Comment on "Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States" by R A Lemen, Journal of Toxicology and Environmental Health, Part B 2016;19:250-265

Our plain-English summary of Comment on "Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States" by R A Lemen, Journal of Toxicology and Environmental Health, Part B 2016;19:250-265, by C. Magnani, D. Mirabelli, B. Terracini (Journal of Toxicology and Environmental Health. Part B, Critical Reviews, 2017).

The study

• Authors: C. Magnani, D. Mirabelli, B. Terracini
• Journal: Journal of Toxicology and Environmental Health. Part B, Critical Reviews
• Published: 2017;20(8):387-388
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor reporting no new data. Three Italian authors commented on R A Lemen's 2016 review of mesothelioma from asbestos exposure in the United States. The authors wrote that Lemen's review confirmed Irving Selikoff's expectation: mesothelioma occurs earlier and more often in people exposed to doses that are high, but not high enough to cause serious competing parenchymal fibrosis (lung scarring). They said a 2015 Italian conference report also confirmed it. They objected that Lemen had called the Italian report "in contrast" with earlier work by Selikoff, Lee and others; they said no such contrast exists. Citing that report, they argued that higher exposure raising disease frequency necessarily shortens the time to disease (latency). Yet average latency is unaffected, and they called average or median latency a useless measure here. They also stressed cumulative exposure: later exposure also increases how often the disease occurs. The authors asked for a correction retracting the reference to a contrast. All three declared serving as expert witnesses for the public prosecutor and/or the judge in Italian criminal trials on asbestos-related cancers.

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 a published review; no new data
• Who was studied: No population was studied. The letter comments on R A Lemen's 2016 review and on the 2015 report of the Third Italian Conference on Mesothelioma.
• Exposure: Asbestos exposure in general, discussed in terms of intensity, duration and cumulative exposure in relation to mesothelioma latency; no specific fiber types are named
• Main results:
  • The letter states that Lemen's review provides evidence confirming Selikoff's expectation that mesothelioma occurs earlier and more frequently in those exposed to doses that are high but insufficient to incite serious competition from parenchymal fibrosis
  • Citing the Italian report, the letter argues that an increase in exposure causing an increase in incidence necessarily entails an acceleration of latency time
  • Citing the Italian report, the letter argues that, contrary to intuition, the average latency is unaffected
  • The letter argues that average or median latency is a useless metric for studying the role of latency in epidemiological studies
  • The letter stresses the role of cumulative exposure, that is, that subsequent exposure also increases the frequency of disease
  • The authors state that the alleged contrast between the Italian report and the earlier observations of Selikoff, Lee and others does not exist
  • Declaration of interest: all three authors have been expert witnesses for the public prosecutor and/or the judge in criminal trials on asbestos-related cancers in Italy
• The authors' conclusion: The authors recommended a correction to Lemen's wording, including retraction of the allusion to a contrast between the Italian report and the weight of the scientific evidence

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, Asbestos Exposure.

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