Cancer And The Worker

Our plain-English summary of Cancer And The Worker, by P. Lehmann (1977).

The study

• Author: P. Lehmann
• Published: New York: New York Academy Of Sciences, Pp. 1-77 (1977)
• Our copy: from Johns-Manville's own medical library, J-M no. 003418. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1977 book was not a research study. It was a plain-language adaptation, written for workers, of papers from a 1975 conference on occupational cancer. It described other researchers' work on many workplace hazards. On asbestos, it reported a Mount Sinai study of 250 workers heavily exposed for three months or less, who died of lung cancer at three-and-a-half times the expected rate. It also reported a study of 1,249 New York City area asbestos insulation workers in which 57 of the 59 who developed lung cancer died, even though they had been regularly examined and x-rayed. It described an examination of 326 relatives of workers from one plant: 35 percent had x-ray evidence of asbestos-related lung disease, and four developed mesothelioma. It repeated an estimate that 300,000 to 400,000 of 1 million current and former U.S. asbestos workers could be expected to die of cancer. The book argued that no safe level of exposure to a carcinogen had been shown and that the only real solution was to clean up the workplace.

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: Plain-language book written for workers, adapted from the papers of a 1975 New York Academy of Sciences conference (Annals volume 271, Occupational Carcinogenesis). It is not original research: it summarizes studies done by others.
• Who was studied: No study population of its own. Among the groups it describes are New York City area asbestos insulation workers studied by Mount Sinai researchers from 1963 through 1974 (1,249 workers), 250 briefly exposed asbestos workers, and 326 household relatives of asbestos workers from one plant.
• Exposure: Many workplace carcinogens. Asbestos is described as used in insulation, fireproofing, textiles, cement and drywall compounds. The book does not name individual fiber types; it states that all commercial forms of asbestos have been linked with cancer. It also covers household exposure to asbestos carried home on work clothes.
• Main results:
  • In a study cited from Dr. Irving J. Selikoff of Mount Sinai, 250 asbestos workers heavily exposed for three months or less, at least 25 years earlier, died of lung cancer at three-and-a-half times the expected rate.
  • Among 1,249 New York City area asbestos insulation workers observed by Mount Sinai scientists from 1963 through 1974, 59 developed lung cancer. Although they had been regularly examined and x-rayed, 57 of the 59 died.
  • Mount Sinai investigators examined 326 relatives of asbestos workers from one plant whose first household contact had been 25 or 30 years earlier. X-rays showed evidence of asbestos-related lung disease in 35 percent of the relatives, and four cases of mesothelioma occurred. A footnote states that by 1977 all four had died.
  • The book repeated a scientists' estimate that of 1 million current and former U.S. asbestos workers, 300,000 to 400,000 can be expected to die of cancer: one in five from lung cancer, one in 10 from gastrointestinal cancer and one in 20 from mesothelioma.
  • The book stated that cigarette smokers with heavy asbestos exposure may be 90 times more likely than the average nonsmoker to develop lung cancer.
  • Citing Mount Sinai studies, the book reported that deaths from asbestosis among asbestos workers went down as dustiness decreased, but deaths from lung cancer were not necessarily reduced.
  • The book reported that recent studies among hard-rock gold miners showed fibers shorter than five micrometers can also cause cancer and nonmalignant respiratory disease.
  • On U.S. asbestos standards, the book stated that lung cancer was first mentioned as a concern in October 1975, when OSHA proposed 0.5 fibers per milliliter and NIOSH recommended 0.1 fibers per milliliter. Earlier limits had been designed only to prevent asbestosis.
• The authors' conclusion: The author argued that no safe level of exposure to a carcinogen such as asbestos has been shown, so any exposure above zero carries some risk. The book's position was that, until better diagnosis and treatment exist, the only real solution to occupational cancer is to clean up the workplace.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Insulator, Mesothelioma, No Safe Level of Exposure.

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