Re: Asbestos exposures in public and commercial buildings

Our plain-English summary of Re: Asbestos exposures in public and commercial buildings, by T.P. Sterling, W.L. Rosenbaum, J.J. Weinkam (American Journal of Industrial Medicine, 1994).

The study

• Authors: T.P. Sterling, W.L. Rosenbaum, J.J. Weinkam
• Journal: American Journal of Industrial Medicine
• Published: 1994;26(6):845-7
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a commentary presenting no new data. The authors replied to Upton and Shaikh, who had criticized their 1993 review of a 1991 Health Effects Institute-Asbestos Research (HEI-AR) report on asbestos in public and commercial buildings. They argued that HEI-AR's key assumption, that asbestos disease risk rises linearly with dose, was unsupported, because most studies had only between two and four data points for small doses. They said a straight line fitted to data from Seidman and colleagues would predict a standardized mortality ratio (SMR) of approximately 2.5 at zero fiber count or zero length of employment. They argued that linear downward extrapolation substantially underestimates low-dose risk. They also said HEI-AR wrongly left family members, especially homemakers, out of its risk estimate and failed to properly acknowledge its industry funding. They conceded that the McDonald et al. data had uncertainties and limitations. Because these data had no more than four semiquantitative scale values, they could be fitted by a straight line, but the authors said any number of other dose-response functions fit them better.

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: commentary (reply to another commentary); no original data
• Exposure: No exposure was studied. The debate concerned how HEI-AR estimated risk from asbestos exposure in public and commercial buildings, and whether family members exposed through household contact should have been included.
• Main results:
  • The authors argued that the dose-response data presented by the HEI-AR Panel could fit almost any shape, because most studies had only between two and four data points for small doses.
  • The authors argued that animal intraperitoneal and intrapleural injection studies support a relationship in which the rate of increase in tumor response decreases rapidly as dose increases.
  • The authors stated that a straight line fitted to the Seidman et al. data would predict an SMR of approximately 2.5 when either the fiber count or length of employment is zero.
  • The authors said the McDonald et al. data fit any number of dose-response functions better than a straight line would.
  • The authors argued that HEI-AR's risk estimate was at fault for leaving out family members, especially homemakers.
  • The authors argued that involuntarily exposed people may not be affected by asbestos in the same way as healthy blue collar workers, pointing to the healthy worker effect.
  • The authors asserted that HEI-AR failed to properly acknowledge its funding sources.
• The authors' conclusion: The authors maintained that linear downward extrapolation of the dose-response substantially underestimates the risk of asbestos disease from low-dose exposure.
• Limitations the authors state:
  • The authors conceded that the McDonald et al. data have uncertainties and limitations. Because these data rest on no more than four semiquantitative scale values, they could also be fitted by a linear function, although the authors held that other functions fit them better.

Topics

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

Related studies

• Asbestos exposures in public and commercial buildings — A.C. Upton, R.A. Shaikh (1995)
• Comments on the Health Effects Institute-Asbestos Research (HEI-AR) report: "Asbestos in public and commercial buildings," with emphasis on risk assessment methods used — T.D. Sterling, C.W. Collett, et al. (1993)
• Extreme airborne asbestos concentrations in a public building — E. Ganor, A. Fischbein, et al. (1992)
• Asbestos in New York City public school buildings--public policy: is there a scientific basis? — R. Wilson, A.M. Langer, et al. (1994)
• Mineral fiber content of lung tissue in patients with environmental exposures: household contacts vs. building occupants — V.L. Roggli, W.E. Longo (1991)
• Asbestos in the air of public buildings: a public health risk? — J. Whysner, V.T. Covello, et al. (1994)

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