Asbestos-related lung disease

Our plain-English summary of Asbestos-related lung disease, by B.T. Westerfield (Southern Medical Journal, 1992).

The study

• Author: B.T. Westerfield
• Journal: Southern Medical Journal
• Published: 1992;85(6):616-20
• Type of article: Review
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004451).

Abstract

Asbestos is a versatile fibrous mineral that can cause lung disease and death. Asbestosis, benign pleural disease, lung cancer, and mesothelioma can all result from inhaling asbestos. The history of disease and exposure risks are discussed. The difficult assessment of risk and the long latency period for development of disease demand evaluation and regular surveillance of asbestos-exposed workers.

In plain English

This 1992 article was a review, not a new study; its figures came from its cited sources, not from new data. The author, a Lexington, Kentucky physician, summarized published literature on asbestos history, uses and health effects, grouping disease into asbestosis, benign pleural disease, lung cancer and mesothelioma. It stated that asbestosis usually appears 20 to 30 years after exposure, and that pleural plaques do not impair lung function but diffuse pleural thickening may. It stated, as printed, that the lung cancer risk of the asbestos-exposed smoker is 50 to 90 times that of the nonexposed smoker, and that lung cancer is uncommon in asbestos workers who never smoked. It said about 80% of mesothelioma patients have a history of asbestos exposure, that the latency is 35 to 40 years, and that risk is highest for crocidolite, intermediate for amosite and low for chrysotile. The author concluded that environmental risk appears low and that previous asbestos workers need regular medical surveillance, though the review said exposed people with normal chest films and lung function do not need regular follow-up.

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 review article (no original data collected)
• Who was studied: No people were studied. The author reviewed published textbooks, journal articles and IARC publications (22 references) on asbestos history, disease and exposure risk.
• Exposure: Asbestos in general, in its serpentine (chrysotile) and amphibole (crocidolite, amosite, anthophyllite, tremolite, actinolite) forms, through occupational, domestic and environmental exposure
• Main results:
  • The review stated that asbestosis usually appears at least 15 years, and more often 20 to 30 years, after exposure.
  • In its discussion of pleural plaques, the review stated that pleural thickening does not impair pulmonary function.
  • The review stated that, unlike pleural plaques, diffuse pleural thickening may cause symptoms and impair pulmonary function.
  • Citing other sources, the review stated (as printed) that the lung cancer risk of the asbestos-exposed smoker is 50 to 90 times that of the nonexposed smoker.
  • The review stated that lung cancer is uncommon in asbestos workers who have never smoked.
  • The review stated that approximately 80% of patients with mesothelioma have a history of asbestos exposure.
  • The review stated that the latency from first asbestos exposure to diagnosis of mesothelioma is 35 to 40 years.
  • The review stated that mesothelioma risk varies by fiber type: highest for crocidolite, intermediate for amosite, low for chrysotile.
  • The review gave the occupational standard of the time as 0.2 asbestos fibers longer than 5 microns per cubic centimeter over an 8-hour period.
  • The review stated that smoking markedly increases lung cancer risk in asbestos workers.
  • The review stated that exposed people with normal chest films and normal pulmonary function do not need regular follow-up, while those with abnormal chest films or lung function should be evaluated by a respiratory specialist and regularly followed.
• The authors' conclusion: The author concluded that environmental risk for asbestos-related respiratory disease appears to be low and that previous asbestos workers need regular medical surveillance. Earlier in the article, the author said that surveillance is not needed for exposed people with normal chest films and normal pulmonary function.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Latency.

Related studies

• Asbestos related diseases from environmental exposure to crocidolite in Da-yao, China. I. Review of exposure and epidemiological data — S. Luo, X. Liu, et al. (2003)
• Diagnostic Performance of Ultra-Low-Dose Computed Tomography for Detecting Asbestos-Related Pleuropulmonary Diseases: Prospective Study in a Screening Setting — M. Schaal, F. Severac, et al. (2016)
• Asbestos-related diseases in automobile mechanics — J. Ameille, N. Rosenberg, et al. (2012)
• Asbestos-related chest diseases: plain radiographic findings — W.T. Miller, W.B. Gefter, et al. (1992)
• Asbestos-related pleuropulmonary diseases: benign and malignant — A. Lazarus, A. Massoumi, et al. (2012)
• Asbestos-related diseases of lung and pleura: clinical picture and illustrative cases — B. Varkey, U.N. Kumar (1978)

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