Evaluation of exposure to the airborne asbestos in an asbestos cement sheet manufacturing industry in Iran

The prevalences and levels of occupational exposure to dusts and/or fibres (silica, asbestos and coal): A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury

BACKGROUND

The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large number of individual experts. Evidence from human, animal and mechanistic data suggests that occupational exposure to dusts and/or fibres (silica, asbestos and coal dust) causes pneumoconiosis. In this paper, we present a systematic review and meta-analysis of the prevalences and levels of occupational exposure to silica, asbestos and coal dust. These estimates of prevalences and levels will serve as input data for estimating (if feasible) the number of deaths and disability-adjusted life years that are attributable to occupational exposure to silica, asbestos and coal dust, for the development of the WHO/ILO Joint Estimates.

OBJECTIVES

We aimed to systematically review and meta-analyse estimates of the prevalences and levels of occupational exposure to silica, asbestos and coal dust among working-age (≥ 15 years) workers.

DATA SOURCES

We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines and organizational websites; hand-searched reference lists of previous systematic reviews and included study records; and consulted additional experts.

STUDY ELIGIBILITY AND CRITERIA

We included working-age (≥ 15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but excluded children (< 15 years) and unpaid domestic workers. We included all study types with objective dust or fibre measurements, published between 1960 and 2018, that directly or indirectly reported an estimate of the prevalence and/or level of occupational exposure to silica, asbestos and/or coal dust.

STUDY APPRAISAL AND SYNTHESIS METHODS

At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, then data were extracted from qualifying studies. We combined prevalence estimates by industrial sector (ISIC-4 2-digit level with additional merging within Mining, Manufacturing and Construction) using random-effects meta-analysis. Two or more review authors assessed the risk of bias and all available authors assessed the quality of evidence, using the ROB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates.

RESULTS

Eighty-eight studies (82 cross-sectional studies and 6 longitudinal studies) met the inclusion criteria, comprising > 2.4 million measurements covering 23 countries from all WHO regions (Africa, Americas, Eastern Mediterranean, South-East Asia, Europe, and Western Pacific). The target population in all 88 included studies was from major ISCO groups 3 (Technicians and Associate Professionals), 6 (Skilled Agricultural, Forestry and Fishery Workers), 7 (Craft and Related Trades Workers), 8 (Plant and Machine Operators and Assemblers), and 9 (Elementary Occupations), hereafter called manual workers. Most studies were performed in Construction, Manufacturing and Mining. For occupational exposure to silica, 65 studies (61 cross-sectional studies and 4 longitudinal studies) were included with > 2.3 million measurements collected in 22 countries in all six WHO regions. For occupational exposure to asbestos, 18 studies (17 cross-sectional studies and 1 longitudinal) were included with > 20,000 measurements collected in eight countries in five WHO regions (no data for Africa). For occupational exposure to coal dust, eight studies (all cross-sectional) were included comprising > 100,000 samples in six countries in five WHO regions (no data for Eastern Mediterranean). Occupational exposure to silica, asbestos and coal dust was assessed with personal or stationary active filter sampling; for silica and asbestos, gravimetric assessment was followed by technical analysis. Risk of bias profiles varied between the bodies of evidence looking at asbestos, silica and coal dust, as well as between industrial sectors. However, risk of bias was generally highest for the domain of selection of participants into the studies. The largest bodies of evidence for silica related to the industrial sectors of Construction (ISIC 41-43), Manufacturing (ISIC 20, 23-25, 27, 31-32) and Mining (ISIC 05, 07, 08). For Construction, the pooled prevalence estimate was 0.89 (95% CI 0.84 to 0.93, 17 studies, I2 91%, moderate quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing, the pooled prevalence estimate was 0.85 (95% CI 0.78 to 0.91, 24 studies, I2 100%, moderate quality of evidence) and the pooled level estimate was rated as of very low quality of evidence. The pooled prevalence estimate for Mining was 0.75 (95% CI 0.68 to 0.82, 20 studies, I2 100%, moderate quality of evidence) and the pooled level estimate was 0.04 mg/m3 (95% CI 0.03 to 0.05, 17 studies, I2 100%, low quality of evidence). Smaller bodies of evidence were identified for Crop and animal production (ISIC 01; very low quality of evidence for both prevalence and level); Professional, scientific and technical activities (ISIC 71, 74; very low quality of evidence for both prevalence and level); and Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level). For asbestos, the pooled prevalence estimate for Construction (ISIC 41, 43, 45,) was 0.77 (95% CI 0.65 to 0.87, six studies, I2 99%, low quality of evidence) and the level estimate was rated as of very low quality of evidence. For Manufacturing (ISIC 13, 23-24, 29-30), the pooled prevalence and level estimates were rated as being of very low quality of evidence. Smaller bodies of evidence were identified for Other mining and quarrying (ISIC 08; very low quality of evidence for both prevalence and level); Electricity, gas, steam and air conditioning supply (ISIC 35; very low quality of evidence for both prevalence and level); and Water supply, sewerage, waste management and remediation (ISIC 37; very low quality of evidence for levels). For coal dust, the pooled prevalence estimate for Mining of coal and lignite (ISIC 05), was 1.00 (95% CI 1.00 to 1.00, six studies, I2 16%, moderate quality of evidence) and the pooled level estimate was 0.77 mg/m3 (95% CI 0.68 to 0.86, three studies, I2 100%, low quality of evidence). A small body of evidence was identified for Electricity, gas, steam and air conditioning supply (ISIC 35); with very low quality of evidence for prevalence, and the pooled level estimate being 0.60 mg/m3 (95% CI -6.95 to 8.14, one study, low quality of evidence).

CONCLUSIONS

Overall, we judged the bodies of evidence for occupational exposure to silica to vary by industrial sector between very low and moderate quality of evidence for prevalence, and very low and low for level. For occupational exposure to asbestos, the bodies of evidence varied by industrial sector between very low and low quality of evidence for prevalence and were of very low quality of evidence for level. For occupational exposure to coal dust, the bodies of evidence were of very low or moderate quality of evidence for prevalence, and low for level. None of the included studies were population-based studies (i.e., covered the entire workers' population in the industrial sector), which we judged to present serious concern for indirectness, except for occupational exposure to coal dust within the industrial sector of mining of coal and lignite. Selected estimates of the prevalences and levels of occupational exposure to silica by industrial sector are considered suitable as input data for the WHO/ILO Joint Estimates, and selected estimates of the prevalences and levels of occupational exposure to asbestos and coal dust may perhaps also be suitable for estimation purposes. Protocol identifier: https://doi.org/10.1016/j.envint.2018.06.005. PROSPERO registration number: CRD42018084131.

A critical review of asbestos concentrations in water and air, according to exposure sources

Asbestos, a group of minerals with unique physical and chemical properties, has been widely used in various industries. However, extensive exposure to asbestos fibers, present in the environment, has been linked to several types of cancer, mesothelioma, and asbestosis. Despite worldwide regulations prohibiting or regulating the use of this material, the uncertainty surrounding the concentrations of asbestos fibers in the environment (air and water) from different sources of exposure persists. The objective of this review paper is to identify the levels of asbestos in air and water reported in the literature based on the source of exposure in diverse contexts to assess conformity with the reference limits for this mineral. Initially, the review delineates various forms of exposure and the origin of fiber generation in the environment, whether direct or indirect. Regarding the presence of asbestos in the environment, high concentrations were identified in natural water bodies known as Naturally Occurring Asbestos (NOA), and there is a risk in the process of distributing drinking water due to the presence of asbestos-cement pipes. In the air, studies to determine asbestos concentrations vary based on the sources of exposure in each region or city studied. The presence of asbestos mines around the city and the intensity of vehicular traffic are some of the most relevant sources found to be related to high concentrations of asbestos fibers in the air. The present review paper features a critical review section in each chapter to highlight critical points found in the literature and suggest new methodologies/ideas to standardize future research. It emphasizes the necessity to standardize methods for measuring asbestos concentrations in air and water arising from diverse sources of exposure to enable comparisons between different regions and countries.

Cancer risk assessment of exposure to asbestos during old building demolition

BACKGROUND: Years ago, the use of asbestos in construction materials was common. Although asbestos has been recently banned in many countries, exposure to asbestos during old building demolition is not unexpected. OBJECTIVE: The aim of this study is to assess the concentration of exposure to asbestos and estimate its cancer risk among old building demolition workers. METHODS: In this study, personal air samples were collected during building demolition. The number of asbestos fibers in collected samples were determined according to the NIOSH-7400 standard method. Chemical compositions of fibers were assessed using scanning electron microscopy (SEM). The carcinogenic risk of exposure to asbestos was determined based on the recommended United State Environmental Protection Agency (USEPA) method and Monte-Carlo simulation used to estimate the probability of cancer. RESULTS: Chemical analysis confirmed the presence of asbestos in collected air samples, and 67% of counted fibers were asbestos. In a number of buildings, workers had exposed to asbestos that was higher than occupational exposure limit (0.10 f/ml). Results of cancer risk estimation showed that cancer risk were considerable among workers. CONCLUSION: Implementation of asbestos risk management program such as separation of asbestos containing material, personal protective equipment’s and use of wet method in demolition could minimize asbestos exposure during old building demolition.

Spatio-seasonal variation, distribution, levels, and risk assessment of airborne asbestos concentration in the most industrial city of Iran: effect of meteorological factors

Like other dangerous pollutants in the air, asbestos has negative and adverse effects on human and animal health. The present study is designed to determine the concentration of asbestos in the air of the most industrial city of Iran (Karaj) in 2018-2019. For this purpose, 4 samples were taken from different areas of the air of Karaj during a year with an SKC pump and flow of 6 L/min for 8 h and in 45 days, and a total of 68 samples of asbestos fibers were collected. Then, the samples were analyzed by phase-contrast microscope (PCM) and scanning electron microscopy (SEM). Eventually, the health effects of asbestos fibers were evaluated by the IRIS EPA method. The average concentration of asbestos fibers was 1.84 f/L PCM and 18.16 f/L SEM. Also, the results of statistical correlation analysis indicated that asbestos fibers are positively correlated with wind speed but negatively correlated with the other three parameters (temperature, relative humidity, and pressure). On the other hand, the average annual risk of asbestos fiber in the ambient air of Karaj for all samples was in the range of 4.32 × 10^-6 to 1.81 × 10^-4 which in some places had more danger than the recommended risk range. According to the EPA guidelines, carcinogenicity acceptable levels are in the range of 10^-4 and 10^-6. Values higher than 10^-4 have more carcinogenic risk and values lower than 10^-6 have a lower carcinogenic risk.

Recent Scientific Evidence Regarding Asbestos Use and Health Consequences of Asbestos Exposure

To justify the continuous use of two million tons of asbestos every year, it has been argued that a safe/controlled use can be achieved. The aim of this review was to identify recent scientific studies that present empirical evidence of: 1) health consequences resulting from past asbestos exposures and 2) current asbestos exposures resulting from asbestos use. Articles with evidence that could support or reject the safe/controlled use argument were also identified. A total of 155 articles were included in the review, and 87 % showed adverse asbestos health consequences or high asbestos exposures. Regarding the safe/controlled use, 44 articles were identified, and 82 % had evidence suggesting that the safe/controlled use is not being achieved. A large percentage of articles with evidence that support the safe/controlled use argument have a conflict of interest declared. Most of the evidence was developed in high-income countries and in countries that have already banned asbestos.

Concentrations of asbestos fibers and metals in drinking water caused by natural crocidolite asbestos in the soil from a rural area

Asbestos fibers and metals in drinking water are of significant importance to the field of asbestos toxicology. However, little is known about asbestos fibers and metals in drinking water caused by naturally occurring asbestos. Therefore, concentrations of asbestos fibers and metals in well and surface waters from asbestos and control areas were measured by scanning electron microscopy (SEM), inductively coupled plasma (ICP) optical emission spectrometer, and ICP-mass spectrometry in this study. The results indicated that the mean concentration of asbestos fibers was 42.34 millions of fibers per liter by SEM, which was much higher than the permission exposure level. The main compositions of both asbestos fibers in crocidolite mineral and in drinking water were Na, Mg, Fe, and Si based on energy dispersive X-ray analysis. This revealed that the drinking water has been contaminated by asbestos fibers from crocidolite mineral in soil and rock. Except for Cr, Pb, Zn, and Mn, the mean concentrations of Ni, Na, Mg, K, Fe, Ca, and SiO2 were much higher in both surface water and well waters from the asbestos area than in well water from the control area. The results of principal component and cluster analyses indicated that the metals in surface and well waters from the asbestos area were significantly influenced by crocidolite mineral in soil and rock. In the asbestos area, the mean concentrations of asbestos fibers and Ni, Na, Mg, K, Fe, Ca, and SiO2 were higher in surface and well waters, indicating that asbestos fibers and the metals were significantly influenced by crocidolite in soil and rock.

Assessment of airborne asbestos exposure at an asbestos cement sheet and pipe factory in Iran

Iran imports nearly 55,000 metric tons of asbestos per year, and asbestos cement (AC) plants contribute nearly 94% of the total national usage. In the present study, asbestos fiber concentrations during AC sheet and pipe manufacturing were measured by phase-contrast microscopy (PCM) and polarized light microscopy (PLM) in 98 personal air samples. The fiber type and its chemical composition were also evaluated by scanning electron microscopy (SEM) and energy-dispersive X-ray analysis (EDX). Personal monitoring of fiber levels indicated a range from 0.02 to 0.55PCM f/ml (0.02-0.69PLM f/ml). The AC workers' geometric mean asbestos exposure was 0.09 PCM f/ml (0.11 PLM f/ml), with arithmetic mean of 0.13 PCM f/ml (0.16 PLM f/ml). The observed fiber concentrations in many processes were higher than the threshold limit value (TLV) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH), which is 0.1 f/ml. Based on these findings, the PLM values were approximately 25% higher than PCM values. The SEM data demonstrate that fibrous particles contained chrysotile. The thinnest fiber recognized by SEM had a diameter of 0.2μm. Mean exposure exceeded the TLV for asbestos in pipe molding and finishing (100%) as well as sheet molding and finishing (45.5-83.3%). In conclusion exposure control may be needed to be in compliance with the ACGIH TLV and other guidance levels. Also, with regard to PCM limitations for airborne fiber analysis, the use of microscopic methods other than PCM can be used to improve the techniques used presently.