Asbestos And Mesothelioma: A Review

Our plain-English summary of Asbestos And Mesothelioma: A Review, by M. Kannerstein, J. Churg, W.T.E. Mccaughey (1978).

The study

• Authors: M. Kannerstein, J. Churg, W.T.E. Mccaughey
• Published: Pathology Annual 13(Part 1):81-129 (1978)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 002128. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article was a review, not an original study. The authors surveyed published research on asbestos and its effects on health, with most attention on mesothelioma. They also drew on their own experience diagnosing the tumor. They described the fiber types (chrysotile, crocidolite, amosite, anthophyllite and tremolite) and noted that all types except anthophyllite had been linked with mesothelioma in people. Cigarette smoking was described as the most important known factor alongside asbestos for lung cancer, but no such association had been shown for mesothelioma. Among the reports reviewed, one study found asbestos fibers in lung tissue in 92 percent of mesothelioma cases, compared with less than half of controls. Other reports showed mesothelioma cases rising over time. On diagnosis, the authors reported that observer variation was not insignificant even among experienced pathologists. For example, the Canadian Mesothelioma Panel accepted the diagnosis in only 50 percent of the cases submitted to it. The authors concluded that this tumor served more specifically than other tumors as an indicator of the asbestos hazard.

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: Review of published literature on asbestos and mesothelioma, supplemented by the authors' own diagnostic experience
• Who was studied: No population was studied directly; the authors reviewed published reports from many countries, including epidemiologic, pathologic and animal studies
• Exposure: Asbestos in general, covering chrysotile (serpentine) and the amphiboles crocidolite, amosite and anthophyllite, plus tremolite as a contaminant of talc; occupational, indirect ("bystander"), neighborhood, domestic and general environmental exposure
• Main results:
  • In the studies reviewed, all asbestos types except anthophyllite had been linked with mesothelioma in humans.
  • Cigarette smoking was described as the most important single known factor related to asbestos disease (for lung cancer), but no such association had been shown for mesothelioma.
  • In a cited study by Pooley using electron microscopy, lung tissue was positive for asbestos fibers in 92 percent of mesothelioma cases from various sources, compared with less than half of the control series.
  • In reviewed studies based on exposure histories, the share of mesothelioma cases with a definite or probable asbestos association ranged from 20 percent or less to 85 percent.
  • Reported cases increased over time. In the London series of Newhouse and Thompson, 10 cases died before 1950, 33 between 1950 and 1960, and 40 from 1960 to 1964.
  • In a cited Canadian survey, the Canadian Mesothelioma Panel accepted the mesothelioma diagnosis in only 50 percent of submitted cases.
  • In a cited cytology study by Klempman, malignant cells were identified in the fluid effusions of 22 of 27 mesothelioma cases.
• The authors' conclusion: The authors concluded that because most mesotheliomas appeared causally related to asbestos and no other agent had been similarly incriminated, this tumor served more specifically than others as an indicator of the asbestos hazard.
• Limitations the authors state:
  • The authors stated that observer variation in the diagnosis of mesothelioma was not insignificant, even among experienced pathologists.
  • The authors noted that published statistics did not yet give an annual national rate of mesothelioma in the United States, so an expected incidence could not be set.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Chrysotile, Crocidolite, Amosite, Anthophyllite, Tremolite, Lung Cancer.

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