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Journal Article 
Asbestos-Related Disease in Custodial and Building Maintenance Workers from a Large Municipal School District 
Balmes, JR; Daponte, A; Cone, JE 
Annals of the New York Academy of Sciences
ISSN: 0077-8923
EISSN: 1749-6632 
Asbestos was used extensively in school and other construction over the several decades prior to 1978, when its use was severely restricted by the U.S. Environ- mental Protection Agency (EPA). Contamination of the environment in public school buildings can occur not only during construction and demolition, but also throughout the existence of these buildings, on account of friable asbestos-con- taining materials (ACM) such as spray-on acoustical insulation and decoration, thermal insulation applied around steam pipes and boilers, and fire-proofing of structural beams. On the basis of a survey of the nation's public schools, the EPA estimated in 1982 that approximately 8,600 schools had friable ACM in place. The EPA has also estimated that approximately 23,000 janitorial and maintenance workers are potentially exposed to airborne asbestos in these schools.

Asbestos fibers are released from friable ACM as a result of general deteriora- tion of the material, or as a result of contact or impact with the material during activity within the contaminated structure. Once released, fibers settle slowly but can be resuspended with further activity in the structure. Sawyer and Spooner have measured concentrations of fibers released by routine maintenance activities in various buildings including school. Custodial activity (e.g., sweeping and vacuuming) in an urban grammar school with an exposed ceiling containing 15% chrysotile was associated with a mean airborne asbestos concentration of 643 ng/ m3, with a range of 186 to 1,100 ng/m3. The EPA has reported the results of air monitoring for asbestos fiber concentration in a number of public schools. In 10 schools evaluated because of visibly damaged areas of sprayed-on chrysotile asbestos during the late 1970s, the airborne concentrations ranged from 9 to 1,950 ng/m3 with a mean of 217 ng/m3 (Ref. 4). Thus, there appears to have been a potential for occupational exposure to asbestos dust of public school custodial and building maintenance employees.

We hypothesized that occupational exposure to asbestos of many public school employees was of sufficient intensity and duration to have induced pulmo- nary parenchymal and pleural fibrosis. We were able to collect descriptive data relevant to this hypothesis by studying a group of public school custodial and building maintenance workers who were known to have been exposed to ACM in school buildings. 
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