Induction of thoracic malignancy in inorganic dust pneumoconiosis

Our plain-English summary of Induction of thoracic malignancy in inorganic dust pneumoconiosis, by J.C. Scatarige, F.P. Stitik (Journal of Thoracic Imaging, 1988).

The study

• Authors: J.C. Scatarige, F.P. Stitik
• Journal: Journal of Thoracic Imaging
• Published: 1988;3(4):67-79
• Type of article: Review
• Cited by: 7 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. 000933).

Abstract

Pulmonary carcinoma is now the leading cause of death due to cancer in men and women. Aside from cigarette smoking, occupational exposure to carcinogens is the most important cause of lung cancer, accounting for up to one third of all cases. The following article is a review of occupationally induced thoracic neoplasms with an emphasis on those related to the inhalation of inorganic dust. After introducing some basic terms, describing the research methods, and reviewing the process of carcinogenesis, current information on the relationship between exposure to asbestos, synthetic mineral fibers, silica, and other nonfibrous mineral dusts and the development of lung cancer and malignant mesothelioma of the pleura will be presented. The goal of this article is to provide the practicing radiologist with knowledge and insight into this difficult area.

In plain English

This article was a review, written for radiologists, of published research on chest cancers linked to work exposures, mainly inhaled mineral dusts. It covered asbestos, synthetic mineral fibers (fibrous glass, rock wool, slag wool), silica, coal dust, vermiculite and talc. The authors described a large cohort study by Selikoff and Hammond. In it, lung cancer risk rose fivefold with asbestos exposure alone, tenfold with smoking alone and 50-fold with both. The authors wrote that crocidolite has the strongest association with malignancy and is the main fiber responsible for malignant mesothelioma. They wrote that mesothelioma has a 30- to 40-year latent period and that asbestos-related pleural plaques are not precursors of mesothelioma. In their own experience, about half of mesothelioma patients showed asbestos-related pleural disease on the opposite side of the chest. A European study of 21,967 synthetic mineral fiber workers found a relative risk for lung cancer death of 1.25. The authors said this may reflect other exposures. A cohort of 406 men from a Montana vermiculite mine whose ore contained tremolite had higher than expected deaths from lung cancer and mesothelioma. Asbestos contaminants were described as responsible for added harms of talc.

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 of published literature on occupationally induced chest cancers, with illustrative radiographs and CT images
• Who was studied: No new population was studied. The review drew on published studies of workers exposed to mineral dusts and on chest images of the authors' patients.
• Exposure: Asbestos (chrysotile, crocidolite, amosite), synthetic mineral fibers (fibrous glass, rock wool, slag wool), silica, coal dust, vermiculite contaminated with tremolite, and talc contaminated with tremolite and anthophyllite
• Main results:
  • In a large cohort study by Selikoff and Hammond, cited in the review, lung cancer risk rose fivefold with asbestos exposure alone.
  • In the same cited Selikoff and Hammond cohort, lung cancer risk rose tenfold with smoking alone.
  • In the same cited Selikoff and Hammond cohort, lung cancer risk rose 50-fold in workers exposed to both asbestos and smoking.
  • The review stated that, of the asbestos fiber types, crocidolite has the strongest association with malignancy.
  • The review stated that crocidolite is the major fiber type responsible for malignant mesothelioma.
  • The review stated that mesothelioma has a 30- to 40-year latent period.
  • The review stated that asbestos-related pleural plaques are not precursors of malignant mesothelioma.
  • The review stated that asbestosis, unlike pleural plaques, is clearly associated with lung cancer.
  • In the authors' own experience with malignant mesothelioma patients, signs of asbestos-related pleural disease were seen on the opposite side of the chest in about half.
  • In a European cohort study of 21,967 workers in synthetic mineral fiber factories, cited in the review, death from lung cancer was slightly higher (relative risk 1.25).
  • The authors wrote that this slightly higher lung cancer risk among synthetic mineral fiber workers may reflect exposure to other confounding agents.
  • At a Montana vermiculite mine whose ore contained 4% to 6% tremolite, a cited cohort study of 406 men found higher than expected deaths from lung cancer, malignant mesothelioma and pneumoconiosis.
  • The cited Montana vermiculite cohort had substantially higher than expected mortality from lung cancer, malignant mesothelioma and pneumoconiosis.
  • Workers in New York State talc mines, where the talc is contaminated with tremolite and anthophyllite, were described as having a substantially increased risk of lung cancer.
  • The review stated that asbestos contaminants in talc are responsible for its additional adverse effects.
• The authors' conclusion: The authors said their aim was to give diagnostic radiologists who read chest images of patients with lung cancer and malignant mesothelioma some understanding of this complex area.

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: Pneumoconiosis, Carcinoma, Occupational Exposure, Lung Cancer, Neoplasm, Carcinogenesis, Mineral Fiber, Malignant Mesothelioma.

Related studies

• The effect of cigarette smoking on the detection of small radiographic opacities in inorganic dust diseases — P.D. Blanc, G. Gamsu (1988)
• Characterization of the lower respiratory tract inflammation of nonsmoking individuals with interstitial lung disease associated with chronic inhalation of inorganic dusts — W.N. Rom, P.B. Bitterman, et al. (1987)
• "Labrador lung": an unusual mixed dust pneumoconiosis — H.W. Edstrom, D.M. Rice (1982)
• Pneumoconiosis: comparison of imaging and pathologic findings — S. Chong, K.S. Lee, et al. (2006)
• Inorganic dust pneumonias: the metal-related parenchymal disorders — P. Kelleher, K. Pacheco, et al. (2000)
• Relationship of inflammatory cell cytokines to disease severity in individuals with occupational inorganic dust exposure — W.N. Rom (1991)

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