Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States

Our plain-English summary of Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States, by R.A. Lemen (Journal of Toxicology and Environmental Health. Part B, Critical Reviews, 2016).

The study

• Author: R.A. Lemen
• Journal: Journal of Toxicology and Environmental Health. Part B, Critical Reviews
• Published: 2016;19(5-6):250-265
• Cited by: 46 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Mesothelioma, a rare tumor, is highly correlated with asbestos exposure. Mesothelioma, similar to all asbestos-related diseases, is dose/intensity dependent to some degree, and studies showed the risk of mesothelioma rises with cumulative exposures. Multiple processes occur in an individual before mesothelioma occurs. The impact of mesothelioma in the United States has been continuous over the last half century, claiming between 2,000 and 3,000 lives each year. Mesothelioma is a preventable tumor that is more frequently reported as associated with asbestos exposure among men than women. However, the rate of asbestos-associated mesothelioma is on the rise among women due to better investigation into their histories of asbestos exposure. It is of interest that investigators detected asbestos-associated cases of mesothelioma in women from nonoccupational sources-that is, bystander, incidental, or take-home exposures. It is postulated that asbestos-associated mesotheliomas, in both men and women, are likely underreported. However, with the implementation of the most recent ICD-10 coding system, the correlation of mesothelioma with asbestos exposure is expected to rise to approximately 80% in the United States. This study examined the demographic and etiological nature of asbestos-related mesothelioma.

In plain English

This article was a single-author narrative review of published research and U.S. data on who develops mesothelioma and how asbestos exposure relates to it; it collected no new data. The author did not cover differences in potency between fiber types. The review cited CDC WONDER death-certificate data: 2,497 U.S. mesothelioma deaths in 2013 (1,911 males, 586 females) and 29,776 during 2003–2013. Cited incidence data (Henley and colleagues, 2013) gave an average annual age-adjusted rate for 2003–2008 of 1.05 cases per 100,000 (95% CI 1.03–1.06), with 1.93 in men and 0.41 in women. Peritoneal tumors made up 18% of women's cases and 7% of men's. A quoted French case-control study reported cases below a cumulative exposure of 5 fiber/ml-years. A cited review by Bignon and colleagues reported odds ratios rising from 1.2 (95% CI 0.8–1.8) in the lowest exposure category to 8.7 (95% CI 4.1–18.5) in the highest. The author concluded that science has not defined an exposure level below which there is no cancer risk, and that risk rises with cumulative exposure. The author disclosed testifying for plaintiffs in asbestos litigation.

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 of published literature and U.S. surveillance data by a single author; no new data were collected
• Who was studied: No study population of its own. The review drew on published studies and U.S. data sources, including SEER cancer incidence data and the CDC WONDER death-certificate database
• Exposure: Asbestos exposure in general, including occupational, bystander, incidental, take-home and environmental exposures, and the role of cumulative, low and multiple exposures. Differences in potency between fiber types were not addressed
• Main results:
  • Cited CDC WONDER death-certificate data recorded an estimated 2,497 mesothelioma deaths in the United States in 2013 (1,911 males, 586 females), and 29,776 mesothelioma deaths during 2003–2013
  • Cited U.S. data (Henley et al. 2013) gave an average annual age-adjusted incidence rate for 2003–2008 of 1.05 (95% CI 1.03–1.06) cases per 100,000, with rates of 1.93 in men and 0.41 in women
  • In the same cited data, men's cases were 85% pleural and 7% peritoneal, and women's cases were 73% pleural and 18% peritoneal
  • A cited French case-control study (Iwatsubo et al. 1998) reported mesothelioma cases below a cumulative exposure of 5 fiber/ml-years and perhaps below 0.5 fiber/ml-years
  • A cited review by Bignon et al. (2002) reported that, with exposure summed over an entire working life, the odds ratio rose from 1.2 (95% CI 0.8–1.8) in the lowest exposure category to 8.7 (95% CI 4.1–18.5) in the highest
  • In a cited London factory study (Newhouse and Berry 1979), among workers with more than 2 years of asbestos exposure, the mesothelioma rate was 360 per 100,000 in women compared with 243 per 100,000 in men
• The authors' conclusion: The author concluded that science has not been able to define an asbestos exposure level below which there is no cancer risk, and that mesothelioma risk rises as cumulative exposure rises
• Limitations the authors state:
  • The review did not address differences in potency between asbestos fiber types
  • The author disclosed having testified on behalf of plaintiffs in asbestos 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: Mesothelioma, Asbestos Exposure, Cumulative Exposure, Take-home Exposure.

Related studies

• Comment on "Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States" by R A Lemen, Journal of Toxicology and Environmental Health, Part B 2016;19:250-265 — C. Magnani, D. Mirabelli, et al. (2017)
• Author's response to: "Letter to the Editor" regarding content of "Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States" by R. A. Lemen, Journal of Toxicology and Environmental Health, Part B 2016; 19: 250-265 — (2017)
• Patterns of care and survival among patients with malignant mesothelioma in the United States — L. Enewold, E. Sharon, et al. (2017)
• Occupational and environmental exposures among Alaska Native and American Indian people living in Alaska and the Southwest United States — D. Redwood, A.P. Lanier, et al. (2012)
• Mesothelioma incidence in 50 states and the District of Columbia, United States, 2003-2008 — S.J. Henley, T.C. Larson, et al. (2013)
• Impact of Hospital Volume on Outcomes of Elective Pneumonectomy in the United States — J. Hadaya, V. Dobaria, et al. (2020)

Browse more research in Journal of Toxicology and Environmental Health. Part B, Critical Reviews, or return to medical research.