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CHEST Official publication of the American C ollege of Chest Physicians Asbestos burden and the pathology of lung cancer. M L Warnock and W Isenberg Chest 1986;89;20-26 DOI 10.1378/chest.89.1.20 The online version of this article, along with updated information and services can be found online on the World Wide Web at: http://www.chestjoumal.org/content/89/1/20 CHEST is the official journal of the American College of Chest Physicians. It has been published monthly since 1935. Copyright 1986 by the American College of Chest Physicians, 3300 Dundee Road, Northbrook, IL 60062. All rights reserved. No part of this article or PDF may be reproduced or distributed without the prior written permission of the copyright holder. (http://www.chestjournal.org/site/misc/reprints.xhtml) ISSN:0012-3692 Downloaded from www.chestjoumal.org by guest on August 25, 2009 Copyright 1986 American College of Chest Physicians Table 1--Age, Smoking History, Occupation, and Latency Periodfor 75 Subjects Croup Age, yr**t * Smoking, pack-yr*t Occupational Category^ --------------------------------------- --------------------------------------- - White Blue Collar Collar Construction Shipyard Time from First Asbestos Exposure to Dx of Tumor, yr* Time Exposed, yr* 1 62.7 9.6 67 38 5(33) 6(40) 2 62.69.9 51 23 0 4(12) 3 62.7 6.4 57 36 0 4(16) 1(7) 5(14) 3(12) 3(20) 26(74) 18(72) 35 16|| 38 10 356 24 12|| 26 11 24 10 *MeanSD. tDifferences among groups were not significant (analysis of variance). $No. of subjects (number within parentheses is percent of subjects in group). Difference among groups is not significant if the 8 unexposed subjects in group 1 are omitted. IjAverage for 7 subjects with exposure. who had never worked in the shipyard were classified as construction workers, even if the history was brief. Other manual laborers were classified as blue collar workers. The distribution of subjects in each group by job category is shown in Table 1. Groups 2 and 3 were similar in this distribution and in the subjects' actual job titles (Table 2). Over 70 percent of the subjects in each of these groups were shipyard workers; however, of the subjects in group 1, some 73 percent (11/15) were classified as white-collar or blue-collar workers. The difference in distribution of subjects by job category between group 1 and groups 2 and 3 combined was significant (p = 0.05; x2 test with Bonferroni correc tion). Total Years Exposed and Latency Period When the eight subjects with no history of exposure to asbestos were omitted from group 1, the three groups did not differ significantly (ANOV) in the average number of years from first exposure to diag nosis of tumor (latency period) or the average number of years of exposure (Table 1). Concentrations ofAsbestos Bodies and Fibers The combined concentrations of amosite and crocidolite fibers in the 75 subjects ranged from undetect able to 69 million/g; the range of chrysotile fiber concentrations was somewhat smaller (77,000/g to 28 million/g). Amosite fibers predominated over crocidolite fibers by a factor of22 (group 2) to 32 (group 3). The median concentrations ofasbestos bodies (AB) and of the various types ofasbestos fibers in each group are listed in Table 3. Median values are given because neither the concentrations nor the log transforms of most of the concentrations were normally distributed. The median concentration of asbestos bodies in group 3 was 260 times that in group 1; the median concentra tion of amosite was 40 times that in group 1; but the chrysotile and TAAG concentrations were only 4 and 2.6 times as great, respectively. Asbestos body concen- Table 2--Major Occupations cf 75 Subjects* Croup 1 Croup 2 Group 3 Insurance sales Physicist Cook Car salesman Hardware salesman Machinery salesman Bartender Carpenter Foundry worker Truck driver Aircraft mechanic Machinist (2) (S) Shipwright (S) Maintenance worker Longshoreman Foundry worker (4) Steel mill worker Fire fighter (2) House construction (2) Weapons assemblyman Auto mechanic Aircraft construction Shipfitter (4) (S) Chipper; caulker (S) Engineer (3) (S) Machinist (6) (S) Sheet metal worker (2) (S) Maintenance worker (4) (S) Electrician (3) (S) Pipefitter (4) (S) Painter (S) Welder (2) (S) Tool and dye maker (S) Longshoreman Printer Steel mill worker Asbestos miner Asbestos pipe manufacturer (2) Rigger (S) Sandblaster (S) Shipfitter (S) Chipper; caulker (2) (S) Engineer (4) (S) Machinist (3) (S) Sheet metal worker (S) Maintenance worker (2) (S) Electrician (S) Pipefitter (6) (S) Painter (2) (S) Welder (4) (S) Some subjects had more than one occupation. No. in parentheses is number of subjects. (S) indicates work in shipyard. 22 Asbestos Burden and Pathology of Lung Cancer (Wamock, Isenberg) Downloaded from www.chestjournal.org by guest on August 25, 2009 Copyright 1986 American College of Chest Physicians cally simpler to determine than the AC fiber burden, does not give an accurate estimate of the AC fiber burden because of the large variation of the AC/AB ratios (4:1 to 136,000:1). Nevertheless, it is apparent from Figure 2 that asbestos body concentrations over 1,000/g of dry lung are likely to be associated with concentrations of AC fibers over 100,000/g of dry lung. Few persons in the general population have asbestos body concentrations in this range.35 In the absence of an amosite and crocidolite fiber determination, an asbestos body concentration over 1,000/g ofdry lung in a person with a history of exposure to such fibers should be used in place of asbestosis as an indication that a lung cancer may be asbestos-related. 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M L Warnock and W Isenberg Chest 1986;89; 20-26 DOI 10.1378/chest.89.1.20 This information is current as of August 25, 2009 Updated Information & Services Citations Open Access Permissions & Licensing Reprints Email alerting service Images in PowerPoint format Updated Information and services, including high-resolution figures, can be found at: http://www.chestjournal.org/content/89/1/20 This article has been cited by 5 HighWire-hosted articles: http://www.chestjournal.org/content/89/1/20#related-urls Freely available online through CHEST open access option Information about reproducing this article in parts (figures, tables) or in its entirety can be found online at: http://www.chestjournal.org/site/misc/reprints.xhtml Information about ordering reprints can be found online: http://www.chestjournal.org/site/misc/reprints.xhtml Receive free email alerts when new articles cite this article. Sign up in the box at the top right corner of the online article. 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