Abstract

A series of 83 patients from the London Hospital with a diagnosis of mesothelioma confirmed by necropsy or biopsy has been studied for possible exposure to asbestos. The series consisted of 41 men and 42 women; 27 of the patients had peritoneal and 56 pleural tumours. The earliest death recorded was in 1917, but only 10 of the series died before 1950 and 40 (48%) between 1960 and 1964.

In 76 of the series full occupational and residential histories were obtained. Forty (52·6%) gave a history of occupational or domestic (living in the same house as an asbestos worker) exposure to asbestos compared with nine (11·8%) out of 76 patients from the same hospital suffering from other diseases (p < 0·001). None of the 17 suspected cases of mesothelioma, rejected on pathological grounds, was found to have had any exposure to asbestos. There was also evidence that neighbourhood exposures may be important. Among those with no evidence of occupational or domestic exposures, 30·6% of the mesothelioma patients and 7·6% of the in-patients with other diseases lived within half a mile of an asbestos factory (p < 0·01). Out of the 31 patients with occupational exposures only 10 were in jobs scheduled under the Asbestos Regulations of 1931. The interval between first exposure and the development of the terminal illness of mesothelioma ranged between 16 and 55 years.

In 47 patients in the mesothelioma series, lung tissue or sputum was available for examination. In 30 (62·5%), either asbestosis or asbestos bodies were present.