Pleural plaques related to "take-home" exposure to asbestos: An international case series

Our plain-English summary of Pleural plaques related to "take-home" exposure to asbestos: An international case series, by A. Peretz, V.C. Van Hee, M.R. Kramer, et al (International Journal of General Medicine, 2008).

The study

• Authors: A. Peretz, V.C. Van Hee, M.R. Kramer, S. Pitlik, M.C. Keifer
• Journal: International Journal of General Medicine
• Published: 2008;1:15-20
• Type of article: Case report
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Context: While a large number of studies indicate the risks of high-level exposures to asbestos in the workplace setting, a relatively small number of studies describe the risk of pleural disease related to "take-home" asbestos brought into the household by workers exposed to asbestos. Consequently, the risk of pleural disease in family members of asbestos-exposed workers is likely underappreciated.

Case Presentations: Two families of siblings, one in Israel and one in the US, were evaluated because of their significant exposures to asbestos brought into the home by family members with heavy occupational exposures. Two of the four children of an asbestos cement debagger in Petach Tikvah, Israel and two children of a pipe lagger in a naval shipyard near Seattle, Washington, manifested benign pleural disease without parenchymal disease, despite having no occupational exposure to asbestos.

Discussion: These cases illustrate that "take-home" asbestos exposure may lead to pleural disease at higher rates than commonly realized.

Relevance To Clinical Practice: Providers should recognize that due to the potential for "take-home" exposures, asbestos-related disease in a patient may be a marker for disease in household contacts. Patients with family members heavily exposed to asbestos should be strongly encouraged to quit smoking in an effort to reduce any further carcinogenic exposures. Additionally, workplace control and regulation of asbestos use should be emphasized to protect both workers and their families.

In plain English

This case report described two families, one in Petach Tikvah, Israel, and one near Seattle, Washington, USA. In each, the children of a father heavily exposed to asbestos at work were examined for asbestos-related disease. No sibling was found to have significant occupational asbestos exposure. In Israel, the father emptied bags of dry asbestos fibers at an asbestos cement plant from 1952 to 1962 and often came home with dusty clothing. Data from another plant in the region showed about 90% chrysotile and 10% crocidolite. Two of his four children, never-smoking men aged 57 and 55, had pleural abnormalities on chest CT with normal lung function. The other two siblings had no such findings. In Seattle, the father was a naval shipyard pipe lagger whose overalls were washed at home weekly. His son, 52, and daughter, 58, both had bilateral calcified pleural plaques without lung tissue disease. The daughter's diffusing capacity was mildly reduced (71% predicted). All four affected siblings had no symptoms. The authors concluded that take-home exposure may cause pleural plaques more often than previously realized.

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 (case series of two families)
• Who was studied: Two families of siblings with no reported occupational asbestos exposure. In Petach Tikvah, Israel: four siblings examined in 2003 (an index man aged 57, brothers aged 55 and 59, and a sister aged 52). Near Seattle, Washington, USA: a 52-year-old man seen in 2002 and his 58-year-old sister.
• Exposure: Household (take-home) asbestos from fathers' work clothing. In Israel, the father was a debagger at an asbestos cement sheet and plate plant from 1952 to 1962. Data from another regional plant indicated about 90% chrysotile and 10% crocidolite. In Seattle, the father was a pipe lagger at a naval shipyard from 1953, and his overalls were washed at home weekly. The daughter shook out and washed these overalls from about age 10 to 18. She also washed the clothing of her husband, a shipyard rigger exposed near laggers from 1966 to 1969. The Seattle son had extensive silica exposure as a laborer.
• Main results:
  • Israel, index case (57-year-old man): HRCT showed bilateral thickening of the diaphragmatic pleura suggestive of asbestos exposure. Pulmonary function testing was normal.
  • Israel, 55-year-old brother (never-smoker): bilateral calcified pleural plaques on HRCT, with normal pulmonary function tests.
  • Israel, other two siblings (a 59-year-old man and a 52-year-old woman): no radiographic findings suggestive of asbestos exposure, and normal pulmonary function tests.
  • Seattle, 52-year-old man: widespread calcified pleural plaques, with no parenchymal changes consistent with asbestos-related disease or silicosis. Pulmonary function tests were normal.
  • Seattle, 58-year-old sister: bilateral pleural plaques first seen on chest X-ray in 1995, which progressed to diffuse, patchy calcified plaques by 2003. Diffusing capacity was mildly reduced (71% predicted), and no parenchymal disease was seen.
  • All affected siblings were asymptomatic when diagnosed.
• The authors' conclusion: The authors concluded that these cases illustrate that pleural plaques related to take-home asbestos exposure may occur more often than previously realized.
• Limitations the authors state:
  • No exposure monitoring data were available from the Israeli father's cement plant. The fiber composition figures come from a different plant in the region.
  • Detailed information on the specific asbestos fiber types in the Seattle father's shipyard work was not available.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Occupational Exposure, Asbestos-Cement, Insulator, Asbestos Exposure, Carcinogenic.

Related studies

• Evaluation of take home (para-occupational) exposure to asbestos and disease: a review of the literature — E.P. Donovan, B.L. Donovan, et al. (2012)
• Evaluation of take-home exposure and risk associated with the handling of clothing contaminated with chrysotile asbestos — J. Sahmel, C.A. Barlow, et al. (2014)
• Evaluation of take-home exposure to asbestos from handling asbestos-contaminated worker clothing following the abrasive sawing of cement pipe — A. Abelmann, J.R. Maskrey, et al. (2017)
• Commentary on 'evaluation of take home (para-occupational) exposure to asbestos and disease: a review of the literature', Donovan et al.1 — D.S. Egilman, N.M. Druar (2013)
• Ventilatory insufficiency due to asbestos-related diffuse pleural fibrosis successfully treated with noninvasive home mechanical ventilation — X. Muñoz, A. Roger, et al. (2001)
• Ecological association between asbestos-related diseases and historical asbestos consumption: an international analysis — R.T. Lin, K. Takahashi, et al. (2007)

Browse return to medical research.