The costs of imprecision: perspectives in asbestos abatement

Our plain-English summary of The costs of imprecision: perspectives in asbestos abatement, by N.A. Esmen (Annals of the New York Academy of Sciences, 1991).

The study

• Author: N.A. Esmen
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:582-8
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004484).

In plain English

This paper was a commentary by the author, not a study with new data. The author argued that vaguely defined terms in asbestos laws and regulations, such as "friable" and "worker training", led to asbestos-containing material in buildings being treated as an immediate hazard and sometimes removed haphazardly and unnecessarily. The author compared three approaches. On removal, the author drew on figures from other work showing that removing undamaged asbestos could raise exposure as much as three orders of magnitude for up to 4-5 months. The author calculated this could equal as much as 300 years of the original exposure. The author also noted that removal workers' 3-day training lacked follow-up studies of its effectiveness, and that respirators were prescribed without a medical examination. Delaying removal, the author argued, shifted costs onto a small group of maintenance workers. Preventive maintenance was described as preferable but as needing the resources of a large corporation with occupational health services. Several points rested on personal experience and anecdotal evidence, as the author stated. The author recommended encouraging abatement through preventive maintenance.

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: Commentary and policy analysis; no new data were collected
• Who was studied: No study population. The paper discussed asbestos abatement in the United States, including schools, residences and office buildings, removal workers, maintenance and janitorial personnel, and small businesses.
• Exposure: Asbestos-containing material already in place in buildings, and three ways of dealing with it: removal, delayed removal, and control by preventive maintenance. Differences between fiber types and fiber sizes, and the risk of very low exposures, were deliberately not considered.
• Main results:
  • Using cited figures on exposure after removal, the author estimated that unnecessary removal could create extra exposure equal to as much as 300 years of the original exposure. The author added that even if this estimate was wrong by an order of magnitude, it would still be a 30-year equivalent exposure for a distinct cohort.
  • The author noted that the 3-day certification training for asbestos removal workers had no follow-up studies showing that it worked.
  • The author noted that in this training, respirators were prescribed without a prior medical examination.
  • The author argued that delaying removal until repairs or demolition would shift health costs onto a small group of maintenance workers.
  • The author argued that control by preventive maintenance (survey by a professional, stabilization, isolation, limited removal) required the resources of large organizations with occupational health services.
• The authors' conclusion: The author concluded that careful planning and preventive actions were the preferable and, in the long run, least costly abatement strategy. The author concluded that a moratorium on current removal practices would do more for public health than continuing it, and recommended social, political or regulatory encouragement, but not enforcement, of abatement through preventive maintenance.
• Limitations the authors state:
  • The author stated that some points rested on personal experience and anecdotal evidence, without substantiating data.
  • The author stated that the views on worker training were based on personal observation and anecdote.
  • The author did not consider fiber type, fiber size, or the risk at very low exposures.

Topics

Medical terms in this study, explained in our Lexicon: Abatement.

Related studies

• Personal airborne asbestos exposure levels associated with various types of abatement — J.H. Lange, K.W. Thomulka, et al. (2006)
• Asbestos in place: a building management perspective — H.G. Irwig, L.C. Oliver, et al. (1991)
• Air sampling during asbestos abatement of floor tile and mastic — J.H. Lange, K.W. Thomulka (2000)
• Airborne exposure concentrations during asbestos abatement of ceiling and wall plaster — J.H. Lange, K.W. Thomulka (2002)
• Asbestos abatement of pipe and floor tile/mastic and comparison of critical plastic barrier controls — J.H. Lange (2004)
• Airborne exposure during asbestos abatement of floor tile, wall plaster, and pipe insulation — J.H. Lange (2005)

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