ATS, American Bar Association, and asbestos

Our plain-English summary of ATS, American Bar Association, and asbestos, by J.J. Renn (American Journal of Respiratory and Critical Care Medicine, 2003).

The study

• Author: J.J. Renn
• Journal: American Journal of Respiratory and Critical Care Medicine
• Published: 2003;168(11):1399-400; discussion 1400
• Type of article: Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item was a letter to the editor, not a research study, published with a reply. The letter's author, Joseph J. Renn III, objected to an April 2003 letter about asbestos-related disease that Dr. Thomas Martin, then president of the American Thoracic Society (ATS), sent to the American Bar Association (ABA). The author argued that the Martin letter bypassed the ATS process for official documents and was being used in asbestos litigation as an official ATS opinion. The author objected to Dr. Martin's statement that impairment could be shown by a reduced diffusing capacity (DLCO) without any other physiological abnormality. Citing test variability and confounding factors, the author argued that DLCO alone, without ruling out confounders and without other objective evidence, does not allow impairment to be attributed to asbestosis. The author also wrote that people with only circumscribed pleural thickening (plaques) usually have normal lung function results. In reply, Dr. Martin called the concern unfounded. The reply stated that members of an ATS asbestos committee chaired by Dr. Tee Guidotti helped draft the letter and approved its wording. No new data were presented.

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) with a reply from the person criticized; not a research study
• Main results:
  • The letter's author argued that Dr. Martin's letter to the ABA bypassed the ATS process for developing official documents.
  • The letter's author stated that members of the Bar were presenting the Martin letter as an official opinion of the Society and using it that way in asbestos litigation.
  • The letter's author objected to Dr. Martin's statement that impairment could be shown by a decrease in diffusing capacity (DLCO) without any other physiological abnormality. The author argued that DLCO, without rigorously ruling out confounders and without other objective medical evidence, does not allow an impairment to be attributed to asbestosis alone.
  • The letter's author wrote that a person with only circumscribed pleural thickening (plaques) usually has lung function tests in the normal range and usually has no shortness of breath on exertion.
  • In reply, Dr. Martin stated that members of the ATS asbestos committee helped draft the letter to the ABA and approved the wording of its final draft.
• The authors' conclusion: The letter's author concluded that no one in the Society's leadership should express personal opinions without clearly stating that they are their own. Dr. Martin replied that this concern was unfounded.

Related studies

• Thoracoscopy: a useful tool in the diagnosis of thoracic disease — J.I. Miller, C.R. Hatcher (1978)
• Taking a retrospective look at asbestos-related thoracic disease produces interesting results — E.B. Gottschall (2010)
• Notes from the 2012 Annual Meeting of the Korean Society of Thoracic Radiology: asbestos-related thoracic diseases — J.S. Kim, J.G. Yi, et al. (2013)
• ACR Appropriateness Criteria® Occupational Lung Diseases — Expert Panel on Thoracic Imaging, C.W. Cox, et al. (2020)
• Health effects of tremolite. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, June 1990 — (1990)
• Commentary on pathologic diagnosis of asbestosis and critique of the 2010 Asbestosis Committee of the College of American Pathologists (CAP) and Pulmonary Pathology Society's (PPS) update on the diagnostic criteria for pathologic asbestosis — S.P. Hammar, J.L. Abraham (2015)

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