By: Jerome E. Spear, CSP. CIH, FAIHA
The history of appreciating the hazards of asbestos begins in the last part of the 1890s. In Great Britain, as early as 1898, the Lady Inspector of Factories noted that asbestos was causing disease among textile workers (Castleman, 1996).
In 1918, a statistician with Prudential Life Insurance Company referred to premature mortality among asbestos workers, after which those workers were generally declined life insurance on account of the industry’s assumed health-injurious condition (Castleman, 1996).
Although the first recorded case of asbestosis was in 1899 (Henderson and Leigh, 2011), the first detailed report of asbestosis in an individual, published in the general medical literature, was by British pathologist W.E. Cooke in 1924 (Castleman, 1996). At this time, “asbestosis” was coined by Cooke (Frank, 2006).
In 1930, Merewether and Price of the British Factory Department completed their investigation of conditions in the asbestos industry and produced a landmark report on the effects of asbestos dust on the lungs and dust suppression in the asbestos industry. By the mid-1930s, Lanza in the U.S. showed that suggested levels of asbestos were often too high to protect workers.
The first suggestion of the relationship of asbestos exposure and lung cancer was by Lynch and Smith (1935) based on their observations of workers at a South Carolina asbestos textile plant. By 1942, Hueper, director of occupational cancer studies at the National Cancer Institute, wrote that he felt asbestos caused lung cancer. Others repeatedly suggested the link between asbestos and lung cancer several times in the 1940s and early 1950s. In 1955, the relationship between asbestos exposure and lung cancer was firmly established when Doll reported on the first systematic epidemiologic and pathologic study of lung cancer among asbestos workers. Doll concluded that carcinoma of the lung was a specific industrial hazard of asbestos workers (Doll, 1955).
Case reports of mesothelioma began accumulating in the 1940s, and by the early 1950s, there were studies linking asbestos to the development of mesothelioma. The relationship between asbestos exposure and mesothelioma was more firmly established in 1960 by the seminal paper authored by Wagner et al.
Epidemiologic studies have indicated that there is a synergistic effect between cigarette smoking and asbestos exposure in the production of lung cancer. (Roggli et al., 2004; Hammond et al., 1979; Selikoff et al., 1968; Selikoff and Hammond, 1979; Selikoff et al., 1980). Selikoff et al. (1968) published the first study that suggested the multiplicative, or synergistic, effect between cigarette smoking and asbestos exposure in the production of pulmonary carcinomas (Selikoff, Churg, & Hammond, 1968).
Furthermore, it is generally accepted that gastrointestinal tract cancers, throat cancers, and kidney cancers are also found in excess following exposure to asbestos, with the risk increasing with increasing exposure (Frank, 2006; Selikoff, 1975).
The evolution of medical knowledge concerning asbestos-related diseases can be summarized by landmark publications in the medical literature. Major publications concerning asbestos-related diseases since the 1920s are listed in Table 1.
Table 1: Evolution of Knowledge of Asbestos-Related Diseases (Major Publications)
| Date | Author/Title | Lung Disease | Asbestosis (Fibrosis) | Lung Cancer | Mesothelioma | Other Cancers |
| 1924 | Cooke – Fibrosis of the Lungs Due to Inhalation of Asbestos Dust | Yes | Yes | |||
| 1930 | Merewether and Price – Report on the Effects of Asbestos Dust on the Lungs and Dust Suppression in the Asbestos Industry | Yes | Yes | |||
| 1931-35 | Lanza – USPHS Reports, Effects of the Inhalation of Asbestos Dust | Yes | Yes | |||
| 1935 | Lynch and Smith – Pulmonary Asbestosis III: Carcinoma of Lung in Asbestosis-Silicosis | Yes | Yes | Yes | ||
| 1942 | Hueper – Occupational Tumors and Allied Diseases | Yes | Yes | Yes | ||
| 1949 | Editorial – The Journal of the American Medical Association | Yes | Yes | Yes | ||
| 1955 | Hueper – Silicosis, Asbestosis, and Cancer of the Lung | Yes | Yes | Yes | ||
| 1955 | Doll – Mortality from Lung Cancer in Asbestos Workers | Yes | Yes | Yes | ||
| 1960 | Wagner et al. – Diffuse Pleural Mesothelioma and Asbestos Exposure in NW Cape Province | Yes | N/A | Yes | Yes | |
| 1964 | Selikoff et al. – Relation Between Exposure to Asbestos and Mesothelioma | Yes | N/A | Yes | Yes | |
| 1968 | Selikoff et al. – Synergist Effect of Smoking and Asbestos Exposure in Production of Lung Cancer | Yes | N/A | Yes | ||
| 1975 | Selikoff – Asbestos Disease in the United States | Yes | Yes | Yes | Yes | Yes |
References
Castleman, B. L. (1996). Asbestos: Medical and Legal Aspects (4th Edition). New York: Aspen Publishers.
Doll, R. (1955). Mortality from Lung Cancer in Asbestos Workers. British Journal of Industrial Medicine, 12(81), 81-86.
Editorial. (1949, May – August). The Journal of the American Medical Association, 140, 1219.
Frank, A. L. (2006). The History of the Extraction and Uses of Asbestos. In R. F. Dodson, & S. P. Hammar (Eds.), Asbestos: Risk Assessment, Epidemiology, and Health Effects (pp. 1-8). Boca Raton: CRC Press.
Henderson, D. W., & Leigh, J. (2011). The History of Asbestos Utilization and Recognition of Asbestos-Induced Diseases. In R. F. Dodson, & S. P. Hammar (Eds.), Asbestos: Risk Assessment, Epidemiology, and Health Effects (2nd ed., pp. 1-22). Boca Raton: CRC Press.
Hueper, W. (1942). Occupational Tumors and Allied Diseases. Springfield, IL: Charles C. Thomas Publisher.
Hueper, W. C. (1955). Silicosis, Asbestosis, and Cancer in Asbestos Workers. American Journal of Clinical Pathology, 25, pp. 1388-1390.
Lanza, A. J. (1935, January 4). Effects of the Inhalation of Asbestos Dust on the Lungs of Asbestos Workers. Public Health Reports, 50(1).
Lynch, K., & Smith, W. (1935). Pulmonary Asbestosis and Carcinoma of the Lung in Asbestos – Silicosis. The American Journal of Cancer, XXIV, 62.
Merewether, E. R., & Price, C. W. (1930). Report on Effects of Asbestos Dust on the Lungs and Dust Suppression in the Asbestos Industry. London: His Majesty’s Stationary Office.
Selikoff, I. J. (1975). Asbestos Disease in the United States, Supplement 1. Rev. fr. Mal Resp., 4, 560-565.
Selikoff, I. J., Churg, J., & Hammond, E. C. (1964). Relationship Between Exposure to Asbestos and Mesothelioma. The New England Journal of Medicine, 560-565.
Selikoff, I., & Lee, D. (1978). Asbestos and Disease. New York: Academic Press.
Selikoff, I., Churg, J., & Hammond, E. (1968). Asbestos Exposure, Smoking and Neoplasia. JAMA, 204, 104-110.
Wagner, J. C., Sleggs, C. A., & Marchand, P. (1960). Diffuse Pleural Mesothelioma and Asbestos Exposure in the North Western Cape Province. British Journal of Industrial Medicine, 17, 260-271.