Asbestos and product defence science. Response to: Boffetta and La Vecchia

Our plain-English summary of Asbestos and product defence science. Response to: Boffetta and La Vecchia, by B. Terracini, D. Mirabelli (International Journal of Epidemiology, 2016).

The study

• Authors: B. Terracini, D. Mirabelli
• Journal: International Journal of Epidemiology
• Published: 2016;45(5):1692-1693
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter, not a new study. The authors replied to Boffetta and La Vecchia in a debate over whether later asbestos exposure adds to mesothelioma risk in workers first exposed long ago. The authors wrote that Boffetta and La Vecchia had softened their earlier view and now accepted that avoiding the last 10 years of exposure would lower risk. Using a published formula by Peto and colleagues, the authors estimated risk for hypothetical workers first exposed at age 20 at a constant level. They compared stopping exposure early with continuing to age 60. Stopping at 50 lowered mesothelioma risk by 0.4% at age 60, rising to 5.3% at age 80. Stopping at 40 lowered it by 6.7% at age 60, rising to 23.1% at age 80. The authors concluded that the reduction depends on age at risk and may be substantial. They noted that the model has known limitations and that their figures hold only if the model predicts correctly. They also criticised Boffetta and La Vecchia for ignoring trends by duration of exposure.

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 (correspondence) replying to Boffetta and La Vecchia, including a modelled calculation of risk using the Peto et al. exposure-response formula; not an original study of people
• Who was studied: Hypothetical workers, assumed first exposed at age 20, with risk estimated at ages 60 to 80. Workers stopping exposure at age 40 or 50 were compared with workers exposed continuously until age 60.
• Exposure: Occupational asbestos exposure at a constant level (fiber type not specified), lasting at most 40 years; the intervention groups had 20 or 30 years of exposure
• Main results:
  • Hypothetical workers stopping exposure at age 50 (30 years of exposure), compared with workers continuing to age 60: modelled mesothelioma risk was lower by 0.4% at age 60, 1.2% at 65, 2.5% at 70, 3.9% at 75 and 5.3% at 80
  • Hypothetical workers stopping exposure at age 40 (20 years of exposure), compared with workers continuing to age 60: modelled mesothelioma risk was lower by 6.7% at age 60, 10.5% at 65, 14.7% at 70, 19.0% at 75 and 23.1% at 80
  • The authors stated that, in their latest letter, Boffetta and La Vecchia accepted that avoiding the last 10 years of exposure would lower the risk
  • The authors stated that Boffetta and La Vecchia had ignored trends in mesothelioma risk by duration of exposure
• The authors' conclusion: The authors concluded that, in their modelled table, the percentage reduction in mesothelioma risk from preventing exposure during the last 10 years of employment depends on age at risk and may be substantial
• Limitations the authors state:
  • The authors noted that limitations of the Peto et al. model have been pointed out elsewhere
  • The authors noted that their figures depend on the model predicting correctly

Related studies

• Asbestos and product defence science — B. Terracini, D. Mirabelli (2016)
• Re: Asbestos and product defence science — P. Boffetta, C. La Vecchia (2016)
• Manufactured uncertainty: protecting public health in the age of contested science and product defense — D. Michaels (2006)
• Product stewardship and science: safe manufacture and use of fiber glass — T.W. Hesterberg, R. Anderson, et al. (2012)
• Potential health hazards associated with exposures to asbestos-containing drywall accessory products: A state-of-the-science assessment — A.D. Phelka, B.L. Finley (2012)
• Comment on the paper 'Boffetta et al. Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy. Ann Oncol 2018; 29(2): 484-489' — D. Consonni, C. Mensi (2019)

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