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Table 1,0ccupational exposure limits for asbestos Exposure limits MWW* OSHA PEL TWA 0.2 Action level 0.1 NIOSH REL TWA (Ca)t 0.1 ACGIH Tus TWA (Ala)§ 20 Chrysotile 0.5 Amosite 0.2 Crocidolite 2.0 Other forms * Fibers greater than 5 µm in length -a potent human car- t (Ca): NIOSH recommends treating po cinogen. § (Ala): Human carcinogen with an assigned TLV®. HEALTH HAZARD INFORMATION • Routes of exposure Asbestos may cause adverse health effects following exposure via inhalation or ingestion. • Sumnvary of toxicology 1 �ects on animals: Single intrapleural injections of asbestos in rats, rabbits, and hamsters produced mesothelioma (cancer of the chest or abdominal linings). In rats, chronic inhalation or oral administration of asbestos produced cancers of the All forms lungs, stomach, kidneys; liver, or mammary glands. of asbestos were found to be carcinogenic in treated animals. 2. Effects on humans: Exposure to asbestos has been found to significantly increase the risks of contracting asbestosis, lung cancer, and mesothelioma. • Signs and symptoms of exposure 1. Short-term (acute): Exposure to asbestos can cause short- ness of breath, chest or abdominal pain, and irritation of the skin and mucous membranes. 2. Long-term (chronic): Exposure to asbestos can cause reduced pulmonary function, breathing difficulty, dry cough, broadening and thickening of the ends of the fingers, and bluish discoloration of the skin and mucous membranes. IA RECOMMENDED and biologic monitoring, medical screening, and morbidity and mortality data. This analysis may provide information about the relatedness of adverse health effects and occupational ex- posure that cannot be discerned from results in individual workers. Sensitivity, specificity, and predictive values of bio- logic monitoring and medical screening tests should be evalu- ated on an industrywide basis prior to application in any given worker group. Intrinsic to a surveillance program is the dis- semination of summary data to those who need to know, in- cluding employers, occupational health professionals, potentially exposed workers, and regulatory and public health agencies. • • Preplacement medical evaluation Prior to placing a worker in a job with a potential for exposure to asbestos, the physician should evaluate and document the workers baseline health status with thorough medical, environ- mental, and occupational histories, a physical examination, and physiologic and laboratory tests appropriate for the anticipat- ed occupational risks. These should concentrate on the func- tion and integrity of the respiratory system using the principles and methods recommended by NIOSH and the American Thoracic Society, (ATS). A preplacement medical evaluation is recommended in order to detect and assess preexisting or concurrent conditions which may be aggravated or result in increased risk when a worker is exposed to asbestos at or below the NIOSH REL. The ex- amining physician should consider the probable frequency, in- tensity, ntensity, and duration of exposure, as well as the nature and degree of the condition, in placing such a worker. Such con- ditions, which should not be regarded as absolute contraindi- cations to job placement, include cigarette smoking, preexisting asbestos-related disease, and significant breathing impairment due to preexisting chronic lung diseases. In addi- tion to the medical interview and physical examination, the means to identify these conditions may include the methods recommended by NIOSH and ATS. • Periodic medical screening and/or biologic monitoring Occupational health interviews and physical examinations should be performed at regular intervals. Additional examina- tions may be necessary should a worker develop symptoms that may be attributed to exposure to asbestos. The interviews. ex- • Medical surveillance Program at and appropriate medical screening and/or biologic ssive Workers with potential exposures tohazards o medicrveillance decrease or adverse trend in the Phys ologictng functioan n of the be monitored in a systemaatprogram and disease. respiratory system as compared to the baseline status of the in - intended to prevent or control occupational injury p values for a suitable refer - The program should include education of employers and work dividual worker or to the expected ers about work-related hazards, placement of workers in jobs ence population. The following testsshoouul d evale used ua- that do not jeopardize their safety and health, earliest possi- interpreted according to standardized procedures ble detection of adverse health effects, and referral of workers tion criteria recommended by NIOSH and ATS: standardized for diagnostic confirmation and treatment. The occurrence of questionnaires, tests of lung function, and chest X-rays. disease (a "sentinel health event, SHE) or other work-related adverse health effects should prompt immediate evaluation of primary preventive measures (e.g., industrial hygiene monitor- ing, engineering controls, and personal protective equipment). A medical surveillance program is intended to supplement, not replace, such measures. A medical surveillance program should include systematic col- lection and epidemiologic analysis of relevant environmental E ® Medical practices recommended at the time of JUU h ans- fer or termination and occupational history inter - The medical, environmental, views, the physical examination, and selected physiologic and laboratory tests which were conducted at the time of placement should be repeated at the time of job transfer or termination. Any changes in the worker's health status should be compared to those expected for a suitable reference pop 11