The diagnosis of nonmalignant diseases related to asbestos

Our plain-English summary of The diagnosis of nonmalignant diseases related to asbestos, by A. Franzblau, R. Lilis (The American Review of Respiratory Disease, 1987).

The study

• Authors: A. Franzblau, R. Lilis
• Journal: The American Review of Respiratory Disease
• Published: 1987;136(3):790-1
• Type of article: Letter
• Cited by: 2 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. 000965).

In plain English

This was a letter to the editor, not a research study, and it reported no new data. The authors, from Mount Sinai Medical Center in New York, commented on a 1986 consensus statement by an Ad Hoc Committee on diagnosing nonmalignant asbestos-related disease. They argued that the statement's remark that world asbestos production had dropped since the mid 1970s was misleading. In their view the decline was probably due to the world-wide recession, and they cited a U.S. Bureau of Mines prediction of a 4% annual increase in U.S. asbestos use from 1985 through 1990. They called the committee's definition of asbestosis, which left out pleural fibrosis, artificially restrictive. They said the phrase "direct contact" could mislead, because many patients with asbestosis were exposed while working in areas such as shipbuilding and construction, where only a few employees handled asbestos. They argued that an ILO chest x-ray classification of 1/0, rather than 1/1, was the more appropriate cut-off. They also objected that pleural abnormalities were missing from the final diagnostic criteria. The authors concluded that the criteria were too restrictive for patient care, workers' compensation, liability, public health and public policy.

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 commenting on a published consensus statement; no original data
• Who was studied: No patients or subjects were studied
• Exposure: Asbestos exposure in general, including bystander exposure of workers in shipbuilding, ship repair and construction who did not personally handle asbestos
• Main results:
  • The authors argued that the consensus statement's remark about falling world asbestos production was misleading. They cited a U.S. Bureau of Mines prediction of a 4% annual increase in U.S. asbestos use from 1985 through 1990.
  • The authors argued that the committee's definition of asbestosis, which excluded pleural abnormalities, was artificially restrictive.
  • The authors argued that the advice to focus on 'direct contact' with asbestos was misleading. In their experience, many patients with asbestosis worked in areas where only a small fraction of employees handled asbestos.
  • The authors argued that an ILO chest x-ray profusion of 1/0, rather than the committee's 1/1, was the more appropriate cut-off. They noted that the PA chest x-ray is not the most sensitive test for interstitial fibrosis.
  • The authors objected that pleural abnormalities were entirely absent from the final summary of diagnostic criteria.
• The authors' conclusion: The authors concluded that the committee's diagnostic criteria for nonmalignant asbestos-related disease were too restrictive from the perspectives of patient care, workers' compensation, third-party liability, public health and public policy.

Topics

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

Related studies

• Workers' compensation for nonmalignant asbestos-related lung disease — C. Nevitt, W. Daniell, et al. (1994)
• Diagnosis and initial management of nonmalignant diseases related to asbestos — American Thoracic Society (2004)
• Diagnosis and initial management of nonmalignant diseases related to asbestos — D. Weill, H. Weill (2005)
• Diagnosis and initial management of nonmalignant diseases related to asbestos — D.D. Smith (2005)
• Diagnosis and initial management of nonmalignant diseases related to asbestos — A.J. Ghio, V.L. Roggli (2005)
• Diagnosis of asbestos-related lung diseases — E.J.A. Harris, A. Musk, et al. (2019)

Browse more research in The American Review of Respiratory Disease, or return to medical research.