Asbestos: the turbulent interface between science and policy

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

The study

• Author: D.V. Bates
• Journal: CMAJ
• Published: 1991;144(5):554-6
• Type of article: Editorial
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004412).

In plain English

This 1991 editorial in the Canadian Medical Association Journal was an opinion piece, not a new study, and reported no original data. The author discussed why people reading the same scientific literature on asbestos could reach different policy conclusions, especially on removing asbestos from buildings. Drawing on other published work, the author listed points generally agreed on: low-level exposure carries risks of pleural mesothelioma, pleural plaques and lung cancer, and the mesothelioma risk is believed to be greater for amphiboles than for chrysotile alone. The author then set out questions that could not be precisely answered, such as how many chrysotile fibres pose a significant risk and what exposures occur during work above false ceilings in office buildings. The author argued that the view that a smoker's lung cancer should be linked to asbestos only when asbestosis is present had never been shown to be correct. The author concluded that removal decisions must depend on specific circumstances, and that careful review of the data can lead to defensible but different conclusions.

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 (opinion piece discussing published research; no original study)
• Who was studied: No study population. The author discussed published research and policy on asbestos, mainly in buildings, in Canada and the United States.
• Exposure: Asbestos in buildings (friable and non-friable), with discussion of chrysotile compared with amphiboles
• Main results:
  • The author listed as generally agreed that low-level asbestos exposure carries three main health risks: pleural mesothelioma, pleural plaques and an increased risk of lung cancer. The author added that classic asbestosis is unlikely unless exposure is considerable.
  • Citing Mossman and associates, the author reported air counts of about 0.00059 fibres per mL (fibres longer than 5 micrometres) in buildings with asbestos not in a friable state, and 0.00073 per mL in buildings with some friable asbestos. The author noted that different sampling methods make precise comparison unreliable.
  • The author argued that the position that only lung tissue showing asbestosis should allow lung cancer in a smoker to be attributed to asbestos has never been shown to be correct.
  • In the author's view, during maintenance work above false ceilings in office buildings with sprayed asbestos, a level of 2 fibres/mL might well be exceeded.
• The authors' conclusion: The author concluded that the answer to asbestos removal must depend on specific circumstances, and that careful consideration of the existing data can lead to defensible but different conclusions.

Related studies

• Asbestos: the turbulent interface between science and policy — K. Morgan (1992)
• Asbestos: the turbulent interface between science and policy — J.B. Gee (1992)
• Asbestos: the turbulent interface between science and policy — K. Morgan (1991)
• Asbestos: the turbulent interface between science and policy — K. Morgan (1992)
• Asbestos-associated diseases. Science, public policy, and litigation — H. Weill (1983)
• NIOSH's Respiratory Health Division: 50 years of science and service — K.J. Cummings, D.O. Johns, et al. (2019)

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