Asbestosis and malignancy

Our plain-English summary of Asbestosis and malignancy, by N.G. Demy, H. Adler (The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine, 1967).

The study

• Authors: N.G. Demy, H. Adler
• Journal: The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine
• Published: 1967;100(3):597-602
• Type of article: Historical article
• Cited by: 10 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. 001476).

Summary of the article

Two radiologists at the Somerset Hospital in Somerville, New Jersey, reported their experience with asbestosis and cancer. The paper was presented at the 1966 American Roentgen Ray Society meeting. They began with a historical review of how occupational diseases, including asbestosis, were recognised, and of industry's resistance to accepting responsibility. Their material came from 20 years' experience in a community where three industries employing 5,000 people used asbestos. They described 47 patients with malignancy: 37 proven cases of asbestosis with lung carcinoma and 10 mesotheliomas, of which 5 were pleural and 5 peritoneal. Occupational histories had to be obtained by persistent questioning, because the industries declined to give information. Most patients had exposures of about 15 to more than 25 years, and the latent period was generally longer than 20 years. One pleural mesothelioma occurred 17 years after 6 months of work in an asbestos plant. Patients with lung tumours were aged 38 to 78, and patients with mesothelioma 40 to 79. Squamous cell carcinoma was the predominant lung tumour type, followed by adenocarcinoma. In all autopsied cases, asbestos bodies were found in the lung parenchyma and in the tumour. In one case, a company physician had denied any dust exposure, but laboratory studies at Saranac confirmed advanced asbestosis. The authors concluded that their data supported a relationship between asbestosis and malignancy. They called for epidemiologic studies.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was written by two radiologists at Somerset Hospital in Somerville, New Jersey. It reported cases seen in their community hospital practice. The authors said it was not a planned research project. Drawing on 20 years' experience in a community where three industries used asbestos, they described 37 patients with proven asbestosis and lung carcinoma and 10 with mesothelioma. Their table lists five pleural and five peritoneal mesotheliomas. The article did not name any asbestos fiber type. Squamous cell carcinoma was the most common lung tumor type, followed by adenocarcinoma. The only woman in the series had a fibrosarcoma. Nearly all the lung cancers were intimately part of underlying lung fibrosis, advanced pleural thickening and calcification. Lung tumors were generally in patients over 60, and mesotheliomas in younger patients. One patient who worked in an asbestos plant for 6 months at age 22 died 17 years later of pleural mesothelioma. The authors said work histories were hard to obtain and often approximate, and that the industries declined to give information. The authors concluded that they were offering additional clinical data to support others' experience of a relation between asbestosis and malignancy.

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 community hospital radiology practice; the authors state it was not a planned study
• Who was studied: 47 patients with malignancy at a community hospital in Somerville, New Jersey, over 20 years: 37 with asbestosis and lung carcinoma and 10 with mesothelioma (table lists 5 pleural and 5 peritoneal). The community had three industries using asbestos.
• Exposure: Occupational asbestos exposure in local industries. No fiber type is named. Exposure durations in the table range from 6 months to about 30 years or 'long term'. One described job used asbestos as a filler in wall board.
• Main results:
  • Among the lung tumors, squamous cell carcinoma was the most common cell type, then adenocarcinoma. One fibrosarcoma occurred in the only female patient (Case 21).
  • Nearly all the bronchogenic carcinomas were intimately part of underlying pulmonary fibrosis, advanced pleural thickening and calcification.
  • Lung tumors were generally in patients over 60, and mesotheliomas in younger patients. The youngest mesothelioma patient was 40 and the oldest 79.
  • One patient worked in an asbestos plant for 6 months at age 22 and died 17 years later of pleural mesothelioma (Case 40).
  • For one lung cancer patient (Case 15), an industry physician said the patient could not have asbestosis. The lungs were sent to Saranac for incineration, spectrographic and petrographic studies, which confirmed the histologic diagnosis of advanced asbestosis.
  • The mesotheliomas were classified as such because no other primary tumor was found. One had a concomitant lymphosarcoma (Case 38).
• The authors' conclusion: The authors concluded that they were offering additional clinical data on asbestosis and its relation to malignancy, to support the experience of others.
• Limitations the authors state:
  • Exposure durations were largely approximations because patients were reluctant, evasive or ignorant about their occupational histories.
  • The industries declined to provide information beyond confirming employment.
  • Specific occupational data were difficult to obtain.
  • The case collection was incidental to routine radiology practice rather than a systematic search.

Topics

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

Medical terms in this study, explained in our Lexicon: Roentgen, Occupational Disease, Carcinoma, Mesothelioma, Pleural Mesothelioma, Squamous Cell Carcinoma, Adenocarcinoma, Asbestos Bodies.

Related studies

• Asbestosis associated with bronchogenic carcinoma — R. Stoll, R. Bass, et al. (1951)
• Sputum cytology of asbestosis patients — M.S. Huuskonen, E. Taskinen, et al. (1978)
• Relation between exposure to asbestos and mesothelioma — I.J. Selikoff, J. Churg, et al. (1965)
• Asbestos exposure, smoking, and neoplasia — I.J. Selikoff, E.C. Hammond, et al. (1968)
• Combined effect of asbestos exposure and smoking on mortality from lung cancer in factory workers — G. Berry, M.L. Newhouse, et al. (1972)
• Use of job-exposure matrix in an occupational analysis of lung and bladder cancers on the basis of death certificates — D. Coggon, B. Pannett, et al. (1984)

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