The silent epidemic: asbestosis and related diseases

Our plain-English summary of The silent epidemic: asbestosis and related diseases, by B. Cassingham (Occupational Health Nursing, 1985).

The study

• Author: B. Cassingham
• Journal: Occupational Health Nursing
• Published: 1985;33(7):360-2
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001257).

In plain English

This 1985 article was an overview of asbestosis and related diseases written for occupational health nurses, not a research study; its figures came from other sources. The author covered asbestos types, exposure settings, diagnosis, history and legal issues. Estimates of living exposed workers ranged from 21 million (Selikoff) to two to five million (Epler, 1984). Citing Epler, the article stated that it is estimated that bronchogenic carcinoma occurs in 20% to 50% of asbestosis patients. It stated that asbestos workers who smoke have a 10 times greater chance of developing lung cancer than smokers in the general population, and a 75 to 100 times greater chance than non-smokers. It gave a mesothelioma rate of 1-2 per million in a non-exposed population, and stated that one of every 15 exposed individuals will develop it. The article quoted a 1980 NIOSH report concluding there is no exposure level below which clinical effects do not occur. It described two planned National Cancer Institute-funded trials of beta-carotene and retinol, in Tyler, Texas, and Seattle. The author concluded that nurses may need to encourage smoking cessation and do case finding, including among nearby office workers and workers' families.

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: Narrative overview (non-systematic review) for nurses; no original data. Figures are drawn from conference presentations, a NIOSH report and other cited sources.
• Who was studied: No study population. The overview concerns asbestos-exposed workers in the United States, along with office workers near asbestos plants and families of asbestos workers.
• Exposure: Asbestos in general. The article lists amosite, fibrous actinolite, fibrous anthophyllite, crocidolite and "chrysolite", and names "chrysolite" and amosite as the most common in the United States. Jobs named include shipyard work, brake lining, asbestos refining, work around high-temperature pipes, construction and roofing. Non-occupational exposure includes adjacent offices, buildings and household contact through work clothing.
• Main results:
  • Estimates of living workers exposed to asbestos ranged from 21 million (Selikoff, 1981) to two to five million (Epler, 1984).
  • Citing Epler (1984), it is estimated that bronchogenic carcinoma occurs in 20% to 50% of asbestosis patients.
  • Citing Epler (1984), asbestos workers who smoke have a 10 times greater chance of developing lung cancer than smokers in the general population, and a 75 to 100 times greater chance than non-smokers.
  • Citing Epler (1984), mesothelioma occurs at a rate of 1-2 per million in a non-exposed population, while one of every 15 individuals exposed to asbestos will develop mesothelioma.
  • A 1980 NIOSH report quoted in the article concluded there is no level of asbestos exposure below which clinical effects do not occur.
  • The article reported 16,000 pending third-party lawsuits against the Manville Corporation (Churg, 1984), and an estimated 28,000 asbestos lawsuits in the U.S. (Whelan, 1984).
  • Two National Cancer Institute-funded chemoprevention studies of beta-carotene and retinol in asbestos-exposed people were described as beginning, one in Tyler, Texas, and one in Seattle, Washington. No results were reported.
• The authors' conclusion: The author concluded that nurses working with asbestos-exposed patients may have to encourage smoking cessation and should do case finding, including among office workers near asbestos plants and families of asbestos workers.

Topics

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

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