1931: Asbestosis of the Lungs, Spleen, and Lymph Nodes, and the Potential Similarity with Tuberculosis

By 1931, the medical community in the United States was well aware that even light asbestos exposure was dangerous and needed more study. The eight page pamphlet titled Asbestosis: Report of Two Cases published in the Archives of Pathologies during December 1931 (my copy is a reprint by the American Medical Association) is loaded with surprising, at least to me, historical facts such as:

“From the histories there appears to be a further need for study along the lines of prevention of this disease.”

So, as of 1931, the medical community in the United States knew that they had a problem with asbestosis and was recommending more studies. In addition:

“In asbestosis the lung is not the only organ invaded by asbestosis bodies. As we have shown, the spleen and the lymph nodes may harbor large asbestosis bodies.”

That means, as of 1931, asbestosis was known as a potential issue affecting organs other than the lungs.

As to the doctors’ understanding of the role asbestos played in inhalation issues:

“Its expansion from 500 tons in 1880 to 330,000 tons in 1925 and the fact that methods of manufacture have been introduced for utilizing the fine dust for new purposes have contributed to the beginning appearance of a pneumokoniosis due to inhalation of asbestos dust, known as pulmonary asbestosis.”

Based on the above, it is pretty tough to argue that asbestos was not dangerous to those who worked in the industry or with the product. Even the shape of the asbestos fibers seemed to scream “danger” to the doctors:

“The asbestos fiber itself under dark-ground illumination has the appearance of a sharp piece of wire. Fibers measuring 200 microns can pass the protective mechanism of the upper respiratory track and enter the lung.”

The authors’ comment on the relationship between pulmonary asbestos and tuberculosis was:

“The question of the relation of pulmonary asbestos to tuberculosis is an interesting one. The fact that they are frequently associated is settled.”

Of course, as discussed in my January 10, 2024 blog at https://theasbestosblog.com/?p=11474, the current medical literature does not support such an association. When I get some time, I would like to research the trail of tuberculosis’s association with asbestos from the 1920s to today, to understand the facts underlying the various positions over years.

One of the more interesting points is that, as of 1931, the medical community knew that even a light exposure was a concern that justified requiring the workers to take precautions against exposure, including wearing masks. As stated:

“The other point is that one has to do preventive medicine. The exposure was for nine years in a comparatively well ventilated factor in which precautionary appliances were used, and yet the patient developed a minor grade of the disease. It would seem that further precautionary means are necessary in this occupation to obviate a disease in itself so preventable.”

And:

“This demonstrates that the symptoms of a pneumokoniosis may come on years after a short exposure and emphasizes again the absolute necessity for wearing masks in even the less dusty atmospheres.“

My takeaway from this short, but fully loaded, 1931 medical discussion on asbestos-related health risks occurring even at low exposures, basically was a wakeup call. Unfortunately, the various recommendations about wearing masks “even in the lest dusty atmospheres” was not the norm as adopted at the time by industry in general. Think about how our people and society might be different had the recommendations been followed.

This was an excellent publication (as of 1931, at least). Let me know if you have any questions either by leaving a comment or emailing me at TheAsbestosBlog@gmail.com. Thanks. Marty