"Så länge detta inte är bevisat av någon opartisk forskning kan man inte heller ta detta på allvar, utan man får nog bara se det, som att tillverkarna återigen, försöker komma undan sitt ansvar. "
http://www.ivl.se/rapporter/pdf/B1531.pdf
http://www.av.se/regler/afs/2004_01.pdf
J Occup Environ Med. 2004 Jan;46(1):55-67.
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Historical cohort study of U.S. man-made vitreous fiber production workers IX: summary of 1992 mortality follow up and analysis of respiratory system cancer among female workers.
Stone RA, Youk AO, Marsh GM, Buchanich JM, Smith TJ.
Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261, USA.
roslyn@pitt.eduWe report the 1946-1992 mortality experience of 4008 females employed in any of 10 U.S. fiberglass manufacturing plants between 1945 and 1978 relative to external population rates. We also examine respiratory system cancer (RSC) mortality as a function of estimated exposure to respirable fibers (RFib), formaldehyde (FOR), silica, phenolics, urea, and other agents based on internal cohort comparisons. No statistically significantly elevated standardized mortality ratios were observed for all-cause mortality (930 deaths), any of the 25 nonmalignant causes considered, all malignant neoplasms (266 deaths), or any of the 27 malignant causes considered. Internal cohort comparisons revealed no significant positive associations between RSC mortality (53 cases) and exposure to RFib, FOR, or any of the other agents considered, although exposure levels were generally low. Some demographic subgroups appear to be at relatively increased risk of RSC.
Regul Toxicol Pharmacol. 2003 Feb;37(1):28-44.
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Fiber glass and rock/slag wool exposure of professional and do-it-yourself installers.
Maxim LD, Eastes W, Hadley JG, Carter CM, Reynolds JW, Niebo R.
Everest Consulting Associates, 15 North Main Street, Cranbury, NJ 08512, USA.
postsf@aol.comThe fiber glass (FG) and rock/slag wool (RSW) manufacturers have developed a Health and Safety Partnership Program (HSPP) with the participation and oversight of the Occupational Safety and Health Administration (OSHA). Among its many provisions the HSPP includes the continuing study of FG and RSW workplace concentrations in manufacturing facilities operated by FG/RSW producers and among their customers and end users. This analysis estimates the probable cumulative lifetime exposure (fiber-months/cubic centimeter [f-months/cc]) to those who install FG and RSW insulation in residential, commercial, and industrial buildings in Canada and the United States. Both professional and do-it-yourself (DIY) cohorts are studied and the estimated working lifetime exposures are compared with benchmark values derived from an analysis of the epidemiological studies of FG and RSW manufacturing cohorts. The key finding of this analysis is that both of these end-user cohorts are likely to have substantially lower cumulative lifetime exposures than the manufacturing cohorts. As the most recent updates of the epidemiological studies concluded that there was no significant increase in respiratory system cancer among the manufacturing cohorts, there is likely to be even less risk for the installer cohorts. This analysis also underscores the wisdom of stewardship activities in the HSPP, particularly those directed at measuring and controlling exposure. Copyright 2003 Elsevier Science (USA)
Am J Ind Med. 2002 Oct;42(4):354-62.
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Respiratory cancer and exposure to man-made vitreous fibers: a systematic review.
Berrigan D.
Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Executive Plaza North, Executive Blvd., Bethesda, Maryland 20892-7344, USA.
berrigad@mail.nih.govBACKGROUND: Man-made vitreous fibers (MMVF's) have some structural features similar to those found in asbestos. This has lead to concern that exposure to MMVF's could increase the risk of respiratory cancer. METHODS: Bibliographic resources were used to identify 10 case-control and 10 cohort studies, which analyzed the relationship between exposure to MMVF's and cancer of the respiratory system. Standardized mortality ratio's (SMR's) were extracted from the cohort studies for a meta-analysis. RESULTS: A significant increase in SMR was observed for workers exposed to rock and glass wool, but not in workers exposed to glass filament. Meta-analysis of SMR's after stratification by fiber type resulted in aggregate estimates of risk of 1.23 (95% CI = 1.10-1.38), 1.08 (95% CI = 0.93-1.26), and 1.32 (95% CI = 1.15-1.52) for exposure to glass wool, glass filament, and rock wool, respectively. Some or all of the increased mortality could be attributed to tobacco use. CONCLUSIONS: The results highlight the difficulty of assessing small increases in risk of respiratory cancer potentially caused by occupational exposure in populations with high prevalence of tobacco use. Published 2002 Wiley-Liss, Inc.
J Occup Environ Med. 2001 Sep;43(9):803-8.
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Comment in:
J Occup Environ Med. 2002 Feb;44(2):106-8.
Historical cohort study of US man-made vitreous fiber production workers: VI. Respiratory system cancer standardized mortality ratios adjusted for the confounding effect of cigarette smoking.
Marsh GM, Buchanich JM, Youk AO.
Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
gmarsh@pitt.eduTo date, the US cohort study of man-made vitreous fiber workers has provided no consistent evidence of a relationship between man-made vitreous fiber exposure and mortality from malignant or non-malignant respiratory disease. Nevertheless, there have been small, overall excesses in respiratory system cancer (RSC) among workers from the fiberglass and rock/slag wool production plants included in the study that were unexplained by estimated worker exposures to respirable fiber or other agents present in the plants. The present investigation was designed to provide a quantitative estimate of the extent to which the overall excess in RSC mortality observed at the total cohort level among male fiberglass and rock/slag wool workers is a result of the positive confounding effects of cigarette smoking. Because cigarette-smoking data were neither available nor obtainable at the individual level for all members of the fiberglass and rock/slag wool cohorts, we used the "indirect" method to adjust RSC standardized mortality ratios (SMRs) at the group (cohort and plant) level. Our adjustment suggested that cigarette smoking accounts for all of the 7% and 24% excesses in RSC observed, respectively, for the male fiberglass and rock/slag wool cohorts in the latest mortality updates. The same conclusion was reached regardless of which of several alternative formulations were used to adjust local rate-based RSC SMRs. We found that our smoking adjustments were robust with respect to several alternative characterizations and (with the exception of one fiberglass plant) produced adjusted RSC SMRs that were lower than their unadjusted counterparts. Further, all statistically significantly elevated unadjusted SMRs were reduced to not statistically significant levels. These results reaffirm that RSC SMRs based on US and local rates must take into account the potential confounding effects of cigarette smoking. They also suggest that the use of local county mortality rate-based SMRs may not help to adjust for cigarette smoking to the degree suggested by some investigators.
J Occup Environ Med. 2001 Sep;43(9):779-92.
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Comment in:
J Occup Environ Med. 2002 Feb;44(2):106-8.
Historical cohort study of US man-made vitreous fiber production workers: IV. Quantitative exposure-response analysis of the nested case-control study of respiratory system cancer.
Stone RA, Youk AO, Marsh GM, Buchanich JM, McHenry MB, Smith TJ.
Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA.
roslyn@pitt.eduAs part of the 1992 update of an historical cohort study of 32,110 workers employed for at least 1 year in any of 10 US fiberglass manufacturing plants, a nested case-control study was done in which data on tobacco smoking were obtained for 631 male case subjects with respiratory system cancer (RSC) and 570 control subjects matched on age and year of birth. In this more extensive analysis of the nested case-control data, we provide a detailed assessment of the most prominent findings from the initial report. We expand the scope of the analysis to consider quantitative measures of exposure to respirable fibers (RFib), formaldehyde (FOR), and silica (Sil) and consider these and other exposures together in the same model. We investigate the functional form of possible exposure-response relationships between RSC risk, RFib, and FOR. In addition, we address the statistical issues of collinearity, effect modification, and potential confounding by coexposures. All analyses are adjusted for smoking. Neither measure of exposure to RFib (average intensity of exposure or cumulative exposure) was statistically significantly associated with RSC risk in any of the hundreds of fractional polynomial models considered. This more extensive analysis has substantiated our initial finding of no apparent exposure-response relationship between RSC risk and either cumulative or average intensity of exposure to RFib at the levels experienced by these workers. This study provides some evidence of increased RSC risk among workers at the higher observed levels of average intensity of exposure to FOR and/or Sil. No positive associations were identified between RSC risk and any of the other exposures considered in this case-control study.
Regul Toxicol Pharmacol. 1999 Oct;30(2 Pt 1):96-109.
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Comment in:
Regul Toxicol Pharmacol. 2001 Feb;33(1):102-3.
A risk assessment for exposure to glass wool.
Wilson R, Langer AM, Nolan RP.
Harvard University, Cambridge, Massachusetts, USA.
Synthetic vitreous fibers (SVFs) have been widely used as insulation material in places where asbestos was used many years ago and therefore the hazards have been compared. Since the three principal types of asbestos fibers types have caused lung cancer at high exposures, there is a widely held belief that all fibers are carcinogenic if inhaled in large enough doses. Hence, on a morphological basis, SVFs have been studied for their carcinogenic potential. However, there is considerable evidence that differences exist among fibers in their potency to produce a carcinogenic response. In this attempt to carry out a numerical risk assessment for the installers of blown glass wool (fiber) insulation, we start with a characterization of the material; then we review the exposures both in manufacturing and installation. Neither the epidemiological studies of human exposure nor the animal studies have shown a marked hazardous effect from glass wool and we can therefore be sure that any effect that might exist is small. But in this case, as in many other situations where there is a potential hazard, society desires further reassurance and therefore we have made a mechanistic calculation. There are good estimates of the risk associated with exposure to chrysotile asbestos at high exposures and doses. We have therefore taken these numbers and discussed how much less risky an exposure to glass wool fibers might be. We conclude that for a given fiber count, glass wool is five to ten times less risky (and of course the risk might be zero). The risk for a nonsmoking installer of glass wool fiber insulation who wears a respirator is about 6 in a million (and might be zero) per year. This means that out of a million installers there might be six lung cancers from this cause every year or out of 10,000 installers there might be one in 16 years. The low risk of 6 in a million per year of a worker blowing glass wool is consistent with the fact that no one has found any of cancer attributable to the manufacture or installation of glass wool fibers in spite of diligent searches. This is compared with several other occupational risks. Nonetheless common prudence suggests that any installer of blown glass wool fiber insulation wear a respirator. Copyright 1999 Academic Press.
Scand J Work Environ Health. 1999 Jun;25(3):222-6.
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Cancer incidence among European man-made vitreous fiber production workers.
Boffetta P, Andersen A, Hansen J, Olsen JH, Plato N, Teppo L, Westerholm P, Saracci R.
International Agency for Research on Cancer, Lyon, France.
boffetta@iarc.frOBJECTIVES: This study analyzed cancer incidence among man-made vitreous fiber workers. METHODS: A cancer incidence follow-up was conducted among 3685 rock-slag wool (RSW) and 2611 glass wool (GW) production workers employed for > or =1 year in Denmark, Finland, Norway, or Sweden, and the standardized incidence ratios (SIR) were calculated on the basis of national incidence rates. RESULTS: Overall cancer incidence was close to expectation. Lung cancer incidence was increased among the RSW [SIR 1.08, 95% confidence interval (95% CI) 0.85-1.36] and GW (SIR 1.28, 95% CI 0.91-1.74) workers. For both subcohorts, a trend was suggested for time since first employment (P-value for linear trend 0.1 and 0.2, respectively). Neither subcohort showed an association with employment during the early technological phase, when fiber exposure was high. The incidence of oral, pharyngeal, and laryngeal cancer was increased among the RSW (SIR 1.46, 95% CI 0.99-2.07) and the GW (SIR 1.41, 95% CI 0.80-2.28) subcohorts. Despite a trend in risk for these neoplasms among the GW workers with time since first employment, the lack of a positive relation with other indirect indicators of fiber exposure points against a causal interpretation. No association between RSW or GW exposure and the risk of other neoplasms was suggested. CONCLUSIONS: These lung cancer results are similar to those of a mortality study that included a larger number of factories. For other cancers there was no suggestion of an association with RSW or GW exposure.
Epidemiology. 1998 Mar;9(2):218-9; author reply 219-20.
Epidemiology. 1998 Mar;9(2):218; author reply 214-20.
Cancer mortality among man-made vitreous fiber production workers.
Boffetta P, Saracci R, Andersen A, Bertazzi PA, Chang-Claude J, Cherrie J, Ferro G, Frentzel-Beyme R, Hansen J, Olsen J, Plato N, Teppo L, Westerholm P, Winter PD, Zocchetti C.
International Agency for Research on Cancer, Lyon, France.
We have updated the follow-up of cancer mortality for a cohort study of man-made vitreous fiber production workers from Denmark, Finland, Norway, Sweden, United Kingdom, Germany, and Italy, from 1982 to 1990. In the mortality analysis, 22,002 production workers contributed 489,551 person-years, during which there were 4,521 deaths. Workers with less than 1 year of employment had an increased mortality [standardized mortality ratio (SMR) = 1.45; 95% confidence interval (CI) = 1.37-1.53]. Workers with 1 year or more of employment, contributing 65% of person-years, had an SMR of 1.05 (95% CI = 1.02-1.09). The SMR for lung cancer was 1.34 (95% CI = 1.08-1.63, 97 deaths) among rock/slag wool workers and 1.27 (95% CI = 1.07-1.50, 140 deaths) among glass wool workers. In the latter group, no increase was present when local mortality rates were used. Among rock/slag wool workers, the risk of lung cancer increased with time-since-first-employment and duration of employment. The trend in lung cancer mortality according to technologic phase at first employment was less marked than in the previous follow-up. We obtained similar results from a Poisson regression analysis limited to rock/slag wool workers. Five deaths from pleural mesothelioma were reported, which may not represent an excess. There was no apparent excess for other categories of neoplasm. Tobacco smoking and other factors linked to social class, as well as exposures in other industries, appear unlikely to explain the whole increase in lung cancer mortality among rock/slag wool workers. Limited data on other agents do not indicate an important role of asbestos, slag, or bitumen. These results are not sufficient to conclude that the increased lung cancer risk is the result of exposure to rock/slag wool; however, insofar as respirable fibers were an important component of the ambient pollution of the working environment, they may have contributed to the increased risk.
Regul Toxicol Pharmacol. 1997 Apr;25(2):103-20.
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Quantitative risk assessment for a glass fiber insulation product.
Fayerweather WE, Bender JR, Hadley JG, Eastes W.
Owens Corning, Toledo, Ohio 43659, USA.
California Proposition 65 (Prop65) provides a mechanism by which the manufacturer may perform a quantitative risk assessment to be used in determining the need for cancer warning labels. This paper presents a risk assessment under this regulation for professional and do-it-yourself insulation installers. It determines the level of insulation glass fiber exposure (specifically Owens Corning's R-25 PinkPlus with Miraflex) that, assuming a working lifetime exposure, poses no significant cancer risk under Prop65's regulations. "No significant risk" is defined under Prop65 as a lifetime risk of no more than one additional cancer case per 100,000 exposed persons, and nonsignificant exposure is defined as a working lifetime exposure associated with "no significant risk." This determination can be carried out despite the fact that the relevant underlying studies (i.e., chronic inhalation bioassays) of comparable glass wool fibers do not show tumorigenic activity. Nonsignificant exposures are estimated from (1) the most recent RCC chronic inhalation bioassay of nondurable fiberglass in rats; (2) intraperitoneal fiberglass injection studies in rats; (3) a distributional, decision analysis approach applied to four chronic inhalation rat bioassays of conventional fiberglass; (4) an extrapolation from the RCC chronic rat inhalation bioassay of durable refractory ceramic fibers; and (5) an extrapolation from the IOM chronic rat inhalation bioassay of durable E glass microfibers. When the EPA linear nonthreshold model is used, central estimates of nonsignificant exposure range from 0.36 fibers/cc (for the RCC chronic inhalation bioassay of fiberglass) through 21 fibers/cc (for the i.p. fiberglass injection studies). Lower 95% confidence bounds on these estimates vary from 0.17 fibers/cc through 13 fibers/cc. Estimates derived from the distributional approach or from applying the EPA linear nonthreshold model to chronic bioassays of durable fibers such as refractory ceramic fiber or E glass microfibers are intermediate to the other approaches. Estimates based on the Weibull 1.5-hit nonthreshold and 2-hit threshold models exceed by at least a factor of 10 the corresponding EPA linear nonthreshold estimates. The lowest nonsignificant exposures derived in this assessment are at least a factor of two higher than field exposures measured for professionals installing the R-25 fiberglass insulation product and are orders of magnitude higher than the estimated lifetime exposures for do-it-yourselfers
Scand J Work Environ Health. 1995 Oct;21(5):353-61.
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Cancer incidence, mortality and exposure-response among Swedish man-made vitreous fiber production workers.
Plato N, Westerholm P, Gustavsson P, Hemmingsson T, Hogstedt C, Krantz S.
Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden.
OBJECTIVE--The objective of this study was to provide an extended follow-up of workers in three Swedish plants producing man-made vitreous fibers (MMVF). METHOD--Mortality and cancer incidence was investigated among 3539 male and female workers, employed for at least one year before 1978. Mortality was followed from 1952 to 1990 and cancer incidence from 1958 to 1989. National and regional mortality and cancer incidence rates were used to calculate the expected numbers. RESULTS--Twenty-seven lung cancer deaths were observed compared with 23 expected (standardized mortality ratio 117, 95% confidence interval 81-176), based on regional mortality. With a latency time of 30 years, the lung cancer risk was significantly elevated, but not trend was found for the standardized mortality ratio with increasing duration of exposure to MMVF. The lung cancer and stomach cancer mortality was higher in the rock wool industry than in the fiber glass industry. Fiber exposure from 1938 to 1990 was estimated in the two rock wool plants by applying a model for historical fiber exposure estimation, specific for different job titles in the rock wool production industry. No relationship was found between individually cumulated rock wool fiber exposure and lung cancer or stomach cancer risk. CONCLUSIONS--The numbers of lung cancers and stomach cancer cases were low and did not therefore allow more general conclusions regarding the cancer hazard for exposed workers. A large European study in progress will probably allow more precise conclusions.