Changing attitudes and opinions regarding asbestos and cancer 1934-1965

Our plain-English summary of Changing attitudes and opinions regarding asbestos and cancer 1934-1965, by P.E. Enterline (American Journal of Industrial Medicine, 1991).

The study

• Author: P.E. Enterline
• Journal: American Journal of Industrial Medicine
• Published: 1991;20(5):685-700
• Type of article: Historical article
• Cited by: 51 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004912).

Abstract

Literature published in the years 1934-1965 was reviewed to determine attitudes and opinions of scientists as to whether asbestos is a cause of cancer. In Germany, the issue was decided in 1943 when the government decreed that lung cancer, when associated with asbestosis (of any degree), was an occupational disease. In the United States, however, there was no consensus on the issue until 1964. Opinions of scientists over a 22 year period are shown and the contributions of various cultural, social, economic and political factors to these opinions are discussed. A lack of experimental and epidemiological evidence played a major role in delaying a consensus. Other important factors included a rejection of science conducted outside of the U.S. during this period, particularly a rejection of German scientific thought during and after WWII, and a rejection of clinical evidence in favor of epidemiological investigations. Individual writers rarely changed their minds on the subject of asbestos as a cause of cancer.

In plain English

This was a historical review of writings published from 1934 to 1965 on whether asbestos causes cancer. The author classified each writing by whether its writer thought asbestos definitely or possibly caused lung cancer, or considered the relationship unproven. In the 104 writings on lung cancer, opinions shifted fairly rapidly toward "definitely causes" between 1934 and 1942, then changed little until 1956. Most individual writers held to their original position. German writers had made up their minds by 1943, when the German government declared lung cancer associated with asbestosis (of any degree) an occupational disease. Textbook writers were among the last to acknowledge a relationship, and editorial writers among the first. Among 61 writings on malignant mesothelioma, few doubted a link with asbestos, and in 1965 none did, though many thought crocidolite the type most likely involved. At a 1964 conference, 20 of 23 papers on asbestos and cancer supported a relationship. The author concluded that political reasons, among others, delayed acceptance, including rejection or lack of knowledge of German science during and after World War II.

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: historical literature review; each published writing was classified by its writer's opinion on whether asbestos causes lung cancer (definitely, possibly, or unproven)
• Who was studied: the open medical literature (articles, editorials, letters, textbooks) on asbestos and cancer published from 1934 through 1965
• Exposure: asbestos in general, and asbestosis, as possible causes of lung cancer and mesothelioma, as discussed by writers; the review also recorded whether writers tied their opinion to the type of asbestos fiber
• Main results:
  • 104 writings on asbestos and lung cancer published through 1965 were found
  • In writings on lung cancer, opinions shifted fairly rapidly from unproven or possible toward definite causation between 1934 and 1942
  • Between 1942 and 1956 little change in opinion on lung cancer occurred
  • Most individual writers kept their original position on whether asbestos causes cancer
  • Textbook writers were among the last to acknowledge a relationship; editorial writers were among the first
  • German writers had decided on the relationship between asbestos and lung cancer by 1943
  • In 1943 the German government declared lung cancer associated with asbestosis (of any degree) an occupational disease
  • 61 writings on malignant mesothelioma and asbestos were found
  • Few writers doubted a relationship between malignant mesothelioma and asbestos exposure; by 1953 the issue seemed fairly well resolved
  • In 1965 no writer expressed doubts about the asbestos and mesothelioma relationship
  • Many writers on mesothelioma believed crocidolite was the type of asbestos most likely to be related to it
  • At the 1964 New York Academy of Sciences conference, of the papers dealing with asbestos and cancer, 20 supported a relationship and 3 expressed no opinion
• The authors' conclusion: The author concluded that the delay in accepting that asbestos causes cancer had several causes. These included scientific, economic and cultural reasons, failures by scientists, and political reasons tied to the war with Germany and the rejection of German science.
• Limitations the authors state:
  • Some writings reporting negative animal experiments were classified as 'unproven' even though their writers may personally have believed in an association

Topics

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

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

Related studies

• Re: "Changing attitudes and opinions regarding asbestos and cancer 1934-1965" — J. Keane (1992)
• Re: "Changing opinions and attitudes regarding asbestos and cancer 1934-1965" — G. Berry (1992)
• Re: "Changing attitudes and opinions regarding asbestos and cancer 1934-1965" — R. Ehrlich, J. Myers (1992)
• Re: "Changing attitudes and opinions regarding asbestos and cancer 1934-1965" — J.E. Craighead (1992)
• Re: "Changing attitudes and opinions: asbestos and cancer 1934-1965" — G.W. Schepers (1992)
• Re: Attitudes and opinions regarding asbestos and cancer, 1937-1965 — D.J. Kilpatrick, M. Kottek (1994)

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