Clinical aspects of pulmonary asbestosis

Our plain-English summary of Clinical aspects of pulmonary asbestosis, by A.C. Haddow (British Medical Journal, 1929).

The study

• Author: A.C. Haddow
• Journal: British Medical Journal
• Published: 1929;2(3586):580-1
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003102).

Summary of the article

This paper, read at the 1929 Annual Meeting of the British Medical Association in Manchester, described asbestos workers seen in a general practice in Leeds. In 1926 the author and a colleague noticed that several patients with chest complaints were asbestos workers. They examined every asbestos worker who came their way, about fifteen in all, and had most of them radiographed. Four workers had died: three women and one man. Their average age at death was 41, and they had spent on average under twenty years in the factory, mostly in asbestos mattress-making. The man's death was certified as bronchopneumonia secondary to chronic asbestos poisoning causing pulmonary fibrosis, which led to a coroner's inquest and official recognition of the disease. Tubercle bacilli were found in the sputum of only one of the four. The author also described four advanced cases under treatment. All were women from the mattress department, with an average age of 35 and an average of fourteen years in the factory. They had breathlessness on exertion, cough, anorexia, reduced chest expansion and signs at the lung bases. Radiographs showed infiltration in the lower zones, particularly on the right. Asbestosis bodies were found by lung puncture in two of the four and in the sputum of three. The author concluded that inhaled asbestos dust produces fibrosis that is mainly basal and peripheral. He found that the disease is usually not complicated by tuberculosis and is first recognized after more than five years' exposure. He reported that it worsens in winter, and that sputum examination and radiography are useful in diagnosis.

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 1929 paper, read at a British Medical Association meeting, was a clinical report by a general practitioner in Leeds on asbestos workers with chest disease. Starting in 1926, the author and a colleague examined about fifteen asbestos workers who came to their practice, and most were X-rayed. The author described four fatal cases. Their average age at death was 41, they had spent on average under twenty years in the factory, mostly in asbestos mattress-making, and tubercle bacilli had been found in the sputum of only one. Four other advanced cases were permanently incapacitated. All were women from the mattress department, with an average age of 35 and an average of fourteen years in the factory. They had breathlessness on exertion, cough without phlegm and loss of appetite. X-rays showed infiltration in the lower lungs, particularly on the right. Asbestosis bodies were found in the sputum of three and by lung puncture in two. The author concluded that inhaled asbestos dust "in the long run" produces fibrosis, mainly at the lung bases, usually first recognized after more than five years' exposure.

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: Clinical report (case series) from a general practice
• Who was studied: About fifteen asbestos workers seen in the author's general practice in Leeds from 1926. The report describes four fatal cases and four living advanced cases, all four of the latter women.
• Exposure: Asbestos dust in an asbestos factory, mostly in asbestos mattress-making. The article does not name a fiber type.
• Main results:
  • In the four fatal cases, the average age at death was 41.
  • Of the four fatal cases, three had been incapacitated for an average of two and a half years before death. The male patient had worked until two days before death.
  • Among the fatal cases, tubercle bacilli had been found in the sputum of only one.
  • The four advanced cases under treatment were all women, with an average age of 35 and an average of fourteen years in the factory.
  • In the four advanced cases, X-rays showed definite infiltration in the lower lung zones, particularly on the right side.
  • All four advanced cases had lung puncture, and asbestosis bodies were found in two of them.
  • In the four advanced cases, three yielded asbestosis bodies in sputum. The fourth had no sputum but was positive on lung puncture.
  • Patients generally believed their symptoms began after five years of work.
• The authors' conclusion: The author concluded the following points:
• Inhaling asbestos dust will "in the long run" produce fibrosis that is peripheral and mainly at the lung bases.
• The disease is not as a rule complicated by tuberculosis.
• It is usually first recognized after more than five years' exposure.
• Asbestosis bodies can be found in the sputum in advanced cases.
• Radiography is of great value in diagnosis.
• Treatment so far is purely palliative.
• Limitations the authors state:
  • Patients are unlikely to allow more than one lung puncture, so a negative puncture result is inconclusive.
  • Many workers had left the factory or stopped work, and any fibrosis could have been overlooked when they died years later, so deaths may have been missed.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Pulmonary Fibrosis, Sputum, Fibrosis.

Related studies

• Clinical Aspects of Pulmonary Asbestosis — T. Oliver (1927)
• The relative importance of clinical, radiological and pulmonary function variables in evaluating asbestosis and chronic obstructive airway disease in asbestos workers — G.M. Regan, B. Tagg, et al. (1971)
• Clinical and radiological criteria for the differential diagnosis between asbestosis and idiopathic pulmonary fibrosis: Application in two cases — A. Stufano, A. Scardapane, et al. (2021)
• Clinical aspects of asbestos-related diseases--what are the unresolved topics? — D.E. Banks (2014)
• Surgical and pathologic aspects of asbestosis — W.F. Sasser, W.A. Bari (1981)
• Identifying the pulmonary hazard of high aspect ratio nanoparticles to enable their safety-by-design — K. Donaldson, F. Murphy, et al. (2011)

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