Asbestos screening and education programs for building and construction trades unions

Our plain-English summary of Asbestos screening and education programs for building and construction trades unions, by S. Tillett, P. Sullivan (American Journal of Industrial Medicine, 1993).

The study

• Authors: S. Tillett, P. Sullivan
• Journal: American Journal of Industrial Medicine
• Published: 1993;23(1):143-52
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Worker notification involves informing current and past employees of their risk of disease. It also involves suggesting ways to reduce their risks. The asbestos screening and education programs designed for the building and construction trades unions were a national multisite effort that focused on improving the health of eligible union members and retirees at high risk of developing asbestos-related disease. The asbestos screening and education programs were made available to "high-risk," asbestos-exposed local union members through the efforts of a number of international unions, including the International Union of Elevator Constructors and the Laborers' International Union of North America--both affiliates of the Building and Construction Trades Department, AFL-CIO. Consultation and program assistance in developing and implementing these programs were provided by the Occupational Health Foundation, a labor-sponsored, nonprofit organization with a multidisciplinary safety and health staff. Program components included identification of "high-risk" individuals, notification of risk, education, medical screening, legal referral, and various support services. Community-based physicians and/or physician-staffed mobile testing units provided services on a contractual basis according to a standardized medical protocol. Between 1988 and 1991, 2,136 union members and retirees from 89 local unions affiliated with the Elevator Constructors or the Laborers were screened in 59 regional programs. A general description and historical perspective are offered concerning program implementation, integration into existing union infrastructures. Emphasis is placed on the role of the unions in advancing members' interests when dealing with the health and socioeconomic implications of asbestos-related disease.

In plain English

This article described asbestos screening and education programs that two building trades unions, the International Union of Elevator Constructors and the Laborers' International Union of North America, ran between 1988 and 1991 with help from the Occupational Health Foundation. The authors stated that it was not conducted as a scientific study. Programs were generally limited to members and retirees with 20 years or more since first exposure to asbestos at work. The programs offered medical screening, including two chest X-rays, along with education sessions. Local attorneys were also identified for each regional program. In total, 1,088 Elevator Constructors and 1,048 Laborers were seen. The authors estimated participation at 16% and 17% of eligible members and called these figures approximations. Medical results were not analyzed. Preliminary information suggested that approximately 18% of Elevator Constructors and approximately 37% of Laborers screened had evidence of an abnormality consistent with asbestos-related disease. The authors noted low participation, potential self-selection bias, and the absence of a formal evaluation plan. They concluded that the effort produced a national model of notification, screening, and education.

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: Descriptive report of union-sponsored asbestos screening and education programs (a demonstration service program, not a scientific study)
• Who was studied: Members and retirees of local unions of the Elevator Constructors and the Laborers in the United States, generally with 20 or more years since first workplace exposure to asbestos, screened 1988 to 1991. In total 2,136 participants from 89 local unions took part in 59 regional programs.
• Exposure: Past occupational asbestos exposure in construction trades. For elevator constructors this included sprayed-on insulation in elevator shafts and elevator clutch or brake linings. For laborers it included carrying insulation, mixing dry asbestos into plaster, and cutting asbestos shingles. No fiber types were named.
• Main results:
  • Elevator Constructors: 1,088 union members and retirees from 60 local unions were seen in 42 cities.
  • Laborers: 1,048 members were screened in 17 cities.
  • Estimated participation rate among eligible members was 16% for Elevator Constructors and 17% for Laborers.
  • Of the 2,136 participants, 151 (8%, as printed) paid for the examination themselves; most self-payers were retirees.
  • Preliminary, unanalyzed information suggested that approximately 18% of Elevator Constructors and approximately 37% of Laborers screened had evidence of an abnormality consistent with asbestos-related disease.
  • Screening included two chest X-rays (PA and lateral).
  • Local attorneys were identified for each of the 59 regional programs.
  • Physician charges ranged from $105 to $205 per participant.
  • Participating attorneys offered reduced contingency rates for third-party suits, generally 25% to 33.3%.
• The authors' conclusion: The authors concluded that one positive outcome was the development of a national model of notification, screening, and education for high-risk asbestos-exposed union members.
• Limitations the authors state:
  • There was no formal evaluation plan to assess the programs' overall effectiveness.
  • Medical results were not analyzed and would not give reliable figures because of low participation and potential self-selection bias.
  • Participation rates are only approximations, because they rely on union counts of eligible members.
  • Retirees' participation was severely limited by the need to pay for the examination themselves.

Related studies

• Experiences of a state-sponsored notification and screening program for asbestos workers — A.P. Bender, A.N. Williams, et al. (1993)
• Beyond notification: a case study from Cloquet, Minnesota — M.J. Finendale (1993)
• Worker produced health education material for the construction trades — D.L. Roter, R.E. Rudd, et al. (1986)
• "Serving two masters"--an interview with school teacher and union organizer Debra Askwith — M.K. Scammell, E. Rodrigues (2010)
• Teachers Union Organizes Members to Enforce AHERA Law--A Work in Progress — M.P. Sireci, C. Levenstein, et al. (2016)
• Cancer incidence among members of the Norwegian trade union of insulation workers — B. Ulvestad, K. Kjaerheim, et al. (2004)

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