The relationship between lung cancer and asbestos exposure

Our plain-English summary of The relationship between lung cancer and asbestos exposure, by T. Kishimoto, K. Okada (Chest, 1988).

The study

• Authors: T. Kishimoto, K. Okada
• Journal: Chest
• Published: 1988;94(3):486-90
• Cited by: 24 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. 000918).

Abstract

This study supports the theory that asbestos exposure may be implicated in a recent upsurge of terminal lung cancer cases in Kure, Japan. The number of asbestos bodies found in the lung during autopsy of 158 subjects from 1984 to 1986 suggests that 70.4 percent of the 51 diagnosed lung cancer cases could be attributed to asbestos exposure. Of the 107 subjects in whom death was not caused by cancer, 38.4 percent had significant asbestos exposure. Types of asbestos bodies found in diagnosed lung cancer cases were analyzed using scanning electron microscopy and x-ray analyzer. Chrysotile was the most widely found component, but amphiboles such as crocidolite and amosite also were detected. Residents of Kure had high exposure to the inhalation of asbestos bodies, possibly related to the upsurge in lung cancer deaths. In our earlier report, asbestos exposure was implicated in the increased incidence of malignant mesothelioma in Kure, an active Japanese ship-building port since the 1920s. Our current findings indicate that asbestos exposure may be a pathogenic factor in lung cancer in world seaports where asbestos exposure has been prevalent.

In plain English

This autopsy study counted lung asbestos bodies in 158 people from the city or suburbs of Kure, Japan, autopsied at Kure Kyosai Hospital from 1984 to 1986. Of these, 51 had lung cancer, seven had malignant mesothelioma and 100 had no cancer. The authors treated more than 100 asbestos bodies per gram of lung as above baseline. Of lung cancer patients, 36 of 51 (70.6 percent) exceeded this, versus 38.6 percent of noncancer cases, reported as significant (p less than 0.01). All mesothelioma patients exceeded 500 per gram. Two of six women and 75.6 percent of men with lung cancer exceeded 100 per gram. Of the lung cancer patients, 36 had a definite asbestos exposure history, 25 men had worked in the Japanese naval shipyard before or during World War II, and 78.6 percent of men smoked heavily. Chrysotile was the main fiber in 70 percent of lung cancer patients; crocidolite and amosite dominated in 30 percent. The authors concluded that asbestos exposure is likely an etiologic factor in Kure City's recent lung cancer upsurge. Several of the article's figures conflict with each other.

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: autopsy study comparing lung asbestos body counts in lung cancer, mesothelioma and noncancer deaths, with electron microscopy fiber typing in lung cancer cases
• Who was studied: 158 patients autopsied at Kure Kyosai Hospital, Kure, Japan, 1984 to 1986, who had lived in the city or suburbs of Kure: 51 lung cancer, 7 malignant mesothelioma, 100 noncancer
• Exposure: asbestos bodies per gram of lung tissue; occupational history, mainly naval and other shipyard work; fiber types chrysotile, crocidolite and amosite
• Main results:
  • 36 of 51 lung cancer patients (70.6 percent) had more than 100 asbestos bodies per gram (up to 381,025/g), reported as significantly higher than noncancer cases (38.6 percent)
  • All 7 mesothelioma patients had more than 500 asbestos bodies per gram
  • Mean counts per gram: lung cancer 10,432 (plus or minus 7,778); noncancer 151 (plus or minus 28); mesothelioma 37,118 (plus or minus 19,723)
  • In the noncancer group, 18 cases exceeded 500 asbestos bodies per gram
  • Among lung cancer patients, 2 of 6 women and 75.6 percent of men had more than 100 bodies per gram
  • Among lung cancer cases, the difference in counts between squamous cell and small cell carcinoma was reported as significant
  • Among lung cancer patients, 36 of 51 were above 400 on the Brinkman smoking index
  • Among lung cancer patients with a definite exposure history, exposure lasted six months to 48 years (average nine years)
  • In lung cancer cases, chrysotile was the main fiber in 70 percent; crocidolite and amosite were dominant in 30 percent
• The authors' conclusion: The authors concluded that asbestos exposure is likely an etiologic factor in the recent upsurge of lung cancer in Kure City

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: Lung Cancer, Asbestos Exposure, Asbestos Bodies, Autopsy, Scanning Electron Microscopy (SEM), Chrysotile, Amphibole Group, Crocidolite.

Related studies

• Malignant mesotheliomas in Kure City, Japan: the relationship of asbestos exposure — T. Kishimoto, T. Sato, et al. (1989)
• Significant relationship between the extent of pleural plaques and pulmonary asbestos body concentration in lung cancer patients with occupational asbestos exposure — T. Yusa, K. Hiroshima, et al. (2015)
• Relationship between number of asbestos bodies in autopsy lung and pleural plaques on chest X-ray film — T. Kishimoto, T. Ono, et al. (1989)
• Malignant pleural mesothelioma in parts of Japan in relationship to asbestos exposure — T. Kishimoto, S. Ozaki, et al. (2004)
• Relationship between chest X-ray findings and pulmonary function tests in dust workers — Y. Tonori, M. Niitsuya, et al. (2005)
• Asbestos-induced cellular and molecular alteration of immunocompetent cells and their relationship with chronic inflammation and carcinogenesis — H. Matsuzaki, M. Maeda, et al. (2012)

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