Mortality experience in a group of asbestos workers

Our plain-English summary of Mortality experience in a group of asbestos workers, by M. Kleinfeld, J. Messite, O. Kooyman (Archives of Environmental Health, 1967).

The study

• Authors: M. Kleinfeld, J. Messite, O. Kooyman
• Journal: Archives of Environmental Health
• Published: 1967;15(2):177-80
• Cited by: 21 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. 002519).

Abstract

Mortality data on 46 asbestos insulators in New York state who had 15 or more years of exposure to asbestos dust by 1945 or had achieved 15 years of exposure between 1945 and 1965 were reviewed. The average age at death was 60.3 years with a range of 33 to 81 years. There were 12 deaths due to malignancies of lung or pleura. The differences in the mean age and mean duration of exposure for the 46 deaths and the group that developed cancers of lung or pleura were not statistically significant.

Proportional mortality from carcinoma of the lung and pleura among asbestos workers studied was nine times that expected in US white males. The observed mortality was significantly higher in the 40- to 59- as well as in the 60- to 79-year age groups. This was at variance with authors' previous findings among talc workers who had a similar duration of exposure covering a similar period but where the observed incidence increased significantly only in the 60- to 79-year age category. The occurrence of malignancy of lung and pleura in the younger age group of asbestos workers may be attributed to the greater carcinogenicity of asbestos or the longer duration of exposure to asbestos dust or both as compared to talc dust exposure. The mean duration of exposure of the asbestos workers with lung or pleural cancers was five years longer in duration than that found in the talc group with similar malignancies. In addition, other components in the asbestos dust exposure such as the presence of metallic cations may also be a factor to account for the difference in incidence between the two groups. Carcinoma of the gastrointestinal tract and peritoneum, of which there were seven cases, showed a significantly greater incidence in the observed as compared to the expected in US white males. Death due to cor pulmonale was observed in only two individuals. The low incidence of cor pulmonale as a cause of death as compared to the high incidence of pulmonary and gastrointestinal carcinoma may be ascribed to a lower level of asbestos dust exposure occurring over a longer period of time.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

This study looked at deaths among 152 asbestos insulators in New York state who had at least 15 years of exposure to asbestos dust. The authors used union records, death certificates, physicians' and hospital records, and some autopsies. Between 1945 and 1965, 46 of the men died. For lung and pleural cancers and for gastrointestinal and peritoneal cancers, the authors compared the share of deaths with that expected among US white males in 1948. The article did not name the fiber types. Twelve deaths were from cancers of the lung and pleura: ten lung carcinomas, one pleural mesothelioma and one fibrosarcoma. Seven deaths were from cancers of the gastrointestinal tract and peritoneum, including two peritoneal mesotheliomas. The share of deaths from lung and pleural cancer was about nine times that expected. The share from gastrointestinal and peritoneal cancer was also significantly higher, 15.2% against 3.9% expected. Only two deaths were from asbestosis complicated by cor pulmonale. The authors suggested this pattern may reflect lower asbestos dust levels over a longer time. They noted that smoking histories were too scant to judge smoking's role in the lung cancers.

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: Proportional mortality study of a group of asbestos insulators. The share of deaths from cancer of the lung and pleura, and from cancer of the gastrointestinal tract and peritoneum, was compared with the share expected among US white males in 1948.
• Who was studied: 152 asbestos insulators in New York state, identified from union records. All had 15 or more years of asbestos exposure by 1945, or reached 15 years between 1945 and 1965. Deaths from 1945 to 1965 were studied (46 deaths).
• Exposure: Asbestos dust from work as insulators; fiber types were not named. Mean exposure was 26 years (range 15 to 56) for all 152 workers and 31.8 years (range 15 to 47) for the 46 who died. Fiberglass was introduced into the industry in the last ten years of the period.
• Main results:
  • There were 46 deaths among the 152 insulators. 23 (50%) were from malignancies, 13 were cardiac deaths other than cor pulmonale, 2 were from asbestosis and complications, 2 were accidents and 6 had other causes.
  • Of the 12 deaths from cancer of the lung and pleura, 10 were lung carcinomas. The other two were pleural tumors: one mesothelioma and one fibrosarcoma.
  • Of the 7 deaths from cancer of the gastrointestinal tract and peritoneum, 3 were peritoneal tumors. Two of these were mesotheliomas and one was a mesenteric sarcoma.
  • Among these asbestos workers, the share of deaths from cancer of the lung and pleura (26.1%) was about nine times that expected in US white males.
  • The increase in lung and pleural cancer deaths was statistically significant (P less than 0.01) in both the 40 to 59 and 60 to 79 age groups. In the 40 to 59 group, 23.8% of deaths were observed against 7.4% expected.
  • Deaths from cancer of the gastrointestinal tract and peritoneum were significantly more frequent than expected, both overall and in the specific age groups. They made up 15.2% of deaths overall against 3.9% expected.
  • X-ray data were available for 26 of the deaths, and 12 of these showed changes consistent with asbestosis. Asbestosis contributed to death in only two of the 12, with cor pulmonale as the primary cause in both.
  • The 12 workers with lung or pleural cancer had a mean age of 56.5 years and mean exposure of 28.2 years. The 46 deaths overall had a mean age of 60.3 years and mean exposure of 31.8 years. These differences were not statistically significant.
• The authors' conclusion: The authors concluded that the low share of deaths from cor pulmonale, compared with the high share from lung and gastrointestinal cancer, may be due to lower asbestos dust exposure over a longer period of time.
• Limitations the authors state:
  • Smoking histories were meager (available for only 4 of the 12 workers with lung or pleural cancer), so the role of smoking in the lung cancers could not be assessed.
  • The small number of cases, and missing information for four of them, prevented any correlation between lung cancer and asbestosis.

Topics

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

Medical terms in this study, explained in our Lexicon: Insulator, Pleura, Proportional mortality, Carcinoma, Talc, Cation, Peritoneum, Cor Pulmonale.

Related studies

• Mortality experience of family contacts of asbestos factory workers — L. Joubert, H. Seidman, et al. (1991)
• Mortality among talc miners and millers in New York State — M. Kleinfeld, J. Messite, et al. (1967)
• Mortality experience of insulation workers in the United States and Canada, 1943--1976 — I.J. Selikoff, E.C. Hammond, et al. (1979)
• Mortality experience of amosite asbestos factory workers: dose-response relationships 5 to 40 years after onset of short-term work exposure — H. Seidman, I.J. Selikoff, et al. (1986)
• Tyler asbestos workers: mortality experience in a cohort exposed to amosite — J.L. Levin, J.W. McLarty, et al. (1998)
• Mortality experience among Minnesota taconite mining industry workers — E.M. Allen, B.H. Alexander, et al. (2014)

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