Porcelain factory worker with asbestos-related mesothelioma

Our plain-English summary of Porcelain factory worker with asbestos-related mesothelioma, by M.T. Tsou, J.C. Luo (Journal of the Formosan Medical Association = Taiwan Yi Zhi, 2009).

The study

• Authors: M.T. Tsou, J.C. Luo
• Journal: Journal of the Formosan Medical Association = Taiwan Yi Zhi
• Published: 2009;108(10):819-25
• Type of article: Case report
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Malignant mesothelioma is a rare tumor among the general population, but for people exposed to asbestos, the lifetime risk is high. A 58-year old man presented with suffering from chest pain, upper back pain, shortness of breath, and coughing that had continued for several months. A chest X-ray revealed right-side pleural effusion; however, pleural biopsy from drainage treatment confirmed a diagnosis of malignant mesothelioma. According to his occupational and environmental history, the patient had worked continuously in a porcelain factory for 30 years. The specific characteristics of his work, making asbestos wallboards and gaskets, entailed working in high-temperature conditions with a high fine-particle content in the atmosphere. The high working temperature caused asbestos debris and dust to fall down regularly from the wallboards, however, it was not until recently that the patient had started to wear personal protection. Asbestos is a significant source of hazardous exposure in old buildings, and this case serves as a reminder of the importance of asbestos-related exposure history, which facilitated the correct diagnosis of pulmonary malignant mesothelioma. Asbestos-containing materials that are now banned or regulated are still present in older buildings and remain an exposure hazard; they continue to be a serious health concern in many countries.

In plain English

This case report described a 58-year-old Taiwanese man who worked in a porcelain factory for 30 years from 1975, 8–10 hours a day, five days a week. The article's body says he wore no respiratory protective equipment during the working day. Its abstract says he had only recently started wearing personal protection. The old factory building had asbestos wallboards and gaskets, and by his own account high working temperatures made asbestos debris and dust fall regularly from the wallboards. The article does not report the asbestos fiber type in his workplace. The authors wrote that the factory's airborne asbestos concentration was difficult to determine because these materials had been replaced with iron ones. A May 2004 chest X-ray showed partial pleural thickening, and asbestos-related lung disease was indicated. In September 2005 a right-side pleural effusion was first treated as suspected tuberculosis. A pleural biopsy then showed papillary mesothelioma, though no asbestos fibers were found in it. The authors wrote there was insufficient evidence of any other cause. They concluded that an asbestos exposure history helps reach the correct diagnosis and that Taiwan should strengthen asbestos-control programs.

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 a single patient
• Who was studied: one 58-year-old man in Taiwan who had worked in a porcelain factory for 30 years starting in 1975
• Exposure: Work in an old porcelain factory building where asbestos wallboards and gaskets had been used. The asbestos fiber type in the workplace is not stated. The work itself involved mixing titanium dioxide and aluminum oxide powder with recycled china. The patient worked there 8–10 hours a day, 5 days a week, for 30 years.
• Main results:
  • The patient was exposed to the factory environment 8–10 hours a day, 5 days a week, for 30 years.
  • The body of the article says the patient did not wear respiratory protective equipment during the working day.
  • The article's abstract says the patient had only recently started to wear personal protection.
  • According to the patient's description, the high working temperature caused asbestos debris and dust to fall regularly from the wallboards.
  • The patient lived in a 30-year-old apartment renovated in 1977, 1990 and 2002. His wife's job did not involve contact with asbestos.
  • At a general checkup in May 2004, a chest X-ray showed partial pleural thickening, and asbestos-related lung disease was indicated.
  • In September 2005, a right-side pleural effusion was initially treated as suspected tuberculosis with tube drainage and anti-TB drugs.
  • A pleural biopsy showed papillary mesothelioma. No asbestos fibers were found in the biopsy.
  • A CT scan in September 2005 showed heavy pleural effusion and further asbestos-related lesions in other parts of the lungs.
  • The authors stated there was insufficient evidence of any other factor that might have caused the patient's malignant mesothelioma.
• The authors' conclusion: The authors concluded that the case is a reminder of the importance of taking an asbestos-related exposure history to reach the correct diagnosis of malignant mesothelioma. They also wrote that Taiwan should strengthen asbestos-control programs.
• Limitations the authors state:
  • The authors stated that the concentration of asbestos fibers in the factory air was difficult to determine, because the manager had replaced the asbestos wallboards and gaskets with iron-material ones.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Malignant Mesothelioma, Chest X-Ray, Pleural Effusion, Pleural Biopsy, Gasket, Exposure History, Asbestos-Containing Material (ACM).

Related studies

• Porcelain factory worker with asbestos-related mesothelioma — C. Mensi, A. Garberi, et al. (2010)
• Acute abdomen in an asbestos factory worker — S. Narasimhan, D. Brian, et al. (2008)
• Malignant mesothelioma among employees of a Connecticut factory that manufactured friction materials using chrysotile asbestos — M.M. Finkelstein, C. Meisenkothen (2010)
• Combined effect of asbestos exposure and smoking on mortality from lung cancer in factory workers — G. Berry, M.L. Newhouse, et al. (1972)
• Mortality experience of amosite asbestos factory workers: dose-response relationships 5 to 40 years after onset of short-term work exposure — H. Seidman, I.J. Selikoff, et al. (1986)
• Mortality of factory workers in east London 1933-80 — M.L. Newhouse, G. Berry, et al. (1985)

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