Asbestos bodies in routine necropsies on Tyneside: a pathological and social study

Our plain-English summary of Asbestos bodies in routine necropsies on Tyneside: a pathological and social study, by T. Ashcroft (British Medical Journal, 1968).

The study

• Author: T. Ashcroft
• Journal: British Medical Journal
• Published: 1968;1(5592):614-8
• Cited by: 27 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. 004708).

Abstract

Smears were prepared from the base of the right lung in 311 routine necropsies of patients over 15 years of age. Asbestos bodies were found in 20.3 % of cases (25.5% of 196 males and 11.3% of 115 females). The majority of smears contained scanty bodies, but in 17 cases they were numerous. In cases with positive smears histological sections failed to reveal asbestos bodies in over 50%. Histological evidence of minimal asbestosis was found in 10 cases. There were no cases of classical asbestosis. The series includes one case of mesothelioma of pleura. There was no significant excess of positive smears in patients dying from gastrointestinal or lung carcinoma. The incidence was higher in patients living in urban areas (25.6%) than in those from rural areas (3.5%). Twenty-nine patients definitely or probably were exposed to asbestos dust at work and two further patients had non-occupational exposure. Neighbourhood contamination with asbestos dust is probably not important in this series. When compared with a series of 23 cases of mesothelioma of pleura or peritoneum, 21 (91%) of which showed asbestos bodies in histological sections of lung, the greater incidence of asbestos bodies in the cases of mesothelioma is statistically highly significant.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

The author examined lung smears from 311 routine necropsies of people aged 15 or over in Newcastle upon Tyne, a shipbuilding area. Asbestos bodies were found in 20.3% (25.5% of 196 males, 11.3% of 115 females). Most positive smears had few bodies; 17 had many. Of 62 positive cases with tissue sections, 33 (53%) showed no bodies in the sections. Ten cases showed mild early asbestosis; none had classical asbestosis. Positive smears were commoner among urban residents (25.6%) than rural Northumberland residents (3.5%). Positive smears occurred in 20 of 74 cases with malignant disease and 43 of 237 without, a difference that was not statistically significant. Relatives' reports showed more than a third of positive cases had worked in shipyards. Of 23 pleural or peritoneal mesothelioma cases (one also in the smear series), 21 (91%) had asbestos bodies in lung sections. The author reported this as a highly significant excess over the smear series, although the two used different methods and most mesothelioma cases had scanty bodies. The author concluded this supports an association between mesothelioma and the presence, not the number, of asbestos bodies.

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: Necropsy study of lung smears and tissue sections for asbestos bodies. Next of kin of positive cases were sent a questionnaire or interviewed about exposure. Results were compared with a series of mesothelioma cases examined by lung sections.
• Who was studied: 311 patients aged 15 or over (196 males, 115 females) who came to necropsy in the department of pathology, University of Newcastle upon Tyne, in the shipbuilding area of Tyneside. Study dates are not given. A comparison series of 23 necropsy cases of diffuse mesothelioma of pleura or peritoneum from Tyneside was also used; one of these was also in the smear series.
• Exposure: Asbestos bodies in the lung. The article does not name fiber types. Sources were traced through occupation, mainly shipyard work, where asbestos was used as insulation for boilers and pipes. Other sources were docks, building work, lorry driving, a steel works, and two non-occupational exposures.
• Main results:
  • Asbestos bodies were found in 20.3% of the 311 smears: 25.5% of 196 males and 11.3% of 115 females.
  • 17 smears had large numbers of bodies (171 to 3,363 per smear). These came from 15 males and two females.
  • Histological sections were available for 62 of the 63 positive-smear cases. No asbestos bodies could be identified in 33 of these 62 (53%), all from cases with small numbers of bodies in the smear.
  • Histological evidence of early asbestosis (mild fibrosis) was found in 10 cases. There were no cases of classical asbestosis.
  • Positive smears were found in 20 of 74 cases with malignant disease (27.0%) and 43 of 237 cases with miscellaneous non-malignant diseases (18.1%). The difference was not statistically significant (chi-squared 2.23, P=0.13).
  • Positive smears were found in 25.6% of patients from urban areas (58 of 227) and 3.5% of those from rural Northumberland (2 of 57).
  • More than a third of cases with positive smears, and more than half of those with numerous bodies, had worked in shipyards at some time.
  • Two patients had non-occupational exposure. One was the wife of a shipyard pipe-lagger; the other was a woman who lived for 13 years in a prefabricated asbestos house. Neighbourhood contamination was judged probably not important.
  • One case in the smear series had pleural mesothelioma. He had worked as a plater in a ship-repair yard.
  • In the series of 23 mesothelioma cases, 21 (91%) had asbestos bodies in lung sections. One of these 23 was also in the smear series; no smears were made in the others.
  • Compared with the smear series, the greater incidence of asbestos bodies in the mesothelioma cases was highly significant (chi-squared 54.4, P less than 0.001). A majority of the mesothelioma cases (15 of 21) showed only scanty bodies in lung sections.
• The authors' conclusion: The author concluded that the results support an association between mesothelioma and the presence, but not the number, of asbestos bodies in the lung.
• Limitations the authors state:
  • Smears varied in thickness, so strict case-to-case comparison of body counts was not permissible.
  • Only one smear was made per case. Sampling more lung tissue might have found a higher rate of positive cases.
  • Occupational information from relatives was scanty, and many relatives knew few details of the patient's work.
  • No information was available for nine positive cases.
  • The author noted that the mesothelioma figure can legitimately be compared only with a series using the same technique.

Topics

Medical terms in this study, explained in our Lexicon: Asbestos Bodies, Mesothelioma, Pleura, Carcinoma, Non-Occupational Exposure, Peritoneum.

Related studies

• Ferruginous bodies and the histologic evaluation of dust exposure — E. Crouch, A. Churg (1984)
• Epidemiological and quantitative relationships between mesothelioma and asbestos on Tyneside — T. Ashcroft (1973)
• The incidence of asbestos bodies in the lungs at random necropsies in Montreal — L. Anjilvel, W.M. Thurlbeck (1966)
• Asbestos exposure in the Monfalcone area. A social and pathological study of 100 autopsy cases — C. Bianchi, A. Brollo, et al. (1981)
• Asbestos bodies in the lung: Southampton (UK) and Wellington (New Zealand) — R.H. Steele, K.J. Thomson (1982)
• Asbestos bodies and mesothelioma — J. Stumphius, P.B. Meyer (1968)

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