Non-occupational exposure to asbestos and malignant mesothelioma in females

Our plain-English summary of Non-occupational exposure to asbestos and malignant mesothelioma in females, by N.J. Vianna, A.K. Polan (Lancet, 1978).

The study

• Authors: N.J. Vianna, A.K. Polan
• Journal: Lancet
• Published: 1978;1(8073):1061-3
• Cited by: 137 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. 002156).

Abstract

A study of the occupational histories of 52 females with malignant mesothelioma and certain of their relatives, carried out to measure the risk of this disorder attributable to indirect asbestos exposure, showed that a significantly greater number of husbands and fathers of cases than of controls worked in asbestos-related industries, and the relative risk for this factor was 10. The frequency of parental cancer, especially gastrointestinal malignancy, was also significantly greater for cases than for their controls. This raises the possibility of a genetic predisposition to malignant mesothelioma.

In plain English

This case-control study, from the New York State Department of Health, looked at women aged 20 or older in New York State outside New York City who died between 1967 and 1977 with malignant mesothelioma confirmed by tissue examination. Of 65 reported deaths, 52 were confirmed: 32 pleural and 20 peritoneal. Each patient was matched with one woman who died of a cause other than cancer. Investigators collected work histories for the women, their fathers and their husbands. Six patients had worked in asbestos-related jobs; none of their matched controls had. Ten patients had husbands and/or fathers in asbestos-related jobs while their controls did not, and all ten routinely hand-laundered those relatives' clothing. The estimated relative risk for this exposure was 10 (95% confidence interval 1.42 to 37.40). Cancer in a parent was more common among patients than controls (17 pairs versus 5, P=0.008). The authors concluded that their results suggest women run the risk of mesothelioma not only from working in asbestos-related industries but also from indirect exposure. They also raised the possibility of a genetic predisposition.

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: case-control study with one matched control (died of a cause other than cancer) per case
• Who was studied: 52 females with histologically confirmed malignant mesothelioma (32 pleural, 20 peritoneal), out of 65 reported. All were residents of New York State excluding New York City, aged 20 or more, who died between 1967 and 1977. Each was matched to one control.
• Exposure: The women's own occupations and those of their fathers and husbands, classed as asbestos-related or not. Exposure through hand-laundering of relatives' work clothing and living near factories using asbestos were also examined. Specific fiber types were not reported for the study subjects.
• Main results:
  • 6 patients (A-F) worked in asbestos-related occupations; none of their matched controls did.
  • There were 2 reverse instances, in which controls (but not their cases) worked with asbestos textiles for 3-7 years.
  • 10 patients had husbands and/or fathers in asbestos-related occupations while their controls did not. All of these patients routinely hand-laundered the clothing.
  • In only one pair was the reverse true: the control's husband worked in the heat insulating industry for 20 years (P=0.006).
  • The estimated relative risk of mesothelioma for exposure through husbands' and/or fathers' asbestos-related work was 10 (95% confidence interval 1.42 to 37.40).
  • Fathers' and/or husbands' work in jobs linked to other pneumoconioses (such as silica): 17 pairs where only the case's relatives were exposed versus 12 reverse pairs. This was not statistically significant (P>0.05).
  • 2 patients lived within 3.6 km of factories using asbestos in New York State for 20-27 years, and one lived about 1.2 km from an asbestos textile factory in Leeds, England, for 18 years. None of the controls lived within 8 km of asbestos factories.
  • Parental cancer: in 17 pairs only the patient's parents had malignancies, versus 5 pairs where only the control's parents did (P=0.008). Gastrointestinal malignancies were the most common.
  • Patients with a parental history of cancer had a lower mean age at diagnosis than the 35 patients without (62.3 years), but the difference was not statistically significant.
• The authors' conclusion: The authors concluded that their results suggest women run the risk of malignant mesothelioma not only if they work in asbestos-related industries but also if they are indirectly exposed to environmental asbestos. They named the husband's occupation as the most important risk factor and raised the possibility of a genetic predisposition.
• Limitations the authors state:
  • The authors stated that the high frequency of cancer among patients' parents is difficult to interpret.

Topics

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

Medical terms in this study, explained in our Lexicon: Non-Occupational Exposure, Malignant Mesothelioma, Asbestos Exposure, Relative Risk.

Related studies

• Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum — R.L. Attanoos, R. Webb, et al. (2002)
• Well-differentiated papillary mesothelioma of the female peritoneum: a clinicopathologic study of 26 cases — A. Malpica, S. Sant'Ambrogio, et al. (2012)
• Mesotheliomas with deciduoid morphology: a morphologic spectrum and a variant not confined to young females — J.H. Shanks, M. Harris, et al. (2000)
• Malignant peritoneal mesothelioma, clear cell variant, in a female and its differentiation from clear cell carcinoma — H. Hayashi, T. Kawata, et al. (2017)
• Collagenous Spherulosis in Well-Differentiated Papillary Mesothelioma in a Female With Multilocular Peritoneal Inclusion Cysts — B. AbdullGaffar, L.G. Raman (2019)
• A study of the mortality of female asbestos workers — M.L. Newhouse, G. Berry, et al. (1972)

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