Comments on the causation of malignant mesothelioma: rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma

Our plain-English summary of Comments on the causation of malignant mesothelioma: rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma (Industrial Health, 2016).

The study

• Journal: Industrial Health
• Published: 2016;54(1):92-3
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

The Collegium Ramazzini is an international scientific society that examines critical issues in occupational and environmental medicine with a view towards action to prevent disease and promote health. The Collegium derives its name from Bernardino Ramazzini, the father of occupational medicine, a professor of medicine of the Universities of Modena and Padua in the late 1600s and the early 1700s. The Collegium is comprised of 180 physicians and scientists from 35 countries, each of whom is elected to membership. The Collegium is independent of commercial interests.

In plain English

This is a position statement from the Collegium Ramazzini, an international society of physicians and scientists. It is not an original study and presents no new data. It responded to an argument used by the Italian asbestos industry and its expert witnesses in mesothelioma court cases: that when a worker had prolonged or multiple asbestos exposures, only the earliest periods of exposure caused the disease. The statement described a 'hard' trigger-dose version of this argument and a 'soft' version from a review by La Vecchia and Boffetta, which it called biased and highly selective. It cited a 2011 Italian consensus conference working group, whose systematic review concluded that mesothelioma incidence is proportional to cumulative asbestos exposure. That group said an increase in exposure is expected to be more effective early during a prolonged exposure. It set no time limit after which further exposure adds no risk. A 2015 review found that both the intensity and the duration of exposure determine risk. The Collegium concluded that all exposures, early and late, contribute to mesothelioma risk. It rejected the industry claim as false and scientifically unfounded.

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: Position statement (commentary) by a scientific society; no original data, relies on cited reviews
• Who was studied: No study population. The statement addresses mesothelioma cases brought before Italian courts as possible occupational diseases.
• Exposure: Occupational asbestos exposure in general, with particular attention to prolonged or multiple exposures. No fiber types are named.
• Main results:
  • The statement described a 'hard' version of the defendants' thesis: a small trigger exposure induces mesothelioma only in susceptible individuals, and later exposures have no effect. It attributed this version to a 2005 paper by Chiappino.
  • The statement said the 'soft' version, from a review by La Vecchia and Boffetta, has little scientific merit and rests on a biased and selective literature review.
  • The statement cited the 2011 Epidemiology and Public Health Working Group of the Second Italian Consensus Conference on Pleural Mesothelioma. According to the statement, the group's systematic review found that mesothelioma incidence is proportional to cumulative exposure, so later exposures cannot be considered without influence on risk.
  • According to the statement, the Working Group noted that an increase in exposure is expected to be more effective when it occurs early during a prolonged exposure.
  • According to the statement, the Working Group's report set no time limit beyond which further exposure would not raise risk, and did not say such a limit should be set after a few years.
  • The statement cited a 2015 review of published epidemiological studies that analyzed intensity and duration of asbestos exposure separately. That review found both to be determinants of mesothelioma risk.
  • The Collegium rejected the industry claim that only the earliest periods of exposure contribute to mesothelioma induction.
• The authors' conclusion: The Collegium Ramazzini concluded that malignant mesothelioma risk is related to cumulative asbestos exposure, with all exposures, early and late, contributing to the total risk.

Topics

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

Medical terms in this study, explained in our Lexicon: Causation, Mesothelioma, Collegium Ramazzini.

Related studies

• Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma — B. Terracini, D. Mirabelli, et al. (2016)
• Comments on the Causation of Malignant Mesothelioma: Rebutting the False Concept That Recent Exposures to Asbestos Do Not Contribute to Causation of Mesothelioma — P.J. Landrigan, Collegium Ramazzini (2016)
• Comments on the causation of malignant mesothelioma: rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma — C. Ramazzini (2016)
• Re: Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma — B. Terracini, D. Mirabelli, et al. (2016)
• Re: Terracini et al. Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma. Am J Ind Med 2016;59:506-507 — P. Boffetta (2016)
• Comments on a recent case-control study of malignant mesothelioma of the pericardium and the tunica vaginalis testis — G. Mezei, E.T. Chang, et al. (2021)

Browse more research in Industrial Health, or return to medical research.