British Medical Journal

Our medical research library holds 10 studies published in British Medical Journal (1981–1984). Each entry links to the study's record on PubMed and, where there is one, to the publisher's page and a free full text. 1 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 6 studies PubMed has no abstract for, we give the abstract printed in the article or, where there is none, a summary we wrote from it, each labeled as such.

About the journal

• Publisher: British Medical Association
• Published: 1981–1988, England
• Language: English
• ISSN: 0267-0623 (print)
• Continued by: BMJ (Clinical Research Ed.)
• Its record in the NLM Catalog

1980s

• Are all mesotheliomas due to asbestos?. D. Davies. 1984;289(6453):1164-5. Editorial PubMed · Publisher · Free full text

  Summary

  This editorial asked whether all mesotheliomas are caused by asbestos. The author noted that mesothelioma is closely related to asbestos exposure, which is sometimes light and transient. The author cited a Liverpool study of 100 patients with pleural mesothelioma: exposure was established in 88, and all but one of these had over 20 000 asbestos fibres per gram of dried lung by light microscopy. No exposure was discovered in seven; six of these had counts below 20 000, and two had no fibres seen. Among controls, 29% had over 20 000 fibres per gram. Electron microscopy would probably find more fibres, but mainly chrysotile rather than the amphiboles that are the main determinants of mesothelioma. The author cited reports that some mesotheliomas were diagnosed before asbestos became common, that unexposed patients develop them at an earlier age, and that their parents have a high incidence of cancer. From latency data on gas mask workers, asbestos factory workers (mean latent period to death 32 years), South Africa and the erionite area of Turkey, the author concluded that most, if not all, fibre-induced mesotheliomas have a latent period of at least 12 years. Because sporadic cases occur in unexposed children under 12, the author considered it reasonable to postulate that some adult cases are not caused by asbestos, and stressed the medicolegal importance of the latent period.

  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.

• Mesothelioma due to domestic exposure to asbestos. K. Browne, T. Goffe. 1984;289(6437):110-1. Letter PubMed · Publisher · Free full text

  Summary

  This letter responded to a report by Dr G C Ferguson and Dr H Watson (BMJ, 2 June 1984) of two sisters who both developed pleural mesotheliomas, which those authors attributed to wire brushing of a white asbestos cement roof. The letter's authors noted that several occurrences of two or more cases of mesothelioma within the nuclear family had been reported, and said this was probably not simply due to a shared source of asbestos exposure. They asked whether the diagnosis had been confirmed in both cases by a pathologist with particular experience in mesothelioma histology. They cited a US review in which only 26% of cases diagnosed as mesothelioma by local pathologists could be accepted as definite, probable or possible by a member of a mesothelioma reference panel. They noted that one sister survived for a prolonged period after pleurectomy, although surgery had rarely been found to influence survival in diffuse mesothelioma. They argued that the attribution to white asbestos ignored epidemiological evidence that chrysotile, as distinct from amphibole asbestos, plays little or no part in causing mesothelioma, and quoted the 1983 Acheson and Gardner report to the UK Health and Safety Executive. They asked whether the lung fibre burden had been studied in the fatal case. They also cited a 1976 report of two Australian sisters with mesothelioma in whom no asbestos exposure was found. They concluded that not all cases of mesothelioma are due to asbestos exposure. The authors were listed with Cape Industries Ltd and TBA Industrial Products Ltd.

  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.

• Asbestos related diseases without asbestosis. D. Davies. 1983;287(6386):164-5. Editorial PubMed · Publisher · Free full text

  Summary

  This editorial discussed a 1982 report by the Industrial Injuries Advisory Council, 'Asbestos-related disease without asbestosis', which proposed changes to the diseases prescribed for compensation under the British Industrial Injuries Scheme. Asbestosis and mesothelioma were already prescribed. The council recommended prescribing diffuse pleural thickening when it was bilateral, over 5 mm thick, and extended over more than a quarter of the chest wall. Pleural plaques and pleural effusions were not to be prescribed. The council also recommended prescribing primary lung cancer when it was accompanied by asbestosis, bilateral diffuse pleural thickening, or bilateral pleural plaques, irrespective of tumour type. US studies of insulation workers gave relative risks of lung cancer of 1 for non-exposed non-smokers, 5 for asbestos-exposed non-smokers, 11 for non-exposed smokers and 53 for exposed smokers. Citing these figures, the council recommended that smoking be disregarded. The author welcomed the extension of prescription but argued that pleural lesions were a less than satisfactory index of exposure. The reasons given were that pleural disease correlated poorly with asbestosis and could follow light exposure, that calcification usually took over 20 years from first exposure, and that only a minority of plaques were detectable during life. The author concluded that the proposals favoured people with pleural shadows from light exposure and discriminated against heavily exposed people without pleural lesions. The author also stated that the case for necropsies in exposed workers who died of lung cancer was clear.

  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.

• Can society live with asbestos?. D. Gloag. 1982;284(6331):1728-9. Editorial PubMed · Publisher · Free full text

• Mesotheliomas and asbestos type in asbestos textile workers: a study of lung contents. J.C. Wagner, G. Berry, F.D. Pooley. 1982;285(6342):603-6. PubMed · Publisher · Free full text

  Abstract

  The asbestos contents of the lungs of former employees of an asbestos textile factory were determined at necropsy using a transmission electron microscope. Those who had died of mesothelioma were compared with a matched sample of those who had died of other causes. The predominant fibre processed in the factory was chrysotile, but crocidolite had also been used. The lung content was consistent with the known exposure to chrysotile, but the crocidolite content was also high, being about 300 times that of the general population of the United Kingdom. The lungs of those with mesothelioma did not contain more of either chrysotile or crocidolite than the lungs of the controls, so no particular type of asbestos could be implicated in causing the mesotheliomas. The evidence of substantial exposure to crocidolite means that the mesotheliomas that occurred in this factory could not be attributed with any certainty to the exposure to chrysotile.

• A guide to compensation for asbestos-related diseases. M.G. Britton, D.T. Hughes, T.J. Phillips. 1981;282(6282):2107-11. PubMed · Publisher · Free full text

  Summary

  This review, written for clinicians, set out how patients in Britain with asbestos-related disease could obtain compensation. It covered two routes: industrial injuries benefit and common law compensation. The authors stressed that 'asbestosis' should refer only to fibrosis of the lung. Under the Social Security Act 1975, industrial injuries benefit required a prescribed disease and work in a prescribed occupation at some time since 5 July 1948. The relevant prescribed diseases were pneumoconiosis, which includes asbestosis, and diffuse mesothelioma. People with pleural changes alone were not eligible. Lung cancer was not a prescribed disease, but pneumoconiosis medical boards accepted it as a consequence of asbestosis. The authors described how asbestosis and mesothelioma are diagnosed. They also described the claims procedure: insurance officers, pneumoconiosis medical panels and boards, and appeals. Disablement was assessed in steps of 10%, and the basic pension at 100% was £44.30 a week. The article also covered death benefit and coroners' investigations. For common law claims, the claimant had to show that the disability was caused by the occupation and resulted from employer negligence under the asbestos-related regulations of 1931 to 1969. Proceedings had to start within three years of the claimant becoming aware of the diagnosis. The authors concluded that fair compensation would not be possible until awards could reflect the claimant's condition at the time of the award, with a right to claim more if the condition worsened or the claimant died.

  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.

• Asbestos fibres and the environment. D. Gloag. 1981;282(6264):623-6. PubMed · Publisher · Free full text

  Summary

  This article in a British Medical Journal series on pollution reviewed what was known about asbestos fibres and the risk to the general public. The author first discussed why cancer risk differed between groups of asbestos workers. She cited evidence that crocidolite and amosite were more hazardous than chrysotile for mesothelioma, and that fibre size and shape, supported by animal and cell culture studies, might matter more than chemical composition. She then reviewed exposure outside industry. For drinking water and beverages, she described studies in Connecticut, Duluth (Minnesota), Quebec and the San Francisco Bay area. She concluded that the balance of evidence did not point to a risk from ingested asbestos in the general population, and noted that the San Francisco findings would need a case-control study. Airborne concentrations in the general environment were described as probably about 1000 times lower than in industry under current standards. Higher levels had been found in some buildings with unsealed sprayed asbestos. In a preliminary British survey, the highest airborne crocidolite reading was under 0.2% of the occupational standard. The author argued that banning all asbestos was neither practicable nor desirable at present. She said that asbestos already in buildings required inspection, sealing or removal, and vigilance, and that generous safety margins should apply to the general population. She judged that spreading alarm about a cancer risk for council tenants was unjustified.

  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.

• Asbestos fibres and the environment. 1981;282(6277):1707. Letter PubMed · Free full text

• Asbestos--can it be used safely?. D. Gloag. 1981;282(6263):551-3. PubMed · Publisher · Free full text

  Summary

  This article, part of a British Medical Journal series on pollution, asked whether asbestos could be used safely and whether there were health hazards at low levels of exposure. The author reviewed published epidemiological and case studies and official reports. She described the main asbestos types (crocidolite, amosite, anthophyllite and chrysotile), their uses, and the associated cancers. These were mainly lung cancer and pleural and peritoneal mesothelioma, with increases in gastrointestinal and laryngeal cancers reported in some studies. She outlined limitations of the evidence: latent periods of commonly 20-50 years, incomplete exposure histories, inappropriate control groups, and dust concentrations that were often impossible to estimate. Evidence on household and neighbourhood exposure was summarised. A cited study estimated the annual mesothelioma rate in Canada in 1972 at 2.8 per million in men and 0.7 in women. The review reported a generally accepted gradient of risk from chrysotile through amosite to crocidolite. For Quebec chrysotile miners and millers, the mesothelioma risk was perhaps three to six times that of the general population, compared with 100-200 times in insulation workers exposed to mixed fibres. Some data suggested that risk was proportional to cumulative dose. Citing an EEC report, the author noted suggestive but inadequate evidence for a threshold. She concluded that for chrysotile at low levels the epidemiological data were reassuring, because even without a threshold the risks must be exceedingly small.

  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.

• Smoking, coal, asbestos, and the lungs. 1981;283(6289):457-8. Editorial PubMed · Free full text

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