New standard for assessing asbestos exposure and its consequences?

Our plain-English summary of New standard for assessing asbestos exposure and its consequences?, by L.C. Oliver, L. Welch, A.L. Frank, et al (Occupational and Environmental Medicine, 2016).

The study

• Authors: L.C. Oliver, L. Welch, A.L. Frank, R.A. Lemen, L. Mutti
• Journal: Occupational and Environmental Medicine
• Published: 2016;73(10):709-10
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This is a published comment, not a research study. The authors responded to a commentary by Boffetta and La Vecchia that praised a paper by Gilham and colleagues on pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden. The authors argued that the Gilham paper had methodological and substantive flaws. They noted that Gilham and colleagues reported consent for postmortem sample analysis from 77% of patients with mesothelioma 'and their next of kin'. They said the paper did not report whether work histories came from patients or from relatives at different rates among patients with mesothelioma and among lung cancer controls. They called this key to judging recall bias. They argued that using lung cancer patients as controls created potential selection bias. They questioned the cited lifetime risk estimates for British males born in 1945: 0.86% for asbestos-related mesothelioma and 0.47% for asbestos-related lung cancer. They said the approach ignored chrysotile and short fibres. They also said that occupational history, not fibre burden, is the gold standard for assessing exposure. The authors concluded that these flaws call the study's results and conclusions into question.

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: comment (published correspondence) criticising a published case-control study and a commentary on it; no new data
• Who was studied: No population was studied. The comment discusses the Gilham et al study, which obtained lifetime occupational histories by telephone interview from patients with malignant mesothelioma and from general population and lung cancer controls.
• Exposure: Asbestos exposure assessed by occupational history and lung fibre burden in the criticised study. The comment argues that this approach ignores chrysotile asbestos and short fibres.
• Main results:
  • The authors noted that Gilham et al reported consent for postmortem sample analysis from 77% of patients with mesothelioma 'and their next of kin'.
  • The authors argued that Gilham et al did not report whether the share of work histories given by patients themselves versus next of kin differed between patients with mesothelioma and lung cancer controls. They said this is key to evaluating recall bias.
  • The authors noted that the lifetime risk estimates cited for British males born in 1945 were 0.86% for asbestos-related mesothelioma and 0.47% for asbestos-related lung cancer.
  • The authors argued that these estimates run counter to published estimates that asbestos-related lung cancer risk is at least twice that of malignant mesothelioma.
  • The authors argued that the choice of lung cancer controls created potential for selection bias.
  • The authors argued that occupational history, not fibre burden, is the gold standard for assessing asbestos exposure.
  • The authors argued that a rational basis for regulating asbestos exposure and monitoring exposed workers already exists, and that the paper contributes nothing to prevention.
• The authors' conclusion: The authors concluded that methodological and substantive flaws in the Gilham et al paper call its results and conclusions into question.

Topics

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

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

Related studies

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• Mineral phases and some reexamined characteristics of the International Union Against Cancer standard asbestos samples — N. Kohyama, Y. Shinohara, et al. (1996)
• Multipolar mitosis and aneuploidy after chrysotile treatment: a consequence of abscission failure and cytokinesis regression — B.A. Cortez, P. Rezende-Teixeira, et al. (2016)
• Recent Scientific Evidence Regarding Asbestos Use and Health Consequences of Asbestos Exposure — M. Valenzuela, M. Giraldo, et al. (2016)
• Assessing specific causation of mesothelioma following exposure to chrysotile asbestos-containing brake dust — M.D. Freeman, S.S. Kohles (2012)
• Setting new standards for epidemiological research on mesothelioma — P. Boffetta, C. La Vecchia (2016)

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