Malignant mesothelioma after exposure to asbestos in dental practice

Our plain-English summary of Malignant mesothelioma after exposure to asbestos in dental practice, by A.S. Reid, B.E. Causton, J.S. Jones, et al (Lancet, 1991).

The study

• Authors: A.S. Reid, B.E. Causton, J.S. Jones, I.O. Ellis
• Journal: Lancet
• Published: 1991;338(8768):696
• Type of article: Case report, Letter
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, the authors reported malignant mesothelioma in a dentist and discussed asbestos exposure in dental practice. A 60-year-old retired dentist presented with recurrent left pleural effusions. Histology of tissue from a left pleurectomy confirmed malignant mesothelioma. He developed paraplegia and died 10 months after presentation. Post-mortem examination showed a mixed-type mesothelioma that had extended into the pericardial cavity, chest wall and paravertebral tissue. Mineral analysis found 0.7 x 10^6 crocidolite fibres per gram of dry lung. The authors described this as lower than expected with longstanding occupational exposure but higher than in the general population. No chrysotile fibres were found. The authors described how, until the mid-1970s, asbestos paper was used to line casting rings and crucibles for metal fillings and dentures, and chrysotile powder served as a binder in periodontal dressings. They cited measurements of 21 to 27 fibres per ml of air released when moulds were dismantled. They noted that dental undergraduates commonly cast at least 40 sets of dentures. The Health and Safety Executive found no other source of the patient's exposure to asbestos and no previous reports of mesothelioma in dental personnel. The authors concluded that this first reported case illustrated another potential occupational association between asbestos exposure and mesothelioma.

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 letter to the Lancet reported one case: a 60-year-old retired dentist who developed malignant mesothelioma of the pleura, the lining around the lungs. The patient had repeated fluid build-up around the left lung and had surgery to remove the left pleura. Tissue examination confirmed malignant mesothelioma. The patient died 10 months after presentation, and post-mortem examination showed a mesothelioma of mixed type. Lung tissue analysis found 0.7 million crocidolite (blue asbestos) fibres per gram of dry lung. The authors described this as lower than expected after longstanding occupational exposure but higher than in the general population. No chrysotile fibres were found in the lung tissue, which the authors said may be consistent with a clearance effect (fibres being cleared from the lungs). The authors explained that until the mid-1970s, dentistry used asbestos paper to line casting rings for fillings and dentures, and chrysotile powder in periodontal dressings. The Health and Safety Executive found no other source of asbestos exposure for this patient. The authors concluded that this case illustrated another potential occupational association between asbestos and mesothelioma.

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: Case report (letter to the editor)
• Who was studied: One 60-year-old retired dentist, reported from Nottingham, UK
• Exposure: Crocidolite asbestos fibres from dental practice. The authors described two past dental uses of asbestos until the mid-1970s. Asbestos paper was used to line casting rings and crucibles, and liners were used for casting dentures. Powder containing chrysotile was used as a binder in periodontal dressings.
• Main results:
  • Histology of tissue removed at left pleurectomy confirmed malignant mesothelioma.
  • The patient's condition deteriorated, paraplegia developed, and the patient died 10 months after presentation.
  • At post-mortem, the tumour was a malignant mesothelioma of mixed type.
  • Mineral analysis of the patient's lung tissue found 0.7 x 10 to the power of 6 crocidolite fibres per gram of dry lung.
  • The authors judged the patient's crocidolite level lower than expected with longstanding occupational exposure, but higher than in the general population.
  • No chrysotile fibres were found in the patient's lung tissue. The authors said this may be consistent with a clearance effect.
  • The Health and Safety Executive found no other source of asbestos exposure for this patient, and no previous reports of malignant mesothelioma in dental personnel.
• The authors' conclusion: The authors concluded that this first reported case illustrated another potential occupational association between asbestos exposure and mesothelioma.

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Asbestos Exposure, Pleural Effusion, Histology, Autopsy, Mesothelioma, Pericardial, Crocidolite.

Related studies

• An investigation into asbestos related disease in the dental industry — C. Fry (2009)
• Pleural malignant mesothelioma in dental laboratory technicians: A case series — C. Mensi, F. Ciullo, et al. (2017)
• Malignant mesothelioma due to asbestos exposure in dental tape — S.B. Markowitz, J.M. Moline (2017)
• The effect of casting ring liners on the potential expansion of a gypsum-bonded investment — R. Earnshaw (1988)
• The fit of gold-alloy full-crown castings made with pre-wetted casting ring liners — E.F. Morey, R. Earnshaw (1992)
• Potential health hazards of ceramic ring lining material — D.R. Davis (1987)

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