Document wgdYObQGOQEvjaYjNVjXQk76
FILE NAME Synkaloid SYN
DATE 1978
DOC SYN027
DOCUMENT DESCRIPTION 1978 Journal article on lung cancer in drywall taping worker Citation Alf Fischbein Arthur M. Langer Yasunosuke Suzuki Irving J.
Selikoff 1978
Carcinoma of the lung in a drywall taping worker report of a case Toxicology Letters Volume 2 Issue 4 Pages 231-236 https://doi.org/10.1016/0378-4274(78)90072-3
Toxicology Letters 1978 231-236 'Holland Biomedical Press
231
CARCINOMA OF THE LUNG IN A DRYWALL TAPING WORKER REPORT OF A CASE
ALF FISCHBEIN ARTHUR M. LANGER YASUNOSUKE SUZUKI and IRVING J. SELIKOFF
Environmental Sciences Laboratory Department of Community Medicine Mount Sinai
School of Medicine of the City University of New York Fifth Avenue and 100th Street New York NY 10029 U.S.A. Received June 14th 1978 Accepted June 29th 1978
SUMMARY
Squamous cell carcinoma together with pulmonary asbestosis is reported in a drywall taping worker In this trade vigorous sanding of dried taping compounds produces a dust which is known to contain chrysotile asbestos Fibrils of chrysotile asbestos were seen on transmission electron microscopy of ashed lung tissue The authors emphasize the need to institute adequate preventive
measures in this trade
INTRODUCTION
New industrial processes may considerably widen the range of occupational
health hazards Drywall construction was introduced in the United States on a large scale basis immediately after World War II During the past two decades drywall construction has achieved a dominant role in the United States con- struction industry This trade has recently been described by us in detail and has been shown to be associated with significant asbestos exposure 1,6 The occurrence of a pulmonary carcinoma in a drywall taping worker with the
finding of very large numbers of asbestos fibers in the lung raises the possibility that this trade may soon become the source of asbestos neoplastic disease
in addition to asbestosis
Dust diseases of the lung may be diagnosed in different ways and with various degrees of accuracy In order to achieve definitive diagnosis the identification of the hazardous agent is required The substance may be found in the material used in a work process in air samples or in human tissues as
a result of exposure
:
Supported in part by Grants from the National Institute of Environmental Health Sciences ES 00928 and the American Cancer Society 53C
232
We report here a case of lung cancer in a drywall taping worker as well as the results of tissue analysis for asbestos fibers and other inorganic materials The importance of utilizing adequate techniques for tissue analysis is stressed
CASE REPORT
E.S. a year white male was admitted to another hospital in May 1971
because of weight loss chest pain and sudden hemoptysis Two weeks before
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an a chest radiograph had shown infiltrative process in the left upper lung field
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This persisted despite antibiotic therapy and the patient was admitted for
a
further study
ew Bronchoscopy was negative for malignancy and cytological examination of
bronchial washings showed only atypical cells Scalene node biopsy was un-
remarkable A left upper lobectomy was performed A portion of the fourth
rib was adherent to the pleural surface on the anterior lateral aspect Section
of the lung revealed an area of grayish consolidation beneath the rib adhesion
Macroscopically the area was suggestive of a neoplastic tissue There was no
involvement of the lower lobe The patient was followed for 1 year as an out-
patient developed symptoms suggestive of cerebral metastases and died on
May 23 1972. No autopsy was performed Past medical history had been un-
remarkable The patient had been a smoker and had been a drywall
F construction worker for 25 years mixing applying and sanding various
spackling and taping compounds
Histopathological examination
The tumor tissue in the surgical specimen from the peripheral part of the lung
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fibrotic alveoli 270 x
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Fig 2. Tumor tissue with pearl formation 1700 x
was a differentiated squamous cell carcinoma Fig 1 The neoplastic
cells were irregular in shape and formed nests of various sizes Occasionally pearl formation was observed Fig 2 Polymorphism atypical features and
abnormal mitosis was remarkable There was invasion of the tumor into the
pleural region with much fibrosis
In addition to the neoplastic changes described above the pulmonary
parenchyma showed congestion edema and pneumonia which was
partially organized Alveolar macrophages had accumulated in alveolar spaces
Hemosiderin and anthracotic pigments were frequently seen in the cytoplasm
i
of the macrophages
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Of interest was the presence of pulmonary fibrosis in the form of alveolar
septal Fig 3 and bronchiolar fibrosis This fibrosis consistent with
pulmonary asbestosis was not accompanied by the finding of asbestos bodies
either in the alveolar space or in the fibrotic tissue itself
Mineralogical analysis of lung tissue
A ...mthick unstained uncovered tissue section was prepared for electron
microscopy by the carbon extraction technique 4 The prepared specimen was examined by transmission electron microscopy utilizing an RCA EMU
Scan magnification ranged from approx 2000-31 000 x At magnification
greater than 15 000 x particles too small to be seen by light microscopic methods became visible The appearance of numerous particles by electron
microscopy invisible by all other microscopic techniques has been described
5 Everywhere in the relic tissue numerous particles were observed Fig 4
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Sheet silicates diatom fragments and chrysotile asbestos were observed in
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