Mesothelioma in Scotland

Our plain-English summary of Mesothelioma in Scotland, by J. McEwen, A. Finlayson, A. Mair, et al (British Medical Journal, 1970).

The study

• Authors: J. McEwen, A. Finlayson, A. Mair, A.A. Gibson
• Journal: British Medical Journal
• Published: 1970;4(5735):575-8
• Cited by: 58 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. 001402).

Abstract

In a retrospective study of the incidence of mesothelioma in Scotland for 1950-67 80 cases were traced from pathological reports and biopsy material of malignant tumours invading the pleura and peritoneum. These cases were matched with two sets of controls. Detailed histories of residence, occupation, and degree of exposure to asbestos confirmed that the incidence of mesothelioma in Scotland is similar to that in other parts of Britain.

In plain English

The authors searched Scottish pathology records for 1950-67 and studied 80 people with mesothelioma (73 men, 7 women). Each case was to have two controls from the same hospital, matched for sex and age within five years; one case had no age-matched controls and another had no cancer control. One control had died of coronary artery disease, the other of lung cancer (pleural cases) or stomach cancer (peritoneal cases). An interviewer who did not know which group each person was in collected work and home histories from relatives. Because there were few women, only men were compared. Of the 73 men with mesothelioma, 49 (67%) had ever worked in shipbuilding, docks or seagoing jobs, compared with 23 (32%) of cancer controls and 22 (31%) of heart-disease controls. 'Definite' asbestos exposure was reported for 20 cases, no cancer controls and two heart-disease controls. Relatives could not say which type of asbestos was involved. The authors concluded that mesothelioma incidence in Scotland was similar to that elsewhere in the United Kingdom, and confirmed the association with occupational 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 survey of mesothelioma cases from pathology records, with a matched case-control comparison using two control groups
• Who was studied: Mesothelioma was accepted in 83 cases from Scotland for 1950-67. After exclusions, 80 cases (73 men, 7 women) were studied. Each case was to be matched by sex and by age (within five years) with a coronary artery disease control and a lung or gastric carcinoma control from the same hospital's necropsy records. No age-matched controls were found for one case, and no cancer control for another. Only the 73 men and their controls were compared.
• Exposure: Asbestos exposure, assessed from relatives' accounts of occupation and residence. Occupational exposure was graded definite, probable, possible or none. Living within half a mile of asbestos factories or dumps, shipyards or docks counted as neighbourhood exposure, and household and spare-time exposure was also recorded. The type of asbestos was very seldom known.
• Main results:
  • Ever employed in shipbuilding, docks or seagoing occupations (men): 49 (67%) of mesothelioma cases, 23 (32%) of carcinoma controls, 22 (31%) of cardiovascular controls. The authors reported this difference as significant (P less than 0.005).
  • There was no difference between cases and controls in employment in other heavy industries (P greater than 0.75).
  • Considering all categories of occupational exposure to asbestos, the difference between cases and controls was highly significant (chi-square 84.0 with 6 degrees of freedom, P less than 0.005).
  • 'Definite' exposure to asbestos was found in 20 cases, no cancer controls and two cardiovascular controls (chi-square 36.0 with 2 degrees of freedom, P less than 0.005).
  • Significantly more male cases than either control group had lived within half a mile of shipbuilding, docks or asbestos factories (Table V: 51 of 73 cases, 37 of 71 carcinoma controls, 35 of 72 cardiovascular controls).
  • Of the 51 male cases with residential exposure, all but one also had some evidence of occupational exposure to asbestos.
  • There was no statistical difference between the three groups in household or spare-time exposure to asbestos.
  • Smoking habits differed significantly (at the 1% level) between male cases and controls across the Medical Research Council smoking categories.
  • Evidence of asbestosis was found in only two of the mesothelioma cases.
• The authors' conclusion: The authors concluded that the incidence of mesothelioma in Scotland is similar to that in other parts of the United Kingdom, and that the association between the tumour and occupational exposure to asbestos was confirmed.
• Limitations the authors state:
  • The exact times a person had worked with asbestos could not be obtained accurately.
  • Relatives could not give information about the type of asbestos.
  • Because of the small number of women, only men were compared with controls.
  • Labour was highly mobile, so where people lived at death does not fully show where they were exposed at work.
  • Only hospital-admitted cases with histological evidence supporting the diagnosis were included.

Topics

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

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

Related studies

• Asbestos and lung cancer in Glasgow and the west of Scotland — H. De Vos Irvine, D.W. Lamont, et al. (1993)
• Asbestos in Scotland — T. Gorman, R. Johnston, et al. (2004)
• Home interviews with relatives of deceased persons: a means of obtaining histories of exposure to a hazardous substance — A. Finlayson, J. McEwen, et al. (1971)
• Malignant peritoneal mesothelioma: a series of 19 cases — T. van Gelder, H.C. Hoogsteden, et al. (1989)
• Malignant peritoneal mesothelioma in patients with endometriosis — K.J. Butnor, J. Rueckert, et al. (2018)
• Abdominal pain and bloating in an auto mechanic — L. Neshatian, M. Halland, et al. (2014)

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