Recent Advances And Perspectives Relevant To The Pathology Of Asbestos-Related Diseases In Man

Our plain-English summary of Recent Advances And Perspectives Relevant To The Pathology Of Asbestos-Related Diseases In Man, by M. Kannerstein (1980).

The study

• Author: M. Kannerstein
• Published: Biological Effects Of Mineral Fibres (J.C. Wagner, Editor), Lyon: Iarc Scientific Publications, Volume 30, Pp. 149-162 (1980)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library, J-M no. 000822. The article is still under copyright, so we describe it here rather than post it.

In plain English

This was a brief narrative review of recent work on the pathology of asbestos-related disease in humans, written for a symposium. It presented no new series of patients, although a few remarks on mesothelioma variants drew on the author's personal observations. The author covered asbestosis, lung carcinoma, mesothelioma, immune findings and fibre measurement in human tissue. Among the studies described, Whitwell and colleagues (1977) found that 78 of 100 mesothelioma cases had 100,000 or more fibres per gram of lung, while 71 of 100 control cases had less than 20,000. A report by Jones and colleagues on 86 mesothelioma cases found about 10 times as much amosite and crocidolite as in controls, with the same amount of chrysotile in both. Sébastien and colleagues studied 29 patients, most of whom had asbestos exposure. In the positive cases, parietal pleura fibres were overwhelmingly short chrysotile, and lung retention was not a good indicator of pleural retention. The author concluded that progress was being made in diagnosing mesothelioma, but that uncertainties and deficiencies still existed in almost every area.

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: Narrative review of published studies and other papers in the same symposium
• Who was studied: No new patient series of its own. The review covered published human pathology studies and symposium reports on asbestos-related disease, including autopsy series, mesothelioma panels and lung-fibre studies. A few remarks on mesothelioma variants are footnoted as the author's personal observations.
• Exposure: Asbestos in general, with discussion of amosite, crocidolite, chrysotile, anthophyllite and tremolite. Attapulgite, a fibrous mineral other than asbestos, was also mentioned.
• Main results:
  • Whitwell et al. (1977) compared 100 mesothelioma cases, 100 lung carcinoma cases and 100 controls. 78 of the mesothelioma cases had 100,000 or more fibres per gram of lung tissue, while 71 of the control cases had less than 20,000.
  • Jones et al. (symposium report) studied lung tissue from 86 confirmed mesothelioma cases. On average the tissue held about 10 times as much amosite and crocidolite as controls, while chrysotile was the same in both groups. 30 cases contained no chrysotile, and only two had chrysotile but no amphiboles.
  • Whitwell (1978), in the control group, found pleural plaques in 55% of patients with over 20,000 fibres per gram, compared with 5.5% of those with lower counts.
  • Sébastien et al. (symposium report) studied lung parenchyma and parietal pleura from 29 patients, most of whom had asbestos exposure. The word describing that exposure is cut off in the scan.
  • In the Sébastien et al. report, more than half of the 29 cases were significantly positive for fibres in the parietal pleura, especially in plaques. In the positive cases the pleural fibres were overwhelmingly short chrysotile, and lung retention was not a good indicator of pleural retention.
  • Vianna and Polan (1978) found that a significantly greater number of female mesothelioma patients than controls had husbands or fathers employed in asbestos-using industries, or had lived near an asbestos facility.
  • Selikoff (1979) was cited for a five-fold increased death rate from bronchogenic carcinoma in nonsmoking asbestos insulation workers compared with nonsmoking, nonasbestos workers.
• The authors' conclusion: The author concluded that progress was being made in diagnosing mesothelioma from morphological studies, but that uncertainties and deficiencies still existed in almost every area. The author also wrote that the predominant role of amphiboles in forming asbestos bodies appeared to be established.
• Limitations the authors state:
  • The author stated that the review touched on only certain parts of the ongoing research effort.

Topics

Medical terms in this study, explained in our Lexicon: Pathology, Mesothelioma, Carcinoma, Amosite, Crocidolite, Chrysotile, Asbestos Exposure, Parietal Pleura.

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