Diseases related to asbestos exposure: historical perspective

Our plain-English summary of Diseases related to asbestos exposure: historical perspective, by H.P. Pendergrass, J.D. Snell, F.E. Carroll (Southern Medical Journal, 1987).

The study

• Authors: H.P. Pendergrass, J.D. Snell, F.E. Carroll
• Journal: Southern Medical Journal
• Published: 1987;80(12):1546-52
• Type of article: Historical article
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000342).

Abstract

Our goal in this brief and limited historical summary of asbestos-related diseases has been to bring the clinician up to date with the current status of this important medical and public health issue. The references will provide an information source for those who require more comprehensive knowledge.

In plain English

This 1987 article was a short review of asbestos-related diseases in historical perspective. It reported no new study of patients or workers. The authors described sources of asbestos in the environment, the history of medical recognition of asbestos disease, and its clinical signs, diagnosis and complications. Citing earlier work, the article noted that a review of chest films of 1,135 exposed workers found benign pleural effusion to be the only asbestos-related disorder in the first ten years after exposure. It also noted that epidemiologic studies suggested that, in a heavily exposed group, asbestos workers who smoked had a lung cancer death rate 53 times that of nonsmoking workers not exposed to asbestos. From their own experience, the authors reported that oblique chest views added information about the pleura, and that CT was more sensitive for detecting pleural calcification, though they did not recommend it routinely. They wrote that the plain chest x-ray remained, in most instances, the best means of evaluating people exposed to asbestos. The authors described their review as selective and short.

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: Review article (brief historical and clinical review of asbestos-related diseases); no original data collected
• Who was studied: No study population; the article reviewed published reports, articles and reviews on asbestos-related disease, plus the authors' clinical and radiologic experience
• Exposure: Asbestos in general, described as a fibrous silicate mineral. Sources discussed include natural outcroppings, mining and mine dumps, manufacturing of asbestos products, industrial insulation, school and home pipe insulation and fireproofing, and ship dismantling. In vitro and in vivo differences between chrysotile and crocidolite were mentioned.
• Main results:
  • Citing an earlier study (not the authors' own data): a review of multiple chest films over a period of years in 1,135 exposed workers in several asbestos-related occupations identified benign pleural effusion as the only asbestos-related disorder in the first ten years after exposure, and the most common in the first 20 years
  • Citing epidemiologic studies (not the authors' own data): in a heavily exposed group, the lung cancer death rate for asbestos workers who smoke was suggested to be 53 times that of nonsmoking workers not exposed to asbestos, and about ten times that of nonsmoking asbestos workers
  • In the authors' experience with individuals at high risk for asbestosis, oblique views of the chest added information about the pleural surfaces of the lung
  • In the authors' hands, CT was a more sensitive technique for detecting pleural calcification, but they did not recommend it as a routine procedure
  • In the authors' experience, rounded opacities or fibrosis with associated calcifications were usually not asbestosis
  • The article stated that pleural calcification is rarely seen before the third decade after exposure
  • The article stated that bronchiolar (small airway) inflammation seen in asbestos-exposed animals and workers has been shown to cause no change in FEV1
  • The authors stated that the plain chest x-ray film remains, in most instances, the best means of evaluating and following up patients exposed to asbestos
• The authors' conclusion: The authors concluded that clinicians should keep a low threshold for considering asbestos-related disease when typical pleural or parenchymal changes are seen, without suggesting more specificity than the chest x-ray warrants. They described their goal as bringing clinicians up to date.
• Limitations the authors state:
  • The authors stated that an extensive review was beyond the scope of their selectively short report

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure.

Related studies

• Ecological association between asbestos-related diseases and historical asbestos consumption: an international analysis — R.T. Lin, K. Takahashi, et al. (2007)
• Historical developments and perspectives in inorganic fiber toxicity in man — I.J. Selikoff (1990)
• Historical perspectives of occupational cancer — P. Bogovski (1980)
• Pathological recognition of diffuse malignant mesothelioma of the pleura: the significance of the historical perspective as regards this signal tumor — E.J. Mark, R.L. Kradin (2006)
• Historical perspective on asbestos: policies and protective measures in World War II shipbuilding — J.K. Corn, J. Starr (1987)
• Asbestos: historical perspective — L. Garfinkel (1984)

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