Project Summary (2014-2020)

As part of this project, researchers are conducting an environmental epidemiologic and ethnographic study of asbestos-related disease among residents of Ambler, Penn., one of the largest asbestos waste sites in the U.S. where there was substantial industrial and community exposure to asbestos from the late 1800s through the late 1980s. The known adverse health effects of asbestos exposure in work settings raise the possibility of analogous effects from community level exposure. The Pennsylvania Department of Health has identified in the Pennsylvania Cancer Registry an excess of cases of mesothelioma in the Ambler zip code, with a 2.7 times higher than expected rate among men and a 4.5 times higher than expected rate among women. However, a combination of circumstances including out-migration of families from the area following closure of the asbestos industry, the long latency period characteristic of asbestos related diseases, the under-reporting of lung diseases in earlier periods, and the mismatch between administrative boundaries and actual exposure to asbestos, may have affected the ability of standard public health surveillance methods to fully capture the magnitude of the problem in this area.

Frances Barg, Ph.D., and her research team are building on Department of Health findings and on their own previous pilot work in which they used ethnographic methods to delineate parameters of the relevant communities of exposure and to describe normative lifestyle patterns and circumstances of potential asbestos exposure. In the process of developing these data, the researchers have formed strong relationships with these communities, which will facilitate their access to current and past residents and workers to conduct a geographic case control study to analyze the contribution of community, occupational, and social factors among individuals who developed mesothelioma. Specifically, the researchers will determine the association between the development of mesothelioma and geographic proximity to the plant and asbestos waste piles that had been publicly discarded in the Ambler area.

Their study design is based on the following hypotheses:

• The incidence of mesothelioma is related to both occupational and non-occupational (community exposures) in the Ambler area;
• There is an association between the incidence of mesothelioma and proximity of residence to the asbestos waste sites; and
• The relationships between proximity to the site and mesothelioma are modified by various social, lifestyle and economic factors that influence asbestos exposure.

To test these hypotheses, the researchers will focus on the following aims:

1. Utilizing an ethnographic approach with residents to identify patterns of exposure related to lifestyle and social factors to inform the case control analysis.
2. Identifying, characterizing, and mapping all cases of mesothelioma in Ambler Borough and the four adjacent townships.
3. Identifying a set of controls that are frequency matched with cases based upon a minimum five year residence in the area.
4. Using a geographic case-control design to characterize the contribution of geographic factors found among people who developed mesothelioma in the greater Ambler area.