Behavioral, attitudinal, and physiologic characteristics of smoking and nonsmoking asbestos-exposed shipyard workers

Our plain-English summary of Behavioral, attitudinal, and physiologic characteristics of smoking and nonsmoking asbestos-exposed shipyard workers, by V.C. Li, Y.J. Kim, P.B. Terry, et al (Journal of Occupational Medicine., 1983).

The study

• Authors: V.C. Li, Y.J. Kim, P.B. Terry, J.C. Cuthie, D. Roter, E.A. Emmett, A. Harvey, S. Permutt
• Journal: Journal of Occupational Medicine.
• Published: 1983;25(12):864-70
• 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. 000621).

Abstract

The smoking characteristics of shipyard workers participating in an Asbestos Medical Surveillance Program (N = 3,991) were assessed. Sources of data were: (1) a self-assessment questionnaire on the smoking history and respiratory symptomatology of the 871 current smokers who participated in the smoking study, and (2) chest roentgenograms and pulmonary function test results and medical records for the entire population. The study population included 1,711 current smokers, 988 former smokers and 1,292 never smokers. The annual "quit rate" for former smokers had increased from less than 1% in 1961 to 4.2% in 1978. Of the 871 current smokers who participated in the smoking study, 19% had resumed smoking after having given up cigarettes for one year or longer. Men in the smoking study were reasonably well informed about the health consequences of smoking. While they perceived themselves to be susceptible to disease, and the disease to be serious, the benefits they saw in quitting were related more to economics and aesthetics than to health. When the results were age adjusted, no differences in rate of pulmonary function abnormalities and chest film abnormalities were found between current smokers who voluntarily participated in the smoking study and those who did not. All pulmonary function testing abnormality and chest film abnormality rates were significantly lower for former smokers and never smokers.

In plain English

This study described 3,991 asbestos-exposed workers (1,292 never, 988 former and 1,711 current smokers) in a U.S. Navy asbestos surveillance program at the Naval Shipyard in Charleston, South Carolina. Of the current smokers, 871 completed a questionnaire on smoking and breathing symptoms. Among these 871 participants, 22% had abnormal lung function tests and 19% had chest X-ray abnormalities of any type. In 10%, the chest film changes were compatible with occupational exposure. Lung function abnormalities were associated with higher estimated asbestos exposure, among other factors. Those who answered seven questions on smoking hazards scored 74% correct overall. The benefits they saw in quitting centred more on saving money and appearance than on health. Of those who had tried to quit, 19% had stopped for longer than a year before resuming. After age adjustment, smokers who refused the study did not differ significantly from participants in lung function or chest film abnormality rates. Former and never smokers had significantly lower rates of both than participants, apart from chest films compatible with occupational exposure. The authors noted possible selection bias.

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: Descriptive cross-sectional analysis of workers in a shipyard asbestos medical surveillance program, including baseline data from smokers enrolled in a smoking cessation study
• Who was studied: 3,991 asbestos-exposed workers eligible for the U.S. Navy Asbestos Medical Surveillance Program at the Naval Shipyard in Charleston, S.C.: 1,292 never smokers, 988 former smokers, 1,711 current smokers. Of 1,030 eligible smokers, 871 completed the questionnaire and 159 refused. Baseline data were collected June 1979 to June 1980.
• Exposure: Asbestos exposure in shipyard jobs, estimated from medical records and work histories using program criteria and a physician's estimate (fiber type not stated); cigarette smoking
• Main results:
  • Among the 871 smoking study participants, 22% had abnormal pulmonary function tests and 19% had chest X-ray abnormalities of any type
  • In 10% of participants, chest films showed abnormalities compatible with occupational exposure
  • Among participants, increases in pulmonary function abnormalities were associated with higher levels of asbestos exposure, as well as with lower education and self-reported heart trouble, emphysema and bronchitis
  • Unadjusted abnormal pulmonary function rates were 19% in former smokers, 12% in never smokers and 29% in smokers who refused the study (compared with 22% in participants)
  • After age adjustment, refusals and participants did not differ significantly in pulmonary function abnormalities; former and never smokers had significantly lower rates than participants
  • After age adjustment, chest film abnormality rates for former and never smokers were significantly lower than for participants
  • Participants reported having been diagnosed with chronic bronchitis less often than they met the criteria for it on a standardized respiratory questionnaire
  • Among participants who answered seven questions about health hazards of smoking, the overall correct score was 74%
  • Participants valued saving money and appearance more than health as perceived benefits of stopping smoking
  • Among participants who had tried to stop smoking before the program, 19% had stopped for longer than one year but then resumed
  • In this shipyard population, annual quit rates ranged from less than 1% to 4% a year between 1960 and 1978; after the program began, the point cessation quit rate was 4.2%
• The authors' conclusion: The authors concluded that, once adjusted for age, refusals and participants did not differ appreciably in rates of pulmonary function and chest film abnormalities. Former and never smokers had significantly lower rates of these abnormalities than current smokers, except for chest films compatible with occupational exposure.
• Limitations the authors state:
  • Possible selection bias from workers who missed program appointments (30%) and those who refused the study (15%)
  • No information on the health knowledge, attitudes and beliefs of workers who missed appointments

Topics

Medical terms in this study, explained in our Lexicon: Pulmonary Function Test (PFT), Chest X-Ray.

Related studies

• Lung function and exercise performance in smoking and nonsmoking asbestos-exposed workers — D.Y. Sue, A. Oren, et al. (1985)
• Railroad workers with pleural plaques: I. Spirometric and nitrogen washout investigation on smoking and nonsmoking asbestos-exposed workers — U. Hjortsberg, P. Orbaek, et al. (1988)
• Does smoking cessation lead to weight gain? The experience of asbestos-exposed shipyard workers — T.J. Coates, V.C. Li (1983)
• Pulmonary function, smoking habits, and high resolution computed tomography (HRCT) early abnormalities of lung and pleural fibrosis in shipyard workers exposed to asbestos — S. Neri, P. Boraschi, et al. (1996)
• Asbestos disease in construction, refinery, and shipyard workers — K.H. Kilburn, R.H. Warshaw (1991)
• Combined effect of asbestos exposure and smoking on mortality from lung cancer in factory workers — G. Berry, M.L. Newhouse, et al. (1972)

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