Pulmonary Asbestosis: Incidence And Prognosis

Our plain-English summary of Pulmonary Asbestosis: Incidence And Prognosis, by J. Donnelly (1936).

The study

• Author: J. Donnelly
• Published: Journal Of Industrial Hygiene 18(4):222-228, April (1936)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 002948. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1936 article, by a physician at a North Carolina sanatorium, reviewed chest x-ray films of 151 asbestos mill workers and described individual case histories. The article does not name the type of asbestos. Of the 151 workers, 52 showed definite x-ray evidence of asbestosis, which the author gave as 34.4 per cent. Among the 86 who had worked 4 to 20 years, 51 were positive (59.3 per cent). Only four of the 52 positive workers had worked less than 5 years. None of the eleven advanced cases had worked less than 8 years. Ninety-nine workers showed no x-ray evidence of asbestosis. In three workers with definite asbestosis and apparently healed tuberculosis, the films showed no evidence that asbestosis had yet activated the tuberculosis. In two cases, the condition progressed after exposure had stopped. The author concluded that the condition is slowly progressive even after exposure ends, that hope for relief of breathlessness is not encouraging, and that mill employees need more complete protection. The author had no record of how long each worker had spent in the different mill departments.

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: Review of chest x-ray films from a series of asbestos mill workers, plus case histories with serial x-ray films of individual workers
• Who was studied: 151 workers in asbestos mills. The mills' location and the dates of the films for the full series are not stated. The author worked at Mecklenburg Sanatorium, Huntersville, N.C., and the paper was read in October 1935.
• Exposure: Asbestos dust in asbestos mills. Lengths of service ranged from a few months to 20 years. No fiber type is named. The author states that the carding room is the dustiest department and the weave room probably next.
• Main results:
  • 52 of the 151 workers showed definite x-ray evidence of asbestosis in varying degrees (34.4 per cent).
  • Among the 86 workers who had worked in asbestos for 4 to 20 years, 51 were positive, a percentage of 59.3.
  • Of the 52 workers with asbestosis, only four had worked less than 5 years and 48 had worked 5 years or more.
  • Eleven workers had an advanced type of asbestosis. None of them had worked less than 8 years.
  • 99 of the 151 workers showed no positive x-ray evidence of asbestosis. Some of them had worked 6 to 15 years.
  • Three workers had definite asbestosis together with apparently healed tuberculosis.
  • In those three workers, the films showed no evidence that asbestosis had yet activated the tuberculous lesion.
  • In the case histories, the condition progressed in Case II and progressed extensively in Case III, even though exposure had stopped in both.
  • Careful examination of sputum from workers with definite asbestosis frequently failed to show asbestosis bodies.
• The authors' conclusion: The author concluded that serial x-ray films indicate asbestosis is slowly progressive even several years after exposure stops. In the author's view, the outlook for prolonging life is encouraging where involvement is not far advanced, but hope for relief of breathlessness is not encouraging. The author also concluded that the high rate found shows the need for more complete protection of employees in asbestos mills.
• Limitations the authors state:
  • The author had no record of how long each worker had served in the various departments of the mills, which differ in dustiness.

Topics

Medical terms in this study, explained in our Lexicon: Asbestosis, Prognosis, Chest X-Ray.

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