Occupational medicine-epitomes of progress: asbestos-related diseases

Our plain-English summary of Occupational medicine-epitomes of progress: asbestos-related diseases, by J.S. Felton (The Western Journal of Medicine, 1980).

The study

• Author: J.S. Felton
• Journal: The Western Journal of Medicine
• Published: 1980;133(2):149-50
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Free full text

In plain English

This was a short review, an 'epitome' of progress in occupational medicine, not an original study. It summarized earlier research without naming which listed reference each figure came from. It stated that about 20 percent of deaths among asbestos workers were from lung cancer and 6 to 7 percent from pleural or peritoneal mesothelioma, with excess deaths from several other cancers. It described a study of 17,800 asbestos insulation workers followed from 1967 to 1977, in which 2,270 deaths were observed where 1,661 were expected. These included 994 cancer deaths where 320 were expected, 175 mesotheliomas where none were anticipated, and 162 deaths from asbestosis without malignant change. It also reported mesotheliomas in household family contacts of asbestos workers and in people living within about a quarter mile of facilities using asbestos materials. It described a 15- to 35-year lag before clinical disease, and increased risk of cancer death after just one month of shipyard employment. The author concluded that asbestosis is a potentially dangerous precancerous lung disease and called for periodic medical surveillance of exposed people.

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: brief narrative review (an 'Epitomes' item in occupational medicine) summarizing earlier studies; no original data
• Who was studied: No study population of its own. The review discussed asbestos workers in general, including a study of 17,800 asbestos insulation workers (1967 to 1977), shipyard workers in the United States, household family contacts of asbestos workers, and people living near facilities using asbestos materials.
• Exposure: Inhalation of free asbestos fiber (no fiber types named), in insulation work, shipyard trades, household contact and living near facilities using asbestos-containing materials
• Main results:
  • Among asbestos workers, the review stated that approximately 20 percent of all deaths were due to lung cancer and 6 to 7 percent to pleural or peritoneal mesothelioma, or both.
  • The review reported excess deaths among asbestos workers from cancer of the esophagus, stomach, colon-rectum, oropharynx, larynx and kidney.
  • In the study of 17,800 asbestos insulation workers followed from January 1, 1967 to January 1, 1977, 2,270 deaths were observed where 1,661 had been predicted.
  • In the same insulation worker group, 994 deaths were from cancer where only 320 had been expected.
  • In the same group there were 175 mesotheliomas, where none had been anticipated because of the rarity of the tumor.
  • In the same group, asbestosis without malignant change accounted for 162 deaths.
  • Mesotheliomas were also found among family contacts of asbestos workers living in the same households, and among persons living within a quarter mile or so of facilities where asbestos-containing materials were used.
  • The review described a 15- to 35-year lag between first contact with asbestos and clinical evidence of disease.
  • Among shipyard workers, the review reported that just one month of employment had led to increased risk of death from cancer.
  • At one shipyard site, approximately half of the workers examined showed radiographic evidence of pulmonary and pleural changes usually seen after asbestos exposure.
• The authors' conclusion: The author concluded that primary care physicians should accept asbestosis as a potentially dangerous precancerous lung disease even in patients without symptoms, and that periodic medical surveillance (chest radiography, pulmonary function tests, physical examination) of people exposed to asbestos must become routine. The author also listed recommended preventive procedures, including stopping smoking and avoiding contamination of homes with asbestos-soiled work clothing.

Related studies

• Recent progress in the study of occupational lung diseases in Romania — B. Barhad, L. Pilat, et al. (1975)
• Compensation scheme for complementary and alternative medicine use in asbestos-related diseases in New South Wales, Australia — C. Oak, H.J. Choi, et al. (2012)
• Occupational health: the intersection between clinical medicine and public health — L. Rosenstock, P.J. Landrigan (1986)
• Not just a research method: If used with caution, can job-exposure matrices be a useful tool in the practice of occupational medicine and public health? — M. Fadel, B.A. Evanoff, et al. (2020)
• Position Paper on Asbestos of the Italian Society of Occupational Medicine — P. Apostoli, P. Boffetta, et al. (2019)
• The 10-year experience of an academically affiliated occupational and environmental medicine clinic — L. Rosenstock, W. Daniell, et al. (1992)

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