Regarding "absence of radiographic asbestosis and the risk of lung cancer among asbestos-cement workers: extended follow-up of a cohort", by Murray Finkelstein, American Journal of Industrial Medicine 2010

Our plain-English summary of Regarding "absence of radiographic asbestosis and the risk of lung cancer among asbestos-cement workers: extended follow-up of a cohort", by Murray Finkelstein, American Journal of Industrial Medicine 2010, by R.M. Ross (American Journal of Industrial Medicine, 2011).

The study

• Author: R.M. Ross
• Journal: American Journal of Industrial Medicine
• Published: 2011;54(6):495-6; author reply 497-8
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This is a letter to the editor, not a new study. The author, a physician at Baylor College of Medicine, commented on a 2010 article by Finkelstein that extended mortality follow-up of workers from an Ontario asbestos-cement factory exposed to chrysotile and crocidolite. As the letter describes it, that article found a raised risk of lung cancer death even among workers without radiographic asbestosis at 20 and 25 years after first exposure. At 20 years, 16 of 156 radiographs showed asbestosis, about 10%. The letter pointed to earlier Finkelstein papers on the same cohort. A 1982 paper reported that 61 of 157 men (39%) in the production group had certified asbestosis by July 1, 1980. A 1984 radiographic study suggested that about 61% of the cohort would be expected to show ILO 1/0 or greater by 32 years. The author argued that the 2010 article judged asbestosis at two arbitrary time points rather than asking whether workers ever developed it. The author concluded that the study does not appear to address lung cancer risk below doses that cause asbestosis. The author disclosed being an expert witness in asbestos litigation.

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 commenting on a published cohort study (Finkelstein 2010); it presents no new data
• Who was studied: No population was studied by the letter's author. The letter discusses the cohort of workers from an Ontario asbestos-cement factory that Finkelstein studied in papers from 1982, 1984, 1997 and 2010.
• Exposure: As described in the letter, the cohort was exposed to asbestos (chrysotile and crocidolite), with an average cumulative exposure of about 100 fiber-years/ml.
• Main results:
  • The letter reports the following figures from the 2010 article. At 20 years from first exposure there were 156 radiographs. Of these, 140 showed no radiographic asbestosis and 16 did, a prevalence of about 10%.
  • The letter cites Finkelstein's 1982 paper on a subgroup of the cohort. By July 1, 1980, 61 of 157 men (39%) in the production group had developed certified asbestosis.
  • The letter cites Finkelstein and Vingilis's 1984 radiographic study of the same cohort. Based on the exposures reported there, about 61% of the cohort would be expected to have small irregular opacities of ILO 1/0 or greater by 32 years from first exposure. The cumulative probability was much lower at 20 and 25 years.
  • The letter's author argued that the 2010 article related mortality to X-ray readings taken at two arbitrary points in time (20 and 25 years after first exposure). In the author's view, it should instead have compared workers who ever showed asbestosis with those who never did.
  • The letter's author disclosed having been an expert witness in asbestos litigation for many years.
• The authors' conclusion: The author concluded that the 2010 study does not appear to address whether asbestos increases lung cancer risk at doses below those at which asbestosis occurs. The author noted that the population had very heavy asbestos exposure and a high prevalence of asbestosis.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Asbestos-Cement.

Related studies

• Absence of radiographic asbestosis and the risk of lung cancer among asbestos-cement workers: Extended follow-up of a cohort — M.M. Finkelstein (2010)
• Radiographic asbestosis is not a prerequisite for asbestos-associated lung cancer in Ontario asbestos-cement workers — M.M. Finkelstein (1997)
• Commentary: Exposure and mortality among chrysotile asbestos workers. American Journal of Industrial Medicine 4:421-433, 1983 — M.M. Finkelstein (1984)
• Response to a letter to the editor by Dr. Murray M. Finkelstein regarding the article by Finley et al. (2012) — B.L. Finley, J.S. Pierce, et al. (2013)
• Lung function predicts survival in a cohort of asbestos cement workers — H. Moshammer, M. Neuberger (2009)
• Survival in cohorts of asbestos cement workers and controls — M. Albin, V. Horstmann, et al. (1996)

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