EPA/560/OPTS-86/002     itatet        Off ice of Pesticides and        June 1986
               mental Protection    Toxic Substances
            „„-.._,         Asbestos Action Program
            Guidance for Preventing
            Asbestos Disease Among
            Auto Mechanics

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       PREVENTING ASBESTOS DISEASE AMONG AUTO MECHANICS
I  MECHANICS' EXPOSURE TO ASBESTOS

     Friction materials,  such  as  brake  linings  and  clutch
facings, often contain asbestos.  Millions of asbestos  fibers
can be  released  during  brake  and  clutch  servicing  (1-8).
Grinding and beveling friction products can  cause  even  higher
exposures  (1,8).  Like germs, asbestos fibers are small  enough
to be  i nvisible  and  they  can  remain and  accumulate in the
lungs.  When you  see  a  dust cloud during brake  work, you are
seeing clumps  containing thousands  of  fibers.  Most of the
smaller fibers will not  show up  with  the  methods  commonly
used for measuring  asbestos  levels  in  the  air, such as the
method used  to  determine compliance  with the  OSHA  asbestos
standard,  since most  asbestos  fibers  in brake  dust  are too
small to be measured by these methods (1-3,5-8).

     Asbestos released  into the air  lingers  around a  garage
long after  a brake  job is  done  and can  be breathed  in by
everyone inside a garage,  including customers.  While  lowering
exposure lowers risk, there  is  no  known level of  exposure to
asbestos below which health effects do not occur (9-12).  The
EPA has proposed phasing out the use of asbestos  products.  In
situations where  asbestos  exposures  cannot  be   eliminated
entirely, they should be reduced to the lowest possible  level
(9,13).

     Asbestos can be  carried  on work clothing,  contaminating
the family  car  and home.   This  can cause  asbestos  disease
among family members.   An ordinary  house vacuum cleaner  cannot
collect these asbestos  fibers,  since its  filter is  not fine
enough to  trap  them.   In  fact,   an ordinary   house  vacuum
cleaner is likely to stir these fibers up and and scatter them
into the air.

     Asbestos can  also  get  on a  mechanic's  hands  and  be
swallowed when  eating or  smoking  a cigarette.   This  is  a
particularly difficult  problem  for  mechanics,   since  they
often get grease on their hands and asbestos fibers can  stick
to the grease.
II HEALTH EFFECTS OF ASBESTOS EXPOSURE

     TJntil the use of asbestos products is phased out,  the best
best way  of   limiting  health  damage to  workers  exposed  to
asbestos is to  use proper  controls.   It is  not  possible  to
predict whether an individual person exposed to asbestos will
later develop asbestos-related disease.   But  studies  of dis-
ease patterns among large groups of workers exposed to asbestos
make general observations possible.   The  following can be the
consequences of inadequate prevention:

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                                  -2-
Asbestosis
     Asbestos exposure  can cause  scar tissue  to  form  in  the lungs.
     This is a very gradual process that usually takes many years be-
     fore its effects are  noticed.  This  scarring  is  called asbesto-
     sis.  It  causes  gradually  increasing  shortness  of  breath.   A
     person with this disease must  breathe  harder and deeper  to get
     his or her  breath  because the scar  tissue makes it  harder for
     oxygen to get into the blood stream.   This scarring  is caused by
     repeated exposures  to  asbestos  and  is permanent.  Nearly one half
     of mechanics who work for many years without proper control mea-
     sures can develop this scarring (7,14).
Cancer

1.  Mesothelioma

     Mesothelioma  is a  type of fatal cancer of the lining of the chest
     or abdominal  cavity.   It can be  caused  by very low exposures to
     asbestos.   This cancer has occurred among brake  mechanics (15-20),
     their wives (20),  and their children (21).

2.  Lung  Cancer

     Lung cancer is currently  responsible  for the  largest  number  of
     deaths from exposure to asbestos  (22).  Even short-term occupation-
     al exposures  have  been  shown  to  increase the  risk  of lung  cancer
     (22-24).   Each added  exposure increases the risk of cancer.  Like
     asbestos,  smoking  can  independently cause lung cancer,  increasing
     the risk by about  10 times.  VThen smokers are  exposed to asbestos,
     the risks  do  more  than  add together; they actually multiply.   For
     example, asbestos  insulators  who  smoke  have  a lung cancer  risk
     over fifty times higher than nonsmokers without  asbestos exposure.
     However, stopping  smoking greatly  reduces this risk, even if a per-
     son has smoked for many years.   Smokers  who have been  exposed to
     asbestos should  be especially  encouraged  to stop  smoking.   The
     extent of  risk of lung  cancer among mechanics  is  not  now  known;
     but, given the known lung cancer risk among other groups exposed to
     asbestos,  caution  is necessary.

3.  Other Cancers

     Other cancers which appear to be caused by asbestos  include cancer
     of the voice  box  (25,26)  and  of the stomach and large intestine
     (27, especially page 315).


Latency  Period

      It  usually takes  15 to  30 years or  more  for cancer or  as-
bestos  lung  scarring  to show  up  after  exposure.   (Scientists
call this the latency  period.)    Until  then,  the victim often
feels fine.    This  gives a  false  sense  of  security.   For

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                                 -3-
example, if  one  touches  a  hot  stove,  one  gets burned  right
away.   With  asbestos,  the  damage  isn't  obvious  until  many
years  later.   This  false  sense  of security can  easily  lead a
worker and/or  supervisor  to  follow work practices  which  can
cause  harmful  exposures,  since they are not aware that disease
may develop  later.
Ill  MEDICAL  TESTS

      Medical tests   only  discover  asbestos-related  disease
after it has developed.   In some cases,  where the  condition
may  be curable,  especially with asbestos-related cancers  of
the  large  intestine  and  voice  box,  early  detection  can  be
very important.

Asbestosis

      Asbestosis, or lung scarring from asbestos, is permanent and can-
      not be treated.   It is diagnosed by chest x-rays, breathing tests
      (called  lung or pulmonary function tests), and/or listening to the
      lungs, together  with a  history  of  exposure to asbestos.   Very
      early asbestos is  may be missed by these techniques.  Early asbes-
      tosis is difficult to see on a  chest x-ray and is best  evaluated
      by a doctor  who has experience  and/or specialized training with
      asbestosis.  (This type  of  specialist is called a "B reader" of
      x-rays.)

Lung Cancer

      Very often lung  cancer from asbestos has already spread by the
      time it  can  be seen on a chest  x-ray or by tests of the phlegm.
      This is why  more frequent  tests  for lung cancer do not help the
      average person who develops  this cancer to live  longer.   Lung
      cancer is thus a condition  needing prevention more than early
      detection and cure.

Intestinal Cancer

      Cancer of the large  intestine  can  often  be  detected  early  by
      yearly exams of  the  rectum and  sigmoid area,  with a  hemoccult
      .test for blood in the stool.  Early detection and treatment  of
      this condition can result in cure.

Voice Box Cancer

      Voice box cancer  can  often be discovered at a curable stage by a
      medical exam. It  may show up as hoarseness that does not go away
      in a few weeks.

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                                 -4-
IV EXTENT  OF  EXPOSURE DURING  BRAKE  AND  CLUTCH MAINTENANCE

      Using a  compressed  air  hose  to  clean  drum  brakes  can
release up to  16 million asbestos fibers in the cubic meter  of
air  around a mechanic's  face  (1).*   Even hitting a  brake drum
with a hammer  can release over  a  million asbestos fibers (4).
Much less  dust   from  asbestos-lined   disc  brake   pads  will
settle on disc brakes,  but  some dust  can  get on a  mechanic's
hands and into the garage air during maintenance.  The asbestos
fibers released  from  brake  and clutch  work  can  be  scattered
throughout a  garage,   where   they can  present  a hazard  for
months or years.

      Because of  this,  many  garages  are  now  turning  to newer
methods for  brake  cleaning.   However,  some  of  these newer
methods may actually contribute to  the problem.  For example,
millions of asbestos  fibers  can be  released  from drum brakes
with these methods:

     •Wiping with a dry rag or brush  (1-3).

     •Wiping with a wet rag or brush (2,3).   The water doesn't prevent
      scattering of much  of the asbestos,  and when  the  rag dries or
      is shaken,  asbestos is spread around the garage.

     •Liquid squirt bottles or solvent sprays (3).  The water or  sol-
      vent under pressure  scatters much of  the asbestos,  and when it
      dries the  asbestos  is  still  all  over the  surrounding  work
      surfaces.   Brake  cleaning  equipment using these methods with  a
      brush or squirt gun is likely to have the same problems.  In
      fact, measurements  from one manufacturer using  a  liquid spray
      system showed that  over a million fibers  can be released near
      a mechanic's  face  (28).  Using a specially designed low-pressure
      spray and  properly  collecting  and  disposing  of  contaminated
      liquid may prevent  some  asbestos  from spreading around  the
      garage.  Some recirculating  wet method equipment uses  a solvent
      to collect brake dust into  a  tray.    If the  solvent  evaporates
      from the  tray,  normal  air  currents  easily  lift  the  asbestos
      fibers back into the air.
     •Using a garden hose  may  prevent some brake  dust  from  beconing
      airborne,  but this  can easily contaminate  the garage floor or
      other work areas by scattering the asbestos.

     •Using a standard shop vacuum cleaner.   A shop vacuum cleaner can
      spread asbestos  about a  garage as much as does a compressed air
      hose  (6: using a shop vacuum cleaner  raised asbestos  concentra-
      tions in adjacent bays to levels greater than those  found using  a
      compressed air hose).  A  shop vacuum cleaner filter is  not fine
      enough to collect asbestos fibers.


      All of these brake  cleaning  methods can release enough
asbestos into  a  garage (6,29) so that an average of  over one
million of  the  larger  fibers could  be breathed  each  day   by
workers in  that  garage.    These  brake cleaning  methods  can

*These are  the larger fibers measured  by  corrnon methods  for  counting
 asbestos fibers.  The very small ones are far more numerous,  but can be
 only be seen with  the electron microscope.

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                              __ c	
also cause  customers to be exposed, since asbestos  from brake
work can  be  spread  75  feet  away  from  the  mechanic  (1).

     When grinding is done to renew used brake  block  linings,
concentrations  of up to  seven million  asbestos  fibers  per
cubic meter  can  be  released.    Bevelling   new  linings  can
release concentrations  of  up to  72 million  fibers and  light
grinding of new  linings  of up  to 4.8  million  fibers  (7).
V  CONTROLLING  EXPOSURES

     NIOSH, OSHA,   and  EPA  recommend  that  where   asbestos
exposures  cannot  be  eliminated,  they  must  be  controlled  to
the lowest level   possible  (9,13).   Effective   containment
prevents problems  associated with housekeeping  and with  stir-
ring up  settled dust  (13).   The  best  approach  is to  contain
brake dust and  prevent its release into a garage.
Brake Cleaning

     Enclosure  equipment  for  brake  cleaning  is  available,
which slips  easily over the  brake  assembly and  forms  a  tight
seal against  the  backing plate.  A  compressed air  system  can
then be  used inside  this  type  of  enclosure  system for good
brake cleaning  without exposing the brake mechanic  or  others.
Clear plastic  walls  or  windows allow easy  visibility of  the
work being done.   Brake dust is sucked  into a vacuum  cleaner
equipped with  a special filter called  a  HEPA or "high-effi-
ciency particulate air"  filter.  Only this type  of  filter  can
capture the  small, invisible asbestos fibers.   Non-permeable
glove attachments  on  some equipment  allow a  mechanic to  do
work inside  the  enclosure without  getting  asbestos  on  the
hands.  If glove  attachments  are available only  as  an  option,
this option  should be selected.
How to  Use  Enclosure  Equipment  for  Cleaning  Drum  Brakes

     Steps for using  this  type  of equipment  on  drum brakes are
simple:

    1. Check  that the hose  is  securely  fastened  to  the HEPA  vacuum
       container and to the  brake  enclosure.   Also  check that  the
       vacuum container  seals and  clips  are  in  proper  functioning
       order according to the manufacturer's instructions.

    2. Remove the wheel.

    3. Turn on the asbestos vacuum cleaner.

    4. Place the enclosure over the  drum,  making sure it  forms a tight
       seal behind the backing plate.

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                              -6-
    5. Place hands into the attached rubber gloves.

    6. Remove the brake drum.  Some equipment allows use of a hammer
       or other tools  inside the enclosure for drums that are hard to
       remove.
    7. Blow dust off the drum and brake assembly using the air gun
       attachment inside the enclosure.
    8. Blow dust off all inside surfaces of the enclosure towards the
       vacuum exit using the air gun attachment inside the enclosure.
    9. Remove the enclosure and turn off the vacuum cleaner.

     If grease  accumulates on  the  inside  surfaces  of  the
enclosure, clean according to the manufacturer's  instructions
with a  soft  cloth  and  with  the vacuum  running.   Dispose  of
the cloth  according  to  OSHA  regulations
should not be  handled with bare hands.
        Dispose
(30)".    This  cloth
Disc Brakes

     For disc  brakes,  vacuum  the  pads,  rotor,  and  caliper
directly with  a  crevice attachment and  avoid handling  them
before vacuuming.
Filter Change  and  Waste Disposal

     Asbestos  vacuum cleaners have several  filters.   Changing
filters and disposing of asbestos waste can release  dangerous
concentrations of  asbestos unless done properly.   Some equip-
ment allows  for  filter or  collection  bag change while  the
vacuum motor  is running.   This  draws loose  brake dust  into
the vacuum collector and away from the mechanic,  reducing the
risk of exposure.   Some equipment has a renewable main filter
that can  be  cleaned  repeatedly  without   opening the  vacuum
cleaner.  Ideally,  all vacuum equipment should  be designed to
prevent opening the vacuum  chamber when  the  vacuum  motor is
turned off,  since  opening the  chamber can cause release of
collected asbestos into the air.

     Always follow the manufacturer's instructions for filter
or collection  bag change.  Request a demonstration and practice
session from   the  manufacturer  to go  through  all steps  for
equipment use  and  filter or collection bag  change, until each
person who  is  to  use this  equipment is  completely  familiar
with these  procedures.  Place the  filter  or  collection  bag
directly  into  a  6 mil  (heavy)  plastic  bag  and  double  tie.
Place the  bag directly   into  a  55-gallon  drum  or  similar
leakproof, air-tight container  designated  for  asbestos waste
according to   OSHA  regulations  (30)  and mark  it  as  follows:

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                               — 7 —
                             CAUTION
                    Contains  Asbestos Fibers
                      Avoid  Breathing Dust
  Breathing Asbestos  Dust Can  Cause Lung  Disease and  Cancer

Keep  this  drum  for asbestos waste  locked between  filter  or
collection bag changes.   Transport  and disposal  of  asbestos
waste  should be done only by individuals familiar with  proce-
dures  for  handling  asbestos  waste  in  accordance  with  EPA's
asbestos disposal guidance  (31).
Clutch  Repair

      Significant exposure can also occur during  clutch repair.
Since a mechanic's head is typically under  the clutch assembly
during  clutch repair,  asbestos  often  falls on a mechanic's
face  and  clothing.   Enclosure  equipment  with  a  HEPA  vacuum
cleaner to  prevent this exposure  is  under development.
Non-Asbestos  Brake Linings

     The  use  of  non-asbestos friction materials  is  increasing.
Available information suggests  that none  of these substitute
materials is  as dangerous  as asbestos.   Unless  a mechanic is
certain before brake work  starts that  a particular  vehicle's
brakes are not lined with  asbestos, it  should be assumed  for
the sake  of  caution that there  is asbestos in the brake  dust.
In addition,  friction materials often contain adhesives,  toxic
metals, and  other hazardous  chemicals  which can harm the body
(2).  Thus, even for  r.on-asbestos friction products,  an enclo-
sure system  can  control exposures  to  materials  which may  be
harmful.
What to  Look  for  in  Enclosure Equipment  for  Brake Cleaning

     Recommended features  to  look for  in  selecting enclosure
equipment  include:

    1. Features  which  prevent  hand contact  with  asbestos,  including
      rubber  (or other  non-permeable)  gloves to  cover  both  hands.
      Look  for  attached gloves with  no  spaces  for leakage.   If
      attached gloves  are  not standard  with the  equipment,  they
      should be selected as an option.

    2. Enclosures large  enough to  fit  around the biggest  size brake
      drums likely  to  be  encountered to  prevent  exposure   during
      drum  removal.

    3. Reports  of  air  sampling with  analysis by transmission elec-
      tron microscopy that  show no release  of asbestos  fibers when
      using this equipment  during  brake  maintenance.   This  helps
      ensure against design defects.

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                              -8-
    4. A  sturdy seal behind  the  backing  plate  to  prevent leakage
      during blow out.

    5. A  pressure  gauge  or manometer  indicating  when  vacuum filter
      change or cleaning of renewable filter  is  needed.  This helps
      ensure effective suction during use.

    6. Safety of filter change  or renewable filter cleaning.   Ideally,
      future models of these devices will have  a feature that prevents
      opening the  filter housing while the  vacuum motor  is  switched
      off.
in
     Enclosure  system
   references  32-35.
manufacturer  information  is discussed
Machining and  Bevelling

     Whenever  possible, pre-ground,  installation-ready  brake
linings and  clutch  facings  should  be  used.   If  friction
materials must be  arced, this should be done  by lathe-turning
at low speed,  rather than by grinding.  Linings should not be
ground to fit  brake systems for which they  were not designed.
Where friction materials must  be machined,  bevelled, or lathe-
turned, adequate local  exhaust ventilation equipment connected
to a HEPA vacuum collector should be used  to  prevent mechanic
exposure and  shop  contamination.   Such equipment  should  be
designed and  set up  by a  professional  ventilation engineer,
using specifications  such  as  those  found  in  the  American
Conference of  Governmental Industrial Hygienists'  ventilation
manual (36)  as a  minimum  design  standard.   There must,  be a
comprehensive  asbestos  control  and monitoring program  where
machining, bevelling, or lathe-turning  is  done (30).
Special Areas  for Brake Work

     Eating, drinking, and  smoking should  not be done  in an
area where  brake work is done.  Mechanics  should wash  their
hands and  face before eating  and  wash  all  exposed  skin  and
change clothes before going  home.   If possible,  work clothes
should be  laundered  at  special  facilities  equipped  to  wash
clothing contaminated with asbestos.   Smokers  should be  urged
to quit and,  if necessary, be provided assistance in entering
a smoking  cessation program.

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                             -9-
VI  RESPIRATORS

     The National Institute for Occupational Safety and Health
(NIOSH) recommends the  use of  engineering controls  and good
work practices  as the  primary means  of  reducing  exposures
(9,13).  Proper use of a respirator specially recommended for
asbestos (37) when using the brake cleaning methods described
in Part IV of this guidance can only protect a mechanic while
the respirator is being worn.   Since  any  of the brake cleaning
methods described in Part  IV  could  contaminate a garage with
brake dust, mechanics  and  other employees would have to wear
such a  respirator all  day to be  protected.    In  addition,
effective respirator  use  requires  a  complete  respiratory
protection program,  including  worker  training, medical evalua-
tions, proper respirator selection and maintenance,  fit test-
ing, and periodic inspections.   Furthermore,  NIOSH  and  EPA
recommend only  certain  air-supplied  respirators for asbestos
exposure (37).  These respirators  could be very cumbersome in a
garage setting.

     Air-purifying respirators  with HEPA  cartridges may  be
appropriate for  secondary  protection during  floor  cleaning,
filter or collection bag changing,  and waste disposal.   Air-
purifying respirators with  HEPA cartridges should be used only
as a precaution against the accidental disturbance of asbestos,
and not as  a substitute for  effective engineering controls.  It
should be noted that,  while NIOSH  and EPA do not  recommend the
use of air-purifying respirators with HEPA cartridges in asbes-
tos environments, various existing regulations currently allow
their use.

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                                  -10-
    \-\\                  Additional  Information

      This guidance  was  prepared to  support  technical materials
being developed as  part of the  Brake Mechanic Education Program
under EPA's Asbestos Action Program.  The following are addition-
al  sources of information on asbestos:
EPA  Regional Asbestos Coordinators
 (CT,  MA, ME, NH, RI, VT)
 EPA Region I
 JFK Federal Building
 Boston, Mass. 02203
 (617) 223-0585
 (NJ,  NY,  PR, VI)
 EPA Region II
 Woodbridge Avenue
 Edison, N.J. 08837
 (201) 321-6668
 (DE,  MD,  PA, VA, WV)
 EPA Region III
 Curtis Building
 6th and Walnut Streets
 Phila., Penna 19106
 (215) 597-9859

 (AL,  FL,  GA, KY,
  MS,  NC,  SC, TN,)
 EPA Region IV
 345 Cortland St., N.E.
 Atlanta,  Georgia 30365
 (404) 881-3864
           (IL, IN, MI, MN,  OR, WI)
           EPA Region V
           230 S. Dearborn St.
           Chicago, 111. 60604
           (312) 886-6003
           (AR, IA, NM, OK,  TX)
           EPA Region VI
           Internfirst II Bldg.
           1201 Elm Street
           Dallas, Texas 75270
           (214) 767-2734

           (IA, KA, MO, NE)
           EPA Region VII
           726 Minnesota Ave.
           Kansas City,
           Kansas 66101
           (913) 236-2835

           (CO, MT, ND, SD,  UT, WY)
           EPA Region VIII
           One Denver Place
           999 18th St., Suite 1300
           Denver, Colorado  80202
           (303) 293-1730
            (AZ, CA, HI,  NV, CM,
            American Samoa, Guam)
            EPA Region IX
            215 Fremont Street
            San Francisco,  CA 94105
            (415) 974-8588

            (AK, ID, OR,  WA)
            EPA Region X
            1200 6th Avenue
            Seattle, Wash.  98101
            (206) 442-2870
Toll-Free Numbers
 EPA
 800-424-9065
Where general public
can get technical
assistance
Consumer Product
Safety Commission
800-638-2772
For information on
asbestos in consumer
products or homes
 NIOSH

 National Institute for
   Occupational Safety and Health
 4676 Columbia Parkway
 Cincinnati, Ohio 45226
 (513) 533-8323
                        U.S.  Occupational Safety
                        and Health Administration

                        OSHA Office of Information and
                          Consumer Affairs, Room N-3637
                        200 Constitution Avenue,  N.W.
                        Washington, D.C. 20210
                        (202)  523-8151

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                             -11-
                          References

 1. Rohl,  A.N.,  Langer,  A.M.,  Wolff,  M.S.,  and  Weisman,  I.
    Asbestos Exposure during Brake Lining Maintenance and
    Repair.  Environmental Research 12:110-128. 1976.

 2. NIOSH.  Report  32.4  Industrial Hygiene  Summary Report of
    Asbestos Exposure Assessment for Brake Mechanics.  November
    22, 1982.

 3. PEI Associates.   Asbestos Dust Control  in Brake Maintenance.
    EPA Office of Pesticides  and Toxic  Substances Contract Mo.
    68-02-3976.  September 30, 1985.

 4. GCA  Corporation.   Asbestos  Product  Test  Results.   EPA
    Office of Pesticides and Toxic Substances Contract
    No. 68-02-3168.   February 1980.

 5. Hatch, D.  Possible Alternatives to Asbestos  as a Friction
    Material.   Annals  of  Occupational Hygiene  13:25-29. 1970.

 6. Knight, K.L.  and Hickish, D.E.  Investigations and Alterna-
    tive Forms of  Control for  Dust Generated  during Cleaning
    of Brake  Assemblies  and  Drums.   Annals of  Occupational
    Hygiene 13:37-39. 1970.

 7. Lorimer, W.V.,  Rohl, A.N., Miller,  A.,  Nicholson, W.J., and
    Selikoff,  I.J.   Asbestos  Exposure of Brake Repair Workers in
    the United States.  Mount Sinai Journal of Medicine
    43:207-218.  1976

 8. Rohl, A.N., Langer, A.M., Klimentidis,  R., Wolff, M.S., and
    Selikoff,  I.J.    Asbestos Content  of  Dust Encountered  in
    Brake Maintenance  and Repair.   Proceedings  of  the Royal
    Society of Medicine 70:32-37.  1977.

 9. NIOSH-OSHA Asbestos  Work  Group.   Workplace  Exposure  to
    Asbestos:   Review  and Recommendations.   DHHS  (NIOSH)  Pub-
    lication No.  81-103.  November 1930.

10. OSHA.  Occupational  Exposure to Asbestos:   Emergency  Tem-
    porary Standard.  Federal Register Vol. 48, No.  215.
    November 4, 1983.

11. National Research  Council.  Asbestiform  Fibers:  Nonoccu-
    pational Health   Risks.   National  Academy  Press.   1984.

12. Chronic Hazard  Advisory  Panel on Asbestos.   Report to the
    U.S. Consumer Product Safety Commission.  July 1983.

13. NIOSH.  Statement of the National Institute for  Occupation-
    al Safety  and  Health.   Public  Hearing  on  Occupational
    Exposure to Asbestos.   June 21, 1984.

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                             -12-
14. Nicholson,  W.J.   Investigation  of  Health  Hazards  in
    Brake Lining Repair and Maintenance Workers Occupationally
    Exposed to  Asbestos.    NIOSH  Contract  No.  210-77-0119.
    February 1983.

15. McDonald, A.D., Harper, A., El Attar, O.A., and McDonald,
    J.C.  Epidemiology of  Primary Malignant Mesothelial Tumors
    in Canada.  Cancer 26:914-919.  1970.

16. Greenburg, M. and Lloyd Davies,  T.A.  Mesothelioma Regis-
    ter 1967-68.   British  Journal  Of  Industrial  Medicine
    31:91-104.  1974.

17. Newhouse, M.L.  and Thompson, H.  Mesothelioma of the Pleura
    following Exposure to  Asbestos.  British Journal of Indus-
    trial Medicine  22:261-269.   1965.   (Table  on  p.  269,
    case #58.)

18. NIOSH.  Asbestos:  Asbestos Exposure during Servicing of
    Motor Vehicle Brake and Clutch Assemblies.  Current Intel-
    ligence Bulletin 5.  August 8, 1975.

19. Langer, A.M.  and McCaughey, W.T.E.  Mesothelioma in a Brake
    Repair Worker.  Lancet 8307:1101-1103  November 13, 1982.

20. Ziera.  G.   Three  case reports  of  mesothelioma  in brake
    mechanics.  In:  Castleman, B.   Asbestos:  Medical  and Le-
    gal Aspects.   Harcourt Brace  Jovanovich.   1984.   (Four
    additional cases in mechanics and a case in a mechanic's
    wife in publication.)

21. Yorkshire Television.    "Alice:  A Fight  for Life."  July
    14, 1982.   (Mesothelioma  in a  ten-year  old son  of brake
    mechanic described and filmed.)

22. EPA.  Asbestos;  Proposed  Mining and Import Restrictions
    and Proposed Manufacturing Importation and Processing Pro-
    hibitions.  Federal Register Vol. 51, No. 19.  January 29,
    1986.

23. Seidman, H. , Selikoff, I.J., and Hammond, E.G.  Short-term
    Exposure to  Asbestos  and  Long  Term Observation.   Annals
    of the  New  York  Academy   of  Sciences 330:61-90.   1979.

24. EPA.  Support Document for Final Rule on Friable Asbestos-
    Containing Materials  in School Buildings:  Health Effects
    and Magnitude of Exposure.  January  1982.

25. Stell, P.M.  and McGill, T.  Asbestos  and Laryngeal Cancer.
    Lancet 7826:416-417.  August 25, 1973.

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                             -13-
26.  Shettigara, P.T. and Morgan,  R.W.   Asbestos,  Smoking and
    Laryngeal Carcinoma.   Archives  of  Environmental  Health
    30:517-519.  1975.

27.  Selikoff,  I.J.  and  Lee,   D.K.    Asbestos  and  Disease.
    Academic Press.  1978.

28.  National Loss  Control  Service Corportation.   Report of
    Industrial Hygiene  Study  for  Ammco  Tools,   Inc.   1978.

29.  Data from  reference  3  show TWA levels with these methods
    at about  200,000  fibers  per  cubic meter.   The average
    worker doing light to moderate work,  such as a mechanic,
    breathes ten cubic meters of air  during an eight-hour work
    day, thus inhaling  about  two million asbestos  fibers daily.
    Rohl's data  (reference  1)  shows that  levels  twelve  feet
    away using a dry brush were the same as using  a compressed
    air hose.   His  data also  show  shop  contamination  of
    100,000 fibers per  cubic meter at  distances  of  up  to 75
    feet from  the   site  of  compressed air  use,  and  other
    measurements indicating significant  scatter.

30.  OSHA.   29 CFR 1910.1001(h)(2).

31.  EPA.   Asbestos  Waste Management Guidance  - Generation,
    Transport,  Disposal.  EPA/530-SW-85-007.  May 1985.

32.  Nilfisk.  Nilfisk Asbesto-Clene Systems;  Rohl, A.  Letter
    to Robert  Magdelain,  April  11,   1979,   on  air  sampling
    during equipment use with transmission electron microscop-
    ic analysis  reporting  virtual  elimination  of  asbestos
    levels; Nilfisk  instructions  for use;  Nilfisk Simplifies
    the Safe Collection and Disposal of Toxic, Hazardous, and
    Nuisance Waste Materials.   Nilfisk  of  America,  Inc.,  300
    Technology Drive, Malvern, Pennsylvania 19355
    (215)  647-6420.

33.  Clayton Associates.  Asbestos  in Automotive Shops;  Rohl,
    A.  Letter  to   Jim Clayton,  October  12,  1984,  on  air
    sampling during  equipment  use  and  filter  change  using
    transmission electron microscopic analysis reporting vir-
    tual elimination of  asbestos  levels;  Asbestos  and You.
    Clayton Associates,  Inc.,   P.O.    Box  589,   30  Southard
    Avenue, Farmingdale, New Jersey   07727   (201)  938-6700.

34.  Control Resource  Systems.   CRSI 2000  and CRSI Labmaster
    Vacuums, Brakemaster enclosure system  description.   Con-
    trol Resource Systems, Inc.,  670 Mariner Drive,  Michigan
    City,  Indiana 46360.  (219) 872-5591.

35.  Hako  Minuteman.   Hako  Minuteman  Asbestos  Brake  Drum
    Vacuum System.   Hako Minuteman, Inc., Ill South Route 53,
    Addison, Illinois 60101  (312) 627-6900.

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36.  American Conference of  Government  Industrial Hygienists.
    Industrial Ventilation:   A Manual of Recommended Practice.
    18th Edition.  ACGIH.   Page 5-128.   1984.

37.  NIOSH.   Guide to Respiratory  Protection for the Asbestos
    Abatement Industry.   EPA/560-OPTS-86-001.    April  1986.
    This contains NIOSH's most  extensive  recommendations for
    a program  of  respiratory protection  against  asbestos.

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