Mesothelioma and asbestos fibre type

Our plain-English summary of Mesothelioma and asbestos fibre type, by A.D. McDonald, J.C. McDonald (British Journal of Industrial Medicine, 1985).

The study

• Authors: A.D. McDonald, J.C. McDonald
• Journal: British Journal of Industrial Medicine
• Published: 1985;42(8):567-8
• Type of article: Letter
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001229).

In plain English

This was a letter to the editor, not a new study. The authors replied to an earlier letter by Dr Finkelstein about their own published cohort studies of workers at two American asbestos textile plants, one in Pennsylvania and one in South Carolina. They wrote that the exposure-response patterns for cancer mortality, particularly of the respiratory tract, were remarkably similar in the two plants. They added that, dose for dose, these workers' experience was far worse than that of chrysotile miners and millers or chrysotile friction product workers. The Pennsylvania plant had 14 deaths from mesothelioma (plus five more in women not reported in that paper), compared with one case at the South Carolina plant. The Pennsylvania plant used small quantities of amphibole fibre. A later published correction made clear that the authors did not agree this difference was due to misdiagnosis. They said there was evidence of underestimated mesothelioma counts in the Pennsylvania cohort, but certainly not in South Carolina. There, they and a NIOSH team searched necropsy records and death certificates and found only one case. The authors agreed that exposure estimation was perhaps the most serious problem.

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: letter to the editor (correspondence) replying to an earlier letter by Dr Finkelstein; no new data
• Who was studied: the authors' earlier cohort studies of workers at two American asbestos textile plants, one in Pennsylvania and one in South Carolina
• Exposure: asbestos in textile manufacture; the Pennsylvania plant used small quantities of amphibole fibre
• Main results:
  • Pennsylvania plant: 14 deaths from mesothelioma, plus five more in women not reported in that paper. South Carolina plant: one case.
  • The patterns of relative risk for cancer mortality, particularly of the respiratory tract, were remarkably similar in the two plants.
  • Dose for dose, the textile workers' experience was far worse than that of chrysotile miners and millers or chrysotile friction product workers.
  • In South Carolina, the authors and a NIOSH team searched local necropsy records and cohort death certificates for missed cases and found only the one case. The authors said mesotheliomas were certainly not underestimated there.
  • Many mesotheliomas were found in the local South Carolina area, where there are shipyards, but none in employees of the textile plant.
• The authors' conclusion: According to the published correction, the authors did not agree that the difference in mesothelioma cases between the two plants was due to misdiagnosis rather than the use of small quantities of amphibole fibre at the Pennsylvania plant. They stated that the case against the amphiboles also rests on other evidence in which diagnostic biases do not appear to have been a major factor. That evidence includes Ontario asbestos cement workers exposed to chrysotile and crocidolite.
• Limitations the authors state:
  • The authors agreed that exposure estimation is perhaps the most serious problem in the controversy over mesothelioma and fibre type.
  • The authors acknowledged evidence that the number of mesotheliomas in the Pennsylvania cohort was underestimated.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma.

Related studies

• The effect of fibre size on the in vitro biological activity of three types of amphibole asbestos — R.C. Brown, M. Chamberlain, et al. (1978)
• Hydroxyl radical production in the presence of fibres by a Fenton-type reaction — M. Gulumian, J.A. van Wyk (1987)
• Fibre type and concentration in the lungs of workers in an asbestos cement factory — B. Gylseth, G. Mowé, et al. (1983)
• Comparison of fibre types and size distributions in lung tissues of paraoccupational and occupational cases of malignant mesothelioma — A.R. Gibbs, D.M. Griffiths, et al. (1990)
• Chemotactic factor generation by asbestos. Fibre type differences and the effects of leaching — E. Yano, A. Takeuch, et al. (1984)
• Comparison of NIOSH and AIA methods for evaluating asbestos fibres: effects of asbestos type, mounting medium, graticule type and counting rules — E. Gonzalez-Fernandez, F.R. Martín (1986)

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