Asbestos-induced cancer and asbestosis are diseases that are almost never seen in children. Practicing pediatricians should not expect to see any asbestos-related disease in their patients. There is a mounting concern, however, that exposure to asbestos in childhood, particularly in school settings, can put children at increased risk later in life for diseases caused by asbestos. Pediatricians are frequently asked to advise school authorities and parents on the dangers posed by asbestos. In this statement, current information on asbestos exposure in schools is reviewed and basic remedial approaches to prevent significant exposure to children are described.
Asbestos was used as a spray-on material in the construction of school ceilings, primarily during the 1950s through early 1970s, because of its acoustical, fire-proofing, and decorative qualities. Such dried materials can, over time, become friable; this process is dramatically speeded up by any external factors that disrupt the structural integrity of the ceiling material. Friable asbestos often flakes off as a fine dust that settles on surfaces but is readily resuspended in classroom air.
Asbestos was also used in insulating materials for pipes, boilers, and structural beams in schools. Less commonly, this use of asbestos may be a problem for children when deteriorating conditions lead to disruption and spread of asbestos fibers. In 1973, the US Environmental Protection Agency (EPA) banned most uses of spray-on asbestos materials. Concern for potential long-term effects in children surfaced dramatically in 1976 when flaking of asbestos ceiling materials was noted in six schools in one state. The initial public health strategy, which continues unchanged, was that (1) medical screening and follow-up of children so exposed should not be recommended because of the transient and uncertain degree of exposure, the probable rarity of significant asbestos-related disease, and the extremely long latent periods (probably 30 or more years) for any effects that might occur, and (2) public health efforts should focus on the prevention of exposure to assure that any long-term risks are minimized or completely removed.
- Copyright © 1987 by the American Academy of Pediatrics