Asbestos dust and the curious bodies found in pulmonary asbestosis

Our plain-English summary of Asbestos dust and the curious bodies found in pulmonary asbestosis, by W.E. Cooke (British Medical Journal, 1929).

The study

• Author: W.E. Cooke
• Journal: British Medical Journal
• Published: 1929;2(3586):578-80
• Cited by: 40 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. 003099).

Summary of the article

This paper, read at the 1929 Annual Meeting of the British Medical Association in Manchester, described the findings behind the 1924 diagnosis of pulmonary asbestosis and further work on the "curious bodies" found in asbestotic lungs. The author recalled an unpublished 1899–1900 case of a man who had worked ten years in an asbestos factory, and noted that the first published case was in 1924. Chrysotile asbestos and factory dust were analysed. The iron content, as ferrous oxide, was 2.81 per cent in chrysotile, 0.1 per cent in the finished article and 18.4 per cent in carding-room dust. Lung sections and trypsin digests showed abundant fine black granular dust, an almost complete absence of the very fine spicules that made up most factory dust, and large fragments of 10 to 360 microns that closely matched particles in asbestos dust. The curious bodies, found in every necropsy in pulmonary asbestosis, measured 20 to 100 microns or more, were golden brown, did not stain with aniline dyes and gave the Prussian blue reaction for iron. The author proposed that the bodies formed when fine asbestos spicules became coated with colloidal aggregates derived from plasma proteins. Because no other mineral dust is fibrous, he concluded that the bodies, if found in any numbers, are pathognomonic of pulmonary asbestosis.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This paper came from the Pathological Department at Wigan Infirmary and was read at the 1929 British Medical Association meeting in Manchester. The author described chrysotile asbestos and the dust made during manufacture. The author examined lung tissue from the 1924 case of pulmonary asbestosis, the first published case, and reported on lungs from necropsies (autopsies) in the disease. Carding-room dust was reported to contain 18.4 per cent iron (as ferrous oxide), against 2.81 per cent in chrysotile itself. In the lungs the author found much fine black granular dust and almost none of the very fine translucent spicules that make up most factory asbestos dust. There were also large fragments 10 to 360 microns long that closely resembled particles in asbestos dust. Curious bodies were reported in every necropsy in pulmonary asbestosis; the larger ones were golden-brown and 20 to 100 microns or more long. The author proposed that they formed when blood proteins coated fine asbestos spicules. The author concluded that the bodies, if found in any numbers, are pathognomonic (a sure sign) of pulmonary asbestosis.

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: Descriptive pathology and laboratory study of lung tissue and asbestos dust, presented as a conference paper
• Who was studied: Lungs from the 1924 case of pulmonary asbestosis, the first published case, and from necropsies in pulmonary asbestosis, studied at the Pathological Department, Wigan Infirmary. The number of necropsies is not stated.
• Exposure: Chrysotile asbestos and the dust generated during its manufacture, including dust from the carding room
• Main results:
  • Iron content (as ferrous oxide): chrysotile 2.81 per cent, finished article 0.1, dust from the carding room 18.4
  • Lung sections showed an almost complete absence of the very fine translucent fibre spicules that make up most asbestos dust in factories
  • The lungs contained large fragments 10 to 360 microns long, found in fibrotic and necrotic areas
  • The large particles in the lung closely resembled those in asbestos dust in size, shape and colour
  • For the 1924 case, the author stated that, on this evidence, only one answer was possible to whether the deceased's occupation caused or contributed to death
  • Curious bodies were found in every necropsy in pulmonary asbestosis
  • The larger curious bodies measured from 20 to 100 microns or more in length and were golden-brown
  • The colour of the smaller types of body ranged from very pale yellow to yellowish-brown
  • The bodies did not stain with aniline dyes but, in chrysotile workers, gave the Prussian blue reaction for iron
  • The author proposed that fine asbestos spicules mechanically injure bronchioles and alveoli, causing small bleeds or serous exudates that envelop the spicules
• The authors' conclusion: The author concluded that the curious bodies, if found in any numbers, are pathognomonic of pulmonary asbestosis
• Limitations the authors state:
  • The Prussian blue (iron) reaction of the bodies may be due to the iron of haemoglobin
  • In principle, any fine mineral spicule could become coated and form such a body. The author judged this too rare to matter for diagnosis because no other mineral dust is fibrous.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Chrysotile, Carding, Autopsy.

Related studies

• Experimental asbestosis. The development of lung cancer in rats with pulmonary deposits of chrysotile asbestos dust — P. Gross, R.T. DeTreville, et al. (1967)
• Case report: Lung disease in World Trade Center responders exposed to dust and smoke: carbon nanotubes found in the lungs of World Trade Center patients and dust samples — M. Wu, R.E. Gordon, et al. (2010)
• Pulmonary Asbestosis — W.E. Cooke (1927)
• Asbestos dust as a nucleation center in the calcification of old fibrous tissue lesions, and the possible association of this process to the formation of asbestos bodies — J.M. Davis (1970)
• Ferruginous bodies and the histologic evaluation of dust exposure — E. Crouch, A. Churg (1984)
• Fibrous dust particles and ferruginous bodies. Methods for quantitating them and some results from the lungs of city dwellers — P. Gross, J. Tuma, et al. (1970)

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