Modified EPA algorithm needed re: Asbestos in schools

Our plain-English summary of Modified EPA algorithm needed re: Asbestos in schools, by D. Kern (American Journal of Public Health, 1984).

The study

• Author: D. Kern
• Journal: American Journal of Public Health
• Published: 1984;74(4):391-2
• Type of article: Letter
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004661).

In plain English

This item is a letter to the editor, not a study, and it reports no new data. The author commented on a 1983 paper by Findley and colleagues, which judged the EPA's Asbestos Hazard Evaluation Algorithm too unreliable for assessing spray-on asbestos in schools. Citing earlier school surveys, the author wrote that only 6-12 per cent of schools built from 1946 to 1973 contained spray-on asbestos. Only 3-4 per cent contained enough friable spray-on asbestos in student areas to warrant corrective action under the Algorithm. The author argued that by studying only sites containing spray-on asbestos, Findley and colleagues had deflated the Algorithm's specificity. Including 41 sites free of the material would raise it from the reported 53 per cent to 96 per cent. If the 50 per cent positive and 98-99 per cent negative predictive values suggested by their data held, 90 per cent of schools would be quickly cleared. The author said air sampling was not a suitable second test in schools, and that the reported 98 per cent sensitivity poorly reflected underreporting by school administrators. The author recommended that industrial hygienists inspect all schools built before 1973.

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: Letter to the editor commenting on a published evaluation of the EPA Asbestos Hazard Evaluation Algorithm; no original data
• Who was studied: No study population of the author's own; discusses Findley and colleagues' analysis and US public schools, using figures from earlier surveys
• Exposure: Spray-on (friable) asbestos in schools
• Main results:
  • Citing earlier surveys, the author stated that 6-12 per cent of schools built from 1946 to 1973 contain spray-on asbestos
  • Citing the same surveys, the author stated that 3-4 per cent contain friable spray-on asbestos in areas of student exposure, to an extent warranting corrective action under the EPA Algorithm
  • The author calculated that including 41 study sites free of spray-on asbestos would raise the Algorithm's specificity from the 53 per cent Findley and colleagues reported to 96 per cent
  • The author argued that if the Algorithm were used only at schools proven to contain spray-on asbestos, the 53 per cent specificity would be offset by a 30-40 per cent prevalence of schools requiring corrective action
  • The author wrote that if the 50 per cent positive predictive value and 98-99 per cent negative predictive value suggested by Findley and colleagues' data could be relied on, 90 per cent of schools would be quickly exonerated
  • The author stated that air sampling cannot be considered an appropriate second test in school settings
  • The author stated that the Algorithm's reported 98 per cent sensitivity poorly reflects marked underreporting by school administrators
  • The author noted that, at the time, federal rules required schools only to identify friable asbestos-containing materials and notify those affected
• The authors' conclusion: The author recommended that industrial hygienists, not school administrators, inspect all schools constructed before 1973, characterize all asbestos exposure sources, and base corrective action on a yet to be agreed upon algorithm

Related studies

• Airborne concentrations of asbestos in 71 school buildings — M. Corn, K. Crump, et al. (1991)
• Asbestos in New York City public school buildings--public policy: is there a scientific basis? — R. Wilson, A.M. Langer, et al. (1994)
• Asbestos contamination in United States schools from use of asbestos surfacing materials — W.J. Nicholson, E.J. Swoszowski, et al. (1979)
• Asbestos abatement in schools: observations and experiences — R.N. Sawyer, E.J. Swoszowski (1979)
• State responsibility for the control of asbestos in the schools — L.P. Stavisky (1982)
• Asbestos in school buildings: results of a nation-wide survey — K.Z. Silver (1979)

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