The Effect Of Differing Concepts Of The Criteria That Should Be Used For The Diagnosis Of Asbestos Disease

Our plain-English summary of The Effect Of Differing Concepts Of The Criteria That Should Be Used For The Diagnosis Of Asbestos Disease, by N. Tait (1980).

The study

• Author: N. Tait
• Published: Biological Effects Of Mineral Fibres (J.C. Wagner, Editor), Lyon: Iarc Scientific Publications, Volume 30, Pp. 855-859 (1980)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library, J-M no. 004986. The article is still under copyright, so we describe it here rather than post it.

In plain English

This paper was a commentary by an author from the Society for the Prevention of Asbestosis and Industrial Disease (SPAID). It reported no new study of its own. The author argued that UK asbestos disease statistics were incomplete because of the rules Pneumoconiosis Medical Panels used for disablement benefit claims. Lung cancer counted only if asbestosis was also present, and asbestos bodies had to be found in lung tissue. Citing government figures, the author noted three trends. Recorded asbestosis deaths doubled from 82 to 169 between 1967 and 1976. Additions to the mesothelioma register rose from 148 to 314 over the same years. Applicants refused asbestosis benefit almost trebled, from 124 to 357 by 1977. Most refusals were given on the ground that fibrosis affected the pleura, not the lung. Citing other researchers, the author argued that chrysotile-related disease may be missed because asbestos bodies form less often with chrysotile than with crocidolite. The author concluded that arbitrary benefit rules made the statistics unrealistic and that asbestos, including chrysotile, affects the health of the community.

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: Commentary (position paper) by an advocacy society, drawing on UK government statistics, benefit case reports and other researchers' published work. Not an original study.
• Who was studied: UK asbestos disease cases in official statistics, 1967 to 1977: recorded asbestosis deaths, mesothelioma register additions, and workers claiming industrial disablement benefit for asbestosis who were examined by Pneumoconiosis Medical Panels
• Exposure: Asbestos generally, with discussion of chrysotile and crocidolite. Jobs mentioned include the asbestos manufacturing industry, thermal insulation work and work with asbestos-cement dust.
• Main results:
  • The Pneumoconiosis Medical Panels required lung cancer to be accompanied by asbestosis before it was treated as an industrial disease
  • The Panels required asbestos bodies to be identified in tissue
  • UK deaths from asbestosis recorded on death certificates doubled from 82 to 169 over 1967 to 1976
  • New cases added to the Mesothelioma Register increased from 148 in 1967 to 314 in 1976. The author considered 314 an underestimate.
  • The number of applicants refused asbestosis benefit almost trebled, from 124 to 357 by 1977, according to Table 2, which covers 1973 to 1977
  • The reason given in most cases for refusing benefit was that the fibrosis affected the pleura rather than the lung
  • Citing Pooley (1972), the author noted that asbestos bodies form more frequently with crocidolite than with chrysotile. The author argued that this means chrysotile-related asbestosis may go undiagnosed.
  • The author's own reading of Berry et al. (1979) suggested that, to meet the aim of the UK Hygiene Standard of 2 fibres/ml, the control limit would need to be between 0.5 and 0.1 fibres/ml
• The authors' conclusion: The author concluded that arbitrary rules for deciding benefit cases add to the problems of diagnosing asbestos disease. In the author's view, the resulting statistics are unrealistic and leave out cases showing that asbestos, including chrysotile, affects the health of the community.

Topics

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Lung Cancer, Asbestos Bodies, Mesothelioma, Fibrosis, Pleura, Chrysotile, Crocidolite.

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