Malignant disease and environmental control in an asbestos cement plant

Our plain-English summary of Malignant disease and environmental control in an asbestos cement plant, by L. Djerassi, G. Kaufmann, M. Bar-Nets (Annals of the New York Academy of Sciences, 1979).

The study

• Authors: L. Djerassi, G. Kaufmann, M. Bar-Nets
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:243-53
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004026).

Summary of the article

The authors described an asbestos-cement plant (Isasbest) in North Nahariya, Israel, and the mortality of its workforce. The plant began regular production in 1953, mainly of pipes and corrugated sheets, using chrysotile and crocidolite. Since 1953, 3608 workers had been employed, 750 of them currently, and 54.8% had worked less than one year. Dust monitoring began in 1960 with an impinger and later a koniometer, but these measurements were sporadic and unreliable. Asbestos fiber counts were introduced in 1972, and 70 work stations were monitored with personal samplers. Fibers from work clothing were detected at a laundry almost 40 km away. In 1967, after a high incidence of malignant disease became evident, crushing of crude asbestos was stopped and asbestos was delivered in dust-proof bags. Among 53 deaths in the cohort, there were two bronchial carcinomas and one laryngeal carcinoma, three stomach and two colon cancers, four kidney, two brain, one leukemia and one mesothelioma. The mesothelioma occurred in a man with four to six months' exposure and was judged probably unrelated to the plant. Malignant disease caused 30% of deaths, compared with an average of 16.1% among Israeli males and 22.1% at a Haifa power station. The cancer share fell from 41% (1960-66) to 18.8% (1972-78). The authors said the numbers were too small for statistical evaluation and, given the long latency of asbestos-related cancer, did not necessarily show environmental improvement.

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In plain English

This article described an asbestos-cement plant in Nahariya, Israel, using chrysotile and crocidolite, and deaths among its 3608 workers since 1953. In 1967 the plant stopped crushing asbestos and began receiving it in dust-proof bags. Cancer caused 30% of 53 deaths, against an average 16.1% among Israeli men (1960-1975) and 22.1% at the Haifa Electrical Power Station (1973-1976). Two bronchial and one laryngeal cancer occurred, an incidence the authors called below national figures. Other cancers: three stomach, two colon, four kidney, two brain and one leukemia. The authors judged the single mesothelioma probably unrelated to this plant given the short latency: the man, who died at 40, was exposed four to six months and left the factory and area two years before falling ill. Cancer's share of deaths fell from 41% in 1960-66 to 18.8% in the latest period. With cancer's long latency, the authors cautioned this did not necessarily show a better environment. They said the few respiratory and gastrointestinal cancers and one mesothelioma could not be statistically evaluated. The authors concluded cancer mortality was more prevalent among these workers.

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 study of a single plant's workforce: causes of death in the worker cohort, with cancer deaths expressed as a share of all deaths (per 100 deaths) and compared with national male figures and a power station workforce, alongside a description of dust monitoring and control
• Who was studied: All 3608 workers employed at the Isasbest asbestos-cement plant in North Nahariya, Israel, since 1953, including 750 current employees. 54.8% had been employed less than one year. Deaths were recorded from 1960 to 1978.
• Exposure: Work in asbestos-cement manufacture, mainly pipes and corrugated sheets, using chrysotile (from Canada, Rhodesia and Russia) and crocidolite (from South Africa) at a constant ratio. Asbestos use was 944 tons in 1954, rising to almost 10,000 tons in 1976.
• Main results:
  • Malignant disease accounted for 30% of all deaths in the cohort (16 of 53 deaths)
  • Among the Israeli male population in 1960-1975, cancer's share of deaths ranged from 13.1% to 17.1%, averaging 16.1%
  • At the Haifa Electrical Power Station in 1973-1976, cancer accounted for 22.1% of deaths
  • Among the plant's workers there were two cases of bronchial carcinoma and one of carcinoma of the larynx
  • The authors stated that the incidence of these respiratory cancers among the plant's workers was lower than national figures
  • Among the plant's workers there were three cases of stomach cancer and two of colon cancer
  • Other cancers among the plant's workers: kidney (four cases), brain (two cases) and leukemia (one case)
  • One mesothelioma occurred in a man who died at age 40 after four to six months' exposure. He had left the factory and the area two years before his illness appeared.
  • Because of the short latency, the authors considered this mesothelioma probably unrelated to exposure at this factory
  • Cancer's share of deaths at the plant was 41% in 1960-66 and 18.8% in the third period, after the major production changes
  • In 1967 crushing of crude asbestos at the factory was halted and crushed asbestos imported, arriving in dust-proof bags
  • Fibers from work clothing were detected at a laundry site almost 40 km from the plant
• The authors' conclusion: The authors concluded that mortality due to cancer was more prevalent in the Isasbest population than in the comparison figures
• Limitations the authors state:
  • The small numbers of respiratory cancers, the single mesothelioma and the few gastrointestinal cancers could not be statistically evaluated
  • Given the long latency of cancer in asbestos-exposed workers, the falling cancer share of deaths did not necessarily indicate an improved working environment
  • Early dust measurements (from 1960) were sporadic and proved unreliable

Topics

Medical terms in this study, explained in our Lexicon: Asbestos-Cement, Chrysotile, Crocidolite, Midget Impinger, Carcinoma, Colorectal Cancer, Mesothelioma, Latency.

Related studies

• The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case-control study in the city of Bari (Italy) — M. Musti, A. Pollice, et al. (2009)
• A case control study of lung cancer and exposure to chrysotile and amphibole at a slovenian asbestos-cement plant — M. Dodic Fikfak, D. Kriebel, et al. (2007)
• Mortality in a cohort of cement workers in a plant of Central Italy — F. Giordano, V. Dell'orco, et al. (2012)
• Public health control of environmental asbestos disease: consumer products — B.H. Franklin (1979)
• Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy — F. Luberto, D. Ferrante, et al. (2019)
• Mortality of workers in a French asbestos cement factory 1940-82 — A.M. Alies-Patin, A.J. Valleron (1985)

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