RESUMO
We employed the parametric G formula to analyze lung cancer mortality in a cohort of textile manufacturing workers who were occupationally exposed to asbestos in South Carolina. A total of 3,002 adults with a median age of 24 years at enrollment (58% male, 81% Caucasian) were followed for 117,471 person-years between 1940 and 2001, and 195 lung cancer deaths were observed. Chrysotile asbestos exposure was measured in fiber-years per milliliter of air, and annual occupational exposures were estimated on the basis of detailed work histories. Sixteen percent of person-years involved exposure to asbestos, with a median exposure of 3.30 fiber-years/mL among those exposed. Lung cancer mortality by age 90 years under the observed asbestos exposure was 9.44%. In comparison with observed asbestos exposure, if the facility had operated under the current Occupational Safety and Health Administration asbestos exposure standard of <0.1 fibers/mL, we estimate that the cohort would have experienced 24% less lung cancer mortality by age 90 years (mortality ratio = 0.76, 95% confidence interval: 0.62, 0.94). A further reduction in asbestos exposure to a standard of <0.05 fibers/mL was estimated to have resulted in a minimal additional reduction in lung cancer mortality by age 90 years (mortality ratio = 0.75, 95% confidence interval: 0.61, 0.92).
Assuntos
Asbestos Serpentinas/efeitos adversos , Neoplasias Pulmonares/mortalidade , Exposição Ocupacional/efeitos adversos , United States Occupational Safety and Health Administration/legislação & jurisprudência , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Asbestos Serpentinas/análise , Feminino , Regulamentação Governamental , Humanos , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/prevenção & controle , Masculino , Pessoa de Meia-Idade , Fibras Minerais/efeitos adversos , Exposição Ocupacional/análise , Exposição Ocupacional/legislação & jurisprudência , Exposição Ocupacional/prevenção & controle , South Carolina/epidemiologia , Indústria Têxtil/legislação & jurisprudência , Indústria Têxtil/estatística & dados numéricos , Fatores de Tempo , Estados Unidos , United States Occupational Safety and Health Administration/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: In a study of asbestos industry transfers in Asia, we examined the transfer of health and safety measures at the time of industry transfer and resulting health outcomes thereafter. METHODS: Field surveys were conducted in Japan, Germany, Indonesia, and South Korea over a 5 year period beginning in 2007. The surveys involved interviews and field assessments of health and safety conditions. RESULTS: Even when there were transfers of entire engineering plant processes, we observed that the health and safety measures that should have accompanied the transfer, including technical capacities of risk assessment and management, regulatory protection, and cultural practices, were not actually transferred. According to work environment assessment records, there were differences in airborne asbestos levels of approximately 5-6 fibers/cc between the exporting and importing sides of the transfer. This amounted to a 10 years of time delay in comparable health and safety conditions. These differences resulted in repeated adverse health consequences at each factory operation site. CONCLUSIONS: Dangerous transfers of asbestos industry technology have occurred repeatedly over the years with the result that Asia has become the largest consumer of asbestos in the world. No effective internationally accepted safety measures have been introduced in the region. The study results support the need for both improved public awareness and international cooperation, such as sharing of substitute material technologies by the exporting countries, and provide the rationale for the creation of an Asian fund for asbestos victims.