Asbestos: the turbulent interface between science and policy

Our plain-English summary of Asbestos: the turbulent interface between science and policy, by K. Morgan (CMAJ, 1991).

The study

• Author: K. Morgan
• Journal: CMAJ
• Published: 1991;145(4):291-3
• Type of article: Comment, Letter
• Read it: PubMed · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M nos. 004414, 004415, 004416).

In plain English

This item is a letter to the editor, not a research study, by Keith Morgan of the Chest Diseases Unit, University Hospital, London, Ontario. It responded to an editorial by David V. Bates in the same journal and reported no new data. The author argued that Bates misrepresented an Ontario royal commission. The letter quoted the commission as writing that, except for asbestos material lying free on building surfaces, the programme for removing asbestos from all schools was not justified by the health risk to students. Citing a survey of US buildings and schools with exposed asbestos, the author noted asbestos fibres in air averaging 0.00073/mL. The author compared this with Ontario's occupational standard of 1 fibre/mL of air for chrysotile. The author also argued that asbestos exposure has been found to raise lung cancer risk only in people with asbestosis. The author further argued that mesothelioma occurs only with a significant and high fibre burden in the lungs. Finally, the author suggested that US asbestos litigation creates an incentive to perpetuate what the author called a myth that asbestos in buildings is a significant hazard.

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) responding to an editorial; no original data
• Who was studied: No study population. The letter comments on an editorial by Dr. David V. Bates (Can Med Assoc J 1991; 144: 554-556).
• Exposure: Asbestos in buildings and schools, and occupational exposure to asbestos including chrysotile, as discussed in the letter
• Main results:
  • The author argued that Bates misrepresented the Ontario royal commission. According to the letter, the commission concluded that, apart from asbestos material lying free on building surfaces, the programme for removing asbestos from all schools was not justified by the health risk to students. It also recommended that encapsulation was generally preferable to removal.
  • Citing a survey of US buildings and schools where exposed asbestos was present, the letter states that asbestos fibres averaged 0.00073/mL of air. It contrasts this with Ontario's occupational standard of 1 fibre/mL of air for chrysotile.
  • The author stated that exposure to asbestos has been found to increase lung cancer risk only in patients with asbestosis. The author cited articles indicating no increased risk of lung cancer or asbestosis if exposure is kept to no more than 1 fibre/mL of air over a 35- to 40-year working life.
  • The author argued that animal studies in which chrysotile was injected into the pleura do not reflect how chrysotile reaches the human pleura. According to the letter, almost any fibre longer than 5 micrometres that persists after intrapleural injection induces mesothelioma, including Fiberglas, man-made mineral fibres, sepiolite and aluminum whiskers.
  • The author stated that mesothelioma only occurs with a significant and high fibre burden in the lungs. The author disputed Bates's inference that 25 of 75 mesothelioma patients in a Massachusetts General Hospital postmortem series with no occupational asbestos history had mesotheliomas caused by low-level environmental exposure.
  • The author argued that if building asbestos caused mesothelioma, the number of women affected should have risen over the past 15 to 20 years, and stated this has been shown not to be true.
  • The author stated that US lawyers in asbestos litigation usually take 40% to 50% of the award and that claimants have been estimated to receive about 20%. The author also stated that a recent Collegium Ramazzini meeting was funded totally or in part by claimants' lawyers.
• The authors' conclusion: The author argued that Bates's editorial contained misleading statements. The author also argued that there is a strong incentive for the myth that asbestos in buildings is a significant hazard to be perpetuated.

Topics

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

Related studies

• Asbestos: the turbulent interface between science and policy — J.B. Gee (1992)
• Asbestos: the turbulent interface between science and policy — K. Morgan (1992)
• Asbestos: the turbulent interface between science and policy — K. Morgan (1992)
• Asbestos: the turbulent interface between science and policy — D.V. Bates (1991)
• Asbestos-associated diseases. Science, public policy, and litigation — H. Weill (1983)
• Asbestos neglect: Why asbestos exposure deserves greater policy attention — T. Douglas, L. Van den Borre (2019)

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