Epidemiology of asbestos-related diseases

Our plain-English summary of Epidemiology of asbestos-related diseases, by R.A. Lemen, J.M. Dement, J.K. Wagoner (Environmental Health Perspectives, 1980).

The study

• Authors: R.A. Lemen, J.M. Dement, J.K. Wagoner
• Journal: Environmental Health Perspectives
• Published: 1980;34:1-11
• Type of article: Review
• Cited by: 37 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000828).

Abstract

This paper is intended to give the reader an overview of the epidemiology of asbestos-related diseases and is restricted to primarily occupational exposure studies. However, some mention of nonoccupational exposures are made because of their direct relationship to a worker or to a secondary occupational source. Over 100 epidemiological studies are reviewed, dating back to the first case of asbestos-associated disease reported by Montague Murray in 1906. The studies are divided by specific fiber type and by specific disease outcomes and the interaction of asbestos and cigarette smoking is discussed in great detail.

In plain English

This 1980 paper was a review, not a new study. The authors reviewed over 100 epidemiological studies, going back to the first asbestosis case reported by Montague Murray in 1906. Most concerned people exposed at work, with some attention to household and neighborhood exposure. They grouped the studies by fiber type (mixed fibers, crocidolite, chrysotile, amosite, anthophyllite, and amphibole fibers in the cummingtonite-grunerite ore series) and by disease, including asbestosis, lung cancer, pleural and peritoneal mesothelioma and other cancers. They also discussed cigarette smoking. Among the studies described, Hammond et al. reported that asbestos insulation workers, whether smokers or nonsmokers, each had five times the lung cancer death risk of controls with the same smoking status. Anderson et al. reported radiographic abnormalities in 35.9 percent of household contacts of former amosite plant workers, compared with 4.6 percent of a control group. The authors noted that no study had shown more pleural or peritoneal mesothelioma in smokers than in nonsmokers. They concluded that all commercial forms of asbestos had been shown to cause cancer in humans, and that household contact with asbestos workers carried a risk of both nonmalignant and cancerous effects.

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: Review (narrative overview) of published epidemiological studies of asbestos-related disease
• Who was studied: Studies mainly of occupationally exposed groups (asbestos manufacturing, insulation, shipyard, mining and milling workers, among others), with some studies of household contacts and people living near asbestos sources; studies dated from the 1906 Montague Murray case report onward
• Exposure: Asbestos exposure grouped by fiber type: mixed fibers, crocidolite, chrysotile, amosite, anthophyllite, and amphibole fibers in the cummingtonite-grunerite ore series. Interaction with cigarette smoking was also covered.
• Main results:
  • In the Hammond et al. study reviewed, nonsmoking asbestos insulation workers had five times the lung cancer death risk of nonsmoking controls, and smoking asbestos workers had five times the risk of smoking controls (12,051 asbestos insulation workers compared with 73,763 men from the American Cancer Society's prospective study)
  • The authors stated that none of the epidemiologic studies had shown an increase of pleural or peritoneal mesothelioma among smokers compared with nonsmokers
  • In the Anderson et al. study reviewed, 35.9 percent of household contacts of former employees of an amosite insulation plant in Paterson, New Jersey had radiographic abnormalities, compared with 4.6 percent of a control group
  • In the Wagoner et al. study reviewed, of a plant using predominately chrysotile in textile, friction and packaging products, workers had statistically significant standard mortality ratios of 122 for all malignant neoplasms and 244 for malignant neoplasms of the respiratory system
  • In the McDonald and McDonald study reviewed, of 199 workers exposed to crocidolite during gas mask manufacture in Canada (1939 to 1942), 56 deaths had occurred by 1975: four (7%) were from mesothelioma and eight (14%) from lung cancer
  • In the Seidman et al. study reviewed, of 820 men first employed 1941 to 1945 in amosite insulation production, 83 lung cancers were observed on death certificates versus 23.1 expected. Among the 61 men employed less than 1 month, three were observed versus 1.3 expected.
  • A cited estimate (reference 108) projected that of 4 million workers heavily exposed to asbestos, at least 1.6 million (35-44%) would die of asbestos-related cancers, compared with about 0.35 million (8-9%) expected to die of cancer without asbestos exposure
• The authors' conclusion: The authors concluded that, besides nonmalignant effects, all commercial forms of asbestos had been shown to be carcinogenic in humans. They added that household contact with asbestos workers had demonstrated a risk of nonmalignant and carcinogenic effects.
• Limitations the authors state:
  • The authors noted that historical records of cigarette smoking are lacking for most retrospective cohort studies of asbestos workers (a limitation of the reviewed evidence)
  • The authors noted that three studies showed poor agreement between the certified cause of death and the tissue diagnosis of mesothelioma, so mesothelioma counts from death certificates may be unreliable

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology, Occupational Exposure.

Related studies

• Diagnosis and initial management of nonmalignant diseases related to asbestos — A.J. Ghio, V.L. Roggli (2005)
• Asbestos related disease in Barrow-in-Furness — J.R. Edge (1976)
• Work-related respiratory disease in the United Kingdom, 1989-1992: report on the SWORD project — S.K. Meredith, J.C. McDonald (1994)
• Occupational and work-related respiratory disease attributed to cleaning products — M. Carder, M.J. Seed, et al. (2019)
• SWORD '93. Surveillance of work-related and occupational respiratory disease in the UK — B.A. Sallie, D.J. Ross, et al. (1994)
• SWORD '97: surveillance of work-related and occupational respiratory disease in the UK — D.J. Ross, H.L. Keynes, et al. (1998)

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