Asbestos and cancer: epidemiological and public health controversies

Our plain-English summary of Asbestos and cancer: epidemiological and public health controversies, by M. Huncharek (Cancer Investigation, 1994).

The study

• Author: M. Huncharek
• Journal: Cancer Investigation
• Published: 1994;12(2):214-22
• Type of article: Review
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

This paper discusses many of the currently controversial issues surrounding asbestos health effects and their relationship to cancer risk assessment and risk management. The major conclusions reached from this analysis are: (1) All asbestos fiber types are carcinogenic and pose a threat to human health. Therefore, all fiber types should be regulated similarly. (2) The health risks associated with indoor asbestos exposure are uncertain. Available data show that some groups, such as building maintenance personnel (among others), may contract asbestos-related diseases secondary to indoor exposure. Clearly, additional research is needed to accurately determine the extent and nature of disease risk under these conditions. (3) Controlled use has proved an elusive goal. Limited information from underdeveloped countries parallels the experience of Western industrialized nations. Efforts by the Canadian government to establish markets for asbestos in these areas should be opposed. (4) Finally, asbestos-related cancer risk is no longer confined to asbestos industry workers. Asbestos-related mesothelioma has been documented in a wide variety of occupational and nonoccupational settings, highlighting the need for continued surveillance to minimize potential health risks.

In plain English

This 1994 article was a review and commentary by a single author, not a new study. The author discussed published research on disputed questions about asbestos and cancer. On fiber type, the author cited an analysis by Nicholson of 14 exposed worker groups. In that analysis, lung cancer risk per unit of exposure varied by more than two orders of magnitude, and it found no evidence of substantially different lung cancer risk between fiber types. The author also cited animal studies in which amosite, anthophyllite, crocidolite and chrysotile all produced tumors. On asbestos in buildings, the author reported that a 1986 US EPA report found a mean airborne level of 0.006 fibers per cc in 43 federal buildings. The author argued that short-term air sampling may not reflect levels during routine building use. On "controlled use," the author described poor working conditions reported in Thailand and Egypt. The author also cited reports of mesothelioma in brake mechanics, railroad workers and construction workers. The author concluded that all asbestos fiber types are carcinogenic and should be regulated similarly, and that indoor exposure risks are uncertain.

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: Narrative review and commentary; no original data were collected
• Who was studied: No study population of its own; the author discussed published epidemiological, lung-fiber, animal and building air-sampling studies and reports
• Exposure: All asbestos fiber types: chrysotile (serpentine) and amphiboles (amosite, crocidolite, tremolite, anthophyllite). Topics included asbestos in buildings, asbestos cement use in developing countries, and jobs such as brake mechanics, railroad work and construction trades
• Main results:
  • In Nicholson's analysis of 14 asbestos-exposed cohorts, as reported by the author, the increase in lung cancer per unit of exposure varied by more than two orders of magnitude. Differences between studies of the same fiber type exceeded differences between fiber types.
  • The author quoted a cited source as finding the ratio of mesotheliomas to excess lung cancers the same for predominantly chrysotile, 100% amosite and mixed exposures, and about twice as great for 100% crocidolite. The author suggested the crocidolite difference may result from bias.
  • Cited animal inhalation studies showed that amosite, anthophyllite, crocidolite and chrysotile all produced tumors.
  • A 1986 US EPA report of 43 federal buildings found airborne asbestos levels from 0.0 to 0.2 fibers per cc, with an arithmetic mean of 0.006 fibers per cc (printed as 'fkc' in the scan). The author argued that short-term sampling does not reflect levels during routine building use.
  • The author cited a UK case report of pleural mesothelioma in a female office worker exposed to amosite in her workplace building. The author also cited a study finding X-ray abnormalities and impaired lung function in school custodians.
  • A 1988 Canadian broadcast investigation in Thailand, as described by the author, found power saws used on asbestos cement, open bags of asbestos, rare mask use and no ventilation. The author noted that similar conditions had been reported in Egypt.
  • In a cited case-control study of US railroad employees, 20 of 15,059 deaths recorded by the Railroad Retirement Board were due to mesothelioma.
  • In a cited Swedish Cancer Registry study, 13 of 35 confirmed peritoneal mesothelioma cases (1961 to 1979) were among construction industry employees.
• The authors' conclusion: The author concluded that all asbestos fiber types are carcinogenic and should be regulated similarly, and that indoor exposure risks are uncertain and need more research. The author also concluded that controlled use has proved elusive, that Canadian efforts to market asbestos in developing countries should be opposed, and that asbestos-related cancer risk is no longer confined to asbestos industry workers.
• Limitations the authors state:
  • The author stated that no large-scale study of brake mechanics existed, so the true magnitude of their disease burden was difficult to estimate.
  • The author stated that the biological significance of lung fiber burden measurements is unclear.

Topics

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

Medical terms in this study, explained in our Lexicon: Carcinogenic, Asbestos Exposure, Controlled Use, Mesothelioma.

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