Idiopathic pulmonary fibrosis and asbestos use

Our plain-English summary of Idiopathic pulmonary fibrosis and asbestos use, by C.M. Barber, D. Fishwick (BMJ, 2019).

The study

• Authors: C.M. Barber, D. Fishwick
• Journal: BMJ
• Published: 2019;364:l1041
• Type of article: Letter, Comment
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, two occupational lung disease specialists responded to a study by Salciccioli and colleagues that noted high mortality from interstitial lung disease in the United Kingdom. They summarised their own earlier work. A UK study had found a significant association between mortality from idiopathic pulmonary fibrosis, the commonest form of interstitial lung disease, and mesothelioma, most deaths from which can be explained by asbestos exposure. Mortality from both conditions had risen steadily since the 1960s, in parallel with asbestos imports. A second study of 31 European countries had found a significant association between mesothelioma and idiopathic pulmonary fibrosis mortality, but not two other common forms of interstitial lung disease. Although limited by the available data, it also found a significant association between asbestos use and idiopathic pulmonary fibrosis mortality for each country. The authors argued that a link between asbestos and idiopathic pulmonary fibrosis was a biologically plausible hypothesis. Their reasons included that asbestos exposure, based on job title, was very common in the UK; that asbestos causes pulmonary fibrosis in humans and animal models; that recent research does not support a threshold of exposure for asbestosis; that diagnosing idiopathic pulmonary fibrosis requires excluding known causes, including asbestosis, which looks similar radiologically; and that diagnosing asbestosis relies on patients' recall of past exposure and a clinician's subjective judgement of a "sufficiently high" lifetime dose. Their final point was that idiopathic pulmonary fibrosis is likely to be diagnosed in people who have worked with asbestos if they are judged not to meet the criteria for asbestosis.

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 is a letter to the BMJ responding to a study by Salciccioli and colleagues that noted high mortality from interstitial lung disease in the United Kingdom. The letter presents no new data and no effect estimates or detailed numerical results. They described their own earlier work. They reported that an earlier UK study found a significant association between deaths from idiopathic pulmonary fibrosis (the commonest interstitial lung disease) and from mesothelioma, with deaths from both rising steadily since the 1960s in parallel with asbestos imports. A second earlier analysis of 31 European countries found a significant association between mesothelioma and idiopathic pulmonary fibrosis deaths, but not two other common interstitial lung diseases. Although limited by available data, it also found a significant association between asbestos use and idiopathic pulmonary fibrosis mortality for each country. The authors concluded that a link between asbestos and idiopathic pulmonary fibrosis is a biologically plausible hypothesis. Among their reasons: asbestosis and idiopathic pulmonary fibrosis look similar on imaging, and diagnosing asbestosis depends on patients recalling past exposure and on a clinician's subjective judgment.

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) responding to a published study. It summarizes the authors' own earlier mortality studies and presents no new data.
• Who was studied: No new population was studied in this letter. The earlier studies it describes looked at deaths in the UK and in 31 European countries.
• Exposure: Asbestos imports and asbestos use at national level (UK and European countries). No fiber types or doses are given.
• Main results:
  • The authors' earlier UK study (not this letter) found a significant association between mortality from idiopathic pulmonary fibrosis and mortality from mesothelioma. The letter gives no effect estimates.
  • In the earlier UK study, deaths from both idiopathic pulmonary fibrosis and mesothelioma had risen steadily since the 1960s, in parallel with asbestos imports.
  • The authors' earlier European analysis found a significant association between mesothelioma and deaths from idiopathic pulmonary fibrosis in 31 European countries. No such association was found for two other common forms of interstitial lung disease.
  • The same European analysis also found a significant association between asbestos use and idiopathic pulmonary fibrosis mortality for each country.
• The authors' conclusion: The authors concluded that a link between asbestos and idiopathic pulmonary fibrosis is a biologically plausible hypothesis. One reason they gave is that idiopathic pulmonary fibrosis is likely to be diagnosed in people who have worked with asbestos if those people are judged not to meet the criteria for asbestosis.
• Limitations the authors state:
  • The authors stated that the country-level analysis of asbestos use and idiopathic pulmonary fibrosis mortality was limited by the available data.

Topics

Medical terms in this study, explained in our Lexicon: Idiopathic, Pulmonary Fibrosis, Occupational Lung Disease, Interstitial Lung Disease, Mesothelioma, Asbestos Exposure.

Related studies

• UK asbestos imports and mortality due to idiopathic pulmonary fibrosis — C.M. Barber, R.E. Wiggans, et al. (2016)
• Estimating Lifetime Asbestos Exposure in Patients With Idiopathic Pulmonary Fibrosis — C.M. Barber, R.E. Wiggans, et al. (2016)
• Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Australia: case-control study — M.J. Abramson, T. Murambadoro, et al. (2020)
• Radiological characteristics, histological features and clinical outcomes of lung cancer patients with coexistent idiopathic pulmonary fibrosis — K.A. Khan, M.P. Kennedy, et al. (2015)
• Loss of ANT1 Increases Fibrosis and Epithelial Cell Senescence in Idiopathic Pulmonary Fibrosis — J. Sui, J.C. Boatz, et al. (2023)
• The Role of Occupational and Environmental Exposures in the Pathogenesis of Idiopathic Pulmonary Fibrosis: A Narrative Literature Review — S.P. Trethewey, G.I. Walters (2018)

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