Current Intelligence Bulletin 62

In the 1970s, NIOSH determined that exposure to asbestos fibers causes cancer and asbestosis in humans on the basis of evidence of respiratory disease observed in workers exposed to asbestos. Consequently, it made recommendations to the federal enforcement agencies on how to reduce workplace exposures. The enforcement agencies developed occupational regulatory definitions and standards for exposure to airborne asbestos fibers based on these recommendations. Since the promulgation of these standards, which apply to occupational exposures to the six commercially used asbestos minerals—the serpentine mineral chrysotile, and the amphibole minerals cummingtonite-grunerite asbestos (amosite), riebeckite asbestos (crocidolite), actinolite asbestos, anthophyllite asbestos, and tremolite asbestos—the use of asbestos in the United States has declined substantially and mining of asbestos in the United States ceased in 2002. Nevertheless, many asbestos products remain in use and new asbestos-containing products continue to be manufactured in or imported into the United States.

Asbestos has been a highly visible issue in public health for over three decades. During the mid- to late-20th century, many advances were made in the scientific understanding of worker health effects from exposure to asbestos fibers and other elongate mineral particles (EMPs). It is now well documented that asbestos fibers, when inhaled, can cause serious diseases in exposed workers. However, many questions and areas of confusion and scientific uncertainty remain. The National Institute for Occupational Safety and Health (NIOSH) has determined that exposure to asbestos fibers causes cancer and asbestosis in humans on the basis of evidence of respiratory disease observed in workers exposed to asbestos, and recommends that exposures be reduced to the lowest feasible concentration. As the federal agency responsible for conducting research and making recommendations for the prevention of worker injury and illness, NIOSH has undertaken a reappraisal of how to ensure optimal protection of workers from exposure to asbestos fibers and other EMPs. As a first step in this effort, NIOSH convened an internal work group to develop a framework for future scientific research and policy development. The NIOSH Mineral Fibers Work Group prepared a first draft of this State of the Science and Roadmap for Scientific Research (herein referred to as the Roadmap), summarizing NIOSH's understanding of occupational exposure and toxicity issues concerning asbestos fibers and other EMPs. NIOSH sought other views about additional key issues that should be identified, additional research that should be conducted, and methods for conducting the research. In particular, NIOSH sought input from stakeholders concerning study designs, techniques for generating size-selected fibers, analytic approaches, sources of particular types of EMPs suitable for experimental studies, and worker populations suitable for epidemiological study. The purpose of this Roadmap is to outline a research agenda that will guide the development of specific research programs and projects that will lead to a broader and clearer understanding of the important determinants of toxicity for asbestos fibers and other EMPs. NIOSH recognizes that results from such research may impact environmental as well as occupational health policies and practices. Many of the issues that are important in the workplace are also important to communities and to the general population. Therefore, NIOSH envisions that the planning and conduct of the research will be a collaborative effort involving active participation of multiple federal agencies, including the Agency for Toxic Substances and Disease Registry (ATSDR), the Consumer Product Safety Commission (CPSC), the Environmental Protection Agency (EPA), the Mine Safety and Health Administration (MSHA), the National Institute of Environmental Health Sciences (NIEHS), the National Institute of Standards and Technology (NIST), the National Toxicology Program (NTP), the Occupational Safety and Health Administration (OSHA), and the United States Geological Survey (USGS), as well as labor, industry, academia, health and safety practitioners, and other interested parties, including international groups. This collaboration will help to focus the scope of the research, to fund and conduct the research, and to develop and disseminate informational materials describing research results and their implications for establishing new occupational and public health policies.

This volume is comprised of a multidisciplinary assessment of the interplay between asbestos and cancer as well as new research about the biology and treatment of malignant mesothelioma. Chapters on the various types of asbestos and other mineral fibers, epidemiology, history and future of asbestos-related diseases are included. Other reviews present new information about the role of asbestos-related inflammation and genetic factors, including the role of inherited mutations of BAP1, in mesothelioma causation, as well as recent research about gene signatures, cell signaling, and epigenetic mechanisms in asbestos-related diseases. Other chapters provide updates of novel disease biomarkers and prevention, mechanistic lesson from genetically engineered mouse and 3-D models of mesothelioma tumorigenesis and therapeutic resistance. Also included are up-to-date reviews of surgical, molecularly targeted chemotherapeutic, and immunotherapeutic approaches for mesothelioma as well as an overview of legal issues.

Asbestos: Risk Assessment, Epidemiology, and Health Effects offers a key text on the evolving information regarding asbestos and human health. Now in its third edition, this bestseller explores the pathological complexities of asbestos-related disease and examines how asbestos induces diseases in biological systems. The book also discusses the types of instruments and methods available for evaluation of the content of asbestiform minerals in products, air, water, surface areas, and tissue. It explains the relevance of each of these applications and gives readers the tools to evaluate data in the future. Edited by leading authorities on the subject and with contributions from a team of international experts, this book takes a cross-disciplinary approach and an authoritative review of the history, pathology, epidemiology, sampling, and analysis of asbestos. Backed up with photos and numerous diagrams, tables, and photographs, it features case studies, methodologies, and sampling/analytical schemes that put learning into context. Fully up-to-date and featuring four brand new chapters covering asbestosis and immunity, asbestos litigation and surgical and non-surgical management of mesothelioma, this book remains the most comprehensive source of information on asbestos and the only guide the reader will ever need to own. This essential text will appeal to any professional at any level who requires the latest expertise in dealing with asbestos. It suits researchers and practitioners alike, as well as those in the fields of law, health, education, hospitality, emergency response, building management and maintenance, construction, safety, insurance, and industrial hygiene.

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Although asbestos is no longer mined in the United States, prior and ongoing exposures to asbestos continue to contribute to respiratory diseases, including mesothelioma, lung cancer, and asbestosis. To examine ongoing issues and concerns in this field, the National Institute for Occupational Safety and Health (NIOSH) drafted a research roadmap, Asbestos Fibers and Other Elongated Mineral Particles: State of the Science and Roadmap for Research, that provides an overview of the state of the science and a plan for future research in areas including toxicology, mineralogy, epidemiology, and exposure assessment. The focus of the proposed research is on clarifying the relationship between human health effects and the physical and chemical characteristics of a wide range of elongate mineral particles. In 2008, NIOSH asked the Institute of Medicine and the National Research Council to form a committee to provide a review of the scientific and technical quality of the January 2009 draft NIOSH Roadmap document. The present volume provides the committee's assessment of the Roadmap and recommendations for strengthening its utility for NIOSH, other federal agencies, the private sector, and other stakeholders.