Community exposure to asbestos

Our plain-English summary of Community exposure to asbestos, by D. Davies (Lancet, 1977).

The study

• Author: D. Davies
• Journal: Lancet
• Published: 1977;2(8044):924
• Type of article: Letter
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004821).

In plain English

This is a letter to the editor of The Lancet, not a research study, and it reports no new data. The author, writing from a Department of Thoracic Medicine in Nottingham, questioned a Lancet statement that people living near an asbestos mill in Yorkshire had acquired asbestosis. The author noted that the cited reference gave no source. The author argued that the answer depends on how asbestosis is defined. An official guide described two forms, alveolar fibrosis and pleural thickening, but the author wrote that few physicians would count isolated pleural disease as asbestosis. The author wrote that community exposure may cause parietal pleural plaques and doubted these ever produce disability. Relatively light exposure may also cause pleural effusions that sometimes lead to restrictive impairment of ventilation. From what the author had been told, local people unconnected with the industry had pleural plaques and effusions; the author had seen no evidence of alveolar fibrosis. A reply printed alongside, by Bertram T. Mann, disagreed. It described patients with pleural asbestosis from community exposure and urged caution before dismissing it as harmless.

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: Letter to the editor (correspondence) giving the author's opinion; no original study or data. It is followed by an editor-invited reply from another physician.
• Who was studied: No group was studied. The letter discusses people living near an asbestos mill in Yorkshire who were not connected with the industry. No numbers or dates are given.
• Exposure: Community (non-occupational) exposure to asbestos dust dispersed around a mill. No fiber type or dose is given.
• Main results:
  • The author stated that the reference the Lancet cited for its statement that people near the Yorkshire mill had acquired asbestosis did not give a source for that information.
  • The author noted that the Lancet's statement had been repeated in the New England Journal of Medicine.
  • The author argued that whether the statement is correct depends on how asbestosis is defined.
  • The author wrote that the official guide to the Industrial Injuries Act describes two forms of the disease, alveolar fibrosis and pleural thickening. The author added that few physicians would include isolated pleural disease as asbestosis.
  • The author wrote that community exposure may cause parietal pleural plaques, but that it is doubtful these ever produce disability, even when extensive.
  • The author wrote that relatively light exposure may also produce pleural effusions. These sometimes result in considerable thickening of both pleural layers and restrictive impairment of ventilation.
  • The author wrote that, as far as the author knew, these pleural diseases have no other significance except as markers of asbestos exposure.
  • The author wrote that, from what the author had been told, local people unconnected with the asbestos industry had acquired pleural plaques and effusions.
  • The author had seen no evidence to date that alveolar fibrosis had occurred among people near the mill.
  • In the reply printed with the letter, Bertram T. Mann stated that some of the reply author's patients have pleural asbestosis due to community exposure.
  • The reply argued that great caution should be exercised before a long-term disease like pleural asbestosis is dismissed as harmless.
• The authors' conclusion: The author concluded that it did not sound as if there had been enough asbestos dust pollution around the mill to produce alveolar fibrosis. Local people had acquired pleural plaques and effusions.
• Limitations the authors state:
  • The author indicated that the information about the people near the mill came from what the author had been told, not from the author's own study.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Pleural plaques and thickening.

Related studies

• Radiographic abnormalities and exposure to asbestos-contaminated vermiculite in the community of Libby, Montana, USA — L.A. Peipins, M. Lewin, et al. (2003)
• Associations between radiographic findings and spirometry in a community exposed to Libby amphibole — T.C. Larson, M. Lewin, et al. (2012)
• Asbestos in the workplace and the community — W.J. Smither (1974)
• Community health risk assessment after a fire with asbestos containing fallout — S. Bridgman (2001)
• Environmental epidemiology. 3. Community effects of nonoccupational environmental asbestos exposure — I.J. Selikoff, E.C. Hammond (1968)
• Mesothelioma in a community in the north of England — A.T. Edward, D. Whitaker, et al. (1996)

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