Pulmonary fibrosis in asbestos insulation workers with lung cancer

Our plain-English summary of Pulmonary fibrosis in asbestos insulation workers with lung cancer, by Y. Suzuki, H. Kipen, R. Lilis, et al (British Journal of Industrial Medicine, 1987).

The study

• Authors: Y. Suzuki, H. Kipen, R. Lilis, I.J. Selikoff
• Journal: British Journal of Industrial Medicine
• Published: 1987;44(10):719-20
• Type of article: Letter
• Cited by: 4 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. 001003).

Summary of the article

This letter was the authors' reply to a letter by Rudd (Br J Ind Med 1987;44:428-9) about their study of pulmonary fibrosis in asbestos insulation workers with lung cancer. The authors explained that lung parenchyma sections had been submitted for review by pathologists at various institutions in the United States and Canada, often from unspecified parts of the lung. Diffuse interstitial fibrosis had been sought in all available parenchyma. They rejected Rudd's proposal to exclude subpleural areas, saying there were no data showing that this parenchyma differed and that it often held a considerable concentration of asbestos fibres. They restated that one or more asbestos bodies had been seen in 130 of 138 cases. They argued that bodies may be absent from single thin (5 μm) sections even when present in the lung, and that detection depended on the amount of tissue, section thickness, tissue digestion, fibre type and fibre size. They expressed surprise that in the United Kingdom fibrosis with "too few" asbestos bodies was often classed as cryptogenic fibrosing alveolitis. They said uncoated fibres, seen only by electron microscopy, were likely present in the few cases without bodies. They declined to advise UK compensation agencies and noted Rudd's statement that he did not suggest the fibrosis was not caused by asbestos.

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 item is a letter, not a new study. Writing in 1987, the authors answered a letter by Rudd about their earlier paper on pulmonary fibrosis in asbestos insulation workers with lung cancer. That paper reviewed lung tissue sections sent by pathologists at institutions in the United States and Canada. The letter restated one result: one or more asbestos bodies were seen in 130 of 138 cases. The authors defended including the areas of lung just under the pleura, saying there were no data showing that tissue there differs from tissue elsewhere. They explained that the chance of seeing asbestos bodies depends on how much tissue is examined, section thickness, fiber type (more with amphiboles than chrysotile) and fiber size. They said that in the few cases without visible asbestos bodies, uncoated fibers would likely have been seen if they had had the opportunity to examine an adequate tissue sample by electron microscopy. Sometimes only a single thin section was available. The authors declined to advise on United Kingdom compensation. They highlighted Rudd's statement that Rudd did not intend to suggest the fibrosis in these cases was not caused by asbestos exposure.

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: Letter to the editor (correspondence) replying to another letter (Rudd's) about the authors' earlier histopathology study
• Who was studied: Lung tissue sections from asbestos insulation workers with lung cancer, submitted by pathologists at various institutions in the United States and Canada; 138 cases
• Exposure: Long occupational exposure to asbestos dust in insulation work
• Main results:
  • In 130 of 138 cases, one or more asbestos bodies were seen in the lung sections
  • The authors said there are no data showing that lung tissue just under the pleura differs from lung tissue elsewhere, so they did not exclude it
  • The authors stated that the likelihood of seeing asbestos bodies depends on the amount of tissue studied. They said bodies are seen more often in thick than thin sections, with amphibole than chrysotile exposure, and with long, thick fibers than short, thin ones
  • The authors considered it likely that, in the few cases without asbestos bodies, uncoated asbestos fibers would have been seen if an adequate tissue sample could have been examined by electron microscopy. They said they had yet to study an asbestos worker's lung without uncoated fibers
• The authors' conclusion: The authors called Rudd's statement, that Rudd did not intend to suggest the fibrosis in these cases was not caused by asbestos exposure, the heart of the matter. They declined to advise on compensation in the United Kingdom
• Limitations the authors state:
  • Sometimes only a single thin tissue section was available for review
  • In the few cases without asbestos bodies, the authors had not had the opportunity to examine an adequate tissue sample by electron microscopy

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, Insulator, Lung Cancer, Parenchyma, Interstitial Fibrosis, Asbestos Bodies, Tissue Digestion, Fibrosis.

Related studies

• Pulmonary fibrosis in asbestos insulation workers with lung cancer: a radiological and histopathological evaluation — H.M. Kipen, R. Lilis, et al. (1987)
• Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking — R. Lilis, I.J. Selikoff, et al. (1986)
• Serum type III procollagen peptide: indicator for pulmonary fibrosis: II. Application in 80 asbestos insulation workers — I. Okazaki, K. Maruyama, et al. (1987)
• Pulmonary fibrosis in asbestos insulation workers with lung cancer — W. Weiss (1989)
• 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)
• Interstitial pulmonary fibrosis in an automobile body shop worker — A. Fischbein, A.N. Rohl, et al. (1985)

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