Quality of evidence must guide risk assessment of asbestos, by Lenters, V; Burdorf, A; Vermeulen, R; Stayner, L; Heederik, D

Our plain-English summary of Quality of evidence must guide risk assessment of asbestos, by Lenters, V; Burdorf, A; Vermeulen, R; Stayner, L; Heederik, D, by D.W. Berman, B.W. Case (The Annals of Occupational Hygiene, 2013).

The study

• Authors: D.W. Berman, B.W. Case
• Journal: The Annals of Occupational Hygiene
• Published: 2013;57(5):667-9
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor, not a new study. Its authors, Berman and Case, were replying to a 2012 response by Lenters and colleagues to an earlier Commentary by Berman and Case. The debate concerned a meta-analysis of lung cancer potency estimates (called KL) from asbestos studies. The letter reported no new data. Instead, it reinterpreted tables from the Lenters analyses. The authors argued that significant trends vanished when the South Carolina study was excluded, but not when the Libby study was excluded. They wrote that, with South Carolina excluded, the best-fitting model was the one that considered fiber type alone. They added that none of the study-quality coefficients in the multivariate models was significant, even at the 0.1 level. They also reported that, without South Carolina, the nine largest of 18 KL values came from amphibole or mixed exposures rather than chrysotile, which they called a significant result (P less than 0.03). The authors concluded that any weak evidence of a study-quality effect was overshadowed by, and confounded with, stronger effects of fiber type.

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 replying to a response by Lenters et al. (2012) to the letter authors' earlier Commentary; no new data, a reinterpretation of published meta-analysis tables
• Who was studied: No study population of its own; the letter discussed the Lenters et al. meta-regression models of lung cancer potency (KL) estimates from published asbestos studies, including the South Carolina and Libby studies
• Exposure: Asbestos fiber type (chrysotile, amphibole, mixed exposures) and, possibly, fiber dimension, compared with study quality as explanations for differences in lung cancer potency estimates
• Main results:
  • According to the letter authors, significant trends disappeared when the South Carolina study was excluded, but not when the Libby study was excluded
  • The authors wrote that, with South Carolina excluded, the best overall fit by Akaike's Information Criterion in Lenters et al.'s Table 3 was the univariate model with fiber type
  • The authors wrote that, in the multivariate models with South Carolina excluded, no study-quality coefficient was significantly different from zero, even at the 0.1 level
  • With South Carolina excluded, the nine largest of 18 KL values were all from amphibole or mixed exposures rather than chrysotile, which the authors called a significant result (P less than 0.03) independent of study quality
• The authors' conclusion: The authors concluded that there may be weak evidence of a study-quality effect, but that it is overshadowed by, and confounded with, much stronger effects of fiber type

Topics

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

Related studies

• Quality of evidence must guide risk assessment of asbestos, by Lenters, V; Burdorf, A; Vermeulen, R; Stayner, L; Heederik, D — J.T. Hodgson (2013)
• Quality of evidence must guide risk assessment of asbestos — V. Lenters, A. Burdorf, et al. (2012)
• Overreliance on a single study: there is no real evidence that applying quality criteria to exposure in asbestos epidemiology affects the estimated risk — D.W. Berman, B.W. Case (2012)
• A ban on asbestos must be based on a comparative risk assessment — M. Camus (2001)
• An air quality data analysis system for interrelating effects, standards, and needed source reductions: Part 13--Applying the EPA Proposed Guidelines for Carcinogen Risk Assessment to a set of asbestos lung cancer mortality data — R.I. Larsen (2003)
• Reply: response to the letter by Drs Berman and Case — D. Heederik, V. Lenters, et al. (2013)

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