Asbestosis among household contacts of asbestos factory workers

Our plain-English summary of Asbestosis among household contacts of asbestos factory workers, by H.A. Anderson, R. Lilis, S.M. Daum, et al (Annals of the New York Academy of Sciences, 1979).

The study

• Authors: H.A. Anderson, R. Lilis, S.M. Daum, I.J. Selikoff
• Journal: Annals of the New York Academy of Sciences
• Published: 1979;330:387-99
• Cited by: 74 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. 004015).

Summary of the article

The authors studied whether household contacts of asbestos factory workers, with no occupational exposure of their own, had asbestos-associated chest x-ray changes. From 1973 to 1978, over 3,100 household contacts of 1,664 workers at a factory that made amosite asbestos insulation products from 1941 to 1954 were identified, and 771 were examined. The analysis included 679 contacts who had lived with a worker while he was employed and had no personal occupational asbestos or fibrogenic dust exposure. Posteroanterior chest films were read blind by five readers using the 1971 ILO U/C classification and compared with films from 325 controls from the same urban New Jersey community with a similar age and sex distribution. All contacts were more than 20 years from first exposure. Abnormalities were found in 239 (35%) contacts and 15 (5%) controls. These included pleural thickening (19% vs 1%), pleural calcification (8% vs 0) and small opacities (17% vs 3%). Prevalence rose with longer household exposure and with earlier onset of exposure. Wives had the highest prevalence (48%) and daughters the lowest (21%). Dyspnea, rales, cyanosis and clubbing were more common among contacts with abnormal x-rays. Five of slightly over 550 recorded deaths were due to pleural mesothelioma. The authors concluded that household exposure can cause pleuro-pulmonary disease and that pleural changes are a better indicator of environmental exposure than small opacities.

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 study reported chest x-ray and clinical examinations of people who had lived with workers at a factory that made amosite asbestos insulation products from 1941 to 1954. Between 1973 and 1978, over 3100 household contacts of the factory's 1,664 workers were identified, and 771 were examined. The analysis included 679 who had lived with an actively employed worker and had no job exposure to asbestos or other fibrogenic dust. Their x-rays were mixed with those of 325 urban New Jersey controls and read without knowing who was in which group. One or more asbestos-associated x-ray abnormalities were found in 239 (35%) household contacts and 15 (5%) controls. Pleural abnormalities were more common than small opacities in the lung tissue. Abnormalities were more frequent with longer household exposure and with earlier first exposure. Wives had the highest prevalence (48%). Shortness of breath and rales were more common in those with abnormal x-rays. Of slightly over 550 deaths traced so far, 5 were due to pleural mesothelioma. The authors concluded that pleuro-pulmonary disease can occur from exposure in asbestos workers' homes. They noted that actual exposure levels were unknown.

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: Cross-sectional chest x-ray and clinical survey of household contacts in a continuing cohort investigation, compared with a control group; x-rays were read by a panel without knowledge of exposure group
• Who was studied: Household contacts of the 1,664 workers of an amosite asbestos factory. Over 3100 contacts were identified in 1973-1978 and 771 were examined. The main analysis included 679 who had lived with an actively employed worker and had no personal occupational exposure to asbestos or other fibrogenic dust. The comparison group was 325 urban New Jersey residents from the same community with no recorded occupational asbestos contact, x-rayed in 1975-1976.
• Exposure: Household exposure to dust from a factory making amosite asbestos insulation materials, 1941-1954. In their earlier report the authors postulated that dust was carried home on shoes, hair and work clothes brought home for laundering. Exposure duration was estimated as the time lived in the household while the worker was actively employed.
• Main results:
  • One or more asbestos-associated x-ray abnormalities were found in 239 (35%) of household contacts, compared with 15 (5%) of controls.
  • Pleural abnormalities were more prevalent than parenchymal small opacities.
  • Pleural calcification was seen in 8% of household contacts and in none of the controls. Pleural thickening was seen in 19% of household contacts and 1% of controls.
  • All types of abnormality increased in prevalence with longer duration of household exposure. The trend for combined small opacities was not statistically significant.
  • Household contacts with more than ten years of exposure had four times as much pleural thickening and three times as much pleural calcification as those with less than one year of exposure.
  • 40% of household contacts first exposed in 1941-1946 had an abnormal x-ray, compared with 22% of those first exposed in 1950-1954.
  • Among household contacts, wives had the highest prevalence of abnormalities (48%) and daughters the lowest (21%). Sons had a statistically significantly higher prevalence than daughters despite the same mean duration of exposure.
  • 33 people had lived in the household only after the worker's employment ended; 4 (12%) of them had abnormalities. They showed no increase in small opacities but a statistically significantly increased prevalence of pleural abnormalities compared with controls.
  • Among 51 household members with their own past occupational asbestos exposure (excluded from the main analysis), 45% had abnormalities.
  • Dyspnea (shortness of breath) was present in 10% of household contacts with parenchymal small opacities, compared with 4% of those with normal x-rays.
  • Rales were found in 9% of household contacts with abnormal x-rays, compared with 3% of those with normal x-rays. Rhonchi were not significantly associated with x-ray abnormalities.
  • Of slightly over 550 deaths recorded so far in the household contact cohort, 5 were due to pleural mesothelioma.
• The authors' conclusion: The authors concluded that their survey indicates pleuro-pulmonary disease can occur under the conditions of nonoccupational exposure experienced in the homes of asbestos workers. They also stated that pleural changes appear to be a better indicator of environmental asbestos exposure than parenchymal small opacities.
• Limitations the authors state:
  • The actual extent and intensity of each household member's asbestos exposure was unknown. The worker's employment history was used as an approximation.
  • For controls, only PA (front) chest films were available, and no clinical examinations or spirometry were done.
  • Only nearly one-third of the living household contact cohort had been examined.
  • No information was available on how much asbestos contamination remained in the house after the worker changed employment.
  • Tracing of deaths in the cohort was not complete.

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 Exposure, Chest X-Ray, Amosite, Fibrogenic, Pleural Thickening, Pleural Calcification, Dyspnea, Cyanosis.

Related studies

• Household-contact asbestos neoplastic risk — H.A. Anderson, R. Lilis, et al. (1976)
• Mortality experience of family contacts of asbestos factory workers — L. Joubert, H. Seidman, et al. (1991)
• Asbestos-related radiographic findings among household contacts of workers exposed to Libby vermiculite: impact of workers' personal hygiene practices — T.J. Hilbert, A. Franzblau, et al. (2013)
• Mineral fiber content of lung tissue in patients with environmental exposures: household contacts vs. building occupants — V.L. Roggli, W.E. Longo (1991)
• Asbestos disease in family contacts of shipyard workers — K.H. Kilburn, R. Lilis, et al. (1985)
• Long term radiological effects of short term exposure to amosite asbestos among factory workers — R. Ehrlich, R. Lilis, et al. (1992)

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