Reanalysis of non-occupational exposure to asbestos and the risk of pleural mesothelioma

Our plain-English summary of Reanalysis of non-occupational exposure to asbestos and the risk of pleural mesothelioma, by M.M. Finkelstein (Occupational and Environmental Medicine, 2018).

The study

• Author: M.M. Finkelstein
• Journal: Occupational and Environmental Medicine
• Published: 2018;75(6):472-473
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

In this letter, the author reanalysed a published meta-analysis by Marsh and colleagues of non-occupational (household and neighbourhood) asbestos exposure and pleural mesothelioma. The author replaced a 1998 Canadian study with a 2004 Quebec public health report that identified 17 cases among women in the mining region. The author then ran a meta-regression and three sensitivity analyses. In the main model, any exposure compared with no exposure had a relative risk of 6.09 (95% CI 2.14 to 17.3), and the sensitivity analyses gave estimates from 5.71 to 6.15. Neither fibre type (chrysotile, amphibole or mixed) nor household versus neighbourhood exposure was a statistically significant explanatory variable in any analysis. Pooling two chrysotile studies, the relative risk for chrysotile exposure compared with no exposure was 20.0 (12.2 to 32.8). The author concluded that the data showed no evidence of potency differences between chrysotile and the amphiboles for pleural mesothelioma. The author also noted that comparing fibre-type potency is not readily feasible because there are few studies of single fibre types and no quantitative exposure data.

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 presenting a reanalysis (meta-regression with three sensitivity analyses, plus a random effects meta-analysis for chrysotile) of a previously published meta-analysis by Marsh and colleagues, with the 1998 Camus et al study replaced by a 2004 Quebec public health report
• Who was studied: Studies included in Marsh and colleagues' meta-analysis of non-occupational asbestos exposure and pleural mesothelioma, with Quebec data replaced by a 2004 Public Health Institute of Quebec report identifying 17 mesothelioma cases among women in the mining region
• Exposure: Non-occupational asbestos exposure (household/domestic and neighbourhood), classified by fibre type as chrysotile, amphibole or mixed fibres, compared with no exposure
• Main results:
  • Base model: the relative risk of pleural mesothelioma for any non-occupational asbestos exposure compared with no exposure was 6.09 (95% CI 2.14 to 17.3)
  • Sensitivity analyses: the estimates for any exposure compared with no exposure were 6.09 (2.35 to 15.7), 6.15 (2.41 to 15.7) and 5.71 (2.32 to 14.03)
  • Neither fibre type nor household versus neighbourhood exposure was a significant explanatory variable in the base model or in any sensitivity analysis. In the base model, chrysotile versus mixed fibres was 0.61 (0.10 to 3.85), amphibole versus mixed fibres was 2.85 (0.32 to 25.5), and neighbourhood versus household exposure was 1.39 (0.38 to 5.09)
  • In a random effects meta-analysis of two chrysotile studies (Quebec Public Health and Madkour), the relative risk for chrysotile exposure compared with no exposure was 20.0 (12.2 to 32.8)
• The authors' conclusion: The author concluded that the data analysed found no evidence of potency differences between chrysotile and the amphiboles for causing pleural mesothelioma, and that neighbourhood and domestic chrysotile exposures were significantly associated with a substantially elevated risk
• Limitations the authors state:
  • Assessing relative fibre-type potency is not readily feasible because there are few studies of single fibre-type exposures and no quantitative exposure data

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: Non-Occupational Exposure, Pleural Mesothelioma.

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