Pulmonary Asbestosis

Abstract

THE fact that the inhalation of asbestos dust produces an effect upon the lungs was observed many years ago, but the serious results which follow have only more recently been recognized. The pathologic lesions which it produces and its symptomatology have been studied in more detail just recently at the City of London Chest Hospital, by Dr. W. Burton Wood and Dr. S. R. Gloyne. As the result of the study of the radiologic appearances in a series of patients suffering from this disease we have been able to gain some idea of the changes it produces in the lung, which may, I hope, in future be of some value in the further study of this condition and its earlier recognition. This disease was described by H. K. Pancoast and E. P. Pendergrass (12), of Philadelphia, as long ago as 1925, since which time practically no literature on the subject has been published in America, so far as I am able to learn, apart from a recent editorial in the Journal of the American Medical Association (1) describing the death of a patient from pulmonary asbestosis. This patient apparently commenced to be exposed to the dust as long as 32 years before death. This would not suggest that the disease was a very serious one from the point of view of shortening the duration of life. Asbestos, which was known to the ancient world, is a silicate occurring in minerals in combination with iron, magnesium, calcium, or aluminum and is quarried or mined in various parts of the world, including Italy, South Africa, and Canada. Of the asbestos imported into England, 80 per cent comes from Canada, so that it seems unlikely that you in the United States are dealing with a type of asbestos different from that employed in England. It seems reasonable to suppose, therefore, that an effect should be produced on the lungs similar to that produced in England, providing that the manufacturing processes are carried out in the same way. Unfortunately, I have no knowledge of the processes employed in America. It may be that we are more economical in our country in that we make use of the short asbestos fibers which would otherwise be wasted and they are used for dry cloth weaving. In its natural state asbestos differs from other minerals in that it is fibrous, occurring in long silky strands which are highly resistant to heat, strong acids, and alkalis. During the manufacturing processes the workers may be exposed to dust containing varying amounts of asbestos. In some of these processes the asbestos content is very high and in others much lower, the higher asbestos content being present in the air of the rooms devoted to the textile branch of the industry. I have no knowledge of the effect on the workers mining the crude material as there are no mines in England.