Changing trends in US mesothelioma incidence

Our plain-English summary of Changing trends in US mesothelioma incidence, by M. Greenberg (Occupational and Environmental Medicine, 2005).

The study

• Author: M. Greenberg
• Journal: Occupational and Environmental Medicine
• Published: 2005;62(2):134
• Type of article: Comment, Letter
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Summary of the article

In this letter, the author responded to a paper by Weill, Hughes and Churg (Occup Environ Med 2004;61:438–41). That paper had associated a decline in US mesothelioma incidence with an earlier decline in amphibole asbestos use. The author argued that public health policy makers should read the paper with great circumspection and should not conclude that the asbestos problem had been largely solved. He stated that expert opinion published by WHO, ILO and IARC was less sanguine about chrysotile, and that its safe use was increasingly acknowledged not to be reasonably practicable. He cautioned against reading the authors' statement that asbestosis and asbestos-attributable lung cancer are linked as implying that pulmonary fibrosis is a necessary stage in cancer development. He cited an expert consensus that this sequence was not necessary, and experimental and tissue culture evidence that all asbestos species induce malignant change apart from fibrosis. He criticised the chain of reviews relied on for the 'biological plausibility' of chrysotile being less potent than amphiboles. He questioned the authors' explanation of lower US than UK mesothelioma rates, citing US amphibole imports for 1964 and 1965 (amosite 23 932 and 17 042 tonnes; crocidolite 21 163 and 17 042 tonnes) and UK 1965 imports (amosite 22 582, crocidolite 3425 tonnes). He argued that national import tonnages and whole-population denominators were poor surrogates for exposure of at-risk groups. Noting that the USA exposed its workforce to some 25 million tonnes of asbestos between 1900 and 2002, he concluded that service workers, construction workers and bystanders would remain at risk and that policy makers should maintain a watching brief for many years.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This is a letter to the editor, not a research study. The author responded to a 2004 paper by Weill, Hughes and Churg which, as the letter describes it, linked falling US mesothelioma incidence to an earlier decline in amphibole use. The author argued it would be premature to conclude from that paper that the asbestos problem is largely solved. The letter noted that WHO, ILO and IARC expert opinion is less reassuring about chrysotile. The author disputed any implication that asbestosis is a necessary step toward asbestos-related lung cancer, citing experimental evidence, in whole animals and in tracheal explants, that all asbestos species are equally potent inducers of bronchial epithelial metaplasia and malignant change. The author argued that national import tonnages are poor stand-ins for the exposures of the people at risk. The letter stated that the USA exposed its workforce to some 25 million tonnes of asbestos (all species) between 1900 and 2002. The author argued that service workers, construction workers and bystanders will remain at risk, and concluded that policy makers need to keep watch for many years.

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 another published paper; no original data
• Who was studied: No population studied; the letter comments on a 2004 paper by Weill, Hughes and Churg on US mesothelioma incidence trends
• Exposure: Asbestos in general, with discussion of amphiboles (amosite and crocidolite) compared with chrysotile
• Main results:
  • The author argued it would be premature to conclude from the Weill paper that the asbestos problem has been largely solved because of the decline in US mesothelioma incidence
  • The author stated that expert opinion published by WHO, ILO and IARC is less reassuring about chrysotile, and that its safe use is increasingly acknowledged as not reasonably practicable
  • The author stated that expert consensus was reached that asbestosis (interstitial pulmonary fibrosis) is not a necessary step before asbestos-related bronchial carcinoma
  • The author cited experimental evidence, in whole animals and in tracheal explants, that all species of asbestos are equally potent inducers of bronchial epithelial metaplasia and malignant change
  • The author cited official figures for US amphibole imports in tonnes for 1964 and 1965 respectively: amosite 23 932 and 17 042; crocidolite 21 163 and 17 042. UK imports in 1965 were given as 22 582 tonnes of amosite and 3425 of crocidolite
  • The author argued that national import tonnages are poor surrogates for the exposures of the population subsets at risk
  • Citing official statistics, the author stated that the USA exposed its workforce to some 25 million tonnes of asbestos (all species) between 1900 and 2002
  • The author argued that service workers, construction workers and bystanders will continue to be at risk
• The authors' conclusion: The author concluded that public health policy makers need to maintain a watching brief for many years yet

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Amphibole Asbestos, IARC, Chrysotile, Lung Cancer, Pulmonary Fibrosis, Fibrosis, Biological Plausibility.

Related studies

• Changing trends in US mesothelioma incidence — H. Weill, J.M. Hughes, et al. (2004)
• Incidence and survival trends for malignant pleural and peritoneal mesothelioma, Australia, 1982-2009 — M.J. Soeberg, J. Leigh, et al. (2016)
• Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005 — B. Price, A. Ware (2009)
• Recent trends in mesothelioma incidence in the United States — R. Spirtas, G.W. Beebe, et al. (1986)
• Response to Letter to the Editor Regarding "Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence Between Urban and Rural Areas in the United States (1973-2012)" by Finkelstein — K.A. Keeton, M.E. Glynn, et al. (2018)
• Letter Concerning: Glynn ME, Keeton KA, Gaffney SH, Sahmel J. Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence Between Urban and Rural Areas in the United States (1973-2012). Risk Analysis 2018;38(3):454-471 — M.M. Finkelstein (2018)

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