Commentary: environmental disease--a preventable epidemic

Our plain-English summary of Commentary: environmental disease--a preventable epidemic, by P.J. Landrigan (American Journal of Public Health, 1992).

The study

• Author: P.J. Landrigan
• Journal: American Journal of Public Health
• Published: 1992;82(7):941-3
• Type of article: Comment
• Cited by: 27 articles, 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. 004137).

Abstract

Toxic environmental diseases are highly preventable causes of morbidity and mortality. Toxic diseases in the work environment cause an estimated 50,000 to 70,000 deaths and 350,000 new cases of illness each year in the United States; the asbestos pandemic will ultimately claim at least 300,000 lives; pediatric lead poisoning is epidemic, and an estimated 3 to 4 million US preschool children have blood lead levels above 10 micrograms/dl and could suffer long-term neuropsychological impairment. Prevention of environmental diseases can be achieved through legislation and regulation that control common-source exposures to chemical toxins. Modification of personal behaviors, such as tobacco and alcohol consumption, complements but does not replace control of toxic environmental exposures.

In plain English

This was a commentary, not a research study. The author responded to an article by Sir Richard Doll in the same journal issue. The author argued that disease caused by toxic chemicals in the environment and workplace is common and highly preventable. On asbestos, the author wrote that its hazards were known in the 1930s, yet billions of tons were used in the United States until the 1980s. The author cited a 1982 projection by Nicholson and colleagues that an estimated 300 000 American workers would have died of asbestos-caused diseases by the year 2000, principally asbestosis, lung cancer and malignant mesothelioma. The author disputed Doll's phrase "the few cases of mesothelioma" as inconsistent with epidemiological data and projections. Other figures also came from cited sources: New York State studies estimating that 50 000 to 70 000 US workers die each year of chronic occupational disease, and a Centers for Disease Control estimate of 3 to 4 million US preschool children with blood lead levels above 10 micrograms per deciliter. The author concluded that these diseases can be prevented by controlling common sources of exposure through legislation and regulation.

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: Commentary (opinion piece) responding to an article by Sir Richard Doll in the same issue; no original data
• Who was studied: No study population. The commentary discusses environmental and occupational disease in the United States and worldwide, drawing on other published estimates.
• Exposure: Toxic chemicals in the environment and workplace in general, including asbestos, lead, workplace toxic substances, ozone and oxides of nitrogen, and pesticide residues
• Main results:
  • The author stated that asbestos hazards were known in the 1930s, yet billions of tons of asbestos were used in the United States from then until the 1980s
  • Citing a projection by Nicholson, Perkel and Selikoff (1982), the author wrote that by the year 2000 an estimated 300 000 American workers will have died of asbestos-caused diseases, principally asbestosis, lung cancer and malignant mesothelioma
  • The author disputed Doll's reference to 'the few cases of mesothelioma' as inconsistent with accumulated epidemiological data and with projections of future mortality
  • The author wrote that, with the overseas spread of asbestos-containing building materials, the asbestos pandemic is extending to the Third World
  • Citing New York State studies, the author reported an estimate that 50 000 to 70 000 US workers die each year of chronic occupational disease from past exposures to toxic substances
  • Citing a Centers for Disease Control estimate, the author reported that 3 to 4 million American preschool children have blood lead levels above 10 micrograms per deciliter
  • The author cited Stallones and Downs (1979), who calculated that toxic factors encountered at work were responsible for at least 20% of all human cancer
• The authors' conclusion: The author concluded that toxic environmental diseases are highly preventable, through legislation, regulation and other communal action to contain common sources of exposure

Topics

Medical terms in this study, explained in our Lexicon: Environmental Exposure.

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