Epidemiology of diffuse mesothelial tumors: evidence of an association from studies in South Africa and the United Kingdom

Our plain-English summary of Epidemiology of diffuse mesothelial tumors: evidence of an association from studies in South Africa and the United Kingdom, by J.C. Wagner (Annals of the New York Academy of Sciences, 1965).

The study

• Author: J.C. Wagner
• Journal: Annals of the New York Academy of Sciences
• Published: 1965;132(1):575-8
• Cited by: 45 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. 001546).

Summary of the article

This conference paper reviewed evidence linking asbestos exposure to diffuse mesothelioma in South Africa and the United Kingdom. In South Africa, the first case of pleural mesothelioma with asbestos bodies in the lung was diagnosed in Johannesburg in 1956, after patients in Kimberley were found to have pleural malignancy rather than tuberculosis. Detailed life histories were taken from patients and relatives. By 1959 an association with the Cape asbestos fields or industrial asbestos use was established in 32 of 33 proven pleural cases. The average time from first exposure to tumor was 40 years. By the end of 1961, 87 pleural and two peritoneal mesotheliomas had been diagnosed. Only two lacked a history of asbestos exposure, and only one lacked definite crocidolite exposure. Twelve had industrial exposure. The rest came from the Cape asbestos fields region, many through environmental exposure from living near mills and dumps. No cases were reported from the amosite or chrysotile mining areas. The total later exceeded 100. In Britain, thoracic surgery and pathology departments examined lung tissue, sputum and occupational histories. Asbestos exposure was found in 5 of 6 cases in Cardiff, 11 of 13 in Newcastle and 2 of 3 in Portsmouth. The author concluded that the association was with asbestos exposure, sometimes slight, rather than with asbestosis. He reported that crocidolite exposure was established in most British cases and that no indisputable pure chrysotile case had been found.

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

The author described mesothelioma cases in South Africa and Britain and patients' exposure histories. It reported case counts, not rates. By 1959, 32 of 33 patients with proven pleural mesothelioma had been linked to the Cape Asbestos fields or industrial asbestos use. Most had lived near the mines and mills rather than working with asbestos. By the end of 1961, 87 pleural and two peritoneal mesotheliomas had been diagnosed. Only two lacked an established history of asbestos exposure, and only one lacked definite crocidolite exposure. Some miners had slight exposure and no evidence of asbestosis, so the association appeared to be with asbestos dust, not asbestosis. Tumors developed an average of 40 years after first exposure. In Britain, asbestos exposure was found in five of six cases at Sully Hospital, 11 of 13 in Newcastle and two of three in Portsmouth. Most British cases had been exposed to several asbestos types, so no single type was clearly implicated, though crocidolite exposure was established in a majority and no indisputable pure chrysotile case was found. The author called the British work preliminary.

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: Descriptive report of mesothelioma case series and patients' asbestos exposure histories (no comparison group or rates)
• Who was studied: Patients with histologically diagnosed diffuse mesothelioma: in South Africa, 87 pleural and two peritoneal cases diagnosed by the end of 1961 (many from Kimberley and the Cape Asbestos fields region); in Britain, cases from Sully Hospital near Cardiff (6), Newcastle-upon-Tyne (13), Portsmouth (3) and Dunbarton (2 referred)
• Exposure: Asbestos dust, mainly crocidolite in South Africa: environmental exposure from living near mines, mills and dumps; occupational exposure in mining, road work and railway yards using dump material, well digging, and industrial use. In Britain, mixed asbestos types, including ship-building areas and boiler lagging.
• Main results:
  • By 1959, an association with the Cape Asbestos fields or industrial use of asbestos was established in 32 of 33 patients with histologically proven pleural mesothelioma; most of them had not worked with asbestos but had lived near the mines and mills
  • In South African cases, the average period between first exposure and tumor development was 40 years
  • Of the 89 South African cases (87 pleural, two peritoneal) diagnosed by the end of 1961, asbestos exposure could not be established in only two, and only one had no definite exposure to crocidolite
  • Of the 87 pleural cases, 12 had industrial exposure and the rest came from the region of the Cape Asbestos fields
  • Among some miners, exposure seemed slight and there was no evidence of asbestosis, so the association appeared to be with asbestos dust rather than asbestosis
  • No case of mesothelioma had been reported from the other South African areas, which produce amosite and chrysotile (the sentence is cut off in the text)
  • At Sully Hospital, five of six pleural mesothelioma cases had a definite history of asbestos exposure
  • In Newcastle-upon-Tyne, there was evidence of asbestos exposure in 11 of 13 histologically diagnosed cases
  • In Portsmouth, there was evidence of asbestos exposure in two of three cases
  • In Britain, most cases had been exposed where several asbestos types were used, so no single type could be clearly implicated as in South Africa
  • In Britain, crocidolite exposure was established in a majority of cases, and no indisputable case of pure chrysotile exposure had been found
  • In British cases, the latent period between first exposure and diagnosis was again about 40 years
• The authors' conclusion: The author concluded that the British findings confirmed the South African finding that the association is with asbestos exposure and not necessarily with asbestosis
• Limitations the authors state:
  • The British findings were preliminary and the investigations far from completed
  • In Britain, a single asbestos type could not be clearly implicated because most cases were exposed where several types were used

Topics

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

Medical terms in this study, explained in our Lexicon: Epidemiology, Asbestos Exposure, Mesothelioma, Pleural Mesothelioma, Asbestos Bodies, Kimberley, Cape Asbestos, Peritoneal Mesothelioma.

Related studies

• Radiological and pathological correlations in asbestosis in the Republic of South Africa and the United Kingdom. II. A preliminary study of observer variation in the classification of radiographs of asbestos-exposed workers and the relation of pathology and x-ray appearances — A. Caplan, J.C. Gilson, et al. (1965)
• Radiological and pathological correlations in asbestosis in the Republic of South Africa and the United Kingdom. I. A proposed radiological classification of asbestosis — G.K. Sluis-Cremer, C.P. Theron (1965)
• Excess mortality from stomach cancer, lung cancer, and asbestosis and/or mesothelioma in crocidolite mining districts in South Africa — J.L. Botha, L.M. Irwig, et al. (1986)
• The social context of occupational disease: asbestos and South Africa — J. Myers (1981)
• Double standards: the multinational asbestos industry and asbestos-related disease in South Africa — J. McCulloch, G. Tweedale (2004)
• Mesotheliomatous tumors in South Africa: pathology and experimental pathology — I. Webster (1965)

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