Asbestos An Environmental Health Hazard

Our plain-English summary of Asbestos An Environmental Health Hazard, by W.D. Norwood, P.A. Fuqua, T.F. Mancuso (1967).

The study

• Authors: W.D. Norwood, P.A. Fuqua, T.F. Mancuso
• Published: Northwest Medicine P.821-828, September (1967)
• 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 1967 article by physicians in Richland, Washington, and Pittsburgh, Pennsylvania, aimed to draw Northwest physicians' attention to asbestos-related disease. It presented four case reports from the authors' area. The authors also briefly described studies by other researchers as background, and those findings are not results of this paper. Case one was a former shipyard asbestos mechanic who died in 1953. Autopsy showed asbestotic pulmonary fibrosis, emphysema, cor pulmonale and pleural thickening. His widow's compensation claim was awarded against his last employer, which the authors said contributed the least exposure. Case two, a pipe insulator for 23 years and a cigarette smoker, had a mucoepidermoid lung carcinoma together with asbestosis. Case three, a boiler plant engineer who periodically repaired asbestos insulation, had a mesothelioma of the tunica vaginalis, found after a swelling of the left scrotum. Case four, an asbestos insulator and heavy smoker, was found at autopsy to have adenocarcinoma of the rectum with metastases, plus pulmonary fibrosis with asbestos bodies. The authors concluded that more cases of lung cancer and other late effects may be expected from wartime asbestos use in the Northwest.

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 with brief discussion of published literature and four case reports; the authors state it is not intended as a literature review
• Who was studied: Four men from the authors' geographic area (the Northwest, Richland, Washington area) who were asbestos workers or whose jobs exposed them to asbestos
• Exposure: Occupational asbestos exposure: shipyard asbestos mechanic work and later insulating company work (case one), pipe insulation (case two), periodic repair of asbestos insulation as a stationary boiler plant engineer plus a roll of asbestos kept at home (case three), and asbestos insulation work (case four). Fiber types are not specified for the cases.
• Main results:
  • Case one: a white male, age 55, who had been an asbestos mechanic at a shipyard from 1943 to 1946, died in 1953. Autopsy showed bilateral interstitial asbestotic pulmonary fibrosis, emphysema, cor pulmonale and pleural thickening.
  • Case one: the workmen's compensation claim was awarded to the widow against the last employer, which contributed the least asbestos exposure, because state law placed responsibility on the employer at the time the disability became apparent.
  • Case two: a white male, age 49, had done pipe insulating work for 23 years for more than a dozen employers and was a cigarette smoker. The amount he smoked cannot be read reliably from the scan. He had a lung lesion removed in July 1964. It was a mucoepidermoid carcinoma, and asbestosis was identified in the lung tissue. He died with widespread metastases in April 1965.
  • Case three: a white male, age 55, seen in July 1967 for swelling of the left scrotum, had a biopsy reported as mesothelioma of the tunica vaginalis, with metastases to the skin. He had worked as an engineer in stationary boiler plants and periodically repaired asbestos insulation on pipe and boiler covering.
  • Case four: a white male asbestos insulator and heavy cigarette smoker. A bronchial biopsy had been reported as bronchogenic epidermoid carcinoma, but autopsy showed a poorly differentiated adenocarcinoma of the rectum with metastases to lung, liver, adrenals, lymph nodes and kidneys, and diffuse pulmonary fibrosis with asbestos bodies.
  • One insulation worker the authors studied had done asbestos pipe covering work for 20 years in nine states and two countries, at 53 locations for 41 firms.
• The authors' conclusion: The authors concluded that increased numbers of cases of lung cancer and other late effects may be expected because of widespread asbestos use in insulation and other Northwest industries during the Second World War. They also recommended that asbestos workers have chest x-rays and pulmonary function tests as part of an annual health inventory.
• Limitations the authors state:
  • The authors state that the groups exposed to asbestos in the Northwest had not been identified or studied, so they had no accurate data on how common asbestosis is there.

Topics

Medical terms in this study, explained in our Lexicon: Autopsy, Pulmonary Fibrosis, Emphysema, Cor Pulmonale, Pleural Thickening, Insulator, Carcinoma, Mesothelioma.

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