The radiological investigation of the early manifestations of exposure to asbestos dust

Our plain-English summary of The radiological investigation of the early manifestations of exposure to asbestos dust, by F.A. Mackenzie (Proceedings of the Royal Society of Medicine, 1971).

The study

• Author: F.A. Mackenzie
• Journal: Proceedings of the Royal Society of Medicine
• Published: 1971;64(8):834-7
• Cited by: 2 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. 002446).

Summary of the article

This paper described the radiological investigation of early signs of asbestos exposure among workers at British Naval Dockyards. Over the previous twenty-five years these dockyards had used large quantities of asbestos lagging in ships' engine rooms and under the flight-decks of aircraft carriers. Registered asbestos workers had been examined with annual large chest films, and the author first found signs of early pulmonary fibrosis in this group in 1959. A Medical Research Unit was set up at HM Dockyard, Devonport, in 1966. A 1 in 10 population sample on 100 mm film showed that over 4% of Devonport men had changes related to asbestos exposure, with similar prevalence at other dockyards. Pleural abnormalities were ten times more common than lung lesions. In May 1970 Devonport had 106 men with disability pensions for asbestosis, 35 cases of mesothelioma and 500 with asbestos pleural abnormalities. The author described the survey methods. Mobile 100 mm film surveys could examine about 400 people a day. Large films used a low kilovoltage technique. A special 45° right anterior oblique view showed the pleura and the posterior diaphragmatic sulcus, where early plaques and fibrosis appear. Pulmonary fibrosis was hard to assess on a single film, and the author advised that the term asbestosis be confined to pulmonary fibrosis. He also described hyaline and calcified plaques, visceral pleural lesions, recurrent silent pleural effusions and diffuse pleural thickening. Some cases of diffuse pleural thickening progressed to mesothelioma.

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 1971 article by a naval radiologist at the Royal Naval Hospital, Plymouth, described X-ray methods for finding early signs of asbestos exposure among Naval Dockyard workers. In the dockyards, asbestos lagging had been used in ships' engine rooms and under aircraft-carrier flight-decks. It was a descriptive account, not a formal study with a defined sample. The author reported that in May 1970 Devonport Dockyard had 106 patients with disability pensions for asbestosis, 35 cases of mesothelioma and 500 showing evidence of asbestos pleural abnormalities. The author stated that pleural abnormalities were ten times more common than lung lesions. A mobile 100 mm film survey, reaching about 400 patients a day, was described as the first choice for screening the whole dockyard population. A special 45-degree oblique view was described as the most important additional view. The author also described silent pleural effusions seen increasingly in naval ratings over 30 and in dockyard workers, and noted that some cases of diffuse pleural thickening progressed to mesothelioma. The author held that the term 'asbestosis' should be limited to pulmonary fibrosis.

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: Descriptive account of radiological methods and findings, drawing on the author's experience; no formal study design or defined sample
• Who was studied: Registered asbestos workers and other workers at Naval Dockyards, especially HM Dockyard, Devonport, examined by annual large chest films over about twenty-five years; counts given for Devonport as of May 1970
• Exposure: Asbestos lagging used in ships' engine rooms and on the undersides of aircraft-carrier flight-decks; fiber type not stated
• Main results:
  • At Devonport Dockyard in May 1970 there were 106 patients with disability pensions for asbestosis, 35 cases of mesothelioma and 500 showing evidence of asbestos pleural abnormalities
  • Pleural abnormalities were ten times more common than lung lesions, and both could occur together
  • A mobile 100 mm film survey usually achieved a rate of 400 patients per day and was the first choice for selecting patients from the whole dockyard population
  • A special oblique view at 45-degree angulation was used to show the pleural surface on the anterior and posterior axillary lines and on the diaphragm. If only one oblique view was taken, the right anterior oblique was more rewarding
  • Silent pleural effusions, found on routine chest radiographs, were being seen with increased frequency in naval ratings over the age of 30 and in dockyard workers. A few such patients had been observed for as long as ten years
  • Some cases with diffuse pleural thickening over the lateral chest wall progressed to the invasive pleural thickening of mesothelioma
• The authors' conclusion: The author held that the term 'asbestosis' should at present be confined to the diagnosis of pulmonary fibrosis, and that a special oblique view is the most important view to add to standard films

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Chest X-Ray, Pulmonary Fibrosis, Mesothelioma, Pleura, Fibrosis, Pleural Effusion, Diffuse Pleural Thickening.

Related studies

• The radiological manifestations of malignant pleural mesothelioma — R.M. Heller, M.L. Janower, et al. (1970)
• UK Naval Dockyards Asbestosis Study: radiological methods in the surveillance of workers exposed to asbestos — G. Sheers, C.E. Rossiter, et al. (1978)
• Recurrent malignant peritoneal mesothelioma: radiological manifestations — F.F. Souza, J. Jagganathan, et al. (2010)
• Radiological manifestations of malignant pleural mesothelioma — V.W. Au, M. Thomas (2003)
• Clinical, radiological, and pathological investigation of asbestosis — T. Kishimoto, K. Kato, et al. (2011)
• Nodular thickening of interlobar fissures: an early manifestation of malignant mesothelioma: a case report — S. Bandoh, J. Fujita, et al. (2001)

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