Experiences of a state-sponsored notification and screening program for asbestos workers

Our plain-English summary of Experiences of a state-sponsored notification and screening program for asbestos workers, by A.P. Bender, A.N. Williams, D.L. Parker (American Journal of Industrial Medicine, 1993).

The study

• Authors: A.P. Bender, A.N. Williams, D.L. Parker
• Journal: American Journal of Industrial Medicine
• Published: 1993;23(1):161-9
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Worker notification can involve a broad range of activities including medical screening, personal and mass communications, cohort identification and tracing, and even litigation. The inclusion or exclusion of various supporting activities in a worker notification program may pose significant medical, public health, financial, logistical, and even legal implications for targeted individuals as well as for the agencies involved. This report describes some experiences in a state-sponsored notification and screening program of approximately 4,500 asbestos workers in Minnesota. In this program, a variety of factors led to the decision to provide medical screening to 1,101 workers and 451 spouses. It is anticipated that another 3,400 workers will be notified but not screened. A follow-up survey of notified workers showed overwhelming support for this program. It is estimated that this program will cost more than $650,000 by its completion. The decision to institute medical screening and other support activities should be made with careful consideration of the diverse implications of these activities to the individuals, communities, and agencies involved.

In plain English

This article was a descriptive report of a Minnesota Department of Health program to notify and medically screen former workers of the Conwed Corporation plant in Cloquet, Minnesota. Asbestos was used at the plant to make fire-rated ceiling tile and wallboard from 1958 to 1974. No industrial hygiene measurements of asbestos levels appeared to be available. Over 33 work days, the program screened 1,552 people, including 451 spouses. The authors reported that about 40% of workers with 20 or more years of latency (time since exposure) had some abnormal finding on chest X-ray, lung function testing or physical examination. Risks to spouses were much lower than expected. In a follow-up survey with a 92% response rate, over 95% of respondents supported having been notified. Company records later identified about 2,200 previously unknown workers. About 1,800 of them were traced and sent a notification that did not offer screening. The authors estimated the total cost would exceed $650,000. They concluded that such programs can be very complex and costly. They noted that their survey had no true control group.

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 a state-sponsored worker notification and medical screening program, including a follow-up mailed survey of notified workers
• Who was studied: Former workers employed 1958 to 1974 at the Conwed Corporation plant in Cloquet, Minnesota, and their spouses. 1,552 individuals were screened, including 451 spouses. In total about 4,500 workers were expected to be identified.
• Exposure: Asbestos used in producing fire-rated ceiling tile and wallboard at the plant between 1958 and 1974. The fiber type was not specified. No industrial hygiene data on asbestos levels appeared to be available.
• Main results:
  • Among screened workers with 20 or more years of latency, about 40% had some abnormal finding from the chest radiograph, pulmonary function test, or physical examination
  • Risks to spouses were much lower than expected
  • Screening covered 1,552 individuals (stated as 1,105 workers and 451 spouses) over 33 work days, with 91% of potential appointment times filled
  • The follow-up survey of about 1,300 initially notified workers had an overall response rate of 92%
  • Over 95% of survey respondents supported having been notified of their health risks
  • About one-third of survey respondents had discussed their exposure or screening results with a doctor
  • Company personnel records identified approximately 2,200 previously unknown workers, of whom approximately 1,800 were traced
  • The notification and screening phase cost about $326,000 through March 1989
  • The whole program was estimated to cost more than $650,000 by completion
• The authors' conclusion: The authors concluded that worker notification programs can be very complex and costly, more so than a typical occupational follow-up study. They found that including medical screening greatly increased complexity, and that the decision to institute screening should be made with careful consideration of its implications for individuals, communities and agencies.
• Limitations the authors state:
  • The follow-up evaluation did not include a true control group
  • Because there was no control group, factors such as stress and anxiety could not be examined
  • Cost estimates did not include costs to individuals or insurers for medical follow-up, missed work, or other indirect costs
  • Company personnel records contained many duplicates and omitted many known workers

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Related studies

• Assessing quality of life when planning and evaluating worker notification programs: two case examples — B.E. Meyerowitz (1993)
• Beyond notification: a case study from Cloquet, Minnesota — M.J. Finendale (1993)
• Asbestos disease risk communication conducted by the New Jersey Department of Health — M. Stanbury, G. Solice-Sample, et al. (1993)
• Reactions of asbestos-exposed workers to notification and screening — B.E. Meyerowitz, C.D. Sullivan, et al. (1989)
• Asbestos screening and education programs for building and construction trades unions — S. Tillett, P. Sullivan (1993)
• FIOH-sponsored newsletter misrepresents asbestos hazards in Zimbabwe — J.C. Bailar, S.G. Ballal, et al. (2006)

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