Thursday, February 03, 2005

Asbestosis and Silicosis, Legislative Update

BrooklynDodger noticed the following in the 1/31 Daily Labor Reporter posting:

Specter Suggests Limiting State Silica Suits to Prevent Dual Filings

"Reacting to new testimony that asbestos- and silica-related disease are easy to distinguish, Senate Judiciary Committee Chairman Specter (R-Pa.) says lawmakers should now be able to draft language in a multibillion-dollar asbestos trust fund bill to prevent asbestos claimants from recasting their claims to refer to other harmful substances, such as silica. "There is no confusing asbestos and silica-related disease," Specter says after a hearing on the issue of "mixed dust" claims. "That should leave us a clear path to eliminate second claims" of asbestos claimants in court. "

BrooklynDodger is not going to take a position here on asbestos compensation legislation or Senator Specter's role. Whoever is getting a raw deal now, or would get a better or worse deal under new legislation, the victims of asbestos are not now and never will be made whole.

However, there is a bit of data on asbestos, silica, claims and x-rays. Michigan has a “Silicosis and Dust Disease Fund,” paid out of a tiny surcharge on workers compensation premiums. Employers who recognize a worker’s claim for silicosis may apply to this fund for reimbursement. In addition, Michigan has an occupational disease reporting law. Together, these provide something of a convenience sample of disease victims.

Two papers provide insight into the relationship of silica exposure – in the foundry environment – and asbestosis.

Am J Ind Med. 1998 Aug;34(2):197-201.

Asbestos-related x-ray changes in foundry workers.

Rosenman KD, Reilly MJ.
Michigan State University, Department of Medicine, East Lansing 48824-1316, USA.

Michigan has a statewide mandatory occupational disease reporting system. As part of that system, reports are received from hospital, physicians, death certificates, the worker's compensation bureau, and company medical departments. Based on this reporting, the State of Michigan has a special emphasis program for the surveillance of silicosis, a known disease outcome among foundry workers. From 1985-1996, 115 cases reported to the State Surveillance System as silicosis, pneumoconiosis not specified, or pulmonary fibrosis were reclassified as having asbestos related x-ray changes after a B-reader interpretation of each case's chest x-ray. During this same period there were an additional 697 reports confirmed as silicosis and 6,724 cases reported to the surveillance system as asbestosis. Among the 115 reports reclassified as having asbestos-related x-ray changes without evidence of silicosis-related x-ray changes, 54 had worked in foundries. Only 7 (14.8%) of these individuals had their primary work in maintenance in the foundry; 40 (85.1%) had their primary foundry work in a production job; and for 10 individuals the occupation was not known. Asbestos has been used in foundries on pipe laggings, boiler coverings, as insulation in fan housings, in gloves, aprons and curtains, as insulation in cupolas, and in ladles and insulation in sand molds. Clinicians caring for foundry workers need to be aware that asbestos-related x-ray changes are not uncommon in this population and asbestos exposure should be considered as one of the carcinogens contributing to the known increased risk of lung cancer among foundry workers.>>>>>>>>>>>>>>>>>>>>>>>>>

Am J Epidemiol. 1996 Nov 1;144(9):890-900.
Silicosis among foundry workers. Implication for the need to revise the OSHA standard.

Rosenman KD, Reilly MJ, Rice C, Hertzberg V, Tseng CY, Anderson HA.

Department of Medicine, College of Human Medicine, Michigan State University, East Lansing, USA.

[Note that College of Human Medicine is there to distinguish the faculty from the College of Veterinary Medicine.]

To evaluate the risk of pneumoconiosis among workers in a Midwestern automotive foundry, medical records and silica sand exposure data were analyzed for 1,072 current and retired employees with at least 5 years of employment as of June 1991. Approximately half of these employees had worked at the foundry for 20 or more years. Sixty workers were found to have radiographic evidence of pneumoconiosis. Twenty-eight workers had radiographs consistent with silicosis, of which 25 were consistent with simple silicosis and three with progressive massive fibrosis. The prevalence of radiographic changes consistent with silicosis increased with: number of years worked at the foundry (6% for 20-29 years and 12% for 30 or more years); cigarette smoking (12.2% among smokers with high silica exposure vs. 4.4% among never smokers with high silica exposure); work area within the foundry (cleaning room, core room, mold area, core knockout); and quantitative silica exposure (0.3-2.7% of workers at the current Occupational Safety and Health Administration (OSHA) standard and 4.9-9.9% of workers above the OSHA standard). In addition, the odds of developing radiographic changes consistent with silicosis were increased for African Americans (odds ratio = 2.14, 95% confidence interval 0.85-5.60) in comparison with whites. (The risk was similar when silica exposure was equal, but African-American workers on average had greater exposure to silica, despite having a similar duration of work as white workers.) Another eight workers had radiographic evidence of asbestosis, and 24 had pleural plaques. These asbestos-related changes were not associated with increasing exposure to silica but rather were associated with being in the maintenance department and performing repair work. After controlling for cigarette smoking, race, and exposure to silica at another job besides the foundry, the authors found a 1.45 increased risk of developing a radiograph consistent with silicosis after 20 years of work at the current OSHA standard, and a 2.10 increased risk after 40 years of work at the current OSHA standard. On the basis of these findings, the authors recommend maintaining silica air levels no higher than the exposure level of 0.05 mg/m3 recommended by the National Institute for Occupational Safety and Health.

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