Mesotheliomas among railroad workers in the United States

Our plain-English summary of Mesotheliomas among railroad workers in the United States, by T.F. Mancuso (Annals of the New York Academy of Sciences, 1991).

The study

• Author: T.F. Mancuso
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:333-46
• Cited by: 5 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. 004163).

Summary of the article

This paper described asbestos exposure among U.S. railroad workers, mainly in the steam locomotive era, and the occurrence of mesothelioma among them. Retired machinists described how asbestos lagging was stripped from and applied to locomotive boilers, producing heavy dust throughout railroad shops. About 375 lagging blocks, roughly 6,000 pounds of insulation, were used on a 30-foot boiler. The cohort study used a seniority list from railroad company "A" of machinists and other crafts alive on January 1, 1945, who had been hired before 1935. A subcohort of 181 white male machinists hired in 1920-1929 was followed through 1989, analyzed by individual year of hire. There were 159 deaths, 42 from cancer. Of these, 15 (35%) were histologically confirmed mesotheliomas (14 pleural, one peritoneal) and 11 were lung cancers. Together they made up 61% of cancers, or 1 in every 7 machinists. The interval from first employment to death ranged from 33 to 64 years. The author also compiled 151 mesothelioma deaths among railroad workers from at least 20 companies across the country. He stressed that this was not a national study, and most of these deaths occurred at age 65 or over. He noted that research based on the Railroad Retirement Board omits 4.9 million former workers with under 10 years of service. An appendix cited railroad medical proceedings from 1932-1958 that discussed asbestosis and dust control. The author concluded that an unrecognized epidemic of occupational cancer had occurred among railroad workers, and he called for further studies, including of short-term workers and families.

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 paper combined four things: a description of asbestos exposure in U.S. railroad shops, a cohort of railroad machinists from one company ("Company A"), a collection of mesothelioma deaths among railroad workers, and historical material from railroad physicians' meetings. The main exposure described was asbestos lagging insulation put on and stripped from steam locomotive boilers. A 1919 source described that asbestos as chrysotile. The cohort was 181 white male machinists hired in 1920-1929 and employed in 1945, followed through 1989. Among them were 159 deaths, 42 from cancer. Fifteen cancers were mesotheliomas (14 pleural, one peritoneal, all histologically confirmed), about one for every 12 machinists hired. Mesotheliomas plus 11 lung cancers made up 61% of the 42 cancers. Separately, the author gathered 151 mesothelioma deaths among railroad workers from at least 20 companies, mostly people aged 65 and over. The author stressed that this was a combination of individual observations, not a national study, and could not show the true magnitude. The author concluded that railroad workers had suffered an unrecognized "epidemic of occupational cancer."

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: Descriptive report combining an occupational cohort of railroad machinists from one company (analysed by individual year of hire), an informal collection of mesothelioma deaths among U.S. railroad workers, and a historical appendix
• Who was studied: From a seniority list of railroad company "A": 285 white male machinists and other crafts hired before 1935 and alive in 1945, and a subcohort of 181 white male machinists hired 1920-1929 and employed in 1945 (159 deaths with cause-of-death information, 22 not known), followed through 1989. Separately, 151 mesothelioma deaths among railroad workers from across the United States.
• Exposure: Asbestos lagging (block insulation) installed on and removed from steam locomotive boilers, and on steam cranes, in railroad shops. Workers of all crafts in the shop were exposed. A 1919 publication described the lagging asbestos as chrysotile.
• Main results:
  • Among the 181 machinists hired 1920-1929, there were 159 deaths, 42 of them from cancer
  • Fifteen of the cancer cases in the machinist cohort were mesotheliomas: 14 pleural and one peritoneal, all histologically confirmed
  • In the cohort of 181 machinists, one mesothelioma occurred for every 12 machinists hired
  • In the machinist cohort, the interval from first employment to death from mesothelioma ranged from 33 to 64 years
  • In the machinist cohort, the 15 mesotheliomas plus 11 lung cancers made up 61% of the 42 cancer cases (described by the author as 1 of every 7 machinists hired 1920-1929)
  • The author's collection of mesothelioma deaths among railroad workers nationally came from at least 20 different railroad companies
  • In the collection of 151 persons dying of mesothelioma, deaths occurred overwhelmingly among those aged 65 and over
  • Historically, a railroad hospital clinician (Otto) presented, but did not publish, nine cases of mesothelioma among railroad workers occurring between 1957 and 1966
• The authors' conclusion: The authors concluded that railroad workers had experienced an epidemic of occupational cancer that was slow, silent, unrecognized and ignored for decades, and called for further studies of railroad workers, including those with under 10 years of service and family members.
• Limitations the authors state:
  • The national collection of mesothelioma cases was not a national study but a combination of individual observations
  • The grouping of the 151 mesothelioma deaths cannot represent the true nature or magnitude of what occurred
  • Mesotheliomas were under-identified and under-reported by physicians

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure, Cohort Study, Lung Cancer, Dust Control.

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)
• Relative risk of mesothelioma among railroad machinists exposed to chrysotile — T.F. Mancuso (1988)
• Mesothelioma among machinists in railroad and other industries — T.F. Mancuso (1983)
• 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)

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