Letter Concerning: Glynn ME, Keeton KA, Gaffney SH, Sahmel J. Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence Between Urban and Rural Areas in the United States (1973-2012). Risk Analysis 2018;38(3):454-471

Our plain-English summary of Letter Concerning: Glynn ME, Keeton KA, Gaffney SH, Sahmel J. Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence Between Urban and Rural Areas in the United States (1973-2012). Risk Analysis 2018;38(3):454-471, by M.M. Finkelstein (Risk Analysis, 2018).

The study

• Author: M.M. Finkelstein
• Journal: Risk Analysis
• Published: 2018;38(8):1521-1523
• Type of article: Letter, Comment
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor responded to a 2018 study by Glynn and colleagues. That study concluded that its results suggested regional differences in ambient (outdoor air) asbestos levels had not influenced pleural mesothelioma risk in the United States. The author argued that the study did not account for asbestos from body and baby powders, and cited earlier studies by others reporting tremolite and anthophyllite in consumer talcs. The author searched a lung fiber burden database compiled by Dr. Victor Roggli of Duke University. It covered 566 people with pleural mesothelioma, 75 of them women. Talc fibers were found in 332 of 491 men (68%) and 62 of 75 women (83%). Age-adjusted odds ratios comparing women with men were 3.24 (1.65 - 6.35) for talc and 2.97 (1.74 - 5.08) for talc plus tremolite. Using assumed exposure values, the author calculated that a talc user's yearly exposure would be 35 times that from ambient air. The author stated that there was no suitable control group for calculating risk. The author concluded that the Glynn conclusion could not be drawn.

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, including the author's own query of an existing lung fiber burden database and an illustrative exposure calculation
• Who was studied: 566 people with pleural mesothelioma whose lung fiber burden was measured, 75 (13%) of them female, from a database compiled by Dr. Victor Roggli of Duke University (December 1978 through March 2015)
• Exposure: Talc, tremolite and anthophyllite fibers detected in lung tissue, discussed in relation to use of cosmetic talc (body and baby powders), compared with ambient asbestos in outdoor air
• Main results:
  • Talc fibers were found in the lung tissue of more than 65% of both men and women with pleural mesothelioma: 332/491 (68%) of men and 62/75 (83%) of women
  • Talc and tremolite together were found in 205/491 (42%) of men and 46/75 (61%) of women
  • Detection of tremolite was significantly associated with the presence of talc (p less than 0.001). Detection of anthophyllite was also significantly associated with talc (p = 0.002).
  • Age-adjusted odds ratio, women versus men, for talc in lung tissue: 3.24 (95% confidence interval 1.65 - 6.35)
  • Age-adjusted odds ratio, women versus men, for talc and tremolite: 2.97 (95% confidence interval 1.74 - 5.08)
  • Age-adjusted odds ratio, women versus men, for talc and anthophyllite: 1.03 (95% confidence interval 0.51 - 2.06). For talc, tremolite and anthophyllite together it was 1.31 (0.61 - 2.81).
  • Assuming a user was exposed to 1 fiber/cc for 1 minute per day (an exposure level taken from Gordon et al. 2014), the author calculated an annual dose of 0.0007 fiber-years. Compared with a mean ambient air concentration of 0.00002 fibers/cc (from Lee and Van Orden 2008), this gave a ratio of 35.
• The authors' conclusion: The author concluded that it is not possible to conclude, as Glynn and colleagues did, that regional differences in ambient asbestos concentrations have not influenced pleural mesothelioma risk. In the author's view, exposures from talc products, more likely among women than men, greatly exceed exposures from ambient air.
• Limitations the authors state:
  • There was no suitable control group, so the lung fiber data could not be used to calculate risk
  • No data were available on the urban or rural locations of powder users
  • The author could not locate data on historic sales patterns of talc products
  • Disclosure: the author has served as a consultant to plaintiffs' lawyers in asbestos and talc litigation

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• Response to Letter to the Editor Regarding "Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence Between Urban and Rural Areas in the United States (1973-2012)" by Finkelstein — K.A. Keeton, M.E. Glynn, et al. (2018)
• Letter concerning: Burns AM, Barlow CA, Banducci AM, Unice KM, Sahmel J. Potential Airborne Asbestos Exposure and Risk Associated with the Historical Use of Cosmetic Talcum Powder Products — M.M. Finkelstein (2019)
• Historical ambient airborne asbestos concentrations in the United States — M.M. Finkelstein (2016)
• Response to Letter to the Editor from Egilman, Castleman and Bird (2020) concerning Bullock (2020), Perspectives on the knowledge of asbestos disease in the United States - what was known, by whom and when — W.H. Bullock (2020)
• Historical ambient airborne asbestos concentrations in the United States - an analysis of published and unpublished literature (1960s-2000s) — A. Abelmann, M.E. Glynn, et al. (2015)
• Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005 — B. Price, A. Ware (2009)

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