Asbestos in the work place and the community

Our plain-English summary of Asbestos in the work place and the community, by M.L. Newhouse (The Annals of Occupational Hygiene, 1973).

The study

• Author: M.L. Newhouse
• Journal: The Annals of Occupational Hygiene
• Published: 1973;16(2):97-107
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The fibrogenic properties of asbestos dust were detected early, later knowledge accumulated about the carcinogenic properties of the mineral and a hazard of bronchial carcinoma and mesothelial tumours was recognised. Mortality studies have measured the effect of exposure on working populations. Recent analysis of data from a cohort of asbestos factory workers shows that even with low to moderate exposure there is excess mortality from cancer of the lung and pleura and other cancers, after more than 25 years' observation. The mesothelioma rate increases both with severity and length of exposure. Occurrence of these and other tumours appears to be dose-related. The markers of a community effect of asbestos dust in the environment are the occurrence of mesothelial tumours in neighbourhoods of a source of asbestos dust, and the presence of asbestos bodies or calcified asbestos pleural plaques in the general population. Conditions giving rise to neighbourhood mesothelial tumours may not now occur, but the importance of adequate control in all countries where asbestos is mined or manufactured is stressed.

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

In plain English

This article reviewed asbestos research and updated the author's mortality study of an East London factory using crocidolite, amosite and chrysotile. Deaths were compared with those expected for England and Wales. Men with low-moderate exposure employed under 2 years showed no excess mortality. Those employed longer showed a significant cancer excess after over 25 years' observation. Severely exposed men showed excess lung cancer after 15 or more years. Among 126 women with low-moderate exposure, 2 lung cancer deaths occurred versus 0.3 expected. Mesothelioma rates, counted over years at risk after the first ten years of follow-up, rose with severity and length of exposure. Among men, they went from 25 per 100,000 subject-years (low-moderate, under 2 years) to 154 (severe, over 2 years). The author wrote that these figures suggest the risk of mesothelial tumours and bronchogenic lung cancer is strongly related to degree and length of exposure. A separate section reviewed community studies. These included the author's earlier series of 76 mesothelioma cases, in which 11 people, significantly more than among controls, had lived near an asbestos factory without other asbestos contact.

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: Updated cohort mortality analysis of the author's own factory study (observed versus expected deaths), combined with a narrative review of studies on community exposure
• Who was studied: Male workers who started at an East London asbestos factory between April 1933 and its closure in 1968, and a smaller cohort of women first employed 1936 to 1942. Men were followed to 31 March 1970 and women to 31 December 1968. Total cohort sizes are not stated in the text.
• Exposure: Work at a factory that was a heavy user of crocidolite and also used amosite and chrysotile. Exposure was graded low-moderate (non-production workers and those working with low proportions of asbestos in the product) or severe (openers, disintegrators and production workers). Length of employment was split into less than or more than 2 years.
• Main results:
  • Men with low-moderate exposure and short employment: no excess mortality found.
  • Men with low-moderate exposure and longer employment, with more than 25 years of observation: significant excess of cancer mortality, not seen in the earlier study with shorter follow-up.
  • Men with severe exposure, whether employed short or longer periods: excess lung cancer mortality apparent in those followed 15 years or longer. Relative risk of lung carcinoma was highest with long and severe exposure.
  • Women with low-moderate exposure (126 women): significant excess of lung cancer, 2 observed versus 0.3 expected, p less than 0.05.
  • Severely exposed women, mostly textile workers: marked excess of cancer of the lung and pleura and of other sites.
  • Excess mortality from chronic respiratory diseases, which include asbestosis, was seen only in those with severe and long exposure (men and women).
  • The mesothelioma rate counts pleural and peritoneal tumour deaths per 100,000 subject-years, using only years at risk after the first ten years of follow-up. It rose with severity and length of exposure. Men with low-moderate exposure: 2 deaths in 7899 subject-years, rate 25 (under 2 years); 5 deaths in 4926 subject-years, rate 102 (over 2 years). Men with severe exposure: 8 deaths in 11193 subject-years, rate 71 (under 2 years); 9 deaths in 5851 subject-years, rate 154 (over 2 years). Women with severe exposure: 6 deaths in 7176 subject-years, rate 84 (under 2 years); 5 deaths in 3538 subject-years, rate 141 (over 2 years).
  • Excess annual death rates for lung cancer and other cancers among men, after more than 10 years' follow-up, showed a similar progression. Severe exposure, under 2 years' employment: lung cancer 119 and other cancer 84 per 100,000 subject-years. Severe exposure, over 2 years: 506 and 227.
  • Community section, the author's earlier London Hospital series of 76 mesothelioma cases (Newhouse and Thompson, 1965): 11 had no occupational or other contact with asbestos but had lived within half a mile of an asbestos factory, significantly more than in the control series.
  • The community section also reviewed other researchers' work. It covered mesothelioma in people living near asbestos mines, asbestos bodies in the lungs of the general public, and pleural changes in people living near mines or large users.
• The authors' conclusion: The author wrote that the figures suggest the risk of mesothelial tumours and bronchogenic lung cancer is strongly related to both degree and length of asbestos dust exposure. In the author's view, there may be no critical level at which cancer risk is eliminated, but strict factory hygiene and dust suppression may minimise it. The author also stressed adequate control wherever asbestos is mined or manufactured.
• Limitations the authors state:
  • The group of women with low-moderate exposure was small (126).

Topics

Medical terms in this study, explained in our Lexicon: Fibrogenic, Carcinogenic, Carcinoma, Pleura, Mesothelioma, Asbestos Bodies, Pleural Plaques.

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