Global use of asbestos - legitimate and illegitimate issues

Our plain-English summary of Global use of asbestos - legitimate and illegitimate issues, by A.L. Frank (Journal of Occupational Medicine and Toxicology, 2020).

The study

• Author: A.L. Frank
• Journal: Journal of Occupational Medicine and Toxicology
• Published: 2020;15:16
• Type of article: Review
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: Exposure to asbestos causes non-malignant and malignant diseases including asbestosis, lung cancer, and mesothelioma. The modern history of such diseases goes back more than a century.

Main Text: While much is known about the ability of asbestos to cause disease, the carcinogenic mechanism is not yet understood. Continuing legitimate scientific questions include such issues as potential differential toxicity and carcinogenicity of different fiber types. Illegitimate issues include the supposed "safe" use of asbestos, and the chrysotile hypothesis.

Conclusion: Asbestos disease issues are highly politicized and vested economic interests perpetuate false issues regarding the hazards of asbestos.

© The Author(s) 2020.

In plain English

This article is a narrative review by a single author, not a new study. It collected no new data. The author described the six asbestos fiber types and noted that chrysotile has made up some 90–95% of all asbestos ever used. The author also cited an estimate by Furuya and colleagues of some 250,000 asbestos-related deaths a year worldwide. The author argued that some scientific questions remain legitimate, such as how toxic amphiboles are compared with chrysotile and what role fiber size plays. The author called other claims illegitimate and said they should be set aside. These were that chrysotile cannot cause mesothelioma, that only fibers above five microns cause disease, that fibers or asbestos bodies must be seen in tissue, that asbestosis must be present to link a cancer to asbestos, that chrysotile can be used 'safely', and an Indian industry claim that Indians do not develop asbestos disease. The author argued that there appears to be no safe threshold of exposure. The author concluded that asbestos disease issues are highly politicized, that vested economic interests perpetuate false issues, and that the world could become asbestos free.

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: narrative review written by a single author; no new data were collected
• Who was studied: no study population; the article discusses asbestos use and asbestos-related disease worldwide
• Exposure: asbestos in general: the amphiboles (amosite, crocidolite, anthophyllite, actinolite, tremolite) and chrysotile, which the author says has made up some 90–95% of all asbestos used worldwide
• Main results:
  • The author cited Furuya and colleagues' estimate of some 250,000 asbestos-related deaths each year worldwide.
  • The author named as legitimate scientific questions the relative toxicity of amphiboles compared with chrysotile, and the role of fiber size.
  • The author argued that claims that chrysotile does not cause some asbestos-related diseases, including mesothelioma, should be completely set aside.
  • The author said the claim that only fibers above five microns cause disease has little real support. The five-micron counting limit in the United States reflected the optical threshold of light microscopy.
  • The author called the 'safe use' of chrysotile asbestos a sham put forward by industry and stated that no country has ever documented safe use.
  • The author called it a fallacy that asbestos fibers or asbestos bodies must be seen in tissue. The author noted that chrysotile forms asbestos bodies less often than amphiboles and disappears from tissue more rapidly.
  • The author called it a fallacy that underlying asbestosis must be present to relate a cancer to asbestos exposure.
  • Against an Indian industry claim that Indians do not develop asbestos-related disease, the author cited an earlier report. That report described 32 mesothelioma cases treated in 1 year at one hospital in India, none officially recorded by the government at that time.
  • The author argued that short exposures reported in the literature support the concept that there appears to be no threshold for asbestos as a carcinogen.
• The authors' conclusion: The author concluded that asbestos disease issues are highly politicized, that vested economic interests perpetuate false issues about asbestos hazards, and that the world could become asbestos free.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Carcinogenic, Chrysotile.

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• Global problems from exposure to asbestos — A.L. Frank (1993)
• New molecular and epidemiological issues in mesothelioma: role of SV40 — M. Carbone, S. Fisher, et al. (1999)
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