Asbestos: the turbulent interface between science and policy

Our plain-English summary of Asbestos: the turbulent interface between science and policy, by J.B. Gee (CMAJ, 1992).

The study

• Author: J.B. Gee
• Journal: CMAJ
• Published: 1992;146(1):14-5
• Type of article: Comment, Letter
• Cited by: 1 article, 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 nos. 004410, 004411).

In plain English

This was a letter to the editor, not a research study. The author, a professor of medicine at Yale University School of Medicine, responded to an editorial and a letter by Dr. David V. Bates about asbestos and mesothelioma. The author argued that recent evidence, including work from a McGill group and autopsy studies of asbestos lung burdens, had gone uncited. The author disputed Bates's account of a study by Oliver, Sprince and Greene of 57 school custodians. According to the author, those researchers reported plaques in 12 of the 57 (21%), not one-third. They also noted that their four-view chest x-rays found 1.4 times more plaques than the two views usually used. The author criticized that study for lacking an internal control group. The author also stated that the figure of 15 fibres/mL referred to book dusting, with 4 fibres/mL cited for custodians. That figure came from an older microscopy method that poorly distinguishes asbestos fibres from other fibres. The author concluded that precision matters when decisions concern tiny risks to society.

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 (commentary responding to an editorial and letter by Dr. David V. Bates); no new data
• Who was studied: No population was studied. The letter discussed other studies, chiefly Oliver, Sprince and Greene's study of 57 public school custodians, and a study of three groups of Parisians including university workers in buildings with friable asbestos.
• Exposure: Low-level environmental and building asbestos exposure (school custodians; university workers in buildings with friable asbestos). Chrysotile was mentioned only in the author's reference to arguments by Gibbs.
• Main results:
  • The author stated that Oliver, Sprince and Greene reported plaques in 12 of the 57 custodians (21%), not one-third as Bates had said.
  • The author stated that the custodian study's use of four-view x-rays produced 1.4 times more plaques than standard PA and lateral films would suggest.
  • The author criticized the custodian study for having no internal control population.
  • The author stated, citing court testimony, that an experienced reader rereading the custodians' x-ray films found only one plaque.
  • The author stated that the 15 fibres/mL figure came from book dusting in the Yale Art and Architecture building, and that 4 fibres/mL was the value cited for custodians.
  • The author stated that the Sawyer and Spooner measurements used obsolete phase microscopy, which poorly distinguishes asbestos fibres from other fibrous structures. According to the author, Sawyer now uses electron microscopy and discounts these data.
  • The author described a Paris study whose results distinguished the asbestos-worker group but could not distinguish university workers in buildings with friable asbestos from those in asbestos-free buildings.
• The authors' conclusion: The author concluded that precision is particularly important when decisions concern tiny risks to society, and that human fallibility in responding to risks is made worse when risks are overstated in the medical literature.

Topics

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

Related studies

• Asbestos: the turbulent interface between science and policy — K. Morgan (1992)
• Asbestos: the turbulent interface between science and policy — D.V. Bates (1991)
• Asbestos: the turbulent interface between science and policy — K. Morgan (1991)
• Asbestos: the turbulent interface between science and policy — K. Morgan (1992)
• Asbestos as a public health risk: disease and policy — H. Weill, J.M. Hughes (1986)
• Rural public health policy models to address an evolving environmental asbestos disaster — S.W. Kuntz, C.A. Winters, et al. (2009)

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