title: Tyler asbestos workers: mortality experience in a cohort exposed to amosite.
abstract: OBJECTIVE
  To examine the causes of death among 1130 former workers of a plant in Tyler, Texas dedicated to the manufacture of asbestos pipe insulation materials. This cohort is important and unusual because it used amosite as the only asbestiform mineral in the production process. High level exposure of such a specific type was documented through industrial hygiene surveys in the plant.
  
  
  METHODS
  Deaths were ascertained through various sources including data tapes from the Texas Department of Health and the national death index files. As many death certificates as possible were secured (304/315) and cause of death assigned. After select exclusions, 222 death certificates were used in the analysis. Causes of death were compared with age, race, and sex specific mortalities for the United States population with a commercial software package (OCMAP Version 2.0).
  
  
  RESULTS
  There was an excess of deaths from respiratory cancer including the bronchus, trachea, and lung (standardised mortality ratio (SMR) 277 with 95% confidence interval (95% CI) 193 to 385). Four pleural mesotheliomas and two peritoneal mesotheliomas were identified. The analysis also showed an increasing risk of respiratory malignancy with increased duration of exposure including a significant excess of total deaths from respiratory cancer with less than six months of work at the plant (SMR 268 with 95% CI 172 to 399).
  
  
  CONCLUSIONS
  The importance of the cohort lies with the pure amosite exposure which took place in the plant and the extended period of latency which has followed. The death certificate analysis indicates the pathogenicity of amosite, the predominant commercial amphibole used in the United States. These data confirm a link between amosite asbestos and respiratory malignancy as well as mesothelioma.
authors.affiliation: Department of Occupational and Environmental Medicine, University of Texas Health Center 75710, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Levin
authors.forename: J W
authors.initials: JW
authors.lastname: McLarty
authors.forename: G A
authors.initials: GA
authors.lastname: Hurst
authors.forename: A N
authors.initials: AN
authors.lastname: Smith
authors.forename: A L
authors.initials: AL
authors.lastname: Frank
mesh_terms: D000328:Adult; D000368:Aged; D017639:Asbestos, Amosite / Q000009:adverse effects*; D001195:Asbestosis / Q000209:etiology / Q000401:mortality*; D015331:Cohort Studies; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000209:etiology / Q000401:mortality*; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D012142:Respiratory Tract Neoplasms / Q000209:etiology / Q000401:mortality*; D012189:Retrospective Studies; D013781:Texas / Q000453:epidemiology; D013997:Time Factors
chemical_list: D017639:Asbestos, Amosite