Mesothelioma And Its Association With Asbestosis

Our plain-English summary of Mesothelioma And Its Association With Asbestosis, by M. Borow, A. Conston, L.L. Livornese, et al (1967).

The study

• Authors: M. Borow, A. Conston, L.L. Livornese, N. Schalet
• Published: Journal Of The American Medical Association 201(8):93-97, August 21 (1967)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 004218. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1967 report from Somerset Hospital in Somerville, New Jersey, described 17 cases of mesothelioma, nine of the pleura and eight of the peritoneum, and gave detailed accounts of three patients. The authors stated that an industrial facility two miles from the hospital converted about 75% of the asbestos fiber mined in North America to commercial use. They attributed the cluster of cases to that mill. The fiber types used there were not named. Two patients had only environmental exposure from living near the mill. The one woman in the series never worked at the plant but lived nearby. Among 1,330 autopsies from 1955 to 1965, the authors counted 22 cases of bronchogenic cancer with pulmonary asbestosis. The three described patients were men who had worked 28 years, 25 years and 18 months at an asbestos mill or refining plant. The authors reported that treatment had little effect: half the patients died within one year and the rest by the second year. The authors concluded that mesothelioma was increasing, while noting that earlier cases may have been misdiagnosed. The article's case counts are internally inconsistent.

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 from one hospital (surgical cases plus a review of hospital autopsy records), with three individual case reports
• Who was studied: 17 patients with mesothelioma (9 pleural, 8 peritoneal) at Somerset Hospital, Somerville, NJ, all reported as diagnosed within the three years before publication. 11 of them were operated on by one author within the past two years. The authors also reviewed hospital autopsy material from 1948 through 1965.
• Exposure: Work at, or living near, a major asbestos mill and refining plant two miles from the hospital. The article does not state which fiber types this facility handled.
• Main results:
  • Two of the 17 patients had only environmental exposure, from living in a community next to the asbestos mill.
  • Only one patient in the series was female. She never worked in the asbestos plant but lived nearby.
  • Among 1,330 autopsies performed from 1955 to 1965, there were 22 cases of bronchogenic cancer with pulmonary asbestosis.
  • Case 1: a 52-year-old man who had worked 28 years at an asbestos mill and was retired with disability from pulmonary asbestosis. He had peritoneal mesothelioma, died of a myocardial infarction 14 months after surgery, and at autopsy had pleural plaques.
  • Case 2: a 51-year-old man who had worked 25 years at an asbestos refining plant. He had peritoneal mesothelioma and died four months after biopsy diagnosis. At autopsy he had pleural plaques and many asbestos bodies in the lungs.
  • Case 3: a 47-year-old man who had worked as a stock boy in an asbestos refining plant for 18 months, 24 years earlier. Biopsy diagnosed pulmonary asbestosis and pleural mesothelioma, and he died ten months later.
  • Treatment with cobalt radiation, radioactive gold and chromium, and chemotherapy, alone or in combination, had little effect on the course of the disease.
  • Fifty percent of the patients with pleural or peritoneal mesothelioma died within one year and the remainder by the second year. In the scanned text this sentence is split across interleaved column lines.
• The authors' conclusion: The authors attributed the concentration of cases to the nearby asbestos mill. They believed that the incidence of mesothelioma, like that of asbestosis, was increasing as asbestos use spread across industries.
• Limitations the authors state:
  • The authors said the number of patients with these conditions was hard to determine because earlier cases were often diagnosed as pulmonary fibrosis or silicosis.
  • The authors said the apparent recent rise may partly reflect that earlier mesothelioma patients were likely diagnosed as generalized carcinomatosis and rarely autopsied.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Peritoneum, Environmental Exposure, Bronchogenic Carcinoma, Asbestosis.

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