Document gaVEa3D0pa9e544B78yxRjEp3

FILE NAME State of the Art Literature SAL DATE 1955 DOC SAL062 DOCUMENT DESCRIPTION Journal Editorials - Silicosis Asbestosis and Cancer of the Lung American Journal of Clinical Pathology OFFICIAL PUBLICATION OF THE AMERICAN SOCIETY OF CLINICAL PATHOLOGISTS W. D. ANDERSON P. R. BEAMER LAWRENCE BERMAN G. R. BISKIND O. A. BRINES C. G. CULBERTSON ELBERT DECOURSEY Israel DaviDSOHN L. W. DIGGS Board of Editors S. E. GOULD Editor E. A. GALL A. S. GiordANO GEORGE GOMORI W. HOFFMAN J. W. KERNOHAN H. J. LINK T. B. MagATH F. D. MANN P. J. MELNICK A. R. MORITZ -- ---- -- --, ROBERT SCHREK T. H. SELDON KURT STERN G. STILWELL F. W. SundeRMAN N. TOMPKINS L.A. L.A. WEED JEAN L. KING Assistant to the Editor Volume 25. Numbers 7+ DECEMBER TOMPKINS LIBRARY MA 24 R 958 RICHMOND VA Baltimore The Williams & Wilkins Company 1955 - LIBRARY TOMPKINS MCCAW 64562 64562 MEDICAL COLLECE VIRGINIA 15 VIRGINIA RICHMOND ee OT oe eC re oe are dag Aen tnd: Tate Pe et ge | . - = - i 3 - ! Ez: za Sy bao EDITORIALS dim SILICOSIS ASBESTOSIS AND CANCER OF THE LUNG e20 The concept that members of occupations especially exposed to dust particu- dows dae is larly silica have an unusual liability to cancer of the lung is an old one which 64m still held Reliable epidemiologic data from various sources however show that pulmonary cancers are not excessively frequent among persons having occupa- tional contact with coal and silica dust 10.16 10.16 and affected with anthracosis silicosis and anthracosilicosis such as gold and coal miners In fact in 2] Joachimsthal radioactive ore miners with severe silicofibrosis in Schneeberg and Joachimsthal eet who have a ee notoriously high frequency of lung cancer the lungs are not often the site of such a tumors Likewise Bonser Faulds and Stewart recently reported the existence e of an inverse relation inters inters inters found per cent were between cancer of the lung and siderosilicosis in English Merewether nated that only 99 of 6881 races of siliensis 1.32 to have carcinoma of the lungs on postmortem examination In a series of 383 autopsy cases of silicosis in men 47 to 75 years old lung cancer was present in only 7 i.c. in 1.8 per cent against an expected rate of 9.9 to 12 per cent according to the age range and sex of the series Sp^rleinsuggested on the ae basis of this evidence that an antagonism may exist between silicosis and cancer etmn of the lung especially since not a single instance of lung cancer was among UO found 187 men with severe silicosis The epidemiologic and pathologic evidence supporting a causal relationship between asbestosis and cancer of the lung on the other hand is quite substantial Asbestos a magnesium silicate mined on the North American continent and in South Africa is incriminated in this respect.4 4.6.17 4.6.17 A total of 127 cases of States asbestosis cancer of the lung are on record United 21 cases Canada 6 Great Britain 88 Germany 12 Ten of the Xinchivan v^/derwere recently ch served by O'Donnell among 21 autopsy cases of asbestosis seen between 1940 and 1954 in small community in Pennsylvania and occurring among employees of an asbestos textile plant The incidence reported for asbestosis cancer of the lung in autopsy series of asbestosis ranges from 7.5 per centto 50 per cent."It 15.5 per cent for a series of 738 autopsies of asbestosis with 114 lung cancers collected from the literature According to Merewether the female ratio of asbestosis cancer of the lung is at the low level of 2.45 Asbestosis cancers show a diversity of histologie types Among 50 cases 29 were of squamous cell type 15 were of the round anaplastic variety 7 were adeno- carcinomas and 5 were combination forms of squamous cell and adenocarcinoma Asbestosis cancers follow the topographic pattern of asbestosis by involving often the lower lobes fifths according to Isselbacher Klaus and Hardy A multicentric genesis of cancer in the diffuse asbestotic lungs is not unusual The exposure period to asbestos preceding and accompanying the development of --. asbestosis and cancer of the lung ranges from 6 months to 42 years The lag between cessation of exposure and appearance of the pulmonary tumor may be 1388 ' s ca ie Smetana ets 1 4 ay a4 4 wae ee Pom wee tee fee! ~ Pa at oe EEE a wat.eaet cvhy ert dave ry a ee . wes par : < se hes - Lotsa fet p 2a Bere 5 Be ETO TsN te . , aa wee om ~ A * nee Ud SIE ot. oe BN _ so * > LLUNG gsed used used dust is an is however one which s, rsons however show -reons ted anthracosis ted In anthracosis radioactive himsthal himsthal often the site of t reported reported reported the existence erosiliosis erosiliosis erosiliosis cases of silicosis cases of silicosis ination years old lung dears ed rate of to ed ^rlein ^rlein suggested suggested suggested on een silicosis and cancer een ancer found among ancer was found among rc quite substantial LINTORIALS par, Der ata sone hit caver 1359 as long long 200 These tumors accur on ay average at somewhat earlier m as years These tumors occur occur average than cryptogenetic lung production accomplished experimental cryptogenetic cancers cancers the been accomplished asbestosis asbestosis cancers cancers It is uncertain animals has reliably reliably particles particles particles per liter is 4 prerequisite prerequisite uncertain development minimum 170,000 dust is cancer and whether particles the development development development asbestosis asbestosis asbestosis inhaled particles effective Asbestosis whether the lung lung compensable occupational certain to effective Germany's and notifiable with of * the the Inspector Factories ocupational disease in Germany's of + the the Inspector and Wales Wales a Canadian asbestosis cancer Factories in England litigated setlement settlement was occupational occupational of lung which made in favor of plaintiff adequate adequate adequate made cancer The available available scientific evidence adequate occupa- recognizing asbestosis cancer reasons medicolegal : tional disease Since Since least least former years asbestos asbestos effluents effluents caused a i possibility environmental environmental pollution former industrial industrial the absence a local the possibility exists history history specific employment pollution individual asbestosis might be autopsy because of former deceased individual plant Since observed observed autopsy characteristic near asbestos asbestosis asbestosis berylliosis berylliosis presents presents histologic lesion there should be serious difficuity in identifyin identifyin identifyin identifyin neighborhcoaodses of asbestosis and : be Epidemiologic Epidemiologic data of present indicate asbestosis cancer cancer the lung of the lung available available present that that increased liability to cancer limited the presence of . asbestosis the lung and does not extend to exposure : asbestosis resulting therefrom pneumoconiosis | existence existence of W. HUEPER HUEPER M.D. National Cancer Institute Bethesda Institutes of Health Chief HUEPER Cancer Environmental American American continent total 127 cases 4 ruses ruses Canada Canada 16, cases were recently ob- irring seni bekaton 19:10 . irring irring among among employees employees employees aug autopsy series cted cted from for series stosis stosis cancer of literature literature of vted aed fra' m cancer the ; Among Among cases cases were -- and adenocarcinoma adenocarcinoma adenocarcinoma adenocarcinoma sje stosis involving involving adenocarcinoma Klaus Hardy ungs is unusual The ring development development of ths to 42 years lag julmonary julmonary tumor be Hsto 42 years. The be " tumor may be 7 Bethesda Maryland REFERENCES pneumoconiosis of of 2 associated with pneumoconiosis 2 ists J. Indust Indust Branchiogenic carcinom1a934 the urinary urinary Occupational G. Faribs Faribs 16 346 347 J Occupational cancer S. BONSER operatives operatives AND STEWART STEWART dyestuf^fls dyestuf^fls asbestos asbestos textile textile the urinary urinary 9 _ kholder Am Cimi operatives and the the lung miners Am 851 151 Some clinical observations observations observations 151 Sun than mine and mill workers workers Ateh. CARTIER Some Some 214-207 observations asbestosis asbestosis 4. 4. Indust HeMaloth rHtealailttyhMortality from cancer asbestos asbestos workers Doll cancer J. Indust Med , 8186 1955 from lung 5. HOMBURGER HOMBURGER F carcinoma the lung and pulmonary pulmonary AmAm incidence primary primary asbestosis 6. Environmental Environmental Environmental lung cancer 1943 Conference Conference Cancer Cancer InstitutCeanada 1954. York Academic Proc First Inc. 1955. pp 18-236 18-236 Cancer 7. ISSELBACHER Klaus II and Academic pp Asbestosis bronchogenic bronchogenic ISSELBACHER K. one autopsied ease Hardrey view Asrbeesvtioseisw available available literature Am. report of _ carcinoma 1953 1953 autopsied and JAMES 721-732 pneumoconi- JAMES W. ( Primary jung 1935 Wales coal workers pneumoconi- 9. LYNCH Brit M. AND IndustW1. 2 8.7: Asbe9 sto1sis Asbestosis Analysis Analysis necropsied necropsied necropsied Case. qos. M. AND CANNOx W. Asbestosis Asbestosis 10. MEREWEThen MEREWEThen E. R 14.46 Report Your Your Meur Annual Pusthrne ts 1948 1947 Stationery Stationery Stationery Stationery inspector 11. NORDMANN Section Section London H. Lungenkrebs Lungenkrebs durch Asbesteraub pp 17 Tierversuch BORGE Lungenkrebs Lungenkrebs Asbesteraub Asbesteraub Tierversuch Ztschr Krebsforsch Krebsforsch Lancaster 165 182 165 182 12. O'DONNELS L AUPE Lancaster Pa Personal communication rentgenologische ; Rostosk Gewerbehygienische Gewerbehygienische Untersuchungen an Erzherglentes Gewerbehygienische Jobanngeorgenstadter - rentgenologische rentgenologische 12, Untersuchungen Erzherglentes Jobanngeorgenstadter Grubenbezirkes Jobanngeorgenstadter 13. Sachsen Arch Arch Gewerbepath Gewerbepath Gewerbepath Gewerbebyg 193i Sachsen . Gewerbepath Gewerbepath. u. Gewerbebyg 731-734 1931 in Sachsen, Arch. f. s 4 Lo 2. ar . TTF : woe a a i ae aEoak " 13190390 EDITORIALS EDITORIALS EDITORIALS Vol 25 Vol 25 14. Sporters S. 200. 1952 Sch^...tztdie Silikose vor Lungenkrebs Zentralbi alig Path 89 197 15. TABERSHAW 1. R Report un industrial hygiene in the Western Zone of Germany Arch Indust Hyg 3 2015-315 1951 16. VORWALD A. J. AND KArk J. W Pneumoconiosis and pulmonary carcinoma Am J. Puth 14 49-58 1938 17. Wyens H AsbestosisAsbestosis Postgrad M. 25 631 6381949 MEDICAL GENETICS The science of genetics has made rapid strides during the past half century_ Among the many applications of the recent advances in this field are those relat- ing to human health and disease That these applications are recognized as im- ' portant is testified to by the results of a recent survey by Herndon in which he reported that instruction in geneties is now given in 55 per cent of the medical schools of the American Association of Medical Colleges The instruction varies from fledged courses to material included i didactic lectures Several thousand deviations from normality in man have been investigated from the genetic standpoint and for several hundred of them a simple genetic basis has been reasonably well established It is not a simple matter to confirm the genetic basis of a suspect trait and precise technics are required for its es- tablishment A recent book by Neel and Schull is particularly valuable for its . discussion and evaluation of many of these technics Snyder in his recent presentation to the medical section of the American Life Convention pointed out that not only are hereditary factors or genes being identified in man but that much is known of how they act The basic function of a gene is the development of a specific substance which determines the effect of the gene on the individual This substance is as a rule an enzyme and is re- sponsible for the catalysis ofa particular step in synthesis or degradation leads A mutation which may derive from an inexact copying of the gene durinigts usual process of constructing a duplicate of itselfin cell division generally to a diminution or loss of activity in catalyzing the specific reaction that the unmutated geneaccomplished Thus the mutated g^newhich henceforth dupli- cates itselfin its altered chemical form just as faithfully as the unmutated gene previously copied its original form produces an enzyme dysfunction and hence a physiologic or morphologic aberration The aberration may be striking and readily recognizable as in phenylketonuria in which the mutant gene fails to develop the enzyme which converts phenylalanine to tyrosine in Sachs disease in which the mutant gene does not provide provide the enzyme enzyme required to oxidize spiningomycin spiningomycin spiningomycin or in glycogen glycogen discuss in which the phosphorylase needed to convert glycogen to glucose is not de- veloped On the other hand the aberration resulting from the changed activity of the mutant gene may be only a slight deviation in physiologic activity under- lying susceptibility resistance growth or some other quantitative characteristic In such instances the aberration may be appreciable only when several genes of this nature polygenes act cumulatively Se Reateare * de%- Selai nkias ae Se RageAs SPit ud aN