Diffuse mesothelioma and exposure to asbestos dust in the Merseyside area

Our plain-English summary of Diffuse mesothelioma and exposure to asbestos dust in the Merseyside area, by W.G. Owen (British Medical Journal, 1964).

The study

• Author: W.G. Owen
• Journal: British Medical Journal
• Published: 1964;2(5403):214-8
• Cited by: 55 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. 001558).

In plain English

This 1964 report described 17 people with diffuse mesothelioma (16 pleural, one peritoneal) in Merseyside, England. Most cases came from Liverpool cancer and thoracic surgery records for 1955 to 1963. The author re-examined tissue, took work histories from patients or relatives, and searched lung tissue for asbestos bodies. There were 12 men and five women. Strong evidence of asbestos exposure was found in 14 of the 17 (82%). Eleven had handled asbestos at work. They included laggers and others in heat insulation, two asbestos factory workers, and two women who sorted used sacks. One worked in the office of a factory with asbestos dust. Two others with no clear history of asbestos exposure had asbestos bodies in their lungs. Where it could be dated, first known exposure came 13 to 66 years before the tumour, with an average of 38.5 years. Asbestos bodies were found in seven of the 10 cases with lung tissue available. The type of asbestos was not identified. The author concluded that asbestos exposure is a major factor, and possibly an essential one, in causing diffuse mesothelioma.

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: Case series: review of 17 cases with histological reassessment, occupational histories, and microscopic search for asbestos bodies in lung tissue
• Who was studied: 17 patients with diffuse mesothelioma (16 pleural, 1 peritoneal; 12 men, 5 women; ages 46 to 82) in the Merseyside area, England. Most were identified from the files of the Liverpool Cancer Control Organization and the Liverpool Regional Thoracic Surgery Unit, 1955 to 1963.
• Exposure: Occupational asbestos exposure. Jobs included laggers mainly insulating steam pipes (five), sheet-metal workers and boiler-makers (two), workers in asbestos-processing factories (a card-room operative and a foreman), sorters of used sacking including asbestos sacks (two women), and an office worker. The type of asbestos fiber was not identified.
• Main results:
  • Asbestos exposure had occurred in 14 of the 17 cases (82%).
  • Eleven patients were known to have handled asbestos at work.
  • Five patients gave a negative or inconclusive occupational history. In two of them, asbestos bodies were seen in lung tissue.
  • Where it could be established, the interval from first known exposure to the tumour ranged from 13 to 66 years, with an average of 38.5 years. Table I gives no exposure dates for case 3 or for cases 15 to 17, and many of the figures it does give are marked as approximate.
  • Asbestos bodies were identified in 7 of the 10 cases where lung tissue was available.
  • No patient had symptoms suggestive of pulmonary asbestosis.
  • In the 12 post-mortem examinations, no primary carcinoma was found elsewhere in the body.
  • A mixed microscopic pattern was found to some degree in all tumours examined.
• The authors' conclusion: The author concluded that exposure to asbestos is a major factor, and possibly an essential one, in the causation of diffuse mesothelioma.
• Limitations the authors state:
  • The type of asbestos the patients were exposed to was not identified.
  • Exposure information came from patients or relatives only; employers were not contacted.
  • Very little lung tissue was available for examining asbestos bodies.
  • One diagnosis was accepted without histological reassessment because the tissue could not be found.
  • No pleural or peritoneal fluids were available for examination.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer, Mesothelioma, Peritoneal mesothelioma.

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

Related studies

• Exposure to asbestos and mesothelioma of the pleura — P.B. Fowler, J.C. Sloper, et al. (1964)
• The pathology of mesotheliomata and an analysis of their association with asbestos exposure — D.O. Hourihane (1964)
• Peritoneal tumours in asbestosis — J.B. Enticknap, W.J. Smither (1964)
• Pulmonary ventilatory function in talcosis of lung — M. Kleinfeld, J. Messite, et al. (1964)
• Asbestos bodies in human lungs at autopsy — D. Cauna, R.S. Totten, et al. (1965)
• Talc pneumoconiosis: a report of six patients with postmortem findings — M. Kleinfeld, C.P. Giel, et al. (1963)

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