Asbestos-associated diseases. Science, public policy, and litigation

Our plain-English summary of Asbestos-associated diseases. Science, public policy, and litigation, by H. Weill (Chest, 1983).

The study

• Author: H. Weill
• Journal: Chest
• Published: 1983;84(5):601-8
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001712).

In plain English

This 1983 article was a commentary and review by the author, not a new study, and it reported no original data. The author examined how scientific knowledge about asbestos-associated diseases had, and had not, been used in United States public policy on compensation and prevention, and in litigation. The author stated that tort litigation had been shown to be inequitable, costly, and markedly unjust. As a possible structure, the author suggested a national panel of experts to set guidelines, with regional panels deciding individual claims. Reviewing the evidence, the author wrote that pleural plaques indicate exposure, not disease. The author also wrote that where exposures are reduced to levels without evidence of asbestosis, excess lung cancer is not likely to be detected. Once mesothelioma is validly diagnosed, a history of exposure, even if short, was described as sufficient for a judgment of causation. The author reported that mesothelioma experience was strikingly less favorable in populations exposed to crocidolite than in those exposed to chrysotile. The author concluded that scientific input into US decision-making was not sufficiently broad and varied.

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: Commentary and narrative review of the scientific evidence on asbestos-associated diseases and its use in public policy and litigation; no original data
• Exposure: Occupational asbestos exposure in general (mining and milling, manufacturing, and use of end products such as insulation and shipyard work), with discussion of fiber types: amphibole (particularly crocidolite) versus chrysotile
• Main results:
  • The author stated that pleural plaques indicate exposure, not disease, and that the term 'pleural asbestosis' should be abandoned
  • The author wrote that in occupational settings where exposures have been reduced to levels without evidence of asbestosis, excess lung cancer is not likely to be detected
  • The author stated that, once mesothelioma is validly diagnosed, a history of exposure, even if short, is sufficient for a judgment of causation, and that smoking does not affect mesothelioma risk
  • From the studies reviewed, the author described a gradient of lung cancer risk by industry for a given dose: lowest in miners and millers and highest in asbestos textile manufacturing workers
  • The author reported that the reviewed studies showed mesothelioma experience strikingly less favorable in populations exposed to crocidolite than chrysotile, and that the US had not yet accepted this evidence in its standards
  • The author wrote that clinically important chronic airways obstruction is not likely to be primarily the result of asbestos exposure
  • Because study results on gastrointestinal and other cancers were inconsistent, the author considered it prudent to withhold final judgment on the role of asbestos in these cancers
  • The author stated that tort litigation had been shown to be inequitable, costly and markedly unjust in distributing resources
• The authors' conclusion: The author concluded that responsible and informed scientific input into US decision-making processes on these issues was not sufficiently broad and varied

Related studies

• Asbestos: scientific developments and implications for public policy — B.T. Mossman, J. Bignon, et al. (1990)
• Naturally occurring asbestos: a recurring public policy challenge — R.J. Lee, B.R. Strohmeier, et al. (2008)
• Asbestos in New York City public school buildings--public policy: is there a scientific basis? — R. Wilson, A.M. Langer, et al. (1994)
• Asbestos as a public health risk: disease and policy — H. Weill, J.M. Hughes (1986)
• The role of threshold limit values in U.S. air pollution policy — J.C. Robinson, D.G. Paxman (1992)
• Asbestos and cancer: history and public policy — M.P. Weller (1993)

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