Discussion Summary - Berry

Our plain-English summary of Discussion Summary - Berry, by G. Berry (1973).

The study

• Author: G. Berry
• Published: BIOLOGICAL EFFECTS OF ASBESTOS (J.C. WAGNER, EDITOR), LYON: IARC SCIENTIFIC PUBLICATIONS, VOLUME 8, PP. 334 (1973)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This item is not a research study. It is a short summary by the author of the discussion after two papers in one session of the IARC volume Biological Effects of Asbestos. It gave figures Mr Akehurst presented from a Devonport survey comparing workers with asbestosis and controls. Those with asbestosis lost on average £150 per year from transfer to a less arduous job, £180 per year from more time off for illness and £600 per year from premature retirement. That came to about £900 per year per case, excluding the cost of disability itself. Participants reported that chrysotile could be substituted for crocidolite in asbestos cement pipes, so crocidolite was no longer essential. However, chrysotile produces micro-fibres, and whether this could be prevented was unknown. Speakers discussed the difficulty of placing a value on health and life. They noted strict regulation could shift hazardous processes to workers elsewhere, which the economic analysis did not account for. They added the economic approach was meant for policies applied to groups, not for clinicians treating individual patients.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Discussion summary of a conference session (not an original study); reports figures from Mr Akehurst's survey and points raised in discussion
• Who was studied: Workers with asbestosis and controls in a survey in Devonport, UK, as presented by Mr Akehurst; no numbers of workers are given
• Exposure: No specific exposure was measured; the discussion concerned asbestosis costs and the substitution of chrysotile for crocidolite in asbestos cement pipe manufacture
• Main results:
  • In the Devonport survey (Akehurst), workers with asbestosis compared with controls lost on average £150 per year from transfer to a less arduous job, £180 per year from more time off for illness, and £600 per year from premature retirement
  • The extra cost of using the health service was small compared with these losses
  • Asbestosis was estimated to cost about £900 per year per case, excluding any estimate of the cost of disability itself
  • It was reported that initial problems with substituting chrysotile for crocidolite in asbestos cement pipes had been overcome, so crocidolite was no longer essential for this purpose
  • The use of chrysotile leads to production of micro-fibres, and it was not known whether this could be prevented
• The authors' conclusion: As summarised from the discussion, applying economic methodology would make the implicit valuation of health and life explicit. The approach was intended only for evaluating policies applied to groups, not for clinicians treating individuals. The methodology was expected to be applicable in other fields.
• Limitations the authors state:
  • The economic analysis did not account for the possibility that strict regulation might transfer the hazard to workers in another country
  • The £900 per case estimate excludes the cost of disability itself
  • As the first attempt to apply economic principles to regulating a material, Mr Akehurst's study faced great difficulties

Topics

Medical terms in this study, explained in our Lexicon: IARC, Chrysotile, Crocidolite, Asbestos-Cement.

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