Asbestos-Related Diseases

Our plain-English summary of Asbestos-Related Diseases, by O. Eliasson (1990).

The study

• Author: O. Eliasson
• Published: New England Journal Of Medicine 322(2):130, January 11 (1990)
• Type of article: Letter
• Our copy: from Johns-Manville's own medical library, J-M no. 000012. The article is still under copyright, so we describe it here rather than post it.

In plain English

This is a letter to the editor, not a research study. The author, Orn Eliasson of the North Parkville Health Center in Baltimore, criticized an article by Mossman and Gee in the Journal. The author wrote that the article subtly presented the asbestos industry's view. That view included doubt that asbestos alone can cause lung cancer, a requirement for evidence of asbestosis before lung cancer can be blamed on asbestos, and claims that chrysotile does not cause mesothelioma and that asbestos does not cause gastrointestinal cancers. Citing other published work, the author stated that many epidemiologic studies had established the link between asbestos and lung cancer, that pleural disease does impair lung function, that chrysotile has been associated with mesothelioma, and that a meta-analysis had linked asbestos exposure to excess gastrointestinal cancer risk. The author reported that an attorney for an asbestos manufacturer handed over a copy of the article three days before the author's own copy arrived. The author concluded that the article was biased against patients' interests and that any conflict of interest should be disclosed.

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 (correspondence) criticizing a published article; not a study
• Exposure: No study exposure. The letter discusses asbestos exposure in general, including chrysotile, in relation to lung cancer, mesothelioma, gastrointestinal cancers and pleural disease.
• Main results:
  • The author wrote that the Mossman and Gee article presented the asbestos industry's view. This included doubt that asbestos alone can cause lung cancer and claims that chrysotile does not cause mesothelioma and that asbestos does not cause gastrointestinal cancers.
  • The author stated, citing other studies, that numerous epidemiologic studies had established the relation between lung cancer and asbestos exposure.
  • The author stated, citing other work, that the asbestos-related lung cancer risk can be estimated even without interstitial fibrosis, and that fibrosis appears to increase the risk further.
  • The author stated, citing other work, that pleural disease does impair function.
  • The author stated, citing a meta-analysis by others, that asbestos exposure is associated with an excess risk of gastrointestinal cancers. The author added that OSHA and the Environmental Protection Agency support this position.
  • The author reported that an attorney representing an asbestos manufacturer gave the author a copy of the article three days before the author's own copy of the Journal arrived.
  • The author wrote that any conflict of interest should be disclosed by Mossman and Gee, as Journal guidelines and the American Thoracic Society require.
• The authors' conclusion: The author concluded that the Mossman and Gee article was biased against the interests of the patient and could be used by the asbestos industry to defend against product-liability lawsuits.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Chrysotile, Mesothelioma, Meta-Analysis, Asbestos Exposure.

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