Mesothelioma among employees with likely contact with in-place asbestos-containing building materials

Our plain-English summary of Mesothelioma among employees with likely contact with in-place asbestos-containing building materials, by H.A. Anderson, L.P. Hanrahan, J. Schirmer, et al (Annals of the New York Academy of Sciences, 1991).

The study

• Authors: H.A. Anderson, L.P. Hanrahan, J. Schirmer, D. Higgins, P. Sarow
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:550-72
• Type of article: Case report
• Cited by: 8 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. 004437).

Abstract

The occurrence of mesothelioma is a sentinel event in occupational and environmental disease. A mesothelioma surveillance system was established utilizing existing computerized Wisconsin vital statistics data maintained since 1959 and a Cancer Reporting System (CRS) established in 1978. Review of the death certificate listing of usual occupation and industry from 487 mesothelioma deaths in Wisconsin from 1959 to 1989 led to the investigation of 41 persons with likely exposure to inplace asbestos-containing building materials (ACBM): 12 school teachers, 10 school maintenance employees, 7 public building maintenance workers, 5 private building maintenance workers, and 7 commercial and factory workers performing maintenance activities. For 10 (34%) of the 29 maintenance workers the only source of asbestos exposure identified was their maintenance work. For five (17%) histories indicated some prior employment in occupations and industries with probable asbestos exposures. Opportunities for indirect occupational exposure were identified for ten who had been employed in the residential construction industry. One maintenance worker was exposed to asbestos in the household and another had neighborhood exposure. For 9 (75%) of the school teachers, the only identifiable potential source of asbestos exposure was derived from in-place ACBM in schools. One teacher had spent a season in the merchant marine aboard an iron ore-hauling ship and 2 had worked in the residential construction industry. Two of the teachers were sisters, and in two instances, two teachers had taught in the same school facility. We conclude that individuals occupationally exposed to in-place ACBM are at risk for the subsequent development of mesothelioma.

In plain English

The Wisconsin Division of Health built a mesothelioma surveillance system from state death certificates (since 1959) and the state Cancer Reporting System (since 1978). The authors reviewed the usual occupation and industry on the death certificates of 487 mesothelioma deaths from 1959 to 1989. They then investigated 41 people likely to have had contact with in-place asbestos-containing building materials: 12 school teachers and 29 maintenance workers. Work histories came from medical records, next-of-kin questionnaires and interviews, and employment records. All 29 maintenance workers were men with pleural mesothelioma. For 10 (34%), maintenance work was the only asbestos source identified; ten had also spent time in the construction industry. For 9 (75%) of the 12 teachers (6 men and 6 women; three of the women had peritoneal mesothelioma), in-place materials in their schools were the only potential asbestos source identified. Building inspection records were available for the schools of only 8 teachers. Two of the teachers were sisters. The authors concluded that building maintenance workers are at increased risk of mesothelioma from in-place materials. The article does not name fiber types.

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 investigation of mesothelioma deaths (a case series) found through a state surveillance system. Lifetime work histories were rebuilt from medical records, questionnaires and phone interviews with next-of-kin, and public employment records.
• Who was studied: Of 487 mesothelioma deaths in Wisconsin from 1959 to 1989, 41 people chosen by the occupation and industry on their death certificates: 12 school teachers, 10 school maintenance employees, 7 public building maintenance workers, 5 private building maintenance workers, and 7 commercial and factory maintenance workers.
• Exposure: In-place asbestos-containing building materials (ACBM) in schools and other buildings, mainly thermal insulation around boilers and pipes, and less often acoustical or surfacing material. No fiber types are named.
• Main results:
  • All 29 maintenance workers were male and all had pleural mesothelioma. Their maintenance work lasted 20 years on average (range 5 to 36 years).
  • For 10 (34%) of the 29 maintenance workers, the maintenance work was the only asbestos source identified.
  • Among the maintenance workers, five (17%) had earlier jobs with probable asbestos exposure (shipyards, and in one case also an asbestos product plant). Ten had spent time in the construction industry. One had household exposure and one had neighborhood exposure.
  • Among the maintenance workers, the average time from starting maintenance work to the disease (latency) was 26 years. For three it was under 15 years (9, 9 and 11 years). Counting their possible earlier exposures, all latencies exceeded 20 years.
  • The 12 teachers were 6 men and 6 women. All 6 men had pleural mesothelioma; three of the six women had peritoneal mesothelioma.
  • For 9 (75%) of the 12 teachers, in-place ACBM in schools was the only potential asbestos source identified.
  • Two of the teachers were sisters. In two instances, two teachers had taught in the same school.
  • Building inspection (AHERA) records were available for the schools of 8 of the teachers. Six taught in schools with friable surfacing material and thermal insulation; two taught in schools with only friable thermal insulation.
  • Two pairs of maintenance workers had worked at the same university facility or in the same school district. The authors considered these clusters unlikely to be due to chance alone.
  • For 1979 to 1988, the Cancer Reporting System identified 19% more mesothelioma deaths than death certificates alone.
• The authors' conclusion: The authors concluded that building maintenance workers are at increased risk of developing mesothelioma from exposure to in-place ACBM. They also concluded that people occupationally exposed to in-place ACBM are at risk of later developing mesothelioma.
• Limitations the authors state:
  • The surveillance system certainly contains more people who did maintenance work than were studied, because maintenance may not have been listed as the usual occupation on the death certificate.
  • Selecting cases by death certificate occupation misses people with short-term employment that may add to the cumulative risk.
  • For the two schools where two teachers each had taught, damaged materials were found in 1988 to 1989, but their condition when the teachers were there is unknown.
  • Whether asbestos materials were present was unknown for the schools of 4 of the 12 teachers.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Death Certificate, Asbestos Exposure, Occupational Exposure, Environmental Exposure, Merchant Marine.

Related studies

• A radiographic survey of public school building maintenance and custodial employees — H.A. Anderson, L.P. Hanrahan, et al. (1992)
• Asbestos-containing materials in New York City buildings — P. Lundy, M. Barer (1992)
• Asbestos in place: a building management perspective — H.G. Irwig, L.C. Oliver, et al. (1991)
• Asbestos-related disease in custodial and building maintenance workers from a large municipal school district — J.R. Balmes, A. Daponte, et al. (1991)
• Mineral fiber content of lung tissue in patients with environmental exposures: household contacts vs. building occupants — V.L. Roggli, W.E. Longo (1991)
• Asbestos in New York City public school buildings--public policy: is there a scientific basis? — R. Wilson, A.M. Langer, et al. (1994)

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