The Lancet, London, Saturday October 1960 (issue contents)

Our plain-English summary of The Lancet, London, Saturday October 1960 (issue contents) (1960).

The study

• Published: The Lancet, London, October 1960 issue (pages approx. 723-764)
• 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 1960 single-author article was a case series. It searched records of The London Hospital since 1948 for inpatients diagnosed with asbestosis: 23 women and 19 men. Tables listed jobs such as asbestos grinding, spinning, weaving or pipe lagging, and years of exposure, where known; some jobs were unspecified, and one woman's notes recorded no exposure history. Fiber types were not named. Of 30 known deaths (15 men, 15 women), 14 died with lung cancer: 10 men and 4 women. The author partly explained the high figure in men by selection, which did not apply to the women, all non-smokers. Nine women and one man died with ovarian or peritoneal cancer. Of the women, one had ovarian carcinoma and four had peritoneal growths possibly of ovarian origin. The man was thought to have a malignant mesothelioma of the peritoneum, though some features suggested a lung primary. The author wrote that this appeared more than a chance association and that spread from undiagnosed lung cancer seemed unlikely, though harder to exclude in two cases. Outpatients were not counted, so total numbers were unknown.

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: case series based on a search of hospital records
• Who was studied: Inpatients with a diagnosis of asbestosis at The London Hospital, London, from 1948: 23 women and 19 men
• Exposure: Occupational asbestos exposure, recorded by type of work (for example asbestos grinding, spinning, weaving, mattress department, slab-making, pipe lagging, boiler covering) and duration where known. Some occupations were listed as unspecified, and for one woman (case 9) no exposure history was recorded in the notes. Fiber types were not specified.
• Main results:
  • Of 30 deaths (15 men, 15 women), 14 died with lung cancer: 10 men and 4 women
  • The high lung cancer figure among the men was partly explained by selection; this did not apply to the women, who were all non-smokers
  • Of the 15 women known to have died, 4 had lung cancers and 9 had intra-abdominal neoplasms
  • Among the 9 women with intra-abdominal neoplasms, 1 had an ovarian carcinoma and 4 had peritoneal growths, possibly of ovarian origin
  • In total, 9 women and 1 man died with ovarian or peritoneal cancer
  • One man was thought to have a malignant mesothelioma of the peritoneum, though some features suggested a primary bronchial neoplasm
  • According to the author, at least four of the tumours were not of ovarian origin
• The authors' conclusion: The author wrote that the link between asbestosis and ovarian or peritoneal cancer appeared to be more than chance, and that spread from undiagnosed lung cancer seemed unlikely. The author suggested that a combination of mechanical and chemical factors may determine the peritoneum as the site of inflammatory and later neoplastic change.
• Limitations the authors state:
  • Many patients with asbestosis attended only as outpatients and were not in the diagnostic index, so their total numbers were not known
  • In two cases (case 24 and case 9), the possibility of a missed bronchial primary was harder to refute
  • The author noted that some doubt must be cast on the ovarian diagnosis, since in 3 cases where the ovaries were identified they appeared not to be the primary site

Topics

Medical terms in this study, explained in our Lexicon: Pipe Covering, Exposure History, Lung Cancer, Carcinoma, Mesothelioma, Peritoneum.

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