Fifteen cases of pleural mesothelioma associated with occupational exposure to asbestos in Victoria

Our plain-English summary of Fifteen cases of pleural mesothelioma associated with occupational exposure to asbestos in Victoria, by J. Milne (The Medical Journal of Australia, 1969).

The study

• Author: J. Milne
• Journal: The Medical Journal of Australia
• Published: 1969;2(14):669-73
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001428).

Abstract

Fifteen cases of pleural mesothelioma occurring in Victoria are described. Occupational histories and the finding of asbestos bodies in lung tissue indicate a relationship between occupational exposure to asbestos and induction of pleural mesothelioma many years later. The exposure in some cases was relatively short but intense. Crocidolite or blue asbestos would seem to be particularly potent in the induction of these tumours.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This 1969 article described 15 patients with pleural mesothelioma in Victoria, diagnosed from 1962 to 1968 and including one private case. There were nine men and six women, and five were still alive. Work histories were hard to obtain accurately, especially from friends and relatives, the author noted. Nine patients had definite heavy occupational asbestos exposure, four probable exposure, and two no evidence of exposure. Jobs included winding asbestos string onto welding rods, naval dockyard work, munitions work, lagging and asbestos carding. Four had worked at one firm during or soon after World War II, extremely exposed to Cape blue asbestos (crocidolite). All nine patients autopsied had asbestos bodies in lung tissue. Five had been exposed for five years or less, one for six months. No patient was regarded clinically or radiologically as having asbestosis; one had pleural plaques on X-ray, which the author called strongly suggestive of asbestosis or at least severe exposure. The author concluded that the findings indicated a relationship between occupational asbestos exposure and pleural mesothelioma many years later, and that crocidolite seemed particularly potent.

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: occupational histories and lung-tissue searches for asbestos bodies in patients with pleural mesothelioma
• Who was studied: 15 patients (nine males, six females; five still alive) with pleural mesothelioma in Victoria, Australia, diagnosed from 1962 to 1968. Twelve presented at the Austin Hospital Thoracic Unit. One was a private case of a surgeon at the unit. Two more were found by asking the pathologists of all major Melbourne public hospitals. The author stated that, as far as the author was aware, these were all cases diagnosed in Melbourne public hospitals over the period.
• Exposure: Occupational asbestos exposure, including winding asbestos string onto welding rods (Cape blue crocidolite), naval dockyard work, munitions factory work, lagging, carding asbestos fibres and truck driving for an asbestos-handling firm. One woman's father worked in an asbestos-cement factory. All known or presumed exposures began during or before 1942.
• Main results:
  • Of the 15 patients, nine had definite and heavy occupational asbestos exposure, four had probable exposure, and two had no evidence of asbestos exposure.
  • Nine patients were autopsied. Asbestos bodies were seen in routine stained lung-tissue sections in seven of them, and digestion-concentration of lung tissue found asbestos bodies in the other two.
  • Six patients were diagnosed from tissue removed at thoracotomy. In these six, no asbestos bodies were seen in diagnostic lung and pleural biopsy sections.
  • Of the seven autopsied patients with asbestos bodies on routine sections, only one had scanty bodies. In five of the seven the bodies were comparatively plentiful.
  • Four patients with unequivocal exposure had worked at the same firm during or soon after World War II. Each was unaware of any co-worker with a similar condition.
  • These four patients' exposure was extreme, and the asbestos was Cape blue (crocidolite).
  • The longest exposure was 30 years, but five patients had been exposed for five years or less, one for only six months.
  • No patient was regarded clinically or radiologically as having asbestosis.
  • Pleural plaques were visible on X-ray in one patient, the lagger, who had the longest exposure and the longest time since first exposure. The author described these plaques as strongly suggestive of asbestosis or, at the least, of severe occupational exposure to asbestos.
• The authors' conclusion: The author concluded that the occupational histories and the asbestos bodies found in lung tissue indicated a relationship between occupational asbestos exposure and pleural mesothelioma many years later. The author added that in some cases the exposure was relatively short but intense, and that crocidolite (blue asbestos) seemed particularly potent.
• Limitations the authors state:
  • Accurate occupational histories were difficult to obtain, especially from friends and relatives.
  • There was no comparison series of asbestos body findings from people without mesothelioma.
  • How much asbestos exposure the two munitions workers had was not clear.
  • Whether the woman whose father worked for an asbestos-cement firm was herself exposed was conjectural.

Topics

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

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

Related studies

• Thirty-two cases of mesothelioma in Victoria, Australia: a retrospective survey related to occupational asbestos exposure — J.E. Milne (1976)
• Australia's Ongoing Legacy of Asbestos: Significant Challenges Remain Even after the Complete Banning of Asbestos Almost Fifteen Years Ago — M. Soeberg, D.A. Vallance, et al. (2018)
• Fifteen years in the evaluation of extrapleural pneumonectomy: Lessons to be learned — T. Treasure, F. Macbeth (2015)
• Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Australia: case-control study — M.J. Abramson, T. Murambadoro, et al. (2020)
• Industrial hygiene and occupational health studies in Australian (New South Wales) shipyards — A. Bell (1976)
• Occupational and non-occupational attributable risk of asbestos exposure for malignant pleural mesothelioma — A. Lacourt, C. Gramond, et al. (2014)

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