Asbestos-related pleural thickenings in Japanese sake brewers

Asbestos was long used as an additive material for the filtration of many kinds of alcoholic beverages. There has been, however, only one case report of a distiller in Italy showing pleural thickenings and lung parenchymal fibrosis due to exposure to asbestos. We report a retired Japanese sake brewer who showed bilateral calcified pleural plaques on chest X-ray films. X-ray diffraction analysis and energy disperse X-ray microanalysis demonstrated the additive material used for sake filtration to be almost pure chrysotile. Furthermore, 17 cases showing probably asbestos-related pleural thickenings were found on examination of 235 chest X-ray films of male workers at different sake breweries. These findings indicate that Japanese sake brewers should be listed as workers at possible risk of asbestos-related health problems.