Mesothelioma in an individual following exposure to crocidolite-containing gaskets as a teenager

Our plain-English summary of Mesothelioma in an individual following exposure to crocidolite-containing gaskets as a teenager, by R.F. Dodson, S.P. Hammar, L.W. Poye (International Journal of Occupational and Environmental Health, 2011).

The study

• Authors: R.F. Dodson, S.P. Hammar, L.W. Poye
• Journal: International Journal of Occupational and Environmental Health
• Published: 2011;17(3):190-4
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Mesothelioma is considered a signal tumor for asbestos exposure and typically occurs decades after first exposure to asbestos. Tissue analysis often indicates past exposure to mixed types of asbestos. This report describes the case of a 58-year-old man who developed mesothelioma after reported exposure to crocidolite from asbestos-containing gaskets beginning at age 16 during three summers during high school and for approximately four hours per day during the last semester of his senior year. He had no further known exposure to asbestos. Analytical transmission electron microscopy analysis of digested tissue samples revealed elevated levels of crocidolite asbestos fibers and the presence of crocidolite cored ferruginous bodies. This case is unique in that it establishes that relatively short and/or intense exposures to crocidolite asbestos traumatically released from a previously classified Category 1 nonfriable asbestos-containing material (NESHAP) was confirmed via tissue burden analysis years following the historically defined exposures.

In plain English

This article is a case report about one person. The authors described a 58-year-old nonsmoking man with shortness of breath. He was diagnosed with epithelial mesothelioma of the right pleura (chest lining) over 40 years after first asbestos exposure. A CT scan also showed a calcified pleural plaque. His only reported asbestos contact was teenage work, from age 16, at a company that prepared gaskets. He worked there for three summers and from January to June of his senior year. The authors analyzed his wax-embedded lung tissue for asbestos fibers and ferruginous bodies (iron-coated fibers). Light microscopy found the equivalent of 934 ferruginous bodies per gram of deparaffinized (wax-removed) wet tissue. Two of the authors' laboratories use 20 or fewer per gram of wet tissue as the general-population level. Electron microscopy at 15,000 times magnification detected only crocidolite in the areas examined: 16 fibers, equivalent to 66,644 fibers per gram of deparaffinized wet tissue. No chrysotile was found within the detection limit. The authors concluded that these findings corroborated his reported teenage exposure to crocidolite-containing material.

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 (single patient, with lung tissue fiber burden analysis)
• Who was studied: One 58-year-old male nonsmoker, a college graduate who later worked in computer support and information technology. He presented with shortness of breath.
• Exposure: He cut sheet gaskets at an industrial-specialty company, beginning at age 16. He worked there for three summers and from January to June of his senior year of high school (afternoons, 1:00 to 5:00 PM). He reported that 60% of his time was spent cutting dark gray gaskets identified as crocidolite-containing. He also cut neoprene, cork and gum rubber gaskets, and possibly some gaskets containing chrysotile. He described appreciable dust from cutting.
• Main results:
  • Surgical tissue confirmed right pleural epithelial mesothelioma, diagnosed more than 40 years after first exposure to asbestos
  • A CT scan showed calcified parietal pleural plaque in the right lower chest
  • In his lung tissue, light microscopy counted 46 ferruginous bodies, equivalent to 934 ferruginous bodies per gram of deparaffinized wet weight of tissue
  • The authors described this count as appreciably higher than the general-population level used in two of their laboratories, which is 20 or fewer ferruginous bodies per gram of wet tissue
  • Electron microscopy (ATEM) at 15,000 times magnification identified 16 crocidolite asbestos fibers, equivalent to 66,644 fibers per gram of deparaffinized wet weight of tissue
  • The crocidolite fibers ranged from 2.5 to 16 µm in length, with an average length of 7.1 µm
  • No other types of asbestos fibers or bodies were detected in the areas scanned at high magnification
  • A lower-magnification scan found one crocidolite-cored ferruginous body (10 µm long) and four more uncoated crocidolite fibers (6 to 21 µm long)
  • No chrysotile was found within the limit of detection of the analysis
  • Several pathologists had not found ferruginous bodies in ordinary tissue sections. The authors attributed this to the limited sensitivity of that method.
• The authors' conclusion: The authors concluded that documents showed he was occupationally exposed as a teenager to a traumatized (cut) crocidolite-containing material. They concluded that analysis of his lung tissue by ATEM years later corroborated this exposure.
• Limitations the authors state:
  • The authors noted that he may have cut chrysotile-containing gaskets. Any chrysotile present would have been below the detection limit of their analysis.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Crocidolite, Gasket, Signal Tumor, Asbestos Exposure, Analytical Transmission Electron Microscopy (ATEM), Ferruginous body, Asbestos-Containing Material (ACM).

Related studies

• Assessment of airborne asbestos exposure during the servicing and handling of automobile asbestos-containing gaskets — C.L. Blake, G.S. Dotson, et al. (2006)
• Exposure data from multi-application, multi-industry maintenance of surfaces and joints sealed with asbestos-containing gaskets and packing — F. Boelter, C. Simmons, et al. (2011)
• Evaluation of the dose-response and fate in the lung and pleura of chrysotile-containing brake dust compared to chrysotile or crocidolite asbestos in a 28-day quantitative inhalation toxicology study — D.M. Bernstein, B. Toth, et al. (2018)
• Assessing specific causation of mesothelioma following exposure to chrysotile asbestos-containing brake dust — M.D. Freeman, S.S. Kohles (2012)
• Final results from a 90-day quantitative inhalation toxicology study evaluating the dose-response and fate in the lung and pleura of chrysotile-containing brake dust compared to TiO2, chrysotile, crocidolite or amosite asbestos: Histopathological examination, confocal microscopy and collagen quantification of the lung and pleural cavity — D.M. Bernstein, B. Toth, et al. (2021)
• Evaluation of the fate and pathological response in the lung and pleura of brake dust alone and in combination with added chrysotile compared to crocidolite asbestos following short-term inhalation exposure — D.M. Bernstein, R.A. Rogers, et al. (2015)

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