Asbestos examinations for construction workers

Our plain-English summary of Asbestos examinations for construction workers, by S.P. Schneider (American Journal of Public Health, 1987).

The study

• Author: S.P. Schneider
• Journal: American Journal of Public Health
• Published: 1987;77(5):645-6
• Type of article: Letter
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000998).

In plain English

This letter to the editor was not a research study and reported no new data. The author, an industrial hygienist with the United Brotherhood of Carpenters and Joiners of America, responded to an editorial by Dr. Whorton. The author argued that by and large only unionized workers would get exams, since union dues records let programs track them; the exceptions were non-union workers at responsible asbestos-abatement companies with steady work crews. The letter raised four objections to new OSHA requirements. Construction workers had to be exposed above the action level (0.1 f/cc) for 30 or more days per year to get a free exam, unlike general industry workers. They had no x-ray schedule. The required questionnaire collected no occupational history of previous asbestos exposure; its only exposure question was "Have you ever worked with asbestos?", against almost two pages on smoking. Employers received a written opinion with exam results, which the author believed violated patient-physician confidentiality. The author also noted that the standard provided no exams for workers no longer exposed, such as retirees. The author concluded that construction workers were still not guaranteed the medical surveillance they deserve and need.

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: letter to the editor (commentary responding to an editorial); no study data
• Who was studied: US construction workers, union and non-union, covered by the new OSHA asbestos standard; no group was studied
• Exposure: asbestos exposure above the OSHA action level of 0.1 f/cc; for construction workers, exams were tied to 30 or more days per year above that level
• Main results:
  • The author argued that union programs can track workers through dues records and give them their results, while non-union workers have no such mechanism
  • The author argued that by and large only unionized workers would get the exams, and that the exceptions were non-union workers at responsible companies doing only asbestos abatement and keeping a steady work crew
  • The author noted that under the general industry standard any exposure over the action level brings a free medical exam, but construction workers must be exposed over the action level for 30 or more days per year
  • The author noted that industrial workers have an x-ray schedule based on time since first exposure, because the latency period is normally 10-20 years, while construction workers receive x-rays only at the physician's discretion
  • The author wrote that the OSHA-required questionnaire contains no occupational history of previous asbestos exposure; its only exposure question is "Have you ever worked with asbestos?", while almost two pages of questions cover smoking
  • The author believed that the requirement for employers to obtain a written opinion with examination results violates patient-physician confidentiality
  • The author noted that the standard has no provision for exams for workers no longer exposed to asbestos, such as retirees or those who switched to other construction work
  • The author stated that all four objections had been raised in a legal challenge to the standard by the Building and Construction Trades Department, AFL-CIO
• The authors' conclusion: The author concluded that construction workers were still not guaranteed the medical surveillance they deserve and need

Related studies

• Asbestos examinations for construction workers: a workable alternative — M.D. Whorton (1986)
• Comparison of U.S. Occupational Safety and Health Administration standards and German Berufsgenossenschaften Guidelines for Preventive Occupational Health Examinations — K. Straif, M. Silverstein (1997)
• Development of a medical examination program for former workers at a Department of Energy national laboratory — P.N. Breysse, V. Weaver, et al. (2002)
• Swedish approaches to industry-wide studies: the construction industry — A. Englund (1991)
• A labor-management occupational health service in a construction industry — I.R. Tabershaw, W.C. Cooper, et al. (1970)
• Participatory mapping of occupational hazards and disease among asbestos-exposed workers from a foundry and insulation complex in Canada — M.M. Keith, J.T. Brophy (2004)

Browse more research in American Journal of Public Health, or return to medical research.