Pneumoconioses And Related Diseases

Our plain-English summary of Pneumoconioses And Related Diseases, by H.C. Hinshaw, J.F. Murray, H.C. Hinshaw, et al (1980).

The study

• Authors: H.C. Hinshaw, J.F. Murray, H.C. Hinshaw, Jr
• Published: Diseases Of The Chest, 4Th Edition, Philadelphia: W.B. Saunders, Pp. 707-743 (1980)
• Type of article: Book excerpt
• Our copy: from Johns-Manville's own medical library, J-M no. 003346.

In plain English

This is a chapter from the fourth edition of the textbook Diseases of the Chest (1980), not a research study. The authors reviewed the causes, diagnosis and treatment of the common pneumoconioses: silicosis, asbestos-related disease, coal workers' disease and rarer dust diseases. On asbestos, they named chrysotile as by far the most commonly used type. They wrote that pleural plaques serve as a marker of exposure to asbestos, and that asbestosis (lung scarring) commonly continues to progress after exposure ends. They wrote that the latent period for mesothelioma is almost always at least 20 to 30 years, and that observations suggested the tumor is not related to total fiber dose. Once malignant mesothelioma is diagnosed, most patients die within a year (mean of 7 months). They wrote that the excess lung cancer in asbestos workers is almost entirely among cigarette smokers, and that heavy smokers with heavy asbestos exposure may have as much as 90 times the incidence of nonsmokers without exposure. They reproduced a table of deaths among 17,800 insulation workers from Selikoff and Hammond. The authors concluded that asbestos-related disease was not likely to fall significantly for decades.

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: textbook chapter reviewing the literature (not an original study)
• Who was studied: No study population of its own. The chapter discusses workers exposed to dusts in general, including asbestos miners, millers, and insulation and construction workers, coal miners, and others.
• Exposure: Silica, asbestos (chrysotile, crocidolite, amosite, anthophyllite), coal dust, and other dusts (talc, kaolin, fuller's earth, cement, fiberglass, tungsten carbide, graphite, aluminum, diatomaceous earth, iron, tin, barium).
• Main results:
  • The authors stated that the chief importance of pleural plaques is as a marker of asbestos exposure.
  • The authors stated that asbestosis commonly continues to progress after exposure has stopped.
  • The authors stated that the latent period for mesothelioma is almost always at least 20 to 30 years.
  • The authors wrote that the observations suggested mesothelioma is not related to the total dose of asbestos fibers. They presented this as a suggestion, not an established fact.
  • The authors stated that once malignant mesothelioma is diagnosed, most patients die within a year (mean of 7 months).
  • The authors stated that the excess of lung cancer in asbestos-exposed workers is almost entirely in people who also smoke cigarettes.
  • The authors described a synergistic carcinogenic effect between asbestos and cigarette smoking.
  • The authors stated that heavy smokers with heavy asbestos exposure may have as much as 90 times the lung cancer incidence of nonsmokers without asbestos exposure.
  • The chapter reproduced a table, credited to Selikoff and Hammond (1978), of deaths among 17,800 asbestos insulation workers in the United States and Canada from 1967 to 1977. These are not the chapter authors' own data.
  • The authors stated that asbestos exposure is associated with cancers of the gastrointestinal tract (esophagus, stomach, colon-rectum) and larynx, and possibly the kidney and breast.
• The authors' conclusion: The authors concluded that, because of past exposures and old asbestos insulation still in place, the incidence of clinical asbestos-related disease was not likely to be significantly reduced for decades.
• Limitations the authors state:
  • The authors stated that the chapter could not cover all injurious substances.
  • The authors chose to set aside differences in biologic behavior between asbestos fiber types for the purposes of the chapter.

Topics

Medical terms in this study, explained in our Lexicon: Silicosis, Chrysotile, Pleural Plaques, Mesothelioma, Malignant Mesothelioma, Lung Cancer, Asbestos Exposure, Insulator.

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