US EPA

6915118 

Book/Book Chapter 

Exposure to airborne asbestos in Jamaican hospitals 

Scarlett, HP 

2007 

1-230 

English 

Asbestos is a crystalline mineral that is found naturally in almost two-thirds of the earths' crust and it is an established human carcinogen. Occupational exposure to asbestos may be responsible for 5-20% of lung cancers and 80-90% of pleural mesothelioma in developed countries. Asbestos-related diseases account for some 100,000 deaths annually worldwide. Few cases of asbestos-related diseases are reported in Jamaica but two asbestos-cement product manufacturing plants operated in Jamaica during the period 1965-1985. Asbestos was identified in some Jamaican hospitals in 1999. This study was conducted in 2005-2007 to identify asbestos containing material (ACM), its characteristics and its determinants in Jamaican hospitals; to determine if current asbestos exposure in Jamaican hospitals differs by job category; and to assess the knowledge, attitudes and practices of hospital employees/workers with respect to asbestos. It was hypothesized that current exposure to asbestos was related to job type and exposure among maintenance workers was greater than exposure among other workers. 152 bulk samples of suspected ACM was collected and analyzed by polarized light microscopy (PLM). Based on the results the two largest hospitals with ACM were selected for air sampling and interview of selected employees. 131 personal air samples and 32 area samples were collected and analyzed by phase contrast microscopy (PCM). Half of the personal air samples that tested positive for fibers were subjected to transmission electron microscopy (TEM) to confirm if the fibers were asbestos. In addition, 277 hospital employees stratified into three groups according to work performed responded to an interviewer administered questionnaire. The response rate was 90%. Two focus group discussions (FGD) were held with heads of departments (HOD) at both hospitals. Sixteen (61.5%) of the 26 hospitals had ACM and 67 (44.07%) of the 152 bulk samples contained ACM. The predominant ACM was thermal system insulation which was generally in a poor condition indicative of fiber release. Amosite was the most common fiber detected in the samples. Of the 163 air samples analyzed, 24 (14.7%) had fiber concentrations above the LOD ranging from 0.002 to 0.013 f/cc. Fiber concentrations were significantly associated with hospital (p=0.0263). There was no difference in the median fiber concentration (0.0015 f/cc) to which the three groups of employees were exposed. Further analysis of samples that tested positive for fibers by transmission electron microscopy (TEM) confirmed that the fibers detected by PCM were not asbestos fibers. Sixty two (22.4%) of respondents had never heard of asbestos and having heard about asbestos was significantly associated with group of employee (p=0.0001). Gender, age, education, marital status, and duration of employment were all significantly associated with group of employee. Correct responses to knowledge questions on asbestos ranged from 41% to 98.5%. Generally, respondents' attitudes towards asbestos were positive. Based on our study, there were no airborne asbestos fibers with any immediate threat to workers' exposures. The JMOH/hospital management should institute asbestos abatement/management programs in hospitals as a proactive measure against future exposure. This will require manpower, resources and assistance from national and international agencies. 

Health & Safety Science Abstracts; Asbestos; ASW, Caribbean Sea, Greater Antilles, Jamaica; attitudes; Lung cancer; Occupational exposure; Carcinogens; Education; light microscopy; Mortality; USA, Alabama; earth crust; employment; Maintenance; developed countries; Hospitals; Microscopy; Air sampling; Dissertations; USA, Alabama, Birmingham; H 1000:Occupational Safety and Health