Asbestos and mesothelioma of the pleura \[abridged\]

Our plain-English summary of Asbestos and mesothelioma of the pleura [abridged], by D. O'B Hourihane (Proceedings of the Royal Society of Medicine, 1966).

The study

• Author: D. O'B Hourihane
• Journal: Proceedings of the Royal Society of Medicine
• Published: 1966;59(1):60
• Read it: PubMed · Publisher · Free full text

In plain English

This page records part of an abridged Royal Society of Medicine session on asbestos and mesothelioma. In the section credited to D O'B Hourihane, the author described the pathology of mesothelioma based on 121 cases at the London Hospital, most diagnosed since 1954. The author reported three points. A certain diagnosis of diffuse mesothelioma requires a full necropsy, though biopsy can give reasonable accuracy. Peritoneal mesotheliomas resemble pleural ones under the microscope and occur with almost equal frequency. Both are associated with a high incidence of asbestos bodies in the lungs. In a following comment, Dr Muriel Newhouse reported following up 83 of these patients. Of 76 with detailed histories, 51 (67%) had been exposed to asbestos: 31 at work and 20 outside work. The 20 included 9 whose relative brought asbestos dust home and 11 who had lived within half a mile of an asbestos factory. Among 76 matched hospital patients without mesothelioma, 9 (11.8%) had been exposed. This difference was described as highly significant. The page also begins with the end of another speaker's mortality study of asbestos factory workers.

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: Abridged meeting proceedings with several speakers. Hourihane's section is a pathology review of a hospital case series. A discussant (Newhouse) compared asbestos exposure in mesothelioma patients with matched hospital patients without mesothelioma.
• Who was studied: 121 mesothelioma cases at the London Hospital, the vast majority diagnosed since 1954. Newhouse followed up 83 of these patients: 41 men and 42 women, 27 with peritoneal and the remainder with pleural tumours. Newhouse also studied 76 patients from the same hospital without mesothelioma, matched by sex and date of birth.
• Exposure: Asbestos (fiber type not stated). The exposures were occupational (work in asbestos factories, or as insulators or laggers), domestic (a husband or other relative bringing dust home on his clothes), and residential (living within half a mile of an asbestos factory for three to twenty years).
• Main results:
  • Hourihane: the classical tubulo-papillary pattern was less common than solid sheets of epithelial-type cells. Mixtures of histological types were commonly found if 4 to 6 blocks were examined.
  • Hourihane: peritoneal mesotheliomas were histologically similar to pleural neoplasms and occurred with almost equal frequency.
  • Hourihane: both peritoneal and pleural mesotheliomas were associated with a high incidence of asbestos bodies in the lungs.
  • Newhouse: of the 83 patients followed up, 41 were men and 42 women. 27 had peritoneal tumours and the remainder had pleural tumours.
  • Newhouse: of 76 mesothelioma patients with detailed occupational and residential histories, 51 (67%) had been exposed to asbestos. Occupational exposure was found in 31: 23 in asbestos factories and 8 as insulators or laggers.
  • Newhouse: 20 of the exposed mesothelioma patients had non-occupational exposure. In 9, a husband or other relative had brought asbestos dust home on his clothes. The other 11 had lived for three to twenty years within half a mile of an asbestos factory.
  • Newhouse: among 76 matched patients from the same hospital without mesothelioma, 9 (11.8%) had been exposed to asbestos. The difference between the two groups was described as highly significant.
  • Preceding speaker's factory study: heavy excess mortality in Group 1 appeared diminished in Group 2, and Groups 3, 4 and 5 showed little or no evidence of mortality above national rates. The women (Group 6) showed some excess mortality.
  • Preceding speaker's factory study: one lung cancer case was classified as endothelioma. This was a man who died in 1936, aged 65, after twenty-three years of exposure.
• The authors' conclusion: Hourihane concluded that a certain diagnosis of diffuse mesothelioma requires a full necropsy examination, but that reasonable accuracy can be achieved by examining biopsy material.
• Limitations the authors state:
  • Preceding speaker's factory study: the excess mortality among women may be no more than a chance effect. The speaker said it was too early to claim the industry now carries no abnormal risk.
  • Preceding speaker's factory study: without a histological report, the endothelioma case could not be considered a confirmed mesothelioma.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura.

Related studies

• Asbestos and mesothelioma of the pleura [abridged] — M. Newhouse (1966)
• Asbestos, carbon nanotubes and the pleural mesothelium: a review of the hypothesis regarding the role of long fibre retention in the parietal pleura, inflammation and mesothelioma — K. Donaldson, F.A. Murphy, et al. (2010)
• Pleuropneumonectomy in the management of diffuse malignant mesothelioma of the pleura. Experience with 29 patients — E.G. Butchart, T. Ashcroft, et al. (1976)
• Mesothelioma of pleura and peritoneum following exposure to asbestos in the London area — M.L. Newhouse, H. Thompson (1965)
• Diffuse malignant mesothelioma of the pleura in Ontario and Quebec: a retrospective study of 332 patients — P. Ruffie, R. Feld, et al. (1989)
• Length-dependent retention of carbon nanotubes in the pleural space of mice initiates sustained inflammation and progressive fibrosis on the parietal pleura — F.A. Murphy, C.A. Poland, et al. (2011)

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