Asbestos, lung cancer and mesothelioma in the British Journal of Industrial Medicine

Our plain-English summary of Asbestos, lung cancer and mesothelioma in the British Journal of Industrial Medicine, by A. Newman Taylor (Occupational and Environmental Medicine, 2009).

The study

• Author: A. Newman Taylor
• Journal: Occupational and Environmental Medicine
• Published: 2009;66(7):426-7
• Type of article: Editorial, Historical article
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this editorial, the author reviewed three papers from the archives of the British Journal of Industrial Medicine, which he described as arguably the most influential papers in occupational lung disease of the 20th century. In Doll's 1955 study of male Turner Brothers Asbestos employees in Rochdale who had worked at least 20 years in dusty areas, 39 deaths from all causes were observed against 15.4 expected. These included 11 lung cancer deaths, all with asbestosis. The company's directors had pressed Doll and the journal's editor not to publish. Wagner, Sleggs and Marchand found that all but one of 33 cases of pleural mesothelioma had been exposed to crocidolite, mostly in the North Western Cape Province of South Africa, some only as children living near the mines. Newhouse and Thompson's 1965 case-control study of 83 mesothelioma deaths from London Hospital records found asbestos exposure in 40 (55%) cases and nine (12%) controls. Nine exposed cases had relatives who worked with asbestos, most commonly wives who washed work clothes. Among cases without occupational or domestic exposure, 11 (31%) lived within 0.5 miles of an asbestos factory, compared with five (8%) controls. The author concluded that these papers showed that asbestos causes lung cancer and mesothelioma, leading eventually to bans on asbestos imports in the UK and Europe. He noted that unrecognised residual asbestos, chiefly among construction workers, is the primary reason for the continuing rise in mesothelioma.

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 2009 editorial is not a new study. The author described three papers from the British Journal of Industrial Medicine. Doll's 1955 paper reviewed post-mortem causes of death among men with at least 20 years in dusty areas of an asbestos textile factory in Rochdale. Deaths from all causes were 39 against 15.4 expected, including 11 lung cancer deaths in men with asbestosis. Wagner and colleagues' paper, listed as 1960, linked crocidolite asbestos to all but one of 33 pleural mesothelioma cases in South Africa. Some had been exposed only as children living near the mines. Newhouse and Thompson's 1965 study of 83 mesothelioma deaths in London reported asbestos exposure in 40 cases (given as 55%) versus nine (12%) of controls; the editorial does not explain the 55%, as 40 of 83 is about 48%. The exposed cases included wives who had washed work clothes. The author wrote that these papers showed conclusively that inhaled asbestos was carcinogenic. The author added that no threshold of safety could be confidently identified, probably for lung cancer and certainly for mesothelioma.

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: Editorial: a look back at three earlier papers (Doll 1955; Wagner, Sleggs and Marchand 1960; Newhouse and Thompson 1965) from the journal's archives. It reports no new research.
• Who was studied: Three papers published in the British Journal of Industrial Medicine. (1) Doll: male Turner Brothers Asbestos employees in the Turner and Newall textile factory in Rochdale, UK, who had worked at least 20 years in areas scheduled as dusty, with deaths diagnosed at post mortem between 1933 and 1952. (2) Wagner and colleagues: 33 cases of pleural mesothelioma, mostly from the North Western Cape Province, South Africa. (3) Newhouse and Thompson: 83 mesothelioma deaths between 1917 and 1964 from London Hospital pathology records, compared with London Hospital inpatients in 1964 matched for age and sex.
• Exposure: Asbestos dust in an asbestos textile factory (Doll). Crocidolite asbestos from work, from living near the crocidolite mines, and from childhood (Wagner). Asbestos exposure at work, at home through relatives who worked with asbestos, and from living near an asbestos factory in London (Newhouse and Thompson).
• Main results:
  • Doll 1955, as described by the author: among the male textile factory employees, deaths from all causes were more than double the number expected from the mortality of all men in England and Wales. The excess was attributed entirely to excess deaths from asbestosis and from lung cancer in cases of asbestosis.
  • Doll 1955 table, as reprinted: all causes, 39 deaths observed versus 15.4 expected. Lung cancer 'with asbestos', 11 observed (no expected figure given). Lung cancer 'without asbestos', 0 observed versus 0.8 expected.
  • Wagner and colleagues, as described by the author: all but one of 33 cases of pleural mesothelioma had been exposed to crocidolite, most in the Asbestos Hills of north west Cape Province. The tumour developed 20 or more years after first exposure and was uniformly fatal.
  • Wagner and colleagues, as described by the author: 17 of the 33 cases had worked with asbestos, including three asbestos laggers who had neither lived nor worked in the mining area. Eighteen were born near the mines and two more came to the area as infants; 11 of these had been exposed to asbestos dust as children. In some, exposure had occurred only during childhood.
  • Newhouse and Thompson 1965, as described by the author: 40 mesothelioma cases, given in the editorial as 55%, had a history of asbestos exposure, compared with nine (12%) of the controls. The editorial does not state the denominator for the 55%; 40 of the 83 deaths would be about 48%.
  • Newhouse and Thompson 1965: 31 of the 40 exposed cases had been exposed at work, most in the Cape Asbestos factory in Barking; only 10 had been employed in jobs scheduled under the 1931 regulations. The other nine exposed cases had relatives who had worked with asbestos, most commonly wives who had washed their husbands' work clothes.
  • Newhouse and Thompson 1965: among mesothelioma cases with no occupational or domestic exposure to asbestos, 11 (31%) lived within 0.5 miles of an asbestos factory, compared with five (8%) of the controls. None of 17 cases first diagnosed as mesothelioma but later found to have another diagnosis had been exposed to asbestos.
• The authors' conclusion: The author wrote that the three papers showed conclusively that inhaled asbestos was carcinogenic, causing lung cancer and mesothelioma. The author also wrote that no threshold of safety could be confidently identified, probably for lung cancer and certainly for mesothelioma. The author added that exposure to unrecognised residual asbestos, in those working in construction, is the primary reason for the continuing increase in mesothelioma in the UK and across Europe.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Occupational Lung Disease, Turner Brothers Asbestos Company, Pleural Mesothelioma, Crocidolite, Cape Province, Case-Control Study.

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