Part III Pulmonary Asbestosis January 19, 1934

Our plain-English summary of Part III Pulmonary Asbestosis January 19, 1934, by P. Ellman (1934).

The study

• Author: P. Ellman
• Published: British Journal of Radiology, Volume 7. January 19, 1934
• 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 1934 paper was one author's contribution to a discussion on pneumonoconiosis held at the Institute on January 19, 1934. It was not a formal study. The author described the clinical, X-ray and pathological features of pulmonary asbestosis, drawing on their own patients and on the dust exposure from industrial use of asbestos. On X-ray, the disease showed a fine diffuse fibrosis that began at and mainly involved the lung bases. The author reported that isolated asbestosis bodies in sputum showed only past exposure to asbestos dust, while bodies in radially arranged clumps suggested breakdown of lung tissue. Among twenty of the author's own definite cases, most of whom were not at work, seven had tuberculosis. Two case histories described asbestosis later complicated by tuberculosis. The author also described a terrier kept for ratting in an asbestos factory whose lungs showed pleural changes. The author concluded that pulmonary asbestosis, once established, is progressive with a bad prognosis. The author said time had yet to show whether its tuberculosis risk was less than, equal to, or greater than in silicosis. The scanned text is incomplete.

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: Contribution to a discussion meeting: a clinical, radiological and pathological description of pulmonary asbestosis with case histories, including one case in a dog
• Who was studied: The author's own cases of asbestosis: twenty definite cases, most of whom were not at work. Two human case histories are described in detail, plus one dog kept in an asbestos factory.
• Exposure: Inhalation of asbestos dust from the industrial use of asbestos. No fiber types are named.
• Main results:
  • Of twenty of the author's own definite cases of asbestosis, seven had tuberculosis. Three of those seven were alive at the time of writing.
  • X-ray findings were said to confirm the clinical picture: a fine diffuse fibrosis that began at, and mainly involved, the bases of the lungs.
  • On pathology, the visceral pleura was described as usually considerably thickened.
  • Isolated asbestosis bodies in the sputum were taken to indicate only previous exposure to asbestos dust, not necessarily disease.
  • In the author's experience, where there was lung fibrosis, the number of asbestosis bodies in the sputum appeared to vary with how extensive the disease was.
  • Case 1 was a woman with advanced asbestosis whose X-rays raised suspicion of added tuberculosis. A footnote reported that tubercle bacilli had recently been found in her sputum.
  • A second case was described as pure pulmonary asbestosis that was later complicated by tuberculosis.
  • A terrier dog spent most of its life in an asbestos factory, where it was kept for ratting. It developed cough and breathlessness and was put down. Its lungs showed general opacity of the visceral pleura with patches of localised pleural thickening.
  • The author stated, alongside a table from the Chief Inspector of Factories' 1931 report, that the time from exposure to death in asbestosis is only half that in silicosis. The table's numbers are unreadable in the scan.
• The authors' conclusion: The authors concluded that pulmonary asbestosis, once established, is a progressive disease with a bad prognosis, and that the tuberculosis risk in asbestosis must be reckoned with.
• Limitations the authors state:
  • The author stated that time had yet to show whether the tuberculosis risk in asbestosis is less than, equal to, or greater than that in silicosis.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Fibrosis, Sputum, Prognosis, Silicosis.

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