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TOXICOLOGICAL PROFILE FOR ASBESTOS

2,99

441

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3461

Agency for Toxic Substances and Disease Registry

2002

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CONTENTS

FOREWORD v

QUICK REFERENCE FOR HEALTH CARE PROVIDERS vii

CONTRIBUTORS ix

PEER REVIEW xi

LIST OF FIGURES xvii

LIST OF TABLES xix

1. PUBLIC HEALTH STATEMENT 1

1.1 WHAT IS ASBESTOS? 1

1.2 WHAT HAPPENS TO ASBESTOS WHEN IT ENTERS THE ENVIRONMENT? 2

1.3 HOW MIGHT I BE EXPOSED TO ASBESTOS? 3

1.4 HOW CAN ASBESTOS ENTER AND LEAVE MY BODY? 4

1.5 HOW CAN ASBESTOS AFFECT MY HEALTH? 5

1.6 HOW CAN ASBESTOS AFFECT CHILDREN? 7

1.7 HOW CAN FAMILIES REDUCE THE RISK OF EXPOSURE TO ASBESTOS? 8

1.8 IS THERE A MEDICAL TEST TO DETERMINE WHETHER I HAVE BEEN EXPOSED TO

ASBESTOS? 10

1.9 WHAT RECOMMENDATIONS HAS THE FEDERAL GOVERNMENT MADE TO PROTECT

HUMAN HEALTH? 11

1.10 WHERE CAN I GET MORE INFORMATION? 12

2. RELEVANCE TO PUBLIC HEALTH 15

2.1 BACKGROUND AND ENVIRONMENTAL EXPOSURES TO ASBESTOS IN THE UNITED

STATES 15

2.2 SUMMARY OF HEALTH EFFECTS 17

2.3 MINIMAL RISK LEVELS 22

3. HEALTH EFFECTS 23

3.1 INTRODUCTION 23

3.2 DISCUSSION OF HEALTH EFFECTS BY ROUTE OF EXPOSURE 23

3.2.1 Inhalation Exposure 24

3.2.1.1 Death 39

3.2.1.2 Systemic Effects 39

3.2.1.3 Immunological and Lymphoreticular Effects 47

3.2.1.4 Neurological Effects 48

3.2.1.5 Reproductive Effects 48

3.2.1.6 Developmental Effects 48

3.2.1.7 Cancer 48

3.2.2 Oral Exposure 57

3.2.2.1 Death 57

3.2.2.2 Systemic Effects 63

3.2.2.3 Immunological and Lymphoreticular Effects 64

3.2.2.4 Neurological Effects 64

3.2.2.5 Reproductive Effects 64

3.2.2.6 Developmental Effects 65

3.2.2.7 Cancer 65

3.2.3 Dermal Exposure 71

3.2.3.1 Death 71

3.2.3.2 Systemic Effects 71

3.2.3.3 Immunological and Lymphoreticular Effects 71

3.2.3.4 Neurological Effects 71

3.2.3.5 Reproductive Effects 71

3.2.3.6 Developmental Effects 71

3.2.3.7 Cancer 71

3.3 GENOTOXICITY 71

3.4 TOXICOKINETICS 79

3.4.1 Absorption 80

3.4.1.1 Inhalation Exposure 80

3.4.1.2 Oral Exposure 81

3.4.1.3 Dermal Exposure 81

3.4.2 Distribution 81

3.4.2.1 Inhalation Exposure 81

3.4.2.2 Oral Exposure 83

3.4.2.3 Dermal Exposure 83

3.4.2.4 Other Routes of Exposure 83

3.4.3 Metabolism 84

3.4.3.1 Inhalation Exposure 84

3.4.3.2 Oral Exposure 85

3.4.3.3 Dermal Exposure 85

3.4.3.4 Other Routes of Exposure 85

3.4.4 Elimination and Excretion 86

3.4.4.1 Inhalation Exposure 86

3.4.4.2 Oral Exposure 87

3.4.4.3 Dermal Exposure 87

3.4.4.4 Other Routes of Exposure 87

3.4.5 Physiologically Based Pharmacokinetic (PBPK)/Pharmacodynamic (PD) Models 87

3.4.5.1 Summary of PBPK Models 90

3.4.5.2 Asbestos PBPK Model Comparison 90

3.4.5.3 Discussion of Model 91

3.5 MECHANISMS OF ACTION 92

3.5.1 Pharmacokinetic Mechanisms 93

3.5.2 Mechanisms of Toxicity 96

3.5.3 Animal-to-Human Extrapolations 100

3.6 ENDOCRINE DISRUPTION 101

3.7 CHILDREN’S SUSCEPTIBILITY 101

3.8 BIOMARKERS OF EXPOSURE AND EFFECT 105

3.8.1 Biomarkers Used to Identify or Quantify Exposure to Asbestos 106

3.8.2 Biomarkers Used to Characterize Effects Caused by Asbestos 110

3.9 INTERACTIONS WITH OTHER CHEMICALS 111

3.10 POPULATIONS THAT ARE UNUSUALLY SUSCEPTIBLE 113

3.11 METHODS FOR REDUCING TOXIC EFFECTS 115

3.11.1 Reducing Peak Absorption Following Exposure 115

3.11.2 Reducing Body Burden 115

3.11.3 Interfering with the Mechanism of Action for Toxic Effects 116

3.12 ADEQUACY OF THE DATABASE 119

3.12.1 Existing Information on Health Effects of Asbestos 119

3.12.2 Identification of Data Needs 121

3.12.3 Ongoing Studies 131

4. CHEMICAL AND PHYSICAL INFORMATION 135

4.1 CHEMICAL IDENTITY 135

4.2 PHYSICAL AND CHEMICAL PROPERTIES 139

5. PRODUCTION, IMPORT/EXPORT, USE, AND DISPOSAL 143

5.1 PRODUCTION 143

5.2 IMPORT/EXPORT 144

5.3 USE 146

5.4 DISPOSAL 147

6. POTENTIAL FOR HUMAN EXPOSURE 149

6.1 OVERVIEW 149

6.2 RELEASES TO THE ENVIRONMENT 154

6.2.1 Air 154

6.2.2 Water 155

6.2.3 Soil 155

6.3 ENVIRONMENTAL FATE 156

6.3.1 Transport and Partitioning 156

6.3.2 Transformation and Degradation 156

6.3.2.1 Air 156

6.3.2.2 Water 157

6.3.2.3 Sediment and Soil 157

6.4 LEVELS MONITORED OR ESTIMATED IN THE ENVIRONMENT 157

6.4.1 Air 158

6.4.2 Water 164

6.4.3 Sediment and Soil 165

6.4.4 Other Environmental Media 165

6.5 GENERAL POPULATION AND OCCUPATIONAL EXPOSURE 168

6.6 EXPOSURES OF CHILDREN 175

6.7 POPULATIONS WITH POTENTIALLY HIGH EXPOSURES 180

6.8 ADEQUACY OF THE DATABASE 181

6.8.1 Identification of Data Needs 181

6.8.2 Ongoing Studies 185

7. ANALYTICAL METHODS 187

7.1 BIOLOGICAL SAMPLES 189

7.2 ENVIRONMENTAL SAMPLES 192

7.3 ADEQUACY OF THE DATABASE 192

7.3.1 Identification of Data Needs 195

7.3.2 Ongoing Studies 196

8. REGULATIONS AND ADVISORIES 197

9. REFERENCES 205

10. GLOSSARY 319

APPENDICES

A. ATSDR MINIMAL RISK LEVELS AND WORKSHEETS A-1

B. USER’S GUIDE B-1

C. ACRONYMS, ABBREVIATIONS, AND SYMBOLS C-1

D. RISK ASSESSMENT SUMMARY D-1

E. INDEX E-1

F. CHEMICAL-SPECIFIC HEALTH CONSULTATION: TREMOLITE-RELATED ASBESTOS F-1