Asbestos disease in family contacts of shipyard workers

Our plain-English summary of Asbestos disease in family contacts of shipyard workers, by K.H. Kilburn, R. Lilis, H.A. Anderson, et al (American Journal of Public Health, 1985).

The study

• Authors: K.H. Kilburn, R. Lilis, H.A. Anderson, C.T. Boylen, H.E. Einstein, S.J. Johnson, R. Warshaw
• Journal: American Journal of Public Health
• Published: 1985;75(6):615-7
• Cited by: 37 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. 000482).

Abstract

Radiologic signs of pulmonary asbestos disease were found in 11.3 per cent of 274 wives of shipyard workers who were 20 or more years from initial hiring-on in shipyards in Los Angeles County. Asbestosis was also found in 7.6 per cent of 79 sons and 2.1 per cent of 140 daughters of these workers. The wives, sons, and daughters were without occupational exposure. Comparable radiographic signs were not found in comparison groups. It is probable that asbestos exposure in the household places these family members at risk for mesothelioma and lung cancer.

In plain English

This study took chest X-rays in May 1981 of shipyard workers and their families from the Long Beach, Wilmington and San Pedro areas of Los Angeles County, recruited through a public media campaign. The 852 people analyzed were workers 20 or more years from first shipyard employment plus 274 wives, 79 sons and 140 daughters, whom the authors described as having no occupational asbestos exposure. Here "asbestosis" meant X-ray signs in the lungs and/or the lining around them (pleura). Such signs were found in 64.2 per cent of 288 male workers, 21.1 per cent of 71 female workers (all also wives), 11.3 per cent of the wives, 7.6 per cent of sons and 2.1 per cent of daughters. In comparison groups from Long Beach and Michigan, figures ranged from 0.0 to 3.7 per cent. Among wives, those born 1900-10 had the highest figure, 31.8 per cent of 22. The authors concluded it is probable that household exposure places these family members at risk for mesothelioma and lung cancer. They noted that volunteers may have differed from a random sample.

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: Cross-sectional chest X-ray survey measuring how common X-ray signs of asbestos disease were in shipyard workers and their family members. The results were compared with two outside population groups (Long Beach and Michigan). Three experienced readers graded the films using the 1980 ILO classification, with study and comparison X-rays mixed together and identification covered. In this report, "asbestosis" means X-ray signs in the lungs and/or the pleura, including pleural thickening and calcification.
• Who was studied: Shipyard workers and their wives, sons and daughters from the Long Beach, Wilmington and San Pedro areas of Los Angeles County, recruited by a public media campaign and examined in May 1981. Of 1,017 people recruited, 852 were analyzed after exclusions. Those analyzed were 288 male workers, 71 female workers (all of whom were also wives of male shipyard workers), 274 wives, 79 sons and 140 daughters. The comparison groups were Long Beach census tract men (673) and women (674), and a Michigan sample of men (594) and women (583).
• Exposure: The family members had household (non-occupational) exposure through shipyard workers who were 20 or more years from first shipyard employment. The authors state that most of these workers did not work directly with asbestos but were exposed to airborne asbestos during the application and ripout of insulation by pipe coverers and insulators. The wives, sons and daughters analyzed as family contacts had no occupational asbestos exposure. The separate group of 71 female shipyard workers, who were also wives, included two former insulators and one former welder. The article does not name fiber types.
• Main results:
  • Male shipyard workers: 185 of 288 (64.2 per cent) had X-ray signs of asbestosis.
  • Female shipyard workers (all of them also wives of male shipyard workers): 21.1 per cent of 71 had X-ray signs of asbestosis.
  • Wives of shipyard workers (274, mean age 58): 11.3 per cent had X-ray signs of asbestosis. These signs were equally frequent in nonsmokers, ex-smokers and current smokers.
  • Children: 6 of 79 sons (7.6 per cent, mean age 29.5) and 3 of 140 daughters (2.1 per cent, mean age 32.3) had X-ray signs of asbestosis.
  • The X-ray signs were far more common in the wives, sons and daughters than in the comparison groups. Figures in the comparison groups were: Long Beach census tract men 3.7 per cent of 673; Long Beach census tract women 0.6 per cent of 674; Michigan men 0.5 per cent of 594; Michigan women 0.0 per cent of 583.
  • By decade of birth, there was a strong relationship with asbestosis prevalence in male workers, from 86.5 per cent of 37 born 1900-10 to 30.8 per cent of 39 born 1931-40. In wives the relationship was less striking but suggestive: 31.8 per cent of 22 born 1900-10, 12.2 per cent of 90 born 1911-20, 7.8 per cent of 102 born 1921-30, and 10.2 per cent of 49 born 1931-40.
  • Three wives who smoked cigarettes had lung masses on chest X-ray. Two were cancers and one was sarcoidosis.
• The authors' conclusion: The authors concluded that it is probable that asbestos exposure in the household places these family members at risk for mesothelioma and lung cancer. The study itself measured X-ray signs, not rates of these cancers. The authors also wrote that the feasibility and benefits of cancer surveillance in families of asbestos-exposed workers should be considered.
• Limitations the authors state:
  • The participants were volunteers. They may have been more aware of asbestos dangers, or more often previously diagnosed, than a random sample of shipyard families. The authors said their own data on health awareness did not bear this out, with that analysis to be reported later.
  • Decade of birth was used as a stand-in for time since first exposure, because exact dates of first asbestos contact were unknown or the first contact was outside shipyards.
  • The lower figure in daughters may partly reflect difficulty seeing lung opacities through breast shadows on chest X-rays.
  • The authors state that data on risks to family contacts of shipyard workers are still incomplete.

Topics

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

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Asbestos Exposure, Mesothelioma, Lung Cancer.

Related studies

• Mortality experience of family contacts of asbestos factory workers — L. Joubert, H. Seidman, et al. (1991)
• Asbestosis, pulmonary symptoms and functional impairment in shipyard workers — K.H. Kilburn, R. Warshaw, et al. (1985)
• Household-contact asbestos neoplastic risk — H.A. Anderson, R. Lilis, et al. (1976)
• Malignant mesothelioma: clustering in a family producing asbestos cement in their home — K.E. Otte, T.I. Sigsgaard, et al. (1990)
• Interaction of asbestos, age, and cigarette smoking in producing radiographic evidence of diffuse pulmonary fibrosis — K.H. Kilburn, R. Lilis, et al. (1986)
• Asbestos-related radiographic findings among household contacts of workers exposed to Libby vermiculite: impact of workers' personal hygiene practices — T.J. Hilbert, A. Franzblau, et al. (2013)

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