Occupational cancer of the urinary bladder in dyestuffs operatives and of the lung in asbestos textile workers and iron-ore miners

Our plain-English summary of Occupational cancer of the urinary bladder in dyestuffs operatives and of the lung in asbestos textile workers and iron-ore miners, by G.M. Bonser, J.S. Faulds, M.J. Stewart (American Journal of Clinical Pathology, 1955).

The study

• Authors: G.M. Bonser, J.S. Faulds, M.J. Stewart
• Journal: American Journal of Clinical Pathology
• Published: 1955;25(2):126-34
• Cited by: 46 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. 001853).

In plain English

This 1955 paper by three pathologists in Leeds and Carlisle, England, was partly a review of occupational cancer and partly a report of two unpublished autopsy series. Its section on bladder cancer in dyestuffs workers mainly summarized earlier published work. In the first series, postmortem material came from 80 people who had worked in 2 asbestos textile factories. Of these, 72 had pulmonary asbestosis. Cancer arising primarily in the pleurae, lungs or bronchi was found in 26.1 per cent of the males and 8.7 per cent of the females. Four peritoneal cancers (1 male, 3 females) were also found, which the authors called a very high number for such a small series. All cases with asbestosis and cancer had been exposed before 1931. The authors had no comparable unexposed autopsy group. In the second series, 17 of 192 Cumberland hematite miners had lung cancer, compared with 44 of 2378 Cumberland males over 20, a difference reported as statistically significant. The authors suggested that silica, common to both groups, may be the carcinogenic agent.

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• Design: Review and discussion of occupational cancer, including two previously unpublished autopsy (postmortem) case series: asbestos textile workers and hematite (iron-ore) miners compared with unselected local males
• Who was studied: Postmortem material from 80 people who had worked in 2 asbestos textile factories (collected from about 1928). Of these, 72 had pulmonary asbestosis: 46 males and 26 females. Also 192 Cumberland hematite miners autopsied over 20 years, compared with 2378 Cumberland males over 20 years old, unselected for cancer or lung disease.
• Exposure: Work in 2 asbestos textile factories (fiber type not stated). Separately, hematite (iron-ore) mining, with silica and iron measured in the miners' lungs.
• Main results:
  • Among the asbestos textile workers with asbestosis, cancer arising primarily in the pleurae, lungs or bronchi was present in 26.1 per cent of males and 8.7 per cent of females.
  • The authors said the higher rate in males may be accounted for by 7 women dying before the cancer age: 4 after childbirth or abortion and 3 from tuberculosis.
  • Among males, there was no significant difference in average age at death, average period of exposure or average age at starting work between those with uncomplicated asbestosis and those who also had lung cancer.
  • In the asbestos workers, the degree of lung fibrosis was rather less in lungs with cancer than in those without.
  • Of the 13 lung cancers with full notes, 4 were large tumors near the lung hilum and 7 were in the periphery of the lung. Two were pleural in distribution, and both were adenocarcinomas.
  • There were 4 peritoneal cancers in the asbestos series, 1 in a male and 3 in females. All were anaplastic carcinomas with no primary site found in any organ. The authors described this as a very high number for such a small series.
  • All the asbestos workers who had both asbestosis and cancer had been exposed before 1931, when dust-control regulations were introduced.
  • Lung cancer was found in 17 of 192 hematite miners (8.85 per cent) and in 44 of 2378 Cumberland males over 20 (1.85 per cent). The authors reported this difference as statistically significant.
  • In the miners, there was no significant difference in lung silica or iron content between lungs with and without cancer.
• The authors' conclusion: The authors suggested that silica, the common factor in both types of occupational lung cancer, may be the carcinogenic agent. They proposed that the fibrous nature of asbestos or the presence of hematite dust may modify its action, and said further study was needed.
• Limitations the authors state:
  • No comparable postmortem material was available from factory workers not exposed to asbestos dust.
  • A fair assessment of exposure period was difficult. The period was taken as first entry into the factory until death.
  • The exposure-period measure disregarded absences from the factory for any reason.

Topics

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

Related studies

• Nephrogenic adenoma: a form of adenomatous metaplasia of the bladder. A clinical and electron microscopical study — E.A. Molland, P.A. Trott, et al. (1976)
• Nephrogenic metaplasia (adenomatoid tumors) of bladder — J.A. Kaswick, J. Waisman, et al. (1976)
• Occupational asbestos exposure and urinary bladder cancer: a systematic review and meta-analysis — N. Franco, A. Godono, et al. (2023)
• Occupational exposure to asbestos and urinary bladder cancer — R. Molinini, L. Paoletti, et al. (1992)
• A case-control study of mesothelioma in Minnesota iron ore (taconite) miners — C.S. Lambert, B.H. Alexander, et al. (2016)
• Mesothelioma in iron ore (taconite) miners — D. Mirabelli (2016)

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