Retired and former asbestos workers in Hawaii

Our plain-English summary of Retired and former asbestos workers in Hawaii, by G. Fournier-Massey, G. Wong, T.C. Hall (American Journal of Industrial Medicine, 1984).

The study

• Authors: G. Fournier-Massey, G. Wong, T.C. Hall
• Journal: American Journal of Industrial Medicine
• Published: 1984;6(2):139-53
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000536).

Abstract

In 1979, a pilot survey defined respiratory status and unmet health care needs of retired and former male asbestos workers in Hawaii. Of 1,401 identified subjects, 741 were contacted and 411 were interviewed. Forty-five subjects were between 39 and 54 years of age; 208, between 55 and 64; and 158, age 65 or more. They represented the main ethnic groups--Caucasian, Chinese, Filipino, Hawaiian and part-Hawaiian, and Japanese--on Oahu. Most subjects had had significant exposure to asbestos in a shipyard, and 83% were current nonsmokers (160 had never smoked, and 111 were ex-smokers for ten years or more). Taking age and ethnicity into account, our group had more chronic respiratory and gastrointestinal problems than the comparable male population of Oahu in 1979, but fewer such problems than active shipyard workers elsewhere. These problems related primarily to current smoking status and secondarily to the length of asbestos exposure. Health care was available, but former workers used it less than retirees, despite having more symptoms. Very few abnormalities were reported by the subjects on their chest X-rays, pulmonary function tests, and sputum cytology performed elsewhere. These findings are compared to those of other shipyards, and support the hypothesis that the biological effects of asbestos exposure are generally mild in Hawaii.

In plain English

This pilot survey, run from September 1979 to June 1980, studied retired and former male asbestos workers in Hawaii. Most had worked at the Pearl Harbor Naval Shipyard, and a few were contacted through two unions. Of 1,401 men reached by letter, 741 replied and 411 were interviewed. The article does not say which asbestos fiber types these workers were exposed to. Most of the men (341, or 83%) were current nonsmokers. The authors reported that, taking age and ethnicity into account, the group had more chronic respiratory and gastrointestinal problems than comparable Oahu men but fewer than active shipyard workers elsewhere. These problems related first to current smoking and second to length of asbestos exposure. Only 18 men (4%) said their chest X-rays had been abnormal. No lung cancer or mesothelioma was reported among those interviewed. Former workers used health care less than retirees despite having more symptoms. The authors concluded that the findings support the hypothesis that asbestos effects are generally mild in Hawaii. They noted that test results were self-reported and could not be verified.

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: Pilot questionnaire (interview) survey of retired and former asbestos workers
• Who was studied: Retired and former male asbestos workers on Oahu, Hawaii, traced through the Pearl Harbor Naval Shipyard cohort and two unions (ILWU and Boilermakers). Of 1,401 identified, 741 responded and 411 were interviewed between September 1979 and June 1980. They were aged 39 to 84 (45 aged 39-54, 208 aged 55-64, 158 aged 65 or more) and came from several ethnic groups (Caucasian, Chinese, Filipino, Hawaiian and part-Hawaiian, Japanese, other or mixed).
• Exposure: Mainly shipyard asbestos exposure. The article does not identify the fiber types these workers were exposed to. Jobs were rated by risk: pipe coverers, insulators and boilermakers were high risk, and electricians, shipfitters, welders and others were moderate risk. Most men aged 55 or older had first exposure 30 or more years before interview and more than 15 years of exposure.
• Main results:
  • 341 of 411 subjects (83%) were current nonsmokers: 160 (39%) had never smoked, 111 (27%) had stopped 10 or more years earlier, and 70 (17%) had quit more recently. 44% had a history of 21 pack-years or more.
  • Taking age and ethnicity into account, the group had more chronic respiratory and gastrointestinal problems than the comparable male population of Oahu in 1979. Chronic bronchitis was 10% and asthma 18% in this study, against 0.7% and 2.3% in an Oahu male population sample.
  • In multifactorial analysis, respiratory problems were linked more closely to current smoking status (23.9%) than to age and asbestos exposure measures (22.1%). In canonical analysis (p less than 0.0001), Japanese and Chinese nonsmokers had few respiratory problems other than cough even with long asbestos exposure.
  • In self-reported test results, 18 subjects (4%) reported chest X-ray abnormalities, of which one referred to fibrosis and none to pleural abnormalities. 46% had had pulmonary function tests, and 8% reported them abnormal. 12% had had sputum cytology, with one abnormal result.
  • 10% of subjects reported a previous cancer diagnosis, mainly skin (34%). No lung cancer or mesothelioma was reported among the subjects.
  • Most subjects had a personal physician (86%) and insurance (98%), but former workers used health care less than retired workers despite more symptoms.
• The authors' conclusion: The authors concluded that the group had more chronic respiratory and gastrointestinal problems than comparable Oahu men but fewer than active shipyard workers elsewhere. They concluded that the findings support the hypothesis that the biological effects of asbestos exposure are generally mild in Hawaii.
• Limitations the authors state:
  • Limited information on workers after retirement or job change restricted how many subjects could be reached.
  • The study relied entirely on what subjects said, with no way of verifying test results.
  • The low rate of reported abnormalities could reflect the questionnaire method, poor recall by older subjects, or limited information given by physicians.
  • Limited time and staff prevented proper follow-up of referred subjects and better definition of non-respondents.
  • The cancer findings could reflect a selection of survivors. Some who refused were being treated for cancer, and others on the source list had already died.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Chest X-Ray, Pulmonary Function Test (PFT), Sputum, Cytology.

Related studies

• Exposure to biogenic silica fibers and respiratory health in Hawaii sugarcane workers — T. Sinks, R. Hartle, et al. (1994)
• Respiratory cancer in relation to occupational exposures among retired asbestos workers — P. Enterline, P. de Coufle, et al. (1973)
• Past occupational dust exposure, depressive symptoms and anxiety in retired Chinese factory workers: the Guangzhou Biobank Cohort Study — Q.H. Lin, C.Q. Jiang, et al. (2014)
• A case-control study of mesothelioma and employment in the Hawaii sugarcane industry — T. Sinks, M.T. Goodman, et al. (1994)
• Pulmonary cytopathology of former asbestos workers. Report of the first year — S.D. Greenberg, G.A. Hurst, et al. (1976)
• A retired shipyard worker with rapidly progressive pulmonary interstitial fibrosis — E.V. Moy, H. Hu, et al. (1999)

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