Forensic detection and investigation of occupational-environmental disease

Our plain-English summary of Forensic detection and investigation of occupational-environmental disease, by T. Ehrenreich, I.J. Selikoff (The American Journal of Forensic Medicine and Pathology, 1980).

The study

• Authors: T. Ehrenreich, I.J. Selikoff
• Journal: The American Journal of Forensic Medicine and Pathology
• Published: 1980;1(4):325-33
• Cited by: 5 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. 002030).

In plain English

This 1980 article by Ehrenreich and Selikoff was a narrative review, not a study with its own patients or data. It argued that deaths from occupational and environmental hazards should be investigated by medical examiners and forensic pathologists. It outlined how: take a full lifetime work, residence and smoking history, do a complete autopsy, and identify and measure the suspected agent in tissue. For asbestos, the article described earlier knowledge rather than new results. It stated that pleural and peritoneal mesotheliomas had been found in 7 to 11% of deaths after asbestos exposure, compared with about 0.1 or 0.01% of deaths in the nonexposed general population. It also stated that pleural plaques and asbestos (ferruginous) bodies are markers of asbestos exposure. It recounted reports that asbestos workers who smoked had 92 times the risk of lung cancer death of men who neither smoked nor worked with asbestos. It noted that particles smaller than 0.3 microns must be identified by electron microscopy and related methods. The authors concluded that the forensic autopsy was the best potential primary source of autopsy information on these diseases.

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: Narrative review and methods commentary on how forensic pathologists should detect and investigate occupational and environmental disease. No original data were collected.
• Who was studied: No study population. The article discussed deaths from occupational and environmental disease in general, in the context of United States medical examiner practice.
• Exposure: Many occupational and environmental agents, including asbestos, silica, vinyl chloride, metals, solvents and radiation. Asbestos-related lung cancer, pleural mesothelioma and pleural plaques were among the diseases discussed.
• Main results:
  • Not a new finding: the article stated that mesotheliomas of the pleura and peritoneum had been identified in 7 to 11% of deaths following asbestos exposure, versus about 0.1 or 0.01% of deaths in the nonexposed general population.
  • The article described pleural calcification and fibrotic pleural plaques (benign lesions) as markers of asbestos exposure, useful even when found incidentally at autopsy.
  • The article stated that asbestos (ferruginous) bodies have similar significance as markers of exposure.
  • Recounting earlier reports, not this article's data: asbestos workers who smoked had 92 times the risk of lung cancer death compared with men who neither smoked nor worked with asbestos.
  • The article stated that as little as 0.5 g of chrysotile asbestos may be recovered in a case of fatal asbestosis.
  • The article stated that particles smaller than 0.3 microns, which make up most of the lung dust burden, cannot be seen with the light microscope. They must be identified with methods such as transmission electron microscopy and electron microprobe analysis.
  • The authors proposed five criteria for causation in occupational-environmental disease and stated that, in forensic practice, causality rests on a preponderance of evidence rather than absolute proof.
• The authors' conclusion: The authors concluded that comprehensive autopsy information on the prevalence and morphology of environmental-occupational disease was urgently needed to complement epidemiological studies. They considered the forensic autopsy the best potential primary source of that information.

Related studies

• Using environmental forensic microscopy in exposure science — J.R. Millette, R.S. Brown, et al. (2008)
• Diseases associated with asbestos exposure. Diagnostic perspectives in forensic pathology — T. Ehrenreich, I.J. Selikoff (1983)
• Quantifying health effects from the combined action of low-level radiation and other environmental agents: can new approaches solve the enigma? — W. Burkart, G.L. Finch, et al. (1997)
• Relationships of Lower Lung Fibrosis, Pleural Disease, and Lung Mass with Occupational, Household, Neighborhood, and Slate Roof-Dense Area Residential Asbestos Exposure — D. Kang, Y.Y. Kim, et al. (2018)
• Contribution of environmental factors to cancer risk — P. Boffetta, F. Nyberg (2003)
• Environmental mutagens induced transversions but not transitions in regulatory region of mitochondrial DNA — M.A. Partridge, S.X. Huang, et al. (2009)

Browse more research in The American Journal of Forensic Medicine and Pathology, or return to medical research.