Association Between Malignant Tumors Of The Lungs And Pleurae And Asbestosis: A Retrospective Study

Our plain-English summary of Association Between Malignant Tumors Of The Lungs And Pleurae And Asbestosis: A Retrospective Study, by S. Yazicioglu, K. Oktem, R. Ilcayto, et al (1978).

The study

• Authors: S. Yazicioglu, K. Oktem, R. Ilcayto, K. Balci, B.S. Sayli
• Published: Chest 73(1):52-56, January (1978)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 002162. The article is still under copyright, so we describe it here rather than post it.

In plain English

This retrospective study reviewed the hospital files of 221 patients with primary malignant tumors of the lungs or pleura admitted to the Diyarbakir Chest Hospital in southeast Turkey between 1968 and 1976. Of these, 44 had pleural tumors and 177 had lung tumors; tumor types were not distinguished. The authors calculated minimum rates per 100,000 inhabitants by where patients lived. They compared five towns with extensive handling of chrysotile asbestos, which was used as a whitewash without any industrial basis, with towns where asbestos is not found or used. For pleural tumors the rate was 10.55 in the asbestos towns (24 cases) versus 0.92 in the other towns (2 cases), a ratio of 11.4 to 1. For lung tumors it was 14.07 versus 5.50 (32 versus 12 cases), a ratio of 2.5 to 1. Over 90 percent of the men smoked and none of the women did. The authors attributed the higher rates to chrysotile asbestos dust, especially for pleural tumors. They noted that the rates are minimums, because they were based only on admissions to this one hospital and some patients may have gone elsewhere.

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: Retrospective review of hospital records, with area-based rates per 100,000 inhabitants calculated from 1970 census populations
• Who was studied: 221 patients with primary malignant tumors of the lungs or pleura (44 pleural, 177 pulmonary) admitted to Diyarbakir Chest Hospital, Turkey, from 1968 to 1976, drawn from ten cities of southeast Turkey (population 3,293,649)
• Exposure: Non-industrial environmental exposure to chrysotile asbestos, which was dug locally and used as a household whitewash, in Cermik, Ergani and Gungus (Diyarbakir), Maden (Elazig) and Siverek (Urfa). These towns were compared with towns where asbestos is not found or used.
• Main results:
  • Across all ten cities, the overall minimum rate was 6.70 per 100,000 inhabitants: 1.33 per 100,000 for pleural tumors and 5.37 per 100,000 for pulmonary tumors
  • In the areas with extensive handling of asbestos there were 24 pleural and 32 pulmonary cases. In the areas with no asbestos there were 2 pleural and 12 pulmonary cases.
  • Pleural tumor rate: 10.55 per 100,000 in the areas with extensive asbestos versus 0.92 per 100,000 in the areas with no asbestos, a ratio of 11.4 to 1
  • Pulmonary tumor rate: 14.07 per 100,000 in the areas with extensive asbestos versus 5.50 per 100,000 in the areas with no asbestos, a ratio of 2.5 to 1
  • Both tumor types combined: 24.62 per 100,000 in the areas with extensive asbestos versus 6.42 per 100,000 in the areas with no asbestos, a ratio of 3.8 to 1
  • Of all 221 patients, 179 (about 81 percent) were men. Among the pulmonary tumor patients about 87 percent were men. Among the pleural tumor patients, the differences by age and sex did not remain.
  • Over 90 percent of the men were smokers and none of the women were smokers
• The authors' conclusion: The authors concluded that the higher tumor rates in the areas with extensive handling of asbestos were due to chrysotile asbestos dust, especially for the pleural cases. They suggested that pleural tumors occurred similarly in women because women use the mineral in household tasks.
• Limitations the authors state:
  • The rates come only from admissions to the chest hospital and are therefore minimum rates
  • The hospital functioned mainly as a tuberculosis hospital until about six years before the study
  • Some patients with tumors were likely never to come to the hospital, and some may have been referred to other centers
  • No distinction was made between tumor types, and some pleural cases were related to the lungs

Topics

Medical terms in this study, explained in our Lexicon: Pleura, Chrysotile, Whitewash.

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