Asbestos workers and lung cancer

Our plain-English summary of Asbestos workers and lung cancer, by M.M. Kristein (American Journal of Public Health, 1981).

The study

• Author: M.M. Kristein
• Journal: American Journal of Public Health
• Published: 1981;71(12):1409
• Type of article: Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001809).

In plain English

This item was a letter to the editor reporting no new data. The author called a statement in an earlier letter by Dr. David K. Parkinson a very misleading error: that of asbestos workers seeing a doctor with lung cancer, four out of five should be attributed to asbestos exposure irrespective of smoking habits. The author cited Table 13 of a June 1981 OTA report. From it, the author stated that of 58 asbestos workers presenting with lung cancer, only five would be non-smokers. On that basis, the author argued that more than 90 per cent of them owed their illness to the synergistic effects of smoking and occupational exposure. The author added that among non-asbestos workers with lung cancer, one out of 12 would be non-smokers. In a printed reply, Dr. Parkinson accepted the five-in-58 figure. The reply argued that, if a significant exposure to asbestos had occurred, a relative risk of 5 to 1 for asbestos workers versus other workers meant roughly 40 of the 53 smokers' cancers must be ascribed to asbestos.

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 commenting on an earlier letter; no original study
• Who was studied: No population was studied. The letter discusses hypothetical groups of asbestos workers, and of non-asbestos workers, presenting to a doctor with lung cancer, using figures from a June 1981 OTA report.
• Exposure: Occupational asbestos exposure combined with smoking. No fiber types, products, jobs or doses are named.
• Main results:
  • The author stated that of 58 asbestos workers presenting with lung cancer, only five would be non-smokers (figure attributed to Table 13, p. 71 of the OTA report).
  • The author argued that, therefore, more than 90 per cent of asbestos workers with lung cancer owed their illness to the synergistic effects of smoking and occupational exposure.
  • The author stated that among non-asbestos workers presenting with lung cancer, one out of 12 would be non-smokers.
  • In the printed reply, Dr. Parkinson made the attribution argument conditional on a significant exposure to asbestos having occurred.
  • In the printed reply, Dr. Parkinson accepted the figure of five non-smokers among 58, but argued that roughly 40 of the 53 smoking workers must have had lung cancer as a result of asbestos exposure, based on a relative risk of 5:1 for asbestos workers versus other workers.
• The authors' conclusion: The author concluded that the figures show the reverse of the impression given in Dr. Parkinson's earlier letter.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer.

Related studies

• Combined effect of asbestos exposure and smoking on mortality from lung cancer in factory workers — G. Berry, M.L. Newhouse, et al. (1972)
• Combined effect of asbestos and smoking on mortality from lung cancer and mesothelioma in factory workers — G. Berry, M.L. Newhouse, et al. (1985)
• Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking — R. Lilis, I.J. Selikoff, et al. (1986)
• The effect of smoking on the risk of lung cancer mortality for asbestos workers in Great Britain (1971-2005) — G. Frost, A. Darnton, et al. (2011)
• Lung function and exercise performance in smoking and nonsmoking asbestos-exposed workers — D.Y. Sue, A. Oren, et al. (1985)
• Smoking and roentgenographic opacities in US Navy asbestos workers — A.M. Ducatman, B.F. Withers, et al. (1990)

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