Letters to the Editor |
Smoking rates in asbestos workers
Dear Sir,
The paper by Johnson et al. [1] reported that the percentage of asbestos workers who smoke is 64, which is a similar level to that reported in the USA for asbestos abatement workers. Recently, it has been reported that 
78% of these workers are current smokers with an average age of 34 years [2], similar to the 37 average reported by Johnson. This occupational group has the highest percentage of smokers than any other identifiable population, including construction workers, which have a reported smoking rate in the USA of 42% [2]. Studies on smoking in the USA provide validation to the findings in Johnson et al. [1]. Smoking rates in the developed countries are decreasing, now 23% in 2000 for the USA [3]. These rates have also decreased across occupational groups; although, does not appear to have changed for asbestos workers [2]. As discussed by Johnson, these workers are at great risk of disease from smoking. The exposure levels to asbestos in this population, at least in the USA, are now so low [4–6], it appears that the major hazard for these workers is smoking [7].
It should be noted, that smoking at the worksite and inside the work area is common in the asbestos abatement industry, and even those who do not smoke may experience second-hand smoke on a regular basis, increasing their risk as well. These workers, primarily due to their socio-economic status, are also risk takers and are at risk from other activities (e.g. motorcycling). A greater emphasis is needed on smoking cessation programs and prevention of injury and illness that is not directly related to asbestos exposure. Further studies on this population are also warranted to better understand the risks they face.
It may also be worth noting, that a recent investigation [8] on smoking and mesothelioma has surmised a relationship between the two. Thus, smoking may have a causal influence in mesothelioma although only in a subpopulation. It also appears that respiratory disease in asbestos workers can distinguish between causation related to asbestos and smoking [9]. It would be interesting to see if this difference exists in the population studied by Johnson as evaluated by lung function.
Envirosafe Training and Consultants, PO Box 114022, Pittsburgh, PA 15239, USA
Haslemere, Surrey GU27 2JH, UK
Department of Environmental Medicine and Public Health, University of Padova, Via Giustiniani, 2-35128 Padova, Italy
e-mail: johnhlange{at}worldnet.att.net
References
- Johnson A, Farrow P, Jenkins R. (2006) Effectiveness of smoking cessation advice for asbestos workers. Occup Med (Lond) 56:59–60.
- Lange JH, Mastrangelo G, Buja A. (2006) Smoking and alcohol use in asbestos workers. Bull Environ Contam Toxicol (in press).
- Centers for Disease Control and Prevention. (2002) Cigarette smoking among adults—United States. MMWR Morb Mortal Wkly Rep 51:642–645.[Medline]
- Lange JH, Thomulka KW, Sites SLM, Priolo G, Buja A, Mastrengelo G. (2005) Personal exposure during abatement of various asbestos-containing materials in the same work area. Bull Environ Contam Toxicol 74:1034–1036.[CrossRef][ISI][Medline]
- Lange JH, Thomulka KW, Sites SL, Priolo G, Mastrangelo G. (2006) Personal airborne asbestos exposure levels associated with various types of abatement. Bull Environ Contam Toxicol 76:389–391.[CrossRef][ISI][Medline]
- Lange JH. (2005) Asbestos-containing floor tile and mastic abatement: is there enough exposure to cause mesothelioma, lung cancer or asbestosis? Indoor Built Environ 14:83–88.
- Lange JH, Priolo G, Mastrangelo G. (2004) Smoking trend in a high-risk group: asbestos abatement workers. J Occup Environ Med 46:1195.[ISI][Medline]
- Hirao T, Bueno R, Chen C-J, Gordon GJ, Heilig E, Kelsey KT. (2002) Alternations of the p16INK4 locus in human malignant mesotheial tumors. Carcinogenesis 23:1127–1130.
[Abstract/Free Full Text] - Wang X, Yano E, Wang Z, Wang M, Christiani DC. (2006) Adverse effects of asbestos exposure and smoking on lung function. Am J Ind Med 49:337–342.[CrossRef][ISI][Medline]
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