Lung cancer and mesothelioma during prospective surveillance of 1249 asbestos insulation workers, 1963-1974

Our plain-English summary of Lung cancer and mesothelioma during prospective surveillance of 1249 asbestos insulation workers, 1963-1974, by I.J. Selikoff (Annals of the New York Academy of Sciences, 1976).

The study

• Author: I.J. Selikoff
• Journal: Annals of the New York Academy of Sciences
• Published: 1976;271:448-56
• Cited by: 42 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. 002310).

In plain English

This report described a program of regular medical checkups, including chest x-rays, for 1249 union asbestos insulation workers in the New York metropolitan area, followed from January 1, 1963 to December 31, 1974. They were 370 older men who were already union members by 1942 and 879 younger men who joined between 1943 and 1962. A majority of the men had been regular cigarette smokers. Among the 370 older men, 47 died of lung cancer, compared with 6.18 lung cancer deaths expected. Seven died of pleural mesothelioma, 21 of peritoneal mesothelioma and 25 of asbestosis. The 54 deaths among the younger men had not yet been compared with expected numbers. Across all 1249 men, 59 lung cancers occurred: 49 in the older group and 10 in the younger group. Of those 59 men, 57 had died by January 1, 1975. No lung cancer was seen in men without a history of regular smoking. All 31 men with mesothelioma died. The author concluded that the surveillance, as used, did not appreciably improve these men's outlook, and that far more effective early-detection methods are needed.

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: Prospective medical surveillance and mortality follow-up of a union cohort of asbestos insulation workers, with observed deaths compared with expected deaths from U.S. white male death rates for the older group
• Who was studied: 1249 men, all asbestos insulation workers in the New York metropolitan area (New York-New Jersey; union Locals 12 and 32), followed January 1, 1963 to December 31, 1974. The 370 older men were survivors of the men on the union rolls on January 1, 1943; the article calls this group both the 'original 1943 cohort' and the '1942 cohort'. The other 879 men joined the union from 1943 to 1962 and were alive on January 1, 1963.
• Exposure: Work as asbestos insulation workers (members of the International Association of Heat and Frost Insulators and Asbestos Workers). No fiber types or doses are given. Most of the men were also regular cigarette smokers.
• Main results:
  • Among the 370 older men, 198 died from January 1, 1963 to December 31, 1974
  • Among the 370 older men, 47 lung cancer deaths occurred where 6.18 had been expected
  • Among the 370 older men, there were 7 deaths from pleural mesothelioma and 21 from peritoneal mesothelioma
  • Among the 370 older men, there were 25 deaths from asbestosis
  • Among the 370 older men, more deaths from cancer of the esophagus, stomach, colon and rectum occurred than expected
  • Among the 879 younger men, 54 deaths occurred; their observed and expected deaths had not yet been compared
  • 59 bronchogenic carcinomas (lung cancers) occurred among the 1249 men, 49 of them among the 370 older men
  • 10 lung cancers occurred among the 879 younger men
  • Of the 59 men with lung cancer, 57 were dead and 2 were alive on January 1, 1975; both survivors had undergone lobectomy
  • Both lung cancer survivors had been regular cigarette smokers, and no lung cancer was seen among workers without a history of regular smoking
  • Mesothelioma occurred in 28 of the older men and 3 of the younger men
  • In total there were 9 pleural and 22 peritoneal mesotheliomas, and all 31 men were dead at the end of the study period
• The authors' conclusion: The author concluded that the surveillance programs, as used, were insufficient to appreciably improve the prognosis of these workers. At best, they achieved early diagnosis of late disease. Far more effective methods of preclinical diagnosis are needed. For mesothelioma, surveillance likewise failed to appreciably improve prognosis.
• Limitations the authors state:
  • The mortality of the 879 younger workers had not yet been analyzed against expected deaths
  • U.S. death rates for mesothelioma and asbestosis were not available, so no expected numbers were given for these causes
  • Examinations were held in union halls, and it is not known whether workers would have cooperated as well with hospital-based examinations

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: Lung Cancer, Mesothelioma, Insulator.

Related studies

• Survival of asbestos insulation workers with mesothelioma — J. Ribak, I.J. Selikoff (1992)
• Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking — R. Lilis, I.J. Selikoff, et al. (1986)
• Occupational carcinogenesis. High-risk industrial groups: identification, education, and surveillance. Tyler Asbestos Workers Program — S.D. Greenberg, G.A. Hurst, et al. (1976)
• Respiratory morbidity among workers in an amosite asbestos insulation plant — W.M. Johnson, R.A. Lemen, et al. (1982)
• Spirometric abnormalities among asbestos insulation workers — Y. Lerman, H. Seidman, et al. (1988)
• Lung cancer and mesothelioma in the pleura and peritoneum among Swedish insulation workers — B. Järvholm, A. Sandén (1998)

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