Changing risk groups for malignant mesothelioma

Our plain-English summary of Changing risk groups for malignant mesothelioma, by M. Huncharek (Cancer, 1992).

The study

• Author: M. Huncharek
• Journal: Cancer
• Published: 1992;69(11):2704-11
• Cited by: 34 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. 004413).

Abstract

Although malignant mesothelioma is a relatively rare tumor, its incidence is rising. Much of the increase is attributable to widespread exposure to asbestos in past decades in asbestos-related industries. In recent years, it has become increasingly clear that mesothelioma risk is no longer confined to workers in the asbestos industry. This article reports a variety of recently identified "risk groups" and highlights the need for increased surveillance of these groups to document the occurrence of asbestos-related malignancy and the institution of measures for disease prevention.

In plain English

This article was a review, not a new study. The author gathered published reports on groups of people outside the asbestos industry thought to be at risk of malignant mesothelioma. For brake mechanics, it described a 1976 Mount Sinai study that measured 6.6 to 29.4 fibers/ml (mean 15.9) 3 to 5 feet from brake drums while dust was blown out. It also described case reports. For US railroad workers, it described a case-control study by Schenker and colleagues. That study found an odds ratio of 21.4 for skilled trades with regular asbestos exposure and a nonsignificant 2.3 for intermittent exposure. Other reports covered sheet metal workers, building occupants and school teachers, and a family who made an amosite product at home. They also covered a Native American pueblo where asbestos was used in making silver jewelry, and crocidolite cigarette-filter workers, 5 of whose 28 deaths were from mesothelioma. The author noted that death certificate studies may underestimate mesothelioma and that exposure data were often lacking. The author concluded that available data support the idea that all fiber types can cause malignancy, and that risk is no longer confined to asbestos-industry workers.

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: Narrative review of published studies and case reports on newly recognized mesothelioma risk groups; no new data were collected
• Who was studied: Groups described in other published studies: brake mechanics, railroad workers, construction trades (including sheet metal workers and electricians), building occupants and maintenance workers, and other unusual exposure groups (a family, a Native American pueblo, cigarette-filter workers, cases from a hospital case-control study)
• Exposure: Asbestos in brake and clutch linings (chrysotile), asbestos-containing materials in buildings, and other products. The review also discussed whether chrysotile, compared with amphiboles such as amosite and crocidolite, causes mesothelioma
• Main results:
  • In a 1976 Mount Sinai study (Lorimer et al.) of brake repair workers in New York, samples taken 3 to 5 feet from brake drums during blowing of dust showed 6.6 to 29.4 fibers/ml, with a mean of 15.9 fibers/ml
  • In a case-control study of US railroad workers (Schenker et al.), 20 mesothelioma deaths were identified. A significant odds ratio of 7.2 was found for jobs with potential asbestos exposure, and a statistically significant odds ratio of 21.4 for skilled trades with regular exposure
  • In the same railroad study, the odds ratio for workers in occupations with intermittent exposure was 2.3 and was not statistically significant
  • In a cohort of 197 railroad machinists (Mancuso), causes of death were identified for 132. Of 29 cancer deaths, 9 were caused by mesothelioma
  • In an extended proportional mortality study of New York sheet metal workers (Zoloth and Michaels), six mesothelioma deaths were documented on death certificates, described by those authors as 1.8% of deaths (6 of 331)
  • A 1987 EPA report of 43 federal buildings found prevalent airborne asbestos levels of 0.0 to 0.2 fibers per cubic centimeter, with an arithmetic mean of 0.006
  • In the author's earlier review of pleural mesothelioma cases, two cases were in school teachers exposed for many years to friable ceiling and pipe insulation. The insulation was predominantly chrysotile, with small amounts of amosite in one case
  • In a reported family cluster (Otte et al.), the father, mother and son died of malignant mesothelioma after an amosite-containing product was made in the family home's basement for 17 years
  • Driscoll et al. reported five patients with malignant mesothelioma in a Native American pueblo of 2000 persons, where asbestos was used in making silver jewelry and for whitening buckskin
  • In a cohort of 33 male cigarette-filter workers mainly exposed to crocidolite (Talcott et al.), 28 had died by December 31, 1988, against 8.3 expected. Five of the 28 deaths were from mesothelioma
• The authors' conclusion: The author concluded that available data support the idea that all asbestos fiber types can cause malignancy, that the potential risks of chrysotile should not be ignored, and that occupational mesothelioma risk is no longer confined to asbestos-industry workers
• Limitations the authors state:
  • The author noted that death certificate studies may greatly underestimate mesothelioma because the tumor is hard to diagnose and is often misclassified
  • The author noted that risk estimates for brake workers were hampered by a lack of quantitative exposure data
  • The author noted that short-term air sampling in buildings may not reflect long-term fiber levels
  • The author noted that accurate exposure data for comparing fiber types are often lacking or of questionable quality

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Mesothelioma.

Related studies

• Distribution of mesothelioma cases in different occupational groups and industries in Australia, 1979-1995 — P. Yeung, A. Rogers, et al. (1999)
• Impact of occupational carcinogens on lung cancer risk in a general population — S. De Matteis, D. Consonni, et al. (2012)
• Occupational exposures and risk of stomach cancer by histological type — M. Santibañez, J. Alguacil, et al. (2012)
• A case-control study of occupational risk factors for laryngeal cancer — P. Wortley, T.L. Vaughan, et al. (1992)
• Occupational risk factors for brain cancer in Canada — S.Y. Pan, A.M. Ugnat, et al. (2005)
• Lung cancer risk and workplace exposures in black men and women — J.E. Muscat, S.D. Stellman, et al. (1998)

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