Asbestos‐related disease in public school custodians

Abstract

A cross-sectional prevalence study of 120 public school custodians was carried out. The purposes were 1) to investigate the prevalence of asbestos-related disease in a group of custodians at risk for asbestos exposure in public schools and 2) to determine the proportion with disease attributable to exposures in school buildings. Medical and occupational histories, flow-volume loops, and posterior-anterior, lateral, and anterior oblique (AO) chest radiographs were obtained. Single breath DLCO was measured and chest auscultation performed. Mean age of subjects was 57 years and mean duration of work as a custodian, 27 years. Fifty-seven (47.5%) had no known or likely exposure to asbestos outside of their work as a school custodian (NOE). Pleural plaques (PP) occurred in 40 (33%) of the total group and 12 (21%) of the group with NOE. Pulmonary restriction (FVC less than 80% predicted, FEV1/FVC% greater than or equal to 70) occurred in 22 (18%) of the total group and 10 (17%) of those with NOE. DLCO was lower in the group with restriction. Multivariate analysis revealed significant associations (p less than 0.05) between both PP and restriction and duration of asbestos exposure. AO radiographs increased PP detection by a factor of 1.9. Our results reveal PP prevalence in excess of background and pulmonary restriction in the study population, and indicate that PP are attributable to asbestos in schools. Findings with regard to pulmonary restriction need further investigation. Prudent management of asbestos in buildings is indicated for the prevention of related disease.

Characteristics of Asbestos Abatement Projects in Public Buildings in Erie County, Pennsylvania: 1992-1994

“…school custodians) have been 'highly' exposed and are now predisposed to developing asbestosis related dis eases in the future [7,[34][35][36] are important factors that should be considered when evaluating cost. This is most evident when the synergistic effects of asbestos exposure and smoking are evaluated in association with the high percentage of cigarette smokers consistently reported in surveys of asbestos abatement workers [11,37,38].…”

“…This industry has developed as a result of various reports about the occupational envi ronment, of diseases associated with exposure to airborne asbestos [6][7][8][9][10][11][12][13][14][15][16][17] and a public concern of exposure to nonoccupationally related populations [18,19]. Regulations have been enacted that require engineering controls, no tification to regulatory agencies and protective practices for occupationally exposed personnel and for public health protection [19][20][21][22].…”

Cost and Distribution of Bids for Asbestos Abatement Projects in the Public Sector

“…Several investigators have suggested that the risk from some exposure to asbestos, especially for schoolchildren, is extremely low and these extreme activities and cost expenditure for abatement are not warranted [4,[18][19][20]. Certainly the estimates of risk do not apply equally to all persons exposed to asbestos and other studies have suggested that workers in a variety of jobs may experience greater exposure to airborne asbestos than those performing asbestos abatement [21,22]. It has been suggested that higher concentrations of asbestos may exist in the air after abatement is completed than before abatement [4,23,24].…”

Mechanisms of the genotoxicity of crocidolite asbestos in mammalian cells: implication from mutation patterns induced by reactive oxygen species.

“…The fact that asbestos, a well-established carcinogen, has been used extensively in industry and households makes it an important health concern. It has been suggested that the danger of developing asbestos-related diseases extends beyond that of a simple occupational hazard because it has been documented in family members of asbestos workers, in individuals living in the neighborhood of industrial sources of asbestos, and in some schools and public buildings where asbestos is being used as insulation material (3)(4)(5). Moreover, resuspension of materials from asbestos-containing ceilings has been shown to be the main source of asbestos pollution in old, poorly maintained buildings (6).…”