Tyler asbestos workers: A mortality update in a cohort exposed to amosite.

The Tyler asbestos plant produced pipe insulation from 1954 to 1972 and exclusively used amosite asbestos. There were 1130 former workers of this plant during the period of operation. A death certificate mortality analysis was published regarding this plant in 1998 for the period through 1993. This study represents an update of the mortality analysis with additional certificates collected for deaths occurring through 2011.Searches of the National Death Index database were conducted in 2004 and again in 2013. At the time of the latter search, only deaths occurring through 2011 were available. In total, 265 distinct additional death certificates were secured and added to 304 available from the original study. After the new certificates were coded (ICD-9), data were analyzed using the Centers for Disease Control and Prevention Life Table Analysis System (LTAS) and standard mortality ratios (SMR) generated with 95% confidence limits (CL). LTAS constructs cause-specific mortality rates by age, gender, race, and person-time at risk, and compares observed rates with a referent population in order to derive SMR. A significant excess number of deaths due to nonmalignant respiratory disease (asbestosis) and from select malignant neoplasms were identified. There were in total 23 mesothelioma deaths (4% of deaths), with 16 pleural and 7 peritoneal. The SMR for malignant neoplasms of the trachea, bronchus, and lung was 244 (with 95% CL 196, 300), suggesting that exposed workers from this cohort were nearly 2.5-fold (244 %) more likely to die from this cause as the general referent population. The analysis also showed that exposures of short duration (<6 mo) produced significantly elevated SMR for all respiratory cancers, lung cancer, and pleural mesothelioma. There was a significant difference in median duration of exposure for mesothelioma types, confirming association of peritoneal mesothelioma with longer duration of exposure. Deaths due to intestinal cancer (predominantly colon; not including rectum) were also found in excess. The mortality experience of the Tyler cohort continues to be followed with great interest, given the exclusivity of exposure to amosite. Data confirm the inherent pathogenicity of this fiber type for nonmalignant disease as well as select cancers, particularly relevant given the importance of this amphibole's use in the United States.

Faith-based intervention in depression, anxiety, and other mental disturbances.

OBJECTIVE: To determine if the effects of using the Steps to Freedom would be beneficial for a group of individuals who attended a Christian Conference. METHODS: A user-friendly 12-item questionnaire was used to monitor the outcomes of Steps to Freedom addressing six symptom/behavioral problems and six function areas. In addition, the Symptom Checklist-90 R (SCL-90-R) questionnaire was employed to document the validity of the shorter questionnaire. The questionnaires were completed before and after the administration of the Steps to Freedom. The Wilcoxon matched pairs test was used to measure the significance of the findings for the 12-item questionnaire. RESULTS: Thirty-three clients who went through the Steps to Freedom showed statistically significant improvement (P < or = 0.005) at 3 to 4 months in all symptom/behavior categories (items 1-6). All function areas (items 7-12) also demonstrated statistically significant improvement (P < or = 0.05). A comparison group who did not attend the conference or receive counseling showed no significant changes during the same period. CONCLUSIONS: These significant preliminary findings need to be confirmed by additional studies. Steps to Freedom model prayers, used by individual patients personally and/or with a counselor, could expand the care and hopefully lower the cost of mental illness.