Asbestos-induced lung injury among Danish jewelry workers

Our plain-English summary of Asbestos-induced lung injury among Danish jewelry workers, by M. Døssing, S.W. Langer (American Journal of Industrial Medicine, 1994).

The study

• Authors: M. Døssing, S.W. Langer
• Journal: American Journal of Industrial Medicine
• Published: 1994;26(6):755-8
• Type of article: Case report, Review
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos has been used extensively in a variety of occupations. In the jewelry industry, inadequate hygiene practices may often go unrecognized with resultant exposure to hazardous amounts of asbestos. We report on four retired jewelers. Two of these had both pleural and parenchymal changes. One had isolated pleural plaques and the final patient showed only parenchymal infiltrates. Their work involved hand cutting asbestos plates used for protection during soldering. In the soldering process asbestos fibers were then blown into the workroom air as the plates broke down. In addition, at the end of each work day the workroom floor was swept, with subsequent airborne asbestos dust distribution. Any patient with pleural plaques or interstitial lung disease should be questioned about potential sources of asbestos exposure in the past, regardless of present employment status.

In plain English

This article was a report of four cases of lung and pleural disease in people who had worked as jewelers in Denmark: three men and one woman, aged 71 to 79 when seen. The authors were at Bispebjerg Hospital in Copenhagen. The article did not name the type of asbestos. The work involved hand cutting asbestos plates that protected tables during soldering. Asbestos fibers were blown into the workroom air as the plates broke down, and sweeping the floor stirred up dust. None of the four ever used respiratory protection. One man, who had never smoked, was diagnosed with asbestosis with pleural plaques, although the authors noted that cystic changes on CT made the findings not typical. A second man had extensive pleural plaques and normal lung function. A third man was diagnosed with pleural calcification and probable asbestosis, and the woman with probable asbestosis. The authors judged the exposure probably moderate compared with asbestos miners and insulation workers. They concluded that the cases stress the importance of taking an occupational history from retired patients with pleural or interstitial lung changes.

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 series (four case reports)
• Who was studied: Four jewelry workers in Denmark seen at Bispebjerg Hospital, Copenhagen, between 1984 and 1993: men aged 74 (Case 1), 71 (Case 2) and 79 (Case 3), and a woman aged 76 (Case 4). One man had never smoked; the other three had smoked.
• Exposure: Asbestos plates, type of asbestos not stated, hand cut by the jewelers and used to protect tables during soldering. Fibers were released as the plates broke down, and dust was stirred up by sweeping the workroom floor. The work was often done in small, poorly ventilated rooms, with no respiratory protection.
• Main results:
  • Case 1 (man, never smoked): calcified pleural plaques on both sides and on both diaphragms, with reticular and nodular infiltrates. Lung function was restrictive (total lung capacity 69% of predicted). Diagnosis: asbestosis with pleural plaques.
  • Case 2 (man): extensive calcified pleural plaques on both sides, normal lung function, and no lung tissue changes.
  • Case 3 (man, pipe smoker): calcified pleural plaques on both sides and an interstitial pattern in the lower lung fields. Spirometry showed FEV1 of 0.75 litres (28%) and FVC of 1.45 litres (38%), which the authors described as moderate to severe obstructive impairment. Diagnosis: pleural calcification and probable asbestosis.
  • Case 4 (woman, smoker): severe interstitial changes throughout both lungs. FVC was 1.5 litres (58%) and FEV1 was 1.4 litres (74%), which the authors described as severe restrictive impairment. Diagnosis: probable asbestosis.
  • The authors judged that exposure in the jewelry industry was probably moderate compared with asbestos miners and insulation workers, but may still have reached hazardous concentrations.
• The authors' conclusion: The authors concluded that the cases add to the many occupations where asbestos was used. They stressed the importance of taking an occupational history from retired patients who present with pleural or interstitial lung changes.
• Limitations the authors state:
  • In Case 1, cystic changes on CT made the findings not typical for asbestosis.
  • In Case 3, total lung capacity, residual volume and diffusion capacity were not measured.
  • In Case 4, total lung capacity, residual volume and diffusion capacity were not measured.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Interstitial Lung Disease, Asbestos Exposure.

Related studies

• Asbestos-induced lung injury in the sheep model: the initial alveolitis — R. Bégin, M. Rola-Pleszczynski, et al. (1983)
• Increased sensitivity to asbestos-induced lung injury in mice lacking extracellular superoxide dismutase — C.L. Fattman, R.J. Tan, et al. (2006)
• Contrasting effects of alveolar macrophages and neutrophils on asbestos-induced pulmonary epithelial cell injury — D.W. Kamp, M.M. Dunn, et al. (1994)
• Risk of cancer among Danish utility workers--a nationwide cohort study — C. Johansen, J.H. Olsen (1998)
• How conflicted authors undermine the World Health Organization (WHO) campaign to stop all use of asbestos: spotlight on studies showing that chrysotile is carcinogenic and facilitates other non-cancer asbestos-related diseases — X. Baur, C.L. Soskolne, et al. (2015)
• Corporate corruption of medical literature: asbestos studies concealed by W.R. Grace & Co — D. Egilman, W. Wallace, et al. (1998)

Browse more research in American Journal of Industrial Medicine, or return to medical research.