Asbestosis

Our plain-English summary of Asbestosis, by A. Ahlmark, T. Bruce, A. Nystrom (1960).

The study

• Authors: A. Ahlmark, T. Bruce, A. Nystrom
• Published: Silicosis And Other Pneumoconioses In Sweden, London: William Heinemann Ltd., Pp. 353-357 And 392-399 (1960)
• Type of article: Book excerpt
• Our copy: from Johns-Manville's own medical library, J-M no. 001593.

In plain English

This book chapter on asbestosis in Sweden first summarizes earlier research by others. It then reports the authors' own series of 11 men with asbestosis, the cases known by the end of their observation period in 1956. Eight had done insulating work, 2 had done various asbestos jobs including spooling and weaving of brake linings, and 1 had mainly sprayed asbestos. The fiber types were not named. Diagnoses were made from 1950 to 1956, at ages 33 to 63, after 4 to 30 years of exposure. X-rays showed mild fibrosis in 10 men. The sprayer had advanced disease and died of asbestosis plus pneumonia a few months after diagnosis. No tuberculosis or lung cancer was seen during the observation period. Afterwards, lung cancer was found in 1 man, and 2 more men died: 1 of asbestosis alone and 1 of asbestosis with lung cancer. The authors noted that their cases were only a proportion of those known. They concluded that asbestosis may constitute a grave health hazard in Sweden, requiring technical protection and medical supervision.

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 (the authors' own investigation within a book chapter that also reviews earlier literature)
• Who was studied: 11 men with asbestosis in Sweden, diagnosed between 1950 and 1956 (1 in 1950, 1 in 1953, 6 in 1955, 3 in 1956), aged 33 to 63 at diagnosis
• Exposure: Occupational asbestos exposure (fiber type not specified): insulating work in 8 men, various jobs including spooling and weaving of brake linings in 2, and mainly asbestos spraying in 1. Exposure lasted 4 to 30 years before diagnosis: 6 to 30 years in the insulation workers, 4 and 8 years in the brake-lining workers, and 17 years in the sprayer.
• Main results:
  • Across the 11 cases, exposure before diagnosis ranged from 4 to 30 years.
  • Age at diagnosis ranged from 33 to 63 years.
  • In 10 of the 11 men, diagnostic X-rays showed mild interstitial fibrosis or finely mottled infiltration, generally with thickening or calcification of the pleura. The remaining man had advanced asbestosis.
  • The asbestos sprayer had the most advanced lesions and died a few months after diagnosis, at age 63, of asbestosis plus pneumonia. This was the only death during the observation period.
  • No tuberculosis or lung carcinoma was observed in the 11 men during the observation period.
  • After the observation period, lung cancer was found in 1 case. Two more deaths occurred after 1956: 1 from asbestosis alone and 1 from asbestosis with coexistent lung cancer.
  • X-ray progression during the observation period occurred in only 1 case: a 56-year-old insulation worker who continued working with asbestos after diagnosis. In 3 other cases the disease progressed after the observation period.
  • Two men received disablement benefit. The man who died was compensated at full rate. The man with X-ray progression was first assessed at 15 per cent disablement and later at 60 per cent.
  • In 2 cases the time required to produce asbestosis was no more than about 5 years.
  • According to a personal communication cited by the authors, 15 cases were known in Sweden up to 1960.
• The authors' conclusion: The authors concluded that asbestosis may constitute a grave health hazard in Sweden, and that strictly enforced technical protection and medical supervision of exposed persons are necessary, especially because asbestos use had increased in the past decade.
• Limitations the authors state:
  • The authors stated that their cases comprise only a proportion of those known at the time, partly because not all cases had been notified to the insurance authorities.
  • The authors described their investigation as limited in scope.

Topics

Medical terms in this study, explained in our Lexicon: Brake Lining, Fibrosis, Lung Cancer.

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