Pneumoconiosis: Part Ii, Pulmonary Asbestosis

Our plain-English summary of Pneumoconiosis: Part Ii, Pulmonary Asbestosis, by W.B. Wood (1934).

The study

• Author: W.B. Wood
• Published: British Journal Of Radiology 7:277-280, May (1934)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 003042. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1934 paper by W. Burton Wood was the second part of a discussion on pneumoconiosis held at the Institute in January 1934. It was a clinical description, not a statistical study. The author's attention was first drawn to the risks in 1928, when asked to examine a number of employees from a factory in the Barking area who had been sent to the local tuberculosis dispensary as sufferers from phthisis. The author's observations were based on a study of about eighty employees. With two or three exceptions, definite evidence of asbestosis was found in them. The article did not name the asbestos fiber types. Shortness of breath was the dominant symptom, and fine dry crackles were usually heard at the back of the lower chest. Sputum contained golden-yellow asbestos bodies. On X-ray, the lower half or two-thirds of the lung fields looked clouded and the upper part clear, with pleural thickening at the bases. The author wrote that X-rays fail to show the earliest stage of the disease. Tuberculosis was so often present that the author thought the link probably more than accidental. Bronchitis or broncho-pneumonia were common causes of death. The author described the disease as a grave danger to workers in asbestos factories.

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: Clinical and radiological description (a contribution to a discussion meeting) based on the author's examination of asbestos workers; no statistical analysis
• Who was studied: About eighty employees, investigated at Victoria Park with Dr J. V. Sparks and Dr S. Roodhouse Gloyne. The article does not say how all of them came to be studied. The author's attention was first drawn to the risks in 1928, when the Medical Officer of Health for Barking asked the author to examine a number of employees from a factory in that area. They had been sent to the local tuberculosis dispensary as sufferers from phthisis.
• Exposure: Asbestos dust in asbestos factories; fiber types not named. One illustrated case, a male employee of an asbestos factory in the London area, had thirty-eight years' exposure to asbestos dust.
• Main results:
  • Among the roughly eighty employees studied, definite evidence of asbestosis was found in all but two or three
  • Shortness of breath (dyspnoea) was the dominant symptom, to the point that it was what patients complained of
  • Fine dry crackling sounds were usually heard over the lower back of the chest
  • The sputum contained golden-yellow asbestos bodies
  • The lungs showed a diffuse fine fibrosis, especially at the bases, without the nodules characteristic of silicosis
  • On X-ray, after the early stages, the lower half or two-thirds of the lung fields appeared clouded and the upper part clear, with pleural thickening and adhesions best seen at the bases
  • The author stated that radiology fails to reveal the earliest manifestations of pulmonary asbestosis
  • Pulmonary tuberculosis was so often associated with asbestosis that the author considered the association probably more than accidental
  • Bronchitis or broncho-pneumonia were the common causes of death
  • Bronchiectasis was not diagnosed during life in any of the patients seen at Victoria Park
• The authors' conclusion: The author described pulmonary asbestosis as a form of pneumoconiosis that is a grave danger to workers in asbestos factories
• Limitations the authors state:
  • The author noted that X-rays cannot show the earliest stage of the disease, so early cases may be missed
  • The author noted that the shadow of the diaphragm obstructs a satisfactory X-ray view of the lung bases, where this disease mainly occurs

Topics

Medical terms in this study, explained in our Lexicon: Pneumoconiosis, Asbestosis, Sputum, Asbestos Bodies, Pleural Thickening.

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