Head and neck surveillance program for factory personnel exposed to asbestos

Personnel at a local factory that manufactures brake linings and discs in which asbestos is a major component were requested to participate in an on-site surveillance program to detect head and neck abnormalities, specifically cancer. Demographic data included smoking histories and job descriptions that could be delineated into high- and low-asbestos exposure groups. In the first year, 322 factory workers had no cancer identified but 15% had laryngeal abnormalities, mostly laryngitis. Ninety-seven percent of those workers with abnormal findings were smokers, but there were a significant number in the high-asbestos group irrespective of smoking histories. From this report, high-risk individuals were identified and requested to continue in the program for monitoring. In the subsequent 3 years, these individuals and new personnel were examined. Similar results were obtained in that laryngitis was noted in 24% (95% of whom were smokers) with a stronger statistical association with the high-asbestos group. More important, one person previously identified as high-risk was noted to have stage I squamous cell carcinoma and was treated with radiotherapy. The results of this program suggest that individuals at high risk for the development of head and neck cancer can be identified and that such surveillance programs should be implemented in similar arenas.