Re: Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma

Our plain-English summary of Re: Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma, by B. Terracini, D. Mirabelli, X. Baur, et al (American Journal of Industrial Medicine, 2016).

The study

• Authors: B. Terracini, D. Mirabelli, X. Baur, P.J. Landrigan, C. Ramazzini
• Journal: American Journal of Industrial Medicine
• Published: 2016;59(12):1180-1182
• Type of article: Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a research study, and it reports no new data. The authors replied to Dr. Boffetta's defense of a 2012 review by La Vecchia and Boffetta that questioned whether stopping asbestos exposure changes later mesothelioma risk. The authors argued that studies in that review showed mesothelioma risk leveling off or falling one or two decades after exposure stopped, while the model the review cited predicts ever-rising risk, so stopping exposure makes a difference. They wrote that a delayed decline is expected because asbestos fibres persist in the body. They also said duration of exposure matters. They cited a UK case-control study (Rake et al., 2009) in which, among workers exposed before age 30, additional exposure after age 30 more than doubled the risk. The authors concluded that time-related factors cannot be judged by considering only some results. Two authors disclosed being prosecution expert witnesses in Italian asbestos trials. The letter stated that Boffetta and La Vecchia had been defense expert witnesses in a 2011 Turin appeal.

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 (reply in a published exchange with Dr. Boffetta); no original data
• Exposure: Asbestos in general (no fiber type specified). The letter concerns the timing of exposure: stopping exposure, recent exposure, and duration of exposure, in relation to mesothelioma risk.
• Main results:
  • The authors argued that studies included in the 2012 La Vecchia and Boffetta review showed a plateau or a decline in mesothelioma risk one or two decades after exposure stopped. The model the review cited (Peto et al., 1982) predicts risk increasing indefinitely. The authors therefore said that continuing and stopping exposure differ.
  • The authors argued that a decline in risk only several years after external exposure stops is expected, because asbestos fibres persist in the body and internal exposure continues.
  • The authors cited the UK case-control study by Rake et al. (2009), an earlier study, not this letter. In that study, among workers exposed before age 30, additional exposures after age 30 more than doubled the risk.
  • The authors stated that the Second and Third Italian consensus conferences on pleural mesothelioma did discuss that the exposure-response model gives more weight to early exposures, along with the model's limitations.
  • The authors stated that in 2011 Boffetta and La Vecchia appeared as defense expert witnesses before the Court of Appeals in Turin, in a case concerning the Montefibre plant in Verbania.
• The authors' conclusion: The authors concluded that the role of time-dependent factors in how mesothelioma develops cannot be assessed by considering only some study results, as they said Boffetta and La Vecchia had done. They also asked readers to weigh the stated history when judging the credibility of Dr. Boffetta's response.

Topics

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

Medical terms in this study, explained in our Lexicon: Causation, Mesothelioma.

Related studies

• Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma — B. Terracini, D. Mirabelli, et al. (2016)
• Comments on the causation of malignant mesothelioma: rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma — C. Ramazzini (2016)
• Comments on the Causation of Malignant Mesothelioma: Rebutting the False Concept That Recent Exposures to Asbestos Do Not Contribute to Causation of Mesothelioma — P.J. Landrigan, Collegium Ramazzini (2016)
• Comments on the causation of malignant mesothelioma: rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma — (2016)
• Re: Terracini et al. Comments on the causation of malignant mesothelioma: Rebutting the false concept that recent exposures to asbestos do not contribute to causation of mesothelioma. Am J Ind Med 2016;59:506-507 — P. Boffetta (2016)
• 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)

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