Susceptibility To The Asbestos-Related Diseases

Our plain-English summary of Susceptibility To The Asbestos-Related Diseases, by J.C. Wagner (1978).

The study

• Author: J.C. Wagner
• Published: Proceedings Of The Asbestos Symposium, Johannesburg, October 3-7, 1977, Randburg, South Africa: National Institute For Metallurgy, Pp. 109-119 (1978)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library, J-M no. 004013. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1977 Johannesburg symposium paper was the author's review of whether susceptibility to asbestos-related diseases could be identified and acted on. It covered pre-employment examinations, removal from dust exposure, and other dusts such as quartz and talc. Drawing on published studies, the author wrote that there was no significant evidence that HLA genetic typing would identify susceptible people. No known immunological test would predict asbestosis or asbestos-associated cancers at pre-employment examination, and there was no published evidence that removal from exposure prevents progression. The author also described the author's own group's findings. Other researchers had reported depressed T cell function in asbestosis, and some of them suggested it increased with severity; using a lymphocyte test (PHA), the group did not obtain such results. In smokers, lymphocytes were increased across all radiological categories of asbestosis and pleural change studied, except mesothelioma cases, much more markedly than any changes caused by asbestos. Mesothelioma cases showed small, non-specific decreases in lymphocytes. The author urged discouraging smoking. The author concluded that no specific tests indicated susceptibility, before or after exposure. Other participants' studies in the printed discussion are not this paper's findings.

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: Review / conference paper discussing published work, with brief preliminary immunological findings from the author's own group (no numbers given)
• Who was studied: No single study population. The paper reviewed published studies of asbestos workers and referred to work at the MRC Pneumoconiosis Unit of Llandough Hospital, Wales, and to the author's group's immunological studies of asbestos-exposed people (numbers not given).
• Exposure: Asbestos dust in general, including discussion of chrysotile, amosite and crocidolite standards and of crocidolite and mesothelioma, plus smoking and other dusts (quartz, talc) in asbestos-exposed populations
• Main results:
  • The author wrote that there was no significant evidence that HLA typing would help identify susceptible people at pre-employment examination.
  • The author wrote that no known immunological test would indicate at pre-employment examination who would develop asbestosis or asbestos-associated malignancies.
  • The author wrote that there was no published evidence that removal from exposure prevents progression of the disease.
  • Other papers had demonstrated depressed T cell function in asbestosis, and the authors of the first two of these papers suggested that the depression increased with severity. Using phytohaemagglutinin (PHA), the author's group did not obtain such results in relation to asbestosis.
  • In the author's group's studies, smokers showed an overall increase in lymphocytes, particularly T lymphocytes, in all radiological categories of asbestosis and pleural changes studied, with the exception of the mesothelioma cases. This effect was much more marked than any changes caused by asbestos.
  • In mesothelioma cases, the author's study found a small decrease in lymphocytes and a decrease in T lymphocytes measured by rosetting.
  • The author's view was that smoking should be discouraged from the time of the initial examination.
• The authors' conclusion: The author concluded that there were no specific tests to indicate susceptibility to asbestos-related disease, before or after exposure, but that more information could be obtained from the many tests already done.
• Limitations the authors state:
  • The immunological findings in mesothelioma were non-specific, having been seen in patients with other malignant tumours.
  • Whether people with raised rheumatoid and anti-nuclear factors go on to develop severe asbestosis can only be shown by long-term follow-up.

Topics

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

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