Environmental epidemiology. 3. Community effects of nonoccupational environmental asbestos exposure

Our plain-English summary of Environmental epidemiology. 3. Community effects of nonoccupational environmental asbestos exposure, by I.J. Selikoff, E.C. Hammond (American Journal of Public Health and the Nation's Health, 1968).

The study

• Authors: I.J. Selikoff, E.C. Hammond
• Journal: American Journal of Public Health and the Nation's Health
• Published: 1968;58(9):1658-66
• Cited by: 30 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 nos. 001461, 004469).

Summary of the article

This paper, presented at the American Public Health Association meeting in October 1967, reviewed evidence on asbestos disease in people without occupational exposure and set out problems for future study. The authors summarized earlier findings. Kiviluoto found pleural calcification in 499 of 6,312 adults in a Finnish commune with an asbestos mine and none among 7,101 adults in a neighboring commune. Wagner found possible asbestos contact, usually nonoccupational, in 32 of 33 South African pleural mesotheliomas. Thomson found asbestos bodies in 26.4 per cent of 500 Cape Town autopsies. The authors also presented their own data. Among 370 asbestos insulation workers followed from January 1963 to April 1967 there were 94 deaths against 47.5 expected, including 10 mesotheliomas. Lung cancer caused 24 deaths among 283 cigarette smokers and none among the 87 who did not smoke cigarettes. None of 113 asbestos-related deaths occurred within 20 years of first exposure. Preliminary New York City autopsy data found asbestos bodies in 179 of 355 persons (50 per cent). The authors raised several open questions: unrecognized occupational exposure, whether the bodies were truly asbestos, whether general air pollution causes disease, and how to allow for smoking and long latency. They concluded that well-defined cohort studies with long follow-up were needed.

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 1968 article was mainly a review of research on asbestos exposure among people who did not work with it, such as residents near asbestos mines and factories. It also reported the authors' own data: among 370 asbestos insulation workers followed for 52 months, from 1963 to 1967, there were 94 deaths. Ten were from mesothelioma: 3 pleural and 7 peritoneal. None of the 87 men who did not smoke cigarettes died of lung cancer. Among 283 men with a history of regular cigarette smoking, 24 died of lung cancer against 2.98 expected, eight times the expected number with age and smoking habits taken into account. Of 113 workers who died of asbestos-related diseases, none died within 20 years of first exposure. In a preliminary New York City autopsy sample, 179 of 355 people (50 per cent) had asbestos bodies. The authors concluded that asbestos may spread into the community and may produce detectable disease. They left open whether general asbestos air pollution causes disease, and noted that autopsy studies had not proven these bodies came from asbestos.

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 and overview of studies of community (nonoccupational) asbestos exposure, with some of the authors' own data on asbestos insulation workers and a preliminary autopsy series
• Who was studied: Reviewed studies of general populations in several countries. The authors' own data covered 370 asbestos insulation workers, all more than 20 years from first exposure, followed from January 1, 1963 to April 30, 1967. It also covered a preliminary sample of 355 people autopsied in New York City in 1966.
• Exposure: Asbestos spread into the general community from industrial sources or from product use, plus occupational exposure among asbestos insulation workers. The authors' own data do not name a fiber type.
• Main results:
  • Among the 370 insulation workers over 52 months, 10 deaths were due to mesothelioma: 3 pleural and 7 peritoneal.
  • The 370 insulation workers had 94 deaths from all causes, against 47.5 expected (Table 2).
  • Among the 370 insulation workers, none of the 87 who did not smoke cigarettes died of lung cancer.
  • Among the 283 insulation workers with a history of cigarette smoking, 24 died of lung cancer. The authors described this as eight times the expected number, with age and smoking habits taken into account.
  • In Table 4, the 283 men with a history of regular cigarette smoking had 24 observed deaths from bronchogenic carcinoma against 2.98 expected.
  • Among 113 insulation workers who died of bronchogenic carcinoma, pleural or peritoneal mesothelioma, or asbestosis, none died less than 20 years from first exposure. 101 (89 per cent) died 30 or more years after first exposure.
  • Of the same 113 men, three died under age 50 and 49 died after age 65.
  • In the preliminary New York City autopsy sample (1966), asbestos bodies were found in 179 of 355 people (50%). The rate was 120 of 197 blue-collar men (60%), 45 of 111 white-collar men (41%) and 14 of 47 housewives (30%).
  • The authors interpreted the preliminary autopsy data as suggesting that unrecognized occupational sources may add to, and override, general community asbestos exposure.
  • Among 1,117 asbestos insulation workers (Table 1), pleural calcification was rarely seen in less than 20 years from onset of exposure. Calcification was 0.0% at 0 to 9 years, 1.1% at 10 to 19, 10.4% at 20 to 29, 34.5% at 30 to 39 and 57.9% at 40 or more years.
• The authors' conclusion: The authors concluded that asbestos may be widely spread into the community, that this may produce detectable disease, and that methods to study the question can be designed. They added that the situation was not yet clarified.
• Limitations the authors state:
  • Earlier autopsy studies did not prove that the 'asbestos bodies' they found actually came from inhaled asbestos rather than another mineral fiber.
  • Asbestos bodies found at autopsy show only that asbestos was inhaled at some time, not when.
  • The New York City autopsy data were a preliminary analysis.
  • Expected deaths in Table 2 were based on United States mortality data and did not take the workers' smoking habits into account.
  • Whether general asbestos air pollution has any disease potential remained an open question.

Topics

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

Medical terms in this study, explained in our Lexicon: Epidemiology, Asbestos Exposure, Occupational Exposure, Pleural Calcification, Pleural Mesothelioma, Asbestos Bodies, Insulator, Mesothelioma.

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