Amosite mesothelioma in a cohort of asbestos workers

Our plain-English summary of Amosite mesothelioma in a cohort of asbestos workers, by J. Ribak, H. Seidman, I.J. Selikoff (Scandinavian Journal of Work, Environment & Health, 1989).

The study

• Authors: J. Ribak, H. Seidman, I.J. Selikoff
• Journal: Scandinavian Journal of Work, Environment & Health
• Published: 1989;15(2):106-10
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000145).

Abstract

A cohort of 820 asbestos workers with a short duration of exposure to amosite between 1941 and 1945 was followed. These men were alive five years after starting work and were observed until 1988. Seventeen cases of malignant mesothelioma (eight pleural, nine peritoneal) were found. The mean age at the onset of exposure was 33 years for men with pleural mesothelioma and 30 years for those with peritoneal mesothelioma. Chest pain was the main symptom in pleural mesothelioma and abdominal pain in peritoneal mesothelioma. Open lung biopsy was the most useful diagnostic approach for pleural mesothelioma, whereas for peritoneal mesothelioma it was exploratory laparotomy. Pleural patients died of pulmonary insufficiency, and peritoneal patients of wasting and inanition. In both groups the death certificate diagnosis was less accurate than the clinical diagnosis at death. The mean survival was 12.5 months from first symptom to death for the pleural group and 5.4 months for the peritoneal group.

In plain English

This study followed 820 men who worked for some period between 1941 and 1945 at a Paterson, New Jersey, factory making insulation materials, mainly for the US Navy, with amosite asbestos. Very small amounts of chrysotile were also used. The men were known to be alive five years after starting work and were followed to 1988. Most worked only briefly, from under a month to a few years. There were no direct fiber counts, but average exposure was estimated at 50 fibers per cubic centimetre of air. The authors found 17 cases of malignant mesothelioma: eight pleural and nine peritoneal. Time from first exposure to mesothelioma ranged from 20 to 41 years. Chest pain was the main symptom in pleural cases, and abdominal pain in peritoneal cases. Mean survival from first symptom to death was 12.5 months for the pleural group and 5.4 months for the peritoneal group. Death certificates were less accurate than the clinical diagnosis at death. The authors concluded that relying on death certificates alone may result in serious underdiagnosis of mesothelioma.

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: Follow-up of a cohort of factory workers, with a review of the clinical records, pathology and death certificates of the mesothelioma cases found
• Who was studied: 820 men employed for some period between 1941 and 1945 at an asbestos products factory in Paterson, New Jersey, known to be alive five years after starting work, and followed to 1988. They came from 933 men recruited, of whom 113 were excluded.
• Exposure: Amosite asbestos, used almost exclusively in making insulation materials, with very small amounts of chrysotile. Exposure was mostly short, ranging from less than one month to a few years. There were no direct fiber counts; average exposures were estimated at 50 fibers/cm² of air.
• Main results:
  • 17 cases of malignant mesothelioma were identified in the cohort: eight pleural and nine peritoneal.
  • Of the 820 men in the cohort, 740 were known to be dead as of August 1988.
  • Time from the onset of exposure to the development of malignant mesothelioma ranged from 20 to 41 years.
  • Mean age at the onset of exposure was 33 years for men with pleural mesothelioma and 30 years for men with peritoneal mesothelioma.
  • Men with peritoneal mesothelioma had worked at the plant almost twice as long on average as men with pleural mesothelioma (43.8 months versus 25.6 months).
  • Chest pain was the main symptom in the pleural group, and abdominal pain was predominant in the peritoneal group.
  • In the peritoneal group, exploratory laparotomy was done for six patients but gave a positive diagnosis of mesothelioma for only two.
  • In the peritoneal mesothelioma cases, the main cause of death was wasting and inanition (seven out of nine).
  • In the peritoneal group, four cases had been correctly categorized in the initial clinical diagnosis and six at death, but only five were listed as malignant mesothelioma on the death certificate.
  • Mean survival from first symptom to death was 12.5 months for the pleural mesothelioma patients versus 5.4 months for the peritoneal mesothelioma patients.
• The authors' conclusion: The authors concluded that relying on the death certificate diagnosis alone may result in a serious underdiagnosis of mesothelioma.
• Limitations the authors state:
  • There were no direct fiber counts in the factory; exposure levels were estimated from other data sources.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Amosite, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Amosite, Mesothelioma, Pleural Mesothelioma, Peritoneal Mesothelioma, Biopsy, Laparotomy, Death Certificate.

Related studies

• Mortality experience of amosite asbestos factory workers: dose-response relationships 5 to 40 years after onset of short-term work exposure — H. Seidman, I.J. Selikoff, et al. (1986)
• Tyler asbestos workers: mortality experience in a cohort exposed to amosite — J.L. Levin, J.W. McLarty, et al. (1998)
• Tyler asbestos workers: A mortality update in a cohort exposed to amosite — J.L. Levin, A. Rouk, et al. (2016)
• Human health effects associated with the commercial use of grunerite asbestos (amosite): Paterson, NJ; Tyler, TX; Uxbridge, UK — J. Ribak, G. Ribak (2008)
• Long term radiological effects of short term exposure to amosite asbestos among factory workers — R. Ehrlich, R. Lilis, et al. (1992)
• Malignant mesothelioma induced in baboons by inhalation of amosite asbestos — I. Webster, B. Goldstein, et al. (1993)

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