Asbestos in strange places: two case reports of mesothelioma among merchant seamen

Our plain-English summary of Asbestos in strange places: two case reports of mesothelioma among merchant seamen, by G. Varouchakis, E.G. Velonakis, S. Amfilochiou, et al (American Journal of Industrial Medicine, 1991).

The study

• Authors: G. Varouchakis, E.G. Velonakis, S. Amfilochiou, D. Trichopoulos
• Journal: American Journal of Industrial Medicine
• Published: 1991;19(5):673-6
• Type of article: Case report
• Cited by: 16 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. 004871).

Summary of the article

The authors described two cases of malignant pleural mesothelioma in Greek merchant seamen. Both came from a mesothelioma registry in Greece and were seen at Sismanoglio General Hospital, Athens. The first was a 71-year-old man admitted in September 1989 with a month-long history of right pleuritic chest pain and breathlessness on exertion. He had a 41 pack-year smoking history and had quit 9 years earlier. Fluid drained from the chest was a bloody exudate, and a CT scan showed a large pleural mass in the right chest. Needle biopsy showed epithelial-type malignant mesothelioma. He had worked for 35 years as an engineer in the merchant marine, had retired 10 years earlier, and denied ever working in a shipyard. He was undergoing chemotherapy. The second was a 65-year-old man seen in July 1983 with severe acute pain and breathlessness. He had a 20 pack-year smoking history. Chest X-ray showed a left hydropneumothorax. At surgery a tumor was found affecting the parietal pleura and extending into the chest wall with rib destruction. Pathology showed mixed-type mesothelioma. He died a month later, and necropsy showed liver metastasis and spread to the mediastinal lymph nodes. He had worked for 25 years as a deck-department sailor and later as a restaurant waiter. He had never worked in ship engine departments or shipyards. The authors noted that asbestos had been used extensively in ship insulation. They considered the deck-department case of special interest for the risk from low-level exposure, and stated that secondary or bystander exposure may be a serious health hazard.

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 article reported two cases of malignant pleural mesothelioma, a cancer of the chest lining, in merchant seamen. Both came from a mesothelioma registry in Greece. The first patient was a man admitted to Sismanoglio General Hospital in Athens in September 1989. He had been a merchant marine engineer for 35 years and denied ever working in a shipyard. A pleural needle biopsy showed epithelial-type malignant mesothelioma, and he was undergoing chemotherapy. The second patient was a 65-year-old man seen in July 1983. He had worked 25 years as a deck-department sailor, never in the engine departments or a shipyard, and later as a restaurant waiter. Surgery found a mixed-type mesothelioma of the left pleura, and he died a month later. Both men had a history of smoking: 41 pack-years for the first, who had quit nine years earlier, and 20 pack-years for the second. The article did not measure either man's asbestos exposure or name fiber types. The authors concluded that the deck-department case was of special interest for the risk of low-level exposure, and that bystander exposure may be a serious hazard.

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 report (two cases)
• Who was studied: Two men with malignant pleural mesothelioma who had worked as merchant seamen. Both were drawn from a mesothelioma registry in Greece and seen at Sismanoglio General Hospital, Athens. One was admitted in September 1989; his age is unclear in the scanned text. The other was 65 and was seen in July 1983.
• Exposure: Work in the merchant marine: 35 years as an engineer (case 1), and 25 years as a deck-department sailor who never worked in the engine departments or a shipyard (case 2). No asbestos measurements or fiber types were reported for either man.
• Main results:
  • Case 1: a former merchant marine engineer. A pleural needle biopsy showed malignant mesothelioma of epithelial type.
  • Case 1 had been employed in the merchant marine as an engineer for 35 years. He had retired 10 years earlier and denied ever working in a shipyard.
  • Case 1 had smoked 41 pack-years but had quit 9 years earlier.
  • Case 2: a 65-year-old man with a tumor of the left parietal pleura extending into the chest wall. Pathology showed a mixed-type mesothelioma. He died a month later, and necropsy showed liver metastasis and invasion of the mediastinal lymph nodes.
  • Case 2 had a 20 pack-year smoking habit.
  • Case 2 had never worked in the engine departments on board ship or in a shipyard. From ages 45 to 60 he worked as a restaurant waiter.
• The authors' conclusion: The authors considered the deck-department case of special interest for the risk of low-level asbestos exposure. They said secondary or bystander exposure may represent a serious hazard. They expected asbestosis and mesothelioma to continue among seamen, and said such cases will be correctly diagnosed only by clinicians aware of possible past asbestos exposure.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleural Mesothelioma, Pleuritic Chest Pain, Exudate, CT Scan, Needle Biopsy, Merchant Marine, Chemotherapy.

Related studies

• Asbestotic radiological abnormalities among United States merchant marine seamen — I.J. Selikoff, R. Lilis, et al. (1990)
• Cancer mortality in merchant seamen — M. Greenberg (1991)
• Historical state of knowledge of the health risks of asbestos posed to seamen on merchant ships — D.G. Dodge, B.D. Beck (2016)
• Asbestos related abnormalities among United States merchant marine seamen — P.J. Barrett (1990)
• A mortality cohort study of seamen in Italy — E. Rapiti, E. Turi, et al. (1992)
• Irving John Selikoff and the strange case of the missing medical degrees — P.W. Bartrip (2003)

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