An epidemiological view of asbestos in buildings

Our plain-English summary of An epidemiological view of asbestos in buildings, by J.C. McDonald (Toxicology and Industrial Health, 1991).

The study

• Author: J.C. McDonald
• Journal: Toxicology and Industrial Health
• Published: 1991;7(5-6):187-93
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

This article reviewed the epidemiological evidence on health risks from the use of asbestos in building construction. It focused particularly on developing countries, whose main need was for asbestos-cement products for buildings, water supply and drainage. The author set out the costs and benefits, noting that the benefits could only be confirmed by construction engineers, and drew on published survey data and about a dozen cohort studies. EPA survey data suggested that fibre concentrations inside buildings were extremely low and did not closely reflect whether asbestos-cement materials were present. Demolition of buildings containing friable asbestos could produce outdoor levels up to about 1 f/ml. In the United Kingdom, asbestos-cement pipe had not been shown to contribute significantly to fibres in drinking water. Excess lung cancer risk was roughly proportional to duration multiplied by fibre concentration. It was about 1% per fibre-year in textile processes, compared with about 0.02% in chrysotile mining and friction product manufacture. In an analysis of 42 cohorts reported by 1988, excess mortality among workers exposed to chrysotile only was 1.7% for pneumoconiosis, 1.8% for lung cancer and 0.2% for mesothelioma. For workers whose exposure included amphiboles, the figures were 4.0%, 7.0% and 3.8%. The author concluded that strictly controlled use of chrysotile need entail little or no risk. No such assurance could be given for crocidolite or amosite, and friable products should be avoided.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was a review and commentary by the author, not a new study. It drew on published epidemiological studies and agency estimates to discuss the health risks of asbestos used in buildings, especially asbestos cement products. The author reported that survey data published by EPA suggested fibre concentrations inside buildings were extremely low and did not closely reflect whether asbestos cement was present. Demolition of buildings with friable asbestos could produce outdoor levels up to about 1 f/ml. Citing earlier cohort studies, the article gave excess lung cancer risks of about 1% per fibre-year in textile processes and about 0.02% per fibre-year in chrysotile mining and friction product manufacture. In the author's earlier analysis of 42 cohorts, workers exposed to chrysotile only had overall excess mortality of 1.7% for pneumoconiosis, 1.8% for lung cancer and 0.2% for mesothelioma. For workers whose exposure included amphiboles the figures were 4.0%, 7.0% and 3.8%. The author concluded that strictly controlled use of chrysotile need entail little or no risk, but that no such assurance could be given for crocidolite or amosite. The author noted that the risk estimates rest on gross approximations.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review and commentary (epidemiological overview of published evidence); no new data collected
• Who was studied: No study population of its own. The author drew on published cohort studies, including the author's own earlier analysis of excess mortality in all 42 cohorts reported by 1988, plus building fibre surveys and agency risk estimates.
• Exposure: Asbestos in building materials, mainly non-friable (high density) asbestos cement products, as well as friable asbestos materials, asbestos vinyl floor tiles and asbestos cement water pipe. The article compares chrysotile with the amphiboles (crocidolite, amosite, tremolite).
• Main results:
  • Survey data published by EPA (Spengler et al, 1989) suggested that asbestos fibre concentrations within buildings were extremely low and did not closely reflect whether asbestos cement materials were present or what condition they were in.
  • Demolition of buildings containing friable asbestos products could produce outdoor measurements up to about 1 f/ml. Indoor removal of such materials produced almost unmeasurably high levels.
  • In the United Kingdom, asbestos fibre concentrations in drinking water were given as about 400 to 2000 f/ml (as printed). Studies there had not shown that asbestos pipe made any significant contribution.
  • From earlier cohort studies: textile processes carried an excess lung cancer risk of about 1% per fibre-year of exposure.
  • From earlier cohort studies: chrysotile mining and friction product manufacture carried an excess lung cancer risk of about 0.02% per fibre-year. The risk in asbestos cement manufacture approximated that for chrysotile mining, except where amphiboles had been used. There were no data for construction workers as such.
  • In the author's earlier analysis of 42 cohorts (McDonald, 1989), overall excess mortality for workers exposed to chrysotile only was 1.7% for pneumoconiosis, 1.8% for lung cancer and 0.2% for mesothelioma. The corresponding figures for workers whose exposure included amphiboles were 4.0%, 7.0% and 3.8%.
• The authors' conclusion: The author concluded that, until a less hazardous but equally effective substitute is found, strictly controlled use of chrysotile need entail little or no risk. No such assurance could be given for crocidolite or amosite. Products that will inevitably release uncontrollable fibre concentrations with wear, repair or demolition should be avoided.
• Limitations the authors state:
  • Lifetime risk estimates are based on gross approximations and substantial assumptions.
  • Whether a linear non-threshold exposure-response model is correct is controversial. The author assumed it, noting that it almost certainly overstates risk at very low airborne fibre concentrations.
  • The paper could not document the benefits of asbestos use with any authority, only the risks.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos-Cement, Friable, Asbestos-Cement Pipe, Lung Cancer, Chrysotile, Pneumoconiosis, Mesothelioma, Amphibole Group.

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