An elaboration of "proof" of peritoneal mesothelioma from tremolite free chrysotile

Our plain-English summary of An elaboration of "proof" of peritoneal mesothelioma from tremolite free chrysotile, by D. Egilman (American Journal of Industrial Medicine, 2011).

The study

• Author: D. Egilman
• Journal: American Journal of Industrial Medicine
• Published: 2011;54(8):647
• Type of article: Comment
• Read it: PubMed · Publisher

In plain English

This is a short letter to the editor, not a research study. The author, David Egilman, replied to a letter from Dr. Geyer that questioned the diagnosis in a case the author had previously reported. That case was a patient in Quebec, Canada, described as having occupational peritoneal mesothelioma (cancer of the lining of the abdomen) from exposure to tremolite-free chrysotile asbestos. The author accepted that the diagnosis differed from the original pathology report by Dr. Poulin. The author pointed to additional materials, posted in French on the journal's website. In them another pathologist, Dr. Real Lagacé, concluded the diagnosis was peritoneal mesothelioma and distinguished it from oat cell cancer. The Occupational Lung Disease Committee of Sherbrooke Hospital, three physicians, also concluded the patient died from peritoneal mesothelioma. The author stated that the diagnosis came from two boards of experts, each with three occupational disease specialists. The author concluded that the diagnosis was correct on a "more likely than not" standard, adding that there is never absolute proof in science.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: letter to the editor (reply to another letter about a previously published case report)
• Who was studied: one patient, a previously reported case of occupational peritoneal mesothelioma in Quebec, Canada
• Exposure: tremolite-free chrysotile asbestos (as named in the title; the letter gives no further exposure details)
• Main results:
  • The author posted additional materials, in French, on the journal's website, including a report by Begin et al. referring to the notes of a second pathologist, Dr. Real Lagacé
  • Dr. Lagacé concluded the diagnosis was peritoneal mesothelioma and distinguished the findings from oat cell cancer
  • The Occupational Lung Disease Committee of Sherbrooke Hospital (Raymond Begin, Robert Boileau and Andre Cantin) concluded the patient died from peritoneal mesothelioma
  • According to the author, the diagnosis came from two boards of experts, each of three physicians specializing in occupational disease
• The authors' conclusion: The author concluded that the experts' diagnosis was correct on a more likely than not standard, noting that there is never absolute proof in science
• Limitations the authors state:
  • The author acknowledged that the diagnosis of peritoneal mesothelioma differed from the original pathology report

Topics

The National Library of Medicine indexes this study under subjects our site covers: Chrysotile, Mesothelioma, Peritoneal mesothelioma.

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Tremolite, Chrysotile.

Related studies

• Malignant peritoneal mesothelioma in a 17-year-old boy with evidence of previous exposure to chrysotile and tremolite asbestos — A. Andrion, S. Bosia, et al. (1994)
• Short fiber tremolite free chrysotile mesothelioma cohort revealed — D. Egilman, T. Bird (2016)
• Diffuse peritoneal mesothelioma: A case series of 62 patients including paraoccupational exposures to chrysotile asbestos — R.L. Kradin, G. Eng, et al. (2017)
• Comparison of Calidria chrysotile asbestos to pure tremolite: final results of the inhalation biopersistence and histopathology examination following short-term exposure — D.M. Bernstein, J. Chevalier, et al. (2005)
• Carcinogenic implications of the lack of tremolite in UICC reference chrysotile — A.L. Frank, R.F. Dodson, et al. (1998)
• Comparison of Calidria chrysotile asbestos to pure tremolite: inhalation biopersistence and histopathology following short-term exposure — D.M. Bernstein, J. Chevalier, et al. (2003)

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