Air Pollution and Physician Responsibility

Our plain-English summary of Air Pollution and Physician Responsibility, by B.W. Carnow (1971).

The study

• Author: B.W. Carnow
• Published: Archives of Internal Medicine 127:91-95, January (1971)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1971 article was an essay that reviewed published evidence on air pollution and disease. It did not report a new study of its own. The author summarized earlier work, including deadly pollution episodes such as London in 1952, when more than 4,000 excess deaths were recorded in ten days. The author also summarized earlier Chicago studies that linked sulfur dioxide levels to acute respiratory illness in people with chronic lung disease. Asbestos came up only in passing. In the background, the author noted that other researchers had found an unusually high incidence of mesotheliomas and lung cancer in asbestos workers. Later, the author wrote that too little attention had been given to cancer risks from asbestos released by spraying during construction and by brake linings. The author acknowledged that the evidence was incomplete. The author concluded that air pollution may be a significant contributory cause of illness and death from chronic lung disease, lung cancer and perhaps coronary artery disease. The author argued that physicians should take a larger role in environmental health.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Commentary / narrative review essay summarizing other published studies; no original data
• Who was studied: No study population; the article discussed urban populations in general, especially high-risk groups described in earlier studies
• Exposure: Urban air pollution (sulfur dioxide, particulates, carbon monoxide, nitrogen compounds, ozone, lead, pesticides, radioactive materials); asbestos mentioned only as an under-studied airborne contaminant from construction spraying and brake linings
• Main results:
  • From earlier work by others (cited, not studied here): unusually high incidence of mesotheliomas and lung cancer in asbestos workers, with even greater carcinoma incidence among those who smoked cigarettes
  • The author stated that inadequate attention had been given to the cancer-causing effects of several urban air contaminants, including asbestos from construction spraying and brake linings
  • From cited reports of the 1952 London episode: more than 4,000 excess deaths in a ten-day period
  • From cited earlier Chicago studies: on days following high pollution levels, acute respiratory illnesses were twice as frequent as on low-pollution days among people with chronic bronchopulmonary disease
• The authors' conclusion: The author concluded that the evidence was sufficient to state that a relationship exists, and that air pollution may be a significant contributory cause of morbidity and mortality from chronic bronchopulmonary disease, bronchogenic carcinoma and perhaps coronary artery disease. The author also argued that physicians should take a broader role in environmental health.
• Limitations the authors state:
  • The author acknowledged that documentation of health effects was incomplete
  • Pollutants other than sulfur dioxide and particulates had mostly not been measured, so their separate or combined effects were not well documented

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Cancer, Brake Lining.

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