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Medical Sciences Library, Texas A&M University OCLC: TMV DOCLINE: TXUTAM ILL Lending Request Borrowing Library: TXUTEX Max Cost: $100.00 Patron: Yana Posey TN; 197734 Request Date: 6/22/2009 09:28:58 AM Location: MSL Bound Journal Stacks Call #: Process: Regular Delivery Method: ARIEL? Yes 192.68.30.164 Journal Title: American journal of industrial medicine Volume: 10 Issue: 5-6 Billing Category: MSL SCAMeL Fee $1 Charge: $1.00 Payment Method: Ct0M0 Month/Year: 1986 Pages: 479-514 Article Author: Seidman H;Selikoff IJ;Gelb SK IFM: EFTS: Yes Article Title: Mortality experience of amosite asbestos INVOICE: Billing Address If Invoicing: factory w 44 Hou/Houston Academy of Medicine Imprint: Photocopy/InterLibrary 1133 John Freeman Blvd Evans Original TN #: 1548872.0 Houston, TX. 77030-2809 - ILL Number: 27288827 Circle one: Scanned & Arieled, Faxed or Mailed by: Unable to Pull or Scan because : (initial & date) CIRCLE ONE: IFM EFTS INVOICE NO CHARGE $ Comments:_____________ NOS Bnd too Tight Exceeds 50 pgs Rev 8.13.04 COPYRIGHT NOTICE: This material may be protected by copyright law(Title 17 U.S. Code) Other / A / V \ ouj `ssn 'H UBIY 9861 '9861 `SI ^Inf uopBoqqnd joj pajdaooy 6200l AN `VA Man `33Id XastI 1 SABjsnQ I `V9A Majq jo XjisjaAiun ^FD 3UT `auioipsw jo poqos reuis Junoj/q `6S01 xoS `OVi `JJ05IFPS 'f SuF^I sxsanbaj wudaj ssajppy '' ( S TI) *A a\3N `WA MON JO XjisjOAiun Xqo 3l0 `auioipajq jo jooqos puis junojq `aupipajq pnuauiuojiAug jo uoispia ' ' '('O N'S ` S'H) W*. m3N `Xjaioos J3ou>0 ueDuaiuy sdiqsuoijBpj 9S3ip SuiqsqqEjsa ui Xjpioijjip jofeui b `j3A3moh sjusSb oiuaSoupjBO oj ajnsodxa Suiajoaui sdiqsuoijBpj ssuodssj-asop ui js9J3jui ajqEiapxsuoo si aaaqi NOiionaodiNi sasBasip XjBuouqnd snopmjnmou `muoqaqjosaui `jxmgi pupsajinojjsBS `jsoubo 3un| `sajnsodxa jaqij `ajnsodxa iBuopBdnooo `sojsaqsB ajisoure :spjo Xajj Xjipqjoui asjaApn jcqj jo apnjiuSBUi aqj jaqBuis aqj `osjb `puB juapua auioaaq ox Xjiibjjoui asjaApB joj 5[ooj ji joSuoj aqj `asop aqj j3moj aqj `puauaS ui `jsqj punoj sbm ji `pasn si aSssop jo ajnsBaiu jaAaqaiq^ Xjojobj aip ui pBq j3>jjom aqj jBqj qof jupapred aqj qjiM pajBiaossB sajnsodxa jaqy pajBuipsa aqj Xq pa^joM auip jo qjSuaj pauopuauiajojB aqj 8uiXjdijjnm Xq pajBjnaiBa `ajnsodxa Jaqij pajB|nuinaoB sl]BnpiAipui aqj sbm jaqjo aqj pus Xjojobj aqj ui pajjjOM auip jo qjSuaj aqj sbm Xbm auo sXbm omj ui pajnsBaui sbm aSBSop sojsaqsB jaajip aqj ajiqM `qjBap jo sasnuo juBAapj joj XjpBjioiu aqj Xq pajnsBaui si asuodsay sujajjBd asuodsaj-asop qjiM si Xpnjs aqj jo ujaauoa uieui aqj, jjo sjibj uaqj pire ajnsodxa jo jasuo aauis auip SupuBApB qjiM diqsuopBjaj Suojjs b SMoqs XpBpiui aouapioui Biuoipqjosapq jaauBo uinjaaj-uoioo joj uaas si ooj jsouqB jo ypjs juboijiuSis XqBapspBjs y qjeap jo sasnBO pB joj 0Z.I jnoqB pun jaairea jbjoj joj 00 JSOUijb Suiaq apqM `(sisojsaqsB guipnpui) sasBasip XjBUOuqnd snopaajuiuou joj pus jaouBa Sunj joj poqoa aqj joj juappa ajB 00S jo (syj\S) sopny XjqBjjojq pazipjBpuBJS `uopBjndod jojjuoa aqj sb Xasjaj Majq jo sajBui ajiqM qjpw K6I ux pasop Xjojobj aqj pjun sjsaX pjaAas joj paxpoM uaui auios qSnoqj `(sqjuoui `sjjaaM `sXBp) aouauadxa 5(jom jo uopBjnp pajiuiq pBq jioqoa aqj jo jsopj j[jom jo jjbjs jayB sjboX of oj S xuojj paAiasqo sbm Sf6I-IW>I Suunp ^jom usSaq qaiqM Xjojobj sojsaqsB ajisouiB `Xasjaf Majq `uosjajBj b ui uaui 038 J JJoqoo y sw `q|ao uaAajs pue `aw `jjoqiias T Buiaji `vaw `ueuipias IJaqJSH ajnsodxg wom lujai-uo^s jasuo Jauv SJB9A 0t7 oj g sdjijsuo.ijeidu asuodsay-asoa '-sjayjojw Ajojobj sojsaqsv ajisouiy jo aouauadxg Ajubjjo^i (9861) WS-6^0I aupipajv pijjsnpuj jo pujnof uuouauiy 480 Seidman, Selikoff, and Gelb is that there usually is a lengthy latent or induction period between the exposure and the subsequent overt emergence of cancer. Most carcinogenic agents leave an imprint for the cancer but then are excreted or metabolized so as not to be discernible when the cancer becomes evident years later. With asbestos, including amosite asbestos [Selikoff et al, 1972], large amounts of the material are retained in the tissues and fibers are readily identifiable at autospy or biopsy using extraction and electron microscopy techniques [Langer et al, 1973]. It is plausible that the presence of the residual retained asbestos constitutes continuing exposure, which may be termed in situ or residence exposure. Cancer is not the only concern of such exposure. Asbestosis, known principally as a fibrosing disease, may also be lethal after many years. The direct dose as well as the time in residence are then both of great significance. We have previously reported on the mortality experience of a group of Paterson, New Jersey, amosite asbestos factory workers from the onset of work during the years 1941-1945 through 35 years thereafter [Seidman et al, 1979]. Some of these men had a very limited duration of direct asbestos exposure. It was found that work exposure to amosite asbestos for as short a period as one month resulted in a clear excess risk of cancer. With longer periods of exposure (ie, two months, three months, six months, and so on), the cancer risk became greater. With very brief direct exposure, cancer risk was to be found increased only after a latent period of 25 years. On the other hand, longer employment resulted in excess risk of cancer being found after shorter postexposure observation periods. This report is an expansion of the previous study. In addition to an extension of the follow-up period, findings are given in terms of the jobs of the workers and estimates of the dose of fiber exposure (dose = concentration x time) accumulated by the workers during their work at the factory. We have had the opportunity to extend the observation period through December 31, 1982, and thereby the analysis was extended to 40 years after onset of work. At each updating, we thoroughly review the information available for each man and present our results according to the best assessments we can make at that time. This usually results in some very small changes as compared with previous reports. MATERIAL Just before the entry of the United States into World War II, an amosite asbestos factory was established in Paterson, New Jersey, to supply the U.S. Navy with asbestos insulation for the pipes, boilers, and turbines of its ships. From June 1941, when the factory began operations, through December 1945, 933 men were recruited to work in this plant, which continued in operation until November 1954. Though nonwhites were employed in the later years of the plant's operation, the initial group was almost entirely white. Wartime conditions had a marked influence on the com position of this work force. Younger and fitter men having been siphoned off by the Armed Services, the men employed tended to be older than is usual for those entering a new line of work. There were very few "career" men (only 21 had worked with asbestos previously); in contrast to other groups of asbestos workers that have been studied, composed largely of those who continued to work in the industry once they U] Xauppj PUB `xuXjBqd `Xxxabo p?oonq `xuXjbj `mmaai-uopa puB qoBuioxs `sngsqdosa aqj jo sjooubo `SBXuoqaxposam `jaausa 8urq `(BxuasXqdxua pUB asnasxp XiBUOxujnd OAiprujsqo axuojqa gutpnpux) sasBasxp XjBuoxupxd snopaajuxuou jaqxo puB sxsoxsaqsB ssBdxuoaua ox u33{bi uaaq SBq ^sasBasxp soxsaqsB ||B,, pauuax XjoSaiBa aqx XJodaj sxxp ux XJBd xsorn aqx joj pazxpxn xxaaq SBq aauapiAa xsaq Xq paqsqqBisa astiBO aqx `sjaqjOM jo sauogaiBa sixouba axp guouxB saauaiajjxp jo sujapsd aqx uo saiBJiuaauoa osjb inq `dnojg pjxuoa uopByndod jBjauaS axp puB dnojg Xpxqs aqx uaaMiaq XxqBXJom ux saauajajjxp Xpio iou sjapxsuoa sisA[BUB slip aoufs [6161 ] V3 Ja JJ05PPS PUB [6L6l\ P P puoxiniiBH ux ipSuaj JB passnasxp si sasodind iBpiapiBd joj ajqBiajaid si guxpoa qaxqM jo uiajqojd aqx [6161 `P X3 jjo^xps -6L61 `P P puouiuiBH] sguxpuxj paxuxp puB `suqij Xbj-x `suaxuxaads pxaxgjns `XsdoxnB xxxojj xuapaaap aqx xnoqB paurexqo uoxjbuuojux inuopxppB iuojj paqsqqBisa ltaauapiAa xsaq,, ox iuxpioaoB osp uaqx xnq `Xjuo uopsxujojux oxbd -xjpjaa xpsap ox guxpjoaaB `isjuj sXbm omx ux papoa ajaM sxpsap paAjasqo aqx [8961] saxjsxjBJS qxpaH Joj Jaxuao puoxxBN aqx pxre [LL6l`LS6l`8P6l] uoxxbziubSjo qX[B3H ppo^v ux xpEaQ jo sasnB^ puB sasEasiQ jo uoixboxj -ISSBJ3 jBuoxxBUjaxui axp jo suoxsiabj xpuxu qgnojxp xpxxs axp uo pasBq `uo 6P6\ uiojj saxBis pajiufj axp ux asn ux XBip si Xpnxs sup ux xpuap jo sasxiBa joj guxpoa aqx saxBj xpuap asaxp iuojj axuxx jo spAiaxux sxxoxjba ux guxXp jo sapqiqBqoid axndxuoa ox [66I pun paa^] sajnpaaojd aiqBX-ajq paXojdxua uaqx a^ J[sij xb sjBaX-xrexu axp xpiM uopaunfuoa ux sxpsap paxaadxa pus paAiasqo axp xpiM saxsj xpBap paxndxuoa aABq osp a^ ' [6Z.61 ] P P uBiuxpo^ ux uibjSojj xpiM suoixnqijxsxp uossxo<j axp japun spAaj JOO' = d puB `jo` = d `go- = d axp jb paxBnpAa sbm xsax papxs -omx b ux ooi tuoij xuajajjxp Xpxreaxjnigxs XpBapspBxs sjom s^pqs 3lP iou jo jaqxaq^ spouad jsaX-jBpuapa puB sdnojg o8b aiBudoiddn ux Xasjaf Majq jo uopBpdod apxu axxqM pjauaS axp jo saiBJ xpBap Xq sjBaX-xrexu qans guiXidpjnui pxre spouad jBaX jBpuapa jeaX-aAij joj dnojg ags jBaX-aAij Xq dnojg Xpnxs axp ux uopBAjasqo jo sjBaX-uBiu axp BuxzuogaxBa Xq paxndxuoa ajaM sxpuap paxaadxa aqx qjoM jo xasuo jajp sjbbX 3aij xsjxj axp j3ao SuxssBd `xjjom jo xasuo xajp sjboX ox? ox $ sxptap paxaadxa ox sxpsap paAjasqo jo sopBj axp paxndxuoa aABq bm `snqx (syws) soxxb^ Xxxpxjopq pazxpjBpuBxs jo suuax ux sasXpuB xuasajd axp paxanpuoa aABq a^ S3SA1VNV 1VOI1SI1V1S sassaaojd uopanpojd aures axp puB sjaqxj aures axp xpiM XjoxaBj uosjoxbj axp sb sxanpojd aures axp apBxu sapqxaBj asaqx XuBdxuoa aures axp jo sxxrejd omx ux sjboX xuaaaj ajoxu ux apBxu ajaM sxunoa jaqxj `J3A3M0H suBjd Suxjaauxgua uoxiB|puaA jo uopBuxurexa puB xuaxuaSBUBiu pxre sjo^jom xpiM suopxpuoa jo MaiAaj Xq pajiBjap sb uoxjBpxuaA xuaxaxjap Xjoa sbm ajaxp XBip uMouq si u Xjoxobj sxxp ux sxunoa jaqxj jo suopBAjasqo xaajxp ou ajaM ajaqx XuBdxuoa sxqx ux jjjom axp uBxp jaxpo aauauadxa 5[jom soxsaqsB xuanbasqns pnq aq sb uoos sb paiBuixnjax uBxu b jo uopBAjasqo dn-Mopoj pajapxsuoa aABq aM ajnsodxa snp uo snaoj ox uopBAjasqo Suoj Xq paMopoj `sojsaqsB ajxsoxuB ox ajnsodxa j[jom asuaxux jo uopnjnp paixxuq Xjsa xpiM uaxu :aauauadxa anbnin b ux paxinsaj sxqx pasBajaux uaxu joj paau axp sb saaiAias pauuy axp jaxua ox qaj sjaxpo pps pxre `xuaxuXoidxua xuajajjxp ox jjo paxjup dnojg sxxp jo uopjodojd aJB| b `paxJBXS X8f i|J0AV sojsaqsy uuax-XJOMS J^XJY Ahbmoim uuax-8uoq 482 Seidman, Selikoff, and Gelb accordance with Seidman et al [1979], Hammond et al [1979], and Selikoff et al [1979]. "All asbestos diseases" has coherence to us only in terms of best evidence available and only such coding is used for this category. However, some results according to coding of the death certificate information only are detailed for other cause of death categories. Omitting the first five years after onset from our analyses had a number of advantages. It reduced the possibility of the "healthy worker effect" in mortality selection and permitted an unequivocal classification of the men into length-of-timeworked categories. As is usual, the suitability of the general population of an area to portray what the mortality risks of a specific group of workers would have been without their special exposure, is subject to question. As compared with the general population, which includes many persons with sedentary occupations, factory workers might be expected to have lower rates of coronary death, for example, presumably owing to occupational exertion and/or selection. These might well be balanced by higher death rates from other social and life-style differences. With respect to cancer rates, it is known that New Jersey rates are among the highest in the United States [Mason and McKay, 1973]. Of the 933 men recruited to work in this factory from June 1941 through December 1945, 113 men were omitted from further analysis for not attaining the five-year point after start of employment: 21 had prior asbestos work, 14 more took up asbestos work elsewhere before the five-year point, 40 had died, and 38 were lost to follow-up shortly after terminating employment. Table I shows the status of the 820 men who remained for study at the five-year point after start of work and at each subsequent five-year point until either the 40-year point or the termination of obser vation, December 31, 1982. By that time we had determined that there were 6 men who were kept in the study until they began asbestos work elsewhere, 5 men who were lost to follow-up, and 593 men who had died. Only 216 men were still alive at risk in the Study Group, 95 had completed 40 years of follow-up, and 121 were still alive in the 38th to 40th years of follow-up on December 31, 1982. RESULTS Table II shows the total observed and expected deaths and SMRs from 5 to 40 years after onset of work for various causes of death. SMRs of 500 are evident for lung cancer and for noninfectious pulmonary disease, while that for total cancer is almost 300 and for all causes of death is as high as 167. A statistically significant SMR of almost 200 is seen for colon-rectum cancer. Table HI shows the same information (BE) for each five-year period for several of the causes. Expected deaths are not available for mesothelioma and asbestosis, which are very uncommon in the general population. Instead, death rates per million man-years (not adjusted for age) are shown for these causes. Mesothelioma, which usually shows a strong relationship with advancing time since onset of exposure, here shows an anticipated rise in death rates for the 20-24-, 25-29-, and 30-34-year periods but tails off in the 35-39 year period, perhaps partly due to previous heavy selective mortality from other asbestos associated diseases. For the men who worked various lengths of time from less than one month to 2-14 years (when the factory closed), Tables IV-XI show the cumulative mortality 100' > 10' > dq SO' > sasBssip ,,sojsaqsB,, [[E jo uoijiuyap joj jxaj osg X|uo UOIJBUUOJUl 3JR31JIJJ33 qjB3p OJ SuipjOOOB 3SnE0 JO SuqXP `3a `3iqB[IEAB 30U3piA3 JS3q OJ SuipjOOOB 3snB3 jo 8uipoo `gg ssjbj qpsp oypads pousd jboX jEpusjEO puB sSb [Biuuanbuinh 3|Bui sjtqM /(3SJ3f M3jq uo pssEq sqjBsp papadxg g usip sss| ojb sqjEsp popadxa puB p3AJ3sqo qjoq ji u/v\oqs jou HWS* -- -- 0 I 09'SP -- -- o96 8l OO'SS dZSI L6 d091 01 9'9 q0l 0S III S'80 -- SI -- I -- :, OS 068P 9P OP'6 q9l 8 eSI PS'l e0 6 8I S 6' -- -- -- -- EI' 0'I bS8I ZZ eS8I 0611 9SI 6 061 II 8'S "l -- --I 61 90' S9' --P --0 -- --I --6 -- --I --8 -- o6P 01 ^lt'S III IS'0 o99 61 d8 I 6I'P d9I 6 d9I 6S 8'SS HNS (Da) sqo 3WS (39) sqo pspadxg jBjojqns ui popnpui jodub^) SSSBOSIp (lS0JS3qSB,, J|B `|Bjojqn SSSnBO P31jl33dsun puB J3qJO SOSBOSIp JB[nDSBA0IpJB3 sisojssqsy s3SB3sip XjBuouqnd snoipsjuiuojq J33UB3 pgyiDodsun pus jsqjo J90UB3 SB3J0UBd J90UB0 J3ppB|Q J33UB3 Xaupig J3DUBD Uirq03j-U0|03 J90UB3 qOBlUOJS J3DUB3 snSBqdosg J30UB3 xuXjBqd `[Eoonq `xujEg 3A0qB psypsds jou Buioipqjossjg BUIOIpqjOS3lU fBSUOJUSd BUIOipqjOSQUI |Bin9|a P3UB0 Sung S3JIS ||B `J9DUB3 sssnBO [|v *qjB3a JO 3snB3 q `p6I-IP6I JopBj sojssqsy sjisouiy hb ui qjoAV jo jasuo 9DUJS SJB3A pasdBia Of oj uiojj sqjB3Q papsdxg puB p3AJ3sqo II 318V1 lI 0 0 0 0 0 0 00 I 0 I l 0 0 0 0 0 II 0 l 0 I P S 8S 06 11 SOI 01 ZL S P P9 8t 6t 66P 0P IP 9 '6S 6'SS 6'S 8'6P 0'9P 6'IP PIZ P9 8P . 8S 89 9 08 0t~S S-0 0-S S-0 0-SI SI-01 01-s 5[iOM JO PSUO 33UIS SJB3/( p3SdE[3 JO 'OfJ 861 `I Jaquisosa q dn-Avoyoj JO SJE3X Ot7 PSUIBMB JOU pBfJ dn-Moyoj oj jsog 3JJOM. sojsoqsb aoqjo pajJBJs pousd Suunp ti3Aip SfBMBJpqjiM,, jo joquiiqq pouod Suunp sqjEsp jo jaquinjq pousd JO JJBJS jb gsu JB 3jouj jo yp sSb U3ui jo jsquinM pousd JO JJBJS JB UBU1 J3d 3Sb JO JB3/( UB3JAJ pouad JO jjbjs jb 3[su jb uoui jo joqiun^ SP6I~IP6I `^JOjdbj sojssqsy sjisoury ub U| 5|Jm jo jssuq Jajjv $jb3a op oj g ssuqx pasdBjg snouBA jb irajq o8IIV J snjBjg g gggyx 8P VOAV sojsaqsy lujsj-jjoqj,' jsjjy Aji[BJJOj,\ ouax-3uog 484 TABLE III. Observed and Expected Deaths From 5 to 40 Elapsed Years Since Onset o f W ork in an Amosite Asbestos Factory, 1941-1945, by Cause o f Death* O :p < .001. "dVfl AA3 g cl 7) O-- yO 8j '' 3oT. o ,,z 2. 3 oQ. *-"h 75 O" -T3 O rt> a o" 55 tn n o > 9 S2 m c50r o. Q & w m Z s90-o < 90 & 75 g *T3 p a s ?o Q 'gwS- 1 PM oO' &2 re K -o c 3 o s cpa Co03L O2< l-s. SQ aCL re S's -o o a g CL <ra 8 o 575* O 03 Pq ca 7o5 _f_t_, 8 8 3 2 P3 LA w >< S52. fuo 3 . o 9re- 3or> &ST * Bg;. |a Ocr 32* so w to -o -- to <y 4L to LA ^ os so '-o to to j-- so la OS o >3 "^ n U> Ji. -- OS 0- b )0 Os SO WW ^ 0^0 -J LA SO LO to to to to "0 00 s SO 00 O- LA Os "t to to LA OJ LA U> I W LA 4L 00 to W !T 2 z re 3 SO 07 o LA Os 4L 'tJo *0 LO SO to LA s 00 Os u> b lo 1 ft - tO NJ i Os sO u> -o cptq ft 8 --^ 0--0 tMo o 9 r <* LA 00 n- tO Os U> SO SO -- Os " oo 00 S8f 5JJ0M sojssqsy uuax-PMS 4ne)J0^ uuax-Suoq o to to w LA 4l Os L4AL LO tOO SO to LA ~4L0 Os to , to so LJ to to to SO LO LO SO to os 486 Seidman, Selikoff, and Gelb *S M R not shown i f both observed and expected deaths are less than 5. Expected deaths based on New Jersey w hite male quinquennial age and calendar year period specific death rates. 168 82.11 158 76.79 135 68.94 56.00 205c 42.206 ^ 2 0 6 ^ 27.70 1 91 8 0 f Obs 20 44 75 101 co wo r-ov wo so wo CO -h 33 ^ VO ^ WO CO Tf otJ- 5 4wto ^vfso O-- cm o r Tf CO CO 3 CM VO 00 CM 00 wo co c- CM O O CO CM WO CO CM -- 0r-0~ CTMf 3 o Z; w8a , Ov r- **- -- ^ 6 O' cm vo t* 53 CoOo On Tt Ov Tf N ON M H vi h ^ O O 0O0V CO CM ON o o CM CM Tf 00 wo WO CM rf O' Tf VO wo WO o 3 Ov cm oo wo On co rf O ^ c S >A B. QC & t/3 JO o. 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On bO 00 -4 ON On NbO4 bJ >4 -4 s b> 00 tsi 00 NO On 00 4* bJ 00 K) bJ 0 4 ` 4 -&> U> bJ 4 N> nJ ^ s m Hjom sojsaqsy nu^-vioqs Jayy jC)I|C|jo|\[ uuax-Suoq AAA s> + o< 03 2 50 *TwX3 ocv>r 03 2 ?o "tXOn ocVr 03 cn 2 73 (41 1p--1 o14 O1N4 p OJ (N4O1 (41 bo 4 (N4O1 b4J 4O b2) !--i O (41 bJ -- boo ot4o O4O 4p^ 4(41 nNOj 4 bbJJ 4K) \o bO4 oOJ * b(41 0p0 (O4N1 o 2(41 Kp> UON> O4N (b4J1 8 (44l L/i 3ON O00n W(41 400 WN> (0401 N4O Un-> N4O^ bbo 0o0o bJ 8 4ON (o4o1 4NO N--O U00> 44^ 4 * o4(N4O1j bo(441 0p0 O00n N4O t 040 0000 p K- i--i u> bNO 488 Seidman, Selikoff, and Gelb II: ocno i o <o in ri O !^$ PM ^ ** = 04 3 0cn0 vO pM PMn cm ^ r- cm -- O) >n h & r> ri r^ C*s Tf ^ (tN CM --' no -- m 00 O r-; , d <6n ^ cm no ov ri 11 u *o SPs rt i 1 g> a iB i d &s M W-sho OO m -Nd m ocTnof m os n r- Tt oo t|- c- on ?n cn Odg rK vO *-- cm r> m cm y o cm P" Os .o on d On oo I-I fl. uO t- cm ** oo -- on cm r- -- ^ rf cn f- o\ rn z co .-2a N O fO m -- oo Tf 8 d ithsw r~- -- Tt oo -- in Tf cm o 3 C/5 AN i s g --d J*S-, _ tp d in m on t|- - & cm in cm o d $ --< o rn I oo o =: 8-soc/i CL 22 C/3 * c O c/5 CL S *2 C/5 &2 o oO B w U5 V} OBlfl W 2 o eS C C3 i > in 2 " cm 00 NO ON 00 ON r- S 181 soo %l SS Hh 2<Z s o ON -- Nt I, wN ,I o d NO T* I ON ON ^ 00 O--N II CtrNi |I o pm C/5 If 8 3 3 - g5 was C/5 o.a C/5 o o >?2 A W 03 in m PM 8 | t -8 Mg GO |8.1 ,2 " o ss'g-a ,'C i &i lj.fi o so 2 2 > + n 1 sis 43 490 Seidman, Selikoff, and Gelb Long-1; TABLE VIII. Cumulative Observed and Expected Deaths From 5 to 40 Elapsed Years Since Onset of Work in an Amosite Asbestos Factory, 1941-1945, by Length of Time Worked: Noninfectious Pulmonary Diseases (Observed Number of Asbestosis Deaths Shown in Parentheses)*________________________________________________________________________________________ <>Cu oU7 caoi jg o 5? o\ --1 -- 2 SS in -- it) $ s no _ oo C- no 00 Tt --< oS 00 CO Tg --o co 6 Tt CO o6 w --so --6 Ttoo r- 8 ^o in -- m $ S-- 3o <N CO oo 3a W 3 00 IJ*lS 5 U on -- r- -g Zu 3 e0 -a s 3 <D c 6 1> il 8. 3 S 8 JtCDoO WC3O oo -- oo 00 o icioo o 6 nro s o (N oo o oo s <n o 2 e,s o od NO O CO If 1u PQ S5 O Wx v2j aO55 PaxJ.2oo O a.* Uw Oca Wo*. m2s ^ JOS Ug-uS _ Qg O| W&Sw a aO UxJ 2oo Oss UaxJ. S2C/2 o c ,aS. ov 3 Z 6<n ^ teria lV 1 2o 2o c I o 2 o 2 C+4 e -8 f Is 5 StS'l i 8.1 la < ^||s=s 1 v v v 8 -- NO SO CS r- in no -- i I c0 a "8 !I s ?! S co rMi on s8 s Os in -- o o co ft, 2; co CX 2* co o O UX S O UxJ CS/2 O LxU Se3 E o v"> 8.1 fj ,3 25 492 Seidman, Selikoff, and Gelb TABLE X. All Causes: Standardized Mortality Ratios for Cumulative Deaths From 5 to 40 Elapsed Years Since Onset of Work by Length of Time Worked Length of time worked < 1 Month 1 Month 2 Months 3-5 Months 6-11 Months 1 Year 2+ Years Elapsed No. of years since onset of work 5-9 5-14 5-19 5-24 5-29 5-34 6 17 9 33 49 59 9$91 131 13d 137 141 105 101 US 116 131 133 112 ; s 140 156 184 183 179 m159 172 176 179 194 62 ;; 142 129 145 178 191 151 159 178 180 196 206 5-39 son 133 130 182 188 197 205 TABLE XI. Lung Cancer: Standardized Mortality Ratios for Cumulative Deaths From 5 to 40 Elapsed Years Since Onset of Work by Length of Time Worked______________ _____________ Length of time worked Elapsed No. of years since onset of work: Observed (BE)a 5-9 5-14 5-19 5-24 5-29 5-34 5-39 < 1 Month 1 Month 2 Months 3-5 Months 6-11 Months 1 Year 2+ Years OO 0 79 145 208 252 0 217 4S8 331 308 337 281 O 0 104 226 373 423 371 0 9 128 233 254 300 339 0 204 476 574 479 509 498 870 625 645 694 717 770 385 738 974 886 977 970 983 "BE, coding of cause according to best evidence available. results at five-year intervals to 40 years since onset of work, respectively, for all causes of death, all cancers, lung cancers, gastrointestinal cancers, noninfectious pulmonary disease (including asbestosis), and "all asbestos diseases." The data are shown on a cumulative basis to illustrate that, in general, the heavier the dose as measured by the length of time worked, the shorter the time in which an adverse effect is observable. Thus, for cancer of the lung in Table VI, marked excesses are evident within 15 years for the longer-term workers. For those who worked shorter periods of time it may take 25 years or more. Also in Table VI it is clear that the heavier the dose, the greater the response tends to be in terms of higher SMRs. Some of these findings may also be seen in Figures 1-6 and Tables X-XIII. During World War II, between 300 to 400 workers were employed at any one time at the Union Asbestos and Rubber Company factory in Paterson, New Jersey. During peak production, three shifts were worked. There was a great deal of turnover, some men being drafted into the Armed forces and others moving on in short order to other employment. Postwar, the workforce was down to about 100 until the plant closed in 1954. Amosite asbestos was used virtually exclusively. No crocidolite was used and very little chrysotile. 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Ratio of cumulative observed to expected probabilities of dying from all causes from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941-1945, according to length of time worked. LENGTH OF r TIME WORKED 1 MONTH 2 MONTHS 3-5 MONTHS 6-11 MONTHS I YEAR 500 1000 1500 STANDARDIZED MORTALITY RATIO Fig. 5. Ratio of cumulative observed to expected probabilities of dying from lung cancer from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941-1945, according to length of time worked. LENGTH OF TIME WORKED 3-5 MONTHS 6-11 MONTHS I2-23MONTHS 24 4- MONTHS ___ 500 1000 1500 2000 STANDARDIZED MORTALITY RATIO Fig. 6. 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Estimated Exposure to Fibers > Sfim in Length per cc for Jobs in an Amosite Asbestos Factory and Number of Workers W ith Onset o f W ork 1941-1945 by Length o f Time Worked: 820 Study Group Men O *** so NO i-- '-o o <*><*) <N oo r" CS O Tt O in (n m \o o\ io cn e-i ^ Tt- ocmn o** vm> o 8S ??? m no Long oj CO s: 1 S 3 a 121 47 87 28 nU-i Ui Uh-t it--Ji U--i NuOi N> N) OU> SS& &S NO -4 OO NO ON 4^ NO NO On LA LA OO LA NO NO 8 HOn *"* NO 00 hNO NO N- NO fc. oo Ol NO bj La bo bj bj On bj ON OO NO La bj OO ON OO - NO bo oo oo NO NO OO - LA 4*. ON - 00 oo -- NO OO oo 4t ~4 NO La bo oo 00 Os ON On OO bj bo to oo 4^ NO 4* M-i 4^ -J NO LA NO LA NO -4 4W W Ul 00 N* M O O -- NO O to O O to -o bj bj !u si yo o oo m m oo m b- no OO 4i. KO -- NO NO LA NO OO U ^ M s) a NO NO NO La CTs P NO 1 O *-- NO *- H- M IO (Oi W w ON O m ui o b\ La La b- on on *-* ^ M-JOjH sojsaqgy uuax-jjoqs jayy ^HB|Jop\[ uuaj-8u(Ki 498 Seidman, Selikoff, and Gelb Cumulative observed and expected probabilities of dying from all causes by estimated fiber Fig. 7. from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941exposure 1945. Fig. 8. Cumulative observed and expected probabilities of dying from lung cancer by estimated fiber exposure from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941-- 1945. Observed lung cancer deaths shown are those classified according to best evidence available. Fig. 9. Cumulative observed and expected probabilities of dying from all "asbestos" diseases by estimated fiber exposure from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941-1945. See text for definition of all "asbestos" diseases. ajoui Xppuinsajd aqj jo uopBAjasqo jaqjjnj oj ssoj panupuoa aqj ajidsaQ paddojs aABq Xbui ajnsodxa jaajip aqj jape Suoj sanupuoa ajnsodxa (jB[npaa Suipnpui) anssp siqx aauBjJodun jofBui jo si sanssp ui paupjaj sojsaqsB aip uiop Suppsai 4iaauapisai ui,, ajnsodxa aqj `ajnsodxa jaajqj aqj oj uopipps ui `pajBjs XjsnoiAajd sy p aauajinaao jpip jo Xauanbajj sip joa\o{ PUB SP9JJ9 9SJ9ApB JO 00U3JJI10DO aqj XBjap qjoq jqSlUI 9JtlSOdX9 9ip 3upnp9J JSB9J jb `(sju9e aiuaSouiaJBa jaipo jo) sojsaqsB oj ajnsodxa pioAB Xppjduioo oj ajqissod JOU SI JI JI J99UB9 JO {OJJUOa aqj JOJ SUOpBOpdUII JUBJJOdlHl Xj3A SBq spix 9BSOp JO 9JI1SB9UI 9ip sb ajnsodxa J9qp pajBuipsa jo pajpoM auip jo qjSuaj sasn auo jaipaqM Xjijbjjoui pire 3JTISOdx9 SOJSaqSB U33Mjaq JUapiA3 9JB SUJ3JJEd 9SUOdS9J-9SOp 9UIBS 9ip qonui JBip U99S 9q UB9 JI `pUBq JB 9JIlSOdX9 J9qp p9JBUipS9 UO BJBp [BUOpippB M9U 9qj qjl^ '1 XjipjJOUI 9SJ9APB JBip JO 9pnjIUBUI 9ip JdpBUIS 9qj OSp PUB JU9PIA9 9UI039q OJ 90U9lJ9dX9 XjipjJOUI 9SJ9ApB JOJ )JOOJ JI J9UO| 9qj *9SOp 9qj J9AVOJ 9ip `JBJ9U9 UI `JBip pUHOJ 9M *SOJS9qSB JO 9BSOp J99JIp 9qj JO 9JI1SB9UI B SB Xjojobj sojsaqsB ajisoure ub ui pa>[JOAV aunj jo qj8ua[ 9ip uisn `ajqjojajan j SNOISfnONOO sjunoa J9qp jaqHiq qjiM sqof jb jjjom jo qjSuaj jajjoqs UBip jaqjBJ sjunoa jaqp j9avoj qjiM sqof jb jjjom jo qjSuaj jaSuoj qjiM sppqs jaqgiq jo uopaajjp 9ip UI SI JI `SI 9J9qj 90U9J9JJip J9A9JBqM `SpjOM J9lfJO UJ pajpOM S91UIJ J9JJOqS qjiM pajBduioo jaSuoj qjiM. asoip joj sqjsap pajaadxa oj paAjasqo jo sopBJ jaqSiq pjbmoj Xauapuaj jqSqs Xjoa b si ajaqj `sauoSajBa ajnsodxa jaqp uaAiS uiqjiM jBqj rnaas ppioM JI sauoSajBa ajnsodxa jaqp pin? sdnojS pajpoM aunj jo qjSuaj jo suopBjnqBj ssoja aqj joj jasuo japB sjnaX ox oi Joj Xjipjjoui jaauBO Sunj sjuasajd AIXX "BSjaA aaiA pus sdnojS pa3[JOA\ auip jo qjSuaj urejjaa Xq pajBuiuiop bjb sapoSajna aa/JBaX-jaqp uiBjjaa `pajaadxa aq ppioAv sy sajnsodxa jaqp pajBuipsa qji/w pajjjOM auip jo qjSuaj SuijBjnqBj-ssojo Xq sdnojS joj sjo^joai jo uopnqujsip aqj SMoqs TTTYY ajqBx sojsaqsB oj ajnsodxa puopBdnaao qjiM J[su jaairea joj ppqsajqj b jsuieSb sjpads siqj `suuaj papaBJd ui aiqisnBidmi siuaas asuodsaj-asop ppqsajqj ojaz jBauq b `Xpnjs snp jo BJBp ajqBjtBAB aqj jo sjnup aqj uiqji^ '[861] I P JuauiaQ Xq sja?[JOM apjxaj sojsaqsB ajposXjqa Suouib punoj JBip aqi] XjSupjujs ajnjoid b `j ajnSip ui pajuasajd si sjaauBa Sunj puB ajnsodxa sojsaqsB joj diqsuopBpj asuodsaj-asop aqj uo snaoj opBurejp Xjoa y ajnsodxa jo jasuo japB sjboX ox oj g joj ^sassasip sojsaqsB pB,, puB `jaairea Suni `qjBap jo sasnBa jp joj sdnojg ajnsodxa jaqp aqj joj sSuipup Pub qjsap jo XjipqBqojd aqj jo auios Moqs HXX~XX 9IQBX PUB Zl ~L ssjnSip aures aqj qanui ajB aSjauia JBip sujapsd pjauag aqj jnq suopBUBA auios ajB ajaqx sdnojg pajjjOM aunj jo ipSuaj joj xi~AI S3PbX jo sauas aqj oj snoSopire ajB JBip sdnojS ajnsodxa jaqp pajBuipsa joj sappj jo jas b bjb XIX_AIX S9WBX pajjjOAV auip aqj Xq sqof snouBA aqj joj sjunoa jaqp aqj SuiXjdpnui Xq aa jad sjBaX-jaqp sb sajnsodxa jjjom pjoj aqj pajBuipsa aABq a^ jjBdiajunoa uijaj-ja3uo| siq UBip auip jnm jad asop jaqSiq b paAiaaaj aABq paAv Xbui j3^[joa\ uuaj-jajjoqs aqj `snqx aupnoj 3ubj jauoj b ojui uipjas ajojaq pouad JJoqs b joj juauijjBdap jiaqj ui jjjoav japjip aqj jo auios pip Xaqj qaiqM ui pouad diqsaapuajdds ub paauauadxa uaui aqj jo jsoui XjqBqojj pa^JOAV pBq Xaqj auip jo qjSuaj aqj oj SuipjoaaB sqof snoiJBA ui uaui jo jaquinu aqj jo suoijnqujsip aqj bjb HTY ajqBx ui uMoqs osjy puBqaJOjaq pajBdiapuB psq aM UBip anpA jaqSiq b `aa/sjaqp 66P MJ0M sojsaqsy uuax-jjoqs jsyy iCjipjjopq uuax-Suoq i f*SM R not shown both observed and expected deaths are less than 5. Expected deaths based on New Jersey white male quinquinnial age and calendar year period specific death rates. BE, coding o f cause according to best evidence available; DC, coding o f cause according to death certificate information only. 504 Seidman, Selikoff, and Gelb 1.20 1.20 0.98 2 (1) 2 (1) 3 (2) 2 (1) 3 (2) 3 0.78 0.53 8 W Ol/"3 Os Nm/"> I 9t V .s a I .IsM0) 0 a35 U O Vu 1= tl v 0- ll iw.= a= So Z^ 7 Itb 8X. in W S *" II o u* 9 "9 *4*> *45> X 'Z M W5 z'Oaa w-.,^' 4) !$ -a L sos tcs 0i5 1/3 I t- oSfi 1'5aB** 1aE*u3b-9-aa q ll w v; a Mej -4a) 4> q H21 9*J 'i iSR Sl-3 SO On ON Tf 00 (s r- nc*To) 2 cs w SO 0<N0 Tt SQO -2 i :& su 00 CO <N -- OrNj S G$^ m O tjOr-*' aSr/. * X 2 O W co <N oo UC*Jl, 50ZC/4_5 ^Os Wc>,lrCm1s/3* 00 O Cx Oo. Cua Ze o CM 00 SJ H3o o NO V o ri 0.34 0.07 0.18 0 Exp 123 Obs 0 25.0-49.9 AAA 508 Seidman, Selikoff, and Gelb TABLE XX. All Causes: Standardized Mortality Ratios for Cumulative Deaths From 5 to 40 Elapsed Years Fiber-years per cc <6.0 6.0 - 11.9 12.0 - 24.9 25.0 - 49.9 50.0 - 99.9 100.0 - 149.9 150.0 - 249.9 250.0 + 5-9 88 106 w 73 185 125 196 5-14 85 100 127 127 109 188 191 171 Elapsed No. of years since onset of work 5-19 5-24 5-29 99 Iliiilli! 122 140 154 145 172 168 168 163 186 112 138 159 191 186 187 179 159 184 224 240 266 5-34 160 169 204 172 183 195 291 5-39 160 172 199 174 181 199 291 TABLE XXL Lung Cancer: Standardized Mortality Ratios for Cumulative Deaths from 5 to 40 Fiber-years per cc Elapsed No. of years since onset of work: Observed (BE)a 5-9 5-14 5-19 5-24 5-29 5-34 <6.0 6.0 - 11.9 12.0 - 24.9 25.0 - 49.9 50.0 - 99.9 100.0 - 149.9 150.0 - 249.9 250.0 + 0 122 267 217 0 Cl 148 323 0 & 152 328 0 213 476 462 0 1,087 750 593 571 741 769 714 1,290 1,600 1,233 909 667 1,000 1,029 248 354 342 535 625 769 1,122 1,342 301 383 382 508 704 615 1,026 1,667 aBE, coding of cause according to best evidence available. 5-39 282 415 442 468 714 604 1,136 1,596 TABLE XXII. Ail Asbestos Diseases: Standardized Mortality Ratios for Cumulative Deaths From 5 to 40 Elapsed years since onset of work by estimated fiber exposure Fiber-years per cc Elapsed No. of Years Since Onset of Work: Observed (BE)a 5-9 5-14 5-19 5-24 5-29 5-34 5-39 <6.0 98 79 178 165 188 206 214 6.0 - 11.9 0 40 180 212 228 248 12.0 - 24.9 .......... 0...... ......120 220 276 268 302 332 25.0 - 49.9 0 66 276 244 317 341 321 50.0 - 99.9 .......... 0...... 327 279 314 419 513 532 100.0 - 149.9 377 571 566 586 557 541 524 150.0 - 249.9 682 737 728 599 709 732 765 250.0 + 888 526 850 995 1,149 1,255 1,208 aBE, coding of cause according to best evidence available. See text for definition of all `asbestos" diseases. Long! ^ SR XacI o * to. ^ 8 Zo c| 'S SR oc Z2 ^ SR oe Zg `S R zO Cg 1 43> Bo 6o Z S|G *5os5 < ac 1 O i V Z6 G| a 1 1is siB, x f12 o tgq 3 'a Z1 iA * % o f total is indicated by number in parentheses. Uf to OS 81 1 (Ol to 1 SO 1 to 1 to SO SO so 4* so vO SO SO so so SO L/l Ui 8oo O tO U\ to u> U) OS 00 s ^4 SO UJ I 21 w i 5S 2. -3 sa hs! )0 L/i 0 ^ ^ to Sw 5 hs: giJ sa '.J VI \ 1 VI 'TJ 4^ NJ u> ^ 4^ s sa a 60S MJ0M sojsaqsy uuax-jjoqs jajjy ^ijibjjojv uuax-Suoq ^sojsoqse,, qe jo uoijiuijap joj jxaj : 802`I S9L tt tS IZ Z 8tt tit St`l ZL its eis ite to 8tt 901 6tI`I 60L Z.SS 6lt l 89t tit 881 6-S t-S 6t-S b(H9) ps/vjssqo :voav jo j aansod uiojj sqjBSQ 3Ai}B|nuin3 joj soijbj 96`l 9l`l t09 tu 89t ttt Sit t8t L99`l 9t0`l 19 tOL 80S t8 8 10 tt`l ttl`l 69L SZ9 tt t 8tt 6 - t - 6t - ,,(aa) paAJasqo :>Jiom jo 3J1 0j7 oj g iuojj sqjB3Q 3A!JB|nuin3 I6t 661 181 ttl 661 ttl 091 tu 6 - I6t 61 81 tl tot 691 091 901 t - 99Z m 81 6l 981 891 tl 6t- )JJOM JO J9SU0 3D1 SJB9A pasdBia Oh l S mojj sqjesa saij d'dM'S & A. A. A. o. |JO 80OS a tgJO2-SWO+g8: SS-2SW' Ow;IS22C*BO o ,3 CT* "8 E rn Q0fei. 23< 1 g. sa> 1o. O aj as &3 < * s.E? 25SST- ~a0> n> 2CL ao3O(D.' aBST..i S. So fr S. ?2 o *,,rS as -- | oo | oo | oo IIS sojssqsy uuax-JJoqs jayy mjax-Siioq 22Z?02 *c*0n U1N-->J1 tO OO o Oi UJ 0N0) -- ON " l-/4l o N> Os OO 8 OO 8 | oo 8 | oo 8 2 Months Obs 512 Seidman, Selikoff, and Gelb FIBER YEARS PER CUBIC CENTIMETER <6.0 6.0- 11.9 12.0- 2*9 25.0- 49.9 50.0- 99.9 100.0-149.9 150.0-249.9 250.0 + 400 STANDARDIZED MORTALITY RATIO 500 Fig. 10. Ratio of cumulative observed to expected probabilities of dying from all causes from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941-1945, according to estimated fiber exposure. FIBER YEARS PER CUBIC CENTIMETER STANDARDIZED MORTALITY RATIO Fig. 11. Ratio of cumulative observed to expected probabilities of dying from lung cancer from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941-1945, according to estimated fiber exposure. FIBER YEARS PER CUBIC CENTIMETER 100.0-149.9 150.0-249.9 250.0 + 1000 STANDARDIZED MORTALITY RATIO Fig. 12. Ratio of cumulative observed to expected probabilities of dying from all "asbestos" diseases from 5 through 40 elapsed years since onset of work in an amosite asbestos factory, 1941-1945, according to estimated fiber exposure. See text for definition of all "asbestos diseases". Long- 1800- Standardized Mortality Ratio ' 1500- 1200- 90OH 600-1 300-L 0 25 50 Fig. 13. Fiber-years per cubic centii work in an amosite asbestos factory, exposure. "susceptible" men through de after onset of work, the more p 5. Especially with lighter is necessary to evaluate the effe ACKNOWLEDGMENTS We wish to express our ir are particularly grateful to Edw their assistance in processing th Amy Manowitz, Shirley Levine investigations of the men in this ment of records, specimens, an< Drs. J. Churg, Y. Suzuki Unit, reviewed the histological skilled basis for pathological c daily appreciate the learned guii level of fiber exposures to the v; We are also deeply appreci clinicians, hospitals, coroners, s providing detailed information i mention must be made of the ki Center, Iris Salerno, ART, Jam St. Joseph's Hospital and Med Fontannetti, Frank Schell, MD Greater Paterson General Hosp Leone, MD, Allan S. Ellis, MI Shaw; Memorial Hospital, Patri Robert G. Rubin, MD, Patholo `ipjnuig 3ijbj\[ `jBjidsoH Xjunoo souig uoSjog psiSoioqjBj `aw `uiqng o wsqog `aw `SSI3A\ Suiaji `SSOJQ 99U9JMBg `ygg `JU!M UI9UJBJ `[BJldSOH IBIJOUX9JV ;MBqs JOUB913 `jBjidsoH ss9UJ[B9Jd 9qx !sjjbjs jraqi pus `aw `SHI3 S UBjjy `aw `suoog g puBuuy `jpuopjBO 9U9|jy `Supjog y pgjg `ppidson IEJ9U9Q uosjojbj jojbojo isjjsjs jraqj PUB pbjjow siog `aw `jnBjurajs inBj `aw `IP*PS ^ubjj `prauuEjuog qdosof `ygg `s^bjq uosjim ourejjoq `joju93 jBoipow puB jBjidsoH s,qd9sof is Jsjjbjs .iraqi puB `aw `oo/A Sunn-91 puB `ojoow sguref `xgy `ouraiBS sui `joju93 JBlldSOH 1BIJOUI9W lJ9UJBg JO XjIS0J9U9 PUB SS9UpUD[ 9qi JO 9pBUI 9q jsnui UOIJU9UI JBT99d{> SUIBj80U98jU90J pUB `sqOOjq `S9pqs *SpJ099J UOIJBUIJOJUI popBigp SuipiAOid ` S91JI|I9BJ JB9ip9UI JOqjO pUB `SJU9UJlJBd9p qj[B9q 9JBJS `SJ9U0J09 `SJBJldSOq `SUBI9IUI]9 `sjsiSojoqiBd Xq sn oj uoaiS dpq snojouoS 9ip jo 9AijBi99jddB Xjdoop osjb ojb 9^ jjoqoo siqj ui sjgqjoM gqi joj sqof snoiJBA 9ip oj sgjnsodxg joqij jo J9A9[ SutuSissb ui uosjoqoqq f uiBqp^ ja Xq u9ai oouBpinS p9UJB9{ oqj gjBiogjddE XqBio -9ds3 9/yV dpq jraqi 9JBl93jddE 9A\ puB UOlJBZIJO9JB9 IBOlSojOqjBd JOJ SISBq P9IIPIS gqi pojnjijsuoo juouraSpnf puB odiapb jraqi tiBirajBui poiSopisiq 9ip p9A\9iA9j `jiuq XSo[oqiBg reuys lunow 9qi jo `urajsjouuB^ w pus `ppizns A `8jnq3 f -sjq suqij XbJ-X PUB `SU9UII99ds `spjoooj JO JU9UI -oSbUBUI JT1J9JB9 9qj JOJ Z9J9J S99UBJJ OJ pUB tXptlJS Slip UI U9UI 9ip JO SUOI}E8l}S9AUI ppij gqi joj uBjojq a sgjJBq^ pus `sojoSjew bjXb^ PuiAog Xojjiqs `zjimoubw Xrny `U0JJ9J Xipojoa `JJ9qnof nog oj tXpnjs slip jo BjBp 9ip Suissooojd ui ooubjsissb jraqi joj opJBng qdosof puB `EJ9qng y uqof `J9qj9Aqs uiMpg oj jnjoiBjS XjjBpioijJBd 9jb sjjbjs jno jo 99UBJSISSB jnjqpfs oqj oj ssoupojqopui jno ssojdxo oj qsiM siNBWoaanMONxov qJIBOq UO SJ99JJ9 9qj 9JBn[BA9 OJ XjBSS309U SI dn-Avopoj poSuojojd `gjnsodxo joojip (jgjjoqs Jo/puB) jgjqSq qjiAV XpBraodsg g XjqBJJOUI UI S9SS99X3 9qj poounouojd 9JOUI 9ip `qjOM JO J9SUO J9JJB 9UIIJ 9ip J9UOJ oqj `UO S90 9UIIJ SB `JBJ9U9 UI `qjB9p qSnOjqj U9UI tl9iqijd99sns,, ojnsodxs jsqy p9jBuiijs3 J9j9uiiju90 oiqno jgd jboX jsqij Xq `<&opej sojssqsb sitsoiuc ub ui ^jom JO PSUO 30UIS SJBOX p9SdB]9 Qf OJ g UIOJJ J30UB0 Sutl] JOJ J9J3UIIJU3D oiqiio jod SJBOX-JOqiJ \ *Sy jj9ojiiuao 9;qnoj8d sjoaX-jeqij CIS MJ0M sojsaqsy uuax-jjoqs J.1J.JY Xjijbjjow uuax-Suog oiioy X!|djjoW PZipK>pUDlS 514 Seidman, Selikoff, and Gelb ART, Aarend Schwinger, MD, and Edward Wagman, MD; Passaic General Hospital, Margaret VanDuyne, ART, Sigurd E. Johnsen, MD, John R. Gannon, MD, and their staffs; Valley Hospital, Pauline Wickner Carmichael, RRA, Thomas Maguire, MD, William O. Green, Jr, MD, and their staffs; East Orange Veterans Administration Hospital, Maimu Ohanian, MD, and Diethelm Boehme, MD, and their staffs. We also are indebted to many other colleagues in other hospitals including the Hackensack Hospital; Clara Maass Hospital, Bellville; East Orange General Hospital; Fair Lawn Memorial Hospital; Englewood Hospital; Greystone Hospital, Morris Plains; Irving ton General Hospital; Saddlebrook General Hospital; St. Mary's Hospital, Passaic; Good Samaritan Hospital, Suffem, N.Y.; Jersey City Medical Center; Horton Me morial Hospital, Scranton, PA; Point Pleasant Hospital; Hackettstown Community Hospital, and the Dover General Hospital. REFERENCES Dement JM, Harris RL, Jr., Symons MJ, Shy CM (1983): Exposures and mortality among chrysotile asbestos workers. Part II: Mortality. Am J Ind Med 4:421-433. Hammond EC, Selikoff IJ, Seidman H (1979): Asbestos exposure, cigarette smoking and death rates. Ann NY Acad Sci 330:473-490. Langer AM, Ashley R, Baden V, Berkley C, Hammond EC, Mackler AD, Maggiore Cl, Nicholson WJ, Rohl AN, Rubin IB, Sastre A, Selikoff D (1973): Identification of asbestos in human tissues. J Occup Med 15:287-295. Mason TJ, McKay FW (1973): "U.S. Cancer Mortality by County, 1950-1969." DHEW Publication No. (NIH) 74-615. Washington, D.C.: U.S. Government Printing Office. National Center for Health Statistics (1968): "International Classification of Diseases, Adapted for Use in the United States, Eighth Revision." Public Health Service Publication No. 1603, Volumes 1 and 2, Washington, D.C.: U.S. Government Printing Office. Reed LJ, Merrell M (1939): A short method for constructing an abridged life table. Amer J Hygiene (Sect. A) 30:33-62. Rothman KJ, Boice JD, Jr. (1979): "Epidemiologic Analysis With a Programmable Calculator." NIH Publication No. 79-1649. Washington: U.S. Government Printing Office. Seidman H, Selikoff IJ, Hammond EC (1979): Short-term asbestos work exposure and long-term observation. Ann NY Acad Sci 330:61-90. Selikoff IJ, Hammond EC, Churg J (1972): Carcinogenicity of amosite asbestos. Arch Envir Hlth 25:183-186. Selikoff IJ, Hammond EC, Seidman H (1979): Mortality experience of insulation workers in the United States, 1943-1976. Ann NY Acad Sci 330:91-116. World Health Organization (1948): "Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death, 1948 Revision." Volumes 1 and 2. Geneva: World Health Organization. World Health Organization (1955): Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death, 1948 Revision." Volumes 1 and 2. Geneva: World Health Organization. World Health Organization (1957): Manual of the International Statistical Classification of Diseases, Injuries and Causes of Death, 1955 Revision. Volumes 1 and 2, Geneva: World Health Organization. An Smoking, Morbidity, Group of Ex-Asbest E.D. Richter, md, mph, H. Tu and D. Weiler, md Thirty-three of 184 forme evaluate knowledge, attitud three subjects in this group symptom/sign-pulmonary ft ers smoked, and the majori than because of knowledge corned the offer of smokii nonsmokers, were at risk f tained subjects with impairr of breath, cough, rales, or greatly increased the odds t impairments would be foun one hour of person time ] material on smoking, and suggest that smoking alert needed, feasible, and accept Key words: asbestos, smoking, puli INTRODUCTION Smoking cessation in cur their risk of premature death f complications of chronic respi basis for the smoking-asbesto proposals for similar action Committee," 1979; IEPS, 1976 The present work describes a practices concerning asbestos The Division of Occupational Health School, and School of Public Health, J Histadrut Workers Federation, Divisic Kupat Holim Regional Pulmonary Ser Address reprint requests to E.D. Richi of Medical Ecology, Hebrew Universil Accepted for publication July 15, 198( 1986 Alan R. Liss, Inc.
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