Malignant mesothelioma due to asbestos exposure in dental tape

Our plain-English summary of Malignant mesothelioma due to asbestos exposure in dental tape, by S.B. Markowitz, J.M. Moline (American Journal of Industrial Medicine, 2017).

The study

• Authors: S.B. Markowitz, J.M. Moline
• Journal: American Journal of Industrial Medicine
• Published: 2017;60(5):437-442
• Type of article: Case report
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Although most cases of malignant mesothelioma of the pleura are caused by one or more readily recognized sources of exposure to asbestos, cases of the disease with more occult exposure occur, especially since asbestos has been used in over 3,000 products. Dental lining tape contained asbestos from the 1930s until at least the 1970s and was used in the lost wax method of casting crowns, bridges, and other metal dental prosthetic devices. We report six cases of pathology-verified malignant mesothelioma, mostly among dentists, following exposure to airborne dust from asbestos dental tape, which resulted in asbestos tort litigation. According to evidence available at present, chrysotile asbestos was the type of asbestos used in dental tape in the past in the United States, and the described cases followed relatively brief and intermittent exposure to this type of asbestos. These cases underscore the need for comprehensive exposure histories to determine exposure scenarios. Am. J. Ind. Med. 60:437-442, 2017. © 2017 Wiley Periodicals, Inc.

© 2017 Wiley Periodicals, Inc.

In plain English

This case series described six people with malignant mesothelioma, confirmed by pathology, who had used asbestos-containing dental lining tape. Four were dentists, one had attended dental technician school, and one was a silversmith who used the tape to cast jewelry in college. The cases came to the authors for medico-legal evaluation in asbestos tort litigation, and the authors disclosed serving as expert witnesses in such cases. Five had mesothelioma of the pleura and one, the silversmith, had mesothelioma of the peritoneum. All six died of the disease. The tape was the only asbestos source for four people and the main source for two. Each described work with the tape that made visible dust. The time from first exposure to diagnosis ranged from 28 to 44 years. Citing earlier published evidence, the authors stated that dental tape used in the United States contained chrysotile. They concluded that these cases add to evidence that chrysotile at relatively low exposure levels can cause malignant mesothelioma. They also concluded that a thorough occupational history can detect such cases.

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 series (six case presentations). Information came from medical records and legal depositions gathered for medico-legal evaluation in tort litigation. The authors disclosed serving as expert witnesses in asbestos tort litigation.
• Who was studied: Six people with malignant mesothelioma, all deceased, who were referred to the authors as part of tort litigation. Four were dentists (Cases 1 to 4), one attended dental technician school (Case 5), and one was a silversmith who cast jewelry (Case 6).
• Exposure: Airborne dust from asbestos-containing dental lining tape. People were exposed while tearing, cutting, lining casting rings or crucibles, scraping out the lining after casting and sweeping up debris, during dental crown and bridge fabrication or jewelry casting, in the 1960s to the 1970s. Citing earlier studies, the authors stated that US dental tape contained chrysotile, and they judged the exposures a likely modest cumulative exposure to chrysotile.
• Main results:
  • In all six cases a pathology report confirmed malignant mesothelioma, and all six died from the disease.
  • Cases 1 to 5 had malignant mesothelioma of the pleura. Case 6, the silversmith, had malignant mesothelioma of the peritoneum, epithelial type.
  • Dental lining tape was the exclusive source of asbestos exposure in four cases and the primary source in two cases.
  • Other possible exposures were noted in two cases. Case 1 applied and sanded joint compound during a home renovation. Case 5's father worked in shipyards, and Case 5 recalled possible exposure to asbestos sheets on Bunsen burner tripods in high school.
  • The authors described the exposure as episodic, limited in degree and, in most cases, lasting only a few years. Each person described tape use that created visible airborne dust.
  • Latency between first exposure to asbestos and diagnosis of mesothelioma ranged from 28 to 44 years.
  • Surgeons noted pleural plaques in Case 1 and Case 4.
• The authors' conclusion: The authors concluded that these cases add to current evidence that exposure to chrysotile asbestos at relatively low exposure levels can cause malignant mesothelioma. They also concluded that sporadic cases in atypical occupations may be detected by taking a thorough occupational history.

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: Mesothelioma, Asbestos Exposure, Pleura, Pathology, Tort, Chrysotile.

Related studies

• An investigation into asbestos related disease in the dental industry — C. Fry (2009)
• Malignant mesothelioma after exposure to asbestos in dental practice — A.S. Reid, B.E. Causton, et al. (1991)
• Pleural malignant mesothelioma in dental laboratory technicians: A case series — C. Mensi, F. Ciullo, et al. (2017)
• Characterizing and Communicating Risk with Exposure Reconstruction and Bayesian Analysis: Historical Locomotive Maintenance/Repair Associated with Asbestos Woven Tape Pipe Lagging — F.W. Boelter, J.D. Persky, et al. (2016)
• Pleural plaques in dentists from occupational asbestos exposure: a report of three cases — L. Sichletidis, D. Spyratos, et al. (2009)
• Asbestos, dental X-rays, tobacco, and alcohol in the epidemiology of laryngeal cancer — M.W. Hinds, D.B. Thomas, et al. (1979)

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