Correspondence regarding the article "The asbestos fibre burden in human lungs: new insights into the chrysotile debate"

Our plain-English summary of Correspondence regarding the article "The asbestos fibre burden in human lungs: new insights into the chrysotile debate", by L.C. Oliver, F. Belpoggi, L.T. Budnik, et al (The European Respiratory Journal, 2017).

The study

• Authors: L.C. Oliver, F. Belpoggi, L.T. Budnik, D. Egilman, A.L. Frank, D. Mandrioli, C.L. Soskolne, B. Terracini, L. Welch, X. Baur
• Journal: The European Respiratory Journal
• Published: 2017;50(6)
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a research study. The authors criticised a 2017 article by Feder and colleagues. That article had analysed lung asbestos fibre burden in 23955 patients and reported on 12 patients who had two lung tissue samples taken at least 4 years apart. The letter writers objected to the small sample size: only 12 cases, of which only six had electron microscopy. They called the selection threshold of 500 asbestos bodies per gram of wet lung arbitrary, and said exposure was not analysed using detailed occupational histories. They also criticised the microscopy methods, the missing fibre length data, and fibre counts that were similar to or lower than asbestos body counts. They noted that about 94% of asbestos used in Germany was chrysotile. In their view, the small share of chrysotile in two cases sampled 14 and 21 years apart was consistent with low biopersistence of chrysotile. They warned the article could be used in courts against asbestos-harmed workers, and said its authors had not disclosed financial conflicts of interest. The authors concluded that Feder and colleagues' findings were misleading.

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 (correspondence) criticising a published study; no new data
• Who was studied: No people were studied by the letter writers. The letter discusses Feder et al.'s analysis of lung asbestos fibre burden in 23955 patients, including 12 patients with two tissue excisions at least 4 years apart.
• Exposure: Chrysotile and amphibole asbestos fibres retained in lung tissue, and whether chrysotile fibre counts change over time
• Main results:
  • The letter writers argued that the sample was too small: only 12 of the 23955 cases (0.05%) were analysed twice, and only six of these had electron microscopy.
  • They called Feder et al.'s selection criterion of 500 asbestos bodies per gram of wet lung discretionary and arbitrary.
  • They argued that electron microscopy of autopsy specimens alone could not show how chrysotile fibre numbers change over time.
  • They noted that Feder et al. gave no information on fibre length.
  • In the six cases analysed with electron microscopy, they said the reported fibre counts were similar to or lower than asbestos body counts, which they described as contradicting the literature.
  • They stated that about 94% of asbestos used in Germany was chrysotile. They argued that the relative paucity of chrysotile in cases 1 and 2, sampled 14 and 21 years apart, was consistent with low biopersistence of chrysotile.
  • They warned that Feder et al.'s claim that chrysotile is biopersistent could be used in courts to deny justice to asbestos-harmed victims.
  • They stated that Feder et al. failed to disclose significant financial conflicting interests.
• The authors' conclusion: The letter writers concluded that Feder et al. provided misleading findings that failed to refute the generally accepted tenet that chrysotile fibres are not biopersistent in the human lung.

Topics

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

Medical terms in this study, explained in our Lexicon: Chrysotile.

Related studies

• Correspondence regarding the article "The asbestos fibre burden in human lungs: new insights into the chrysotile debate" — I.S. Feder, I. Tischoff, et al. (2017)
• Correspondence regarding the article "The asbestos fibre burden in human lungs: new insights into the chrysotile debate" — P. Sartorelli (2017)
• The asbestos fibre burden in human lungs: new insights into the chrysotile debate — I.S. Feder, I. Tischoff, et al. (2017)
• Misleading "New Insights into the Chrysotile Debate" — H.J. Woitowitz, X. Baur (2018)
• Effects of Chrysotile Exposure in Human Bronchial Epithelial Cells: Insights into the Pathogenic Mechanisms of Asbestos-Related Diseases — G.R. Gulino, M. Polimeni, et al. (2016)
• Commentary regarding the article by Fischer et al.: Fibre years, pulmonary asbestos burden and asbestosis. Int. J. Hyg. Environ. Health 205, 245-248 (2002) — D.W. Henderson (2003)

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