Asbestos--a hazard to the community

Our plain-English summary of Asbestos--a hazard to the community, by C. Gold, J. Cuthbert (Public Health, 1966).

The study

• Authors: C. Gold, J. Cuthbert
• Journal: Public Health
• Published: 1966;80(6):261-70
• Cited by: 5 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. 001500).

Abstract

During a recent study of pulmonary fibrosis in one clinic area in Glasgow 21 proven cases of lung pathology associated with exposure to asbestos have come to light. Difficulties in diagnosis may be due to "patient error" in that the patient may not remember that he had been in contact with asbestos, or know that he is exposed to asbestos in his current occupation -- a joiner, for example, sawing up asbestos boards. Examples are given of asbestosis or pleural tumours occurring many years after a short period of exposure to the dust. Persons in innocent-looking occupations, such as joinery, may be in great danger from working near persons like laggers, who use asbestos. Especially in confined spaces on shipboard. The importance is stressed of taking a very full occupational history, from the time the patient left school, where there is obscure pulmonary fibrosis. The value of open lung biopsy is shown in diagnosing doubtful cases of early asbestosis. The impression is gained that the incidence of asbestosis is increasing, and that it may come to assume great public health importance owing to the increased importation and more widespread use of asbestos. The proposal to mix asbestos with tarmacadam for road use is viewed with concern.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This 1966 article described a series of patients seen at a chest clinic in South-East Glasgow during a study of pulmonary fibrosis. Over two years the authors found 21 cases of asbestos-associated disease, plus three suspected cases that could not be confirmed, two because the patients refused further investigation. Asbestos fiber types were not named. Eight patients had classical asbestosis after an average of twenty-six years' exposure, mostly in shipyard insulating work, and four of them had lung cancer. Five had pleural mesothelioma, all presenting with pleural effusions. The shortest exposure among them was three months, seventeen years earlier. Four others had asbestosis after short or intermittent exposure years before, in what the authors called innocent-looking occupations, and one of them developed carcinoma. In four insulation workers with normal or borderline X-rays, asbestosis was proven by lung biopsy. Lung cancer occurred in 31 per cent of the 16 proven asbestosis cases, but the authors said the series was small and probably not representative. The authors stressed taking a full occupational history and viewed increasing asbestos use with disquiet.

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: case series from a chest clinic, with patients sorted into five groups
• Who was studied: 21 patients with asbestos-associated disease found over two years at a chest clinic in South-East Glasgow, plus 3 suspected cases (24 cases in the table)
• Exposure: Asbestos dust, fiber type not specified. Exposures were mainly shipyard insulating (lagging) work or working near laggers. Other exposures included asbestos-mattress packing, sawing asbestos boards and breaking down asbestos pipe lagging. Exposure ranged from three months to over forty years.
• Main results:
  • Eight classical asbestosis cases had an average of twenty-six years' exposure.
  • Four of the eight classical asbestosis cases had lung cancer.
  • All five pleural mesothelioma cases presented with pleural effusions.
  • The average age at diagnosis of the mesothelioma cases was 50 years.
  • The shortest exposure among the mesothelioma cases was three months, seventeen years before (Case T. W.).
  • Of four asbestosis cases with short or intermittent exposure years earlier, one developed carcinoma.
  • Excluding the mesotheliomas, lung cancer occurred in 31 per cent of the 16 proven asbestosis cases.
  • Four biopsy-proven asbestosis cases had normal or borderline X-rays. Of these, two had normal ventilation and diffusing capacity, one had results just on the lower limits of normal, and one had moderate ventilatory impairment with marked impairment of diffusing capacity.
  • Two suspected cases (insulating engineers) refused further investigation and could not be confirmed.
  • The third suspected case, a 68-year-old woman, was too old for lung biopsy, and a post-mortem was refused after her death.
• The authors' conclusion: The authors stressed taking a very full occupational history in obscure pulmonary fibrosis and the value of open lung biopsy in doubtful early cases. They gave their impression that asbestosis was increasing, and they viewed the increased uses of asbestos, including mixing it with tarmacadam for roads, with concern.
• Limitations the authors state:
  • The series is small and probably does not represent all asbestosis cases in the region.
  • The clinic does not see all chest cases in its area.
  • Without lung biopsy, asbestosis could not be proven in the suspected cases.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Pulmonary Fibrosis, Pathology, Asbestos Millboard, Insulator, Occupational History, Biopsy.

Related studies

• Asbestos dust--a community hazard? — (1969)
• Patterns of histopathological change determined by the point counting method and its application for the hazard assessment of respirable dust — A. Ogami, Y. Morimoto, et al. (2004)
• Mesothelioma in a community in the north of England — A.T. Edward, D. Whitaker, et al. (1996)
• Asbestos in the workplace and the community — W.J. Smither (1974)
• Community health risk assessment after a fire with asbestos containing fallout — S. Bridgman (2001)
• Community exposure to asbestos — D. Davies (1977)

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