Der Berufskrebs der Asbestarbeiter

Our plain-English summary of Der Berufskrebs der Asbestarbeiter, by M. Nordmann (1938).

The study

• Author: M. Nordmann
• Published: Zeitschrift fur Krebsforschuhg V.97 (1938)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1938 German pathology paper from the Pathological Institute in Hannover described two autopsies done there and set them beside four published cases from America and England, making six cases of asbestosis combined with lung cancer. The author's cases were a 35-year-old woman who had worked 7 years in an asbestos factory (carding, spinning and weaving) and a 55-year-old man who had worked 7 years preparing asbestos for spinning. Both had keratinizing squamous cell carcinoma of the left lower lobe, with asbestos needles and asbestos bodies found in the tumor. Across the six cases, 15 to 21 years, on average about 18, passed from first asbestos work to death from cancer, and three people were aged 35 or 41. Of 12 asbestosis autopsies known in Germany, 2 had cancer (about 17%). The article did not name a fiber type. The author concluded that this was an occupational cancer of asbestos workers. The author also stated that percentages from such small numbers could not claim to give the true rate, and that it was unknown which property of asbestos causes the tumor.

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: two autopsy cases from the author's institute, compiled with four previously published cases and crude autopsy counts from Germany and England
• Who was studied: Six people with asbestosis and lung cancer, aged 35 to 71. Two were the author's own autopsy cases in Hannover (a 35-year-old woman and a 55-year-old man). Four were from the literature: Lynch and Smith (America), two cases by Gloyne (England), and Egbert and Geiger (America).
• Exposure: Work in asbestos factories. The woman (Case 5) worked 7 years, 2 of them in asbestos carding and the rest in spinning and weaving. The man (Case 6) worked 7 years, between ages 36 and 43, in the asbestos room preparing material for spinning. The fiber type is not named.
• Main results:
  • Case 5 (35-year-old woman): keratinizing squamous cell carcinoma of the left lower lobe and pleura, with packets of asbestos needles or asbestos bodies in the tumor, and metastases in the liver and kidney
  • Case 6 (55-year-old man): a heavily broken-down keratinizing squamous cell carcinoma of the left lower lobe containing asbestos needles and asbestos bodies
  • Case 6: a second area in the right lower lobe showed strong proliferation of the bronchial lining, which in places spread as true carcinoma
  • Across all six cases, the time from first asbestos work to death from cancer was 15 to 21 years, averaging about 18 years
  • Half of the six cancer cases were young: two were 35 and one was 41
  • In Germany, 12 autopsies were known including the author's own, and 2 of these had cancer (about 17%)
  • In Hannover, 3 asbestosis cases had been autopsied, 2 of them with cancer
  • In Wood's English series, 2 of 12 asbestosis deaths had lung cancer (17%), leaving aside an unclear third case with pleural deposits of growth
  • In the author's two cases, the lungs showed many giant cells around asbestos bodies
  • In most of the detailed cases the cancer lay in the lower lobe and was a keratinizing squamous cell carcinoma (the exact fraction is unreadable in the scan)
• The authors' conclusion: The author concluded that lung cancer in asbestosis is causally related to the disease and is an occupational cancer of asbestos workers. In the author's view it appears about 18 years after asbestos work began, regardless of age, when several years were worked in asbestos dust.
• Limitations the authors state:
  • The author stated that percentages calculated from such small numbers cannot claim to reflect the true percentage
  • The author acknowledged that the co-occurrence could be coincidental, as Gloyne and Wood had suggested
  • The author stated that it was not yet known which properties of asbestos cause the tumor
  • The author stated that morphological methods could not currently draw more from the findings in support of a causal link

Topics

Medical terms in this study, explained in our Lexicon: Pathology, Lung Cancer, Carding, Squamous Cell Carcinoma, Asbestos Bodies.

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