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Occupational Cancer. Part II

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Asbestos and Health Overview Background on asbestos  Uses of asbestos  Health Effects  Risk factors  Medical tests  Proper handling  Standards/ guidelines  What is Asbestos?  Mineral  Fibrous  White/grey  Indestructible  Fireproof How Long Has it Been a Problem? Early Greek miners wore face masks from animal bladders  Insurers stopped selling insurance in 1915  Cancer cases in 1930’s  Asbestos industry withheld information  Selikoff studies in 1960’s  Banning of some uses in 1980’s  Uses of Asbestos  Fireproofing of  Heat buildings insulation  Strengthen building materials Products that can contain asbestos  Spray insulation  Pipecovering  Asbestos cloth  Cements, mastic, sealants  Roofing materials  Floor & ceiling tiles  Plaster & taping compound Hazards of Asbestos  Harmful only when breathed in (maybe when swallowed)  Fiber shape: long, thin  Travels in air, gets deep in lungs  Sharp shape gets stuck in lungs  Doesn’t break down Asbestos Diseases  Asbestosis  Pleural  Cancer Lung Mesothelioma G-I Plaques Tract Asbestos Diseases  No completely safe levels  Higher the exposure, higher the risk  Low exposures have low risk  Everyone exposed to asbestos  Lag time (latency) of 10-40 years  No acute effects Asbestosis  Not cancer Scarring of lungs  From high exposures  Causes shortness of breath  Pleural Plaques Scars on lungs  Shows up on x-rays  Marker of asbestos exposure  Half of heavily exposed will have  “Not a disease”: no symptoms  Does not change into cancer  Legally considered a disease  Lung cancer Most common problem with asbestos  Heavily exposed workers have 5-7 times increased risk over lifetime  About same level of risk as a pack a day cigarette smoking  Interacts with cigarettes: 50-90 times increased risk for both combined  Quitting smoking reduces risk  Other Cancers  Mesothelioma of lining of the lungs Only caused by asbestos Smoking not a risk factor  G-I Cancer tract cancer 2-3 times increased risk for heavily exposed Medical tests  Physical  History  X-rays  Lung function tests What is Risk? Studies are from heavily exposed asbestos workers  Construction trades working with asbestos have 1/4 or less risk than asbestos workers  Chemical plant maintenance has about 1/8  Other maintenance workers are much lower  Asbestos has been phased out & removed in many areas  Safe handling of asbestos Find out where the asbestos is  Management plan  Remove if needed by licensed contractors  Only dangerous if is in the air  may be more dangerous than leaving  If is bound in material (tiles, etc) is not a hazard   Removal Should be labeled if left in place “Safe” handling of asbestos No absolutely safe exposure  Wet methods  HEPA vacuums and respirators  Never dry sweep or compressed air  Stays in air for days  Small fibers can’t be seen  “Friable” asbestos means it can be crumbled  Maintenance & asbestos Do not drill, sand, or saw asbestos materials  Wet mop rather than dry sweep or dust  Do not use a regular vacuum: only HEPA  Do not disturb asbestos materials  If use a face mask, only HEPA  If are air filters, use wet methods, do not shake  Training/ removal  Removal by certified contractors  Enclosures, ventilation, wet methods, HEPA  Glove bags, wetting agents, signs Encapsulation  Training needed based on level of exposure  Level 4 for clean up of asbestos containing materials  Proper disposal while still wet; labeled bags  Regulations EPA regulations on removal  OSHA Standard for general industry or construction  State licensing for asbestos removal  Workers’ compensation  Reporting of suspected occupational diseases  EPA: Control of Asbestos in Buildings Survey to see if asbestos is present  Operations and Management Program  Assess the asbestos  Abatement if needed  Survey Appoint manager & team  Check building records  Locate & document all asbestos in records  Inspect for friable  Collect & test samples  Document  Operations and Maintenance Contact building managers & maintainers  Educate employees and occupants  Train custodians/ maintainers  Clean using HEPA & wet methods; regular basis  Special precautions for construction work  Inspect twice a year  Continue program until all asbestos removed  Assess Asbestos  Assess current conditions and chances of disturbance  Determine Need for further action When it needs to be done What abatement methods to use Conduct Abatement if Needed  Hire To contractor: select: contract Check references Interview Insurance Best, not low bid Precise Managing Abatement Inspect 4 times a day Containment barrier Coveralls & respirators Changing & decontamination facilities  Stop work if problem  Release only when Cleaned at least twice Visual test Airborne asbestos test  OSHA Standard Applies if over maximum exposure  Maximum of 0.2 fibers per cc of air (8 hour)  Maximum of 1 fiber per cc (30 minute)  Exposure monitoring if above action level (0.1 fiber per cc)  Engineering controls where feasible  Proper respirators  OSHA Standard (2)  Regulated  Labels areas for 30 years  Protective clothing  Change rooms & showers  Medical Exams  Recordkeeping
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