Port Allegany Asbestos Health Program: a community response to a public health problem.

The Port Allegany Asbestos Health Program (PAAHP) is a unique, community-run program that resulted from the successful cooperative efforts of a labor union, a corporation, community health care providers, and a medical school. PAAHP's goal is to develop a permanent community health organization that will use the most advanced existing knowledge to mitigate the adverse health effects anticipated as a result of the use of amosite asbestos in a Port Allegany, Pa. factory. All 1,188 persons employed by the factory during the years 1964-72 and the 3,000-4,000 persons in household contact with them are eligible for the program. PAAHP's major services are intensive medical surveillance, smoking cessation assistance, health education for participants, and continuing education for area physicians about asbestos-related diseases. One of the program's policies is not to disturb the usual patterns of medical care. If further testing or treatment is needed, patients are referred to their usual personal physicians. PAAHP does not provide ordinary medical care or medical insurance. Across the nation, the number of workers estimated to have been exposed to asbestos is more than 20 million, and their household contacts are estimated to be about three to four times that number. Adverse health effects resulting from asbestos exposure include elevated risk of lung cancer, mesothelioma, gastrointestinal tumors, and asbestosis. The problem requires the development of public health solutions. PAAHP has demonstrated the feasibility of a community-based model as one useful approach.