270503 Erionite in the United States? Who Knew. Public Health Implications and Ongoing Activities

Wednesday, October 31, 2012

Aubrey Miller, MD, MPH , Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, MD
Patrick Ryan, PhD , Department of Environmental Health Division of Epidemology and Biostatistics, University of Cincinnati, Cincinnati, OH
Michele Carbone, MD, PHD , Department of Pathology; John A Burns School of Medicine, Cancer Research Center of Hawaii, Honolulu, HI
Brian Brass, CIH, CPEA , Safety, Health, and Environment, National Institute of Standards and Technology, Boulder, CO
James Lockey, MD , Department of Environmental Health, University of Cincinnati, Cincinnati, OH
Background: Exposure to erionite, an asbestos-like mineral, causes unprecedented rates of malignant mesothelioma (MM) mortality in several Turkish villages. Erionite deposits are also present in at least 12 US states, and erionite-containing gravel has been used on hundreds of miles of road in ND. We investigated exposures associated with erionite-containing gravels in Dunn County, ND, compared to erionite exposures in Turkish villages with MM. Additionally, a pilot radiographic study of exposed workers in ND was performed to assess the risk of erionite-associated lung abnormalities. Methods: We evaluated erionite samples and airborne point exposure concentrations in ND and in Turkish villages with elevated rates of MM. In ND, 34 participants completed a questionnaire, chest radiograph, and HRCT scan to assess the prevalence of lung changes consistent with fibrous mineral exposure. Results: Airborne erionite concentrations were measured in ND along roadsides, indoors, and inside vehicles, including school buses. While generally lower than Turkish villages, roadside samples could exceed concentrations in Boyali (6.25% MM death rate). The physical and chemical properties of ND and Turkish erionite were very similar. Radiographic changes were observed by HRCT in seven (21%) of the participants. Three participants (8.8%) with extensive occupational gravel exposures demonstrated bilateral localized pleural changes with calcification; two also had accompanying interstitial changes. Conclusions: Public health officials and physicians in areas with erionite contaminated gravels should be aware of the potential health effects of erionite exposure. Precautionary measures should be taken to limit community use and occupational exposure to gravel containing erionite.

Learning Areas:
Environmental health sciences
Occupational health and safety
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
Differentiate the regulatory controls, mineralogy, and health effects associated with exposures to asbestos and the mineral "erionite". Compare erionite exposures in North Dakota to those observed in Turkish villages with high rates of mesothelioma. Assess the potential public health implications for workers and communities related to environmental exposure to erionite in the US. Identify ongoing activities being undertaken to reduce the risks of exposure and to further our understanding of erionite in the United States.

Keywords: Environmental Health Hazards, Asbestos

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the lead PI for EPA investigations of erionite exposures in North Dakota and Turkish Villages in Cappadocia. Senior author of a PNAS publication which discusses these findings. I am also the lead for NIEHS erionite-related activities and interagency facilitation of this issue. I also helped to develop and support additional health investigations in North Dakota by ATSDR and the University of Cincinnati.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.