Lung disease related to exposure to asbestos

Our plain-English summary of Lung disease related to exposure to asbestos, by D.T. Hughes (Medicine, Science, and the Law, 1974).

The study

• Author: D.T. Hughes
• Journal: Medicine, Science, and the Law
• Published: 1974;14(3):147-51
• Cited by: 2 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. 002353).

Summary of the article

This article, written by a chest physician at the London Hospital, reviewed lung disease related to exposure to asbestos for a medico-legal readership. It described the main types of asbestos (chrysotile, crocidolite, amosite and anthophyllite), their uses, and the jobs in which dust is inhaled. A historical section traced recognition of asbestos disease from the first case of pulmonary fibrosis noted in 1900. It cited the Merewether and Price report of 1930, which found definite pulmonary fibrosis in 95 of 363 asbestos textile workers and led to the 1931 Asbestos Regulations. It also cited later work on asbestos bodies, pleural thickening, lung cancer, mesothelioma and pleural plaques. The author set out six factors for diagnosing asbestosis: exposure, breathlessness, finger clubbing, basal crepitations, radiological changes and reduced diffusing capacity. Given exposure, any two of the others were described as strongly suggestive, and four to five as conclusive. Lung cancer was described as about ten times more frequent in asbestos workers than in the general population. Mesothelioma was described as following exposure as short as 3 months, with a latent period of 20 to 50 years, no effective treatment, and a fatal outcome in all cases. The author listed reasons why new cases were still seen despite the 1931 regulations, which were updated in 1969, and noted that sufferers could claim compensation. He concluded that long latent periods, forgotten exposures and failure to follow the regulations explained continuing cases.

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 1974 article by a London chest physician was a narrative review, not a new study, and reported no data on a study group of its own. It described the main asbestos types (chrysotile, crocidolite or 'blue asbestos', amosite and anthophyllite) and the lung diseases linked to asbestos. Among earlier work, it cited a 1930 report by Merewether and Price that found definite pulmonary fibrosis in 95 of 363 asbestos textile workers examined. The author listed six factors for diagnosing asbestosis and said asbestos bodies in sputum show exposure but do not by themselves diagnose asbestosis. He stated that lung cancer occurred in asbestos workers about ten times as often as in the general population, and that mesothelioma had a latent period of 20 to 50 years. He reported seeing asbestosis in a woman who had worked with asbestos for 3 months only. The author concluded that new cases were still being seen partly because of the long latent period and partly because the regulations were not followed.

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 and overview by a single author. It covers the history of research, types of asbestos-related disease, diagnostic criteria and UK regulations. No original study data were reported.
• Who was studied: No study population. The review was written by a chest physician at The London Hospital, Whitechapel, London. It draws on earlier published reports and on the author's clinical experience.
• Exposure: Inhaled asbestos dust in general. The review describes chrysotile, crocidolite ('blue asbestos'), amosite and anthophyllite. It also lists exposing activities, including mining, spinning, cleaning spinning rooms, lagging and stripping pipes and boilers, cutting asbestos boards, and mixing asbestos powder with paste.
• Main results:
  • Earlier work cited by the review, not this article's own finding: the 1930 report by Merewether and Price found definite pulmonary fibrosis due to asbestos dust in 95 of the 363 asbestos textile workers examined.
  • The author stated that diagnosing asbestosis rests on six factors: exposure to asbestos, breathlessness, clubbing of the fingers, basal crepitations, radiological changes and reduced diffusing capacity (transfer factor). Given exposure, any two of the other factors would be strongly suggestive, and four to five would clinch the diagnosis.
  • The author stated that asbestos bodies in the sputum only show that a person has been exposed to asbestos dust. They are not of themselves diagnostic of asbestosis.
  • The author reported seeing a case of asbestosis in a woman who had worked with asbestos fibre and powder for 3 months only.
  • The author stated that lung cancer occurs more frequently in asbestos workers than in the general population, by a factor of about ten.
  • The author noted recent suggestions that asbestos exposure and smoking may have a more than additive effect in producing lung cancer.
  • The author stated that for diffuse mesothelioma of the pleura or peritoneum, exposure may be as short as 3 months, with a latent period of 20 to 50 years. He also stated that there was no effective treatment and that all cases were fatal.
  • The author wrote that there was some evidence that certain types of asbestos, especially blue asbestos, are more likely to cause mesothelioma.
  • The author summarised five abnormalities found in the respiratory system as a result of asbestos exposure: asbestos bodies in the sputum, calcified pleural plaques, asbestosis, bronchial carcinoma and mesothelioma of the pleura. He described the last three as serious and fatal conditions.
• The authors' conclusion: The author concluded that, despite the 1931 Asbestos Regulations, new cases of asbestosis and mesothelioma were still being seen. He attributed this partly to the long latent period before the diseases develop and partly to the regulations not being followed.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer.

Medical terms in this study, explained in our Lexicon: Chrysotile, Crocidolite, Amosite, Anthophyllite, Pulmonary Fibrosis, Asbestos Bodies, Pleural Thickening, Lung Cancer.

Related studies

• A guide to compensation for asbestos-related diseases — M.G. Britton, D.T. Hughes, et al. (1981)
• Ecological association between asbestos-related diseases and historical asbestos consumption: an international analysis — R.T. Lin, K. Takahashi, et al. (2007)
• Fiber counting and analysis in the diagnosis of asbestos-related disease — A. Churg (1982)
• Asbestos related diseases from environmental exposure to crocidolite in Da-yao, China. I. Review of exposure and epidemiological data — S. Luo, X. Liu, et al. (2003)
• Asbestos-related disease from household exposure — G.R. Epler, M.X. Fitz Gerald, et al. (1980)
• Asbestos related disease in Barrow-in-Furness — J.R. Edge (1976)

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