Occupational carcinogenesis. High-risk industrial groups: identification, education, and surveillance. Tyler Asbestos Workers Program

Our plain-English summary of Occupational carcinogenesis. High-risk industrial groups: identification, education, and surveillance. Tyler Asbestos Workers Program, by S.D. Greenberg, G.A. Hurst, W.T. Matlage, et al (Annals of the New York Academy of Sciences, 1976).

The study

• Authors: S.D. Greenberg, G.A. Hurst, W.T. Matlage, J.M. Miller, I.J. Hurst, L.C. Mabry
• Journal: Annals of the New York Academy of Sciences
• Published: 1976;271:353-64
• Cited by: 16 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

It is concluded that sputum cytopathology is an excellent, simple, noninvasive, painless, and inexpensive means for early detection of malignant and premalignant lesions of the lung, and that no special techniques are necessary for the identification of ferruginous bodies.

In plain English

This report gave early results of the Tyler Asbestos Workers Program, a surveillance program begun in July 1974 for 890 former workers of a Tyler, Texas, plant that processed amosite asbestos from 1954 to 1972. About 90% of the men were cigarette smokers. Through December 1974, 733 sputum specimens from 344 former workers had been examined for abnormal cells and ferruginous bodies. About one third of these workers had ferruginous bodies in their sputum. Thirteen workers (4%) had severe atypia of airway lining cells, and 44% had mild atypia, mostly squamous metaplasia. One worker, a 76-year-old heavy smoker, had squamous carcinoma cells in the sputum. The chest X-ray showed no localizing lesion, and bronchoscopy confirmed the cancer, but it had already spread. The patient died six months later, and autopsy also showed asbestosis. Aerosol-induced sputum yielded ferruginous bodies more often, and in larger numbers, than home-collected sputum. The authors concluded that sputum cytopathology is a simple, noninvasive, inexpensive means for early detection of malignant and premalignant lung lesions.

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: report of early results from a medical surveillance (screening) program using sputum cytology, including a description of one cancer case
• Who was studied: Former workers of an amosite asbestos plant in Tyler, Texas, which operated 1954 to 1972. The program cohort was 890 men. This report covers 344 workers and 733 sputum specimens examined from July 1974 through December 1974.
• Exposure: Past occupational exposure to amosite asbestos mined in South Africa, processed at the Tyler plant. About 90% of the men were also cigarette smokers.
• Main results:
  • About one third of the 344 former workers examined had ferruginous bodies in their sputum.
  • Thirteen former workers (4%) had sputum with severe epithelial atypias. 44% had mild atypias, most of which were squamous metaplasia.
  • Only one former worker had sputum cells positive for squamous carcinoma. This worker was 76 years old, had worked at the plant 1954 to 1961, and had smoked 180 pack years.
  • In this worker, the chest X-ray showed no localizing lesion. The cancer found by bronchoscopy had already spread to the visceral pleura.
  • The worker refused radiation therapy and chemotherapy and died six months later. Autopsy showed asbestosis with interstitial fibrosis in both lower lobes.
  • Among workers with ferruginous bodies in their sputum, aerosol-induced sputum gave better results than spontaneous sputum alone. It also contained larger numbers of ferruginous bodies, even though it was a single specimen while the spontaneous specimen was a pool of three.
  • The 21 sputum specimens with severe epithelial atypias were split equally between aerosol-induced and spontaneous specimens.
  • The authors reported that no ferruginous body had been found in 12,000 sputum specimens examined from 1972 to 1975 in their Houston cytopathology laboratory. They stated that finding such bodies in these numbers indicates significant asbestos exposure.
• The authors' conclusion: The authors concluded that sputum cytopathology is an excellent, simple, noninvasive, painless and inexpensive means for early detection of malignant and premalignant lung lesions. They also concluded that no special techniques are needed to identify ferruginous bodies.
• Limitations the authors state:
  • The authors stated that no statistical correlation could yet be made between ferruginous bodies and atypical epithelial cells in the sputum.

Topics

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

Medical terms in this study, explained in our Lexicon: Carcinogenesis, Sputum, Cytopathology, Ferruginous Bodies.

Related studies

• Pulmonary cytopathology of former asbestos workers. Report of the first year — S.D. Greenberg, G.A. Hurst, et al. (1976)
• Surveillance of high-risk groups--a survey of asbestos workers: the present position in the United Kingdom — W.J. Smither (1979)
• Asbestos Surveillance Program Aachen (ASPA): initial results from baseline screening for lung cancer in asbestos-exposed high-risk individuals using low-dose multidetector-row CT — M. Das, G. Mühlenbruch, et al. (2007)
• Surveillance of high-risk groups exposed to asbestos in the United States — H.C. Lewinsohn (1979)
• Copy number gains on 5p15, 6p11-q11, 7p12, and 8q24 are rare in sputum cells of individuals at high risk of lung cancer — E. Kettunen, K. Salmenkivi, et al. (2006)
• Asbestos bodies in the sputum of asbestos workers: correlation with occupational exposure — C. Paris, F. Galateau-Salle, et al. (2002)

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