Mesothelioma of pleura and peritoneum following exposure to asbestos in the London area

Our plain-English summary of Mesothelioma of pleura and peritoneum following exposure to asbestos in the London area, by M.L. Newhouse, H. Thompson (British Journal of Industrial Medicine, 1965).

The study

• Authors: M.L. Newhouse, H. Thompson
• Journal: British Journal of Industrial Medicine
• Published: 1965;22(4):261-9
• Type of article: Case report
• Cited by: 307 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. 001536).

Abstract

A series of 83 patients from the London Hospital with a diagnosis of mesothelioma confirmed by necropsy or biopsy has been studied for possible exposure to asbestos. The series consisted of 41 men and 42 women; 27 of the patients had peritoneal and 56 pleural tumours. The earliest death recorded was in 1917, but only 10 of the series died before 1950 and 40 (48%) between 1960 and 1964. In 76 of the series full occupational and residential histories were obtained. Forty (52·6%) gave a history of occupational or domestic (living in the same house as an asbestos worker) exposure to asbestos compared with nine (11·8%) out of 76 patients from the same hospital suffering from other diseases (p < 0·001). None of the 17 suspected cases of mesothelioma, rejected on pathological grounds, was found to have had any exposure to asbestos. There was also evidence that neighbourhood exposures may be important. Among those with no evidence of occupational or domestic exposures, 30·6% of the mesothelioma patients and 7·6% of the in-patients with other diseases lived within half a mile of an asbestos factory (p < 0·01). Out of the 31 patients with occupational exposures only 10 were in jobs scheduled under the Asbestos Regulations of 1931. The interval between first exposure and the development of the terminal illness of mesothelioma ranged between 16 and 55 years. In 47 patients in the mesothelioma series, lung tissue or sputum was available for examination. In 30 (62·5%), either asbestosis or asbestos bodies were present.

In plain English

The authors studied 83 London Hospital patients whose mesothelioma was confirmed by necropsy or biopsy (41 men, 42 women; 56 pleural and 27 peritoneal tumours) and who died between 1917 and 1964. Work and home histories, mostly from interviews with relatives, were compared with those of 76 patients with other diseases matched for sex and birth period, and of 17 cases whose mesothelioma diagnosis had been rejected. Of 76 traced mesothelioma patients, 40 (52.6%) had worked with asbestos or lived with an asbestos worker, against 9 (11.8%) of the comparison patients. None of the 17 rejected cases was found to have such a history. Among people with neither exposure, 11 of 36 mesothelioma patients and 5 of 67 comparison patients had lived within half a mile of an asbestos factory. The factory employing 18 patients used mainly crocidolite. Time from first exposure to death ranged from 16 to 55 years. The authors concluded that risk may arise from both occupational and domestic exposure. They called for more evidence on risk near asbestos factories and noted that their comparison groups were not ideal.

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: Hospital case series of confirmed mesothelioma patients, with exposure histories compared against matched patients with other diseases and against cases whose mesothelioma diagnosis had been rejected
• Who was studied: 83 patients at the London Hospital with mesothelioma confirmed by necropsy or biopsy: 41 men and 42 women, 56 pleural and 27 peritoneal tumours, deaths from 1917 to 1964. Full histories were obtained for 76. The comparison groups were 76 in-patients from 1964 matched for sex and five-year birth period, and 17 rejected suspected cases.
• Exposure: Several kinds of exposure were examined: work in asbestos factories; work as laggers and insulators; domestic exposure from living with an asbestos worker, such as washing work clothes; and living near an asbestos factory. One factory used crocidolite with small amounts of chrysotile, and introduced amosite in 1926. All 17 of its workers with available details had used crocidolite.
• Main results:
  • Among 76 traced mesothelioma patients, 40 (52.6%) had occupational or domestic asbestos exposure. Among 76 in-patients with other diseases, 9 (11.8%) did (chi-squared 27.11, p less than 0.001).
  • Among those who died after 1950, 36 (50%) of confirmed mesothelioma cases had a history of asbestos exposure. None of the 17 rejected cases did (chi-squared 11.83, p less than 0.001).
  • Among patients with no occupational or domestic exposure, 11 of 36 (30.6%) mesothelioma patients and 5 of 67 in-patients had lived within half a mile of an asbestos factory (chi-squared 7.85, p less than 0.01).
  • Of the 31 mesothelioma patients with occupational exposure, only 10 were in jobs scheduled under the Asbestos Regulations of 1931.
  • In 51 exposed mesothelioma patients, including neighbourhood cases, the interval from first exposure to death ranged from 16 to 55 years.
  • The mean interval differed by type of exposure. It was shortest among the 23 factory workers (29.4 years) and longest among the 11 neighbourhood cases (48.6 years).
  • Lung tissue or sputum was available for 47 mesothelioma patients. In 30 of them, asbestosis or asbestos bodies were present.
  • The authors found no evidence that patients with peritoneal tumours differed in type of exposure from those with pleural tumours.
• The authors' conclusion: The authors concluded there was little doubt that mesothelioma risk may arise from both occupational and domestic asbestos exposure. They said more evidence was needed on risk to people living near asbestos factories or places such as dockyards.
• Limitations the authors state:
  • The authors stated that the choice of comparison groups was not ideal.
  • Very few patients could be traced in the rejected series.
  • The in-patients were all admitted in 1964, unlike the mesothelioma patients, who were admitted over 47 years.
  • Interviewers knew each patient's disease, which could have led to under-reporting of exposure in the in-patient series.
  • Histories for mesothelioma patients came mostly from relatives, who may have misremembered or not known of short exposures.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleura, Peritoneum, Autopsy, Biopsy, Occupational Exposure, Sputum, Asbestos Bodies.

Related studies

• Epidemiology of mesothelial tumors in the London area — M.L. Newhouse, H. Thompson (1965)
• Lung cancer and mesothelioma in the pleura and peritoneum among Swedish insulation workers — B. Järvholm, A. Sandén (1998)
• Pseudomesotheliomatous carcinoma involving pleura and peritoneum: A clinicopathologic and immunohistochemical study of three cases — I.A. Shah, J.R. Salvatore, et al. (1999)
• Malignant mesothelioma presenting in the pleura and peritoneum — N.E. Mischler, T. Chuprevich, et al. (1979)
• A case of mesothelioma of the tunica vaginalis testis, with involvement of the pleura and peritoneum — A. Poggi, F. Longo, et al. (2000)
• Nodular hemangiomatosis of pleura and peritoneum — S. Ribback, A. Thiele, et al. (2011)

Browse more research in British Journal of Industrial Medicine, or return to medical research.