The occurrence of asbestosis among insulation workers in the United States

Our plain-English summary of The occurrence of asbestosis among insulation workers in the United States, by I.J. Selikoff, J. Churg, E.C. Hammond (Annals of the New York Academy of Sciences, 1965).

The study

• Authors: I.J. Selikoff, J. Churg, E.C. Hammond
• Journal: Annals of the New York Academy of Sciences
• Published: 1965;132(1):139-55
• Cited by: 115 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. 001539).

Abstract

An investigation involving 1522 asbestos insulation workers in the New York-New Jersey metropolitan area has been conducted. Among 392 individuals examined more than 20 years from onset of exposure, radiological evidence of asbestosis was found in 339. In half of these, the asbestosis was moderate or extensive. In individuals with less than 20 years of exposure, radiological evidence of asbestosis was less frequent and when present, much less likely to be extensive.

Neoplastic complications of asbestos exposure were studied among 307 consecutive deaths in this group of men. Lung cancer was found to be at least seven times as common as expected and cancer of the gastrointestinal tract three times as common as expected. There were 10 instances of mesothelioma of the pleura or peritoneum.

Of the 1258 men alive at the start of this survey, 1117 were examined. Eleven cancers of the lung or pleura were found during this survey of the living members, all among the 392 men with more than 20 years from onset of exposure. No cancers were found in those men, the onset of whose work experience was less than 20 years.

We may conclude that asbestosis and its complications are significant hazards among insulation workers in the United States at this time.

PubMed has no abstract for this study. This is the authors' abstract, copied from the article.

In plain English

The authors surveyed the 1,522 men who belonged to the New York (Local 12) and New Jersey (Local 32) insulation workers' union locals at any time from 1942 to 1962. Of the 1,258 still alive at the start of 1963, 1,117 were examined, with work histories, symptom questions and chest X-rays. Asbestosis was judged by X-ray changes alone. The insulation materials had largely contained chrysotile asbestos. Almost half the men examined showed X-ray evidence of asbestosis. Among 346 men whose work began less than ten years before examination, 36 (10.4 per cent) had any abnormality. Among 392 men examined more than 20 years after first exposure, 339 had X-ray evidence of asbestosis and 134 had some dyspnea (breathlessness). Ten lung cancers and one pleural mesothelioma were found, all among the men examined more than 20 years after first exposure. Lung tissue from 45 workers all showed asbestosis. The authors noted that nonunion workers were not studied. They concluded that asbestosis and its complications were significant hazards among U.S. insulation workers.

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: Cross-sectional medical and X-ray survey of the members of two union locals, using union employment and death records, plus examination of lung tissue from deceased or operated workers
• Who was studied: 1,522 men who were members of the insulation workers union in New York (Local 12) and New Jersey (Local 32) at any time from 1942 to 1962. 264 had died from 1943 to 1962. Of the 1,258 alive on January 1, 1963, 1,117 were examined in 1963-1964.
• Exposure: Work with asbestos-containing heat insulation materials; chrysotile asbestos was largely used
• Main results:
  • Almost half of the 1,117 men examined showed X-ray evidence of pulmonary asbestosis
  • Of 346 men whose exposure began less than ten years before examination, 36 (10.4 per cent) showed any X-ray abnormality
  • Of 379 men whose exposure began 10 to 19 years before examination, 167 had some X-ray abnormality, but in only nine was the asbestosis greater than minimal
  • Among the 392 men examined more than 20 years after onset of exposure, 339 had radiological evidence of asbestosis; in half of these it was moderate or extensive
  • Among men whose exposure began more than 40 years before examination, only one in 20 showed no X-ray abnormality
  • Of 725 men with less than 20 years from onset of exposure, one had significant dyspnea and 32 others had minimal dyspnea on exertion
  • Of the 392 men with more than 20 years from onset of exposure, 134 had dyspnea of some degree, 61 of them with some disability
  • In lung tissue from 45 insulation workers (mostly men who had died), typical pulmonary asbestosis with fibrosis and asbestos bodies was found in every case
  • During the survey of living members, lung cancer was found in 10 men and pleural mesothelioma in one, each verified histologically
  • All 11 cancers of the lung or pleura found in the survey were among the 392 men with more than 20 years from onset of exposure
  • Among examined working members (984), seven had lung cancer (0.7 per cent). Among the 133 examined men who were retired, ill or had withdrawn, four had lung cancer (three percent); the table notes these four include one pleural mesothelioma.
  • Among 307 consecutive deaths in the group, lung cancer was at least seven times as common as expected; the authors said mortality would be reported separately
  • Among the 307 deaths there were 10 cases of mesothelioma of the pleura or peritoneum
• The authors' conclusion: The authors concluded that asbestosis and its complications were significant hazards among insulation workers in the United States at that time
• Limitations the authors state:
  • X-ray change was the sole criterion for asbestosis; the authors acknowledged this tends to underestimate asbestosis, though few disabling cases would be missed
  • Nonunion insulation workers, some maintenance workers, and insulation work done in other trades or unions were not studied
  • The lung tissue material could not evaluate early changes, since only one case had less than 15 years from onset of exposure
  • The comparison suggesting greater lung fibrosis in 11 men from a factory making asbestos insulation material was based on limited data

Topics

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

Medical terms in this study, explained in our Lexicon: Insulator, Asbestos Exposure, Lung Cancer, Mesothelioma, Pleura, Peritoneum.

Related studies

• Neoplasia among insulation workers in the United States with special reference to intra-abdominal neoplasia — E.C. Hammond, I.J. Selikoff, et al. (1965)
• Mortality experience of insulation workers in the United States and Canada, 1943--1976 — I.J. Selikoff, E.C. Hammond, et al. (1979)
• Mortality of brain tumors among asbestos insulation workers in the United States and Canada — H. Seidman, I.J. Selikoff, et al. (1982)
• Asbestos-associated deaths among insulation workers in the United States and Canada, 1967-1987 — I.J. Selikoff, H. Seidman (1991)
• 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)
• Geologic occurrences of erionite in the United States: an emerging national public health concern for respiratory disease — B.S. Van Gosen, T.A. Blitz, et al. (2013)

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