Two Cases Of Pulmonary Asbestosis

Our plain-English summary of Two Cases Of Pulmonary Asbestosis, by P. Ellman (1931).

The study

• Author: P. Ellman
• Published: Proceedings Of The Royal Society Of Medicine 24:699-703, February 13 (1931)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 003313. The article is still under copyright, so we describe it here rather than post it.

In plain English

This report described two women diagnosed with pulmonary asbestosis. The first, aged 28, made asbestos mats from 1921 to 1926, work said to produce considerable dust. She developed a cough and breathlessness that worsened over time. Her X-ray showed fibrosis at the bases of both lungs with pleurisy. Her sputum contained asbestos bodies and fibres in large numbers but no tuberculosis bacteria. The second woman, aged 34, worked in an asbestos factory during the years the article prints as 1911-17. Her cough became serious about nine months before the report, when she went back to work there. She had fibrosis at both lung bases, pleural thickening on the right, and asbestos fibres and bodies in her sputum. The article did not say which type of asbestos either woman handled. The author based both diagnoses on asbestos bodies in the sputum, the absence of tubercle bacilli, and clinical and X-ray findings. The author concluded that, unlike silicosis, pulmonary asbestosis caused fine, diffuse fibrosis and was not usually complicated by tuberculosis.

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 report of two patients, presented at the Clinical Section of the Royal Society of Medicine
• Who was studied: Two female asbestos workers. Case I (C.N.) was aged 28 and worked in the industry from 1921 to 1926 making mats. Case II (S.L.) was aged 34 and worked in an asbestos factory during the years printed as 1911-17. She returned to the factory about nine months before the report.
• Exposure: Asbestos dust from asbestos mat making (Case I) and from asbestos factory work (Case II). The fibre type each woman handled is not stated. White asbestos, blue asbestos and amosite were shown at the meeting.
• Main results:
  • Case I developed a cough with shortness of breath on exertion, which became progressively worse.
  • Case I's chest X-ray showed fibrosis at the bases of both lungs, with pleurisy.
  • Case I's sputum showed no tuberculosis bacteria and contained asbestos bodies and fibres in large numbers.
  • Case II's cough became seriously troublesome about nine months earlier, when she resumed work at the factory.
  • Case II's clinical findings were fibrosis of both lungs at the bases, with pleural thickening at the right base.
  • Case II's sputum showed no tuberculosis bacteria and contained asbestos fibres and asbestos bodies.
  • The diagnosis in both cases rested on asbestos bodies in the sputum, the persistent absence of tubercle bacilli, and the clinical and X-ray findings.
  • The author also described a dog exposed to the dust for eight years. Its lungs showed chronic pleurisy and diffuse fibrosis.
  • In the discussion, Dr. Norah Schuster reported that one of the two women had left the factory three years earlier, yet her sputum contained more asbestos bodies than Dr. Schuster had seen in anyone else.
• The authors' conclusion: The author considered these cases further examples of the harmful effects of asbestos dust. In the summing-up, the author stated that tuberculosis does not complicate pulmonary asbestosis as it does silicosis. The author also stated that the fibrosis of pulmonary asbestosis is fine and diffuse rather than coarse and nodular. Finally, the author stated that asbestos bodies alone indicate exposure, but that clinical and X-ray evidence of fibrosis is needed for a diagnosis.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Fibrosis, Pleurisy, Sputum, Asbestos Bodies, Pleural Thickening, Silicosis.

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