Pulmonary Asbestosis

Our plain-English summary of Pulmonary Asbestosis, by W.E. Cooke (British Medical Journal, 1927).

The study

• Author: W.E. Cooke
• Journal: British Medical Journal
• Published: 1927;2(3491):1024-5
• Cited by: 128 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003116).

Summary of the article

This paper, read at the Annual Meeting of the British Medical Association in Edinburgh in 1927, described the case of a woman who died after working in an asbestos factory. The author had published a short note on her in 1924. He reviewed the only similar case he knew of: a man aged 33 who had worked for ten years in the carding room of an asbestos factory and died at Charing Cross Hospital in 1900. The paper also covered the history, composition and manufacture of asbestos, and the iron content of asbestos dust. Analyses showed iron, as ferrous oxide, at 0.1% in the finished article, 2.81% in crude raw material and 18.4% in carding-room dust. The woman began work at 13 in a factory with no dust extraction. She developed a cough soon after starting, had ill health from 1917, stopped work in July 1922, and died on 14 March 1924, aged 33. X-ray showed extensive fibrosis, worse in the right lung. Post-mortem examination found pleural thickening, lung fibrosis, cavities, caseation and calcified tuberculous glands. Lung sections contained abundant fine granular pigment and large angular particles 3 to 360 microns long. The author concluded that these particles were heavy, brittle, iron-containing fragments of asbestos fibre. He explained the greater involvement of the right lung by the more vertical right bronchus.

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 1927 case report described one woman and the findings after her death. She began work aged 13 in an asbestos factory with no provision for removing dust. She developed a cough soon after starting, later worked only intermittently because of ill health, and stopped work in July 1922. She died on March 14th, 1924, aged 33. An x-ray showed extensive fibrosis, more marked in the right lung. At post-mortem the right lung was fibrosed and largely airless, with a large cavity and areas of caseation, and the left lung had calcified tuberculous glands. Lung sections showed much fine granular pigment and large angular particles 3 to 360 microns long, which the author matched closely to particles in asbestos dust. Analyses reported in the article found iron (as ferrous oxide) at 0.1% in the finished article, 2.81% in crude raw material and 18.4% in carding-room dust. The author concluded there was no reasonable doubt that the lung particles were heavy, brittle, iron-containing fragments of asbestos fibre.

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, with post-mortem and microscopic findings and chemical analysis of asbestos dust
• Who was studied: one woman, aged 33 at death, a worker in an asbestos factory (the author was at Wigan Infirmary); she died on March 14th, 1924
• Exposure: asbestos dust from work beginning at age 13 in an asbestos factory with no dust extraction; the article does not say which fiber type she worked with
• Main results:
  • She worked intermittently because of ill health and finally stopped work in July 1922.
  • She died on March 14th, 1924.
  • An x-ray showed extensive fibrosis, more marked in the right lung.
  • At post-mortem the right lung was fibrosed and largely airless.
  • The left lung had calcified tuberculous glands at its root.
  • Lung sections showed a very large amount of fine granular pigment.
  • Lung sections showed large solid angular particles ranging from 3 to 360 microns in length.
  • The author found that each particle in the lung sections could be matched to a similar particle in a slide made from asbestos dust.
  • Iron content (as ferrous oxide) was 18.4% in carding-room dust, compared with 2.81% in crude raw material and 0.1% in the finished article.
• The authors' conclusion: The authors concluded that there was no reasonable doubt that the particles in the lungs were the heavy, brittle, iron-containing fragments of asbestos fibre. They proposed that this explained the greater involvement of the right lung, since heavy particles would pass more easily down the more vertical right bronchus.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Carding, Fibrosis, Autopsy, Pleural Thickening, Bronchus.

Related studies

• Asbestos dust and the curious bodies found in pulmonary asbestosis — W.E. Cooke (1929)
• Inhibition of lung injury, inflammation, and interstitial pulmonary fibrosis by polyethylene glycol-conjugated catalase in a rapid inhalation model of asbestosis — B.T. Mossman, J.P. Marsh, et al. (1990)
• Pulmonary endpoints (lung carcinomas and asbestosis) following inhalation exposure to asbestos — B.T. Mossman, M. Lippmann, et al. (2011)
• Pulmonary asbestosis: CT study of subpleural curvilinear shadow. Work in progress — H. Yoshimura, M. Hatakeyama, et al. (1986)
• Experimental asbestosis. The development of lung cancer in rats with pulmonary deposits of chrysotile asbestos dust — P. Gross, R.T. DeTreville, et al. (1967)
• Chrysotile-induced asbestosis: changes in the free cell population, pulmonary surfactant and whole lung tissue of rats — T.D. Tetley, P.M. Hext, et al. (1976)

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