Residential proximity to naturally occurring asbestos and mesothelioma risks: further consideration of exposure misclassification and occupational confounding

Our plain-English summary of Residential proximity to naturally occurring asbestos and mesothelioma risks: further consideration of exposure misclassification and occupational confounding, by M.A. Kelsh, D.W. Berman, A.M. Langer (American Journal of Respiratory and Critical Care Medicine, 2006).

The study

• Authors: M.A. Kelsh, D.W. Berman, A.M. Langer
• Journal: American Journal of Respiratory and Critical Care Medicine
• Published: 2006;174(12):1400; author reply 1400-1
• Type of article: Comment, Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor, not a new study. Three authors commented on a 2005 study by Pan and coworkers of residential proximity to naturally occurring asbestos and mesothelioma in California. They argued that the earlier study probably misclassified exposure. Their reasons included substantial population migration into many regions classified as "exposed," wind carrying fibers mainly downwind rather than evenly in all directions, unrealistic "exposed" distances of up to 100 km, and no consideration of fiber type (amphibole versus chrysotile). They also argued that confounding by past jobs may not have been adequately addressed. The registry gave at most one job title, and occupational information was missing for approximately 25% of cases and 37% of controls. The authors concluded that exposure and confounder assessment needs substantial improvement before risk communication and public health policy can be developed. Kelsh's employer had received funding from the National Stone, Sand & Gravel Association; Berman had received its grants. In a partly cut-off reply, the original authors argued that many such limitations would cause little change or weaken the true risk estimate.

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 (correspondence) commenting on a published study, followed by a reply from that study's authors; no new data
• Who was studied: No people were studied in this letter; it critiques Pan and coworkers' study of residential proximity to naturally occurring asbestos and mesothelioma in California
• Exposure: Residential proximity to naturally occurring asbestos (ultramafic rock sources), with discussion of fiber type (amphibole vs. chrysotile) and occupational asbestos exposure as a possible confounder
• Main results:
  • Argument (not a study finding): many regions classified as "exposed" in the Pan study had experienced substantial population migration, which the letter authors said strongly suggests exposure misclassification when current residence is used
  • Argument: the assumption that weather would spread fibers evenly in all directions around a source is contradicted by actual conditions that favor a downwind direction
  • Argument: the distances assigned as "exposed" in the Pan study, ranging up to 100 km, were not realistic
  • Argument: the Pan study did not consider the potential difference in fiber type (amphibole vs. chrysotile)
  • Argument: occupational information in the Pan study reflected at most one job title from cancer registry records
  • Argument: occupational information was missing for approximately 25% of the cases and 37% of the controls in the Pan study
  • Argument: inadequately addressed occupational confounding could potentially swamp the much smaller effect being studied
  • Disclosure: the employer of M.A. Kelsh (Exponent) received funding from the National Stone, Sand & Gravel Association (NSSGA) for research on naturally occurring asbestos, and D.W. Berman received NSSGA grants and consulted for the NSSGA
  • In the reply, the original study's authors argued that many of the limitations raised would lead to small changes, if any, or to an attenuation of the true underlying risk
• The authors' conclusion: The letter authors concluded that substantial improvement in the assessment of exposure and confounders is needed before appropriate risk communication and public health policy can be developed

Topics

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

Medical terms in this study, explained in our Lexicon: naturally occurring asbestos (NOA), Mesothelioma, Confounding.

Related studies

• Residential proximity to naturally occurring asbestos and mesothelioma risk in California — X.L. Pan, H.W. Day, et al. (2005)
• Residential proximity to naturally occurring asbestos: health risk or ecologic fallacy? — C.A. Brodkin, J.R. Balmes, et al. (2006)
• High-risk mesothelioma relation to meteorological and geological condition and distance from naturally occurring asbestos — A. Abakay, A.C. Tanrikulu, et al. (2016)
• Ophiolitic outcrops, naturally occurring asbestos exposure and mortality risk from malignant mesothelioma in Calabria (Southern Italy) — A. Scarselli, A. Marinaccio, et al. (2021)
• Relationships of Lower Lung Fibrosis, Pleural Disease, and Lung Mass with Occupational, Household, Neighborhood, and Slate Roof-Dense Area Residential Asbestos Exposure — D. Kang, Y.Y. Kim, et al. (2018)
• Community responses to naturally occurring asbestos: implications for public health practice — M.R. Culley, J. Zorland, et al. (2010)

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