Re: "Attitudes and opinions: asbestos and cancer"

Our plain-English summary of Re: "Attitudes and opinions: asbestos and cancer", by M. Greenberg (American Journal of Industrial Medicine, 1992).

The study

• Author: M. Greenberg
• Journal: American Journal of Industrial Medicine
• Published: 1992;22(2):263-5
• Type of article: Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a commentary, not a research study. The author responded to Dr. Enterline's 1991 historical review of changing attitudes and opinions about asbestos and cancer over 1934-65, and disagreed with it on several points. The author's main concern was that the review set out experts' opinions in tables without critically appraising the data behind them, their expertise, or possible bias. For example, the author argued that Merewether's data could not show whether asbestos exposure could cause bronchial cancer without lung fibrosis, and that tables in Beattie and Knox (1961) showed respiratory cancers without lung fibrosis. The author noted that Merewether, a civil servant, needed drafts cleared, and that Knox's freedom to publish was constrained. The author stated that industry experts dismissed Gardner's finding of excess lung cancer in exposed mice, and that Vorwald and colleagues did not mention that experiment. The author warned that less aggressive agents might reach large populations and cause unacceptable numbers of cases that are not readily identified. The author supported collecting adequate statistical data to monitor the health of working populations.

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 (letter) responding to a published historical review by Enterline (1991)
• Who was studied: No study population. The commentary discussed historical published and archival literature on asbestos and cancer, as presented in Enterline's review, whose title in the reference list covers 1934-65.
• Exposure: Asbestos in general (no specific fiber type discussed), including the historical recognition of its health hazards
• Main results:
  • The author's main concern was that the review presented expert opinions in tables without critical appraisal of the observational and experimental data those experts relied on.
  • The author argued that the tables gave equal weight to the various authorities quoted, without regard to their fields of expertise or potential bias.
  • The review listed Merewether in 1949 as holding that asbestos causes lung cancer only after asbestosis. The author argued that Merewether's data set could not show whether bronchial carcinoma could be caused by asbestos exposure in the absence of pulmonary fibrosis.
  • The review presented a 1955 Knox editorial as reaching the same conclusion. The author stated that tables in Beattie and Knox (1961) showed cases of respiratory cancer without pulmonary fibrosis.
  • The author pointed to the working context of the experts quoted. Merewether was a civil servant whose drafts had to be cleared before submission. Knox was a general practitioner acting as Company Medical Officer, whose freedom to publish was also constrained.
  • The author stated that Gardner's observations of excess lung cancer in a group of exposed mice at Saranac were dismissed as irrelevant by industry experts, that Gardner was never permitted to confirm them, and that Vorwald et al. did not mention the experiment.
  • The author argued that the Saranac Laboratory reports, which had been the subject of legal discovery, could now properly be included among published sources.
  • The author cautioned that less aggressive agents than asbestos might reach large populations and cause unacceptable numbers of cases that are not readily identified.
• The authors' conclusion: The author wanted non-specialists not to take the issue as cut and dried. The author supported a policy of collecting adequate statistical data to monitor the health of working populations, as a way to reduce the likelihood of major public health hazards.
• Limitations the authors state:
  • The author stated that, because of limited time, journal space and readers' patience, the commentary covered only a few salient points, and that other caveats about the review exist.

Topics

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

Related studies

• Re: "Changing attitudes and opinions regarding asbestos and cancer 1934-1965" — J.E. Craighead (1992)
• Re: "Attitudes and opinions regarding asbestos and cancer 1934-1965" — D.O. Hourihane (1992)
• Re: "Changing attitudes and opinions: asbestos and cancer 1934-1965" — G.W. Schepers (1992)
• Changing attitudes and opinions regarding asbestos and cancer 1934-1965 — P.E. Enterline (1991)
• Re: Attitudes and opinions regarding asbestos and cancer, 1937-1965 — D.J. Kilpatrick, M. Kottek (1994)
• Re: Attitudes and opinions regarding asbestos and cancer, 1934-1965 — J.M. Harrington (1993)

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