Approach to asbestos worker compensation plan alleged to be flawed

Our plain-English summary of Approach to asbestos worker compensation plan alleged to be flawed, by K.T. Kelsey, D.C. Christiani (Journal of Occupational Medicine., 1985).

The study

• Authors: K.T. Kelsey, D.C. Christiani
• Journal: Journal of Occupational Medicine.
• Published: 1985;27(11):790-1
• Type of article: Letter
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001245).

In plain English

This was a letter to the editor, not a research study, and reported no new data. The two authors criticized a compensation method for asbestos-exposed individuals proposed by Chase et al. First, they disputed the claim that lung cancer in nonsmoking asbestos workers is "exceedingly rare," citing earlier studies showing odds ratios of 4 to 5. Second, they argued that cell type should not, at this time, determine probable cause in environmentally induced lung cancer. They cited one hospital study of shipyard workers that found no difference in cell types: adenocarcinoma was 9% in the unexposed group and 5% in the exposed group. Third, they cited laboratory studies reporting asbestos-induced chromosome changes in cultured cells. They also cited a study reporting elevated sister chromatid exchange in asbestos workers' blood cells. The authors concluded that the proposal was too flawed to be used. In a reply, Chase et al said their method already assigned nonsmokers a relative risk of 4 after 14 years of asbestos-related employment and 10 after 40 years. They said the cited study's "exposed" group was defined by shipyard employment, not asbestos work.

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 commenting on a published article, followed by a reply from that article's authors; no original data
• Exposure: Asbestos exposure in general, as treated in a proposed scheme for assessing cancer risk and compensation in asbestos-exposed workers; the letter writers discuss no specific fiber type
• Main results:
  • The letter writers objected to the statement that lung cancer in asbestos workers is exceedingly rare without smoking. Citing earlier studies, they said odds ratios of 4 to 5 had been shown.
  • The letter writers cited the only study they knew of that compared cell types in asbestos-exposed and unexposed lung cancer cases. That study, from a general hospital, found no difference for asbestos-exposed shipyard workers versus non-exposed workers. Adenocarcinoma made up 9% of cases in the never-employed (unexposed) group and 5% in the exposed group.
  • The letter writers disputed the claim that asbestos fibers had not been identified as capable of chemically interacting with DNA. They cited other studies, including a 1975 report that asbestos causes chromosome aberrations and polyploidy in Chinese hamster ovary cells.
  • The letter writers also cited a report by Rom et al that asbestos workers had elevated frequencies of sister chromatid exchange in their peripheral blood lymphocytes.
  • In their reply, Chase et al said that odds ratios of 4 to 5 were part of their methodology. They said it assigns nonsmokers a relative risk of 4 after 14 years of asbestos-related employment and 10 after 40 years.
  • In their reply, Chase et al said the exposed group in the cited shipyard study was defined by ever having worked in shipyards, not by working with asbestos.
• The authors' conclusion: The letter writers concluded that the proposed scheme was too flawed to be used for assessing cancer risk in asbestos-exposed workers. They also concluded that, at this time, histological cell type should not be used to determine probable cause in environmentally induced lung cancer.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

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