Malignant Mesothelioma in a Motor Vehicle Mechanic

Our plain-English summary of Malignant Mesothelioma in a Motor Vehicle Mechanic, by C. Meisenkothen (New Solutions, 2017).

The study

• Author: C. Meisenkothen
• Journal: New Solutions
• Published: 2017;26(4):524-542
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Case reports remain an important source of data in the debate over the carcinogenic effect of asbestos-containing automotive friction products. This report documents a case of pleural mesothelioma accompanied by asbestos bodies in the lung tissue of a career auto mechanic with no other known sources of exposure. Previously unreported historical and contemporary exposure data are also discussed in the context of providing additional support for the proposition that work with asbestos-containing automotive products presents a risk of significant exposure. While there remains a body of negative epidemiology that fails to find an increased risk of disease among auto workers, those data must be approached with caution. Many of those studies have drawn technical criticisms, which are beyond the scope of this report, but they remain a key part of the legal defense mounted by defendant-companies who are involved in asbestos-related litigation. This ongoing debate provides the context for the continued relevance of case reports such as this one, as well as the presentation of new and previously unpublished exposure data.

In plain English

This article is a case report combined with a review of the literature. The author is an attorney who represents plaintiffs in asbestos litigation. It described a Caucasian man diagnosed in 1999, at age fifty-three, with epithelioid malignant pleural mesothelioma on the left side of the chest. Digestion studies of his lung tissue found asbestos bodies, but the cores of those bodies were never identified or documented. He died twenty-seven months after diagnosis. After military service he worked as a mechanic for thirty-one years, first on automobiles and then on heavy trucks and equipment. He handled brakes, clutches and gaskets, and said he never wore a mask or respirator. The author also reported microscope tests the author commissioned. These found chrysotile fibers protruding from brakes and clutches. During grinding of a drum brake lining, two 7-minute personal air samples measured 23.8 and 26.9 f/cc. The article also described unpublished 1970s industry air measurements. The author concluded that the man's mechanic work contributed to his mesothelioma. The author noted that the data from the lung fiber analysis were not available.

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 of one patient combined with a review of the literature and of previously unpublished exposure data; the author is a plaintiffs' asbestos attorney
• Who was studied: One Caucasian man, a career auto and later heavy truck and equipment mechanic in the United States, diagnosed with malignant pleural mesothelioma in 1999 at age fifty-three
• Exposure: Work as a mechanic with asbestos-containing automotive friction and gasket products (brakes, clutches, gaskets): school training from ages fourteen to eighteen, then about thirty-one years as a mechanic after military service; he denied construction or insulation work
• Main results:
  • The patient was diagnosed with epithelioid malignant pleural mesothelioma in 1999, on the left side of the chest
  • Digestion studies of the patient's lung tissue found asbestos bodies; their cores were never identified or documented
  • The patient died twenty-seven months after diagnosis
  • The patient denied wearing a mask or respirator and denied seeing other mechanics wear them
  • In tests commissioned by the author, grinding an asbestos-containing drum brake lining gave personal air samples of 23.8 f/cc and 26.9 f/cc (7 minutes each)
  • Author-commissioned tests found free crocidolite and anthophyllite fibers on automatic transmission clutch discs, and tremolite and actinolite asbestos in bulk samples of chrysotile-containing friction materials
  • Unpublished 1976 tests in working garages by a telecom company reported a personal sample of 0.13 f/cc while inspecting brakes, and 1.04 f/cc for a man using compressed air to blow out brake drums
  • In 1978, an American auto manufacturer recorded 0.13 f/cc for employees unpacking new clutch discs
• The authors' conclusion: The author concluded that the patient's work as an automotive mechanic contributed to the development of his mesothelioma, based on the wider medical and scientific evidence and the asbestos bodies found in his lung tissue
• Limitations the authors state:
  • Data from the fiber burden analysis of the patient's lung tissue were not available, including the number of asbestos bodies and the identity of their cores
  • The author noted that some other undiscovered amphibole exposure is theoretically possible

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: Malignant Mesothelioma, Carcinogenic, Friction Products, Pleural Mesothelioma, Asbestos Bodies, Epidemiology, Defendant.

Related studies

• Mesothelioma and lung cancer among motor vehicle mechanics: a meta-analysis — M. Goodman, M.J. Teta, et al. (2004)
• Response to Kay Teschke. Re: Mesothelioma among Motor Vehicle Mechanics: An Updated Review and Meta-analysis — D.H. Garabrant, D.D. Alexander, et al. (2016)
• Asbestos exposures of mechanics performing clutch service on motor vehicles — H.J. Cohen, D.R. Van Orden (2008)
• Mesothelioma among Motor Vehicle Mechanics: An Updated Review and Meta-analysis — D.H. Garabrant, D.D. Alexander, et al. (2016)
• Personal exposure to asbestos and respiratory health of heavy vehicle brake mechanics — M.F. Cely-García, C.A. Torres-Duque, et al. (2015)
• The incidence and economic costs of cancer, motor vehicle injuries, coronary heart disease, and stroke: a comparative analysis — N.S. Hartunian, C.N. Smart, et al. (1980)

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