Take Home Exposure to Asbestos: are family members of auto mechanics at risk? Coreen A. Robbins, MHS, PhD, CIH
The Problem Individuals with mesothelioma claim exposure to asbestos via household contact with auto mechanics EPA and OSHA have recently added new recommendations about auto mechanic s work clothes
Changing from soiled work clothes into clean clothes before leaving work provides additional protection against bringing asbestos into the home environment.
Work Practice Do s for Home Mechanics: Change into clean clothes before going inside the home and wash soiled clothes separately.
How are work materials transferred? Work supplies Hands Clothing Work rags Shoes
The Question Are household contacts of auto mechanics exposed to above-background levels of asbestos fibers or at increased risk of mesothelioma?
Methods Review studies reporting on asbestosrelated diseases in household contacts of asbestos-exposed workers Determine the occupations associated with increased asbestos disease risk for household contacts Examine epidemiology of implicated occupations and compare disease risk to that of auto mechanics Compare potential exposure levels of implicated occupations to that of auto mechanics
Literature search Anderson, 1976 Magnani, 1993 Joubert, 1991 Navratil, 1972 Kilburn, 1985 Newhouse, 1965 Vianna, 1978 McDonald, 1980 Whitwell, 1977 Blot, 1978 Goodman, 2004 Ashcroft, 1970 Li, 1978 Epler, 1980 Hirsch, 1982 Roggli, 1997 Bianchi, 1990 Miller, 2005 Huncharek, 1989 Etc..
In 1995, NIOSH reported on a comprehensive review of workers home contamination Includes cohort studies, case-control studies, and case-reports of health effects in workers families
Methods Review studies reporting on asbestos-related diseases in household contacts of asbestosexposed workers Determine the occupations associated with increased asbestos disease risk for household contacts Examine epidemiology of implicated occupations and compare disease risk to that of auto mechanics Compare potential exposure levels of implicated occupations to that of auto mechanics
p. 6 The occupations associated with asbestos-related disease in family members are those where workers were exposed to asbestos dust during: construction and renovation manufacturing textiles, tiles, boilers, & ovens certain railroad shop trades renovation and demolition projects within the construction industry prospecting and mining shipbuilding and associated trades welding, insulation use and manufacture of asbestos products such as cords, seals, and plates
Worker s Occupation Studies reporting asbestosrelated disease in household contact Insulation includes construction Shipyards Cement Manufacturing Auto mechanic??
Methods Review studies reporting on asbestos-related diseases in household contacts of asbestosexposed workers Determine the occupations associated with increased asbestos disease risk for household contacts Examine epidemiology of implicated occupations and compare disease risk to that of auto mechanics Compare potential exposure levels of implicated occupations to that of auto mechanics
Insulation: Processing and Installation
Insulation Process/Install Workers Families Author Selikoff, 1991 McDonald,1980 Levin, 1998 Anderson, 1979 Berry, 1997 Study Design Cohort Cohort Cohort Cohort Casecontrol Asbestos- Related Diseases SMR 375 LC (p<0.001) RR 46.0 M SMR 277 all RC (95% CI 193-385) radiographic abnormalities 35% v 5% controls p<0.001 SIR 22.4 M (95% CI 9.7-44.2)
Shipyard Workers
Shipyard Author Workers Selikoff, 1979 Tagnon, 1980 Blot, 1978 Families Kilburn, 1985 Study Design Cohort Community study Casecontrol Casecontrol Asbestos- Related Diseases O/E 3.7 LC RR 15.7 M (95% CI 7.0-35.0) RR 1.6 LC (95% CI 1.1-2.3) Asbestosis 11.3% vs 0.3% wives vs controls
Asbestos Cement Mining and Processing
Asbestos Cement Workers Families Author Albin, 1990 Finkelstein, 1984 Giaroli, 1994 Magnani, 1993 Study Design Cohort Cohort Cohort Cohort Asbestos- Related Diseases RR M 21.2 (95% CI 2.5-178; >15 f-yr/ml) SMR 480 LC SMR 602 M (90% CI 237-1267) SMR 602 M (90% CI 216-2029)
Asbestos Manufacturing
Asbestos Manufacturing Author Workers Cheng, 1992 McDonald, 1984 Newhouse, 1982 Families Vianna, 1978 Newhouse, 1965 Study Design Cohort Cohort Case-control Case-control Case-control Asbestos- Related Diseases SMR 315 LC (p<0.05) SMR 148 all RC O/E 1.7 LC&M (p<0.01) RR 10 M (95% CI 1.42-37.4) 11.3% vs 1.3% M (domestic exp. vs controls)
Compared to.
Auto Mechanic
Workers Families Auto Mechanic Author Goodman, 2004 Laden, 2004 Wong, 2001 Study Design Review Metaanalysis Metaanalysis Asbestos- Related Diseases RR 0.92 M (95% CI 0.55-1.56) RR 1.07 LC (95% CI 0.88-1.31) No risk RR 0.90 M (95% CI 0.66-1.23) No studies -- --
Epidemiology Studies Show: Industry Insulation Shipyard Cement Processing Auto mechanics Risk to Workers? Yes Yes Yes Yes No Risk to Family? Yes Yes Yes Yes No
Methods Review studies reporting on asbestos-related diseases in household contacts of asbestosexposed workers Determine the occupations associated with increased asbestos disease risk for household contacts Evaluate epidemiology of implicated occupations and compare disease risk to that of auto mechanics Compare potential exposure levels of implicated occupations to that of auto mechanics
Occupational Exposure Range Shipyard nsulation, ins/rem Cement Mining Manuf, friction Manuf, textile Manuf, insulation Auto mechanic 0 50 100 15 f/cc 0 66 0 20 0 Personal samples ranges reported in literature, not TWA
Occupational Exposure Range Shipyard Insulation, ins/rem Cement Mining Manuf, friction Manuf, textile Manuf, insulation Auto mechanic 0 50 100 15 f/cc 0 Yellow = risks in family members 66 0 20 0
Relative Amounts of Bulk Mass of asbestos used to spray ½ insulation on 300 ft 2 ceiling = 8250 g Asbestos (Selikoff, 1965)
Relative Amounts of Bulk Mass of asbestos in brake dust from one brake job = 0.008 g Asbestos (Jacko, 1973)
Relative Amounts of Bulk Asbestos 0.008 g is to 8250 g VW Beetle 13 ft LA to NYC 2450 miles
Relative Amounts of Bulk Asbestos 0.008 g is to 8250 g 100 µm A typical 8½ x 11 Paper with thickness of ~ 100 µm Stack of paper equivalent to 100 m, or ~ 109 yards
Conclusions Multiple studies show high exposures and increased risk of asbestos-related disease in asbestos-exposed workers in insulation, shipyard, cement and asbestos manufacture occupations and increased asbestos related disease in their household contacts No indication of increased risk of asbestosrelated disease in auto mechanics or household contacts of auto mechanics
Coreen A. Robbins PhD, CIH