The American Journal of Roentgenology - Radium Therapy and Nuclear Medicine

Our plain-English summary of The American Journal of Roentgenology - Radium Therapy and Nuclear Medicine, by E.P. Pendergrass (1958).

The study

• Author: E.P. Pendergrass
• Published: American Journal of Roentgenology, Volume 80 No1. July 1958
• 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 article is the 1957 Caldwell Lecture to the American Roentgen Ray Society. It is a lecture and narrative review, not a formal study. The author described X-ray diagnosis of silicosis, asbestosis, coal workers' pneumoconiosis and related conditions, drawing on personal experience and on other investigators' work. Most of the author's silicosis experience came from one industry with essentially pure quartz dust, followed over twenty-two years. On asbestosis, the author reported that the X-ray findings appeared first in the lower half of the chest. Early disease could show essentially normal X-rays while lung biopsies already showed asbestos bodies. These biopsies came from mill and textile laborers and from a man who covered pipes with asbestos insulation, not from mine workers. The author also described advanced asbestosis in that pipe coverer. The author believed asbestosis did not make a person more susceptible to tuberculosis. The author had not personally studied lung cancer in asbestosis and noted that other researchers disagreed on a causal link. The author concluded that the radiologist plays a major role in diagnosing pneumoconiosis and proposed a national committee on pneumoconiosis protection and control.

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: Named lecture (Caldwell Lecture, 1957) combining a narrative review of other investigators' work with the author's personal clinical and radiologic experience; no formal study design or statistics
• Who was studied: Mainly workers in a single industry with essentially pure quartz dust, followed by the author for twenty-two years, plus individual cases and a few collective studies of coal miners, pottery workers, iron miners, foundry workers and asbestos workers; hospital patients and compensation claimants
• Exposure: Silica (pure quartz), coal dust and asbestos; asbestos exposures described include mill and textile work (a weaver, a laborer operating a shaker that removed dust from asbestos fiber) and covering pipes with asbestos for insulation, where dust came from sawing and fitting the coverings; no fiber types are named
• Main results:
  • In the author's experience, X-ray findings of asbestosis appeared first in the lower half of the chest
  • In some patients with early disease, X-rays were essentially normal, yet lung biopsies showed thickening of the alveolar walls and well-formed asbestos bodies; the author therefore disagreed with Cartier's view that clinically important asbestosis is always detected first on X-ray
  • The author described early X-ray signs (limited movement of the diaphragm and chest wall, restricted movement of vascular shadows) as presumptive unless pre-employment films were available for comparison; gradual disappearance of the lateral costophrenic sulci was described as a helpful diagnostic sign
  • The author described a proved case of advanced asbestosis in a self-employed man, aged fifty, who covered pipes with asbestos. After this case the author found it difficult to say how much and what kind of exposure is needed to produce asbestosis
  • The author's experience led to the belief that asbestosis does not make a person more susceptible to tuberculosis, while noting a difference of opinion on this question
  • The author had not personally studied lung cancer in asbestosis and reported only the conflicting views of other investigators: Lynch and Pratt-Thomas found the evidence for a causal relation strong, while Jacob and Bohlig held the opposite opinion
• The authors' conclusion: The authors concluded that pneumoconiosis remains a health hazard and that the radiologist plays a major role in its diagnosis in living people. The author proposed that a National Committee on Pneumoconiosis Protection and Control be set up, modeled on the National Committee on Radiation Protection
• Limitations the authors state:
  • The author's lung biopsy experience in asbestosis did not include mine workers
  • The X-rays the author had seen of lung cancer in asbestosis were of advanced lesions, not serial studies
  • The author's experience was largely limited to a single industry with essentially pure quartz dust

Topics

Medical terms in this study, explained in our Lexicon: Roentgen, Silicosis, Pneumoconiosis, Asbestos Bodies, Insulator, Lung Cancer.

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