Familial mesothelioma after intense asbestos exposure at home

Our plain-English summary of Familial mesothelioma after intense asbestos exposure at home, by F.P. Li, J. Lokich, J. Lapey, et al (JAMA, 1978).

The study

• Authors: F.P. Li, J. Lokich, J. Lapey, W.B. Neptune, E.W. Wilkins
• Journal: JAMA
• Published: 1978;240(5):467
• Type of article: Case report
• Cited by: 63 articles, as counted by NIH iCite
• Read it: PubMed
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002131).

In plain English

This case report described cancers in one family. The father worked as a pipe insulator at a shipyard for about 25 years (1940 to 1965), installing asbestos insulation on ships. Family members said his work clothes were often covered with a whitish, powdery dust. The mother shook the clothes out on the porch and laundered them in the kitchen while the children played nearby. The father, who smoked one to two packs of cigarettes a day, was diagnosed with asbestosis at age 60 and later developed lung cancer. An autopsy showed severe asbestosis and lung cancer. The mother, who had no workplace asbestos exposure, developed fluid around the right lung at age 50. A biopsy showed mesothelioma, and she died in August 1968. A daughter born in 1943, who grew up in the home, developed the same problem at age 34, and a biopsy showed mesothelioma. Two younger daughters had no diagnosable disease. The authors concluded the three cancers can be attributed to asbestos from the shipyard. They also wrote that it was possible asbestos did not cause the two mesotheliomas.

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 report of one family
• Who was studied: One family: the father (patient 1), the mother (patient 2), and three daughters (patients 3, 4 and 5). They lived for many years in a residential neighborhood about 6 km from the shipyard where the father worked.
• Exposure: The father worked as a pipe insulator at a shipyard for approximately 25 years (1940 to 1965) and installed asbestos insulation on ships. His exposure was reported to be particularly intense during World War II and several years after. The mother and children were exposed at home through his dusty work clothes, which the mother shook out on the porch and laundered in the kitchen. The article does not name a fiber type.
• Main results:
  • Father (patient 1): asbestosis was diagnosed at age 60. He later developed lung cancer (metastatic adenocarcinoma in the left upper lobe) and died. Autopsy showed severe pulmonary asbestosis and lung cancer. He had smoked one to two packs of cigarettes daily for several decades.
  • Mother (patient 2): a right pleural effusion developed at age 50. A pleural biopsy specimen showed mesothelioma. She was not a cigarette smoker and had no occupational asbestos exposure. She did not respond to radiotherapy and died in August 1968.
  • Daughter (patient 3), born in 1943: she lived in the parents' home throughout childhood and later held clerical and secretarial jobs without asbestos exposure. A right pleural effusion developed at age 34, and a pleural biopsy specimen revealed mesothelioma.
  • Two younger daughters were examined. Patient 4, aged 30, had slightly prominent lung markings on chest X-ray, but no pleural or lung disease could be diagnosed. Patient 5, aged 23, had normal clinical and X-ray findings.
  • Review of the tissue (histopathology) confirmed mesothelioma in both the mother and the daughter. The two tumors had a similar mixed (biphasic) appearance, with more extensive fibrosis in the mother's tumor.
• The authors' conclusion: The authors concluded that the three cancers in this family can be attributed to asbestos the father carried home from the shipyard on his work clothes. They said no other source of intense asbestos exposure was identified. They suggested possible contributing factors: genetic susceptibility to cancer in the family, and exposure at an early age for the daughter. They said long-term cancer surveillance of the two younger daughters is needed, because the latent period of asbestos-associated mesothelioma is often more than three decades.
• Limitations the authors state:
  • The authors stated it is possible that asbestos did not cause the mesotheliomas in the mother and daughter, since exposure to asbestos cannot be identified in the histories of all mesothelioma patients.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure.

Related studies

• Familial clustering of malignant mesothelioma — B. Risberg, J. Nickels, et al. (1980)
• Familial mesothelioma: a report of two families — S.P. Hammar, D. Bockus, et al. (1989)
• A cluster of familial malignant mesothelioma with del(9p) as the sole chromosomal anomaly — M. Musti, D. Cavone, et al. (2002)
• Familial mesothelioma: review and family study — H.T. Lynch, D. Katz, et al. (1985)
• DNA copy number changes in familial malignant mesothelioma — V. Ascoli, Y. Aalto, et al. (2001)
• Familial pleural malignant mesothelioma: clustering in three sisters and one cousin — V. Ascoli, C.C. Scalzo, et al. (1998)

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