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In 1963, it was
found that a large group of asbestos insulation workers in the New York
metropolitan area had experienced unusual mortality during 1943-1962.1
Six hundred and thirty-two men had been on the union's rolls on January
1, 1943. By December 31, 1962, 262 men had died, nine before reaching
20 years on the job. Of those who died after 20 years from first employment,
lung cancer was found in marked excess; 6.02 such deaths had been expected,
and 42 occurred. In addition, there were several deaths due to pleural
or peritoneal mesothelioma and a modest increase in deaths due to, gastrointestinal
cancer, where 9.71 were expected and 29 were observed. There were 12 deaths
due to pulmonary asbestosis (TABLE 1).
EXPECTED AND OBSERVED
DEATHS AMONG 632 ASBESTOS INSULATION WORKERS,
NEW YORK-NEW JERSEY,
20 OR MORE YEARS AFTER ONSET OF WORK,
JANUARY 1, 1943
TO DECEMBER 31, 1962
| |
Expected * |
Observed |
| Total deaths,
all causes |
196.16 |
253 |
| Total cancer,
all sites |
31.44 |
95 |
| Lung
cancer |
6.02 |
42 |
| Pleural
mesothelioma |
1 |
3 |
| Peritoneal
mesothelioma |
1 |
1 |
| Cancer
of stomach, colon, rectum |
9.71 |
29 |
| All
other cancers |
15.71 |
20 |
| Asbestosis |
1 |
12 |
| All other causes
|
164.72 |
146 |
* Nine men died before
reaching 20 years from first employment. Expected deaths are based upon
white male age-specific death rate data of the U.S. National Office of
Vital Statistics from 1949 to 1962. Rates were extrapolated for 1943-1948
from rates for 1949-1955.
†Rates are not available,
but these diseases are rare causes of death in the general population.
* Supported by the
Health Research Council of the City of New York (U-1272).
It had previously
been established that lung cancer was a formidable hazard of asbestos
factory workers and that termination of employment did not abort the risk:
apparently, once sufficient exposure had occurred with continued retention
of asbestos within the lung, risk remained. This factor was of considerable
concern, because a significant number of men were known to have worked
as asbestos insulation workers in the New York metropolitan area, and
many were still in the trade. In addition to the 370 survivors of the
original 1943 cohort, 890 men had joined the insulation union † during
the period 1943-1962, and 879 of them were alive on January l, 1963. Together,
the two groups constituted a total of 1249 men who were either working
regularly as asbestos insulation workers in 1963 or who had been recorded
as having worked regularly at this trade for shorter or longer periods
in previous years.
MEMBERS OF ASBESTOS
WORKERS' UNION ON JULY 1, 1963, ADMITTED TO THE UNION BEFORE DECEMBER
31, 1942. CLASSIFICATION BY AGE AND SMOKING HABITS ON OR ABOUT JANUARY
1, 1963
| |
|
|
|
|
Current
Cigarette Smokers * |
Age
(yr) |
Total
No. |
Never smoked
Regularly |
Pipe,
Cigar
Only |
Ex-cigarette
Smokers* |
1-9/Day |
10-19/Day |
20-39/Day |
40+/Day |
| 35-39 |
2 |
1 |
--- |
1 |
----- |
---- |
----- |
----- |
| 40-44 |
13 |
2 |
--- |
2 |
----- |
---- |
5 |
4 |
| 45-49 |
32 |
2 |
1 |
5 |
----- |
---- |
12 |
12 |
| 50-54 |
109 |
12 |
6 |
26 |
3 |
5 |
33 |
24 |
| 55-59 |
60 |
6 |
5 |
16 |
----- |
3 |
20 |
10 |
| 60-64 |
42 |
7 |
4 |
15 |
1 |
---- |
11 |
4 |
| 65-69 |
49 |
6 |
8 |
17 |
----- |
4 |
9 |
5 |
| 70-74 |
38 |
7 |
7 |
12 |
1 |
4 |
4 |
3 |
| 75-79 |
21 |
3 |
7 |
6 |
----- |
1 |
3 |
1 |
| 80-84 |
4 |
2 |
1 |
1 |
----- |
---- |
---- |
---- |
| Total |
370 |
48 |
39 |
101 |
5 |
17 |
97 |
63 |
*Includes cigarette
smokers who also smoked pipes or cigars.
Before 1963, there had
been no regular surveillance of these asbestos workers, because they were
not aware of their special risk. It was considered that potential benefit
might be obtained if a program of regular medical surveillance could be
initiated, with special focus on the principal risks that had been identified,
namely, bronchogenic carcinoma, pleural and peritoneal meso- thelioma, gastrointestinal
cancer, and asbestosis. Of these risks, lung cancer took first place. In
addition to the risk associated with asbestos exposure, a majority of the
men had been regular cigarette smokers (TABLE 2). Such
history, even in the absence of asbestos exposure, carried a lung cancer
risk of its own..3 (It was later to be learned that the combination
of the two factors, asbestos exposure and cigarette smoking, resulted in
many more lung cancers than would be assumed from mere summation of the
two effects, with asbestos exposure sharply increasing the lung cancer risk
of cigarette smoking.4, 5)
† International Association
of Heat and Frost Insulators and Asbestos Workers, AFL-CIO, CLC, Locals
12 and 32.
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© Copyright
1999, CPWR – Center for Construction Research and Training (CPWR). Report E1-97. Production
of this document was supported by grant CCU312014 from the National Institute
for Occupational Safety and Health (NIOSH). The contents are solely the
responsibility of the authors and do not necessarily represent the official
views of NIOSH. CPWR is the research arm of the Building and Construction
Trades Department, AFL-CIO: CPWR, 8484 Georgia Ave, Suite 1000, Silver Spring,
MD 20910, tel. 301-578-8500.
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