Asbestos and cancer: history and public policy

Our plain-English summary of Asbestos and cancer: history and public policy, by B.I. Castleman (British Journal of Industrial Medicine, 1991).

The study

• Author: B.I. Castleman
• Journal: British Journal of Industrial Medicine
• Published: 1991;48(6):427-32
• Type of article: Comment, Letter
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004148).

Summary of the article

In this letter, Castleman responded to Murray's statements in the journal that there had been no knowledge of lung cancer or mesothelioma attributable to asbestos during the second world war. He reviewed publications of the 1930s and 1940s. These included case reports of lung cancer with asbestosis, Nordmann's 1938 German paper on the occupational cancer of asbestos workers, and 1943 German legislation treating such lung cancer as an occupational disease. British factory inspectors reported 12 lung cancers among 103 autopsied asbestosis cases (11.6%) as of 1938, when lung cancer was seen in less than 1% of UK autopsies. By 1947 they reported cancer of the lung or pleura in 31 of 235 deaths with asbestosis (13.2%). Castleman then described company documents, discovered through legal proceedings in the 1980s, on industry-sponsored research at the Saranac Laboratory. In 1943 Gardner told sponsors that 8 of 11 mice inhaling long fibre asbestos had developed malignant lung tumours. These findings were not published. In 1948 sponsoring companies decided unanimously to strike all references to cancer and tumours from Vorwald's report, which was published in 1951 without them. Castleman concluded that this suppression was reprehensible and allowed a scientific controversy to be maintained beyond the 1940s. In a reply, Murray stated that his review of Castleman's book had never been submitted, and he reproduced the review.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This is a letter to the editor, not a research study. The author disputed Murray's statements in the journal that there was no knowledge during the second world war that asbestos caused lung cancer or mesothelioma. The author reviewed reports from the 1930s and 1940s, including German case reports and the German view after 1938 that asbestos was carcinogenic. They also included British factory inspectorate figures: 12 cases of lung cancer among 103 autopsied cases with asbestosis as of 1938, and 31 deaths with cancer of the lung or pleura among 235 deaths with asbestosis found at autopsy by 1947. Using company correspondence found through legal proceedings, the author described unpublished mouse experiments by Leroy Gardner at the Saranac Laboratory. In them, 8 of 11 mice inhaling long fibre asbestos developed malignant lung tumours. The author acknowledged that this study could have been improved upon. The author stated that in 1948 sponsoring companies decided to strike all references to cancer and tumours from the laboratory's report, which was published in 1951. The author called this suppression reprehensible.

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: Letter to the editor (Forum section): historical commentary and argument, not an original study
• Who was studied: Published medical literature and unpublished asbestos industry correspondence and research, mainly from Germany, Britain and the United States, 1930s to early 1950s
• Exposure: Asbestos in general; in Gardner's unpublished mouse experiments, inhaled 'long fibre' and 'short fibre' asbestos (fiber types not named)
• Main results:
  • According to the author, Nordmann (1938) observed that in Germany, as in Britain, there were 12 recorded autopsied cases of asbestosis, 2 of them with lung cancer.
  • The author stated that in Germany the view that asbestos was carcinogenic was supported by many and challenged by none after 1938.
  • The author cited the British senior medical inspector of factories: as of 1938, 12 cases of lung cancer among 103 autopsied cases with asbestosis (printed as 11-6%, that is 11.6%), when lung cancer was seen in less than 1% of UK autopsies.
  • The author cited the Chief Inspector of Factories' report for 1947: of 235 deaths with asbestosis found at autopsy, 31 (13.2%) also had cancer of the lung or pleura.
  • Gardner's unpublished 1943 report, as quoted by the author: of 22 mice inhaling short fibre asbestos for not longer than 12 months, 3 developed lung tumours (13.6%).
  • The author stated that at a meeting on 11 November 1948, executives of eight of the nine sponsoring companies decided unanimously to strike all references to cancer and tumours from the Saranac Laboratory report.
  • According to the author, Vorwald's report published in January 1951 did not include the word cancer or any synonym.
  • The author stated that the carcinogenicity of asbestos was widely noted in prominent medical publications by the early 1940s.
• The authors' conclusion: The author concluded that it was reprehensible that industry leaders and scientists suppressed the cancer findings, which allowed a scientific controversy to be maintained beyond the 1940s.
• Limitations the authors state:
  • The author acknowledged that Gardner's mouse study could have been improved upon.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Occupational Disease, Pleura, Saranac Laboratory.

Related studies

• Asbestos and cancer: history and public policy — J.C. Kelso (1992)
• Asbestos and cancer: history and public policy — M.P. Weller (1993)
• Asbestos and cancer: history and public policy — W.K. Morgan (1992)
• Asbestos and cancer: history and public policy — M.P. Weller (1992)
• Asbestos and cancer: history and public policy — M. Greenberg (1993)
• Asbestos: scientific developments and implications for public policy — B.T. Mossman, J. Bignon, et al. (1990)

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