Asbestos-associated pleural mesothelioma in school teachers: a discussion of four cases

Our plain-English summary of Asbestos-associated pleural mesothelioma in school teachers: a discussion of four cases, by D.E. Lilienfeld (Annals of the New York Academy of Sciences, 1991).

The study

• Author: D.E. Lilienfeld
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:454-58
• Type of article: Case report
• Cited by: 11 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. 004441).

Abstract

The causal relationship between malignant mesothelioma and exposure to asbestos is well established. In part as a result of that association, much public attention has focused on asbestos abatement in buildings, such as public schools, in which that asbestos was used as a construction material. The present communication is a report of four cases of malignant mesothelioma in school teachers whose only apparent exposure to asbestos was in the schools in which they taught. The concerns raised by this report are also discussed.

In plain English

This article reported four cases of malignant mesothelioma in school teachers whose only known asbestos exposure was in the schools where they taught. The author drew on deposition transcripts, laboratory results passed on by attorneys, and medical records and specimens. Two men, aged 60 in Chicago and 52 in the upper Midwest, had fluid around the lungs (pleural effusions) and died in 1986 and 1983. A 43-year-old woman had a mass in the front chest wall and said asbestos-containing ceiling material repeatedly fell; she died in 1990. A 64-year-old woman in upstate New York had abdominal pain, abdominal fluid and a pelvic mass, and reported exposure during demolition next to her room. Samples from three of the schools contained chrysotile and amosite, and in one also crocidolite. None of the teachers physically handled asbestos at work. The author noted that the fourth patient's diagnosis may have been incorrect and that asbestos analyses for the first school were pending. The author concluded that the report emphasized the reality of the health risk from asbestos exposure in schools.

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 series (report of four cases)
• Who was studied: Four school teachers with malignant mesothelioma in the United States: two men (aged 60, Chicago, Illinois; aged 52, upper Midwest) and two women (aged 43; aged 64, upstate New York), diagnosed between about 1983 and 1985. Information came from deposition transcripts, independent laboratories (transmitted by attorneys), and medical records and specimens.
• Exposure: Asbestos-containing materials in school buildings (fire protection, acoustic ceiling tiles, pipe insulation, sprayed insulation, ceiling material, and demolition in an adjacent room). Bulk samples contained chrysotile, amosite and, in one school, crocidolite. The teachers did not physically handle asbestos.
• Main results:
  • Case 1: a 60-year-old man had a left pleural effusion. He had taught in Chicago from 1954, and his school had asbestos used for fire protection, in acoustic ceiling tiles and as pipe insulation. He died in March 1986. He had served 1.5 to 2 years in the Navy as a radar man and denied previous occupational asbestos exposure.
  • Case 2: a 52-year-old man had a right pleural effusion and died in September 1983. He had taught in the same room for more than 25 years. Ten insulation samples contained chrysotile, amosite and crocidolite at 2 percent to 30 percent each.
  • Case 3: a 43-year-old woman had an anterior chest wall mass, found in May 1985, and died in 1990. She had taught from 1964 and reported that pieces of the asbestos-containing ceiling repeatedly fell. The ceiling material was 45 percent chrysotile, less than 1 percent amosite, 45 percent glass and 10 percent nonfibrous material.
  • Case 4: a 64-year-old woman had abdominal pain, ascites and a pelvic mass in 1985 and was first presumed to have ovarian cancer. Pathology indicated malignant mesothelioma. She had worked in an upstate New York school district since 1970 and reported continuous exposure during demolition in an adjacent room. School samples contained 30 to 100 percent chrysotile, and two samples contained 50-60 and 70-80 percent amosite.
  • None of the four teachers physically handled asbestos as part of their teaching work.
• The authors' conclusion: The author concluded that the continued presence of asbestos in schools poses a potential health hazard for teachers and other workers, that there may also be a risk for school children, and that the report emphasizes the reality of the health risk from asbestos exposure in schools.
• Limitations the authors state:
  • The author stated that the unusual presentation of case 4 suggests its diagnosis may have been incorrect. The case was included because the diagnosis of malignant mesothelioma was made and not revised.
  • Analyses of the asbestos in the school in case 1 were still pending.
  • The author noted that the time from first exposure to diagnosis in case 4 may seem overly short.
  • No air measurements had been made in rooms with friable insulation to test whether school ventilation systems spread fibers.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Malignant Mesothelioma, Abatement.

Related studies

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• Asbestos in New York City public school buildings--public policy: is there a scientific basis? — R. Wilson, A.M. Langer, et al. (1994)
• Airborne asbestos levels in school buildings in Italy — A. Campopiano, S. Casciardi, et al. (2004)
• Asbestos-related disease in custodial and building maintenance workers from a large municipal school district — J.R. Balmes, A. Daponte, et al. (1991)
• Asbestos-related abnormalities in school maintenance personnel — L.C. Oliver, N.L. Sprince, et al. (1991)
• Teachers Union Organizes Members to Enforce AHERA Law--A Work in Progress — M.P. Sireci, C. Levenstein, et al. (2016)

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