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Epidemiology: non-asbestiform amphiboles
The primary components of asbestiform talcs, other than talc, are cleavage fragments of anthophyllite and tremolite. Since exposure to these cleavage fragments may be a factor in cancer risk from exposure to asbestiform talc, a review of epidemiological studies of workers exposed to nonasbestiform amphiboles is in order and will strengthen this report. Kusiak et al (1991) looked at a cohort of 54128 gold and nickel miners with potential exposure to nonasbestiform amphibole fibers. They found an excess cancer risk in pre-1945 workers but no relationship between cancer excess and exposure to mineral fibers. The concluded that the excess was probably related to exposures to arsenic and radon decay products (radon daughters). Steenland and Brown (1995) studied 3328 gold miners from South Dakota. There was no significant increase in lung cancer risk in this cohort though there was evidence of excessive quartz exposure including elevated deaths from immunological diseases, renal disease and tuberculosis. The authors suggest that a slight excess in lung cancer rates might be related to the smoking habits of miners: they smoke more then the general population. Cooper et al (1992) studied 3444 taconite miners exposed to silica and nonasbestiform amphibole fibers. The standardized mortality rate (SMR) for lung cancer was less than expected at 67 and was not related to duration of employment, exposure level or latency. When Cooper, et al. eliminated those workers with less than 3 months of employment from the analysis, the SMR for lung cancer actually decreased as duration of employment increased.
Epidemiology: asbestiform talc: The association between exposure to asbestiform talc and lung cancer risk is primarily based on the findings of increased cancer risk in workers exposed to asbestiform talc in the Grouvenor talc district (GTD) of upstate New York. A more detailed description of these studies, as well as inclusion of the latest (Dezell et al, 1995) study would be in order. Kleinfeld, et al. (1967, 1974) found a 10 pulmonary and pleural tumors among a study of all GTD workers. All cases occurred in workers who were exposed prior to the introduction of exposure control measures ca. 1945. Twenty-nine of the workers died of pneumoconioses, including 5 who died of a complication of quartz exposure, tuberculosis. This study had the short coming that it did not take into account exposures other then to talc, did not take into account smoking history and did not relate exposure levels to outcome. Recent data developed by NIOSH (1980) can be used to estimate respirable quartz exposures to workers in this study. NIOSH found that for the average dust exposure of 2.9 million particles per cubic foot (mppcf) in GTC mills, the average respirable quartz exposure was 11 µg/m3 and that for the average dust exposure of 8.1 mppcf in the GTC mine the average quartz exposure was 12.4 µg/ m3. Dust exposure measurements were made for GTD mines and mills in the Kleinfeld, et al. study. These exposures can be translated to average respirable quartz exposures as follows:
| Pre-1945 | 1945-1965 | |||
|---|---|---|---|---|
| Mppcf | Qartz (µg/m3) | Mppcf | Quartz (µg/m3) | |
| Mines: drilling | 818 | 1250 | 5 | 8 |
| Mines: other | 129 | 190 | 5-9 | 8-14 |
| Mills | 69-278 | 260-1050 | 27-37 | 102-140 |
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