Investigation into the hazardous use of asbestos. Northern Ireland 1960-76

Our plain-English summary of Investigation into the hazardous use of asbestos. Northern Ireland 1960-76, by P.C. Elmes (The Ulster Medical Journal, 1977).

The study

• Author: P.C. Elmes
• Journal: The Ulster Medical Journal
• Published: 1977;46(2):71-80
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004047).

Summary of the article

The author reviewed research carried out in Northern Ireland between 1960 and 1976 into the hazards of asbestos, prompted by an apparently high frequency of diffuse pleural mesothelioma in Belfast. The work addressed three questions: whether the tumours were related to asbestos, where exposure occurred, and how large the hazard was. Occupational histories from 42 mesothelioma patients and 42 age- and sex-matched controls showed exposure in three-quarters of patients and one-quarter of controls. Asbestos bodies were found in the lungs of 21 of 24 (88%) mesothelioma patients and 6 (25%) of matched controls. Of 62 cases, 45 had worked in the shipyard, and insulation workers were identified as the most exposed group. In a comparison of 50 insulation workers with 50 matched controls, 9 had definite and 11 probable radiological asbestosis. In a survey of all working insulators, evidence of serious lung damage rose from 13% of men with 10 years' exposure to 85% of those with more than 30 years. Of 168 insulation workers employed in 1940, 98 had died by 1966, against 37 deaths predicted. Most excess deaths were due to respiratory cancer, especially lung cancer. The author also described the clinical features of mesothelioma and estimated a mean interval of 42 years from first exposure to death. He concluded that the main limitation of the work was the lack of information on dose and fibre type.

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 article was a review in which the author described a series of studies of asbestos-related disease in Northern Ireland from 1960 to 1976. The author and colleagues carried out these studies and published them separately. In 42 patients with pleural mesothelioma compared with 42 age- and sex-matched controls, three-quarters of the patients and one-quarter of the controls had occupational asbestos exposure. Of 62 mesothelioma cases, 45 had worked in the shipyard. Among 50 randomly selected insulation workers, 9 had definite radiological evidence of asbestosis and 11 had changes probably due to asbestos. Among the insulators then at work, signs of serious lung damage rose from 13 per cent of men with 10 years' exposure to 85 per cent of those with more than 30 years. Of 168 insulation workers employed in 1940, 98 had died by 1966, when 37 deaths were predicted. Most of the extra deaths were from respiratory cancer, especially lung cancer. The author wrote that the early conclusion that there was no special lung cancer risk now seemed misleading. The author also noted that the work had no information on total dose levels or on how much the different types of asbestos contributed.

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: a narrative account by the author of a programme of studies by the author and colleagues, published separately (case-control comparisons, studies of living insulation workers, and a mortality follow-up of insulation workers)
• Who was studied: Patients with pleural mesothelioma in Belfast and Northern Ireland, with matched controls, and insulation workers (laggers) in Northern Ireland, including 168 men working in 1940 followed for mortality
• Exposure: Occupational asbestos exposure, mainly in the shipyard and in insulation work (application or removal of insulation). The article does not report which fiber types were involved.
• Main results:
  • Among 42 pleural mesothelioma patients compared with 42 matched controls, about three-quarters of patients and one-quarter of controls had occupational asbestos exposure (Elmes and Wade, 1965)
  • Asbestos bodies were found in the lungs of 21 (88%) of 24 mesothelioma patients, compared with 6 (25%) of matched controls
  • Of 62 mesothelioma cases, 45 had worked in the shipyard and 17 had never worked in the shipyard
  • Among 50 randomly selected insulation workers, 9 showed definite radiological asbestosis and 11 others showed changes probably due to asbestos (Wallace and Langlands, 1971)
  • Among insulators then at work, evidence of serious lung damage rose from 13 per cent of men with 10 years' exposure to 85 per cent of those with more than 30 years (Langlands, Wallace and Simpson, 1971)
  • Of 168 insulation workers working in 1940, 98 had died by 1966, compared with 37 deaths predicted from Northern Ireland male mortality; 5 were untraced (Elmes and Simpson, 1971)
  • Among the insulation workers, most of the unpredicted deaths were from respiratory tract cancer, especially primary lung cancer
  • Among the insulation workers, mesothelioma caused one-third as many deaths as lung cancer, and asbestosis appeared to contribute to between 9 and 21 of the 61 unpredicted deaths
  • Among the insulation workers, there were 8 deaths from gastro-intestinal cancer between 1950 and 1959, when 0.2 were expected
  • In Northern Ireland, the mean interval between first exposure and death was 42 years
  • Among mesothelioma patients, tumours with a mainly epithelial cell pattern were associated with survival of nearly 18 months, and those with a mainly spindle-celled sarcoma pattern with survival of 8 months
• The authors' conclusion: The author concluded that the Northern Ireland work's main contribution was to stimulate others to carry out large-scale studies to confirm its findings. The author also wrote that the series gave no evidence yet that changes in the work environment had affected the total death rate.
• Limitations the authors state:
  • There was no information on total dose levels or on the contributions of the different types of asbestos
  • The early conclusions (no special lung cancer risk; perhaps a quarter of the male population at risk of mesothelioma) now seemed misleading in light of more precise lung measurement methods
  • Follow-up of the women who worked in a factory filling asbestos cloth quilts had not been completed
  • Shipyard employees who cut and fitted marinite partitioning could not be studied in detail

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, Mesothelioma, Asbestos Bodies, Insulator, Lung Cancer.

Related studies

• Occupational lung disease survey of respiratory physicians in Northern Ireland — T.F. McKeagney, K. Addley, et al. (2015)
• Epigenetic investigation into circulating microRNA 197-3p in sera from patients affected by malignant pleural mesothelioma and workers ex-exposed to asbestos — G. Di Mauro, F. Frontini, et al. (2023)
• An investigation into asbestos related disease in the dental industry — C. Fry (2009)
• Some investigations into the nature and cause of massive fibrosis (MF) in the lungs of South African gold, coal, and asbestos mine workers — M.C. Leibowitz, B. Goldstein (1987)
• An investigation of the penetration of ingested asbestos into the normal and abnormal intestinal mucosa of the rat — M.E. Meek, P. Grasso (1983)
• Malignant pleural mesothelioma incidence and survival in the Republic of Ireland 1994-2009 — C.J. Jennings, P.M. Walsh, et al. (2014)

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