Third Wave of Asbestos Victims

There is anecdotal evidence gathered from conversations with industry experts that respiratory non-compliance among Latino asbestos abatement workers in California does occur, but this information does not appear to be documented in the asbestos literature. Is this important? Should clients, contractors, consultants, and abatement workers be concerned about this documentation deficiency? The answer is a clear and resounding, YES!

 

Dr. Irving Selikoff, a professor at Mt. Sinai School of Medicine and leading asbestos researcher, has coined the term third wave, which refers to those individuals currently exposed to the more than 30 million tons of asbestos put in place in the United States from 1900 to 1980 that may develop asbestos-related diseases in the future due to exposures occurring in the present (Bricher, 1990). These individuals include those people who encounter asbestos during maintenance or renovation related activities (Bricher, 1990). Asbestos abatement workers are members of this population.

Twenty-one percent of the 1.4 million Latino construction workers in the United States are laborers, and asbestos removal workers are embedded within this work classification (Construction Chartbook, 2002). Laborers have a 26% greater incidence of death from pneumoconiosis and other respiratory diseases such as asbestosis. Loomis and Schultz (2000) in “Mortality from six work-related cancers among African Americans and Latinos” documented excess cancer prevalence among Latino workers with a variety of usual occupations that were consistent with widespread exposure to asbestos. Clearly, these asbestos abatement workers are at risk for contracting asbestos-related diseases. If there is the potential of exposure, what has been done to prevent exposures and how is compliance with these procedures documented?

Regulations and laws have been developed and instituted by the Environmental Protection Agency (EPA) to protect the general public from asbestos exposure related to construction projects, such as demolitions and renovations (National Emissions Standard for Hazardous Air Pollutants [NESHAP], 1990). Specific EPA regulations have also been designed to avoid disturbance of asbestos in K-12 schools to prevent childhood exposures (Asbestos Hazard Emergency Response Act, 1987). Engineering and work practice controls have been developed and promulgated through Occupational Safety and Health Agency (OSHA) regulations (Asbestos In Construction Standard, 1994). Current engineering controls and work practice standards have been researched and rigorously tested to ensure that asbestos fiber release and exposure to individuals are minimized by these methods. Some of these studies include mastic removal research conducted by Tharr (1994), the evaluation of vinyl floor tile removal methods by Kominsky, Freyberg, and Boiano (1995), the evaluation of glovebag containments by Froehlich and Hollet (1993) and the evaluation of negative enclosure glovebag containments by Froehlich (1993).

Documentation of compliance with these engineering controls and work practices is an ongoing process achieved through enforcement of EPA and OSHA regulations. A worksite notification process allows local branches of the EPA and OSHA compliance officers to visit work sites and observe work practices and engineering controls (NESHAP, 1990; Asbestos In Construction Standard, 1994). The inspection process documents non-compliance with work practices and engineering controls and may result in citations and fines if appropriate (Asbestos In Construction Standard, 1994). While questions may be raised about enforcement funding and the quantity of citations issued by these agencies, this compliance system has been shown to catch regulatory violators.

In the event that engineering controls and work practices are insufficient to protect against potential exposure, personal protective equipment is used to enhance protection from, and limit exposure to, airborne asbestos fibers (Martyny, Glazer, & Newman, 2002). Personal protective equipment includes the use of respirators to limit inhalation of asbestos fibers. The OSHA regulations stipulate conditions under which respiratory protection is to be instituted within asbestos abatement environments (Asbestos In Construction Standard, 1994). Currently, there is no system in place that documents compliance with respiratory protection. This may turn out to be a very large problem!

Previous asbestos research has focused on the efficiency of respiratory protection (Martyny et al., 2002), as well as physical factors, such as perspiration and facial dimensions, that affect respiratory protection (Howie, Johnstone, Weston, Aitken, & Groat, 1996). Clayton, Bailey, Vaughan, and Rajan (2002) in a study designed to test the performance of powered air purifying respirators in simulated work environments observed inappropriate donning of the respirator straps, failure to carry out negative pressure seal checks, inappropriate fit around facial hair and glasses, and poorly maintained respirators affecting the face seal (Clayton et al., 2002). “Correct use and maintenance of respiratory protection are essential to ensure optimum protection to the wearer (Clayton et al., 2002, 1).”

If respiratory non-compliance is a reality, as it appears to be, then why is it occurring? One answer presented by Moore and Smith (1976) is known as the “behavior effect”. Individuals working in environments of high and low hazard self-interpret the level of hazard in accordance with their environmental and social cues. Some industry experts agree that the type of asbestos may play a role in the “behavior effect”. Individuals inappropriately equate the carcinogenic potential of specific types of asbestos to a graded scale of risk without consideration of the fact that all asbestos is documented by the U.S. Department of Health and Human Services as a known human carcinogen.

From 1940 through 1979 an estimated 27 million individuals had potential asbestos exposure at work (Nicholson, Perkel, & Selikoff, 1982). Approximately six million of these people were deceased as of January 1, 1980 (Nicholson, Perkel, & Selikoff, 1982). The annual incidence of mesothelioma, 2-3 million recorded cases a year for men in North America, has increased over the years (Bang, 1996). The current asbestos abatement worker population of the Bay Area of California is predominately Latino, placing them at risk for contracting an asbestos-related disease. If non-compliance with respiratory protection is realized it may potentially result in profound health effects for this population, and prompt a new wave of asbestos litigation. How can this be prevented?

Ensure that asbestos abatement contractors are complying with OSHA and EPA regulations. Be diligent about documenting the presence of contractor employees on site. Update your asbestos documentation regularly. Seek the advice and counsel of a third party environmental consultant to perform project management.

Written by Nicholas Baker, MPH(c), Manager of Hazard Management Services, Inc.’s office in Santa Clara, CA.

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