Asbestos: Socio-legal and Scientific Controversies and Unsound Science in the Context of the Worldwide Asbestos Tragedy - Lessons to be Learned

Our plain-English summary of Asbestos: Socio-legal and Scientific Controversies and Unsound Science in the Context of the Worldwide Asbestos Tragedy - Lessons to be Learned, by X. Baur (Pneumologie, 2016).

The study

• Author: X. Baur
• Journal: Pneumologie
• Published: 2016;70(6):405-12
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Eight to fifteen per cent of lung cancer cases and nearly all mesothelioma cases are caused by asbestos. Problems in compensation issues ensue from strict legal requirements for eligibility and regulations of the statutory accident insurance institution pertaining to eligibility for occupational disease benefits. The latter include the unscientific requirement for set numbers of asbestos bodies or fibers to be found in lung tissue in order to "prove" disease causation if lung specimen are available. Although the validity of such evidence has been discredited by independent scientists, it is still used as evidence by an influential US pathology department. Frequently, epidemiological evidence regarding causal relationships and exposure histories is also often being ignored by insurance-affiliated medical experts.Similar misleading arguments are currently being used in newly industrialized countries where white asbestos - which is carcinogenic and fibrogenic like other asbestos types - is efficiently promoted as being less harmful. As a result, asbestos use is increasing in some of these countries. Behind the worldwide asbestos tragedy, a well-designed strategy orchestrated by certain transnational or multinational industrial interest groups can be perceived.Beyond the asbestos tragedy their covert plan is motivated by economic interests and discounts the ensuing damage to health and the impact of the diseases they create on public health systems.

© Georg Thieme Verlag KG Stuttgart · New York.

In plain English

This article is a 'Point of View' opinion piece from a Berlin occupational medicine institute. It is not an original research study. The author argued that German compensation practice for asbestos-related occupational disease relies on scientifically unsupported rules, especially the requirement for set numbers of asbestos bodies or fibers in lung tissue before asbestosis or disease causation is accepted. The author stated that chrysotile (white asbestos), the type mostly used in Germany, has a half-life in the lung of about 2 weeks to a few months, while amphibole asbestos has a half-life of decades. The author therefore argued that finding no asbestos bodies or fibers does not rule out asbestosis. The author reported that a PubMed search done with a US pathologist found no peer-reviewed publication containing verified data on the reference values used by German insurance-linked institutions. The author also criticized a US pathologist's views, the 2014 Helsinki criteria and some review authors. The author alleged that some experts had undisclosed industry ties. The author concluded that fiber analyses of the lung should generally not be done.

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: Opinion article (Point of View) discussing compensation practice, diagnostic criteria and industry influence; not an original study
• Who was studied: No study population. The article discusses German occupational disease assessment and compensation practice, insurance-affiliated expert opinions, and practices in the USA and newly industrialized countries
• Exposure: Asbestos in general, with emphasis on the difference between chrysotile (white asbestos) and amphibole asbestos; according to the author, chrysotile was about 94% of the asbestos used in Germany
• Main results:
  • The author reported that in Germany there are more than 9,000 new suspected cases of asbestos-related occupational disease each year, of which about 3,700 are recognized
  • The author stated that the half-life of chrysotile fibers in the lung ranges from about 2 weeks to a few months, depending on the analytical method, whereas amphibole asbestos has a half-life of decades
  • The author argued that the absence of asbestos bodies and asbestos fibers in lung tissue does not preclude asbestosis
  • A PubMed literature search done with US pathologist Jerrold Abraham found no peer-reviewed publication containing verified data on the reference values used by German insurance-linked institutions
  • The author criticized a Duke University pathologist for defending the position that Canadian chrysotile used in brake linings does not cause mesothelioma
  • The author argued that the 2014 Helsinki consensus statement refers only to a 4% risk increase per fiber-year for lung cancer, which is the upper end of the 0.5 to 4.0% range given in the 1997 Helsinki report
  • The author stated that a co-author of a review article had industry funding, including from asbestos interests, that had not been openly declared
  • The author reported that vetoes in May 2015 kept chrysotile out of the Rotterdam Convention, unlike other types of asbestos
• The authors' conclusion: The author concluded that fiber analyses of the lung have limited informative value and lack evidentiary value when negative, and should generally not be done. The author also concluded that the asbestos story is a blueprint for other industries pursuing economic interests at the expense of public health

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Occupational Disease, Asbestos Bodies, Causation, Pathology, Carcinogenic, Fibrogenic.

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