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 I.S. Feder, I. Tischoff, A. Theile, et al (The European Respiratory Journal, 2017).

The study

• Authors: I.S. Feder, I. Tischoff, A. Theile, I. Schmitz, R. Merget, A. Tannapfel
• Journal: The European Respiratory Journal
• Published: 2017;50(6)
• Type of article: Letter, Comment
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this reply, the authors of a 2017 European Respiratory Journal study of asbestos fibre burden in human lungs responded to correspondence from X. Baur and colleagues criticising that study. They stated that the debate about chrysotile causing malignant and non-malignant pleural and lung diseases was over, but that the question of chrysotile biopersistence in workers' lungs remained open. They reported that their study showed high biopersistence of chrysotile fibres in human lungs, in contrast to animal data, and said this was a strong argument for a global ban of asbestos. On concerns about compensation claims, they stated that under the Helsinki criteria a histological diagnosis of asbestosis requires fibrosis plus asbestos bodies or uncoated asbestos fibres. They said they saw no disadvantage for patients with true asbestosis. They described their work as a longitudinal observational study largely unaffected by sample size. They cited an editorial by Nemery et al. reporting seven patients with repeated bronchoalveolar lavage, and a study by Sartorelli et al. of 22 patients, as giving similar results. They stated that the lower chrysotile fraction in lungs than at workplaces reflects lower deposition and accumulation rather than long-term clearance. They maintained that conflicts of interest had been properly disclosed. They concluded that asbestos fibres, including chrysotile, are highly biopersistent in human lungs.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This item is a letter, not a new study. It is the authors' reply to criticism of their 2017 article on the asbestos fibre burden in human lungs. The authors wrote that the debate about chrysotile causing malignant and non-malignant pleural and lung diseases is over, but that the question of chrysotile's biopersistence in workers' lungs remains open. They restated that their article showed high biopersistence of chrysotile fibres in human lungs, in contrast to animal data. They argued that the low number of subjects was not a real weakness of their longitudinal study. They also argued that the lower share of chrysotile in lungs than at workplaces allows no statement about biopersistence. Responding to concerns that their findings may influence compensation claims, they wrote that they did not see disadvantages for patients with true asbestosis, and that conflicts of interest were disclosed properly. The authors concluded that they had shown for the first time that asbestos fibres including chrysotile are highly biopersistent in human lungs. They noted that journal space limits prevented a point-by-point reply.

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: Correspondence (the authors' reply to a letter criticising their earlier article); no new data
• Who was studied: No new population. The letter discusses the authors' earlier study of longitudinal intra-individual data from human lung tissue; the reply itself gives no patient numbers.
• Exposure: Asbestos fibres retained in human lungs, including chrysotile and amphibole fibres
• Main results:
  • The authors stated that the debate about chrysotile causing malignant and non-malignant pleural and lung diseases is over, and that the question of chrysotile biopersistence in workers' lungs is still open.
  • The authors stated that their article showed high biopersistence of chrysotile fibres in human lungs, in contrast to animal data.
  • The authors argued that the low number of subjects was not a real weakness, because theirs was a longitudinal observational study.
  • The authors stated that the lower chrysotile fraction in human lungs compared with workplaces allows no statement about chrysotile biopersistence.
  • The authors suggested that the failure of chrysotile to accumulate in human lungs reflects events early after exposure rather than long-term clearance.
  • Responding to concerns about compensation claims, the authors stated that they did not see disadvantages for patients with true asbestosis.
  • The authors stated that putative conflicts of interest had been disclosed properly. They acknowledged that their institute receives third-party funds from the German Social Accident Insurance (DGUV) for research of the German Mesothelioma Register.
• The authors' conclusion: The authors concluded that they had shown for the first time that asbestos fibres including chrysotile are highly biopersistent in human lungs.
• Limitations the authors state:
  • The authors stated that they could not reply point by point to all criticisms because of the journal's space limit.

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, biopersistence, Helsinki Criteria, Fibrosis, Asbestos Bodies, Bronchoalveolar Lavage (BAL), Deposition.

Related studies

• Correspondence regarding the article "The asbestos fibre burden in human lungs: new insights into the chrysotile debate" — L.C. Oliver, F. Belpoggi, 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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