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September 5, 1966

Intrapleural Instillation Of Asbestos

JAMA. 1966;197(10):822. doi:10.1001/jama.1966.03110100130041

To the Editor:—  A study presented at the Sixth Multidiscipline Research Forum proposed the instillation of a mixture of powdered asbestos and penicillin crystals intrapleurally, in the treatment of recurrent pneumothorax (196:583, 1966), since this produced dense fibrous synechia of the pleura in dogs.The wisdom of this proposal may be questioned, in view of the association between asbestos and the development of pleural mesothelioma. This previously rare tumor is now being reported with increasing frequency among individuals exposed to asbestos; in one series of 307 consecutive deaths among asbestos-insulation workers, ten were due to mesothelioma.1 This incidence of more than 3% of deaths is remarkably high for a tumor ordinarily so rare that neither mesothelioma of the pleura nor mesothelioma of the peritoneum is separately classified in the International Classification of Diseases. Experimental studies have similarly demonstrated that intrapleural instillation of asbestos, at least in small animals,