Neoplasia among insulation workers in the United States with special reference to intra-abdominal neoplasia

Our plain-English summary of Neoplasia among insulation workers in the United States with special reference to intra-abdominal neoplasia, by E.C. Hammond, I.J. Selikoff, J. Churg (Annals of the New York Academy of Sciences, 1965).

The study

• Authors: E.C. Hammond, I.J. Selikoff, J. Churg
• Journal: Annals of the New York Academy of Sciences
• Published: 1965;132(1):519-25
• Cited by: 59 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. 001527).

Summary of the article

The authors reviewed early reports on asbestos workers, who were heavily exposed and often died young of tuberculosis and pneumonia, and argued that such deaths may have prevented cancers from appearing after their long latent period. They then reported mortality among asbestos insulation workers, whose exposure they described as light and intermittent, for deaths after 1942, when antibiotics were available. In a first group of 632 men, all members of New York Local 12 and Newark Local 32 of the International Association of Heat and Frost Insulators and Asbestos Workers on January 1, 1943, followed through December 31, 1962, there were 255 deaths against 203.5 expected from US white male death rates. There were 45 deaths from cancer of the lung and pleura against 6.6 expected, 29 from cancer of the stomach, colon and rectum against 9.4 expected, and 12 deaths from asbestosis. An extended group of 1,522 men was traced through August 1964. Of their 307 deaths, 124 (40.4%) were from cancer, including 53 bronchogenic carcinomas, 10 mesotheliomas (4 pleural, 6 peritoneal) and 34 gastrointestinal cancers, and 17 (5.5%) were from asbestosis. None of 57 lung and pleura cancer deaths occurred less than 20 years after first exposure. The authors did not draw conclusions on gastrointestinal cancer. They concluded that, with light exposure and antibiotics available, neoplasia is a major cause of death in such workers.

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 mortality study, an extension of the authors' earlier report, followed members of New York Local 12 and Newark Local 32 of the insulation workers' union. The authors described the men as having had very light and intermittent exposure to asbestos dust. Of 632 men who were members at the start of 1943 and were traced through 1962, 255 died, compared with 203.5 deaths expected from the death rates of United States white males. There were 45 deaths from cancer of the lung and pleura against 6.6 expected, and 29 from cancer of the stomach, colon and rectum against 9.4 expected. Twelve deaths were attributed to asbestosis. Among 1,522 men traced through August 1964, 124 of 307 deaths (40.4 per cent) were attributed to cancer. These included 53 bronchogenic carcinomas and 10 mesotheliomas (4 pleural, 6 peritoneal). None of 57 lung and pleura cancer deaths occurred less than 20 years after first exposure. The authors noted that some diagnoses rested only on clinical or death certificate evidence. They declined, for now, to draw conclusions about gastrointestinal 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: Mortality follow-up of an entire group of union members (including retired men and men who had left the trade), comparing observed deaths with deaths expected from the death rates of all US white males; an extension of the authors' earlier published report. The article opens with a historical review of earlier reports on asbestos workers, which are not this study's findings.
• Who was studied: 632 men who made up the total membership of New York Local 12 and Newark Local 32 of the International Association of Heat and Frost Insulators and Asbestos Workers at the start of 1943, traced through December 31, 1962. A larger group of 1,522 men was also studied: the 632 plus 890 who joined between 1943 and 1962, traced through August 1964.
• Exposure: Work as insulation workers, described by the authors as very light and intermittent exposure to asbestos dust, compared with the daily heavy exposure in older studies. The first analysis counted men only after 20 or more years from first exposure. No fiber type is named.
• Main results:
  • Among the 632 men, 255 died in 1943-1962, compared with 203.5 deaths expected from US white male death rates.
  • In the first five-year period (1943-1947), fewer deaths than expected occurred among the 632 men (28 observed, 39.7 expected in Table 1). The authors attributed this to all the men being actively at work in 1943. In the last five-year period, 88 died compared with 54.4 expected.
  • Among the 632 men there were 45 deaths from cancer of the lung and pleura, compared with 6.6 expected, which the authors called a mortality ratio of nearly 7 to 1.
  • Among the 632 men there were 29 deaths from cancer of the stomach, colon and rectum, compared with 9.4 expected, which the authors called a mortality ratio of 3 to 1.
  • Of the 255 deaths among the 632 men, 12 were attributed to asbestosis.
  • Among the 1,522 men traced through August 1964, there were 307 deaths. Of these, 124 (40.4 per cent) were attributed to cancer, 17 (5.5 per cent) to asbestosis and 166 (54.1 per cent) to other causes.
  • Of the 124 cancer deaths in the 1,522-man group, 53 (43 per cent of cancer deaths) were attributed to bronchogenic carcinoma, 10 to mesothelioma and 34 to gastrointestinal carcinoma.
  • J. Churg examined sections from all 10 mesothelioma deaths: 4 were pleural and 6 were peritoneal mesotheliomas.
  • Of 57 workers who died of cancer of the lung and pleura, none died less than 20 years after first exposure. Table 3 shows 3 at 20-24 years, 7 at 25-29, 16 at 30-34, 11 at 35-39 and 20 at 40 or more years.
• The authors' conclusion: The authors concluded that, with light exposure and antibiotics available to treat infectious disease, neoplasia is a major cause of death among such workers. They wrote that, taken at face value, asbestos workers would appear to have an abnormally high risk of dying of gastrointestinal cancer, but they refrained from drawing conclusions on that question at the time.
• Limitations the authors state:
  • Diagnoses based only on clinical evidence or death certificate information are open to question.
  • This uncertainty applies particularly to deaths attributed to generalized carcinomatosis (primary site unknown), stomach cancer and liver cancer.
  • A few mesotheliomas may have been missed. One further lesion looked suspiciously like mesothelioma, but its diagnosis was not certain.
  • The authors held back from conclusions about gastrointestinal cancer risk.

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, Stomach Cancer, Bronchogenic Carcinoma, Mesothelioma.

Related studies

• The occurrence of asbestosis among insulation workers in the United States — I.J. Selikoff, J. Churg, et al. (1965)
• Utility of glucose transporter 1 in the distinction of benign and malignant thoracic and abdominal mesothelial lesions — S.M. Lagana, R.N. Taub, et al. (2012)
• Malignant mesothelioma presenting as a giant chest, abdominal and pelvic wall mass — Z.H. Shao, X.L. Gao, et al. (2011)
• Mortality experience of insulation workers in the United States and Canada, 1943--1976 — I.J. Selikoff, E.C. Hammond, et al. (1979)
• Mortality of brain tumors among asbestos insulation workers in the United States and Canada — H. Seidman, I.J. Selikoff, et al. (1982)
• Asbestos-associated deaths among insulation workers in the United States and Canada, 1967-1987 — I.J. Selikoff, H. Seidman (1991)

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