Asbestos bodies in the lung: Southampton (UK) and Wellington (New Zealand)

Our plain-English summary of Asbestos bodies in the lung: Southampton (UK) and Wellington (New Zealand), by R.H. Steele, K.J. Thomson (British Journal of Industrial Medicine, 1982).

The study

• Authors: R.H. Steele, K.J. Thomson
• Journal: British Journal of Industrial Medicine
• Published: 1982;39(4):349-54
• Cited by: 5 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. 004693).

Abstract

Two series of surgically removed and unselected necropsy lungs were examined for asbestos bodies. In the series from Southampton (UK) 30-mu sections were used and in the Wellington (New Zealand) series a modified Gold's digestion method was used for all cases, together with 30-mu sections for some. A further series of Southampton lungs was assessed by Gold's method six years after the initial study. The 30-mu section technique found asbestos bodies in 13% of Southampton men and none in women: the corresponding Wellington figures were 8% for men and nil for women. In Wellington the more sensitive digestion method found asbestos bodies in 78% of men and 63% of women. In Southampton the investigation by Gold's method found asbestos bodies in 83% of men and 74% of women. No statistically significant association was found between the number of asbestos bodies and the various types of lung carcinoma. The prevalence of asbestos in lungs removed between 1956 and 1965 did not differ significantly from its prevalence in those removed in the late 1970's. There was no significant increase in asbestos after the age of 20.

In plain English

This pathology study counted asbestos bodies in lungs from Southampton (UK) and Wellington (New Zealand). The lungs came from people with no asbestosis and no known history of asbestos exposure. Most were surgically removed lungs, mostly with tumours; the others came from necropsies. Unstained 30-micron sections found asbestos bodies in 13% of Southampton men, 8% of Wellington men and no women. A more sensitive digestion method (Gold's method) found them in 187 of 248 Wellington lungs (75%): 78% of men and 65% of women (the abstract says 63%). A 1981 Southampton series examined the same way found them in 83% of men and 74% of women. Heavy contamination affected 24% of Southampton men's lungs, against 6% in Wellington. In Wellington, lungs with cancer were not more often or more heavily contaminated than other lungs. A trend towards more asbestos in adenocarcinomas was not statistically significant. Wellington lungs removed before 1965 did not have significantly less asbestos than those removed after 1975. The authors concluded that the study gave no evidence supporting alarmist views of widespread danger from asbestos.

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: Pathology study counting asbestos bodies in surgically removed and necropsy lung specimens, using two detection methods (30-micron unstained sections and a modified Gold's digestion method)
• Who was studied: Southampton, UK: 212 surgically removed lungs or lobes containing neoplasms, examined 1973 to 1975, plus 107 unselected male necropsy cases without primary lung tumours (ages 16 to 92), all examined by sections. Wellington, New Zealand: 248 lungs, mostly surgical specimens removed from 1956 onwards, examined by digestion. These included 71 non-neoplastic cases, of which 36 came from unselected necropsies and 35 were operative specimens. Of the 248, 98 lungs removed fresh in 1976 and 1977 were also examined by sections. Southampton 1981: a further series of 106 lungs (75 men, 31 women) examined by digestion.
• Exposure: Asbestos bodies retained in lung tissue of people with no asbestosis and no known history of asbestos exposure. Bodies were counted per cm3 of lung by digestion, or per section. Contamination was graded as negative, light (1-9 bodies/cm3), moderate (10-99 bodies/cm3) or heavy (100 or more bodies/cm3). The study did not identify fibre types.
• Main results:
  • By the 30-micron section method, asbestos bodies were found in 13% of Southampton men (38 positive) and 8% of Wellington men (6 positive), and in no women at either centre
  • By the digestion method in Wellington, at least one typical asbestos body was found in 187 of 248 specimens (75%)
  • Wellington digestion results by sex: asbestos bodies were found in 78% of men and 65% of women, as stated in the discussion and consistent with the Table 3 counts (18 of 52 women negative, so 34 of 52 positive). The abstract gives 63% for women.
  • In Wellington, significantly more heavily contaminated cases were male: 11 of 196 men (6%) versus 1 of 52 women (2%). Bartholomew's test statistic was 13.6, p less than 0.01.
  • In the 98 Wellington cases examined by both methods, the digestion and section methods showed poor correlation. Sections showed bodies in only 6% of Wellington lungs, against 75% by digestion.
  • In Wellington, lungs with malignancies showed neither heavier nor more frequent asbestos contamination than benign cases. For example, asbestos was present in 37 of 51 men with non-malignant conditions (72%) and in 67 of 89 men with squamous carcinomas (75%).
  • In Wellington, the trend towards heavier contamination in lungs with adenocarcinoma (asbestos present in 31 of 34 men, 91%) was not statistically significant at the 5% level
  • Of 26 Wellington lungs removed before 1965, 69% contained asbestos and 19% had more than light contamination. This was not significantly less than the 75% contamination of lungs removed after 1975, of which 27% had at least 10 bodies/cm3.
  • In Wellington, 12 of 15 subjects under 30 (80%) had asbestos bodies, and there was no significant trend in contamination across later decades of age
  • In the 1981 Southampton series examined by digestion, asbestos bodies were found in 83% of men (62 of 75) and 74% of women (23 of 31)
  • Heavy contamination was found in 24% of male lungs in Southampton (1981 series) versus 6% in Wellington. The authors presumed this reflected more occupational exposure in the dockland areas of Southampton and Portsmouth.
  • In the 1981 Southampton series, two cases of mesothelioma both had over 1000 bodies/cm3, as did two cases of carcinoma who also had pleural plaques
  • The authors noted that even in the heavily contaminated lungs, the numbers of bodies were very low compared with levels found in asbestosis
• The authors' conclusion: The authors concluded that the study provided no evidence to support alarmist views of widespread danger from asbestos. They wrote that it implied present-day concentrations in the community outside the asbestos industry account for no more than a very small amount of lung cancer, and quite possibly not even that. They also recommended that such studies continue periodically in different places.
• Limitations the authors state:
  • Many of the early Wellington lungs had partially dried out, so they could not be examined by histological sectioning
  • A constant volume of lung was not used for digestion because the degree of inflation of the specimens varied considerably
  • The higher asbestos contamination seen in adenocarcinomas did not reach statistical significance. The authors suggested that a larger series of adenocarcinomas would be needed to test the association.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Bodies, Autopsy, Carcinoma.

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