History of asbestos related disease

Our plain-English summary of History of asbestos related disease, by P.W. Bartrip (Postgraduate Medical Journal, 2004).

The study

• Author: P.W. Bartrip
• Journal: Postgraduate Medical Journal
• Published: 2004;80(940):72-6
• Type of article: Historical article
• Cited by: 23 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The first medical article on the hazards of asbestos dust appeared in the British Medical Journal in 1924. Following inquiries by Edward Merewether and Charles Price, the British government introduced regulations to control dangerous dust emissions in UK asbestos factories. Until the 1960s these appeared to have addressed the problem effectively. Only then, with the discoveries that mesothelioma was an asbestos related disease and that workers other than those employed in the dustiest parts of asbestos factories were at risk, were the nature and scale of the hazard reassessed. In Britain, America, and elsewhere new and increasingly strict regulations were enacted.

In plain English

This article is a historical review by a single author, not a new study. It traced how medical knowledge and regulation of asbestos-related disease developed from the 1920s onward, mainly in Britain and the USA. It described William Cooke's 1924 paper, the first on the subject, about the illness and death of Nellie Kershaw, who had worked in a Rochdale asbestos factory. It then covered Edward Merewether's 1929 investigation, after which the Asbestos Industry Regulations, 1931 were for decades widely believed to have solved asbestosis in British asbestos factories. It recounted Richard Doll's 1955 work linking asbestosis with lung cancer. It also described South African research in a crocidolite mining district that, with later papers in 1964 and 1965, led to mesothelioma being recognised as an asbestos related disease. The review explained that from the 1960s the hazard was recognised to extend to insulation workers, other users of asbestos products and people living near factories, and that stricter British and US rules and a European Union ban on chrysotile followed. It reported that whether SV40 virus causes mesothelioma remained unclear. The author concluded that past exposures will ensure asbestos related disease continues for the foreseeable future.

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: Historical review (narrative history of medical discovery and regulation; no new data collected)
• Who was studied: No study participants. The review covered published medical literature, government inquiries and regulations on asbestos disease in Britain, the USA, South Africa and elsewhere, from the first medical paper in 1924 to the early 2000s.
• Exposure: Asbestos dust in general, with discussion of chrysotile (white), crocidolite (blue) and amosite (brown). The diseases covered were asbestosis, lung cancer, and mesothelioma of the pleura and peritoneum.
• Main results:
  • The review described the first medical paper (1924, William Cooke), which dealt with the illness and death of Nellie Kershaw, who had worked in the spinning room of a Rochdale asbestos factory.
  • After Merewether's investigation and Price's dust-control recommendations, the government enacted the Asbestos Industry Regulations, 1931. For decades it was widely agreed that these regulations had solved asbestosis in British asbestos factories.
  • According to the review, in 1955 Richard Doll established to the satisfaction of most informed observers a causal association between asbestosis and lung cancer.
  • In the 1950s, South African researchers Wagner, Sleggs and Marchand identified mesothelioma cases in the crocidolite mining district of Griqualand West. The review states that papers published in 1964 and 1965 led to general medical recognition of mesothelioma as an asbestos related disease.
  • In the 1960s it was shown that the hazards were not confined to heavily exposed asbestos factory workers. They extended to insulation workers, other users of products containing asbestos, and people living close to asbestos factories.
  • UK asbestos imports peaked in 1973 at some 190 000 tonnes per annum and fell to 4820 tonnes of chrysotile by 1997. Britain implemented the European Union ban on remaining chrysotile use in October 1999.
  • In the USA, OSHA reduced permitted exposure limits from 5 ff/ml (time weighted average) in 1972 to 2 ff/ml in 1976. A limit of 0.1 ff/ml (fibres per millilitre) was introduced in 1994.
  • A table from US Department of Commerce data showed that raw asbestos consumption in the USA peaked at 882 908 tons in 1973. Some 96% of American consumption in 1956 was chrysotile.
  • The review cited other researchers' forecasts. Peto et al predicted in 1995 that male mesothelioma deaths in Britain would peak at between 2700 and 3300 per year around 2020. US male mesothelioma incidence was predicted to peak at about 2300 cases per year at the end of the 20th century.
  • The review reported that it remained unclear whether a causal association exists between SV40 (a virus that contaminated some polio vaccine) and elevated rates of mesothelioma.
• The authors' conclusion: The author concluded that even an immediate worldwide ban would not end asbestos-related death and disease, because past exposures will cause it to continue for the foreseeable future. The author wrote that the history of asbestos related disease still has some distance to travel.

Topics

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

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

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