Dose-time response association between occupational asbestos exposure and pleural mesothelioma: authors' response

Our plain-English summary of Dose-time response association between occupational asbestos exposure and pleural mesothelioma: authors' response, by A. Lacourt, E. Leveque, M. Goldberg, et al (Occupational and Environmental Medicine, 2018).

The study

• Authors: A. Lacourt, E. Leveque, M. Goldberg, K. Leffondre
• Journal: Occupational and Environmental Medicine
• Published: 2018;75(2):161-162
• Type of article: Letter, Comment
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, the authors replied to Boffetta et al's comments on their French case-control study of occupational asbestos exposure and pleural mesothelioma. They clarified its design. The 1196 cases came from two sources: 496 from a hospital-based case-control study conducted in 1987–1993 in five French regions, and 700 incident cases identified by the French National Mesothelioma Surveillance Programme in 1998–2006. Together they covered 42 departments across metropolitan France, and the distribution of occupational asbestos exposure was similar in the two case sources. The 2369 controls came from a 2007 representative national sample (751) and from 15 epidemiological studies conducted in 1984–2000 (1618). They were frequency matched to cases on birth year, and analyses were adjusted for age. The authors acknowledged that controls recruited in 2007 may not represent the source population of earlier cases, and that questionnaires differed across studies. They stated that only birth date, index date and job history were used, and that exposure was assessed with one job exposure matrix. To test robustness, they reanalysed a single French population-based case-control study (1998–2005) of 371 cases and 732 matched population controls, using the same matrix and statistical method. Results were similar, with much wider confidence intervals. Exposure intensity received more than 35 years before diagnosis contributed most to risk, and recent intensity had a non-null weight despite a very large confidence interval.

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

In this letter, the authors replied to criticism by Boffetta and colleagues of their earlier French case–control study of occupational asbestos exposure and pleural mesothelioma. They described how that study's 1196 cases were drawn from several French sources. They said they believed the cases came from areas representative of France for asbestos exposure, and that the controls' exposure was very similar to that of the population the cases came from. They acknowledged two problems. Controls recruited in 2007 had to survive without pleural mesothelioma until then and may not be representative. Questionnaires and interview procedures also differed across the source studies. To check their results, they reanalysed a single French population-based case–control study from 1998–2005 with 371 cases and 732 controls, using the same job exposure matrix and statistical method. They reported results similar to the earlier study, but with much larger confidence intervals because the sample was smaller. Exposure intensity received more than 35 years before diagnosis contributed most to risk. Recent intensity had a non-null weight despite a very large confidence interval.

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 (authors' response to a critique), including a reanalysis of a single multicentre French population-based case–control study
• Who was studied: Reanalysis: 371 incident pleural mesothelioma cases identified within the French National Mesothelioma Surveillance Programme in 1998–2002 and interviewed in 1998–2004 (all also in the earlier study), plus 732 population controls randomly selected from electoral lists. Controls were matched to cases on sex, age (within 5 years) and department of residence, were interviewed in 1998–2005, and were all different from the earlier study's controls. The earlier study being defended had 1196 cases and 2369 controls.
• Exposure: Occupational asbestos exposure, assessed from job history with the same job exposure matrix as the earlier study and analysed with a weighted cumulative index of exposure. The figure shows log odds ratios per one fibre per millilitre increase in average annual daily intensity. No fiber type is specified.
• Main results:
  • In the earlier study, the 1196 cases were recruited in 42 different French departments.
  • The authors stated that they believed the earlier study's cases were not selected from areas with a high prevalence of asbestos exposure.
  • The reanalysis gave results similar to the earlier study, with much larger confidence intervals because of the much smaller sample size.
  • In the reanalysis, asbestos exposure intensity received more than 35 years before diagnosis had the strongest contribution to the risk of pleural mesothelioma.
  • In the reanalysis, recent exposure intensity had a non-null weight, despite a very large confidence interval.
• The authors' conclusion: The authors concluded that they believed the distribution of occupational asbestos exposure in their controls was very similar to that of the source population of the cases.
• Limitations the authors state:
  • Controls recruited in 2007 had to survive without pleural mesothelioma until that date and may not be representative of the source population of cases diagnosed earlier.
  • Questionnaires and interview procedures differed across the studies used to assemble cases and controls.
  • The reanalysis had much larger confidence intervals because of its much smaller sample size.

Topics

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

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Pleural Mesothelioma, Case-Control Study, Mesothelioma, confidence interval.

Related studies

• Dose-time-response association between occupational asbestos exposure and pleural mesothelioma — A. Lacourt, E. Lévêque, et al. (2017)
• Response to: 'Dose-time-response association between occupational asbestos exposure and pleural mesothelioma' by Lacourt et al — P. Boffetta, E. Pira, et al. (2018)
• Pleural plaques and asbestosis: dose- and time-response relationships based on HRCT data — C. Paris, S. Thierry, et al. (2009)
• Hierarchical latency models for dose-time-response associations — D.B. Richardson, R.F. MacLehose, et al. (2011)
• Nonlinear dose-time-response functions and health-protective exposure limits for inflammation-mediated diseases — L.A. Cox (2020)
• Authors's response: Pleural mesothelioma and occupational and non-occupational asbestos exposure: a case-control study with quantitative risk assessment — D. Ferrante, D. Mirabelli, et al. (2016)

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