Mesothelioma in Swiss railroad workers

Our plain-English summary of Mesothelioma in Swiss railroad workers, by J.R. Rüttner (Annals of the New York Academy of Sciences, 1991).

The study

• Author: J.R. Rüttner
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:404-6
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004172).

Summary of the article

The author updated an earlier report of a cluster of mesotheliomas among Swiss railroad workers who had not themselves handled asbestos, and examined mesothelioma in furniture workers. By the end of 1989 the Zurich Pneumoconiosis Research Group had registered 205 autopsied mesotheliomas: 191 in men and 14 in women, 193 pleural and 12 peritoneal. Qualitative mineralogical lung dust analysis was done in 179 cases, and asbestos was found in 168 (94%). Amphiboles alone were found in 109 cases (61%), chrysotile with amphibole in 52 (29%), chrysotile alone in 7 (4%) and no asbestos in 11 (6%). Forty patients had worked in railway coach construction and repair factories in German-speaking Switzerland. About one-third had direct occupational exposure. In the remaining 26 the tumours were attributed to passive, unnoticed workplace exposure. This exposure was recognised only after autopsy, lung analysis and a detailed search of past occupations, which allowed compensation. Responding to a death-certificate study that linked furniture work to mesothelioma and raised wood dust as a possible cause, the author re-examined 18 mesotheliomas in furniture workers. Asbestos was found in the lungs of 17; six had also worked in railroad factories. The author concluded that death certificates cannot establish asbestos exposure. Each case needs a careful occupational history going back decades, mineralogical lung dust analysis and a correct pathological diagnosis.

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 short report described mesothelioma cases in the files of the Zurich Pneumoconiosis Research Group, which had registered 205 autopsied mesotheliomas by the end of 1989. Forty of these patients were railroad workers from railway coach construction and repair factories in German-speaking Switzerland. The author reported that about one-third had direct occupational exposure during train repair and construction. In the other two-thirds (26 cases), the tumors were the result of passive, unnoticed exposure at the workplace, detected only after autopsy and lung analysis. Of 179 qualitative lung dust analyses, 168 (94%) found asbestos: 109 (61%) amphibole only, 7 (4%) chrysotile only and 52 (29%) both. An earlier death-certificate study by other researchers had linked furniture work to pleural mesothelioma. Responding to it, the author found 18 furniture workers in the files. Asbestos was found in the lungs of 17, and six of those had also worked in railroad factories. The author concluded that death certificates alone cannot establish asbestos exposure, and that careful occupational histories, lung dust analysis and a correct diagnosis are essential.

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: Short report (case series) from a registry of autopsied mesothelioma cases, with qualitative mineralogical analysis of lung dust and review of occupational histories
• Who was studied: 205 autopsied mesothelioma patients registered by the Zurich Pneumoconiosis Research Group up to the end of 1989 (191 male, 14 female; 193 pleural, 12 peritoneal). Of these, 40 were railroad workers employed in railway coach construction and repair factories in the German-speaking region of Switzerland, and 18 were furniture workers.
• Exposure: Asbestos exposure in railway coach construction and repair. About one-third of the railroad workers had direct occupational exposure; the other two-thirds (26) had passive, unnoticed exposure at the workplace. Lung dust was analyzed for chrysotile, crocidolite, amosite, tremolite and anthophyllite.
• Main results:
  • Among the 40 railroad workers with mesothelioma, about one-third were attributed to direct occupational exposure. In the remaining 26, the author stated it was possible to prove the tumors resulted from passive, unnoticed workplace exposure, detected only after autopsy and lung analysis.
  • Of 179 mesothelioma cases with mineralogical lung dust analysis, 168 (94%) were asbestos-positive and 11 (6%) asbestos-negative. The analysis was qualitative only, with no quantification.
  • Across all 179 analyzed cases, 109 (61%) had amphibole asbestos only, 7 (4%) had chrysotile only, 52 (29%) had both chrysotile and amphibole, and 11 (6%) had no asbestos.
  • In the 40 coach construction and repair cases, 2 had chrysotile only, 23 had amphibole only, 15 had both, and none had no asbestos.
  • Of 18 furniture workers with mesothelioma in the files, asbestos was found in the lung in 17. Six of these had also worked in the railroad factories, and in three others exposure occurred explicitly during furniture work.
• The authors' conclusion: The author concluded that asbestos exposure at work cannot be established from the death certificate alone. In each mesothelioma case, the author held that a careful occupational history going back decades, mineralogical lung dust analysis and a correct pathological diagnosis are essential.
• Limitations the authors state:
  • Lung dust analysis was only qualitative; no quantification was done.
  • For eight of the furniture-worker cases, no specific occupational history was available, and further investigations were in progress.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pneumoconiosis, Amphibole Group, Chrysotile, Occupational Exposure, Autopsy, Death Certificate, Asbestos Exposure.

Related studies

• A retrospective cohort study of lung cancer and diesel exhaust exposure in railroad workers — E. Garshick, M.B. Schenker, et al. (1988)
• A case-control study of lung cancer and diesel exhaust exposure in railroad workers — E. Garshick, M.B. Schenker, et al. (1987)
• Asbestos-related disease in railroad workers. A cross-sectional study — L.C. Oliver, E.A. Eisen, et al. (1985)
• Railroad workers with pleural plaques: I. Spirometric and nitrogen washout investigation on smoking and nonsmoking asbestos-exposed workers — U. Hjortsberg, P. Orbaek, et al. (1988)
• Past exposure to asbestos among active railroad workers — E. Garshick, M.B. Schenker, et al. (1987)
• Roentgenographic evidence of asbestos exposure in a select population of railroad workers — M.J. Sepulveda, J.A. Merchant (1983)

Browse more research in Annals of the New York Academy of Sciences, or return to medical research.