Asbestos lung cancer and mesothelioma are responsible for over 4,800 deaths yearly in the United States. Well-established links between asbestos exposure and these deadly illnesses makes asbestos safety a must for any employer whose work sites contain asbestos.
What is Asbestos?
Asbestos is a group of minerals that occur naturally as bundles of fibers which are resistant to heat and anti-corrosive. This hardiness led to the mineral being used extensively in industries like construction, ship and boat building and repairing, railroad, steelworks and assorted manufacturing industries. Uses included insulation, plastics, cigarette filters, and even clothing for a time. However, asbestos is highly toxic and presents serious health hazards. By the time this danger was discovered, the widespread use of asbestos ensured that we will be dealing with asbestos and asbestos exposure for a very long time.
Exposure to Asbestos
Part of the hazard of asbestos is that the indicators of asbestos inhalation do not become apparent immediately following exposure. Over periods of prolonged inhalation, fibers irritate lungs and often trigger tumor generation. High risk occupations include construction workers, plumbers, steam fitters, pipe fitters, and electricians, among many others. When symptoms do appear, they can be non-specific and hard to trace back to asbestos in the beginning. Symptoms like shortness of breath, appetite loss, and a cough can be the beginning of asbestosis but could also be any number of other non-asbestos related problems. Exposure to asbestos can lead to serious health concerns including Mesothelioma, lung cancer, asbestosis, laryngeal cancer, clubbed fingers, and other non-cancerous pleural diseases (such as pleurisy).
Role of Lung Function Testing in High-Risk Work Places
Using regular lung testing in high risk occupations can
assist with the process of early detection and symptom recognition of various
stages of the disease. Testing can help determine the chance of contracting an asbestos
related disease, such as lung cancer, based on certain conditions like the
concentration, duration, and dose of asbestos exposure. However, the rule of regular lung function testing goes beyond simply being an early warning for specific workers. Regular lung function testing is a way for employers to monitor whether or not current asbestos safety measures and procedures are adequate and functioning properly. Early indications of health problems for employees may signal the need for changes in the current asbestos safety procedures, changes in personal protective equipment, mask fit testing, and possible retraining of employees in current safety procedures.
(Learn more in "8 Step To Reduce Workers' Compensation Costs".)
While different employers may implement different testing regimens,
results from these tests can be used to improve safety procedures and
compliance with safety procedures. By using indicators from medical
surveillance as early warning, employers can reinforce efforts to reduce
asbestos exposure and know when current procedures are not working
properly, or not being followed. A review of current procedures to
determine where the failure lies should be completed any time
non-optimal results are found during medical surveillance and lung
Overview of Lung Function Testing
Lung function testing is administered to assess the function and capacity of lungs. Tests are performed at rest or during exercise. Results are then standardized based on the individual's age, gender, height and race.
Some common pulmonary function tests (PFTs) that can be done on workplace premises to detect possible asbestos exposure issues include:
- Spirometry Spirometry - A breathing test that measures the amount of air inhaled and exhaled.
- Plethysmography - Measures how much air and individual can hold in their lungs.
- DLCO - Determines how much oxygen travels from the lungs to the bloodstream.
- Maximal voluntary ventilation (MVV) - Measures the maximum amount of air that an individual can inhale and exhale in one minute.
- The six minute walk test - This test requires individuals to walk for six minutes, measuring the distance covered as well as an assessment of their functional status, and ability to perform daily tasks.
- Lung Compliance - Tests the stiffness or elasticity of the lungs.
- Impulse Oscillation - Measures airway resistance while assessing how narrow an individual’s airways are.
These pulmonary function tests can be very useful in discovering anomalies in the breathing passages, sometimes before any physical symptoms are noticed by the employee. Using these tests allows employers to proactively address asbestos issues before problems might otherwise be noticed.
OSHA has medical surveillance outlines for general industries as well as those for the construction industry and shipyard employment.
Upon hire, all employees must complete a mandatory, detailed, questionnaire that establishes their current and former exposure to asbestos. The questionnaire for general industries deals with personal details and occupational history. The occupational history component requires further insight into previous jobs and the risk of exposure to contaminants. The past medical history component of the questionnaire explores the overall health of employee with special stress laid on any respiratory or chest illnesses. One section of the questionnaire also pertains to tobacco smoking as smokers present a higher incidence of asbestos related lung cancer. All employees who are covered by medical surveillance need to fill out these forms. (Learn more in "Uses of Pre-Employment Medical Exams and Differences From Fit-For-Work Testing".)
Asbestos Exposure Control Methods
Install warning signage
Areas that have high asbestos concentrations need to be marked for limiting exposure. This can be done by posting hazard signs in areas that have asbestos containing materials. OSHA standards require such signs to display not only the confirmed presence of asbestos but also warnings to wear protective clothing in the vicinity. Another requirement is to include information about asbestos causing lung damage and cancer.
Determine type and condition of present asbestos
While lung testing results can indicate the presence of asbestos particles on the work site, it is the employer’s responsibility to identify the nature and concentration of this residue.
Undamaged materials with asbestos fibers should be left alone but observed. Personnel on the work site should not touch such undisturbed asbestos reserves.
Implement engineering controls
Engineering controls are methods which regulate the concentration of contaminants in the air through ventilation, filtration, PPE, and other air control measures. Asbestos contaminated areas need to monitored so that the quantity of contaminants released is minimized.
For instance, air quality in such locations can be improved by filtration. The process works to remove pollutants from the air. Creating a negative pressure in the space can not only lower pollutant concentration but also prevent the release of the same into other areas of the job site.
Use of personal protective equipment
The use of personal protective equipment (PPE) is mandatory where asbestos fibers are likely to be in the air. Lung testing results can be used to determine if PPEs are retaining their effectiveness in limiting exposure or if any changes need to be made to PPE types or PPE training. (Learn more in "Why Fit Testing is Important for Workers Wearing Personal Protective Equipment (PPE)".)
All PPE should be inspected regularly and should not leave the work site so that outside areas are not contaminated. Protective gear that becomes heavily contaminated needs to be replaced or discarded.
Provide adequate hygiene facilities
Since asbestos fibers are easy to carry on work clothes, shoes, hair and skin, employers need to provide shower facilities on the premises. It is recommended that employees working on asbestos contaminated sites should wash their skin immediately after suspected contact or contamination. Workers should have scheduled shower breaks after every shift and wash skin before having anything to eat or drink on the premises.
Workers should leave the premises in clean, uncontaminated clothing.
Arrange worker training programs
Employers with asbestos residue on the work site must provide appropriate training to their employees. General training to all workers should include awareness about the properties and correlation of asbestos and lung cancer with additional focus on smokers who work in such environments. In addition, workers should also be informed about the different procedures in case of an emergency.
Since all asbestos related diseases have a long latency period
from the time of exposure to the development of symptoms, regular testing can
help detect any hidden features of the disease. Including common symptom training and surveys for workers can help ensure exposed workers report for testing rather than ignoring symptoms or believing they have a less serious cause.