Asbestos--still a carcinogen

Our plain-English summary of Asbestos--still a carcinogen, by P.J. Landrigan (The New England Journal of Medicine, 1998).

The study

• Author: P.J. Landrigan
• Journal: The New England Journal of Medicine
• Published: 1998;338(22):1618-9
• Type of article: Comment, Editorial
• Cited by: 48 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this editorial, the author commented on a study by Camus et al., in the same journal issue, of nonoccupational asbestos exposure among women in the asbestos-mining townships of Quebec. He summarized evidence that all commercial forms of asbestos, including chrysotile, cause lung cancer, mesothelioma and other asbestos-related diseases. He also described how asbestos in buildings is managed in place under the 1986 Asbestos Hazard Emergency Response Act. Camus et al. had found no excess lung cancer mortality among the women. They also found that excess lung cancer deaths were at least 10 times fewer than an EPA risk-assessment model predicted, that the pleural cancer death rate was more than seven times that in nonmining areas (relative risk 7.63), and that asbestosis mortality was substantially increased. The author weighed possible explanations: a threshold or flatter dose-response at low doses, which he called speculative; overestimated past exposure; and exposure to chrysotile only. He judged it most plausible that many airborne particles in mining areas were too large to reach the lungs, so that light-microscopy counts overstated alveolar exposure. He concluded that the population's highly atypical exposure made the study an inappropriate basis for revising US building regulations. He also concluded that the pleural cancer excess confirmed chrysotile as a potent carcinogen, and that claims that chrysotile can be used safely in developing nations are contrary to fact and extremely dangerous.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This editorial reported no new data. It commented on a same-issue study by Camus and colleagues of women in Quebec's asbestos-mining townships, exposed, the editorial says, only to chrysotile asbestos. Per the editorial, Camus et al. found no excess lung cancer deaths among these women, and excess deaths at least a factor of 10 below an Environmental Protection Agency (EPA) model's prediction. They also found a "pleural cancer" death rate (presumably mesothelioma, the author wrote) over seven times that of non-mining areas (relative risk, 7.63), and substantial excess asbestosis deaths. The author called the suggestion of a threshold below which asbestos causes no cancer entirely speculative and not based on data. The author's most plausible explanation for low lung cancer mortality was that many airborne particles were too large to reach the lungs. The author wrote that Camus et al. went beyond their data in asserting, without qualification, that the EPA model overestimates lung cancer risk among people with nonoccupational exposure by at least a factor of 10. The author concluded that chrysotile is still indisputably a human carcinogen.

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: editorial commenting on another study (Camus et al.) published in the same journal issue; no original data
• Who was studied: The author studied no population. The editorial discusses Camus et al.'s study of women in asbestos-mining townships of Quebec, compared with women in 60 other areas of Quebec
• Exposure: Nonoccupational (environmental) exposure to chrysotile asbestos in Quebec mining areas, as described by the editorial
• Main results:
  • As reported in the editorial, Camus et al. found no excess lung cancer mortality among women in the mining communities
  • As reported in the editorial, Camus et al. found that excess lung cancer deaths among these women were smaller by at least a factor of 10 than the number predicted by the EPA model
  • As reported in the editorial, Camus et al. found a death rate from "pleural cancer" (presumably mesothelioma, per the author) more than seven times that in nonmining areas (relative risk, 7.63)
  • As reported in the editorial, Camus et al. found substantial excess mortality due to asbestosis among women in the mining areas
  • The author described the suggestion of a threshold exposure level below which no carcinogenicity is evident as entirely speculative and not based on data
  • The author argued that the most plausible explanation for the low lung cancer mortality was that women in the mining areas were exposed to an asbestos aerosol in which many particles were too large to reach their lungs
  • The author stated that Camus et al. went beyond their data in asserting, without qualification, that the EPA model overestimates lung cancer risk among persons with nonoccupational exposure to asbestos by at least a factor of 10
• The authors' conclusion: The author concluded that chrysotile asbestos is still indisputably a human carcinogen. The author also wrote that the Camus et al. data, from a rural Quebec population with highly atypical exposure, would be an inappropriate basis for revamping U.S. regulatory standards for asbestos in buildings

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Chrysotile, Lung Cancer, Mesothelioma, Relative Risk, Dose-response relationship.

Related studies

• Nonoccupational exposure to chrysotile asbestos and the risk of lung cancer — M. Camus, J. Siemiatycki, et al. (1998)
• Asbestos is still with us: repeat call for a universal ban — Collegium Ramazzini (2010)
• The case for a global ban on asbestos — J. LaDou, B. Castleman, et al. (2010)
• Asbestos is still with us: repeat call for a universal ban — C. Ramazzini (2010)
• Pulmonary mineral fibers after occupational and environmental exposure to asbestos in the Russian chrysotile industry — A. Tossavainen, E. Kovalevsky, et al. (2000)
• Biological indicators of chrysotile exposure — B.W. Case (1994)

Browse more research in The New England Journal of Medicine, or return to medical research.