Public health policy and practice
Community health risk assessment after a fire with asbestos
containing fallout
S Bridgman
Industrial and
Community Health Research Centre, Department of Postgraduate Medicine,
University of Keele, Staffs ST4 7QB, UK
Correspondence to: Dr Bridgman (Stephen.Bridgman{at}lnsha.wmids.nhs.uk)
Accepted for publication 19 June 2001
BACKGROUND
A factory
fire in Tranmere, Merseyside, England, deposited asbestos containing
fallout in an urban area. There was considerable community anxiety for
months after the incident. Therefore an assessment of the long term
health risks of this acute environmental incident were requested by the
local health authority.
METHODS
The facts of
the incident were gathered and appraised from unpublished and press
reports, involved personnel, and further analysis of material collected
at the time of the incident. The literature on the long term health
risks of asbestos was reviewed, and combined with evidence on asbestos
exposure to estimate community health risk.
RESULTS
Risk was
almost entirely from exposure to fire fallout of chrysotile in asbestos
bitumen paper covering the factory roof. Amosite was only detected in a
few samples and in trace amounts. The number of people who lived in the
area of fallout was 16 000 to 48 000. From a non-threshold model with
assumptions likely to overestimate risk, the lung cancer risk is
estimated to be undetectably small. Risk of mesothelioma from
chrysotile exposure, and risks of lung cancer and mesothelioma from
amosite exposure were based on observational studies and were estimated
to be even lower than that of lung cancer risk from chrysotile
exposure. Academically, there are assumptions that while reasonable
cannot be proven, for example, the validity of extrapolating observed risk from much higher exposures to lower exposures, estimates of
individual exposure, and that there is no threshold for asbestos to
cause cancer.
CONCLUSIONS
The author
is unaware of a similar study on long term health risks in a community
exposed to asbestos in a fire. It is concluded that, using methods that
do not underestimate risk, risk is undetectably small. Practical
lessons from this methodology and approach to health risk assessment
are discussed.
Keywords: asbestos; environmental pollutants; mesothelioma; health risk assessment; lung cancer
© 2001 by Journal of Epidemiology and Community Health
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