A Pilot Study of Participant Performance in Asbestos Training Courses

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A Pilot Study of ParticipantPerformance in AsbestosTraining CoursesJohn H. Lange a & Kenneth W. Thomulka ba Envirosafe Training and Consultants , P.O. Box114022, Pittsburgh, PA, 15239b Philadelphia College of Pharmacy and Science , 600South Forty-third Street, Philadelphia, PA, 19104Published online: 17 Sep 2010.

To cite this article: John H. Lange & Kenneth W. Thomulka (2002) A Pilot Studyof Participant Performance in Asbestos Training Courses, International Journal ofEnvironmental Studies, 59:2, 275-289, DOI: 10.1080/00207230210928

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Environ. Studies, 2002, Vol. 59(2), pp. 275–289

A PILOT STUDY OF PARTICIPANT

PERFORMANCE IN ASBESTOS

TRAINING COURSES

JOHN H. LANGEa* and KENNETH W. THOMULKAb

aEnvirosafe Training and Consultants, P.O. Box 114022, Pittsburgh,PA 15239; bPhiladelphia College of Pharmacy and Science, 600 South

Forty-third Street, Philadelphia, PA 19104

A comparison of asbestos abatement provider initial and audit examinations, and adescriptive evaluation of audit tests for refresher courses was conducted. Asbestosabatement course providers in Pennsylvania, at this time, are not required to includetests as part of refresher courses, therefore, no direct comparison for the refreshergroups could be performed. Types of courses in this study included: asbestosworker=supervisor=contractor, building inspector and project designer. Initialexamination comparisons (provider and audit) suggest that audit scores aredescriptively and statistically different for worker=supervisor=contractor and projectdesigner, and descriptively different for building inspector. All refresher and auditinitial scores were lower than initial provider scores. Refresher audit examinationscores were found to be non-normally distributed. A discussion relating to problemsand solutions associated with the differences in test scores is presented.

Keywords: Abatement; Exposure; Occupational Health; Regulations; Asbestos Training

INTRODUCTION

The United States Environmental Protection Agency (EPA), Occupational

Safety and Health Administration (OSHA) and many states require that per-

sons performing abatement, inspections and project design associated with

asbestos-containing materials (ACM) be properly trained and certified [1–

5]. These training courses were originally designed and described by the

*Corresponding author.

ISSN 0020-7233 print; ISSN 1029-0400 online # 2002 Taylor Francis LtdDOI: 10.1080=00207230290015568

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EPA, and have for the most part been adopted by many states with only little

modification [5,6]. However, the EPA [3] has provided in their promulgation

of training requirements to states a number of general suggestions or recom-

mendations that encourage states to establish minimum requirements be-

yond that described by federal regulation. Requirements that have been

suggested by EPA for states to develop include: examination criteria, and

qualifications for various disciplines and instructors [3]. Training for

the various disciplines requires an initial course that can range from three

to five days in length and an annual refresher course that can range from

one-half to one day in length [3]. These courses, in general, can be charac-

terized as ‘‘adult educational training’’ for occupational protection [7].

The primary purpose of these training programs is to educate personnel

working around asbestos with the hazards imposed. It also provides person-

nel with information on the appropriate practices to prevent exposure and

future disease as well as public health and environmental protection [6,8–

11]. Asbestos exposure [12,13] has been associated with several diseases

(lung cancer, mesothelioma, gastrointestinal cancer, and asbestosis) that

have long latency periods (10 to 40 years) [2,14–17]. Smoking in combina-

tion with exposure to asbestos has been suggested to result in a synergistic

effect in causing some of these diseases (lung cancer and asbestosis) [18–

22]. Other occupational ‘‘groups’’ also have training requirements (hazar-

dous waste), but currently do not have the regulatory oversight and require-

ments associated with asbestos abatement and related activities [3].

However, the lead-based paint (LBP) abatement industry, as a newly regu-

lated entity, appears to be following a similar trend as has occurred for as-

bestos abatement training requirements, although implementation is

currently at the discretion of each state [23–25] with currently little formal

direction from the EPA [26].

Questions have been raised concerning the educational quality of asbes-

tos training programs [27,28]. Types of questions concerning asbestos train-

ing has been varied but include: should this training be performance

oriented or time-based, instructor qualifications, evaluation techniques for

students’ understanding of concepts, and hands-on skills [26,27]. In addi-

tion, the repetitive nature of these courses, for example each having lectures

on health effects, respirator protection, occupational medical surveillance

and related topics, have raised questions related as to the necessity of full

courses as compared to module training [27,28].

276 J.H. LANGE AND K.W. THOMULKA et al.

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Currently, determination of successful completion of an initial training

course is based on passing a final written examination with a score of

70% or greater and attendance=participation in the course [2]. Examina-

tions are prepared by the training provider and approved by the regulatory

body(ies) for which the provider has approval. Each provider grades and

administered their own examination. It is also considered that most provi-

ders conduct their training oriented toward the examination they issue [27].

Participants in these courses are from varied educational and experience

backgrounds. Those attending the abatement type courses (asbestos abat-

ment worker and supervisor) are most often associated directly with the in-

dustry as their primary occupation [10]. Others in the inspection and design

courses (building inspector, management planner and project designer) are

often related to other professions that perform asbestos abatement activities

affiliated to their area of practice (e.g. architect, industrial hygiene, engi-

neering).

This study investigated test scores on initial and refresher examinations

administered by the training provider and course auditors. A discussion of

these comparison tests is presented.

MATERIALS AND METHODS

The EPA originally categorized asbestos abatement activities or occupa-

tions into five different groups: worker, supervisor=contractor, building in-

spector, management planner and project designer. This agency

considered each of these groups to be a separate discipline and requires

completion of a distinct training course [1,2]. Attendance in the manage-

ment planner course has the prerequisite of first successfully completing

the building inspector course, with all others having no prerequisite asbes-

tos training requirements. No educational requirements have been man-

dated beyond attendance and passing a provider developed examination

for any of the courses established by EPA, although recommendations

have been provided [2] with a limited number of states having instituted

requirements or guidelines [29,30]. All courses evaluated were within the

Commonwealth of Pennsylvania during the time period of 1993 to 1994.

Tests (audit examinations) were prepared for asbestos work-

er=supervisor=contractor (WS), building inspector (BI) and project de-

A PILOT STUDY OF PARTICIPANT PERFORMANCE 277

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signer (PD) by the author (JHL) and reviewed by PADLI, Asbestos Advi-

sory Board, Subcommittee on Training and Auditing. These audit examina-

tions (tests) were multiple choice, had between 20 to 30 questions, and were

administered by PADLI asbestos investigators at the conclusion of refresher

or initial courses. The same audit test was used for both refresher and initial

courses in each category (WS, BI and PD). Questions on the tests were or-

iented towards health effects, occupational medical surveillance, exposure

prevention, safe work practices, and personal protection relating to asbestos

activities. Some questions were similar (e.g. respirator protection) in each

category for the dierent audit tests. All tests were collected at the end of

course presentation and practice sessions by the investigator and graded

by the chair (JHL) of the subcommittee, using a standardized answer key.

The EPA and PADLI require that a test be given for all initial asbestos

training courses. The number of questions required for the initial courses

is 50, 100, 50, 100 for worker, supervisor=contractor, building inspector

and project designer, respectively [1,2]. Currently, an examination at the

conclusion of a refresher course is optional in Pennsylvania, with most

training providers not exercising this option. Comparison matches were per-

formed only with initial training courses (audit initial and provider initial).

No provider surveyed in this study required an examination at the conclu-

sion of refresher training, therefore, no comparisons can be performed.

Descriptive statistics were determined for each group of tests adminis-

tered. Shapiro-Wilk and Shapiro-Francia tests were performed on each re-

fresher group that had a population less than or equal to 50 tests collected

(scores) [31,32] and greater that 50 scores, [33] respectively, to evaluate

whether the population is normally distributed. These tests for distribution

employed data in both a transformed (log-base 10-common logarithm) and

non-transformed form [32–34]. Determination of outlier values was per-

formed for lognormal distributions as described by Gilbert [32]. Non-trans-

formed match initial test scores were evaluated using a decimal value (e.g.,

100% corrected to 1.00, 90% corrected to .90). Since the number of com-

parison tests were small and these values discrete, the Mann-Whitney test

[37] was selected for analysis of data. Statistical significance was defined

at a p value of less than 0.05. Initial test results (scores) were provided

by the PADLI from the student evaluation forms submitted by the training

provider. Skewness was determined for each refresher category [38]. Train-

ing providers are allowed to re-administer a test for participants obtaining a


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score less than 70% on their first attempt at passing the course. Only the

score on the first examination was included in this study. A single incident

of the incorrect audit test being given to a class occurred (supervisor class

was tested using the project design audit examination) and was not included

in these evaluation results. When comparing audit and provider initial ex-

amination scores only those initial provider scores that could be verified

were used in this study. Any course conducted by the authors for which eva-

luations were collected were not included in these data as to avoid any re-

sultant bias.

RESULTS AND DISCUSSION

Summary data, measures central tendency and dispersion, for audit (re-

fresher and initial) and provider tests are shown in Tables I and II. These

data show that the audit refresher courses in all categories exhibit lower

median scores than initial examinations, with the opposite existing for

mean scores. Skewness values were only determined for refresher audit

scores with other test groups not having a determination due to the small

sample population. Characteristics of the distribution for refresher audit

data suggest an asymentrical distribution around the mean. Evaluation of

these same data with the Shapiro-Wilk and Shapiro-Francia tests found

all three refresher audit categories to be non-normally distributed at the

5% level using non-transformed data. After transformation, these data

were normally distributed suggesting a lognormal distribution characteris-

TABLE I Descriptive statistics for initial and refresher audit examinations

Examination category Number Mean Median Mode SD Skewness

Refresher

Worker=Supervisor 187 0.81 0.80 0.85 0.11 � 0.37Building Inspector 55 0.74 0.75 0.75{ 0.12 � 0.17

0.85Project Designer 46 0.71 0.73 0.75 0.11 � 0.28

Initial

Worker=Supervisor 14 0.80 0.85 ND 0.11 NDBuilding Inspector 7 0.77 0.80 ND 0.095 NDProject Designer 9 0.75 0.80 ND 0.091 ND

{ Two modes were determined.


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tic. This distribution supports skewness of non-transformed data and sug-

gests analysis of comparison data employ a nonparamteric method. When

a 1% criterion was applied using non-transformed and transformed data

both WS and PD refresher data are non-normally distributed (logarithmi-

cally), but BI refresher data was suggested as normally distributed.

Descriptively comparing initial scores of audit and providers tests, WS

and PD initial scores were both lower in the audit examinations for mean

and median values, with BI having a lower mean audit score but an

equal median value. BI initial provider and audit initial examination scores

were descriptively similar. A similar finding also exists for statistical com-

parison of audit and provider initial scores with a significant difference ex-

isting for WS and PD. All refresher scores in the audit examinations were

lower than scores in the initial provider tests, although direct comparison

may not be applicable, particularly due to educational differences of parti-

cipants. Each audit examination category had a high score of 100% with the

low scores for WS, BI and PD being 35%, 50% and 45%, respectively.

These results suggest that tested participants performed better on the

training provider examinations than audit examinations. Skewness of the

refresher audit examinations and a descriptive similarity of mean and med-

ian values in each category suggest that the nonnormal distribution is a re-

sult of a small number of low values in each population. A skewness to

lower values, a consistency of lower scores on the audit refresher test as

compared to provider tests, and relatively lower scores on the audit initial

comparison tests support a suggested difference between audit and provider

examination results. The lower scores for refresher audit examinations as

compared to provider initial tests, although not directly comparable, sup-

port the initial audit and provider data, and have been suggested to be of

concern [28]. However, the small number of observations in some groups

TABLE II Descriptive statistics for initial provider examinations

Examination category Number Mean Median Mode SD Skewness

Initial

Worker= Supervisor* 14 0.91 0.96 ND 0.087 NDBuilding Inspector 7 0.79 0.80 ND 0.1 NDProject Designer* 9 0.81 0.82 ND 0.047 ND

*Statistically different for initial audit and initial provider examinations. Audit initial and initialprovider test scores are matches.


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and educational differences of persons within training classes and among

categories must be considered when evaluating these results.

The difference in test scores reported in this study raises a number of

questions relating to training of this nature. Certainly, the primary focus

of this type of training is to provide personnel in the various disciplines

with adequate information for protection of themselves, the public and

the environment. Some disciplines (e.g. workers) are directly related to in-

volvement of abatement while others establish criteria to be implemented

(e.g. PD). Varying dierences between audit and provider examinations do

not in themselves provide direct information on the ability of these disci-

plines to perform their work practices. A study [11] during refresher train-

ing classes that evaluated respirator practices, occupational medical

surveillance frequency and airborne exposure to asbestos in workers and

supervisors using a self reporting survey suggested that inadequacies re-

lated to these activities may exist. These inadequacies observed for abate-

ment personnel do not provide direct information on public health and

environmental protection. If studies on building fiber levels, [39–42] expo-

sure concentrations of airborne asbestos during abatement, [17,35] reported

frequency of asbestos disease and anatomical=physiological precursor con-

ditions of asbestos-related disease, [13,21,41,42] and surface concentra-

tions of asbestos in buildings [45–48] are included in this evaluation an

anecdotal association can be inferred. However, caution must be exercised

in making these associations, particularly in reference to reports of asbestos

abatement being unnecessary as related to actual disease prevention and the

high financial expenditures having little economic benefit, especially re-

lated to reduction of exposure and prevention of disease for the general

public [49,50]. The concept of little risk associated with low levels of as-

bestos exposure would tend to nullify concerns related to the dierences

in test scores and the suggested inadequacies of personal protective prac-

tices at least to a partial degree. Whether lower levels of exposure in the

current asbestos industry as compared to past exposures to asbestos in oc-

cupational populations constitutes a serious risk is subject to interpretation

of acceptable levels of disease, economics and public concern [53]. Regard-

less of the risk associated with asbestos, it is generally agreed that exposure

is lower today for occupations involving asbestos than in the past [17].

Some investigators [54–56] have suggested that a number of occupational

groups (e.g. maintenance, custodians) have elevated exposure to asbestos


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that have not been traditionally defined or categorized as asbestos abatement

workers [10,17]. This exposure scenario is of concern, especially since most

of these groups have had limited protection by regulatory agencies and for

the most part do not meet the traditional characteristics defining asbestos

abatement workers. Groups such as maintenance workers for commercial

and apartment buildings often have limited organizational representation;

thus, minimizing their ability to establish group health and safety protection

practices. However, some studies have suggested that these groups com-

monly perform limited asbestos abatement and other non-abatement activ-

ities, such as dry sweeping and cleaning, repairs, maintenance and related

activities, which can result in elevated exposures [10,17,42].

Several suggestions have been proposed [27,28] to explain the variation

observed between test scores. These concepts can be generally categor-

ized into three classifications: inadequate instructors, training oriented to-

ward the test given by the provider and inadequacy of the audit

examinations. One or another of these have legitimacy in explaining

the statistical and descriptive differences observed between scores, with

a practical scenario of all having some influence. However, the question

of establishing a training program that provides adequate information

for protection is the goal of asbestos and related training programs. It

can be considered that if the workers leave training programs with inade-

quate information this will carry through to work practices, although, aca-

demic performance may have little influence or reflection on practical

abilities for this occupational group, especially WS. In some cases, work-

ers may have appropriate information, but economic restrictions placed

upon them by the abatement company may not allow implementation.

The importance of appropriate supervision at the site must also be consid-

ered and included as a factor relating to work practices.(8) Some may go as

far as to consider the first several days or weeks of work on the job to be

most critical in establishing practices performed by workers. This alone es-

tablishes the role of site supervisor in providing adequate guidance and di-

rect training by them as being of critical importance, with ‘‘formal’’ training

serving as no more than an academic preparation. Such a scenario of this

nature would suggest that training time be limited, with a control or require-

ments be applied to initial on-site activities. A concept of this nature can be

extended beyond abatement and include inspectors and project designers,

as has been implemented in many professions (e.g. law-law clerks, med-


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icine-internships), especially in cases where academic practices have a

limited ability in instruction as applied and compared to practical si-

tuations.

This relationship of academic performance as compared to practical ac-

tivities must be carefully considered in this occupational population and the

importance applied to test scores, since many of those in the WS category

often have had little formal academic training (less than high school diplo-

ma) and some being illiterate. Occurrence of this nature may certainly have

some influence on the WS scores and differences observed, however, this

does not explain the lower scores and differences, directly, for the other

groups, which are generally better educated (BI, PD). An educational dis-

crepancy may also exist with the BI and PD categories, with some ‘‘less

academically educated persons’’ participating, which is resulting in lower

test scores and a difference between tests, initial and audit (i.e. PD). How-

ever, caution must be exercised in these suggestions, since no direct data

have been collected on these relationships and possible existence of a

poor relationship between testing itself and practical application may

exist for this occupational group.

Some variation between audit and provider examinations has been sug-

gested to be related to bias of questions on the audit test [27]. Certainly,

some bias exists for examinations and their comparisons relating to word-

ing of questions, administration, style of presentation, focus of the exami-

nation, attitudes of the test population, variation of instruction provided in

both course presentation and testing, and other concepts. The extent to

which test bias influenced differences suggested in this study are unknown,

but should be considered when interpreting these data.

Suggestions to mitigate the variation in provider scores has focused on

two concepts: instructor ability and participant requirements. To ensure

adequate instructor quality, specific and clear requirements on qualifica-

tions can be established and enforced. This, at a minimum, will provide

some assurance that the instructor providing information on a specific

topic has adequate knowledge and experience themselves in the area

they are instructing. Furthermore, to assure adequate knowledge of in-

structors, testing of instructors in different categorical areas (e.g. personal

protective equipment, work practices) has also been discussed [27].

Rather than focus the requirements on the training provider via the in-

structor(s), specific standards can be applied to the participant being


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trained and certified. Specific requirements on education and experience

have been discussed in Pennsylvania for various disciplines [30]. This

will assume, according to the concept, that individuals entering these dis-

ciplines will have had some previous academic preparation (e.g. college

courses in science or=and engineering) related to the category that they

will function. Testing for each discipline by a third party has been imple-

mented by some states as part of the lead-based painting training require-

ments [24]. This will control, in part, training by providers that is oriented

directly for the test. However, questions on a standardized test, as has

been related to the audit examinations, [27] will likely also have some

bias requiring consideration. Certainly, testing of this nature will also

raise the question as to whether annual refresher training is necessary

for those that can pass a standardized test. It may be that refresher train-

ing is only necessary for those not achieving an acceptable score on the

standardized test. Concepts of this nature raises numerous questions re-

garding the current system of asbestos abatement and similar (e.g. lead-

based paint, hazardous waste) types of training, primarily related to per-

formance oriented and time-based programs [4,25,26,57,58].

In Pennsylvania, proposed asbestos regulations will require refresher ex-

aminations for each discipline. Currently, only one provider in Pennsylva-

nia requires an examination at the conclusion of refresher courses. It is

thought that this requirement, in part, will at least strengthen individual

training participant requirements beyond mere attendance and assure that

participants have at least some minimal knowledge of their subject area

[22,27]. Furthermore, the mere successful completion of a refresher exam-

ination will provide some assurances, certainly more than there exists for

attendance alone, that participants have a minimal knowledge in the cate-

gory for which they are being ‘‘certified’’.

Most states have investigators that routinely audit training providers to

evaluate their adequacy in instruction. Some have suggested that this func-

tion alone is adequate in assuring appropriate instruction [28]. Expansion of

this activity would include a more detailed review of training to access eva-

luation of the actual presentation besides determination if the required to-

pics are discussed and presented. Certainly, this can allow some arbitrary

evaluation of provider presentations. A numerical point value for both

form of presentation and discussion or required information could be for-

mulated to balance this type of evaluation.


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This study may be the first investigation that has evaluated performance

of ‘‘instruction’’ in regulatory generated training programs. Previous stu-

dies [7] have been conducted on training effectiveness relating to occupa-

tional protection, but have not focused on the issue(s) of functional

performance and value beyond that of self-evaluated determination. Cer-

tainly, this investigation has not controlled for all the various factors dis-

cussed (e.g. instructor quality). Some may even argue that conclusions or

any generalization beyond recognition of potential problems in this area

of adult training for occupational protection (asbestos abatement) can

not be made from the data in this study. Future investigations will require

a more controlled scenario, with a more definitive study. These studies

will likely include evaluation of a larger population of participants that

can be segregated into categorical groups for comparison. In addition, fol-

low-up of this population will be necessary to better evaluate the exten-

sion of this type of training to practical situations. This pilot study was

not designed to directly address all the issues raised, but has shed consid-

erable light on potential problems, with some limited conclusions possi-

ble.

This study identifies and has practically examined some of the issues

related to adult education training for occupational protection. Conclu-

sions derived from this investigation must be tempered by characterization

of the methodology and the limited controls that were possible for a pilot

study of this nature. However, tentative conclusions derived raise numer-

ous questions regarding training for these various groups. Future studies

are clearly needed for evaluation and establishment of appropriate training

in asbestos and other training programs that are designed for occupational

protection.

CONCLUSION

This paper suggests that some inadequacies may exist in current asbestos

training programs. How extensive this concern is depends on the prospec-

tive from which it is examined [27]. With the current development of lead-

based paint training programs, [25,57] as proposed by the EPA, [26] a care-

ful examination of the concerns in the asbestos training program needs to

be evaluated. Future studies are needed to more adequately identify and de-


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scribe problems in this industry. Little unbiased information exists on expo-

sure, practices, training and activities of asbestos abatement, including de-

sign and inspection for this study population. This may be the first report

that evaluated characteristics of training participants as related to informa-

tion transfer. A larger study of this nature is needed to better answer ques-

tions raised and evaluate training of this nature. Caution must temper the

findings reported from this investigation, especially in light of suggestions

that current risk from asbestos exposure may have been over magnified and

can be resulting in an unnecessary economic burden [49–52].

Acknowledgments

Special thanks are given to the Pennsylvania Department of Labor and

Industry, Bureau of Occupational Safety, Asbestos Section and the Asbes-

tos Advisory Board for suggestions and implementation of this investiga-

tion. Particular thanks goes to members of the Training and Auditing

Subcommittee of the Asbestos Advisory Board and asbestos investigators

for comments and suggestions critical to development of the manuscript.

Special appreciation is also acknowledged of Mr. Charles Sludden, Ms.

Sharon Lawson and Ms. Denise Hesse for their comments and suggestions.

References

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Documents

A Pilot Study of Participant Performance in Asbestos Training Courses