Response to: 'Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom' by Reid et al

Our plain-English summary of Response to: 'Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom' by Reid et al, by A. Farioli, P. Boffetta, S. Curti, et al (Occupational and Environmental Medicine, 2019).

The study

• Authors: A. Farioli, P. Boffetta, S. Curti, G. Garzaro, C. La Vecchia, S. Mattioli, G. Spatari, F.S. Violante
• Journal: Occupational and Environmental Medicine
• Published: 2019;76(5):355
• Type of article: Letter, Comment
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This item is a letter to the editor, not a new study. It reports no new data. The authors commented on a paper by Reid and colleagues about people exposed non-occupationally to blue asbestos at Wittenoom. As the letter describes it, that paper studied a cohort of 4704 people living near an asbestos mine and mill and found higher mesothelioma rates among residents first exposed after age 15 than among those first exposed in childhood. The letter's authors raised several concerns about that paper. They wrote that its rate estimates by time since first exposure were not adjusted for age or gender, so the rise in crude rates may reflect the usual increase in mesothelioma with age. They argued that its regression model allowed residual confounding by age that probably inflated the adult risk estimate. They also criticised how it tested for an interaction between age and exposure, its splitting of age into two broad groups, and its limited discussion of how reliably mesothelioma was diagnosed. The authors concluded that the analysis did not give adequate information on the role of age at first exposure.

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 another published study (Reid et al.); no new data
• Who was studied: No population of its own. The letter discusses Reid et al.'s cohort of 4704 people living near an asbestos mine and mill at Wittenoom. As the letter describes it, that study reported higher mesothelioma rates among those first exposed after age 15 than among those first exposed in childhood.
• Exposure: Non-occupational exposure to blue asbestos at Wittenoom, as studied by Reid et al.
• Main results:
  • The letter's authors pointed out that the rate estimates in Reid et al.'s table 3 were not adjusted for age or gender.
  • The letter's authors argued that the increase in crude rates by age at first exposure reflects the age-related incidence of mesothelioma.
  • The letter's authors argued that the regression model in Reid et al.'s table 4 allowed residual confounding by age, which probably inflated the risk estimate for those first exposed as adults.
  • The letter's authors argued that the main analysis should have included an interaction term between age at first exposure and an estimate of exposure.
  • The letter's authors noted that Reid et al.'s reported non-significant difference between the adult-exposed and child-exposed groups (p=0.58) was tested only on the multiplicative scale, and that the model estimates were not reported.
  • The letter's authors argued that splitting age, a continuous variable, into two broad classes might hamper detection of any interaction with increasing exposure.
  • The letter's authors stated that the quality of mesothelioma diagnosis was scarcely discussed by Reid et al., and that misclassification of the outcome could bias results in any direction.
• The authors' conclusion: The authors concluded that Reid et al.'s analysis does not give adequate information on the role of age at first exposure, as distinct from residual confounding by latency.

Topics

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

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

Related studies

• Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom — A. Reid, P. Franklin, et al. (2018)
• Cancer incidence among women and girls environmentally and occupationally exposed to blue asbestos at Wittenoom, Western Australia — A. Reid, J. Heyworth, et al. (2008)
• Malignant mesotheliomas in former miners and millers of crocidolite at Wittenoom (Western Australia) after more than 50 years follow-up — G. Berry, A. Reid, et al. (2012)
• Migration and work in postwar Australia: mortality profile comparisons between Australian and Italian workers exposed to blue asbestos at Wittenoom — A. Reid, E. Merler, et al. (2018)
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