Asbestos-related pleuropulmonary diseases: benign and malignant

Our plain-English summary of Asbestos-related pleuropulmonary diseases: benign and malignant, by A. Lazarus, A. Massoumi, J. Hostler, et al (Postgraduate Medicine, 2012).

The study

• Authors: A. Lazarus, A. Massoumi, J. Hostler, D.C. Hostler
• Journal: Postgraduate Medicine
• Published: 2012;124(3):116-30
• Type of article: Review
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Asbestos is known for its desirable properties of thermal and heat resistance along with excellent strength and durability. It was widely used in many industries since the late 19th century, until its adverse effects on health were recognized. The occurrence of pleuropulmonary changes from exposure to asbestos often has a latency period of 20 to 30 years. The use of asbestos has been banned, regulated, and minimized in many countries, but in several developing countries, the use of asbestos in industries is still a common practice. In this article, the benign and malignant clinical manifestations of asbestos exposure are discussed.

In plain English

This article was a review of published literature, not a new study. The authors searched Medline using keywords including "asbestos," "pleural effusion," "lung cancer," "pleural thickening," and "asbestosis," and included prospective and retrospective studies and review articles. The review covered nonmalignant conditions (benign asbestos pleural effusion, pleural plaques, diffuse pleural thickening, rounded atelectasis and asbestosis) and malignant ones (pleural and peritoneal mesothelioma and lung cancer), including their diagnosis, treatment and prognosis. Citing other studies, it reported several points. Pleural plaques were the most common manifestation, with a latency of 20 to 30 years after first exposure. Asbestosis needed a higher burden of exposure than benign pleural disease. Median survival with mesothelioma was approximately 1 year. Roughly 4% to 12% of lung cancers globally were attributed to asbestos. Peritoneal mesothelioma accounted for 10% to 15% of mesothelioma cases, and its association with asbestos was not as strong as for pleural mesothelioma. The authors concluded that asbestos-exposed patients should be placed on a surveillance program that includes smoking cessation and respiratory protection.

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: Review of published literature (Medline keyword search plus reference lists); no new data collected
• Who was studied: Published articles found through a Medline search and the reference lists of included articles; no study population of its own
• Exposure: Asbestos in general, described as including chrysotile, amosite, crocidolite, tremolite, actinolite and anthophyllite
• Main results:
  • The review stated, citing other sources, that circumscribed pleural plaques were the most common manifestation of asbestos exposure, with a latency of 20 to 30 years after first exposure
  • Benign asbestos pleural effusion was described, citing other sources, as rare, with a prevalence of 3% to 14.3% that correlated with level of exposure
  • The review stated, citing other sources, that asbestosis required a higher burden of exposure than benign pleural diseases
  • The review stated, citing other sources, that asbestos fibers, mostly amphibole, were the most common cause of mesothelioma, with exposure documented in up to 85% in some studies
  • Median survival with malignant mesothelioma was given as approximately 1 year
  • Peritoneal mesothelioma was described as accounting for 10% to 15% of all mesothelioma cases, with a weaker association with asbestos than pleural mesothelioma
  • Citing another source, the review stated that approximately 4% to 12% of lung cancers globally are due to asbestos exposure
  • Citing Hammond et al., the review gave standardized lung cancer mortality ratios of 5.17 for nonsmoking asbestos workers, 10.85 for smokers without asbestos exposure, and 53.24 for smokers with asbestos exposure
• The authors' conclusion: The authors concluded that asbestos causes benign pleural and parenchymal disease as well as mesothelioma and lung cancer, and that exposed patients should be placed on a surveillance program that includes smoking cessation and respiratory protection

Topics

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

Medical terms in this study, explained in our Lexicon: Latency, Asbestos Exposure.

Related studies

• 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 exposure and benign asbestos diseases in 772 formerly exposed workers: dose-response relationships — G. Mastrangelo, M.N. Ballarin, et al. (2009)
• Chest pain in asbestos-exposed individuals with benign pleural and parenchymal disease — S. Mukherjee, N. de Klerk, et al. (2000)
• Asbestos-related pleuropulmonary diseases: evaluation with low-dose four-detector row spiral CT — M. Remy-Jardin, A. Sobaszek, et al. (2004)
• Asbestos exposure. An update on pleuropulmonary hazards — B. Varkey (1983)
• Clinical value of fluorodeoxyglucose-positron emission tomography/computed tomography in differentiation of malignant mesothelioma from asbestos-related benign pleural disease: an observational pilot study — H. Yildirim, M. Metintas, et al. (2009)

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