

inoculations

pleural

tumors,

of

but

10 mg

no
163

among

75 mice

injected with 10 mg chrysotile.

Rats

A single
chrysotile
an

dose

as

20 mg of

from various

incidence of

little

of

crocidolite,

sources

amosite,

administered

to

CD Wistar

pleural mesothelioma ranging from

0.5 mg

chrysotile

or

crocidolite was

anthophyllite,

19%

to

sufficient

rats

or

produced

70%.

Yet

as

to

Induce

.
,,
107
mesotheliomas.

Various
pleural
_ __
ICI

asbestos

injection

types

appeared

The

casting

doubt

to be

upon

Sprague-Dawley,

carcinogenic

response

following

intra­

CFY and Wistar/Alderly
to

chrysotile

and

107,117
dose-related.'

Oil-extracted asbestos

thus

induced mesotheliomas

in Osborne-Mendel,

107,108,161,11
rats.
’
’
’

crocidolite

have

gave results similar

the hypothesis

to untreated

that natural oils

samples,107,164

and waxes,

166,167
contaminant

oils

from

the milling process

or

organic materials

168
originating from storage
carcinogenicity of

It has

in plastic

or

jute bags

contribute

to

the

asbestos.

also been suggested

that metal

contaminants

added

during

113
processing of
Subsequent

fiber play

experiments

ment with acid,
metal

base,

contaminants;

fibers not

exposed

and

(2)
to

a role

in asbestos

using rats^^*^

carcinogenesis.

have demonstrated that

ethylene diamine

selecting asbestos

treat­

tetra-ascetic acid

to

samples

interior

containminating hammermills;

D-4

(1)

from among
or

(3)

remove

using different

87297537

samples

of

the

trace metals

same

did

heating samples

asbestos

not
for

type

produce

containing different

different

two hours

at

tumor

yields.

900-1000°C

quantities
By way

resulted

in

a

of

of

contrast,

substantial

169
loss

of

carcinogenic

Fiber

diameter

determinants
(Union

of

activity

and

in

length,

rats.

in

addition

carcinogenic potency.

Internationale

Contre

le

individually

mixture.

each

higher

Injection of

yield

superfine
cial

The highest

chrysotile

asbestos.

to

subsample

of mesotheliomas

ence material.

Eight

Cancer)

chrysotile were milled

a

finer

rats

by water

of

may be

subsamples

important

of

U.I.C.C.

reference

Canadian

powder

intrapleurally

tumor yield

Carcinogenicity was

shape,

standard

in Wistar

prepared

to

the

resulted

than did

all was

than

the

of

in

a

pooled

produced

sedimentation

standard

by

Grade

correlated with number

a
7

of

refer­
separate
commer­

fibers

107
less

than 0.5pm in diameter

On
pleura

the
of

other hand,

considered
By

to be

contrast,

after

It

must

crystalline

in

of

fibers

be kept

Guinea

less

injection of

crocidolite.

An apparent

injection of

asbestos

and

10,

in pulverized

25 mg,

thus

length

specimens,

fibers

(see

of

reduced
5-10pm,

were

and

size.

"Intraperitoneal
fully

potent

in

alter

Inducing
the

effects.

Syrian hamsters

amosite,

anthophyllite,

relationship was

respectively.

induced

among

observed
50

dimensions,

greatly reduced

D-5

fibrogenic

activity.

or

for

animals

Prolonged milling,

to submicroscopic

after

by

which

eliminated
109

carcinogenic effects

the

greater

influence biological

in Golden

mesotheliomas

fibers

than

to

pledget

prolonged milling may

dose-response

Or

the majority of

than 0.2pm and

10 mg chrysotile,

9

glass

it

Rabbits

developed

and

coated

applying

87237538

reduced

1,

a

5pm long were

that

4,

before

injection

than

and

of

less

in mind

Pigs,

intrapleural

with 0,

than 10pm long.

carcinogens

intraperitoneal

Pleural mesotheliomas

chrysolite,

diameter

effective

structure of

Hamsters,

by means

greater numbers

less

Injection" below),
tumors.

rats

Fibers

which were present

greater

pulverizing asbestos

Osborne-Mendel

carcinogenicity.

and

-*■ —.mi i —>

One

pleural

tumor was

10 mg crocidolite
a

similar

Of
16 mg
one

group

3

in an

aqueous

rabbits

surviving

at

suspension,

least

Injection

(Mice

of

and

but

pigs

inoculated

none were

observed

with
in

12 months

following

injection with

one

22 and

at

Dawley,

and Wistar

rats

occured

following

colite^^,^’^,^^»^^ and

injection of

chrysotile.

tumors

groups

among

injection

to

chrysotile
four

than

as

opposed

5ym long),

mesotheliomas
inguinal
of

injections
5 weeks.

No

343

of

60

BALB/c mice within

in Charles

intraperitoneal
River

of

the

or

(Mice

the

tumor was

vs.

18/33,

276

rats

173

croci-

peritoneal
time

for

somewhat

the

less

from

25 mg

Tumors were
of

Sprague

following

the

days

(99.8%)

incidence was

32%,

injection of

identical,

chrysotile

CD,

incidence of

6 mg chrysotile.

powdered

River

CD and Wistar

virtually

earliest

for

although

(2+5/17,

of

reported

Charles

the

(12/37,

developed

20

Although

to

Injection

CBA mice

in

40 animals was

injections

chrysotile

Subcutaneous

in

observation of

25 mg

standard

of

Rats)

10 mg crocidolite.'*'^

injection with

Peritoneal mesotheliomas were

vals

guinea

2 developed pleural mesotheliomas,

Peritoneal mesotheliomas
18 months

less

50

,
106
24 months.

Intraperitoneal

by

among

inoculated with chrysotile.

crocidolite,

at

observed

produced

fibers
than for

55%).^^

or

and Rats)

injection-site
2+2/13,

1+1/12)

sarcomas
after

10 mg crocidolite,

tumors were

observed

and

three

pleural
sets

peritoneal

of bilateral

amosite,

or

among

controls

15

and

chrysotile

at

inter­

injected with

174
saline.
findings

The

investigators,

and believe

jected directly
these

cavities

A single
chrysotile

to

into

that,
the

through

local
33

in

their

pleural

or

rats.

have been unable

experiments,
peritoneal

the overlying

tumor was

Wistar

however,

to

asbestos

cavities

duplicate
either was

or ulcerated

their
in­
into

tissues.

observed

112

following

injection of

75 mg

(35
fC
O

D-6

OJ

♦* i>

Oral

Administration

One
fed

100

gastric
mg/day

(Rats

and Hamsters)

leiomyosarcoma developed

chrysotile

5

days

among

per week

for

32 Wistar

100

SPF

rats

days

in a

6-month

441

days

on a

176
period.

No

Among

tumor

42

occurred

animals

among

examined

50 mg/kg body weight

chrysotile

asbestos),

cell

1

lung

carcinomas.

2

cholangiomas,
also noted.
days,

2

increased

of

this

only

cell

study
of

Ten

rats

regards

the

filter

fed

did not
or

veloped

malignant

could be

No

tumors

hamsters

for

their

and

and

to

tumors

of

fed

the

fibers

the

group

<0.01)

fed

of

702

occurred.
asbestos

The

filter

the meaning

is uncertain since

asbestos

comprised

administered.

containing

chrysotile,
Groups

in butter

ingested

5% by weight,

of

once weekly
when

1%

28-35
for

rats

16

or

compared with a

asbestos.

containing

other

intrapleural

only when

for

fed

21

10 mg

18 weeks
control

de­

group,

10

tract were observed

chrysotile or

in

groups

of

amosite by weight

of

a

Other Mineral

than asbestos
or

diameter

have been

intraperitoneal
similar

to

that

Fibers

shown

routes
of

of

to be

carcino­

administration—

asbestos

fibers

(less

5pm) .

In

groups

of

32 rats,

intrapleurally with fibrous
inated with

chrysotile,

in

mesotheliomas
brucite
3 of

or

those

occurred

in

18

of

those

"nemalite," which may be
injected with a

D-7

mm

fibroadenomas were

ceramic

injected
contam­

fiber,

87297540

than

2

lifespans.

Mineral

but

adenoma,

fibroadenomas
the

liver

however,

Carcinogenicity of

genic by

in
(p

gastrointestinal

a diet

4

5

lesions which,
the

lung

(52.6%

kidney

surviving an average

5 mammary

significant

1

2 mammary

and

controls

material

crocidolite

related

45

sarcomas,

develop malignancies.

chrysotile
no

reticulum cell
including

diet

filter material
4

asbestos

a diet

asbestos

observed:

malignant

as

of

tumors were

tumors

untreated

carcinomas

an average
day

papillomas,

statistically

half

months

stomach

incidence of

material was

3

Seven benign

Among 49

liver

per

12 malignant

carcinoma,

controls.

after

containing

carcinomas,

16

and

1 each of

in

powder,
tors,

and

the

25 mg,

(26/34,

injected

results were

(attapulgite)

25/34).

Gypsum,
it

sanidine,

biotite,

talc,

relationship was
2 mg,

10 mg,

(21/73),

53%

(44/77),

among

control

and

animals.

in

although
in

observed

tumors

fibrous,

doses

and

2

doses

71%

(55/77),

of

team of

25

in about
gave

a

glass
of

few or

glass

investiga­

injection of

mg and

4

doses

75% of Wistar

low

Non-fibrous

produced
for

another

intraperitoneal

tissue.

hematite)

of barium sulfate,

by

and nemalite—3

dissolves

injection of

72

fibers

noted:

respectively—resulted

perhaps because

response

with

aluminum oxide.In studies

following

palygorscite
of

those

tumor

dusts

no

yield

rats
(3/35),

(pectolite,

tumors.

A dose-

fibers—intraperitoneal

25 mg results

respectively.

in
No

tumors
tumors

in

27%

appeared

Appendix

E

AIR AND DRINKING WATER ASBESTOS

CONCENTRATIONS

FROM SOME PUBLISHED STUDIES

Table

Atmospheric
In

E-l

Concentrations of

Some U.S .

Concentration
(Nanograins/m^)
Average

Berkeley,
Boston,

CA

MA

Chicago,
Dayton,

EL
OH

Houston,

Los

KY

TX

Angeles

(freeway)

Angeles

(control)

New York City,
Manhattan,
Brooklyn,
Bronx,
Queens,
Staten

67

6

0.4-11

14

0.09

0.02-0.15

14

5

4-6

14

27a

Island,

NY

13.2

Port Allegany,

PA
PA

67

8-65

32

6-39

32

2-25

32

3-18

32

5-14

32

2-8

14

45-100

15

10-20

15

15

15

San Francisco,

25

8.7-68

67

DC

21

1.6-40

14

Identified as

8a

70a
15a

20a

PA
CA

13
8.2-41

4

PA

13

43a

9a

NY

67

67

i2a

NY

Washington,

2.1-12

9.5-200

30a

NY

Ridgewood,

Reference)

24

19a

Philadelphia,

a

NY

NY

Pittsburgh,

Range

Source
(Chapter V

5.0

Frankfort,

Los

6.8

Asbestos

Urban Areas

chrysotlle asbestos

by

the authors.

E-l

Table E-2
Asbestos

Concentrations

in Drinking Water

of

Some

U.S.

Communities

Concentration
Micrograms per Liter
Millions of Fibers per Liter
Mean
Range
Mean
Range

7
tsJ

Birmingham, AL
Montgomery, AL
Tuscaloosa, AL
Fairbanks, AK
Anchorage, AK
Glendale, AZ
Globe, AZ
Yuma, AZ
Jonesboro, AR
Little Rock, AR
Van Buren, AR
Alameda County, CA
Burlingame, CA
Contra Costa County, CA
Long Beach, CA
Livermore, CA
Milibrae, CA
Pittsburg, CA
Redding, CA
Redwood City, CA
Sacramento, CA
San Diego, CA
San Francisco, CA
San Francisco, CA
San Francis co, CA
San Jose, CA
Weaverviile, CA
Boulder, 00
Denver, 00

BDL
BDL-.12(C)
0.45(C)
BDL
0.07(A)
0.010
0.114

0-0.075

0.12(C)
NSS
0.27(C)
40
0.
0.
0.
0.618
0.
0.
NSS
0.5
0.0
NSS
0.
1.54(C)
0.6(C)
0.
4.5
BDL
0.007

0.835
0.
0.2-1.(C)

1
0-0.056

BDL “ Below detection limit (less than 50,000 fibers/1.)
MSS - Mot significant (less than 5 fibers in 20 fields).
C ” Chrysotile
A ” Amphibole

0.042

0-0.333

Source
(Chapter V Ref.)
40
40
40
40
40
7
7
40
40
40
45
43
43
43
7
43
43
40
45
43
40
7
6
40
43
43
45
40
6

Table E-2 (continued)

Duluth, MN
Duluth, MN

NSS
0.38
0.29(C)
NSS
NSS
0.30(C)
BDL
5.75
NSS
0.
1.6
0.18(C)
0.
NSS
BDL
0.88
3.98
1.2
0.13(A)
0.16(A)
0.6
0.24(A)
3. (A)
12.4(A)
1.0(A)
39.33(A)
1.62(A)
24
2.3(A)

N>

New Haven, CT
Stratford, CT
Wilmington, DE
Washington, DC
Ft. Lauderdale, FL
Melbourne, FL
Miami, FL
Atlanta, GA
Cairo, 1L
Chicago, IL
Kankakee, IL
Indianapolis, IN
Kansas City, KS & MO
Topeka, KS
Witchita, KS
Ashland, KT
New Orleans, LA
Boston, MA
Bay City, MI
Eagle Harbor, MI
Marquette, MI
Midland, MI
Ontonago, MI
Saginaw, MI
Beaver Bay, MN
Beaver Bay, MN
Cloquet, MN
Duluth, MN
Duluth, MN
Duluth, MN
Duluth, MN

o

Concentration__________________________________________________
Millions of Fibers per Liter
Micrograms ner Liter
(.Chapter V Ref.)
Mean
Range
Mean
Range

0.192

0.-0.574

0.

0.

0-10.

17-74.(A)

1.006

0.417-1.593

19.55
0.03(C)
2.
1.
.001
3. (A)
.0013

0-35.7

420
60
13.3(A)
110

2.7-27.(A)

10.-35.
1.-5.(A)
BDL-0.4(C)
1.1-120(A)

BDL * Below detection limit (less than 50,000 fibers/l.)
NSS * Not significant (less than 5 fibers in 20 fields).
C ** Chrysotile
A * Amphibole

190

30-800

40
45
40
40
40
40
40
6
40
6
45
40
6
40
7
40
45
6
41
42
42
41
42
7
43
42
42
44
42
41
43
40
39

Source

Table E-2 (continued)

Concentration
Micrograms per Liter
Millions of Fibers per Liter
Range
Mean
Range
Mean

87297546

Grand Marias, MN
Grand Marias, MN
Silver Bay, MN
Silver Bay, MN
Two Harbors, MN
Two Harbors, MN
Jackson, MS
Independence, M0
Kansas City, M0
Springfield, M0
St. Louis, MO
Elizabeth, NJ
Jersey City, NJ
Manville, NJ
Buffalo, NY
Elmira, NY
Glen Falls, NY
New York, NY
New York, NY
Niagara Falls, NY
Rochester, NY
Cincinnati, OH
Dayton, OH
Muskogee, OK
Tulsa, OK
Bethlehem, PA
Erie, PA
Malvern, PA
Philadelphia, PA
South Pittsburg, PA

5.
0.
50.

0.02(A)
0.
0.26(A)
2. (A)
1.95(A)
2.5(A)
NSS

140

0.36-0.58CC)
0.07(C)
0.30(C)
NSS
BDL
0.016(C)
0.82
0.13(C)
NSS
BDL
0.
0.
NSS
BDL
NSS
NSS
BDL
BDL
NSS
0.07(C)
16.95
0.21(C)

0.-130.

BDL ■ Below detection limit (less than 50,000 fibers/1.)
NSS * Not significant (less than 5 fibers in 20 fields).
C - Chrysotile
A ” Amphibole

0.119
0.143

0.001-0.977
0.-0.588

Source
(Chapter V Ref.)
42
44
42
43
42
43
40
40
40
40
40
40
40
45
40
40
40
6
44
40
40
40
40
40
40
40
40
7
6
40

Table E-2 (concluded)

Concentration_______________________
Millions of Fibers per Liter
Mean
Range
Newport, RI
Providence, RI
Columbia, SC
Greenville, SC
Chattanooga, TN
Chattanooga, TN
Clarksville, TN
Memphis, TN
Nashville, TN
Abilene, TX
Amarillo, TX
Dallas, TX
Houston, TX
Brattleboro, VT
Crystal Springs, VT
Eden, VT
Enosburg, VT
Jericho-Underhill, VT
North Troy, VT
Quarry Hill, VT
Richmond-Harrington, VT
Charlottesville, VA
Seattle, WA
Seattle, WA
Ashland, WI
Superior, WI
Superior (Wells), WI
Cheyenne, WY
San Juan, PR

Micrograms per Liter
Mean
Range

0.4-1.0(C)
0.409

0.267-0.579

0.13(C)
NSS
0.13(C)
4.7
0.09(C)
1.696
0.43-0.80(0
BDL
0.09(A)
0.
0.
0.11(C)
NSS
0.08(C)
0.05(C)
NSS

0.

0.98-2.2(0
NSS
NSS
NSS
0.850

0.-1.9
BDL-1.812(A)
NSS-2.464CO

0.31(A)
4. (A)
0.03(A)
NSS
NSS

BDL * Below detection limit (less than 50,000 fibers/1.)
NSS - Not significant (less than 5 fibers in 20 fields).
C * Chrysotile
A ” Amphlbole

0.303

20.
1.4(A)
0.8(A)

0.-1.21

Source
(Chapter '

40
7
40
40
40
45
40
7
40
40
40
6
43
40
40
40
40
40
40
40
40
40
6
40
42
44
42
40
40

Appendix F
SMOKING CESSATION PROGRAMS

Although a number of different program strategies may reduce smoking
rates, significant long-term cessation of smoking is rare.

Most reviews

indicate that the greatest rate of recidivism occurs between 1 and 5 weeks
following treatment, when only 30% of those who had been abstinent at the
end of treatment report continued abstinence.

Follow-up at 3-18 months

indicates approximate cessation rates of 20%-30%.

One report noted 18%

cessation at 5 years after treatment.^
Most smoking cessation programs have enrolled volunteers, who may
have been motivated to quit on their own.

Since 16% of persons who quit

by themselves have been reported to remain abstinent one year,

2

the 20%

to 30% rates of abstinence achieved 3 to 18 months after smoking cessation
programs suggest that formal cessation programs may be only of modest benefit.
Such programs, however, may be substantially beneficial for persons who might
not have been able to quit on their own.
The discussion in this Appendix is intended to provide a broad per­
spective of the available options.

There are several published works that

provide a more comprehensive review of the subject.^’^’^’^’^

Counseling by Health Professionals
When they advise patients to quit or reduce smoking, health profes­
sionals, particularly physicians, serve as agents of behavior change.
One report described the results of a physician counseling program in
which 100 surgical patients were seen for a brief interview during which
the health hazards and financial burdens of smoking were discussed.
one year, 30% of males and 11% of females had stopped smoking.

After

Following

another such program, which included medical lectures, physical examinations,
group discussions and films, the quit rate was 58%, and 29% were still
8 9
abstinent a year later. ’

F-l

r,»;

A number of health organizations have developed visual aids—pamphlets,
films and posters—to assist physicians and others in counseling patients
who smoke.

These organizations include the American Lung Association,

American Cancer Society, National Clearinghouse for Smoking and Health,
and the American Heart Association.

Titles of a number of the visual aids

offered by these organizations are given in the National Cancer Institute's
The Smoking Digest (in press).^

Addresses of the organizations will be

found in Table F-l.

Self-Help Program
A recent Gallup poll (1974) indicated that only 34% of smokers
expressing a desire to quit were interested in attending cessation clinics.
The majority of smokers who became abstinent quit without the use of formal
smoking-cessation interventions.^
There appears, however, to be a great deal of interest in self-help
manuals and kits as judged by the amount of such materials requested during
antismoking campaigns.

A typical self-help manual includes a behavioral

interpretation of smoking, a general explanation of the principles of
behavior change, and specific instructions for Implementing self-control
procedures directed at smoking cessation.

12

For example, the smoker might

be instructed to:
•

List positive reasons for quitting

•

Record the time each cigarette is smoked

•

Note feelings and behavior prior to and during each smoke

•

Reduce gradually the number of cigarettes smoked

•

Impose circumstantial barriers to smoking, such as not
carrying matches

•

Change brands twice weekly, choosing each time a brand
lower in tar and nicotine

•

Increase physical activity

•

Refrain from smoking for 48 hours

•

Avoid situations most closely associated with smoking

•

Find substitute behaviors for smoking

The effectiveness of self-help programs has not been established.

Q5
40
CT
40

F-2

Table

F-l

POTENTIAL SOURCES OF ADDITIONAL INFORMATION
Action on Smoking and Health (ASH)
2000 H Street, NW
Washington, D.C.
20006

(202) 659-4310

American Cancer Society
777 Third Avenue
New York, New York 10017

(212) 371-2900

American Health Foundation
Department of Behavioral Sciences
1370 Avenue of the Americas
New York, New York 10019

(212) 489-8700

American Heart Association
7320 Greenville Avenue
Dallas, Texas
75231

(214) 750-5300

American Lung Association
1740 Broadway
New York, New York 10019

(212) 245-8000

Canadian Council on Smoking and Health
343 O'Connor
Ottawa, Ontario K-2P-1V9

(613) 236-6035

Cancer Information Clearinghouse
7910 Woodmont Avenue
Suite 1320
Bethesda, Maryland 20014

(301) 565-5955

General Headquarters
5 Day Plan to Stop Smoking
Seventh Day Adventist Church
Narcotics Education Division
6840 Eastern Avenue, N.W.
Washington, D.C.
20012

(202) 723-0800

Kaiser Foundation Research Institute
1956 Webster Street, Room 310B
Oakland, California 94612

(415) 645-5000

National Association on Smoking and Health
4155 East Jewel Avenue
Denver, Colorado 80237

(303) 753-0777

(Continued, next page)

F-3

Table F-l

(continued)

National Clearinghouse for Smoking and Health
Public Health Service
U.S. Department of Health, Education & Welfare
Center for Disease Control
Atlanta, Georgia 30333

(404) 633-3311
X 3235 - Tech. Info.
X 3145 - Public Info.

National Interagency Council on Smoking and Health
419 Park Avenue South
New York, New York

(212) 532-6035

Occupational Health and Safety Administration
U.S. Department of Labor
Constitution Avenue and Third Street, N.W.
Washington, D.C.
20210

(202) 523-7081

Schick Center
4101 Frawley Drive
Fort Worth, Texas 76118

(817) 268-1157

Smoking and Health Information Program
P.0. Box 2003
Tyler, Texas 75710

(214) 877-3011

SmokEnders
Memorial Parkway
Phillipsburg, New Jersey

(201) 454-HELP
08865

The Tobacco Institute
1776 K Street, N.W.
Washington, D.C.
20006

(202) 457-4800

Tyler Asbestos Workers Program
P.0. Box 2003
Tyler, Texas 75710

(214) 877-3011

Source:

Adopted from The Smoking Digest. National Cancer Institute
(in press).

F-4

Croup

Therapy

and

Five-Day

Plan

Various health organizations have sponsored community group
smoking cessation clinics, which provide health information, encourage­
ment, and group therapy.

Groups typically involve 8-18 persons and a

group leader, meeting once or twice weekly for a month.

Participants

in the group are informed of smoking risks, asked to describe why they
smoke and to detail their smoking habits, and are then encouraged to
follow one of several procedures for quitting.

Estimates of the effec13 14
tiveness of these programs after one year range from 18%-25%.
’
Higher success rates result from programs stressing formal long-term
maintenance support.
One variant of group therapy is the Five-Day Plan, which consists
of five daily meetings, 1-1/2 to 2 hours each.

Up to several hundred

volunteer participants may be treated at these sessions.

Intervention

strategies range from lectures and inspirational messages to fear-arousing
stimuli and behavior modification procedures.

One such program—a live-in

clinic including lectures, exercise, and individual as well as group therapy—
reported 21%-40% quit rates at a three-month follow-up.^
Isolated use of the nonspecific treatment factors characteristic of
the smoking clinic approach (e.g., suggestion, high expectation of success
in quitting) result in post-treatment cessation rates similar to those of
3 15
clinics that use specific planned intervention strategies. *
A follow­
up of a group of 559 volunteers who had attended such a smoking clinic
(pharmacologic agents, health education, and brief suggestions to use
certain techniques for quitting) indicated that only 18% remained abstinent
at five years.^

Behavior Therapies
The behavior therapy approach assumes that problematic behavior
is a function of a person's learned pattern of interacting with the
environment.

The goal is to teach more adaptive means of responding.

cludes identification of antecedent events that trigger smoking; determin­
ation of thoughts and feelings that influence smoking behavior; analysis of

F-5

87297552

The initial step is a "behavioral assessment," an evaluation that in­

personal smoking behavior (frequency, situations); and identification
of the psychological consequences of smoking.

A number of techniques

may then be used to teach the individual new patterns of interacting
4 12
with environmental smoking stimuli. ’
These techniques can be grouped
into five major categories; systematic desensitization, punishment and
aversive conditioning, stimulus control, reinforcement of nonsmoking, and
multicomponent interventions.
Assuming that it is anxiety that elicits the urge to smoke, attempts
have been made using relaxation techniques to desensitize smokers system­
atically to anxiety-evoking stimuli.^*^’^

However, no substantial effect

on smoking behavior has been reported.
A number of aversive conditioning techniques have been employed to
modify smoking behavior.

Loud noises or electric shocks have been coupled

to smoking or to the urge to smoke, generally with little effect.

12

Two techniques incorporate cigarette smoke as the aversive stimulus:
•

Rapid smoking, which requires the individual to smoke rapidly
and continuously, sometimes in conjunction with drafts of warm
smoky air

•

Satiation, which requires increasing cigarette consumption
over a certain period of time (e.g., smoking double or triple
the usual amount for a week)

In the context of a persuasive interpersonal relationship between
patient and therapist, the rapid smoking technique appears to result
in about 50% abstinence three to six months following termination.

12

While one report of a satiation program indicated 62% cessation four months
19
12
following treatment,
other programs have not been as successful.
Before implementing the rapid smoking method, a medical screening should
be required of participants due to the possible deleterious effects of
increased carbon monoxide levels.

20

Another behavioral technique is stimulus control. This may involve

(e.g., no smoking while drinking coffee, watching TV, or following a
meal) as well as gradually restricting the number of situations where
smoking is permitted.

While (a) there appears to be no clear cessation

F-6

87297553

forbidding smoking in situations where smoking would habitually occur

effect from using this method and (b) a high attrition has been reported
4
frequently, reduction in the rate of cigarette consumption does result.
The reinforcement of abstinence through the use of social or monetary
incentives has been relatively successful.

An example of a technique

incorporating a monetary incentive is the use of a deposit made prior to
initiation of the program.

The money is returned in portions made con­

tingent upon progressively longer periods of abstinence.

Fifty percent

cessation has been reported at six months as opposed to 24% in a group
not employing the incentive.

21,22

Multicomponent interventions have been designed by combining these
techniques.

A number of reports indicate that this approach may yield

high abstinence rates (65% to 100% immediately; 55% to 65% after one
year).23*27

Miscellaneous Individualized Techniques
There are a series of cigarette filters designed to assist smoking
cessation by gradually reducing levels of inhaled tar and nicotine.

The

extent to which this method has been effective has not been evaluated.^
A diverse array of medications—including stimulants as well as
tranquilizers, nicotine substitutes as well as antagonists, and anti­
cholinergics—have been prescribed to assist smokers in overcoming
withdrawal symptoms.

With regard to actual cessation, however, none of
28
these pharmacologic agents has shown any more promise than placebos.
In fact, several studies have suggested that placebo groups may have

higher quit rates.
Very little research is available on the effects of acupuncture
as a smoking cessation tool.

In one study, 50% of subjects were reported
29
abstinent six weeks following auricular acupuncture.
This cessation
rate is similar to those obtained using less invasive techniques, and,
at the present time, the use of acupuncture does not appear to be just lied.
Hypnotic techniques have included attempts to reveal personality

F-7

87297554

conflicts assumed to be major underlying causes of the smoking habit as
30 31
well as direct suggestions to quit.
’
While certain investigators

have reported positive initial results ,
studies.

32 33
’
there have been few controlled

Furthermore, initial successes have not been maintained at

follow-up.

One report of the results of a single session self-hypnotic
3A
treatment noted a cessation rate at one year of 20%.
Using this approach,
another investigator has observed significantly higher rates of recidivism
35
than with group counseling.
Three issues related to smoking cessation—monitoring of smoking
behavior, the "successful quitter," and gain of weight—are summarized
briefly in Table F-2.

Smoking

Cessation Programs

in

Industry

Industry provides an ideal setting for smoking cessation programs.
Industrial programs often have the advantages of:
•

An existing system of occupational health care, which affords
a means of careful health surveillance and follow-up

•

An established network of coimiunications, which permits the
rapid dissemination of health information

•

Peer and management interaction, which provides for social
incentives

•

Readily

perceived benefits

absenteeism,

which

can be

in

terms

of

diminished

assessed against

illness

and

program costs.

While the plant physician may wish to refer workers to smoking
cessation programs outside the workplace, on-site programs reduce lost
time and inconvenience.

The local chapter of the American Cancer Society

would be an excellent resource for information on available outside
programs.

(See also other information resources in Table F-l.)

A number of imaginative industry-based smoking cessation programs
have been established, but as yet there have been no published reports
of their effectiveness.

Several programs have been described

F-8

87297555

Intermatic Incorporated (Detroit) has a no-smoking "parimutuel"
window where employees can bet up to $100 on their ability to
stop smoking for a year.
The company has contributed $1,000 to
be divided among successful participants.
Persons not remaining
abstinent donate their bet to the American Cancer Society.

Table

MONITORING

SMOKING

QUITTER,

•

with

any

critical.
date,

it

desire
to

intervention,

THE SUCCESSFUL

precision

to please,

maintain

with

as

for

denial

accurate

of

The

Successful

Quitter

The

successful

quitter is

his

health,

symptoms,

to be

to

or

1

’

37

at

for

to be

report

major

or

inconsistent
intervals.

and

a man,

to be

"made

it

easier

the

motivation

Such

objective
along

concerned

about

or psychosomatic

tried

spouses

to

36

smoking at

to have
of

used

carbon monoxide,

monitoring.

to have begun

measure

is

reasons which include

fewer neurotic

The behavior

5-year

a

later

to quit on

appears

to quit" were

age,

to be

several
a

spouses who

more

likely

to

also

to

follow-up.^-

Gain
concern expressed by

whether

or not

they will

persons

in

study

Specific
special
be

one

attention

to

those planning to

gain weight.

gained weight
the

Indeed,

after

dietary or behavioral weight management
used

to

good

advantage

Appendix References

in

cited.

F-9

smoking is

three out

giving up

possibility of weight

stop

of

four

cigarettes.

gain—i.e.,

38

a

program—might

pos­

cessation programs.

8729755

Source:

useful

effectiveness

Smokers with nonsmoking spouses,

spouses who

A frequent

sibly

of

the

or expired-air

social milieu,

factor.

remain abstinent

Weight

and

occasions.

significant
quit,

less

smoke

a supportive

previous

to

been

over reporting

likely

older,

treatment

shortcomings,

records

might be

has

a variety

serum thiocyanate

self-support,

have

monitoring of

Although self-support
lacks

measures

•

BEHAVIOR,

AND WEIGHT GAIN

Monitoring Smoking Behavior

As

•

F-2

The Aluminaire Standard Glass Company (Phoenix) has established
a program in which a dollar amount equivalent to what abstinent
smokers would have spent for cigarettes is deducted from paychecks.
At the end of one year the company matches the total deductions
and pays the entire sum to the worker providing he has remained
abstinent.
Sears Roebuck and Company (New York) encourages employees to take
outside smoking cessation courses by rebating a portion of course
fees to those remaining abstinent for six months or more.

An interesting program package including education and social
monetary incentives was implemented at the Dow Chemical Conpany
(Freeport, Texas) in collaboration with the American Cancer Society.
Abstinence was rewarded by a dollar each week, and abstinent workers
were enrolled in monthly and quarterly lotteries for prizes that
included a boat and motor as well as cash awards.
Ex-smokers were
used to recruit program participants.
For each recruited participant
who remained abstinent for one month, the recruiter was awarded a
chance in a lottery.
(Recruiter incentive is thought to provide a
useful source of social mobilization.)39 Of 395 participants, only
15 (less than 4%) continued to smoke at program termination; however,
the lack of adequate follow-up precludes an assessment of long-term
effects.
While these programs are useful in providing rationale and moti­
vation for smoking abstinence, some persons do not possess the skills
needed to quit.

It would be useful to assist such persons through the

use of behavior therapies.

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Appendix

SOURCES

1.

Sources

of

Asbestos

Published

OF

EDUCATIONAL MATERIALS

Educational Materials

Information Association/NA

Materials:

Brochures

on work practices,

scientific
reference

Address:

1835

"K"

articles,

fact books,

conference

reprints

proceedings,

and

of
films;

library.

Street,

Washington,

Asbestos

G

N.W.

D.C.

20006

Information Committee

Materials:

Brochures
control

on work practices,

health

effects,

and

procedures.

10 Wardour Street

Address:

London,

W1V 3HG

England

Asbestos

Research Council

Materials:

Address:

Brochures

on work practices,

procedures,

protective

P.0.

Cleckheaton

Box 18

West Yorkshire,

Congress

of

Materials:

Address:

the United

Pertinent

Document

Materials:

3UJ,

and

disposal methods.

England

Public Laws

Room,

Congress

of

the

United

States,

D.C.

Corporation

Brochures

on work practices,

slides with
newspaper,
of

devices,

control

States

Washington,

Johns-Manville

BD19

ventilation,

sound,

effects,

slides with script,

bulletins,

scientific

health

letters,

articles.

G-l

reports,

films,

video

tapes,

and

reprints

Address:

Health,

Safety

Ken-Caryl
Denver,

National

Environment

Colorado

of Health,

Materials:

"Criteria
disease

Address:

Robert
4676

Document"

Materials:

U.S.

on Asbestos;

and

reports

epidemiologic

of

occupational

investigations.

Taft Laboratories

Columbia Parkway

Cincinnati,

Safety

Safety and Health,

Education and Welfare

research

A.

Department

80217

Institute of Occupational

Department

National

and

Ranch

Ohio

45226

Council

Reprints

of

articles,

safety

data

sheets;

reference

library.

Address:

425

North Michigan Avenue

Chicago,

Occupational

Safety

Illinois

60611

and Health Administration,

U.S.

Department

of Labor

Materials:

Occupational
Subpart

Z,

Brochures

Address:

Sec.

Chemical

Asbestos

Safety and Health

Department

Washington,

Oil,

1910.1001,

Standard:

on OSHA 1970

Occupational
U.S.

Safety and Health

of

Administration

Labor

D.C.

20210

and Atomic Workers

slide-tape

International Union,

Materials:

Poster,

Address:

Citizenship-Legislative Department

cassette presentation

1126-16th Street,

N.W.

Washington,

20036

D.C.

AFL-CIO

Quebec Asbestos Mining Association

Brochures
control

Address:

on work practices,

procedures.

5 Place Ville Marie
Montreal

113,

Quebec,

G-2

Canada

health effects,

and

87297561

Materials:

2.

Possible

Sources

of

Published

American Association

Educational Materials

of Poison Control

c/o Academy of Medicine of
Poison
10525

Information

Centers

Cleveland

Center

Carnegie Avenue

Cleveland,

Ohio

44105

American Medical Association

535 North Dearborn Street
Chicago,

American Public

Center

for

Illinois

Health Association

1015-18th Street,

N.W.

Washington,

20036

Science in

1757

"S"

D.C.

the Public

Street,

Washington,

Interest

N.W.

D.C.

Companies mining asbestos

Consumer

60610

20009

ore

Federation of America

1012-14th Street,

N.W.,

Washington,

20005

D.C.

Suite 901

Consumers Union

256 Washington Street
Mount

Vernon,

New York

10550

Health Research Group

2000

"P"

Street,

Washington,

N.W.,

D.C.

Suite

708

20036

Insulation Industry Hygiene Research Program
Environmental

Sciences Laboratory

Sinai School of Medicine of

of New York
Fifth Avenue and 100th Street
New York,

New York

10029

G-3

the City University

87297562

Mount

Local

affiliates

Association,

of American

and National

Manufacturers

or

fabricators

Mining Enforcement

U.S.

and

asbestos

East

D.C.

products

20210

for Public

53rd

New York,

SOURCE,

American Lung

Department of Labor

Institute

49

of

Society,

Council

Safety Administration

Washington,

Scientist's

Cancer

Safety

Information

Street

New York

10022

Inc.

P.0.

Box

21066

Washington,

State Bureaus

D.C.

20009

of Mines

State

State Workers'

Departments

of Health

Compensation Authorities

Vitalograph Ltd.

8347

Quivira Road

Lenexa,

Workers'

Kansas

Compensation

66215

insurance

underwriters

(casualty insurance

companies)

3.

Proceedings

Public

of

Information

Proceedings
D.C.,

Conferences

of

a

in

the Prevention of

Symposium,

National Academny of

Proceedings

16,

the

1976.

Cancer

December

2-3,

Sciences,

1977.

in

Washington,

the Workplace Conference.

Piscataway,

and Dentistry of New Jersey,

1976.

Cancer.

New Jersey,

1977.

G-4

College of Medicine

87297563

November

of

Occupational

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The hazards

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7.

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IM:

Asbestos

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Environmental Protection Agency:

national

emission standards

amendments

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information on

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JJ,

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P:

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Chicago,

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April

Americans.

air pollution

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California,

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U.S.

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3.

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5.

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9.

Composition

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selected

exposure and health

fiber dust,

US

Rubino

Is

RA:
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the

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Carcinogenesis:

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H-20

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Off No.

Circular

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through

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10.

Harwood

CF,

Technology
088,

USEPA,

available

11.

Harwood

Seibert

CF,

14.

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Asbestos

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In

city

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on Anfclent

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1976.

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Federal

Agency,

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Water Research 9:

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Measurement

of Particle

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removal

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Assoc,

air pollutants:

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controlled

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filtration.

hazardous

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Asbestos:

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as NTIS

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of

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In

GK:

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the lung:

(Lynch HT,

host

Thomas

CC,

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F,

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3.

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4.

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et

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al:

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et

al:

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and

cystic disease

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in

cough,

and

the

lung with

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cancer of

relationship between
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Chest

cancer and bronchitis

et

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The
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Bronchiolar

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50:

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113-119,

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Inst

lung cancer and

$

14.
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15.

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al:

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aryl

25:

Aryl hydrocarbon hydroxylase
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Engl

J Med

289(18):

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Shaw CR:

The

microsomal mixed

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Academic

19.

Paigen
to

20.

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Press,

B,

et

G,

Lillenfeld A

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SRI

al:

23.

Hammond
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Cancer

24.

25.

EC:

JF,

Springfield,

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et

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A

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the

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cancer,

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1975.

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114:

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The

GZ:

lung

1975.

smoking,

T-lymphocytes

their epidemiology

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the

2083-2147,

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Personal

et

1977.

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Immunology and

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31

104:

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Miscellaneous

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In Persons

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chemical

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Genetics.

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Alcohol.

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et

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Administration.

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Development of

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N Eng J Med

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pilot

function

Developmental Biology.

Questionable

cytological screening
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III

1975.

risk.

et

in exfoliated

21.

Inc.,

al:

lung cancer

Saccomanno

Isozymes

radiographs.

and

implications

187-227,

value

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Thorax 23:

of

the

lung and

other organs,

for clinical practice.

Am Rev

1976.

lung cancer detection by
414-420,

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1968.

six-monthly

chest

6ZC8

18.

(VII)

33.

Boucot KR,

Weiss W:

screening?

34.

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35.

chest

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38.

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Early

1977.

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Seidman H,

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Am Rev Resp Dis

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S,

P:

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F,

types

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of

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PC:

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lung

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Scientific

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Quart J

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Cancer 40

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F0,

Lawrenson KB:

Dis

The pathologic

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significance of
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occult blood

87297587

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DR:

Switzerland,

Agency

PC,

of early

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suffering

ILO-U/C

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in

67:

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289-297,

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Chest

Am Rev Resp

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Effects

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International Labour Office:

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a status

Early diagnosis of

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The Philadelphia pulmonary neoplasm

detection

chest X-ray

of pneymoconioses.

43.

interpretation

the interpretation of

lung cancer.

factors

111:

813-818,

Coy

United Kingdom.

42.

lung project

Boucot KR:

research

screening with

41.

in

2122-2144,

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diagnosis of

399-402,

Ann

26:

the

Cancer Res

1975.

Fontana

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in

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A study of variability

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semiannual

1973.

A study of variability

the detection of

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et

lung cancer detected by

1361-1365,

Kordan B:

X-rays

sputum cytology

36.

Is

JAMA 224(10):

7

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47.

Greegor
colon

48.

49.

50.

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Occult blood
Cancer

et

al:

for detection of

131-134,

Sensitivity

and

reproducibility of

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Sherlock P,

Winawer SJ:

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Prolla JC,

Kobayashi

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Expired

measures

of

air

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959-964,

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545-549,

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objective

chemical

false-positive

tests

reactions.

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239-246,

The

on

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asymptomatic

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fecal occult blood with an emphasis

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testing

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Med

51.

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cancer.

Sci

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Arch

calcification

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carbon monoxide

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exposure.

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1.

2.

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of

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Section

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Cancer,

3.

4.

Research

Council:

Cancer.

Washington,

Felton.JS:

Felton

JS:

JS:

and Surg 21:

Geneva,

7.

Scope,

19:

Indust Med 16:

Orientation

107-110,

Committee

of

research

346-350,

in

the

519-525,

about

Sciences,

Objectives,

and

services

of

the

industrial

the health
review.

division

of

Indust Med

1952.

Functions

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p.

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Illinois,

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22.

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CC Thomas,

H-25

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812.

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(Moser RH,

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26.

November 1947.

the new employee by

Organization,

1971).

p.

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Psychosemantics (On Speaking to Patients).
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on Health Education of the Public—First

World Health

National

Occupational

the occupational

May

laboratory—a four-year

March

Z,

of Occupational

and Employers

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Med

Subpart

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Orienting the new employee

(Revised December

8.

XVII,

the Prevention

Sciences,

J Occpp

department.

atomic energy

Expert

D.C.,

Chap.

Health education—a responsibility of

professional.

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in

29,

Informing Workers

health

an

6.

Information

Division of Medical

medical

5.

on Public

Title

(VIII)

9.

Council on
Role

Occupational Health,

of Medicine Within

American Medical

a Business

Association:

Organization.

JAMA

210:

The
(Nov

24)

1969.

10.

Joint

Statement

of

the Role

of the

Registered Nurse

Health Programs—California Medical
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the
p

11.

California Hospital Association,

Associations).

Samuels

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In Public

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in

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of

Help

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and Aerospace Workers,

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GOVERNMENT PRINTING OffICE: 1978 0— 620-009'3905 REGION 3-1

87297589

H-26

AC/
National Cancer Institute

DHEW Publication Number
(NIH) 79-1681

✓