A case of laryngeal cancer induced by exposure to asbestos in a construction site supervisor

Our plain-English summary of A case of laryngeal cancer induced by exposure to asbestos in a construction site supervisor, by S. Roh, S. Park, G. Tae, et al (Annals of Occupational and Environmental Medicine, 2016).

The study

• Authors: S. Roh, S. Park, G. Tae, J. Song
• Journal: Annals of Occupational and Environmental Medicine
• Published: 2016;28:34
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Construction site supervisors are exposed to many chemicals, dusts, and metals including asbestos. Asbestos is a hazardous chemical that is carcinogenic. Laryngeal cancer is not a rare disease in Korea. The most common causes of this disease are tobacco and alcohol, and representative occupational cause is asbestos. However, up to now, no case of laryngeal cancer induced by asbestos has been reported in Korea. In this study, we report such a case in a construction site supervisor.

Case Presentation: A 60-year-old man who had been experiencing hoarseness for 2 months was diagnosed with laryngeal cancer. The pathologic diagnosis was squamous cell carcinoma in situ, based on examination of a biopsy specimen obtained by resection of the lesion. The patient had been exposed to asbestos for 38 years at construction sites where he worked until diagnosed with laryngeal cancer. He had been exposed to asbestos when demolishing buildings and inspecting materials.

Conclusion: The patient in this case worked with construction materials including asbestos and supervised construction for 38 years, and was thus exposed to asbestos at construction sites. Much of the asbestos was highly concentrated especially during demolition processes. We therefore consider the laryngeal cancer of this patient to be a work-related disease.

In plain English

This case report described a 60-year-old man in Korea who had worked for 38 years as a construction site supervisor. He came to Hanyang University Hospital in February 2013 with hoarseness. Examination of tissue removed from his right vocal cord showed squamous cell carcinoma in situ, and he was diagnosed with laryngeal cancer. He was an ex-smoker (20 pack-years) and a social drinker. His work included inspecting building materials that contained white asbestos and taking part in demolition of old buildings. No workplace air measurements existed. Using published exposure data, the authors estimated his cumulative asbestos exposure at a minimum of 10 f/cc*year. His chest X-ray showed no pleural plaques or pleural thickening. After laser surgery there was no sign of recurrence during follow-up. The authors concluded that his laryngeal cancer was work-related. They noted that his past exposure was estimated from his own statements and that other workplace risk factors, such as cement and silica, could not be ruled out. They said further studies are needed to prove the connection definitively.

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 (single patient), with a literature review and a workplace visit by two occupational medicine physicians
• Who was studied: One 60-year-old man, a construction site supervisor in Korea, seen at Hanyang University Hospital, Seoul, in February 2013
• Exposure: 38 years (from 1971) as a construction supervisor doing material inspection, site inspection and site management. He inspected asbestos-containing materials (asbestos-tex, astile, insulator, bamlight), which the article lists as containing white asbestos, and he took part in demolition of old buildings.
• Main results:
  • Pathology of the excised right vocal cord lesion showed squamous cell carcinoma in situ
  • The patient was an ex-smoker with 20 pack-years and a social drinker (1 bottle of so-ju per week)
  • Redevelopment projects that included demolition made up 70 to 80% of the projects he supervised
  • The authors estimated his cumulative asbestos exposure at a minimum of 10 f/cc*year, based on historical data from other industries because no workplace measurements existed
  • His chest X-rays showed no pleural plaques or pleural thickening
  • After laser cordectomy there was no sign of recurrence during follow-up
• The authors' conclusion: The authors considered the patient's laryngeal cancer to be a work-related disease. They stated that further epidemiological and experimental studies are needed to prove the connection definitively.
• Limitations the authors state:
  • His activities before 1996 were not defined, so the precise exposure time could not be calculated
  • The authors assumed that the risk factors for head and neck tumors and for laryngeal cancer are similar, an assumption that needs more investigation
  • The work environment was not measured, and past asbestos exposure was estimated from the worker's statements
  • No pleural plaques or pleural thickening were seen on chest X-ray, so exposure could not be proved by an objective standard
  • Other workplace risk factors, such as cement and silica, or an interaction between asbestos and other factors, could not be ruled out

Topics

Medical terms in this study, explained in our Lexicon: Laryngeal Cancer, Carcinogenic, Squamous Cell Carcinoma, Biopsy.

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