Results Of Asbestos Exposure In Finland

Our plain-English summary of Results Of Asbestos Exposure In Finland, by R. Kiviluoto, L. Meurman (1970).

The study

• Authors: R. Kiviluoto, L. Meurman
• Published: Pneumoconiosis: Proceedings Of The International Conference, Johannesburg 1969 (H.A. Shapiro, Editor), Cape Town: Oxford University Press, Pp. 107-108 (1970)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library, J-M no. 001396. The article is still under copyright, so we describe it here rather than post it.

In plain English

This short conference report described workers of an asbestos mining company in Eastern Finland who were exposed almost purely to anthophyllite asbestos dust. Company records identified 1,092 people who had worked more than three months between 1936 and 1957. The authors analyzed causes of death in 33 deceased open-mine or mill workers exposed for longer than 10 years. They compared lung and gastrointestinal cancer deaths with expected Finnish rates. They also compared questionnaire answers with chest X-rays for 252 former workers. Among the 33 deaths, lung carcinoma was the commonest cause (8 cases, 24%), and 19 had asbestosis. There were 8 lung cancer deaths against 2.4 expected, a difference the authors called statistically highly significant. Gastrointestinal cancer deaths were 2 against 2.1 expected. No pleural or peritoneal mesothelioma was seen. Of the 1,092 workers, 244 had died, and 21 lung carcinoma cases were observed among these deaths. Of those 21, 13 were in workers exposed under 10 years, against 12 expected. About 45% of symptom-free workers and 75% of those with respiratory distress had pleural or lung changes on X-ray. The authors called for further study of these tumors.

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: Mortality study of an asbestos mining workforce, with lung and gastrointestinal cancer deaths compared against expected Finnish rates, plus a comparison of mailed health questionnaire answers with chest X-rays in former workers
• Who was studied: 1,092 people who had worked more than three months between 1936 and 1957 for an asbestos mining company in Eastern Finland. Causes of death were analyzed for 33 deceased open-mine or mill workers exposed longer than 10 years. Questionnaires and chest X-rays were available for 252 living former workers.
• Exposure: Almost purely anthophyllite asbestos dust from mining and milling. Exposure times ranged from 3 months to more than 20 years.
• Main results:
  • Among the 33 deaths of workers exposed longer than 10 years, carcinoma of the lung was the commonest cause of death (8 cases, 24%). Seven of these 8 also had asbestosis.
  • Of the 33 deaths, 19 had asbestosis. Uncomplicated asbestosis was the cause of death in 2 cases and asbestosis with cor pulmonale in 5 cases.
  • In the 33-death group, lung cancer deaths were 8 observed versus 2.4 expected from Finnish rates. The authors described the difference as statistically highly significant. The printed multiplier ('about 3-something times that expected') is unreadable in the scan.
  • In the 33-death group, gastrointestinal cancer deaths were 2 observed versus 2.1 expected, and the authors reported this was not higher than normal.
  • Not a single case of pleural or peritoneal mesothelioma was observed.
  • Of the 1,092 workers, 244 had died, and 21 lung carcinoma cases were observed among these 244 deaths.
  • Of the 21 lung carcinoma cases among the deceased, 13 had exposure shorter than 10 years. The expected number in Finland was printed as 12, and the authors considered this incidence normal.
  • Death certificates omitted asbestosis in some lung cancer cases that had radiologically very severe asbestosis. After amending on the basis of X-ray findings, lung cancer cases with asbestosis among workers exposed under 10 years rose from 1 to 6 of 13.
  • Among the 252 former workers, about 45% of those without respiratory symptoms had pleural or pulmonary pathology on X-ray, compared with 75% of those with respiratory distress.
  • Across the groups of increasing respiratory symptoms, the share with severe radiological lung pathology increased from 0 to 40%.
• The authors' conclusion: The authors concluded that the hazards of exposure to anthophyllite asbestos dust in Finland seemed comparable with those elsewhere (the word is partly illegible in the scan). They attributed a lower lung cancer excess than in another report to exposure times about 10 years shorter in their series. They stated that further studies were needed to find out whether gastrointestinal tumors and mesothelioma may be added to the hazards of anthophyllite asbestos dust.
• Limitations the authors state:
  • The authors noted that asbestosis was not mentioned on death certificates in some radiologically very severe cases, so death certificates alone undercounted asbestosis.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Anthophyllite, Chest X-Ray, Carcinoma, Lung Cancer, Peritoneal Mesothelioma.

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