Pleural mesothelioma resulting from exposure to amosite asbestos in a building

Our plain-English summary of Pleural mesothelioma resulting from exposure to amosite asbestos in a building, by R.C. Stein, J.Y. Kitajewska, J.B. Kirkham, et al (Respiratory Medicine, 1989).

The study

• Authors: R.C. Stein, J.Y. Kitajewska, J.B. Kirkham, N. Tait, G. Sinha, R.M. Rudd
• Journal: Respiratory Medicine
• Published: 1989;83(3):237-9
• Type of article: Case report
• Cited by: 18 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. 000168).

Summary of the article

The authors reported a case of pleural mesothelioma that they attributed to amosite asbestos used as insulation in an office building, from The London Chest Hospital, U.K. A 54-year-old female office worker and lifelong non-smoker presented with six months of malaise, persistent cough and exertional dyspnoea. She had a left pleural effusion. Pleural biopsy was unhelpful, but pleural fluid cytology suggested mesothelioma. She died nine months after presentation, and post mortem examination confirmed pleural mesothelioma. Two pathologists made the diagnosis independently. No asbestos bodies were seen by light microscopy. Transmission electron microscopy of digested tissue showed 31 million fibres per gram of dry lung and 12 million fibres per gram of dry tumour. Of 500 fibres counted in the lung digest, 90% were morphologically compatible with amosite, and X-ray microanalysis of 40 of these fibres confirmed a composition compatible with amosite. She had no occupational, residential or household asbestos exposure apart from the office block, where she had worked since its construction. Its ceilings had been sprayed with soft asbestos, and a sample of this material was 70% amosite. The authors concluded that proximity to poorly maintained asbestos in buildings can result in exposure sufficient to cause serious disease.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This article was a case report about one person, a 54-year-old female office worker who had never smoked. She had fluid around her left lung (a pleural effusion) and died nine months after first being seen. A post mortem confirmed pleural mesothelioma. The authors found no history of asbestos work. Her only identified exposure was the office block where she had worked since it was built. Its ceilings had been sprayed with an inch-thick layer of soft asbestos under paint. After complaints about dust, the ceilings were repaired about eight years later, and a later ceiling sample was 70% amosite. Her husband, a painter, sprayed the ceiling during the repairs. She bagged his overalls weekly but did not wash them, and the authors judged this unlikely to have given significant exposure. Electron microscopy found 31 million fibres per gram of dry lung and 12 million per gram of dry tumour. Of 500 lung fibres counted, 90% looked like amosite. Light microscopy found no asbestos bodies. No airborne fibre-count data were available for the building. The authors concluded that being near poorly maintained asbestos in buildings can result in exposure sufficient to cause serious disease.

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 (one patient)
• Who was studied: One 54-year-old female office worker, a lifelong non-smoker, treated at The London Chest Hospital, U.K.; article received in revised form in 1988
• Exposure: Sprayed asbestos ceiling insulation in the office block where she worked from its construction until she became ill 14 years later. A sample of the ceiling material was later found to be 70% amosite. Her husband sprayed the ceiling during repairs, and she bagged his overalls, which the authors judged unlikely to have given significant exposure.
• Main results:
  • Post mortem examination confirmed the cause of death as pleural mesothelioma.
  • The patient died nine months after first presenting.
  • In the patient's tissue, transmission electron microscopy found 31 million fibres per gram of dry lung and 12 million fibres per gram of dry tumour.
  • Of 500 fibres counted in the lung digest, 90% were morphologically compatible with amosite asbestos.
  • All 40 randomly selected fibres that looked like amosite had an elemental composition compatible with amosite on X-ray microanalysis.
  • Light microscopy found no asbestos bodies in the tissue sections, although electron microscopy showed uncoated fibres.
  • A sample of material from the building's ceiling was found to be 70% amosite asbestos.
  • The authors reported that the lung fibre count was within the range found in people with occupational asbestos exposure.
  • No previous asbestos exposure could be demonstrated for the patient.
• The authors' conclusion: The authors concluded that finding the same asbestos type in the lung, the tumour and the office ceiling supports the building exposure as the cause. They stated that the case illustrates that being near poorly maintained asbestos in buildings can result in exposure sufficient to cause serious disease.
• Limitations the authors state:
  • No data on airborne fibre counts in the building were available.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Amosite, Pleural Effusion, Pleural Biopsy, Fluid Cytology, Mesothelioma, Asbestos Bodies, Transmission Electron Microscopy (TEM).

Related studies

• Serum protein concentrations and respiratory tract abnormalities following short-term exposure to amosite: a comparison between former asbestos workers and unexposed controls — D.R. Nash, N.G. Fortson, et al. (1981)
• Health effects of amosite mining and milling in South Africa — J. Murray, G. Nelson (2008)
• Rapporteur's Report Session 3: exposure to grunerite (amosite) asbestos: historical perspectives of the health effects — G.W. Gibbs (2008)
• Mineralogic parameters related to amosite asbestos-induced fibrosis in humans — A. Churg, J. Wright, et al. (1990)
• Worker exposure to asbestos during removal of sprayed material and renovation activity in buildings containing sprayed material — N.W. Paik, R.J. Walcott, et al. (1983)
• Comments on the Health Effects Institute-Asbestos Research (HEI-AR) report: "Asbestos in public and commercial buildings," with emphasis on risk assessment methods used — T.D. Sterling, C.W. Collett, et al. (1993)

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