Pleural reaction associated with asbestos exposure

Our plain-English summary of Pleural reaction associated with asbestos exposure, by T.F. Collins (The British Journal of Radiology, 1968).

The study

• Author: T.F. Collins
• Journal: The British Journal of Radiology
• Published: 1968;41(489):655-61
• Cited by: 13 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. 001441).

In plain English

This 1968 article from the Durban Chest Clinic, South Africa, reviewed earlier reports of asbestos-related pleural disease and described the author's own observations. The author listed people seen at the clinic with calcified pleural plaques. They included a man with childhood environmental exposure while his father was an engineer on an asbestos mine, a clerk who supervised a surface crocidolite mine for under four months in 1922, and two asbestos-cement labourers. Another was an Indian man who had worked in a rubber factory where he could inhale relatively large quantities of talc powder. The author cited reports that tremolite in talc may explain asbestos bodies seen with talc exposure. The main analysis covered 15 asbestos-cement workers in Durban, all African men, whose X-rays showed pleural reaction. Asbestos bodies were found in the sputum of most of them, and more than half had digital clubbing. Some lesions may have had other causes, such as a chest stab wound, earlier surgery or possible tuberculosis. The author concluded that it was reasonable to attribute the pleural disease in most cases to asbestos exposure.

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: Literature review combined with case descriptions and a clinic case series (analysis of 15 patients with radiological pleural reaction)
• Who was studied: 15 workers from an asbestos-cement industry in Durban, South Africa, who showed pleural reaction on X-ray, all African men; plus individual people with pleural calcification examined at the Durban Chest Clinic during the previous two years
• Exposure: Work in an asbestos-cement industry. The individual clinic cases had various exposures: childhood environmental exposure while the father worked on an asbestos mine, under four months supervising a surface crocidolite mine, asbestos-cement work, carpentry, paint making with 'asbestine', and the opportunity to inhale talc powder in a rubber factory. For the talc case, the author cited reports that Transvaal talc deposits are often associated with thin bands of asbestos and that tremolite in talc may account for asbestos bodies.
• Main results:
  • Among the asbestos-cement workers, asbestos bodies were present in the sputum of most of the men; the author noted this indicates exposure to asbestos
  • Digital clubbing was found in more than half of the asbestos-cement workers. According to the author it was not observed among workers recalled from the other groups
  • The author suggested other possible causes for some lesions: a stab wound of the chest in one man, post-surgical scarring in another, and a probable healed tuberculous focus in a third
  • Two of the 15 men had earlier long service with another asbestos-cement company
  • One worker was admitted to hospital with a right-sided pleural effusion in October 1966. It cleared on anti-tuberculosis treatment, but tuberculous pleurisy was not confirmed. The author suggested it could have been asbestos pleurisy
  • All the workers described were African men. The author stated that their Heaf tuberculin reactions probably indicated tuberculosis infection, but that this finding was not significant in this population
  • The author proposed that the two classes of X-ray abnormality previously described for asbestosis correspond to 'acute' and 'chronic' forms of the disease
• The authors' conclusion: The author concluded that it seemed reasonable to attribute the pleural disease in most of the cases described to asbestos exposure, and that it was probably the earliest sign of disease produced under these conditions
• Limitations the authors state:
  • The author noted that asbestos bodies in sputum only confirm exposure to asbestos
  • The author noted that the positive tuberculin reactions were not necessarily significant, because weak reactions are rare in adult African men in the area

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Pleural plaques and thickening.

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

Related studies

• Fiber localization and its relationship to lung reaction in rats after chronic inhalation of chrysotile asbestos — K.E. Pinkerton, P.C. Pratt, et al. (1984)
• Pulmonary granulomatous reaction: talc pneumoconiosis or chronic sarcoidosis? — P. Tukiainen, J. Nickels, et al. (1984)
• Chronic pleuritic pain in four patients with asbestos induced pleural fibrosis — A. Miller (1990)
• Pleurectomy for persistent pain in benign asbestos-related pleural disease — D.I. Fielding, J.L. McKeon, et al. (1995)
• Asbestos and the pleura: a review — D.W. Cugell, D.W. Kamp (2004)
• Asbestos-induced pleural fibrosis and impaired lung function — D.A. Schwartz, L.J. Fuortes, et al. (1990)

Browse more research in The British Journal of Radiology, or return to medical research.