Pulmonary fibrosis, carcinoma, and ferruginous body counts in amosite asbestos workers. A study of six cases

Our plain-English summary of Pulmonary fibrosis, carcinoma, and ferruginous body counts in amosite asbestos workers. A study of six cases, by V.L. Roggli, S.D. Greenberg, L.H. Seitzman, et al (American Journal of Clinical Pathology, 1980).

The study

• Authors: V.L. Roggli, S.D. Greenberg, L.H. Seitzman, M.H. McGavran, G.A. Hurst, C.G. Spivey, K.G. Nelson, L.R. Hieger
• Journal: American Journal of Clinical Pathology
• Published: 1980;73(4):496-503
• Cited by: 25 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000855).

Abstract

The Tyler Asbestos Workers Program is a continuing study of 1,105 former amosite asbestos workers. This report includes a study of six former workers, five of whom died and had autopsies, and one who underwent a lobectomy. Five of these men were exposed to asbestos for three months or less. Four had lung cancer, and one a rectal carcinoma. All were cigarette smokers. Ferruginous (asbestos) body content of the upper and lower lobes of the lungs was quantitated by a digestion technic. Tissue sections from upper and lower lobes were independently quantitated for fibrosis and ferruginous bodies, and chest roentgenograms were examined for interstitial fibrosis. (Control lung tissue was obtained from consecutive autopsies of 52 adults who did not have a known occupational exposure to asbestos.) Relatively low ferruginous body counts (less than 700/g lung tissue) were associated with mild degrees of fibrosis, and higher counts (greater than 10,000/g) with moderate to severe fibrosis. Mild to moderate pulmonary fibrosis could be identified on tissue sections before interstitial changes were detectable by chest roentgenograms.

In plain English

This article described six men from the Tyler Asbestos Workers Program, a continuing study of 1,105 former amosite asbestos workers from a plant in Tyler, Texas. Five died and were autopsied; one had a lung lobe removed for cancer. Five had worked at the plant for three months or less, and one (Patient 1) for seven years. All were cigarette smokers. Four developed lung cancer, and one died of cancer of the rectum. The authors counted ferruginous (asbestos) bodies in lung tissue and compared the workers with 52 autopsied adults without known occupational asbestos exposure. The workers' mean count was 6,770 per gram of wet lung tissue; the controls' mean was four per gram. The three workers with moderate or severe lung scarring (fibrosis) had mean counts above 10,000 per gram, and the three with no or mild fibrosis had mean counts below 700. In four workers, chest X-rays did not show fibrosis that was seen in tissue sections. The authors concluded that workers with brief exposure of less than three months may still be at risk for malignancies.

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 series of six workers (five autopsies, one lobectomy), with lung tissue compared against 52 control autopsies
• Who was studied: Six men from the Tyler Asbestos Workers Program (1,105 former amosite asbestos workers from a plant in Tyler, Texas, that operated 1954 to 1972); controls were 52 adults autopsied consecutively at The Methodist Hospital in Houston, Texas
• Exposure: Amosite asbestos at the Tyler plant, which made pipe insulation. Five of the six workers were employed for three months or less and had no other occupational asbestos exposure history. One worker (Patient 1) was employed for seven years and had earlier worked as a shipyard mechanic from 1944 to 1946.
• Main results:
  • All six workers were cigarette smokers (mean of 75 pack-years); their mean age was 63 years
  • Four of the six workers developed lung cancer; three died of it, and one was free of disease two and one-half years after lobectomy
  • One worker (Patient 6) died from widespread metastases of rectal cancer; another (Patient 3) died of a knife wound to the chest
  • Patient 1, employed at Tyler for seven years, developed severe pulmonary interstitial fibrosis and lung cancer
  • In the six workers, the mean ferruginous body count per gram (wet weight) was 8,520 in upper lobe tissue (range 13 to 34,200) and 5,020 in lower lobe tissue (range 14 to 27,500). The combined mean was 6,770 per gram.
  • In the 52 controls, ferruginous bodies were found in 92%, with a mean count of four per gram wet weight
  • Moderate (2+) and severe (3+) fibrosis occurred with mean counts above 10,000 ferruginous bodies per gram. The three workers with this degree of fibrosis (Patients 1, 4 and 5) died 20 to 21 years after first employment, and all had lung cancer.
  • Absent (0) or mild (+) fibrosis occurred with mean counts below 700 ferruginous bodies per gram (Patients 2, 3 and 6)
  • Chest X-rays showed interstitial fibrosis only in Patients 1 and 4. In the other four cases, X-rays did not identify interstitial fibrosis, but all four showed some fibrosis (1+ to 2+) on tissue sections.
  • With digestion counts of roughly 5,000 or more per gram, ferruginous bodies could usually be found on iron-stained tissue sections. At about 1,000 or less, they were found only by careful scanning or not at all.
  • Electron diffraction and x-ray analysis of ten ferruginous body cores from Patient 1 identified the core fibers as amosite asbestos
• The authors' conclusion: The authors concluded that the findings confirm the long latency between asbestos exposure and malignancy, and indicate that workers with brief exposure of less than three months may still be at risk for the development of malignancies
• Limitations the authors state:
  • Only coated fibers (ferruginous bodies) were counted. The authors note that uncoated and submicroscopic fibers make up the majority of fibers.
  • Iron-stained tissue sections give only a rough impression of ferruginous body numbers and are much less sensitive than tissue digestion

Topics

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

Medical terms in this study, explained in our Lexicon: Pulmonary Fibrosis, Carcinoma, Ferruginous body, Amosite, Lung Cancer, Fibrosis, Interstitial Fibrosis, Occupational Exposure.

Related studies

• Ferruginous bodies and pulmonary fibrosis in dead low to moderately exposed asbestos cement workers: histological examination — L.G. Johansson, M.P. Albin, et al. (1987)
• Pulmonary fibrosis and ferruginous bodies associated with exposure to synthetic fibers — A.J. Ghio, W. Funkhouser, et al. (2006)
• Interstitial pulmonary fibrosis in an automobile body shop worker — A. Fischbein, A.N. Rohl, et al. (1985)
• A comparison of the ferruginous body and uncoated fiber content in the lungs of former asbestos workers — R.F. Dodson, M.G. Williams, et al. (1985)
• Comparative quantitative evaluation of pleural fibrosis and its effects on pulmonary function in two large asbestos-exposed occupational groups--insulators and sheet metal workers — R. Lilis, A. Miller, et al. (1992)
• Pulmonary asbestos body counts and electron probe analysis of asbestos body cores in patients with mesothelioma: a study of 25 cases — V.L. Roggli, M.H. McGavran, et al. (1982)

Browse more research in American Journal of Clinical Pathology, or return to medical research.