Asbestos-related disease in upholsterers

Our plain-English summary of Asbestos-related disease in upholsterers, by M.J. Cruz, J. Sampol, M. Pallero, et al (Archives of Environmental & Occupational Health, 2018).

The study

• Authors: M.J. Cruz, J. Sampol, M. Pallero, E. Rodríguez, J. Ferrer
• Journal: Archives of Environmental & Occupational Health
• Published: 2018;73(3):186-188
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Before its use was banned in developed countries, asbestos was widely applied in upholstery. However, the risk of asbestos diseases among upholsterers has only rarely been reported. In this case series, we present a first series of 6 workers employed in small workshops who developed several asbestos-related diseases, including pleural plaques, pleural fibrosis, and asbestosis. Exposures were intermittent and difficult to quantify, but lung asbestos content assessed by bronchoalveolar lavage was high in the 3 patients evaluated. In conclusion, upholstery work should be considered an at-risk occupation for developing asbestos-related diseases during the 20th century.

In plain English

This was a retrospective case series from Hospital Universitario Vall d'Hebron in Barcelona, Spain. The authors reviewed the medical charts of all six patients diagnosed there with asbestos-related diseases between 1990 and 2015 who had worked most of their lives as upholsterers in small Barcelona workshops. Besides ordinary furniture work, these upholsterers handled, cut and sewed flame-retardant fabric for cinema seats, wall covers and curtains. They did this without protective measures and only intermittently. The article does not name the asbestos fiber type. Reported exposure ranged from 10 to 50 years. All six developed non-malignant pleural disease, mainly pleural plaques, and two also had asbestosis. Three patients had bronchoalveolar lavage. Their asbestos bodies per ml were 2.3, 7 and 1.5, all above the international normal threshold of one. No cancer or other asbestos-related disease was detected after the initial diagnosis. The authors concluded that upholstery should be considered a high risk activity for people who worked before the asbestos ban. They noted that exposure periods and intensity were difficult to assess.

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: Retrospective case series of six patients, based on review of medical charts
• Who was studied: Six patients diagnosed with asbestos-related diseases between 1990 and 2015 at a hospital pulmonology department in Barcelona, Spain. All had worked most of their lives as upholsterers in different small workshops in Barcelona. Age at diagnosis was 60 to 79 years (Table 1).
• Exposure: Handling, cutting and sewing flame-retardant fabric used to make cinema seats, wall covers and curtains, without protective measures and at irregular intervals. The asbestos fiber type is not specified. Exposure lasted 10 to 50 years and latency was 21 to 65 years (Table 1). Patients did not report exposure to other fibrous materials.
• Main results:
  • All six patients developed non-malignant pleural diseases, mainly pleural plaques. Table 1 also lists rounded atelectasis in one patient, and benign pleural effusion with pleural fibrosis in another.
  • Two of the six patients were diagnosed with asbestosis as well.
  • Three patients had bronchoalveolar lavage. All three had asbestos bodies per ml above the international normal threshold of one: 2.3, 7 and 1.5 per ml (Table 1).
  • The highest value (7 asbestos bodies per ml) belonged to the patient with the longest upholstery involvement. This patient had 50 years of exposure and pleural plaques with asbestosis.
  • At the end of follow-up (5 to 21 years), five patients were alive. One had died in an accident six years after diagnosis. No cancer or other asbestos-related disease was detected after the initial diagnosis.
• The authors' conclusion: The authors concluded that upholstery should be considered a high risk activity for people who worked before the asbestos ban. They added that handling recycled fabrics and repairing old flame-retardant furniture continues to represent a hazard.
• Limitations the authors state:
  • The exact periods and intensity of exposure were difficult to assess.
  • Handling of flame-retardant cloth was intermittent and mixed with other non-risk work, which made cumulative exposure difficult to evaluate.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Fibrosis, Bronchoalveolar Lavage (BAL).

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