Cumulative Retrospective Exposure Assessment (REA) as a predictor of amphibole asbestos lung burden: validation procedures and results for industrial hygiene and pathology estimates

Rasmuson, James O.; Roggli, Victor L.; Boelter, F.; Rasmuson, Eric; Redinger, Charles F.

doi:10.3109/08958378.2013.845273

Cited by 31 publications

(16 citation statements)

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“…Concerning the chrysotile to amphibole ratio it is well known that the chrysotile fraction in the human lung is lower than at workplaces [9][10][11][12], as mentioned in our manuscript. This does not allow any statement about biopersistence of chrysotile in human lungs.…”

confidence: 50%

Correspondence regarding the article “The asbestos fibre burden in human lungs: new insights into the chrysotile debate”

et al. 2017

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The article by FEDER et al. [1] states that the lung asbestos fibre burden in 23 955 patients was analysed to address fibre type and biopersistence; data from 12 patients undergoing two tissue excisions at intervals at least 4 years were considered.We believe that the article has serious shortcomings, as follows.1) Unclear aim. Contrary to the authors' claim, there is no ongoing debate about the biopersistence of chrysotile asbestos among independent, credible scientists. In support of their claim that such a debate exists, the authors rely on an article commissioned, funded and developed in collaboration with asbestos lobbyists.2) Faulty study design. Significant scientific problems in patient/sample selection and applied methods exist. First, the small sample size: only 12 (0.05%) of the 23 955 cases were analysed with two investigations; only six had electron microscopic examination of tissue. Second, the selection criterion of 500 asbestos bodies per gramme of wet lung is discretionary and arbitrary. Third, relationships between outcome and fibre-years were not examined using a detailed occupational history. No statistical analysis accounting for occupation/exposures, interim exposures and latency periods, and exposure changes over recent decades is reported.3) Methods. The authors do not explain why they used both field energy (FE) scanning electron microscopy (SEM) and transmission electron microscopy (TEM), nor is it clear which data come from which method in the supplementary table. TEM is regarded as the method of choice by impartial and credible pathologists; the limitations of SEM have been discussed previously [2].The use of FE-SEM and TEM on autopsy specimens alone does not allow the authors to say anything about the change in the number of chrysotile fibres over time.The term "pulmonary asbestos fibre concentration" defined as "total of asbestos bodies and bare fibres" is incorrectly conflated with asbestos fibre concentration or burden as generally understood. 4) Results.First, there is no information on fibre length, which would be crucial for understanding outcome since short fibres are more rapidly cleared from the lung [3, 4].Second, in the six cases analysed with electron microscopy, the fibre counts reported are generally similar to, or even lower than, asbestos body counts. This unusual finding contradicts the literature where total fibres outnumber asbestos bodies by three orders of magnitude [5].Third, in a large number of ferruginous bodies, the authors were unable to identify the core material. How did the authors define a ferruginous body as asbestos and non-asbestos in those cases not subjected to electron microscopy?Last, the authors mention that "asbestos grading followed national and international criteria, i.e. primarily the Helsinki criteria". It is unclear which criteria were used in each case. There are significant differences @ERSpublications All asbestos types cause asbestosis (cancer): chrysotile is not biopersistent, so fibre analysis is not diagnostic @ERSpublications Long...

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confidence: 50%

Correspondence regarding the article “The asbestos fibre burden in human lungs: new insights into the chrysotile debate”

et al. 2017

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“…The predicted eight‐hour TWA airborne asbestos fibers concentrations are not above current or historical occupational exposure limits (OELs). Estimated exposures (dose) to airborne asbestos fibers are not in the range associated with elevated rates of lung cancer or mesothelioma . Although relative exposure risks are very low regarding the handling of ceiling panels, continued diligence in the use of built environment bulk material survey techniques as well as management and abatement methods are appropriate precautions as conditions above the ceiling may be unknown.…”

Section: Resultsmentioning

confidence: 99%

“…Spot removal of spray‐on fireproofing or acoustical material to anchor or attach the suspended ceiling grid is one example of friable insulation exposure in the course of ceiling system installation . Given the orders of magnitude difference between exposure (dose) estimates for work with ceiling panels and other trade‐related sources of exposure, it is reasonable to deduce that the excess incidence of asbestos‐related disease in construction trade populations is a result of significant exposures to asbestos sources other than ceiling panels …”

Section: Discussionmentioning

confidence: 99%

“…(36) Given the orders of magnitude difference between exposure (dose) estimates for work with ceiling panels and other trade-related sources of exposure, it is reasonable to deduce that the excess incidence of asbestos-related disease in construction trade populations is a result of significant exposures to asbestos sources other than ceiling panels. (37)(38)(39) One potential limitation of this study is that the observation data were based on one specific manufacturer of ceiling panels (Conwed). The panels in both field studies and the chamber study contained 1-5% amosite and less than 2% of chrysotile (Table I).…”

Section: Discussionmentioning

confidence: 99%

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A Bayesian Model and Stochastic Exposure (Dose) Estimation for Relative Exposure Risk Comparison Involving Asbestos‐Containing Dropped Ceiling Panel Installation and Maintenance Tasks

Boelter¹,

Xia²,

Persky³

2016

Risk Analysis

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Assessing exposures to hazards in order to characterize risk is at the core of occupational hygiene. Our study examined dropped ceiling systems commonly used in schools and commercial buildings and lay-in ceiling panels that may have contained asbestos prior to the mid to late 1970s. However, most ceiling panels and tiles do not contain asbestos. Since asbestos risk relates to dose, we estimated the distribution of eight-hour TWA concentrations and one-year exposures (a one-year dose equivalent) to asbestos fibers (asbestos f/cc-years) for five groups of workers who may encounter dropped ceilings: specialists, generalists, maintenance workers, nonprofessional do-it-yourself (DIY) persons, and other tradespersons who are bystanders to ceiling work. Concentration data (asbestos f/cc) were obtained through two exposure assessment studies in the field and one chamber study. Bayesian and stochastic models were applied to estimate distributions of eight-hour TWAs and annual exposures (dose). The eight-hour TWAs for all work categories were below current and historic occupational exposure limits (OELs). Exposures to asbestos fibers from dropped ceiling work would be categorized as "highly controlled" for maintenance workers and "well controlled" for remaining work categories, according to the American Industrial Hygiene Association exposure control rating system. Annual exposures (dose) were found to be greatest for specialists, followed by maintenance workers, generalists, bystanders, and DIY. On a comparative basis, modeled dose and thus risk from dropped ceilings for all work categories were orders of magnitude lower than published exposures for other sources of banned friable asbestos-containing building material commonly encountered in construction trades.

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“…Auf diese Art der alternativen Beweisführung verzichten zu wollen, wäre töricht. Eine kürzlich erschienene Arbeit aus den USA bestätigt unsere Überzeugung, dass die kumulative retrospektive Expositionserfassung und die Faseranalytik komplementäre Verfahren sind, die -insbesondere was Amphibolasbeste angeht -zwar eine signifikante Korrelation aufweisen [21], aber unabhängig voneinander erhoben und bewertet werden sollten.…”

Section: Fazitunclassified

Lungenstaubanalysen

Feder¹,

Theile²,

Tannapfel³

2016

Zbl Arbeitsmed

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Cumulative Retrospective Exposure Assessment (REA) as a predictor of amphibole asbestos lung burden: validation procedures and results for industrial hygiene and pathology estimates

Cited by 31 publications

References 27 publications

Correspondence regarding the article “The asbestos fibre burden in human lungs: new insights into the chrysotile debate”

Correspondence regarding the article “The asbestos fibre burden in human lungs: new insights into the chrysotile debate”

A Bayesian Model and Stochastic Exposure (Dose) Estimation for Relative Exposure Risk Comparison Involving Asbestos‐Containing Dropped Ceiling Panel Installation and Maintenance Tasks

Lungenstaubanalysen

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