Advances in asbestos disease research. Common practical problems: panel discussion

Our plain-English summary of Advances in asbestos disease research. Common practical problems: panel discussion, by G.L. Baum, S. Gitter, J.R. Goldsmith, et al (American Journal of Industrial Medicine, 1986).

The study

• Authors: G.L. Baum, S. Gitter, J.R. Goldsmith, D. Cugell, R. Lilis, E.D. Richter, N. Trainin
• Journal: American Journal of Industrial Medicine
• Published: 1986;10(5-6):563-72
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001150).

In plain English

This article is a transcript of a panel discussion, not an original study. It took place during a 1985 symposium on asbestos-related diseases and was sponsored by an Israeli occupational health committee. The moderator, Lilis, posed three questions: whether lung cancer can be related to asbestos exposure without asbestosis, what pleural fibrosis means clinically, and what degree of asbestos-related change should decide whether a person keeps working. Cugell described disputes over an American Medical Association physicians' guide, which had stated that pleural thickening is a sign of exposure, not disease. Baum said pleural plaques alone need not require a change of employment or compensation. Lilis said asbestos may cause lung cancer without overt asbestosis, though probably rarely. Lilis also reported a departmental comparison of X-ray and tissue findings in 138 insulation workers with lung cancer, and a breathlessness comparison suggesting that extensive pleural changes contribute to shortness of breath. Goldsmith argued that exposed workers with respiratory cancer should be considered eligible for compensation whether or not they smoked. The panelists gave individual views rather than one shared conclusion.

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: Panel discussion (transcript of expert opinions at a symposium); not an original study
• Who was studied: No study population. Seven panelists from Mt. Sinai School of Medicine (New York), Tel Aviv University, Ben Gurion University and Hebrew University spoke at a symposium held April 22, 1985, sponsored by the Israel Committee on Prevention and Research in Occupational Health
• Exposure: Asbestos exposure in general, discussed in relation to lung cancer, pleural fibrosis and plaques, asbestosis, and fitness to continue working; smoking was discussed as a combined factor
• Main results:
  • Cugell reported that the AMA physicians' guide committee had stated that pleural thickening is a sign of asbestos exposure, not disease
  • Baum stated that pleural plaques alone may be said not to require a change in employment status or compensation
  • Lilis stated that occupational asbestos exposure may cause lung cancer without overt asbestosis, with the frequency unknown but likely low
  • Lilis reported a study in their department of 138 lung cancer patients from a cohort of insulation workers. In the article's wording, 25 of the 138 cases had no radiological signs of interstitial fibrosis, and all of these had pathological pulmonary fibrosis ranging from minimal to severe
  • In Lilis's comparison of asbestos workers first exposed over 30 years before, workers with both pleural and parenchymal changes had a significantly higher prevalence of grade 2 and 3 dyspnea (MRC criteria) than workers with parenchymal changes only. No difference was found between workers with parenchymal changes only and those with pleural changes only
  • Goldsmith argued that an asbestos-exposed worker who develops respiratory cancer should be considered eligible for compensation whether or not that worker smokes
  • Lilis stated that eliminating smoking would eliminate many asbestos-related problems, mainly lung cancer, but would not eliminate mesothelioma
• The authors' conclusion: The panel did not reach one joint conclusion. On the question of work, Lilis's view was that an employee with asbestos-related abnormalities may continue working as before if exposure has been reduced to a 'nonhazardous' level, if the person's functional status permits, and if the worker is informed and agrees

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer.

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