1. Natural mineral particles: risks and their control Anthony Seaton

2. Hazard and risk Hazard = potential to do harm (from the Arabic for gaming dice) Risk = the likelihood of harm occurring (but needs qualification by the perceived type/seriousness of the anticipated injury)

3. General rules for reduction of risk from inhaled substances. Good information for exposed public Total avoidance (eg substitution, migration) Exposure reduction –Limit duration of exposure –Reduce/modify activities likely to increase exposure –Personal protection (eg respirators, filtered vehicle cabs) Audit or surveillance of effectiveness.

4. Assessment of hazard Folk law – not to be despised! –Often the first indication of hazards –Always worth talking to local people Toxicology – not always to be swallowed whole! –What is the target? –Problems with dose and extrapolations –Problems with animal and cell models.

5. Considering risk Likelihood of exposure Intensity of exposure Duration of exposure Toxic potential of dust

6. Assessment of risk How toxic to the lungs/other organs? Ergonomics –Personal behaviour (eg children, risk takers) –Activity levels (eg workers moving ash) Personal susceptibility –Nutritional –Genetic Epidemiology –Direct study of populations –Analogy from other, earlier studies

7. Risk reduction How toxic is the dust? –Mineralogy and analogy –Toxicology Understand the population and geography –Can they be moved? –How long will exposure last? –How will exposures be distributed? Reduce exposures –Concentration –Duration

8. Oil crisis looming - where are the US energy reserves? In the Rocky Mountain shale deposits.

9. Joseph Bell (Sherlock Holmes) described skin cancer in shale oil workers in 1876

10. Mineralogy of miner’s lung and of the W Lothian shale seam (from Hunterian museum)

11. What are the health effects of oil shale exploitation? Mortality study of 1960 cohort of Scottish oil-shale workers Follow-up study of survivors, for skin and lung disease case control study of lung cancer in W Lothian –(Am J Indust Med 1986; 9: 409 et seq)

12. An analogy for NMD – silicosis in metal miners

13. An analogy for NMD – COPD in coal miners

14. An analogy for NMD – simple pneumoconiosis in coal miners

15. Montserrat: some practical measures Evacuation and rehousing Exclusion zone Assessment of mineralogy/toxicity of dust Assessment of risks from dust inhalation Information on risk reduction measures Provision of masks Population studies to refine risk estimates

16. Air quality standards or guidelines? Problems – –with different dusts –with regulation, monitoring and compliance –with lack of epidemiology But could be part of a published management strategy, based on analogous mineralogical, epidemiological and toxicological evidence.

17. Thank you

18. An interesting emergency! 68-year old ex-miner, one week post RU lobectomy Increasingly wheezy - put on respirator Diagnosis - acute asthma Treatment - steroids and bronchodilators Outcome - off respirator, and………! (Thorax 1981;36:412)

19. …. Pathology report: PMF: “Which coal mine did you work in?” “I was a shale miner”

21. An analogy for NMD – complicated pneumoconiosis in coal miners