Document koDVLJJ319knjjDMbZGgJbvB

FILE NAME: General Dynamics (GED) DATE: 1949 Aug 13 DOC#: GED012 DOCUMENT DESCRIPTION: Editorial - Medical Journal 1218 u EDITORIALS % m *\* l* * 9 HGUTiGATIONJ A. M. A. Au. 1). 199 J O U R N A L OF THE N MEDICAL ASSOCIATION HBOKN STREET - . CHICAGO 10, ILL. Idiled br A uiiMtofORfdRiItSee,FIASUHSMTIINMS, MMIT.HD,. M.B. ___________ Aitorktt* fditvn JOHNSON F. HAMMOND, M.D. SUCHARD J. HUNKH T. M.D. fditae far Ceettnl Medical U lnvlm o. GtOROI HALPERIN, M.. JUsManl I the Wi W t. WHELAN SabtcnpHon prit - Twtlro delion per annum in advance Coble Addrttl "Medic, Ckic9M oborPthlpeeaortlm*danetenenndtd. twinSot;upb*r1otmtn-aapyttttleyrtinmtohetnicuweldheotmfheencrthiaothnnegeeelhloafnjogaueJrdniraicl!rtre.mrepgcoievrivianergdy wfriolmt btMfoilundfiolln. secImonpdoratadnvtrrliintifnogrmpaatigoen forlleagtarirndgingreacdoinngtribmuattitoenr!. SATURDAY, AUGUST 13, 1949 ASBBSTOSIS AND CANCER OF THE LUNG Until recently the coexistence of nsltcjttosis aiul can* ' of the lung was considered by many investigators .. voincidencc. Since 1935, 23 such cases were recorded by American, English and German physicians. Wcdler1 noted 14 cases of ashestosis cancer in a series of 92 necropsies on patients with asliestosis, or alxmt 15 per cent of cancer of tiie lung in ]>ersons who died from this industrial disease. The exposure time ranged from 3 to 27 years (average 15 years). The ages in 17 cases were 35 to 75 years (average 50 years). Until now the question of a causal relation between ashestosis and cancer of the lung has been an open one. The recently published Annual Report of the Chief Ins]>ector of Factories in England for 1947 provides additional data on the actual existence of such interrelations.3 During 23 years, 1924 to 1946 inclu nsisvbee,s2tn3s5isdehaathds, beietehner ecsatuasbeldishbeydasahtestnoescisroojrwiyn, wwheicrhe reported to the Grief Insjx'clor. Cancer of the lungs or pleura was found in 31 of these cases (13.2 per cent). Of the 128 male deaths In this group 22 (17J2 per cent) were complicated by cancer of the hing, while of the 107 female deaths 9 (8.4 per cent) were lilarly affect!. The mean age at death from asliestosis complicated hy cancer of the lung was 52.1 year. A causal relation between ashestosis and cancer of tltc lung is supported by the following observations: Tlie incidence rate of .cancer of the lung in this group is excessive, since the normal death rate from cancer of the lung among adults examined at necropsy pthreerseenist ias adlixstiiuntclt spheirftcienntthoef asellxndeicsrtoripbsuietsio. nMoofrceaonv of the long in the series of ashestosis cancers repos from England. The malc-fcmaic sex ratio is 2.4 while it is 5:1 for cancers of the lung in gene This strift indicates that an. environmental and < dently occupational carcinogen was active in the asi tosis group, fifhdmg., to equalize the incidence rate cancer of the lung for Imffrsexes. Recent expound observations support this interpretation flf clinical< dence. Nordmann and Sorge * exposed mice to inht tion of asbestos dust and found that in 20 per < of the surviving animals there ilcvcfnped squamous cancer originating from the bronchial mucosa, w other tyics of epithelial proliferation were presew 42 to 57 per cent of tliesc animals, in addition to difl or nodular fibrosis of the lung. The histologic chara of the cancers (squamous cell cancer instead of ad carcinoma seen in the spontaneous cancer of the 1 of mice) and the histogenetic derivation of the tun (bronchial mucosa instead of alveolar epithelium of spontaneous type) indicate that a sjiccifk facto) exogenous origin, represented by the iiiltatcd asbc dust, was rcs(H.nsiliie for the bronchia! cancers obscr Since some 20,000 workers are employed in the as bis-producing industries of this country and Cat and many additional thousands in various asbei consuming industries, increased attention to this p able occn)iational hazard of cancer of the lung fay medical profession is desirable. Cytologic examinat poefrtihoedicbroenxcahmiainl asteiocnretoiofnwmoarkyewrselelxIpkosiendclutodedasii*n dust whenever clinical or roentgenologic evidence cates the possible existence of a pulmonary cat As the available evidence shows that the occurr of caqccr of die lung is related to pulmonary ash and is not merely a possible sequela of expusut asbestos dust, in all fatal cases of ashestosis t should Ik jiostinortem examination with detailed Is logic analysis. The anatomic lesions produced asbestos dust in the hmgs make difficult at times tinction by clinical and roentgenologic diagn methods between changes of pnenmoconiotic nature those that might indicate a cancerous growth. hrtJ.., OKOmiIilrit. f1r11o.9mW).A.jnnAu*aWl Hstnc*ienttmofLthuenle.tltnhrrftbi.. DcaUchc oi mML Fartui I(hWr i)t.cY.XeIaotrMtI,uNattntKn>., liiMl,l,rti.atkwall Solnot, S*e, A.; I.ihiiI., Ht* l.iitiKcuhrrU .H.luir.icjhr.ilAy. tbrStmt Titrvttvtxlt, y.ireht. I. Ktdolwwh. 6 i tl6), 1941. WK CHY 5231