Mesothelioma due to domestic exposure to asbestos

Our plain-English summary of Mesothelioma due to domestic exposure to asbestos, by K. Browne, T. Goffe (British Medical Journal, 1984).

The study

• Authors: K. Browne, T. Goffe
• Journal: British Medical Journal
• Published: 1984;289(6437):110-1
• Type of article: Letter
• Cited by: 4 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 nos. 001651, 001829).

Summary of the article

This letter responded to a report by Dr G C Ferguson and Dr H Watson (BMJ, 2 June 1984) of two sisters who both developed pleural mesotheliomas, which those authors attributed to wire brushing of a white asbestos cement roof. The letter's authors noted that several occurrences of two or more cases of mesothelioma within the nuclear family had been reported, and said this was probably not simply due to a shared source of asbestos exposure. They asked whether the diagnosis had been confirmed in both cases by a pathologist with particular experience in mesothelioma histology. They cited a US review in which only 26% of cases diagnosed as mesothelioma by local pathologists could be accepted as definite, probable or possible by a member of a mesothelioma reference panel. They noted that one sister survived for a prolonged period after pleurectomy, although surgery had rarely been found to influence survival in diffuse mesothelioma. They argued that the attribution to white asbestos ignored epidemiological evidence that chrysotile, as distinct from amphibole asbestos, plays little or no part in causing mesothelioma, and quoted the 1983 Acheson and Gardner report to the UK Health and Safety Executive. They asked whether the lung fibre burden had been studied in the fatal case. They also cited a 1976 report of two Australian sisters with mesothelioma in whom no asbestos exposure was found. They concluded that not all cases of mesothelioma are due to asbestos exposure. The authors were listed with Cape Industries Ltd and TBA Industrial Products Ltd.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This item was not a research study. It was a letter to the editor by Kevin Browne, listed with Cape Industries Ltd, London, and T Goffe, listed with TBA Industrial Products Ltd, Rochdale. It responded to an earlier report by Dr G C Ferguson and Dr H Watson of two sisters who both developed pleural mesothelioma, which those doctors linked to wire brushing of a white asbestos cement roof. The letter writers asked whether both diagnoses had been confirmed by a pathologist experienced in mesothelioma. They cited a US review in which only 26% of locally diagnosed cases were accepted by a reference panel member. They said the prolonged survival of one sister after pleurectomy underlined the importance of accurate diagnosis, because surgery has rarely been found to influence survival in diffuse mesothelioma. They argued that evidence indicated chrysotile, as distinct from amphibole asbestos, plays little or no part in causing mesothelioma. They asked whether the lung fibre burden had been studied in the fatal case. They concluded that not all mesothelioma is due to asbestos. In a reply, Ferguson and Watson stated that the asbestos link had not been definitely established. The reply is cut off.

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), not a research study, by authors listed with Cape Industries Ltd and TBA Industrial Products Ltd
• Who was studied: No group was studied. The letter commented on a previously published report of two sisters who both developed pleural mesothelioma.
• Exposure: Wire brushing of a white asbestos cement roof, the exposure proposed in the original report. The letter discussed chrysotile as distinct from amphibole asbestos.
• Main results:
  • Point raised in the letter, not a finding of its own: it cited a US review (Wright et al.) in which only 26% of cases diagnosed as mesothelioma by local pathologists could be accepted by a reference panel member, and asked whether the sisters' diagnoses were confirmed by an experienced pathologist.
  • Point raised in the letter: the letter writers said the prolonged survival of one sister after pleurectomy underlined the importance of accurate diagnosis, because surgery has rarely been found to influence survival of patients with diffuse mesothelioma.
  • Argument made in the letter: evidence indicated that chrysotile, as distinct from amphibole asbestos, plays little or no part in mesothelioma causation. The letter quoted a 1983 UK report by Acheson and Gardner in support.
  • Question raised in the letter: whether a microscopic study of the lung fibre burden was carried out in the fatal case.
  • In a reply, Ferguson and Watson stated that the link between asbestos exposure and mesothelioma in the two sisters had not been definitely established, partly because no lung fibre burden study was done in the fatal case.
• The authors' conclusion: The authors concluded that cause cannot be assumed from sequence alone and that not all cases of mesothelioma are due to asbestos exposure.

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, Pleural Mesothelioma, Asbestos-Cement, Asbestos Exposure, Histology, Attribution, Chrysotile, Amphibole Asbestos.

Related studies

• Increased risk of malignant mesothelioma of the pleura after residential or domestic exposure to asbestos: a case-control study in Casale Monferrato, Italy — C. Magnani, P. Dalmasso, et al. (2001)
• Domestic asbestos exposure: a review of epidemiologic and exposure data — E. Goswami, V. Craven, et al. (2013)
• Congenital tumours and tumour-like lesions in domestic animals. 1. Cattle. A review — W. Misdorp (2002)
• Assessment of environmental and domestic exposure to tremolite in New Caledonia — D. Luce, M.A. Billon-Galland, et al. (2004)
• Malignant pleural mesothelioma five years after domestic exposure to blue asbestos — S.J. Booth, E.J. Weaver (1986)
• Malignant mesothelioma in Metsovo, Greece, from domestic use of asbestos: 30 years later — A. Gogali, C. Manda-Stachouli, et al. (2012)

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