Asbestos and the lung: highlights of a detrimental relationship

Our plain-English summary of Asbestos and the lung: highlights of a detrimental relationship, by M. Iliopoulou, C. Bostantzoglou, R. Nenna, et al (Breathe, 2017).

The study

• Authors: M. Iliopoulou, C. Bostantzoglou, R. Nenna, V.S. Skouras
• Journal: Breathe
• Published: 2017;13(3):235-237
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Novel aspects of the pathogenesis of asbestos-related diseases are still coming to light http://ow.ly/EPDa30e8JqK.

In plain English

This short review, not a new study, covered published research on asbestos and lung cancer, mesothelioma, and non-cancer lung and pleural diseases. They described a study in which asbestos workers employed for at least 20 years in places with moderate to high exposure had a 10-fold higher lung cancer risk than the general population. Another found smoking and asbestos together raised lung cancer risk more than their separate effects added up. The authors wrote that studies disagree on the most common lung cancer type after asbestos exposure. For malignant pleural mesothelioma, they described a study naming the highest-risk industries and occupations, along with workers' household contacts. The disease can appear up to 45 years after first exposure. One study linked pleural plaques to both duration and level of exposure. In another, pleural thickening and asbestosis appeared to be associated with increased risk of peritoneal, but not pleural, mesothelioma in crocidolite-exposed people. The authors concluded that asbestos is one of the most common avoidable hazards to the lung and that new aspects of these diseases are still coming to light.

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: Short narrative review of published studies, appearing under the journal heading 'Landmark papers in respiratory medicine'; no new data were collected
• Who was studied: No study population of its own; the review discusses earlier published studies of asbestos-exposed people and asbestos-related lung and pleural diseases
• Exposure: Asbestos in general: serpentine fibres, mainly chrysotile, and amphibole fibres including crocidolite, amosite, anthophyllite, actinolite and tremolite; occupational settings such as construction and shipbuilding
• Main results:
  • As described in the review, a 1955 study by Doll found that asbestos workers employed for at least 20 years in places with moderate to high exposure had a 10-fold higher risk of lung cancer than the general population
  • As described in the review, Selikoff et al. found that even light intermittent asbestos exposure was associated with a 6.8-times higher incidence of lung cancer than in the general population
  • As described in the review, a Danish study by Raffn et al. of 8580 asbestos industry employees found that lung cancer incidence depended on the duration of exposure, not its level, and that exposure was associated with an increase only in adenocarcinoma
  • The review authors stated that conflicting studies mean no safe conclusion can yet be drawn about which lung cancer type is most common in asbestos-exposed people
  • As described in the review, Frost et al., in a study of 98 912 asbestos workers, found that the interaction between smoking and asbestos was greater than additive (multiplicative) for lung cancer, and that lung cancer risk remained increased even 40 years after stopping smoking
  • As described in the review, Butnor et al. found that employees in 12 industries or six occupations (including pipefitter, boilermaker and electrician) were at greatest risk of malignant pleural mesothelioma, along with their household contacts
  • The review states that fibres longer than 8 micrometres and thinner than 1.5 micrometres (which it identifies as amphibole-type fibres) have been associated with higher mesothelioma risk, that no definite inducing dose has been determined, and that the interval from first exposure to mesothelioma can be up to 45 years
  • As described in the review, Paris et al. found that pleural plaques depended on both the duration and the level of exposure, while asbestosis depended only on the level
  • As described in the review, Reid et al. found that in a cohort of crocidolite-exposed individuals, pleural thickening and asbestosis appeared to be associated with an increased risk of peritoneal mesothelioma but not of pleural mesothelioma
• The authors' conclusion: The authors concluded that asbestos is one of the most common avoidable hazards to the human lung, and that although its links to malignant and non-malignant lung diseases were established long ago, new aspects of how these diseases develop are still coming to light

Related studies

• Mesothelioma: recent highlights — M. Carbone, H. Yang (2017)
• Proteome screening of pleural effusions identifies galectin 1 as a diagnostic biomarker and highlights several prognostic biomarkers for malignant mesothelioma — F. Mundt, H.J. Johansson, et al. (2014)
• Highlights of the 14th international mesothelioma interest group meeting: Pathologic separation of benign from malignant mesothelial proliferations and histologic/molecular analysis of malignant mesothelioma subtypes — A. Churg, K. Nabeshima, et al. (2018)
• The role of radiation treatment in pleural mesothelioma: Highlights of the 14th International Conference of the International mesothelioma interest group — R.M. MacRae, M. Ashton, et al. (2019)
• Merlin deficiency predicts FAK inhibitor sensitivity: a synthetic lethal relationship — I.M. Shapiro, V.N. Kolev, et al. (2014)
• Malignant mesothelioma: global incidence and relationship with asbestos — C. Bianchi, T. Bianchi (2007)

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