Researchers should talk to workers

Egilman, David

doi:10.1002/(sici)1097-0274(200006)37:6<668::aid-ajim12>3.0.co;2-#

Cited by 6 publications

(2 citation statements)

References 4 publications

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“…9 It should be noted that the exposure levels estimated by the NIOSH and McGill University teams may have systematically underestimated actual dust levels at the Libby vermiculite operation. 27 It follows that as exposure increased, there would have been greater variation in the CFE estimate. Given this, the effect of underestimates of exposure would be more pronounced among highly exposed workers and would bias hazard estimates toward the null.…”

Section: Discussionmentioning

confidence: 99%

Vermiculite Worker Mortality: Estimated Effects of Occupational Exposure to Libby Amphibole

Larson

Antao

Bove

2010

Journal of Occupational &Amp; Environmental Medicine

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Objective: To examine the relationship between cumulative fiber exposure (CFE) and mortality in a retrospective cohort study of vermiculite workers exposed to Libby amphibole (n ϭ 1862). Methods: Extended Cox regression was used to estimate the hazards associated with CFE as a timedependent covariate of multiple-cause mortality. Results: The Cox models for mesothelioma, asbestosis, lung cancer, and non-malignant respiratory disease were significant with rate ratios that increased monotonically with CFE. The model for deaths due to cardiovascular disease was also significant (rate ratio for CFE Ն44.0 f/cc-y vs Ͻ1.4 f/cc-y was 1.5; 95% confidence interval ϭ 1.1 to 2.0). Conclusions: By using a within-cohort comparison, the results demonstrate a clear exposure-response relationship between CFE and mortality from asbestos-related causes. The finding of an association between CFE and cardiovascular mortality suggests persons exposed to Libby amphibole should be monitored for this outcome. L ibby, Montana was the site of a vermiculite mining and processing operation from the 1920s to 1990. Although vermiculite causes no known adverse health effects, Libby vermiculite is contaminated with a mixture of amphibole fibers. These amphiboles have been collectively called tremolite by the community, popular press, and in some scientific literature 1 but Libby vermiculite also contains actinolite 2 and unregulated asbestos-like fibers, including winchite and richterite. 1,3 The only chemical difference between these amphiboles is their iron content; this mineralogic difference is somewhat arbitrary and may have no biological significance. 2 Regardless, the raw vermiculite ore mined in Libby contained up to 26% amphibole fibers by mass. 4 Libby is thought have produced 80% of the world's supply of vermiculite during the 20th century. 5 Because many of its years of operation predated significant regulation of occupational asbestos exposure, the amphibole exposures at the Libby vermiculite operation were quite high, especially before engineering controls were put in place in the late 1960s and early 1970s. The resulting health effects of working at the Libby vermiculite operation have been well documented, demonstrating excesses of asbestos-related morbidity and mortality. 6 -8 An excess of asbestos-related mortality among Libby vermiculite workers is not surprising given their occupational amphibole exposures. In this study, we use mortality data on the entire vermiculite worker cohort updated through the end of 2006. Our objective was to conduct an exposure-response study to obtain estimates of the hazard of asbestos-related mortality associated with cumulative asbestos exposure.

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Section: Discussionmentioning

confidence: 99%

Vermiculite Worker Mortality: Estimated Effects of Occupational Exposure to Libby Amphibole

Larson

Antao

Bove

2010

Journal of Occupational &Amp; Environmental Medicine

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“…One is hard pressed to find an author who has attempted to "create more doubt" about experts and corporate behavior than Dr. Egilman. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Dr. Egilman has provided anti-industry/anti-consultant opinions in many published papers and courts across the country for decades. [35][36][37] His views are generally consistent with claims made by plaintiff lawyers.…”

Section: Peer Reviewmentioning

confidence: 99%

Re: Comments on Egilman's response to Hessel regarding the health hazards of brake dust and his reflections on corporate behavior

Paustenbach

2019

American J Industrial Med

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Re: Researchers should talk to workers Am. J. Ind. Med. 2000. 37:668

McDonald

2001

Am. J. Ind. Med.

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The serious errors in Dr. Egilman's letter [2000] require correction. Amandus et al. did not rely on McDonald's exposure estimates, nor we on theirs. Wheeler in their team and Sebastien in ours collected all available data quite independently. Both conducted lengthy studies of the quarrying and milling processes, and had numerous discussions with past and present employees. They then met together to review and exchange information before deciding separately what estimates should be used in the two statistical analyses. The same procedures were followed in establishing vital status and causes of death and for the radiographic studies of the two cohorts which differed, incidentally, though with considerable overlap. It was in fact a model of how two parallel research programmes in the same work‐force should be conducted. Our final estimates of risk differed from those of the NIOSH team, but because we had collaborated at every stage, it was possible to bring our findings together in two final joint papers [Amandus et al., 1988; Armstrong et al., 1988]. If indeed Amandus et al. and we ourselves had under‐estimated fibre levels in the industry, as alleged by Egilman, our estimates of risk for lung cancer, mesothelioma and pulmonary fibrosis were too high. Does Dr. Egilman really think that tremolite exposures are less hazardous than our results suggest?

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Researchers should talk to workers

Cited by 6 publications

References 4 publications

Vermiculite Worker Mortality: Estimated Effects of Occupational Exposure to Libby Amphibole

Vermiculite Worker Mortality: Estimated Effects of Occupational Exposure to Libby Amphibole

Re: Comments on Egilman's response to Hessel regarding the health hazards of brake dust and his reflections on corporate behavior

Re: Researchers should talk to workers Am. J. Ind. Med. 2000. 37:668

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