The Western Journal of Medicine

Our medical research library holds 10 studies published in The Western Journal of Medicine (1974–1992). 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. 6 have an abstract, the authors' own summary as PubMed records it: open "Abstract" to read it. For 2 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: BMJ Pub
• Published: 1974–2002, United States
• Language: English
• ISSN: 0093-0415 (print), 1476-2978 (electronic)
• Continues: California Medicine
• Absorbed: Arizona Medicine
• Its record in the NLM Catalog

1990s

• Recruitment for the beta-carotene and retinol efficacy trial (CARET) to prevent lung cancer in smokers and asbestos-exposed workers. G.S. Omenn, G. Goodman, J. Grizzle, et al. 1992;156(5):540-4. PubMed · Free full text

  Summary

  The authors described the design and recruitment strategy of the beta-Carotene and Retinol Efficacy Trial (CARET) and answered questions physicians might ask about patients taking part. CARET was a two-armed, double-blind, randomized trial testing whether beta-carotene (30 mg per day) plus retinol (25,000 IU per day) would reduce lung cancer incidence in heavy smokers and in asbestos-exposed workers who had smoked. The Vanguard group came from pilot studies run in Seattle from 1985 to 1988: 1,029 smokers and 816 asbestos-exposed participants, who accumulated 3,000 person-years of treatment. Recruitment of the Efficacy group began in 1989 at six centers: Seattle, Portland, San Francisco, Irvine, Baltimore and New Haven. Asbestos-exposed men aged 45 to 69 were recruited through physicians, workers' compensation programs, labor unions, plaintiffs' attorneys and a Navy asbestos surveillance program. Smokers aged 50 to 69 were recruited mainly from health insurers. The authors estimated that 4,300 asbestos-exposed workers and 13,600 smokers were needed for 80% power to detect a 33% reduction over an average 6.5 years of follow-up. As of March 31, 1992, 10,709 of a goal of 17,906 participants had been randomized. Adherence exceeded 90%, and no differences in symptoms, signs or liver function had been found between the treatment and placebo arms. Mesothelioma was being evaluated in the asbestos-exposed cohort. The authors expected CARET, together with two other major trials, to show by the end of the decade whether these agents can be recommended.

  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.

• The 10-year experience of an academically affiliated occupational and environmental medicine clinic. L. Rosenstock, W. Daniell, S. Barnhart, et al. 1992;157(4):425-9. PubMed · Free full text

  Abstract

  Occupational and environmental diseases are underrecognized. Among the barriers to the successful diagnosis, treatment, and prevention of these conditions are inadequate consultative and information resources. We describe the 10-year clinical and training experiences of an academically affiliated referral center that has as its primary goal the identification of work-related and other environmental diseases. The University of Washington Occupational and Environmental Medicine Program has evaluated 6,048 patients in its diagnostic and screening clinics. Among the 2,841 seen in the diagnostic clinics, 1,553 (55%) had a work-related condition. The most prevalent diagnoses included asbestos-related lung disease (n = 603), toxic encephalopathy (n = 160), asthma (n = 119), other specific respiratory conditions (n = 197), carpal tunnel syndrome (n = 86), and dermatitis (n = 82). The clinics serve as a training site for fellows in the specialty training program, primary care internal medicine residents, residents from other medical specialties, and students in industrial hygiene, toxicology, and occupational health nursing. The program serves two additional important functions: providing consultative services to community physicians and training specialists and other physicians in this underserved area of medicine.

1980s

• Chemical contamination of California drinking water. H.H. Russell, R.J. Jackson, D.P. Spath, et al. 1987;147(5):615-22. Review PubMed · Free full text

  Abstract

  Drinking water contamination by toxic chemicals has become widely recognized as a public health concern since the discovery of 1,2-dibromo-3-chloropropane in California's Central Valley in 1979. Increased monitoring since then has shown that other pesticides and industrial chemicals are present in drinking water. Contaminants of drinking water also include naturally occurring substances such as asbestos and even the by-products of water chlorination. Public water systems, commercially bottled and vended water and mineral water are regulated, and California is also taking measures to prevent water pollution by chemicals through various new laws and programs.

• Asbestos and gastrointestinal cancer. A review of the literature. R.W. Morgan, D.E. Foliart, O. Wong. 1985;143(1):60-5. PubMed · Free full text

  Abstract

  Exposure to asbestos is among several factors cited as possible causes of esophageal, gastric and colorectal cancer. More than 45 published studies have presented mortality data on asbestos-exposed workers. For each cohort, we listed the observed and expected rates of deaths from types of gastrointestinal cancer based on the latest published follow-up. Summary standardized mortality ratios (SMRs) were then derived. Finally, we calculated summary SMRs for total gastrointestinal tract cancer for three occupational groups: asbestos factory workers, insulators/shipyard workers and asbestos miners. Statistically significant elevations in summary SMRs were found for esophageal, stomach and total gastrointestinal tract cancer in all asbestos-exposed workers. Esophageal cancer summary SMRs remained significantly elevated when data were reanalyzed to include only those cohorts with death certificate diagnoses for cause of observed deaths. However, summary SMRs were not statistically significant for stomach and total gastrointestinal tract cancer after reanalysis. Summary SMRs by occupational group showed a significant elevation for total gastrointestinal cancer in insulators/shipyard workers. The elevation was not significant after reanalysis. Based on the results after reanalysis, the elevations in summary SMRs for stomach and total gastrointestinal tract cancer are of a magnitude that could result from diagnostic and investigator error. We conclude that more studies are required before stomach and colorectal cancers are documented as asbestos-related diseases.

• Diffuse malignant mesothelioma: a review. W.N. Rom, J.E. Lockey. 1982;137(6):548-54. Review PubMed · Free full text

  Abstract

  Diffuse malignant mesothelioma is a signal tumor of asbestos exposure. Mesothelioma incidence has been steadily rising during the past two decades, reflecting the increases in asbestos use during and following World War II. The onset of the disease follows exposure by 25 to 40 years. The dose-response relationship appears to be much lower than that for asbestosis or lung cancer-it is not known whether current levels of exposure will entail a risk for disease 30 years hence. There is no synergistic or additive interaction with smoking for this tumor. Current knowledge indicates that pleural plaques, per se, do not increase the risk for this tumor beyond that of the previous asbestos exposure alone. Durable fibers with high aspect ratios, especially amphiboles, are associated with experimental tumor induction. Treatment modalities including surgical procedures and chemotherapy with doxorubicin and 5-azacytidine offer prospects for palliation.

• Mesothelioma: current perspectives. R.A. Taylor, L.P. Johnson. 1981;134(5):379-83. PubMed · Free full text

  Abstract

  Thirty patients with the diagnosis of mesothelioma were admitted to the Swedish Hospital Medical Center, Seattle, from 1975 to 1979. Of these, 26 had pleural and 4 had peritoneal mesothelioma. In 20 of the patients with pleural mesothelioma, the diagnosis had been made by open thoractomy and in only one by needle biopsy of the pleura. The average survival of the patients with pleural tumors from time of diagnosis was 15 months, and two are alive at three and eight months, respectively, one of whom had an apparent solitary benign mesothelioma. The average survival of those with peritoneal mesothelioma was ten months, although one has survived six years. There were 17 patients with a known history of exposure to asbestos, 14 while working in shipyards. Because of the relatively high incidence of this previously rare tumor in the Puget Sound, Washington, area, and the generally dismal results of therapy, better methods of diagnosis including thoracoscopy and a more systematic approach to treatment are recommended.

• Occupational medicine-epitomes of progress: asbestos-related diseases. J.S. Felton. 1980;133(2):149-50. PubMed · Free full text

1970s

• Asbestos-related lung disease. 1979;131(3):225-30. PubMed · Free full text

• Letter: Asbestos exposure and cancer of the larynx. T.L. Guidotti, J.L. Abraham, P.B. DeNee. 1975;122(1):75. PubMed · Free full text

  Summary

  This letter to the editor responded to a review of asbestos-related diseases by Rom and Palmer (West J Med, July 1974). The authors felt that the review had referred only briefly to emerging evidence linking asbestos exposure with cancer of the larynx, and that this possible association deserved wide recognition because any one center would find it difficult to collect enough cases for pathologic study. They summarized published work. A retrospective study of 100 male British patients with squamous carcinoma of the larynx at the Liverpool Ear, Nose and Throat Hospital found an occupational history of asbestos exposure in 31 percent, compared with 3 percent of age-matched hospital inpatients with nonmalignant disease. Smoking histories were comparable in patients with and without significant exposure. The mean latency was 30 years and the mean duration of exposure was 27 years. A prospective study of 4,000 factory workers with presumed exposure found two cases after 41 years, against a general population incidence of 1/50,000. One of the two had only one month of severe exposure. The authors noted that separating an asbestos effect from smoking and alcoholism may be a formidable problem, and that other head and neck cancers may also be associated with asbestos. They proposed searching surgical or necropsy tissue from laryngeal carcinoma cases with complete occupational histories for asbestos bodies and other particulates, using scanning electron microscopy and x-ray spectroscopic analysis.

  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.

• The spectrum of asbestos-related diseases. W.N. Rom, P.E. Palmer. 1974;121(1):10-21. Review PubMed · Free full text

  Abstract

  Diseases caused by exposure to asbestos are prime examples of environmentally-related illnesses. Asbestos produces asbestosis from large exposures over short latent periods; it acts as a carcinogen from small exposures over long latent periods; and it induces mesothelioma with minute exposures. Its presence as the magic mineral is ubiquitous in our modern society.

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