Asbestos-related lung disease

Our plain-English summary of Asbestos-related lung disease (The Western Journal of Medicine, 1979).

The study

• Journal: The Western Journal of Medicine
• Published: 1979;131(3):225-30
• Read it: PubMed · Free full text

In plain English

This article was not a research study. It was an edited 1979 transcript of a Grand Rounds talk by Dr. Jeffrey A. Golden at the Department of Medicine, University of California, San Francisco, in which the author reviewed lung and pleural disease from asbestos. The talk covered pleural plaques, pleural calcifications, benign pleural effusions, asbestosis, and mesothelioma of the pleura or peritoneum. It discussed workplace exposure as well as household and neighborhood exposure, and fibers such as chrysotile and crocidolite. The author stated that pleural plaques indicate only exposure and do not imply that mesothelioma, pulmonary fibrosis or bronchial carcinoma will develop. The author also described benign exudative pleural effusions linked to asbestos exposure. According to the author, chest x-ray categories cannot confirm asbestosis and do not relate well to disability, so exercise testing is needed to judge disability. One patient's exercise results matched chronic bronchitis. The author stated that mesotheliomas may follow brief exposures after a 20 to 30 year incubation period, and called a thorough occupational history the single most important point.

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: Narrative clinical review: edited transcript of a medical staff conference (Grand Rounds) talk, with one illustrative patient case
• Who was studied: No study population. A teaching talk at the Department of Medicine, University of California, San Francisco (published September 1979) about asbestos-exposed people in general. It includes one described patient, a cigarette smoker with small calcified plaques.
• Exposure: Asbestos in general, with chrysotile and crocidolite named. Direct exposure covered mining and milling; manufacture of textiles, cements, roofing and flooring; and application or demolition. Indirect exposure covered neighborhood and household contact.
• Main results:
  • The author stated that pleural plaques indicate only exposure to asbestos and do not imply that a mesothelioma, pulmonary fibrosis or bronchial carcinoma will develop.
  • The author described what appears to be an entity of benign exudative pleural effusions associated with asbestos exposure.
  • The author stated that radiographic abnormalities are not specific for asbestosis: even category 3 does not confirm the diagnosis, and the category does not relate well to disability.
  • The author stated that no resting pulmonary function test can predict disability with exercise, and that exercise testing must be done to assess disability.
  • In one case described by the author, a cigarette smoker with small calcified plaques was judged to have been exposed to asbestos, but the patient's lung function on exercise was that of a person with chronic bronchitic changes.
  • The author stated that mesotheliomas may arise after only brief exposures but require a 20 to 30 year incubation period.
  • Citing another report (Selikoff and Anderson), the author said that among persons indirectly exposed there is an 8 percent incidence of radiographically detectable plaques. This figure is from the cited work, not from this article.
• The authors' conclusion: The author concluded that the single most important point of the discussion is that taking a thorough occupational history is mandatory.

Related studies

• Asbestos-related diseases of the lung and other organs: their epidemiology and implications for clinical practice — M.R. Becklake (1976)
• Diagnosis and initial management of nonmalignant diseases related to asbestos — American Thoracic Society (2004)
• The worldwide pandemic of asbestos-related diseases — L. Stayner, L.S. Welch, et al. (2013)
• Ecological association between asbestos-related diseases and historical asbestos consumption: an international analysis — R.T. Lin, K. Takahashi, et al. (2007)
• Mass and number of fibres in the pathogenesis of asbestos-related lung disease in rats — J.M. Davis, S.T. Beckett, et al. (1978)
• High-resolution CT of benign asbestos-related diseases: clinical and radiographic correlation — D.R. Aberle, G. Gamsu, et al. (1988)

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