On The Occurrence Of Clumps Of Asbestosis Bodies In The Sputum Of Asbestos Workers

Our plain-English summary of On The Occurrence Of Clumps Of Asbestosis Bodies In The Sputum Of Asbestos Workers, by M.J. Stewart, N. Tattersall, A.C. Haddow (1932).

The study

• Authors: M.J. Stewart, N. Tattersall, A.C. Haddow
• Published: Journal Of Pathology And Bacteriology 35:737-741, September (1932)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 003260. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1932 article from Leeds reported on the sputum of asbestos workers and described two workers whose sputum contained clumps of asbestosis bodies. One author had examined the sputum of 24 asbestos workers and found bodies in all but 4. Several of these workers were in excellent health, with nothing to suggest lung fibrosis. The authors also reported finding bodies at post-mortem in the lungs of a man who had lived close to a factory for many years but had never been inside it. In two workers, both women, a large, radially arranged clump of some 20 or 30 bodies was found. Case I, aged 31, developed bronchopneumonia and died in March 1931. Her autopsy showed diffuse fibrosis of both lower lobes. Case II, aged 44, had X-ray findings typical of moderately advanced asbestosis. The authors concluded that clumps in sputum indicate breakdown of lung tissue and an underlying asbestosis. In their view, clumps carry far greater significance than single bodies, however numerous. They noted that their rough method of processing sputum may have missed some clumps.

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 report of two patients, with a brief note on sputum examinations of 24 asbestos workers
• Who was studied: Sputum of 24 asbestos workers examined by one author (M. J. S.) in Leeds. Detailed reports cover two women: Case I, aged 31, who died in 1931, and Case II, aged 44 in 1932.
• Exposure: Work in an asbestos factory. Case I worked from 1915 until 1928, with a two-year break for childbirth. Case II started 27 years before 1932, with a 6-year break; she worked mainly on mattress making and later on "winding and warping" for 5 or 6 years. No fiber type is named.
• Main results:
  • Of the 24 asbestos workers whose sputum was examined, asbestosis bodies were found in all but 4.
  • Several of the workers with bodies in their sputum were in excellent health, with nothing to suggest pulmonary fibrosis.
  • The authors found bodies in the lungs, at post-mortem, of a man who had lived close to a factory for many years but had never been inside it.
  • In two of the workers, a large clump of some 20 or 30 bodies, more or less radially arranged, was found in addition to single bodies.
  • Case I, a woman aged 31, died on 10 March 1931. The clump was found in her sputum on 13.1.31, during an illness with bronchopneumonia.
  • Case I's post-mortem examination showed diffuse fibrosis of the greater (basal) portion of both lower lobes.
  • Under the microscope, Case I's lungs showed large radially arranged clumps of bodies in alveoli next to fibrous patches and within the fibrous tissue itself.
  • Case I had an active tuberculous lesion in one block of the obliterated pleura, but no evidence of tuberculosis of the lungs in any of the blocks cut.
  • Case II's sputum contained bodies in fairly large numbers, including a large radially arranged clump on 4.4.32.
  • Case II's chest X-ray was typical of moderately advanced asbestosis.
• The authors' conclusion: The authors concluded that a large clump of asbestosis bodies in sputum indicates disintegration of lung tissue and a definite underlying asbestosis. They held that such a clump is of far greater significance than single bodies, however numerous.
• Limitations the authors state:
  • The concentration method treats sputum roughly, so gentler handling might reveal clumps more often.

Topics

Medical terms in this study, explained in our Lexicon: Sputum, Fibrosis, Autopsy.

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