Experimental asbestos studies in the UK: 1912-1950.

The asbestos industry originated in the UK in the 1870s. By 1898, asbestos had many applications and was reported to be one of the four leading causes of severe occupational disease. In 1912, the UK government sponsored an experimental study that reported that exposure to asbestos produced no more than a modicum of pulmonary fibrosis in guinea pigs. In the 1930s, the newly established Medical Research Council, with assistance from industry, sponsored a study of the effects of exposing animals to asbestos by injection (intratracheal and subcutaneous) and by inhalation in the factory environment. Government reports, publications, and contemporary records obtained by legal discovery have been reviewed in the context of the stage of scientific development and the history of the times. Experimenters were engaged in a learning process during the 1912-1950 period, and their reports of the effects of asbestos were inconsistent. Pathologists who studied the effects of asbestos experimentally, at whole animal, tissue and cellular levels, advanced experimental methodology and mechanistic knowledge. In the hands of public relations experts, however, research was exploited to preserve an industry and perpetuate preventable diseases, a practice that continues to this day.

[Asbestos at the time of the First World War]. / [L'amianto al tempo della Grande Guerra].

Between the end of the 19th century and the beginning of the 20th numerous asbestos industries began operations in various parts of the world. At the time of the First World War there is ample evidence of the use of this mineral in shipbuilding, the aircraft industry and in the construction industry. In the years 1912-17 the writer Franz Kafka was co-proprietor of a small asbestos factory in Prague. Some of the writer's novels and journal pages were inspired by this experience. In this way asbestos entered into the history of 20th century European literature. In 1917 asbestos extraction was started at the quarry in Balangero, near Turin, Italy. Risks related to the use of asbestos were known at the beginning of the 20th century and legislation aimed at preventing the harmful effects of the mineral were approved in Italy.

Asbestos history and use.

All six fiber types called asbestos can cause all the diseases related to exposure, including lung cancer. Known to the ancients, the modern history of asbestos hazards started in the 1890s with more and more data accumulating over time. Use increased exponentially in the middle of the 20th century with major use coming in construction and ship building. The recognition of asbestos as causing lung cancer dates to the early 1940s.

[Mesothelioma-30 years after the asbestos ban in Germany]. / Mesotheliome ­ 30 Jahre nach dem Asbestverbot in Deutschland.

In 1993, a total asbestos ban was introduced in Germany. Thirty years later, mesothelioma is still one of the most frequent occupational diseases. Recent data on incidence, mortality, recognized occupational diseases, early detection, and assessment are presented in this article.

[Asbestos in pre-industrial times: from natural wonder to subject of scientific investigation]. / L'amianto in epoca preindustriale: da meraviglia della natura ad oggetto di approfondimento scientifico.

The author proposes a reading of "Concerning incombustible flax or asbestos stone" which was published in 1696 by Giovanni Giustino Ciampini, who was a historian, a man of the church and scientist in Rome. The text, which was originally written in Latin, is an excellent and early description of the need felt by the majority of scientists in Europe at that time for a change in method: that is, to use scientific experiments to explain and control the natural phenomena observed and even perhaps mythologized right from antiquity. In the case of asbestos this was necessary to check the veracity and consistency of a series of recommendations handed down by the earliest authors but also to revive and reinvent the techniques that had largely been lost so as to be able to utilize and develop a substance that it was thought could be of great benefit to society. In the presentation of Ciampini's text an attempt is made to recall and contextualize the earliest knowledge on asbestos and follow its evolution over a long historical period, up to the first half of the nineteenth century. It can thus be seen how asbestos, once considered "a wonder of nature", became a raw material widely used in industrial applications. The most significant steps in this phase of transformation were taken thanks to Italian entrepreneurs and technicians and to the presence of asbestos in the Alpine valleys of Italy.

A camel through the eye of a needle: expertise and the late recognition of asbestos-related diseases.

The aim of this study is to provide new insights into the late recognition of asbestos-related diseases in contemporary societies. It addresses the role of expert culture in the identification, management, and control of asbestos risks, and examines the contribution of these processes to the late recognition and minimization of risks. After focusing first on Spain, the article presents three historical case studies to illustrate some shortcomings of the expert explanatory model. First, the narrow definition of asbestosis forged by medical experts in interwar Britain helped shape a public perception of the asbestos issue as finite and controllable. Second, the alternative approach to asbestos hazard management proposed by the Spanish trade union Comisiones Obreras in the early 1980s, inspired by the so-called Italian workers' model, prioritized locally produced knowledge. Finally, in the changing public view of asbestos risks in France during the last third of the 20th century, cultural and social factors played a crucial role in broadening the issue beyond its conception as just an occupational health problem. The author argues that expertise itself becomes a deproblematizing agent for industrial health issues, paving the way for their social invisibility.

[The Amiantus Program in Poland - 20 years of implementation]. / Program Amiantus w Polsce ­ 20 lat realizacji.

BACKGROUND: Despite the ban on the production of asbestos-containing materials, introduced in Poland over 20 years ago, new cases of asbestos-related diseases are still being recorded. Systematic control of respiratory function in people exposed to asbestos dust is, therefore, extremely important due to the biological properties of this mineral. MATERIAL AND METHODS: The Amiantus preventive medical examination program was undertaken in 2000 to implement the legal rights of former employees of asbestos processing plants for this type of examinations. People who have ever been employed in such factories have been authorized to use preventive medical examinations for the rest of their lives. The research is continuous, spread over time and focused, in particular, on the assessment of the respiratory system. RESULTS: Since the beginning of the program, throughout 20 years of its implementation, 8329 people have been examined, including 5199 (62.4%) men for whom a total of 34 454 medical examinations have been carried out. During the program period, the percentage of diagnosed pathologies increased from 8% in 2000 to 25% in 2019. Overall, 2078 asbestos-related diseases were diagnosed among former employees of asbestos processing plants under the Amiantus Program, which accounted for 25% of this group. Among all diseases caused by exposure to asbestos, the most common were: asbestosis (1880 cases - 90.5%), lung cancer (121 cases - 5.8%) and pleural mesothelioma (77 cases - 3.7%). Diseases of pleura in the form of plaques and diffuse pleural thickening were diagnosed in 40% of the examined patients, while radiological pulmonary shadows affected over 65% of former employees of asbestos processing plants. CONCLUSIONS: The Amiantus Program, thanks to the long observation period, enabled monitoring the health of former employees exposed to asbestos, and created a unique opportunity to carry out epidemiological analyzes. These studies allowed the authors to expand their knowledge of the natural history of asbestos-related diseases. Med Pr. 2020;71(5):595-601.

A visual historical review of exposure to asbestos at puget sound naval shipyard (1962-1972).

The study of occupational exposure to asbestos has been an ongoing activity for at least 75 years, dating back to the papers of Merewether and Price (1930). Since that time, literally tens of thousands of air samples have been collected in an attempt to characterize the concentration of asbestos associated with various activities. Many of the individuals who developed diseases from the 1970s to the current day were often exposed to very high airborne concentrations because of direct or indirect exposure to either raw asbestos fiber or insulation during the approximate 1940-1970 time period. Often, these high exposures were associated with work in shipyards during and after World War II and the Korean War, as well as with decommissioning, which continued into the mid-1970s. This study reviews the historical asbestos concentrations measured in shipyards and presents a visual illustration of typical conditions and work practices. A majority of the photographs presented in this article depict work conditions at the Puget Sound Naval Shipyard, circa 1940-1965, which is representative of other military shipyards of the time.

Ecological association between asbestos-related diseases and historical asbestos consumption: an international analysis.

BACKGROUND: The potential for a global epidemic of asbestos-related diseases is a growing concern. Our aim was to assess the ecological association between national death rates from diseases associated with asbestos and historical consumption of asbestos. METHODS: We calculated, for all countries with data, yearly age-adjusted mortality rates by sex (deaths per million population per year) for each disease associated with asbestos (pleural, peritoneal, and all mesothelioma, and asbestosis) in 2000-04 and mean per head asbestos consumption (kg per person per year) in 1960-69. We regressed death rates for the specified diseases against historical asbestos consumption, weighted by the size of sex-specific national populations. FINDINGS: Historical asbestos consumption was a significant predictor of death for all mesothelioma in both sexes (adjusted R2=0.74, p<0.0001, 2.4-fold [95% CI 2.0-2.9] mortality increase was predicted per unit consumption increase for men; 0.58, p<0.0001, and 1.6-fold [1.4-1.9] mortality increase was predicted for women); for pleural mesothelioma in men (0.29, p=0.0015, 1.8-fold [1.3-2.5]); for peritoneal mesothelioma in both sexes (0.54, p<0.0001, 2.2-fold [1.6-2.9] for men, 0.35, p=0.0008, and 1.4-fold for women [1.2-1.6]); and for asbestosis in men (0.79, p<0.0001, 2.7-fold [2.2-3.4]). Linear regression lines consistently had intercepts near zero. INTERPRETATION: Within the constraints of an ecological study, clear and plausible associations were shown between deaths from the studied diseases and historical asbestos consumption, especially for all mesothelioma in both sexes and asbestosis in men. Our data strongly support the recommendation that all countries should move towards eliminating use of asbestos.

Health effects of amosite mining and milling in South Africa.

This study focuses on the amosite mining region in South Africa and associated health effects, compared to other mined asbestos fiber types. Historically, dust and fiber levels were high in the amosite mills and mines, and many miners and members of the surrounding communities were exposed to the fibers. Research has shown that amosite produces both benign and malignant disease. Nevertheless, the mesotheliomagenic potential of amosite is several fold lower than crocidolite. The risk of disease associated with amosite exposure is difficult to quantify. Reasons for this include the scarcity of available information, including fiber measurements, and case ascertainment, as well as the juxtaposition of the amosite and crocidolite asbestos seams in South Africa.

The defence of chrysotile, 1912-2007.

The commercial exploitation of asbestos may be dated from the late 1870s, when Canada was the major world source. Reports of severe and fatal respiratory disease in workers in asbestos factories appeared in Britain (1898, 1906), and in France (1906) and Italy (1908). In 1912 the Canadian Department of Labour denied that the health of Quebec's millers and miners was affected. A series of denials appeared for over 40 years, until in 1955 a Thetford Mines medical officer reported finding that between 1945 and 1953, among some 4,000 asbestos workers 128 had asbestosis of various degrees of severity, 121 diagnosed radiographically, and 33 confirmed at autopsy. Although a committee of inquiry into health in the asbestos industry (1976), and a Royal Commission on health and safety arising in the use of asbestos in Ontario (1984) confirmed that disease had occurred, these findings were to have no adverse effects on asbestos exports. Rather, the inquiries constituted elements in the industry's successful public relations exercise that continues to operate to this day. Even when an increasing number of national bodies have legislated for total bans on asbestos use, a policy with which all the international bodies concerned with public health agree, the Canadian PR apparatus continues to be able to call on physicians and scientists prepared to oppose the consensuses reached by the independent advisors to these bodies.

Jock McCulloch (1945-2018): A Tribute.

Jock William McCulloch, who died at Melbourne, Australia, in January 2018, was one of the foremost historians of occupational health of his generation. This tribute reviews his career and oeuvre, which was tragically ended by his death from mesothelioma.

A review of historical exposures to asbestos among skilled craftsmen (1940-2006).

This article provides a review and synthesis of the published and selected unpublished literature on historical asbestos exposures among skilled craftsmen in various nonshipyard and shipyard settings. The specific crafts evaluated were insulators, pipefitters, boilermakers, masons, welders, sheet-metal workers, millwrights, electricians, carpenters, painters, laborers, maintenance workers, and abatement workers. Over 50 documents were identified and summarized. Sufficient information was available to quantitatively characterize historical asbestos exposures for the most highly exposed workers (insulators), even though data were lacking for some job tasks or time periods. Average airborne fiber concentrations collected for the duration of the task and/or the entire work shift were found to range from about 2 to 10 fibers per cubic centimeter (cm3 or cc) during activities performed by insulators in various nonshipyard settings from the late 1960s and early 1970s. Higher exposure levels were observed for this craft during the 1940s to 1950s, when dust counts were converted from millions of particles per cubic foot (mppcf) to units of fibers per cubic centimeter (fibers/cc) using a 1:6 conversion factor. Similar tasks performed in U.S. shipyards yielded average fiber concentrations about two-fold greater, likely due to inadequate ventilation and confined work environments; however, excessively high exposure levels were reported in some British Naval shipyards due to the spraying of asbestos. Improved industrial hygiene practices initiated in the early to mid-1970s were found to reduce average fiber concentrations for insulator tasks approximately two- to five-fold. For most other crafts, average fiber concentrations were found to typically range from <0.01 to 1 fibers/cc (depending on the task or time period), with higher concentrations observed during the use of powered tools, the mixing or sanding of drywall cement, and the cleanup of asbestos insulation or lagging materials. The available evidence suggests that although many historical measurements exceeded the current OSHA 8-h time-weighted average (TWA) permissible exposure limit (PEL) of 0.1 fibers/cc, average fiber concentrations generally did not exceed historical occupational exposure limits in place at the time, except perhaps during ripout activities or the spraying of asbestos in enclosed spaces or onboard ships. Additionally, reported fiber concentrations may not have represented daily or actual human exposures to asbestos, since few samples were collected beyond specific short-term tasks and workers sometimes wore respiratory protective equipment. The available data were not sufficient to determine whether the airborne fiber concentrations represented serpentine or amphibole asbestos fibers, which would have a pronounced impact on the potential health hazards posed by the asbestos. Despite a number of limitations associated with the available air sampling data, the information should provide guidance for reconstructing asbestos exposures for different crafts in specific occupational settings where asbestos was present during the 1940 to 2006 time period.

The Rochdale asbestos cancer studies and the politics of epidemiology: what you see depends on where you sit.

The history of the exploitation of epidemiology by the U.K. asbestos industry and the subsequent obscuring of the disastrous results of exposures is presented, exploring in particular the roles of Sir Richard Doll and his colleagues. Epidemiology, often regarded as a neutral science, is susceptible to socio-political influences.

Shooting the messenger: the vilification of Irving J. Selikoff.

Dr. Irving J. Selikoff (1915-1992), a New York physician based at Mount Sinai Hospital, was the leading American medical expert on asbestos-related diseases between the 1960s and early 1990s. In a country that had been the world's greatest consumer of asbestos, he was also at the center of the key controversies connected with the mineral. In these controversies, Selikoff was consistently demonized as a media zealot who exaggerated the risks of asbestos on the back of bogus medical qualifications and flawed science. Since his death, the criticism has become even more vituperative and claims have persisted that he was malicious or a medical fraud. However, most of the attacks on Selikoff were inspired by the asbestos industry or its sympathizers, and for much of his career he was the victim of a sustained and orchestrated campaign to discredit him. The most serious criticisms usually more accurately describe his detractors than Selikoff himself.

[Asbestos: a long lasting tragedy. Useful considerations for a historical reconstruction of the most remarkable facts]. / Amianto: una tragedia di lunga durata. Argomenti utili per una ricostruzione storica dei fatti più rilevanti.

A thought back on the "epic of asbestos" scanning the fundamental steps, from the "discovery" of the adverse effects for the workers. A first phase, the "asbestosis one" concluded in Britain in the early thirties with the issue of a technical legislation is described. It was the first regulation shared by the Unions and the asbestos companies, some of which were or will then become leaders all over the world. The main effect of this legislation enforcement is the reduction of the exposure in some units of the asbestos textile industry; no effects were observed instead in other asbestos industrial divisions where it's consumption for insulations and asbestos cement increased massively. The second phase lasting approximately thirty years next sees together to a formidable diffusion of all the asbestos fibres including the crocidolite ones, advertised and accepted like "indispensable" for the economical and social development, an absolute leadership of the companies in the management of health effects information for the workers and therefore also those on the pulmonary cancerogenicity. Such selfish and aggressive leadership, receives in return from government, labour and consumers organizations just inertia, impotence and incredulity. This attitude will also continue in the third phase, beginning in the early sixties of the last century. The time period will be dominated by mesothelioma with all its new and terrible meanings, the dangerousness of asbestos exposure especially to the blue one even at lower levels than those observed in the past for other pathologies and the long latency before the appearance of the effects. Discussing about asbestos substitutes was out of the agenda, indeed just in the period where the mining and the consumption of asbestos touched the highest levels. The initiatives assumed in some countries like the auto limitation of the use of crocidolite and a more rigorous reduction of the occupational exposures will only turn out useful in order to lower the risk for asbestosis and, probably, the one for pulmonary tumour. In the United States, the judicial litigation for compensation between the workers and the companies begins. The same phenomenon will characterize also in the other countries industrializes the fourth phase of the epic, until our days; it is just in these years, and especially during the eighties, that industry starts thinking about the substitution of asbestos; the lively public debate will favour initiatives oriented to obtain economic compensation for damages caused by past occupational and environmental exposures. These legal actions will carry to bankruptcy all the asbestos companies and later to the ban of asbestos. The judicial debates will also uncover "confidential" information useful to better reconstruct the epic, to formulate more dispassionate historical judgments and to allow everyone on answering to more complex questions and more important than how much generally it was previously believed; all this should happen contextualizing the ages in which the scientific acquaintances on the effects of asbestos have been published and disproving prejudgments, able to affect some conclusions of the past.

Clarence Borel.

Borel v. Fibreboard Paper Products Corporation is the 1973 landmark case that paved the way for successful litigation against the asbestos industry. Clarence Borel's granddaughter shares recollections of the reluctant man behind the court case.

[Wonder matter and assassin. The perception of the asbestos danger as a mirror of the time 1930-1990]. / Wonderstof en sluipmoordenaar. De perceptie van het Asbestgevaar als spiegel van de tijd 1930-1990.

In the seventies and eighties of the twentieth century the ideas of the dangers concerning the use of asbestos changed dramatically. The mineral, which had, more than half a century before been introduced in the Netherlands as a miraculous mineral, was completely banned from use. Asbestos became known as a 'silent killer' and 'the blue sand of death', and as a symbol of the hidden hazards of a deteriorating environment caused by unscrupulous companies and indolent authorities. Asbestos seems to fit perfectly into the ubiquitous hazards which Ulrich Beck defines in his concept of the 'risk society' as the dangerous side effects of industrial production. Yet the perception of the risk associated with asbestos depended more on socio-cultural characteristics than on scientifically risk assessments. In the first half of the twentieth century the use of asbestos was limited and therefore did not cause any concern. Economic crisis and war silenced the first alarming signals of asbestos related disease from foreign experts and a handful of Dutch physicians. The asbestos workers themselves were held responsible for their own health and safety. In the 1951 asbestosis became recognised as an industrial disease. Preventive measures with regard to the industrial use of asbestos were prescribed by law. Workers shared the responsibilities for a safe use with employers and authorities. However, during this period, all the attention was directed towards economic growth. Supervision by the labour inspection was scarce and workers and employers were not very interested in upholding the safety measures. Among asbestos workers the use of protective clothes and dust masks was generally seen as unmanly. In the sixties the foreign literature on the connection between the exposure to asbestos and the occurrence of lung cancer and mesothelioma became known among Dutch specialists. The results of these studies were confirmed by research among Dutch insulation workers. At the same time the trade unions rejected the idea of a shared responsibility and formulated the unilateral 'right to a safe working environment', with the implication that, in their view, all unhealthy and unsafe procedures should unconditionally be banned from the workshops, including the use of asbestos. Concerned civilians, environmental lobbyists, progressive political parties and concerned scientists transformed this idea into a 'right to a safe living environment', while mass media spread the message. Asbestos was pointed out as a threat to the public health, tracked down all of its hiding places and ultimately removed. The ban on asbestos was one of the results of democratisation and emancipation movement of the late sixties and seventies. The emancipation expressed itself in an increasing intolerance to risks brought about by powerful companies and bureaucratic authorities.