CHRYSOTILE ASBESTOS. Environmental Health Criteria 203. World Health Organization

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1 This reprt cntains the cllective views f an internatinal grup f experts and des nt necessarily represent the decisins r the stated plicy f the United Natins Envirnment Prgramme, the Internatinal Labur Organisatin, r the Wrld Health Organizatin. Envirnmental Health Criteria 203 CHRYSOTILE ASBESTOS First draft prepared by Dr G. Gibbs, Canada (Chapter 2), Mr B.J. Pigg, USA (Chapter 3), Prfessr W.J. Nichlsn, USA (Chapter 4), Dr A. Mrgan, UK and Prfessr M. Lippmann, USA (Chapter 5), Dr J.M.G. Davis, UK and Prfessr B.T. Mssman, USA (Chapter 6), Prfessr J.C. McDnald, UK, Prfessr P.J. Landrigan, USA and Prfessr W.J. Nichlsn, USA (ChapterT), Prfessr H. Schreier, Canada (Chapter 8). Published under the jint spnsrship f the United Natins Envirnment Prgralnme, the Internatinal Labur Organisatin, and the Wrld Health Organizatin, and prduced within the framewrk f the Inter-Organizatin Prgramme fr the Sund Management f Chemicals. Wrld Health Organizatin Geneva, 1998

2 The Internatinal Prgramme n chemicat safety (Ipcs), esrablished in 1980, is a jint venture f the united Natins Envirnment prgramme (unep), the Internatinal l-abur rganisatin (IL), and the wrld ueatttr rginizatin (WHO). The verall bjectives f the IPCS are t establish the scientific basis fr assessment f the risk t human health and the envirnment frm expsure rc chemicals, thrugh internatinal peer review prcesses, as a prerequisiie fr the prmtin f chemical safety, and t prvide technical assistance in itrengthening natinal capacities fr the sund management f chemicals. _ The Inter{rganizatin Prgranme fr the sund Management f chemicals (IMc) was established in 1995 by unep, IL, the Fd and Agriculture rganizatin f the united Natins, wh, the United Natins Industrial Develpment Organizatin, the United Natins Institute fr Training and Research, and the rganisatin fr Ecnmic c-peratin and Develp-ment (Participating rganizatins), fllwing recmmendatins made by the l9t2 un cnference n Envirnment and Develpment t strengthen cperatin and increase crdinatin in the field f chemical safety. The purpse f the IOMC is t prmte crdinatin f the plicies and activities pursued by the Participating rganizatins, jintly r separately, t achieve the sund management f chemicali in relatin t human health and the envirnment. WHO Library Catalguing in Publicatin Data Chrystile Asbests. (Envirnmental health criteria ; 203) l.asbests, Serpentine - adverse effects 2.Asbests, serpentine - txicity 3.Envirnmental expsure 4.ccupatinal expsure Llnternatinal prgramme n Chemical Safety Il.Series rsbn rssn X (M-M Classificatin: WA 754) The wrld Health rganizatin welcmes requests fr permissin t reprduce r translate its publicatins, in part r in firll. Applicatins and enquiries shuld be addressed t the ffice f Publicatins, wrld Health rganizatin, Geneva, switzerland, which will be glad t prvide the latest infrmatin n any changes made t the text, plans fr new editins, and reprints and translatins alreidy Health Organizatin 1998 Publicatins f the wrld Health rganizatin enjy cpyright prtectin in accrdance with the prvisins f Prtcl 2 f the universal cpyright Cnventin. All rights reserved. The designatins emplyed and the presentatin f the material in this publicatin d nt imply the expressin f any pinin whatsever n the part f the Secretariat f the Wrld Health rganizatin cncerning the legal status f any cuntry, territry, city, r area r f its authrities, r cncerning the delimitatin f its frntiers r bundaries. The mentin f specific cmpanies r f certain manufacturers' prducts des nt imply that they are endrsed r recmmended by the wrld Health rganizatin in preference t thers f a similar nature that are nt mentined. Errrs and missins excepted, the names f prprietary prducts are distinguished by initial capital letters. PRINTED IN FINLAND 98^214r-VAMMALA-5000

3 CONTENTS ENVIRONMENTAL HEALTH CRITERIA FOR GHRYSOTILE ASBESTOS PREAMBLE ABBREVIATIONS lx xix INTRODUCTION 1. SUMMARY Identity, physical and chemical prperties' sampling and analysis.-r^r 1.2 Surces f ""putinal and envirnmental z expsure 1.3 Occupatinal and envirnmental expsure levels Uptake,,l'u'ut", retentin and translcatin Effects " u"i"'uts and cells Effects n human 1.7 nrruir,t*"'tal fate and effects n bita 9 IDENTITY, PHYSICAL AND CHEMICAL PROPERTIES, SefrnpLING AND ANALYSIS 10 I IdentitY, -,,i- i Chemical cmpsitin 10 2.L.2 Structure Fibre frms in the re Fibre PrPerties UICC samples 2..6Assciatedmineralsinchrystilere 214 Physical and chemrcal prperties t PhYsical PrPerties Chemical PrPerties 16 Sampling urro ututltijal mettrds WrkPlace sampling Y Sampiing in the general envirnment L t il,

4 EHC 20J: Chrystile Asbesfs Analyticalmethds Fibre identificatin Measurement f airbme fibre cncentratins Lung tissue analysis Gravimetric anaiysis Cnversin factrs Cnversin frm airbrne particle t fibre cncentatins Cnversin frm ttal mass t fibre number cncentratins SOT/RCES OF OCCUPATIONAL AND EN\{IRONMENTAL EXPOSI.IRE 3.1 Nafural ccrurence 3.2 Anthrpgenicsurces prductin Manufacture fprducts Use f prducts OCCUPATIONAL AND ENVIRONMENTAL EXPOSURE LEVELS 4.1 Occupatinalexpsure Mining and milling Textileprductin Asbests_cement Frictinprducts Expsure f building maintenance persnnel Varius indusfties 4.2 Nn-ccupatinalexpsure Ambient air Indr air UPTAKE, CLEARANCE, RETENTION AND TRANSLOCATION 18 l l t l IV

5 5.1 Inhalatin General principles Fibre depsitin Fibre clearance and retentin Fibre clearance and retentin in humans Fibre clearance and retentin in labratry animals Fibre translcatin Fibre translcatin in humans Fibre franslcatin in animal mdels Mechanisms f fibre clearance Ingestin EFFECTS ON LABORATORY MAMMALS AND IN VITRO TEST SYSTEMS Intrductin 6.2 Effects n labratry mammals Summary f previus studies Recent lng-term inhalatin studies Intratracheal and innabrnchial injectin studies Infraperitneal and intrapleural 5l 5l l injectin studies Ingestin studies 91 Studies n cells Gentxicrty and interactins with DNA Cell prliferatin Inflammatin Cell death and cyttxicity Liberatin f grwth factrs and ther respnse f cells f the immune system l0l 7. EFFECTS ON HUMANS Occupatinalexpsure 103

6 EHC 203: Chrystile Asbesfs 7.I.1 Pneumcnisis and ther nn-malignant respiratry effects Lung cancer and mesthelima Criticalccupatinalchrt studies - chrystile Cmparisns f lung cancer expsure-respnse - critical studies Other relevant studies Other malignant diseases Criticalccupatinalchrt 118 t20 t25 studies invlving chrystile Other relevant studies Nn-ccupatinal expsure ENVIRONMENTAL FATE AND EFFECTS ON BIOTA Envirnmental fiansprt and distributin Chrystile fibres in water 8.L.2 Chrystile fibres in sil 8.2 Effects n bita Impact n plants Impact n terrestrial life-frms Impact n aquatic bita EVALUATION OF HEALTH RISKS OF EXPOSURE TO CHRYSOTILE ASBESTOS 9.1 Intrductin 9.2 Expsure Occupatinalexpsure Prductin Use General ppulatin expsure 9.3 Health effects OccupatinalexPsure Fibrsis 9.3.I.2 Lung cancer 129 t r32 r t37 t t4l 142 vt

7 10. I l Mesthelima General envirnment 9.4 Effects n the envirnment CONCLUSIONS AND RECOMMENDATIONS FOR PROTECTION OF HUMAN HEALTH FURTHER RESEARCH REFERENCES RESUME RESUMEN t t76 187

8 NOTE TO READERS OF THE CRITERIA MONOGRAPHS Every effrt has been made t present infrmatin in the criteria mngraphs as accuntely as pssible withut unduly delaying their publicatin. In the interest f all users f the Envirnmental Health Criteria mngraphs, readers are requested t cmmunicate any errrs that may have ccurred t the Directr f the Internatinal Prgramme n Chemical Safety, Wrld Health Organizatin, Geneva, Switzerland, in rder that they may be included in crrigenda. A detailed data prfile and a legal file can be btained frm the Internatinal Register f Ptentially Txic Chemicals, Case pstale 356,1219 Chdtelaine, Geneva, Switzerland (telephne n. * , fax n. * , This publicatin was made pssible by grant number 5 U01 ES frm the Natinal Institute f Envirnmental Health Sciences, Natinal Institutes f Health, USA, and by financial supprt frm the Eurpean Cmmissin. vilt

9 Envirnmental Health Griteria PREAMBLE Objectives lnl973 the WHO Envirnmental Health Criteria Prgramme was initiated with the fllwing bjectives: (r) t assess infrmatin n the relatinship between expsure t envirnmental pllutants and human health, and t prvide guidelines fr setting expsure limits; (ii) t identify new r ptential pllutants; (iii) t identify gaps in knwledge cncerning the health effects f pllutants; (iv) t prmte the harmnizatin f txiclgical and epidemi- \ / lgical methds in rder t have internatinally cmparable results. The fust Envirnmental Health criteria (EHC) mngraph, n mercury, was published in 1976 and since that time an ever-increasing numbei f assessments f chemicals and f physical effects have been prduced. In additin, nurny EHC mngraphs have been devted t fvaluating txiclgical methdlgy, e.g., fr genetic, neurtxic, teratgenlc and nefhrtxic effects. Other publicatins have been cncerned with epi-demilgical guidelines, evaluatin f shrt-term tests fr carcingins, bimarkers, effects n the elderly and s frth' Since its inauguratin the EHC Prgramme has widened its scpe, and the imprtance f envirnmental effects, in additin t heith effects, has been increasingly emphasized in the ttal evaluatin f chemicals. The riginal impetus fr the Prgramme came frm Wrld Health Assembly rislutins and the recmmendatins f the 1972 I-iN Cnference n the Human Envirnment. Subsequently the wrk became an integral part f the Internatinal Prgramme n Chemical Safety (IPCS), a cperative prgrarnme f UNEP, ILO and wh. In this manner, with the sfing supprt f the new parfirers,_ the imprtance f ccupatinal health and envirnmental effects was fully

10 EHC 203: ChrystiteAsbesfs recgnized. The.EHC-mngraphs have becme widely established, used and recgnized thrughut the wrld. The recmmendatins f the 1992 I_rN cnference n Envirnment and Develpment and the subsequent establishment f the Intergvernmental Frum n chemical safety with the pririties fr actin in the six prgramme areas f chaptet i9, Ag. dizt,all lend further weight t the need fr EHC u-rr.rr-rrrti f the risks f chemicals. Scpe The criteria mngraphs are intended t prvide critical reviews n the effect n human health and the envirnment f chemicals and f cmbinatins f chemicals and physical and bilgical agents. As tu"h, they include and review studies that are f dirjct relevance fr the evaluatin. Hwever, they d nt describe everystudy carried ut. wrldwide data are used and are quted frm riginai studies, ngt frm absfracts r reviews. Bth published and unpubiished reprts are cnsidered and it is incumbent n the authrs t assess all the articles cited in the references. preference is always given t published data. unpublished data are nly used when relevant published data are absent r when they are pivtal t the risk assessment. A detailed plicy statement is available that describes the prcedures used fr unpublishedprprietary data s that this infrmatin can be used in the evaluatin withut cmprmising its cnfidential nature (wh (1990) Revised Guidelines fr the preparatin f Envirnmental Health criteria Mngraphs. pcs/90.6-9, Geneva, wrld Health Organizatin). In the evaluatin f human health risks, sund human data, whenever available, are preferred t animal data. Animal and, in vitr studies prvide supprt and are used mainly t supply evidence missing frm human studies. It is mandatry that research n human subjects is cnducted in full accrd with ethical principles, including the prvisins f the Helsinki Declaratin. The EHC mngraphs are intended t assist natinal and internatinal authrities in making risk assessments and subsequent risk management decisins. Theyiepresent a thrugh evaluatin f risks and are nt, in any sense, recmmendatins f6r regulatin r x

11 standard setting. These laffer are the exclusive purview f natinal and reginal gvernments. Gntent The layut f EHC mngraphs fr chemicals is utlined belw.. Summary - a review f the salient facts and the risk evaluatin f the chemical physical and chemical prperties, analytical methds Surces fexpsure Envirnmentil transprt, distributin and transfrmatin Envirnmental levels and human expsure Kinetics and metablism in labratry animals and humans Effects n labratry mammals and in vitr test systems Effects n humans Effects n ther rganisms in the labratry and field Evaluatin f human health risks and effects n the envirnment Cnclusins and recmmendatins fr prtectin f human health and the envirnment Further research Previus evaluatins by internatinal bdies, e.g., IARC, JECFA, JMPR. Identity - a O a a a a a a a Selectin f chemicals Since the inceptin f the EHC Prgramme, ttre IPCS has rganized meetings f scientists t establish lists f pririty chemicals fi subsequent evaluatin. Such meetings have been held in: Ispra, Italy, 1980; Oxfrd, United Kingdm, 1984; Berlin, Germany, 1987; *dn.th Carlina, USA, The selectin f chemicals has been based n the fllwing criteria: the existence f scientific evidence that the substance ptrtrttir ahazardt human health and/r the envirnment; the pssible use, persistence, accumulatin r degfadatin f the substanceihws that th-ere may be significant human r envirnmental expsure; the size and nature f ppulatins at risk (bth human and th"t species) and risks fr envirnment; internatinal cncern, i'e' the substance is f majr interest t several cuntries; adequate data n the hazards are available.

12 EHC 203: Chrysfile Asbests If an EHC mngraph is prpsed fr a chemical nt n the pririty list the IPCS secretariat cnsults with the cperating rganizatins and all the Participating Institutins befre embarkin[ n the preparatin f the mngraph. Prcedures The rder f prcedures that result in the publicatin f an EHC mngraph is shwn in the flw chart. A designated staff member f IPCS, respnsible fr the scientific quality f the dcument, seryes as Respnsible fficer (R). The Ipcs Editr is respnsibte fr layut and language. The fust draft, prepared by cnsultants r, mre usually, stafffrm_an IPCS Participating Institutin, is based initially n data prvided frm the Internatinal Register f ptentially Txit chemicals, and reference data bases such as Medline and Tiline. The draft dcument, when received by the R, may require an initial review by a small panel f experts t determine its scientifrc qualrty and bjectivrty. nce the R finds the dcument acceptable as a fust draft, it is disfiibuted, in its unedited frm, t well vir 150 EHC cntact pints thrughut the wrld wh are asked t cmment n its cmpleteness and accuracy and, where necessary, prvide additinal material. The cntact pints, usually designited by gvemments, may be Participating Institutins, Ipcs Fcal pints, r individual scientists knwn fr their particular expertise. Generally sme fur mnths are allwed befre the cmments are cnsidered by the R and authr(s). A secnd draft incrprating cmments received and apprved by the Directr, Ipcs, is then disnibuted t Task Grup members, wh carryr ut the peer review, at least six weeks befre their meeting. The Task Grup members serve as individual scientists, nt as representatives f any rganizatin, gvemment r industry. Their functin is t evaluate the accuracy, significance and relevance f the infrmatin in the dcument and t assess the health and envirnmental risks frm expsure t the chemical. A summary and recmmendatins fr further research and imprved safety aspects are als required. The cmpsitin f the Task Grup is diitated by the range f expertise required fr the subject f the meeting and by the need fr a balanced gegraphical distributin. xii

13 l Revisin as l -- - EHC PREPARATION FLOW CHART ffi lrn, l:.' I preparatin f Task Grup CfC) draft I - - )' '\ f llbtl""ss*p,1 fj-- I + rutincprcedurc I Fdltl"c \ lw"td.pt**gl -T I l-*t..---at*tt I - \ / I ApprvalQ'lt*pflPs Frcnclr/Spanish translatins f Summary

14 EHC 203: Chrysfile Asbesfs The three cperating rganizatins f the IpcS recgnize the imprtant rle played by nngvernmental rganizatins. Representatives frm relevant natinal and internatinal assciatins may be invited t jin the Task Grup as bservers. while bservers may prvide a valuable cnfiibutin t the prcess, they can nly speak at the invitatin f the Chairpersn. bservers d nt participate in the final evaluatin f the chemical; this is the sle respnsibility f the Task Grup members. when the Task Grup cnsiders it t be apprpriate, it may meet in camera. All individuals wh as authrs, cnsultants r advisers participate in the preparatin f the EHC mngraph must, in additin t serving in their persnal capacity as scientists, infrm the R if at any time i cnllict f interest, whether acfual r ptential, culd be perceived in their wrk. They are required t sign a cnflict f interest statement. Such a prcedure ensures the transparency and prbrty f the prcess. when the Task Grup has cmpleted its review and the R is satisfied as t the scientific crrectness and cmpleteness f the dcument, it then ges fr language editing, reference checking, and preparatin f camera-ready cpy. After apprval by the Directr, IPCS, the mngraph is submitted t the wh ffice f publicatins fr printing. At this time a cpy f the final draft is sent t the chairpersn and Rapprteur f the Task Grup t check fr any errrs. It is accepted that the fllwing criteria shuld initiate the updating f an EHC mngraph: new data are available that wuld substantially change the evaluatin; there is public cncern fr health r envirnmental effects f the agent because f greater expsure; an appreciable time perid has elapsed since the last evaluatin. All Participating Institutins are infrmed, thrugh the EHC prgress reprt, f the authrs and institutins prpsed fr the drafting f the dcuments. A cmprehensive file f all cmments received n drafts f each EHC mngraph is maintained and is available n request. The Chairpersns f Task Grups are briefed befre each meeting n their rle and respnsibility in ensuring that these rules are fllwed. xtv

15 WHO TASK GROUP ON ENVIRONMENTAL HEALTH CRITERIA FOR CHRYSOTILE ASBESTOS Members Prfessr J.M. Dement, Duke Occupatinal Health Services, Duke University, Durham, NC, USA (Vic e- Chairp er s n)" prfessr J.Q. Huang, shanghai Medical university, shanghai, China Prfessr M.S. Huusknen, Institute f Occupatinal Health, Helsinki, Finland prfessr G. Kimizuka, Deparhnent f Pathbilgy, schl f Nursing, Chiba University, Chiba, Japan Prfessr A. Langer, Envirnmental Sciences Labratries, Brklyn Cliege f the City University f New Yrk, Brklyn, New Yrk, USA (C-Rapprteur) Ms M.E. Meek, Pririty Substances Sectin, Envirnmental Health Directrate, Health Prtectin Branch, Health Canada, Ottawa, Ontari, Canada (ChairP er s n)" Ms M. Meldrum, Health and safety Executive, Txiclgy unit, Btle, United Kingdm (C- Rapprteur) " Prfessr J.M. Dement chaired the meeting sessins when discussins n Chapters 9, l0 and 11 were held. These sessins were held in,*"i withut the presence f bservers. He als chaired the final sessin when the whle dcument was adpted' b Nt present at the last sessin c Nt present at the discussins n Chapter 10'

16 EHC 203: Chrysfile Asbesfs Dr H. Muhle, Fraunhfer Instit'te fr Txiclgy and Aersl Research, Hanver, Germany Prfessr M. Neuberger, Institute f Envirnmental Hygiene, University f Vienna, Vienna, Austria Prfessr J. Pet, Sectin f Epidemilgy, Institute f cancer Research, Ryal Cancer Hspital, Suttn, Surrey, United Kingdm Dr L. stayner, Risk Analysis and Dcument Develpment Branch, Educatin and Infrmatin Divisin, Natinal Institute fr ccupatinal safety and Health, Mrgantwn, west virginia, USA Dr V. Vu, Health and Envirnmental Review Divisin, US Envirnmental Prtectin Agency, Washingtn, D.C., USA Observers Mr D. Buige, Asbests Internatinal Assciatin (AIA), paris, Francea Dr G.w. Gibbs, cmmiuee n Fibres, Internatinal cmmissin n Occupatinal Health, Spruce Grve, Alberta, Canadab Secretariat Dr Pal Bffetta, unit f Envirnmental cancer Epidemilgy, Internatinal Agency fr Research n cancer, Lyn, France a- Present nly during first tw days f the meeting (i.e. befre the discussins n Chapters 9, l0 and l l were held) b Nt present during the discussins n chapters 9, 10 and 11, which were heldin camera xvi

17 Dr I. Fedtv, Occupatinal Safety and Health Branch, Internatinal Labur Office, Geneva, Switzerland Mr Salem Milad, Internatinal Registry f Ptentially Txic Chemicals, United Natins Envirnment Prgramme, Geneva, Switzerland Prfessr F. Valii, IPCS Scientific Adviser, Andrija Stampar Schl f Public Health, Zagreb University,Zagteb, Cratia (Respnsible Officer and Secretary f Meeting) Resurce persns Prfessr J. Crbett McDnald, Deparftnent f Occupatinal and Envirnmental Medicine, Natinal Heart and Lung Institute, Lndn, United Kingdm" Prfessr w.j. Nichlsn, Departrnent f cmmunity Medicine, Munt Sinai Schl f Medicine, New Yrk, NY, USA " Nt present during the discussins n chapters 9, 10 and 11, which were held in camera xvil

18 IPCS TASK GROUP ON ENVIRONMENTAL HEALTH CRITERIA FOR CHRYSOTILE ASBESTOS A Task Grup n Envirnmental Health criteria fr chrystile Asbests met at wh Headquarters, Geneva, switzerland, frm I t 6 July Dr M. Mercier, Directr Ipcs, pened the Meeting and welcmed the participants n behalf f the heads f the thrr. cperating rgantzatrns f the Ipcs (trnep/ila^rh). The Task Grup reviewed and revised the third draft f the mngraph, made an evaluatin f the risks fr human health and the envirnment frm expsure t chrystile asbests, and made recmmendatins fr health prtectin and further research. The first drafts were prepared by Dr G. Gibbs, canada (Chapter 2), Mr B.J. Pigg, USA (Chapter 3), prfessr W.J. Nichlsn, usa (chapter 4), Dr A. Mrgan, uk and prfessr M. Lippmann, usa (chapter 5), Dr J.M.G. Davis, UK and prfessr B.T. Mssman, usa (chapter 6), Prfessr J.c. McDnald, IrK, prfessr P.J. Landrigan, usa and Prfessr w.j. Nichlsn, usa (chapter 7), Prfessr H. Schreier, Canada (Chapter 8). In the light f internatinal cmments, the secnd draft was prepared under the crdinatin f Prfessr F. valii, cratia. chapter 8 was mdified by a grup f experts in risk assessment (Prfessrs J. Hughes, USA, J. Pet, uk, and J. siemiatycki, canada). Prfessr F. valii was respnsible fr the verall scientific cntent f the mngraph and fr the rgannatrn f the meeting, and Dr P.G. Jenkins, IPCS central unit, fr the technical editing r *rt mngraph. The effrts f all wh helped in the preparatin and finalizatin f the mngraph are gratefully acknwledged. xviii

19 ABBREVIATIONS ACM AOS ATEM BAL BP CI EDXA f FGF LDH mpcf mpcm NHMI OR p PCOM PDGF PMR RR SAED SEM SMR TEM TPA TWA UICC asbests-cntaining material activated xygen species analytical transmissin electrn micrscpy brnchalvelar lavage benz(a)pyrene cnfidence interval energy-dispersive X-ray analyser fibre fibrblast grwth factr lactate dehydrgenase millins f particles per cubic ft millins f particles per cubic metre N-nitr sheptamethylene imine dds rati particle phase cntrast ptical micrscpy platelet-derived grwth factr prprtinal mrtality rati relative risk selected area electrn diffractin scanning electrn micrscpy standardized mrtality rati transmissin electrn micrscpy I2-O -tefradecanylphrbl acetate time-weighted average Unin Internatinale Cntre le Cancer (reference asbests samples) xtx

20 INTRODUCTION As early as 1986 the Internatinal Prgramme n Chemical Safety (IPCS) published the Envirnmental Health criteria (EHC 53) n the health effects f natural mineral fibres with particular emphasis n asbests (IPCS, 1986). During the next 7 years, effrts were fcused n pssible reductin f envirnmental asbests expsure (IPCS, 1989; WHO/OCH, 1989), including the evaluatin f a number f pssible substitute fibres such as man-made mineral fibres (IPCS, 1988), and selected rganic synthetic fibres (IPCS, I9g3). ln 1992, fur WHO Member States invited the Directr-General f WHO t request the IPCS t update that part f EHC 53 cncerning the health effects f chrystile asbests. The Directr-General accepted the request and instructed the IPCS t develp an EHC specifically fr chrystile asbests taking int cnsideratin that (a) the Internatinal Labur Organisatin had recmmended the discntinuatin f the use f crcidlite asbests; (b) amsite asbests was, fr all practical purpses, n lnger explited; and (c) there was still wide-spread prductin and use f chrystile asbests in the wrld. A number f reputable scientists (selected slely n the basis f their cnfributins t the pen scientific literature) were apprached with the request t develp individual scientific chapters fr the first draft. Chapters 5, 6 and 7 were drafted by tw r three authrs independently. On the basis f these texts a cherent draft was prepared by the IPCS. The drafu f chapters 5,6 and 7 were sent fr preliminary review t a limited number f recgnized experts prpsed by IPCS participating institutins. The full draft f the dcument was submitted t the standard IPCS wrldwide evaluatin prcedure by circulating it fr cmments t mre than 140 IPCS Cntact Pints. Taking int accunt all the relevant cmments, a secnd draft was develped by the IPCS. Chapter 7, drafted independently by three authrs, was mdified by a wrking grup f experts and fcuses n lung cancer and mesthelima risks in ppulatins expsed almst exclusively t chrystile. The discussin in this chapter has been resficted primarily t direct bservatin frm epidemilgical studies. xx

21 The third draft was submitted fr evaluatin, mdificafin and finalizatin t a Task Grup f experts appintedby WHO. Nne f the primary authrs was appinted t be a member f the Task Grup.

22

23 1. SUMMARY 1.1 ldentity, physical and chemical prperties, sampling and analysis Chrystile is a fibrus hydrated magnesium silicate mineral that has been used in many cmmercial prducts. It is widely used in glbal cmmerce tday. Its physical and chemical prperties as a mineral are bserved t vary amng the explited gelgical depsits. The minerals that accmpany the fibre in res afe many, and amng these may be sme varieties f fibrus amphible. Tremlite is thught t be especially imprtant in this respect; its frm and cncentratin range greatly. Analysis f chrystile in the wrkplace currently entails the use f light and electrn micrscpes. Varius instruments and devices have been previusly used t mnitr envirnments fr the presence and cncentratin f bth ttal dust and fibres. The membrane filter technique and phase cntrast ptical micrscpy arc cmmnly used tday fr wrkplace assay (expressed as fibres per ml air); and the transmissin electrn micrscpy is als emplyed. Envirnmental assays require the use f transmissin elecfrn micrscpy. Tissue burden studies have been emplyed t imprve infrmatin regarding expsures. Depending n the degree f attentin t detail in these studies, inferences regarding mechanisms and etilgy have been drawn. Gravimetric and thermal precipitatr and midget impinger techniques were previusly used fr wrkplace chatacteizatin, and these dust (nt fibre) values are the nly early expsure indices available fr gauging expsure-respnse relatinships. There have been many attempts t cnvert these values t fibres per vlume f air, but these cnversins have had very limited success. Cnversin factrs have been fund t be industry-specific and even pelatin-specific; universal cnversin factrs carry high variances.

24 EHC 203: Chrysfile asbesfs ',.2 surces f ccupatinal and envirnmental expsure Lw cncentatins f chrystile are fund thrughut the crustal envirnment (air, water, ice caps and sil). Bth nafural and human activities cntribute t fibre aerslizatin and distributin. Anthrpgenic surces include dusts frm ccupatinal activities, which cver re recvery and prcessing, manufacfuring, applicatin, usage and, ultimately dispsal. Prductin ccurs n 25 cuntries, and there are seven majr prducers. Annual wrld prductin f asbests peaked at ver 5 millin tnnes in the mid-1970s but has since declined t a current level f abut 3 millin tnnes. Manufacturing f chrystile prducts is undertaken in mre than 100 cuntries, and Japan is the leading cnsumer cuntry. The current main activities resultirg in ptential chrystile expsure are: (a) mining and milling; (b) prcessing int prducts (ftictin materials, cement pipes and sheets, gaskets and seals, paper and textiles); (c) cnstmctin, repair and demlitin; (d) fransprtatin and dispsal. The asbests-cement industry is by far the largest user f chrystile fibres, accunting fr abut 85% f all use. Fibres are released during prcessing, installatin and dispsal f asbests-cntaining prducts, as well as thrugh nrmal wear f prducts in sme instances. Manipulatin f friable prducts may be an imprtant surce f chrystile emissin. 1.3 ccupatinal and envirnmental expsure revers Based n data mainly frmnrttr America, Eurpe and Japan, in mst prductin sectrs wrkplace expsures in the early 1930s were very high. Levels drpped cnsiderably t the late 1970s and have declined substantially t present day values. In the mining and milling industry in Quebec, the average fibre cncentratins in air ften exceeded 20 fibres/ml (f/ml) in the 1970s, while they are nw generally well belw I f/ml. In the prductin f asbests-cement in Japan, typical mean cncentatins were f/ml in 1970s, while mean cncenfratins f flml were reprted in In asbests textile manufacture in Japan, mean cncentratins were 2

25 Summary between 2.6 and 12.8 tlml in the perid between 1970 and 1975, and flrnl in the perid between 1984 and Trends have been similar in the prductin f frictin materials: based n data available frm the same cuntry, mean cncenfratins f f/ml were measured in the perid between 1970 and 1975, while levels flml were reprted in the perid between 1984 and In a plant in ttre United Kingdm in which a large mrtality study was cnducted, cncentratins were generally abve 20 tlrnl in the perid befre 1931 and generally belw I f/ml during t Few data n cncentrafins f fibres assciated with the installatin and use f chrystile-cntaining prducts are available, althugh this is easily the mst likely place fr wrkers t be expsed. In the maintenance f vehicles, peak cncentatins f up t l6 f/ml were reprted in the 1970s, while practically all measured levels after 1987 were less than 0.2 flnl. Time-weighted average expstues during passenger vehicle repair in the 1980s were generally less than 0.05 f/ml. Hwever, with n cnfrls, blwing ff debris frm drums resulted in shrt-term high cncentratins f dust. There is ptential fr expsure f maintenance persnnel t mixed asbests fibre types due t large quantities f friable asbests in place. In buildings with cnfrl plans, persnal expsure f building maintenance persnnel in the USA, expressed as 8-h time-weighted averages, was between and 0.02 f/ml. These values are f the same rder f magnitude as typical expsures during telecmmunicatin switchwrk (0.009 Ad) and abve-ceiling wrk (0.037 f/ml), althugh higher cncentratins were reprted in utility space wrk (0.5 f/ml). Cncentratins may be cnsiderably higher where n cntrl plans have been intrduced. In ne case, shrt-term episdic cncentratins were 1.6 tlml during sweeping and 15.5 f/ml during dusting f library bks in a building with a very friable chrystile-cntaining surface fmrulatin. Mst ther 8-h time-weighted averages are abut tw rders f magnitude less. Based n surveys cnducted befre 1986, fibre cncenfratins (fibres > 5 pm in length) in utdr air, measured in Austria, Canada, Germany, Suth Africa and the USA, ranged between and abut 0.01 f/ml, levels in mst samples being less than f/ml.

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