Malignant pericardial mesotheliomas and asbestos exposure: a case report

Our plain-English summary of Malignant pericardial mesotheliomas and asbestos exposure: a case report, by B. Beck, G. Konetzke, V. Ludwig, et al (American Journal of Industrial Medicine, 1982).

The study

• Authors: B. Beck, G. Konetzke, V. Ludwig, W. Röthig, W. Sturm
• Journal: American Journal of Industrial Medicine
• Published: 1982;3(2):149-59
• Type of article: Case report
• Cited by: 17 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. 001760).

Abstract

Three cases of malignant pericardial mesotheliomas are presented with evidence of occupational asbestos exposure. Examination results are compared with findings from experimental and epidemiological research on biological effects of asbestos dust. There are sufficient indications that time-limited effects of asbestos dust established either by measurements or assessment of the amount of concentration after a latency of more than 20 years are apt to result in the development of mesotheliomas of the pleura and peritoneum and, moreover, the pericardium. It is suggested that malignant pericardial mesothelioma also be recognized as another form of occupational disease caused by asbestos dust.

In plain English

This case report came from the German Democratic Republic (East Germany). The authors reviewed all 15 malignant pericardial mesotheliomas (cancer of the lining around the heart) in the national cancer register from 1970 to 1978, in 13 men and 2 women. They used records, interviews with relatives and co-workers, and workplace checks. They reported proof of job-related asbestos exposure in three cases, some indication of contact in four, no contact in five, and investigations continuing in two. Two of the three were a chemical-plant mechanic and an engine operator in a lignite briquette factory, both of whom replaced asbestos packing cord. The third dusted talc on textile carding machines. Talc samples the authors tested contained 2% to 5% asbestos, and more in a few. No past analyses of the talc he used were available, but it came from the same countries as the asbestos-containing samples. Latency from first exposure to diagnosis was 57, 36 and 30 years. The authors could not use electron microscopy to identify fibers. They concluded that pericardial mesotheliomas strongly suggest some connection with asbestos exposure.

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: Retrospective review of registered cases, presented as a case report of three cases of malignant pericardial mesothelioma with occupational asbestos exposure
• Who was studied: All 15 cases of malignant pericardial mesothelioma (13 men, 2 women) registered in the National Cancer Register of the German Democratic Republic from 1970 to 1978. Three cases are described in detail: men who were aged 77, 63 and 48.
• Exposure: Occupational asbestos dust. Case 1 was a mechanic at a chemical plant from 1923 until 1957 who removed and replaced asbestos packing cord and asbestos diaphragms in electrolytic cells. Case 2 worked 72 months between 1939 and 1947 as an engine operator in a lignite briquette factory, replacing asbestos cord and removing asbestos insulation from piping without respirators. Case 3 worked from 1958 to 1967 at a carding machine in a textile factory, hand-dusting talc powder. The authors considered that talc to contain asbestos. Fiber types were not specified.
• Main results:
  • Among the 15 registered cases, the authors' retrospective studies established occupational asbestos dust exposure in three (cases 1, 2 and 3).
  • There was some indication of asbestos dust contact in four further cases: a submarine sailor, a man who helped demolish a cold-storage unit, a woman who worked in a room with an asbestos-slab heater housing, and a druggist who handled talcum.
  • In five cases there was never any contact with asbestos, and in two cases investigations were still going on.
  • Latency from first asbestos exposure to identification of the pericardial mesothelioma in the three cases was 57, 36 and 30 years.
  • In case 3, relatively small asbestos needles were found in the lung tissue under the light microscope. This man also had silicosis from 12 years in ore mines.
  • In talc samples the authors tested, asbestos contents ranged from 2% to 5%, and were higher in a few cases.
  • Cases 2 and 3 were recognized as occupational disease and the widows were granted pensions. For case 1, the medical opinion recommended a pension for the widow.
• The authors' conclusion: The authors were of the opinion that pericardial mesotheliomas strongly suggest some connection with asbestos exposure. They suggested that malignant pericardial mesothelioma also be recognized as an occupational disease caused by asbestos dust.
• Limitations the authors state:
  • The authors could not use transmission electron microscopy to identify asbestos fibers in the lungs or in the tumors.
  • For case 3, no mineralogic analyses were available of the talc samples used in past years. The authors relied on later samples from the same countries of origin.
  • Information on housing and living conditions came only from relatives.
  • For the woman who worked near asbestos slabs, it could no longer be checked whether fibers had loosened from them.

Topics

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

Medical terms in this study, explained in our Lexicon: Pericardial Mesothelioma, Asbestos Exposure, Latency, Mesothelioma, Pleura, Peritoneum, Pericardium, Occupational Disease.

Related studies

• Surgical pathology of primary cardiac and pericardial tumors — C. Basso, M. Valente, et al. (1997)
• Primary pericardial tumors — C.S. Restrepo, D. Vargas, et al. (2013)
• Primary pericardial mesothelioma: report of two cases and review of the literature — A.L. Sytman, R.N. MacAlpin (1971)
• Primary pericardial mesothelioma — N.T. Eren, A.R. Akar (2002)
• Malignant pericardial mesothelioma : A systematic review of current practice — S. Cao, S. Jin, et al. (2018)
• Pericardial mesothelioma and asbestos exposure — C. Mensi, S. Giacomini, et al. (2011)

Browse more research in American Journal of Industrial Medicine, or return to medical research.