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, by P.J. Landrigan, Collegium Ramazzini (Annals of Global Health, 2016).

The study

• Authors: P.J. Landrigan, Collegium Ramazzini
• Journal: Annals of Global Health
• Published: 2016;82(1):214-6
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: European asbestos manufacturers and their expert witnesses have advanced the claim that recent exposures to asbestos are not of significance in the causation of malignant mesothelioma. They argue that in cases of prolonged exposure to asbestos only the earliest exposures contribute to mesothelioma induction.

Methods: The Collegium Ramazzini examined this claim and compared it with the findings of the Epidemiology and Public Health Working Group of the Second Italian Consensus Conference on Pleural Mesothelioma. This independent Working Group noted that earlier exposures are more effective in inducing mesothelioma, but that subsequent exposures also contribute and cannot be excluded. They found convincing evidence to support the conclusion that mesothelioma incidence is proportional to cumulative asbestos exposure.

Conclusion: The Collegium Ramazzini concludes that risk of malignant mesothelioma is proportional to cumulative exposure to asbestos in which all exposures - early as well as late - contribute to the totality of risk. The Collegium Ramazzini rejects as false and scientifically unfounded the notion that only the earliest exposures to asbestos contribute to mesothelioma induction.

Copyright © 2016 The Author. Published by Elsevier Inc. All rights reserved.

In plain English

This is a short commentary written by the author on behalf of the Collegium Ramazzini. It did not report new research data. It responded to a claim by Italian asbestos industry defendants and their expert witnesses in mesothelioma court cases. That claim holds that when exposure is prolonged, only the earliest exposures contribute to causing mesothelioma. The commentary described the findings of others, chiefly a 2011 independent systematic review by the Epidemiology and Public Health Working Group of the Second Italian Consensus Conference on Pleural Mesothelioma. That Working Group found convincing evidence that mesothelioma incidence is proportional to cumulative asbestos exposure. It noted that earlier exposures are more effective, but that later exposures also contribute and cannot be excluded. Its report set no time limit beyond which further exposure adds no risk. The commentary also cited a 2015 review that found both the intensity and the duration of exposure determine mesothelioma risk. The Collegium concluded that all exposures, early as well as late, contribute to the total risk. It rejected the opposing 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: Commentary (position statement on behalf of the Collegium Ramazzini); no original data
• Who was studied: No study population. The commentary addresses a claim made by European (Italian) asbestos manufacturers and their expert witnesses in mesothelioma court cases.
• Exposure: Asbestos exposure in general, with no fiber types specified. The focus is on the timing of exposure: earliest versus recent or later exposures during prolonged exposure.
• Main results:
  • The 2011 independent systematic review by the Working Group of the Second Italian Consensus Conference on Pleural Mesothelioma (not this article) found convincing evidence that mesothelioma incidence is proportional to cumulative asbestos exposure.
  • The same Working Group noted that earlier exposures are more effective in inducing mesothelioma, but that subsequent exposures also contribute and cannot be excluded.
  • According to the commentary, the Working Group's report did not mention any time limit beyond which further increases in exposure would cause no further increase in mesothelioma risk.
  • A 2015 review cited by the commentary, which analyzed the intensity and the duration of asbestos exposure separately, found that both are determinants of mesothelioma risk.
  • The commentary stated that the La Vecchia and Boffetta review supporting the defendants' thesis was based on a biased and highly selective review of the literature.
• The authors' conclusion: The Collegium Ramazzini concluded that the risk of malignant mesothelioma is proportional to cumulative asbestos exposure, with all exposures, early as well as late, contributing to total risk. It rejected as false and scientifically unfounded the notion that only the earliest exposures contribute.

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, Expert Witness, Collegium Ramazzini, Epidemiology, Pleural Mesothelioma, Asbestos Exposure, Cumulative Exposure.

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 — (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)
• 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: 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)

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