Asbestos-related x-ray changes in foundry workers

Our plain-English summary of Asbestos-related x-ray changes in foundry workers, by K.D. Rosenman, M.J. Reilly (American Journal of Industrial Medicine, 1998).

The study

• Authors: K.D. Rosenman, M.J. Reilly
• Journal: American Journal of Industrial Medicine
• Published: 1998;34(2):197-201
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Michigan has a statewide mandatory occupational disease reporting system. As part of that system, reports are received from hospital, physicians, death certificates, the worker's compensation bureau, and company medical departments. Based on this reporting, the State of Michigan has a special emphasis program for the surveillance of silicosis, a known disease outcome among foundry workers. From 1985-1996, 115 cases reported to the State Surveillance System as silicosis, pneumoconiosis not specified, or pulmonary fibrosis were reclassified as having asbestos related x-ray changes after a B-reader interpretation of each case's chest x-ray. During this same period there were an additional 697 reports confirmed as silicosis and 6,724 cases reported to the surveillance system as asbestosis. Among the 115 reports reclassified as having asbestos-related x-ray changes without evidence of silicosis-related x-ray changes, 54 had worked in foundries. Only 7 (14.8%) of these individuals had their primary work in maintenance in the foundry; 40 (85.1%) had their primary foundry work in a production job; and for 10 individuals the occupation was not known. Asbestos has been used in foundries on pipe laggings, boiler coverings, as insulation in fan housings, in gloves, aprons and curtains, as insulation in cupolas, and in ladles and insulation in sand molds. Clinicians caring for foundry workers need to be aware that asbestos-related x-ray changes are not uncommon in this population and asbestos exposure should be considered as one of the carcinogens contributing to the known increased risk of lung cancer among foundry workers.

In plain English

This article described a case series identified through Michigan's statewide surveillance program for silicosis, a lung disease caused by silica dust. From 1985 to 1996, 115 people first reported as having silicosis, unspecified pneumoconiosis or pulmonary fibrosis were reclassified as having asbestos-related chest x-ray changes. Of these, 57 had worked in foundries: 54 in 17 different foundries and 3 in an unknown foundry. Where the job was known, about 15% had worked mainly in maintenance and 85% in production. Of the 57, 26 had lung-tissue (parenchymal) changes without pleural changes, 17 had pleural changes only, and 14 had both. Only 9 of 49 with a complete work history had held other jobs with possible asbestos exposure. Separately, 697 people were confirmed to have silicosis. Of these, 166 also showed x-ray evidence of asbestos exposure, and 121 of the 166 had worked mainly in foundries. The authors concluded that asbestos-related x-ray changes are not uncommon in foundry workers. They said asbestos should be considered one of the carcinogens contributing to these workers' known increased lung cancer risk. They noted that they examined only a small portion of workers with such changes.

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: Case series drawn from a state occupational disease surveillance system, including three individual case reports
• Who was studied: 57 foundry workers in Michigan, reported to the state surveillance system from 1985 to 1996, who were reclassified from silicosis, unspecified pneumoconiosis or pulmonary fibrosis to asbestos-related x-ray changes; their average year of birth was 1924
• Exposure: Work in foundries. No fiber type was identified for these workers. The authors listed uses of asbestos in foundries: pipe lagging, boiler coverings, insulation in fan housings, asbestos-containing gloves, aprons and curtains, and insulation in cupolas and ladles
• Main results:
  • 115 patients first reported with silicosis, pneumoconiosis not specified, or pulmonary fibrosis were reclassified as having asbestos-related x-ray changes (1985 to 1996)
  • Of the 115, 54 had their primary asbestos exposure in 17 different foundries, and 3 more worked in an unknown foundry
  • Among the foundry workers whose job was known, about 15% worked primarily in maintenance and 85% in production
  • Among the 57 foundry workers, 26 had parenchymal disease without pleural disease, 17 had pleural disease without parenchymal disease, and 14 had both
  • Of the 31 foundry workers with pleural disease, 21 had changes on both sides and 4 had pleural calcification
  • Only 9 of 49 (18.4%) foundry workers with a complete work history had worked at other jobs with possible asbestos exposure
  • During the same period, 697 patients were confirmed to have silicosis
  • Among the confirmed silicosis patients, 166 had x-ray evidence of both silica and asbestos exposure; 121 of these 166 (72.9%) had their primary work exposure in 36 different foundries
• The authors' conclusion: The authors concluded that asbestos-related x-ray changes are not uncommon among foundry workers. They also concluded that asbestos exposure should be considered one of the carcinogens contributing to the known increased lung cancer risk in these workers
• Limitations the authors state:
  • The authors stated that the review examined only a small portion of workers with asbestos-related x-ray changes
  • The authors did not review the radiographs of the thousands of people reported directly with asbestos-related changes, and they did not know where those people worked

Topics

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

Medical terms in this study, explained in our Lexicon: Occupational Disease, Death Certificate, Silicosis, Pneumoconiosis, Pulmonary Fibrosis, B-Reader, Chest X-Ray, Pipe Covering.

Related studies

• Silicosis among foundry workers. Implication for the need to revise the OSHA standard — K.D. Rosenman, M.J. Reilly, et al. (1996)
• Asbestos-related disease among sheet metal workers 1986-2004: radiographic changes over time — L.S. Welch, E. Haile (2009)
• Respiratory health of workers exposed to metal dusts and foundry fumes in a copper refinery — G. Ostiguy, C. Vaillancourt, et al. (1995)
• Change in prevalence of asbestos-related disease among sheet metal workers 1986 to 2004 — L.S. Welch, E. Haile, et al. (2007)
• Historical cohort study of a New Zealand foundry and heavy engineering plant — H.M. Firth, J.M. Elwood, et al. (1999)
• Past asbestos exposure levels in foundries and cement-asbestos factories — S. Mattioli, D. Nini, et al. (2002)

Browse more research in American Journal of Industrial Medicine, or return to medical research.