Surveillance of high-risk groups--a survey of asbestos workers: the present position in the United Kingdom

Our plain-English summary of Surveillance of high-risk groups--a survey of asbestos workers: the present position in the United Kingdom, by W.J. Smither (Annals of the New York Academy of Sciences, 1979).

The study

• Author: W.J. Smither
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:525-32
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003986).

In plain English

This 1979 article was a descriptive overview of medical surveillance of asbestos workers in the United Kingdom. It did not report the findings of a single study. The author traced regulations from 1931 and described how the official 'scheduled areas' missed many exposed workers. Estimates cited in the article put about 12,000 people at risk in the early 1960s and about 20,000 at 'high risk' in 1968. The 1968 figure included 7500 insulation workers and 1000 dockyard insulators. Citing McVittie's 1964 report, 102 of 247 new asbestosis cases diagnosed by four Pneumoconiosis Medical Panels in 1955 to 1963 were in insulation work. Of 473 new cases in the following six years, 51% were insulation workers. The article described a survey begun after the Asbestos Regulations 1969. It included 24,313 workers in May 1977, of whom 16,840 were still exposed. The article gave no health results from that survey. The author concluded that reduction of risk by control of the environment is now possible. The author added that individual susceptibility could be studied only by intensive investigation.

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 overview of UK regulations and surveillance of asbestos workers, including a description of an ongoing national survey (no outcome results reported)
• Who was studied: UK asbestos workers. The survey run by the Employment Medical Advisory Service totaled 24,313 workers in May 1977 (17,662 in August 1976).
• Exposure: Asbestos in UK manufacturing, insulation and other industries. Products listed contained chrysotile, amosite or a mixture of the two; asbestos textiles contained chrysotile only; some products contained crocidolite (blue asbestos), which the article says was no longer imported into the UK.
• Main results:
  • A Factory Inspectorate survey in the early 1960s estimated about 300 registered factories and approximately 12,000 persons employed in asbestos processes or otherwise at risk.
  • The Thermal Insulation Contractor's Association estimated 7500 workers directly employed in insulation, plus 1000 insulators in Her Majesty's dockyards.
  • The numbers at 'high risk' in 1968 were estimated at about 20,000 (from the Senior Medical Inspectorate Advisory Panel memorandum).
  • McVittie (1964 report, cited) found that of 247 new asbestosis cases diagnosed by four Pneumoconiosis Medical Panels in 1955 to 1963, 102 (41%) were principally in insulation work.
  • In the following six years the same four panels diagnosed 473 new asbestosis cases, of which 244 (51%) were insulation workers.
  • The author had reported in 1964 that only 6% of workers in one factory fell within the strict definition of scheduled areas.
  • Among the reasons the author gave for the earlier regulations failing to reduce incidence was that there was no standard method of measuring the workplace environment.
  • Of the survey population, 16,840 were still exposed and subject to biennial examinations. Of these, 11,214 were exposed before the new regulations and 5626 only since.
  • Workers who declined medical and/or x-ray examinations were included only in the mortality study: 763 in August 1976 and 1114 in May 1977.
• The authors' conclusion: The author concluded that reduction of risk by control of the environment is now possible.
• Limitations the authors state:
  • The estimate of roughly 1000 occasionally exposed workers in 1968 was regarded as a considerable underestimate.
  • Lower degrees of exposure risk in para-occupational pursuits could not be estimated.
  • The survey cannot by itself address individual susceptibility, which requires intensive investigation of patients and controls.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Related studies

• Quality control of airborne asbestos fibre counts in the United Kingdom--the present position — N.P. Crawford, A.J. Cowie (1984)
• Surveillance of high-risk groups exposed to asbestos in the United States — H.C. Lewinsohn (1979)
• Occupational carcinogenesis. High-risk industrial groups: identification, education, and surveillance. Tyler Asbestos Workers Program — S.D. Greenberg, G.A. Hurst, et al. (1976)
• Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS) — D.B. Richardson, E. Cardis, et al. (2015)
• A study of the histological cell types of lung cancer in workers suffering from asbestosis in the United Kingdom — F. Whitwell, M.L. Newhouse, et al. (1974)
• Radiological and pathological correlations in asbestosis in the Republic of South Africa and the United Kingdom. II. A preliminary study of observer variation in the classification of radiographs of asbestos-exposed workers and the relation of pathology and x-ray appearances — A. Caplan, J.C. Gilson, et al. (1965)

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