Asbestos-related pleuropulmonary diseases: asbestosis, mesothelioma and lung cancer

Our plain-English summary of Asbestos-related pleuropulmonary diseases: asbestosis, mesothelioma and lung cancer, by D.W. Henderson (Pathology, 1982).

The study

• Author: D.W. Henderson
• Journal: Pathology
• Published: 1982;14(3):239-43
• Cited by: 10 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. 001792).

Summary of the article

This editorial review by a pathologist at Flinders Medical Centre, Adelaide, considered recent developments in the pathology of asbestosis, pleural mesothelioma and asbestos-associated lung cancer, after a brief history of asbestos use. Asbestosis was described as interstitial fibrosis concentrated around the bronchioles and mainly in the lower lobes. The author advised that lung tissue from all cases of usual and desquamative interstitial pneumonia, and from resected tumours, be examined for asbestos bodies. He distinguished true asbestos bodies from ferruginous bodies with carbon or sheet-silicate cores. He cited a study of 600 asbestos bodies from 82 people who were not asbestos workers, in which 98% had amphibole cores and 2% chrysotile cores. The review also covered pulmonary cytoplasmic hyalin and proposed cellular and immune mechanisms of fibrosis. For mesothelioma, it outlined a two-step biopsy diagnosis and the use of mucin histochemistry, electron microscopy and carcinoembryonic antigen staining to tell it apart from adenocarcinoma. The author noted that most asbestos-associated mesotheliomas had resulted from crocidolite, with tremolite and erionite implicated in Turkey. Smoking did not affect mesothelioma risk. Asbestos exposure alone increased lung cancer risk about 5-fold. Cited age-standardized lung cancer death rates per 100,000 man-years were 11.3 for people with neither smoking nor asbestos exposure, 58.4 for non-smoking asbestos workers, 122.6 for smokers and 601.6 for asbestos workers who smoked. Asbestos bodies were found in 96% of an urban population, but there was no persuasive evidence that such low-level exposure caused disease. The author called for further study and stressed that avoiding cigarette smoking was the most important preventive measure for people already exposed.

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 1982 editorial review by a pathologist in Adelaide discussed recent developments in the pathology of asbestosis, pleural mesothelioma and asbestos-associated lung cancer. It drew mainly on published studies, adding the author's own diagnostic experience and an unpublished observation. In one cited study, 98% of 600 asbestos bodies from 82 people who were not asbestos workers had amphibole cores and 2% had chrysotile cores. The review reported Selikoff and Hammond's age-standardized lung cancer death rates per 100,000 man-years: 11.3 for men who neither smoked nor handled asbestos, 58.4 for non-smoking asbestos workers, 122.6 for smokers who did not work with asbestos, and 601.6 for asbestos workers who smoked. The author stated that smoking did not influence mesothelioma risk in asbestos-exposed people, though it did for lung cancer. Another cited study found asbestos bodies in the lungs of 96% of an urban population. The author concluded there was not yet persuasive evidence that this low-level exposure caused disease by itself. The author added that its possible role as a co-factor in lung cancer among smokers deserved serious consideration and further study.

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 review of published literature on the pathology of asbestos-related lung and pleural diseases, with a few of the author's own observations
• Who was studied: No study population of its own; the review covered published research on asbestosis, pleural mesothelioma and asbestos-associated lung cancer
• Exposure: Asbestos in general. Fiber types discussed include chrysotile, amosite, anthophyllite, crocidolite and tremolite, plus the non-asbestos mineral erionite. The author noted that almost all asbestos-associated mesothelioma had previously been attributed to crocidolite, while a high incidence in south-eastern Turkey had been attributed to fibrous tremolite.
• Main results:
  • Cited study (Churg & Warnock): of 600 asbestos bodies from 82 patients who were not asbestos workers, 98% had amphibole cores and the remaining 2% had chrysotile cores
  • Cited study (Selikoff & Hammond): age-standardized lung cancer death rates per 100,000 man-years were 11.3 for men who neither smoked nor handled asbestos, 58.4 for non-smoking asbestos workers, 122.6 for smokers who did not work with asbestos, and 601.6 for asbestos workers who smoked
  • The author stated that, in asbestos-exposed populations, mesothelioma risk is not influenced by cigarette smoking but lung cancer risk is, and that asbestos exposure alone increases lung cancer risk approximately 5-fold
  • Cited study (Churg & Warnock): asbestos bodies were detected in the lungs of 96% of an urban population
  • Cited study: in a comparison of 100 lung cancer cases with controls matched for sex, age, smoking habits and occupation, asbestos body counts did not differ
  • Cited work in the same journal issue: adenocarcinomas frequently contained carcinoembryonic antigen (CEA), while the mesotheliomas studied so far had been consistently negative
  • The author reported that, in the author's own experience, Prussian blue staining or unstained sections had not identified asbestos-body cases missed by careful examination of routine H&E sections
  • The author's unpublished observation: asbestos bodies found together with sarcoidal (non-caseating epithelioid) granulomas, which the author considered probably reflected the chance occurrence of sarcoidosis in an asbestos-exposed individual
• The authors' conclusion: The author concluded that there was as yet no persuasive evidence that low-level background asbestos exposure in urban dwellers produces disease by itself. The author considered that its possible role as a co-factor in lung cancer among smokers merited serious consideration and further study, and stressed avoiding cigarette smoking for people already exposed to asbestos.
• Limitations the authors state:
  • The author stated that the article did not attempt a detailed overview of these diseases and covered only selected recent developments in their pathology

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Cancer, Pathology, Pleural Mesothelioma, Interstitial Fibrosis, Interstitial, Asbestos Bodies, Ferruginous body.

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