Benign asbestos pleural effusions

Our plain-English summary of Benign asbestos pleural effusions (Lancet, 1988).

The study

• Journal: Lancet
• Published: 1988;1(8595):1145-6
• Type of article: Editorial
• Read it: PubMed
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000888).

In plain English

This was an unsigned Lancet editorial reviewing published reports on benign asbestos pleural effusion. It presented no new research. It noted that the condition has no pathological characteristics, so diagnosis rests on a history of asbestos exposure and on excluding other causes. It cited a 1962 report of an insulation worker and stated that well over a hundred similar cases had since been described. In a survey by Epler and colleagues, thirty-five idiopathic effusions were found among 1135 asbestos-exposed workers and none among 707 controls. Martensson and colleagues found asbestos exposure significantly more frequent in men with idiopathic effusions than in controls. Hillerdal and Ozesmi showed that effusions can occur many years after exposure. The editorial stated that no diagnostic features of the pleural fluid had come to light, and that acute presentations may be identical to those of mesothelioma. It concluded that the condition is an accepted clinical entity but remains a diagnosis by exclusion, together with a period of observation to exclude 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: Unsigned editorial reviewing published case reports, surveys, case-control studies and animal experiments; no new data
• Who was studied: No study population of its own; the editorial reviewed published reports, which it said had described well over a hundred cases
• Exposure: Asbestos exposure in general, including an insulation worker in the first reported case and crocidolite asbestos injected into the rabbit pleural space in an animal experiment
• Main results:
  • Cited study (Epler et al): in a radiographic survey of 1135 asbestos-exposed workers and 707 controls, thirty-five idiopathic effusions were found among the asbestos workers and none in the control group (p less than 0.001)
  • Cited study (Martensson et al): asbestos exposure was significantly (p less than 0.01) more frequent in men with idiopathic effusions than in controls
  • Cited study (Hillerdal and Ozesmi): effusions can occur many years after exposure, not only in the first one or two decades
  • Cited study (Hillerdal and Ozesmi's large series): 26% of patients had eosinophilia (printed as 'cosinophilia' in the scanned text)
  • The editorial stated that few extensive studies of the pleural fluid had been done and no diagnostic features had come to light
  • The editorial stated that acute presentations may be identical to those of mesothelioma
• The authors' conclusion: The editorial concluded that benign asbestos pleural effusion is an accepted clinical entity but lacks specific diagnostic features, so it remains a diagnosis by exclusion, together with a period of observation to exclude malignancy

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Benign Asbestos Pleural Effusion.

Related studies

• Prevalence and incidence of benign asbestos pleural effusion in a working population — G.R. Epler, T.C. McLoud, et al. (1982)
• MicroRNA and mRNA features of malignant pleural mesothelioma and benign asbestos-related pleural effusion — G. Ak, S.C. Tomaszek, et al. (2015)
• Benign asbestos pleural effusion: diagnosis and course — B.W. Robinson, A.W. Musk (1981)
• Diagnostic usefulness of tumour marker levels in pleural effusions of malignant and benign origin — F. Kuralay, Z. Tokgöz, et al. (2000)
• Symptomatic benign pleural effusions among asbestos insulation workers: residual radiographic abnormalities — R. Lilis, Y. Lerman, et al. (1988)
• Clinical Investigation of Benign Asbestos Pleural Effusion — N. Fujimoto, K. Gemba, et al. (2015)

Browse more research in Lancet, or return to medical research.