American Journal of Public Health

Our medical research library holds 43 studies published in American Journal of Public Health (1976–2020). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 24 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 6 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: American Public Health Association
• Published: 1971 to the present, United States
• Language: English
• ISSN: 0090-0036 (print), 1541-0048 (electronic)
• Its record in the NLM Catalog

2020s

• Baby Powders and the Precautionary Principle. D. Rosner, G. Markowitz. 2020;110(9):1378-1379. Editorial PubMed · Publisher · Free full text

  Summary

  In this editorial, the authors discussed Johnson & Johnson's (J&J) announcement on May 19, 2020, that it would stop selling talc-based Baby Powder in the United States. Sales would continue in Europe, and North Americans would be offered only a cornstarch-based product. The authors described lawsuits alleging that women and children exposed to talc as infants or while powdering after showers later developed mesotheliomas and ovarian cancers caused by asbestos-contaminated talc. In one case, in which one of the authors testified for the plaintiffs, a jury awarded 22 women $4.69 billion; the award was reduced to $2 billion on appeal. Drawing on historical evidence, the authors noted that asbestos was linked to lung cancer by the mid-1950s and to mesothelioma by the early 1960s, and that talc from many mines had been known since the early 20th century to contain asbestos. They also noted that a 1968 Public Health Service study raised questions about contamination of commercial talcum products, and that the industry forestalled talc testing methods proposed by the Food and Drug Administration in September 1973. They observed that J&J described its product as safe but did not say its talc was free of asbestos. The authors concluded that removing talc, prompted by the prospect of more litigation, was a grudging application of the precautionary principle. They argued that by not switching earlier to cornstarch, which had been available for decades, J&J had put thousands of women in danger by possibly exposing them to a known carcinogen. Both authors disclosed that they had testified for plaintiffs in asbestos and talc litigation.

  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.

2010s

• "Nondetected": The Politics of Measurement of Asbestos in Talc, 1971-1976. D. Rosner, G. Markowitz, M. Chowkwanyun. 2019;109(7):969-974. PubMed · Publisher · Free full text

  Abstract

  The recent lawsuits against Johnson & Johnson have raised the issue of what and when talcum powder manufacturers knew about the presence of asbestos in their products and what they did or did not do to protect the public. Low-level exposure to asbestos in talc is said to result in either mesothelioma or ovarian cancer. Johnson & Johnson has claimed that there was "no detectable asbestos" in their products and that any possible incidental presence was too small to act as a carcinogen. But what exactly does "nondetected" mean? Here, we examine the historical development of the argument that asbestos in talcum powder was "nondetected." We use a unique set of historical documents from the early 1970s, when low-level pollution of talc with asbestos consumed the cosmetics industry. We trace the debate over the Food and Drug Administration's efforts to guarantee that talc was up to 99.99% free of chrysotile and 99.9% free of amphibole asbestos. Cosmetic talc powder manufacturers, through their trade association, pressed for a less stringent methodology and adopted the term "nondetected" rather than "asbestos-free" as a term of art.

• Expert Review Under Attack: Glyphosate, Talc, and Cancer. J.M. Samet. 2019;109(7):976-978. Comment PubMed · Publisher · Free full text

• Public Health and Independent Risk Assessment. P. Vineis. 2019;109(7):978-980. Comment PubMed · Publisher · Free full text

• Reimagining Our System for Public Health Protection. D. Michaels. 2019;109(7):975-976. Comment PubMed · Publisher · Free full text

• Reliance, Not Responsibility: Relations Between Science and Industry. H. Rodenberg. 2019;109(7):980-981. Comment PubMed · Publisher · Free full text

• Yield of Low-Dose Computerized Tomography Screening for Lung Cancer in High-Risk Workers: The Case of 7189 US Nuclear Weapons Workers. S.B. Markowitz, A. Manowitz, J.A. Miller, et al. 2018;108(10):1296-1302. PubMed · Publisher · Free full text

  Abstract

  Objectives: To determine the lung cancer screening yield and stages in a union-sponsored low-dose computerized tomography scan program for nuclear weapons workers with diverse ages, smoking histories, and occupations.

  Methods: We implemented a low-dose computerized tomography program among 7189 nuclear weapons workers in 9 nonmetropolitan US communities during 2000 to 2013. Eligibility criteria included age, smoking, occupation, radiographic asbestos-related fibrosis, and a positive beryllium lymphocyte proliferation test.

  Results: The proportion with screen-detected lung cancer among smokers aged 50 years or older was 0.83% at baseline and 0.51% on annual scan. Of 80 lung cancers, 59% (n = 47) were stage I, and 10% (n = 8) were stage II. Screening yields of study subpopulations who met the National Lung Screening Trial or the National Comprehensive Cancer Network Group 2 eligibility criteria were similar to those found in the National Lung Screening Trial.

  Conclusions: Computerized tomography screening for lung cancer among high-risk workers leads to a favorable yield of early-stage lung cancers. Public Health Implications. Health equity and efficiency dictate that screening high-risk workers for lung cancer should be an important public health priority.

• "Ain't Necessarily So!": The Brake Industry's Impact on Asbestos Regulation in the 1970s. D. Rosner, G. Markowitz. 2017;107(9):1395-1399. PubMed · Publisher · Free full text

  Abstract

  Canada is proposing a ban on asbestos, and the US Environmental Protection Agency has listed it among the first 10 materials it is investigating under the new Toxic Substances Control Act revisions. However, this effort is currently running up against enormous industry and political opposition. Here, we detail the activities in the early 1970s of the Friction Materials Standards Institute, an industry trade association, to stifle earlier attempts to regulate asbestos use in brake linings, one of the oldest and most obvious sources of asbestos exposure to mechanics, among others. (Am J Public Health. 2017: 1395-1399. doi:10.2105/AJPH.2017.303901).

• "Unleashed on an Unsuspecting World": The Asbestos Information Association and Its Role in Perpetuating a National Epidemic. G. Markowitz, D. Rosner. 2016;106(5):834-40. PubMed · Publisher · Free full text

  Abstract

  Examining previously underused corporate documents, we revisit the story of the Asbestos Information Association/North America, an industry trade group that sought in the early 1970s to counteract the growing public attention to, and government regulation of, asbestos as a serious threat to workers and consumers. From the mid-1960s through the early 1970s, according to its own spokesperson, asbestos was exposed as "probably the most hazardous industrial material ever unleashed on an unsuspecting world." In retrospect, thousands of lives may have been saved if the Asbestos Information Association had publicly acknowledged this earlier.

• Gibb et al. respond. H. Gibb, K. Fulcher, S. Nagarajan, et al. 2014;104(2):e1-2. Letter · Comment PubMed · Publisher · Free full text

• Incorrect analyses of radiation and mesothelioma. J. Zhou. 2014;104(2):e1. Letter · Comment PubMed · Publisher · Free full text

• Analyses of radiation and mesothelioma in the US Transuranium and Uranium Registries. H. Gibb, K. Fulcher, S. Nagarajan, et al. 2013;103(4):710-6. PubMed · Publisher · Free full text

  Abstract

  Objectives: We examined the relationship between radiation and excess deaths from mesothelioma among deceased nuclear workers who were part of the US Transuranium and Uranium Registries.

  Methods: We performed univariate analysis with SAS Version 9.1 software. We conducted proportionate mortality ratio (PMR) and proportionate cancer mortality ratio (PCMR) analyses using the National Institute for Occupational Safety and Health Life Table Analysis System with the referent group being all deaths in the United States.

  Results: We found a PMR of 62.40 (P < .05) and a PCMR of 46.92 (P < .05) for mesothelioma. PMRs for the 4 cumulative external radiation dose quartiles were 61.83, 57.43, 74.46, and 83.31. PCMRs were 36.16, 47.07, 51.35, and 67.73. The PMR and PCMR for trachea, bronchus, and lung cancer were not significantly elevated.

  Conclusions: The relationship between cumulative external radiation dose and the PMR and PCMR for mesothelioma suggests that external radiation at nuclear facilities is associated with an increased risk of mesothelioma. The lack of a significantly elevated PMR and PCMR for trachea, bronchus, and lung cancer suggests that asbestos did not confound this relationship.

• Cancer incidence in a cohort of Swedish chimney sweeps, 1958-2006. C. Hogstedt, C. Jansson, M. Hugosson, et al. 2013;103(9):1708-14. PubMed · Publisher · Free full text

  Abstract

  Objectives: We examined cancer incidence in an expanded cohort of Swedish chimney sweeps.

  Methods: We added male chimney sweep trade union members (1981-2006) to an earlier cohort (employed 1918-1980) and linked them to nationwide registers of cancer, causes of deaths, and total population. The total cohort (n = 6320) was followed from 1958 through 2006. We estimated standardized incidence ratios (SIRs) using the male Swedish population as reference. We estimated exposure as years of employment and analyzed for exposure-response associations by Poisson regression.

  Results: A total of 813 primary cancers were observed versus 626 expected (SIR = 1.30; 95% confidence interval = 1.21, 1.39). As in a previous follow-up, SIRs were significantly increased for cancer of the esophagus, liver, lung, bladder, and all hematopoietic cancer. New findings included significantly elevated SIRs for cancer of the colon, pleura, adenocarcinoma of the lung, and at unspecified sites. Total cancer and bladder cancer demonstrated positive exposure-response associations.

  Conclusions: Exposure to soot and asbestos are likely causes of the observed cancer excesses, with contributions from adverse lifestyle factors. Preventive actions to control work exposures and promote healthier lifestyles are an important priority.

• With the best intentions: lead research and the challenge to public health. D. Rosner, G. Markowitz. 2012;102(11):e19-33. Historical article PubMed · Publisher · Free full text

  Abstract

  In 2001, Maryland's court of appeals was asked to decide whether researchers at Johns Hopkins University had engaged in unethical research on children. During the 1990s, Johns Hopkins's Kennedy Krieger Institute had studied 108 African American children, aged 6 months to 6 years, to find an inexpensive and "practical" means to ameliorate lead poisoning. We have outlined the arguments in the case and the conundrum faced by public health researchers as they confront new threats to our health from environmental and industrial insults. We examined the case in light of contemporary public health ideology, which prioritizes harm reduction over the historical goals of prevention. As new synthetic toxins-such as bisphenyl A, polychlorinated biphenyls, other chlorinated hydrocarbons, tobacco, vinyl, and asbestos-are discovered to be biologically disruptive and disease producing at low levels, lead provides a window into the troubling dilemmas public health will have to confront in the future.

2000s

• Asbestos-related disease in South Africa: the social production of an invisible epidemic. L. Braun, S. Kisting. 2006;96(8):1386-96. Historical article PubMed · Publisher · Free full text

  Abstract

  South Africa was the third largest exporter of asbestos in the world for more than a century. As a consequence of particularly exploitative social conditions, former workers and residents of mining regions suffered--and continue to suffer--from a serious yet still largely undocumented burden of asbestos-related disease. This epidemic has been invisible both internationally and inside South Africa. We examined the work environment, labor policies, and occupational-health framework of the asbestos industry in South Africa during the 20th century. In a changing local context where the majority of workers were increasingly disenfranchised, unorganized, excluded from skilled work, and predominantly rural, mining operations of the asbestos industry not only exposed workers to high levels of asbestos but also contaminated the environment extensively.

1990s

• Asbestos-related cancer and the amphibole hypothesis. The amphibole hypothesis: neither gone nor forgotten. A.M. Langer, R.P. Nolan. 1997;87(4):688-9; author reply 690-1. Comment · Letter PubMed · Publisher · Free full text

• Asbestos-related cancer and the amphibole hypothesis. The first documentation of the association. J.C. Wagner. 1997;87(4):687-8. Comment · Letter PubMed · Publisher · Free full text

  Summary

  In this letter, J. Christopher Wagner, who described himself as the original discoverer of mesothelioma in people exposed to asbestos dust, responded to an annotation by Cullen and a review by Stayner and colleagues published earlier in the journal. He said these articles may have confused readers about the association between asbestos exposure and diffuse mesothelioma of the pleura and peritoneum. He recounted that in 1957, in the Cape area of South Africa, his group established that pleural mesotheliomas were occurring in people living near mills processing blue (crocidolite) asbestos and in people milling and mining it. The main paper was published in 1960, and in 1963 the group confirmed that the tumors occurred in the crocidolite mining area but not in the amosite or chrysotile areas of southern Africa. He stated that an international study had supported the initial hypothesis. The vast majority of mesotheliomas were associated with crocidolite exposure, and a small number followed exposure to amosite, tremolite and anthophyllite. None had been shown in chrysotile-exposed workers unless exposure was intense and lasted more than 20 years, and the chrysotile was contaminated with tremolite. He added that most of these tumors followed prolonged exposure to large quantities of fiber, a situation he said rarely exists today. He also said that at least 10% of diffuse mesotheliomas occur without asbestos exposure.

  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.

• Asbestos-related cancer and the amphibole hypothesis. The hypothesis is still supported by scientists and scientific data. B.T. Mossman, J.B. Gee. 1997;87(4):689-90; author reply 690-1. Comment · Letter PubMed · Publisher · Free full text

  Summary

  In this letter, Mossman and Gee responded to an annotation by Cullen, and a review by Stayner and colleagues, that had questioned the amphibole hypothesis of mesothelioma advanced in their 1990 Science article. They stated that the hypothesis rested on Wagner's 1960 study, since updated, and on studies of crocidolite-exposed cohorts such as gas mask workers and cigarette filter manufacturers. They argued that it was wrong to call their article the first introduction of the hypothesis, and that its thrust was mesothelioma, not lung cancer. They noted that they had suggested chrysotile may be less pathogenic than crocidolite for lung cancer, but that smoking made fiber-type roles harder to define. They criticized the review for omitting recent conference and panel conclusions: of its 72 references, only 12 were published after 1991, and half of these supported the hypothesis. They also cited mechanistic studies, including rat inhalation studies in which crocidolite, unlike chrysotile at identical airborne concentrations, induced protooncogene expression and sustained mesothelial cell proliferation. They concluded that the hypothesis remained viable. In his reply, Cullen welcomed the narrowing to mesothelioma. He held that a strong dose-response between cancer and chrysotile was proven, with a slope not differing from other fibers. He agreed that chrysotile is of lower pathogenicity for mesothelioma, though this remains unproven, and noted that 100 lung cancers occur for every mesothelioma in developed countries.

  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.

• Industrial workers' health and environmental pollution under the new international division of labor: the Taiwan experience. M.S. Chen, C.L. Huang. 1997;87(7):1223-31. PubMed · Publisher · Free full text

  Abstract

  Using Taiwan as an example, this paper conducts a historical analysis of the relationship between economic development in the new international division of labor and environmental pollution and industrial workers' health. Three industries-asbestos, plastic, and dye-were chosen for case studies. We trace the emergence of each industry in Taiwan and study each industry's protection of workers' health and environmental quality. Under the new international division of labor, the state's prioritization of economic development leads to lenient regulation. Under such state policies, employers have few incentives to invest in the protection of their workers' health and in the control of environmental pollution. Workers and the public are constrained in their efforts to protect their own health and prevent environmental pollution. This situation is exemplified by the deplorable working conditions and inadequate environmental pollution controls in the asbestos, plastic, and dye industries. Workers' health and the public's health are greatly compromised by economic development in the new international division of labor.

• Occupational exposure to chrysotile asbestos and cancer risk: a review of the amphibole hypothesis. L.T. Stayner, D.A. Dankovic, R.A. Lemen. 1996;86(2):179-86. Review PubMed · Publisher · Free full text

  Abstract

  Objectives: This article examines the credibility and policy implications of the "amphibole hypothesis," which postulates that (1) the mesotheliomas observed among workers exposed to chrysotile asbestos may be explained by confounding exposures to amphiboles, and (2) chrysotile may have lower carcinogenic potency than amphiboles.

  Methods: A critical review was conducted of the lung burden, epidemiologic, toxicologic, and mechanistic studies that provide the basis for the amphibole hypothesis.

  Results: Mechanistic and lung burden studies do not provide convincing evidence for the amphibole hypothesis. Toxicologic and epidemiologic studies provide strong evidence that chrysotile is associated with an increased risk of lung cancer and mesothelioma. Chrysotile may be less potent than some amphiboles for inducing mesotheliomas, but there is little evidence to indicate lower lung cancer risk.

  Conclusions: Given the evidence of a significant lung cancer risk, the lack of conclusive evidence for the amphibole hypothesis, and the fact that workers are generally exposed to a mixture of fibers, we conclude that it is prudent to treat chrysotile with virtually the same level of concern as the amphibole forms of asbestos.

• The amphibole hypothesis of asbestos-related cancer--gone but not forgotten. M.R. Cullen. 1996;86(2):158-9. Editorial PubMed · Publisher · Free full text

  Summary

  In this annotation, which accompanied a review by Stayner and colleagues in the same issue, the author discussed the "amphibole hypothesis": the theory that only amphibole fibers (such as crocidolite, amosite and tremolite), and not serpentine (mainly chrysotile) asbestos, can cause cancer. He presented it as an example of liability issues from asbestos litigation intruding into scientific research. He described how the idea arose in the 1970s from two observations. Chrysotile is cleared from the human lung faster than amphiboles, and several chrysotile-exposed cohorts had lower, though still elevated, rates of lung cancer and mesothelioma. He then summarized contrary evidence. Textile workers exposed only to contaminated chrysotile had very high lung cancer rates, while friction products workers using asbestos from the same source had far lower rates. Groups more heavily exposed to tremolite had modest risks. Animal studies showed largely similar effects of the different fiber types. He acknowledged that two observations remained unexplained: lower mesothelioma rates after chrysotile exposure, and the underrepresentation of chrysotile fibers in the lungs of chrysotile-exposed workers who died of asbestos-related diseases. He noted that several countries had adopted fiber-type-based standards. He also noted that, in his personal observation, compensation claims involving "only" chrysotile exposure had been contested or denied. He concluded that, given overwhelming evidence that fiber type poorly explains differences in lung cancer risk, continued reference to the hypothesis serves only to distort debate and confuse the audience.

  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.

• Commentary: environmental disease--a preventable epidemic. P.J. Landrigan. 1992;82(7):941-3. Comment PubMed · Publisher · Free full text

  Abstract

  Toxic environmental diseases are highly preventable causes of morbidity and mortality. Toxic diseases in the work environment cause an estimated 50,000 to 70,000 deaths and 350,000 new cases of illness each year in the United States; the asbestos pandemic will ultimately claim at least 300,000 lives; pediatric lead poisoning is epidemic, and an estimated 3 to 4 million US preschool children have blood lead levels above 10 micrograms/dl and could suffer long-term neuropsychological impairment. Prevention of environmental diseases can be achieved through legislation and regulation that control common-source exposures to chemical toxins. Modification of personal behaviors, such as tobacco and alcohol consumption, complements but does not replace control of toxic environmental exposures.

• The potential impact of epidemiology on the prevention of occupational disease. D.H. Wegman. 1992;82(7):944-54. Review PubMed · Publisher · Free full text

  Abstract

  This presentation reviews occupational epidemiology as a foundation for workplace disease prevention activities. By examining descriptive, etiologic and intervention occupational epidemiology studies, a range of opportunities are illustrated where epidemiology has played, or could play a principal role in guiding preventive efforts. Descriptive studies presented include ones based on vital records, on epidemic investigations, cross-sectional surveys, and surveillance. Etiologic studies review the largely successful development of knowledge for lung cancer and asbestos exposure for pulmonary effects of isocyanate exposures. However, attention is also directed to the need for etiologic studies of work environment risks for both cardiovascular and musculoskeletal disease. Finally importance is placed on the too infrequent epidemiologic studies of intervention. Historical examples of control of large risks from nickel cancers and silicosis are balanced with more recent examples of successes at reducing smaller risks of cardiovascular disease and oil acne. Throughout, emphasis is placed on the importance of reintegrating the academic discipline of epidemiology into the application of study findings to prevention of workplace risks.

• Epidemiology and the law: courts and confidence intervals. T. Christoffel, S.P. Teret. 1991;81(12):1661-6. PubMed · Publisher · Free full text

  Abstract

  Beginning with the swine flu litigation of the early 1980s, epidemiological evidence has played an increasingly prominent role in helping the nation's courts deal with alleged causal connections between plaintiffs' diseases or other harm and exposure to specific noxious agents (such as asbestos, toxic waste, radiation, and pharmaceuticals). Judicial reliance on epidemiology has high-lighted the contrast between the nature of scientific proof and of legal proof. Epidemiologists need to recognize and understand the growing involvement of their profession in complex tort litigation.

• The silence: the asbestos industry and early occupational cancer research--a case study. D.E. Lilienfeld. 1991;81(6):791-800. Historical article PubMed · Publisher · Free full text

  Abstract

  To gain insight into corporate activities regarding the identification of occupational carcinogens earlier in this century, the actions of one industry, the asbestos industry, were reviewed. This industry, in concert with many of its insurers, systematically developed and then suppressed information on the carcinogenicity of asbestos. The development of warnings for those exposed to the asbestos was delayed. As a result, millions of workers were exposed to the carcinogen and hundreds of thousands died. These events are placed into the context of similar activities in other industries during this time.

• Asbestos and other toxins. P. Lowinger. 1990;80(10):1274. Letter PubMed · Publisher · Free full text

  Summary

  In this letter, the author considered objections that notifying the estimated 20 million workers exposed to asbestos and other workplace toxins would create panic, inappropriate litigation and excessive medical costs. He described a National Institute of Mental Health-sponsored study at the Western Institute for Occupational and Environmental Sciences (WIOES) in Berkeley, California. In 1978, 2,270 former World War II San Francisco Bay Area shipyard and longshore workers volunteered for asbestosis screening by chest x-ray and interview. Three months later, 45 percent were told by letter they had a potentially serious pulmonary asbestosis abnormality, 30 percent a questionable abnormality and 24 percent no significant abnormality. In 1983, a five-year psychosocial follow-up of a 10 percent random sample (230 workers, mostly aged 60 to 80) used structured interviews with the worker and, in half the cases, a family member. The workers showed no increase in emotional turmoil, alcohol use, family or marital instability, depression, or inappropriate use of medical or legal resources after learning their risk status; there was appropriate anger and worry. Family, community and value systems were the most significant factors in behavioral stability and coping. The author concluded that telling exposed workers the truth about their health appeared to reinforce their usual patterns of behavior rather than create new or non-adaptive reactions.

  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.

1980s

• A methodology for identifying workers exposed to asbestos since 1940. M. Stanbury, K.D. Rosenman. 1987;77(7):854-5. PubMed · Publisher · Free full text

  Abstract

  This paper describes a method to identify individual workplaces and to determine the number of employees at those workplaces who have had substantial exposure to asbestos. A total of 486,400 individuals are estimated to have had substantial exposure to asbestos in New Jersey since the start of World War II, including 102,700 individuals from 16 manufacturing plants, 376,200 from eight shipyards, and 7,500 insulators.

• Asbestos examinations for construction workers. S.P. Schneider. 1987;77(5):645-6. Letter PubMed · Publisher · Free full text

• Marriage to a smoker and lung cancer risk. C.G. Humble, J.M. Samet, D.R. Pathak. 1987;77(5):598-602. PubMed · Publisher · Free full text

  Abstract

  As part of a population-based case-control study of lung cancer in New Mexico, we have collected data on spouses' tobacco smoking habits and on-the-job exposure to asbestos. The present analyses include 609 cases and 781 controls with known passive and personal smoking status, of whom 28 were lifelong nonsmokers with lung cancer. While no effect of spouse cigarette smoking was found among current or former smokers, never smokers married to smokers had about a two-fold increased risk of lung cancer. Lung cancer risk in never smokers also increased with duration of exposure to a smoking spouse, but not with increasing number of cigarettes smoked per day by the spouse. Our findings are consistent with previous reports of elevated risk for lung cancer among never smokers living with a spouse who smokes cigarettes.

• Use of court records for supplementing occupational disease surveillance. E. Schwartz, P. Landrigan. 1987;77(11):1457-8. PubMed · Publisher · Free full text

  Abstract

  To conduct surveillance of occupationally related health events, the New Hampshire Division of Public Health Services analyzes death certificates and workers' compensation claims. In an effort to bolster these limited data sources, a previously unrecognized data-set comprised of court records was explored. Court records obtained from the Federal District Court proved to be a readily accessible and detailed source of information for identifying suspected cases of asbestos-related disease and potential sources of asbestos exposure.

• Asbestos disease screening by non-specialists: results of an evaluation. S. Zoloth, D. Michaels, M. Lacher, et al. 1986;76(12):1392-5. PubMed · Publisher · Free full text

  Abstract

  We performed a medical audit of an asbestos disease screening program offered to New York City sheet metal workers by a corporate medical service. The screening program purported to evaluate the health status of workers exposed to asbestos in the past and present during construction and renovation of commercial buildings. Using current Occupational Safety and Health Administration (OSHA) regulations as a benchmark, medical records for more than 800 workers who took the examination between 1982-83 were reviewed; x-ray interpretations of the staff radiologist were compared with the interpretations of specialists in occupational lung diseases. The audit found inadequate record-keeping procedures, a lack of a comprehensive occupational history, poor notification and absence of any form of health education. Further, there was an extreme lack of concordance between the staff radiologist and the specialist readers in the interpretation of x-rays (kappa = .14 for pleural disease and .26 for asbestosis). To an increasing extent, occupational clinical services are being provided by corporate medical groups; such groups may not be familiar with occupational health problems.

• Asbestos examinations for construction workers: a workable alternative. M.D. Whorton. 1986;76(12):1388-9. Editorial PubMed · Publisher · Free full text

• Asbestos disease in family contacts of shipyard workers. K.H. Kilburn, R. Lilis, H.A. Anderson, et al. 1985;75(6):615-7. PubMed · Publisher · Free full text

  Abstract

  Radiologic signs of pulmonary asbestos disease were found in 11.3 per cent of 274 wives of shipyard workers who were 20 or more years from initial hiring-on in shipyards in Los Angeles County. Asbestosis was also found in 7.6 per cent of 79 sons and 2.1 per cent of 140 daughters of these workers. The wives, sons, and daughters were without occupational exposure. Comparable radiographic signs were not found in comparison groups. It is probable that asbestos exposure in the household places these family members at risk for mesothelioma and lung cancer.

• Asbestos contamination of vermiculite. S.B. Hayward, G.R. Smith. 1984;74(5):519-20. Letter PubMed · Publisher · Free full text

• Modified EPA algorithm needed re: Asbestos in schools. D. Kern. 1984;74(4):391-2. Letter PubMed · Publisher · Free full text

• A review of the health effects of energy conserving materials. L. Levin, P.W. Purdom. 1983;73(6):683-90. Review PubMed · Publisher · Free full text

  Abstract

  The energy conservation movement has promoted both greater use of insulating materials and the reduction of heat losses by sealing air leaks. The release of volatile or airborne materials from the installation of these building materials under these conditions has resulted in an exacerbated indoor air pollution with the potential for certain health and safety hazards. Consequently, a comparative review of the health and safety hazards, exposure standards, and regulatory action associated with the more commonly used insulating materials with particular respect to current energy conservation measures was undertaken. The materials reviewed included asbestos, urea-formaldehyde foam, polyvinyl chloride, cellulosic insulations, fibrous glass, mineral wool, and vermiculite. Although no longer used, the past installation of asbestos in a friable form is the greatest potential health hazard. The exposure to formaldehyde gas from its release from urea-formaldehyde foam has elicited subjective complaints of sensory irritation and unresolved controversy and regulatory action regarding its toxicity to humans. Lesser health problems have been associated with the more widely used fibrous glass and mineral or rock wools.

• An assessment of the Environmental Protection Agency's asbestos hazard evaluation algorithm. M.E. Findley, V.E. Rose, G.R. Cutter, et al. 1983;73(10):1179-81. PubMed · Publisher · Free full text

  Abstract

  We performed an exploratory evaluation of the Environmental Protection Agency's algorithm for assessment of risk of exposure to asbestos in buildings. Observers scored five sites using the algorithm. One group (N = 23) conducted their assessments relying only on written instructions, while another (N = 20) was trained in the use of the algorithm. Five professional industrial hygienists, experienced in risk assessment, also used the algorithm on the same sites. A wide range of highly variable results, for both untrained and trained observers coupled with poor comparability with expert's scores raise concern as to the reliability of this assessment tool. The development of a valid and reliable "lay" index of risk is still needed.

• Does smoking cessation lead to weight gain? The experience of asbestos-exposed shipyard workers. T.J. Coates, V.C. Li. 1983;73(11):1303-4. PubMed · Publisher · Free full text

  Abstract

  We examined the relationship between smoking cessation and weight change in a sample of 373 asbestos-exposed workers who had participated in a smoking cessation program. Those who quit smoking for one year and those who quit for shorter periods gained significantly more weight than those who continued to smoke. Those with initially poorer health and those who quit to avoid illness gained less weight.

• Asbestos in Vermont schools: findings of a statewide on-site investigation. L.F. Novick, C. Rice, M.A. Freedman, et al. 1981;71(7):744-6. PubMed · Publisher · Free full text

  Abstract

  Materials containing asbestos were found in 75 per cent of 336 Vermont Schools constructed or renovated between 1946 and 1974, with two-fifths of the materials in student exposure areas. Findings from visits to all schools contrasted with an earlier investigation relying on self-reporting. Of 105 schools with student exposure disclosed by the current survey, only eight had been identified in the earlier effort. Ceiling tiles, previously not believed to contain substantial asbestos material, constituted a source of student exposure in 36 schools.

• Asbestos workers and lung cancer. M.M. Kristein. 1981;71(12):1409. Letter PubMed · Publisher · Free full text

• Past asbestos exposure among cable splicers. A. Fischbein, A.N. Rohl, A.M. Langer, et al. 1981;71(11):1277-8. Case report PubMed · Publisher · Free full text

• Asbestos hazard evaluation in Rhode Island schools. G.A. Faich. 1980;70(2):162-4. PubMed · Publisher · Free full text

  Abstract

  A statewide survey to identify and abate spray-on asbestos hazards in schools has been conducted in Rhode Island. Of 326 target schools, 24 (8 per cent) contained material confirmed in the laboratory to be spray-on asbestos. Overt hazards requiring major corrective measures were found in 4 (1 per cent) of the target schools. Simplified identification and reporting procedures allowed for the efficient conduct of the survey.

1970s

• A hazardous society? Individual versus community responsibility in cancer prevention. Third annual Matthew B. Rosenhaus Lecture. J. Higginson. 1976;66(4):359-66. PubMed · Publisher · Free full text

  Summary

  This article is the text of the Third Annual Matthew B. Rosenhaus Lecture, given at the 103rd Annual Meeting of the American Public Health Association in Chicago in November 1975 by the director of the International Agency for Research on Cancer. The author reviewed environmental and occupational causes of cancer and discussed the roles of the individual and the community in primary prevention. He traced the history of the subject from Percival Pott's 1775 description of scrotal cancer in chimney sweeps. He stated that the causes of 30-40 per cent of cancers in European and American industrial societies had been identified, chiefly cultural habits such as smoking, drinking and sun exposure, and that occupational cancers made up an estimated 1-3 per cent. Using mainly United Kingdom data, he expressed risks as deaths per 100 men by age 65. He calculated that a non-smoking asbestos worker might raise his risk of death by age 65 from 30 to 33 per 100 through mesothelioma. He calculated that a heavy-smoking asbestos worker might theoretically face a lung cancer risk of the order of one in two. He gave comparable figures for vinyl chloride. In a hypothetical population of 100 million males, he estimated that non-smoking asbestos workers would contribute about two lung cancers a year and smoking asbestos workers about 270, out of roughly 60,000 in total. He concluded that personal action through a "Personal Cancer Plan" offered the greatest immediate benefit, and that governments, employers and unions still had to control exposures. He also argued that scientists should express risks clearly.

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