Response to: 'Dose-time-response association between occupational asbestos exposure and pleural mesothelioma' by Lacourt et al

Our plain-English summary of Response to: 'Dose-time-response association between occupational asbestos exposure and pleural mesothelioma' by Lacourt et al, by P. Boffetta, E. Pira, C. Romano, et al (Occupational and Environmental Medicine, 2018).

The study

• Authors: P. Boffetta, E. Pira, C. Romano, F.S. Violante, A. Farioli, C. Zocchetti, C. La Vecchia
• Journal: Occupational and Environmental Medicine
• Published: 2018;75(2):160
• Type of article: Letter, Comment
• Cited by: 3 articles, 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 responded to a case–control study by Lacourt et al on occupational asbestos exposure and pleural mesothelioma in France. They argued that it did not meet two basic requirements of case–control design. First, they argued that cases and controls did not come from the same population and time period. Cases were men diagnosed in parts of France in 1987–1993 or 1998–2006, while controls came from a 2007 national sample and from 15 earlier case–control studies, with none selected between 2000 and 2006. They noted that cases came from areas with a high prevalence of asbestos exposure. Second, they argued that exposure information was gathered with different questionnaires for cases and controls, with no validation or sensitivity analyses reported. They considered this a likely source of information bias. They also said Lacourt et al gave no evidence for their claims of representativeness. The authors concluded that these limitations invalidate the study's results and those of other reports based on the same dataset. The letter does not describe Lacourt et al's findings.

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 critiquing the methods of a published case–control study; no new data
• Who was studied: No participants were studied. The letter discusses the Lacourt et al case–control study. That study's cases were men diagnosed with mesothelioma in five French regions (January 1987 to December 1993) or 22 French districts (January 1998 to December 2006). Its controls came from a 2007 national sample and from 15 community-based case–control studies conducted in 1984–2000.
• Exposure: Occupational asbestos exposure (as studied by Lacourt et al); no fiber types are named in the letter
• Main results:
  • The authors argued that cases and controls in the Lacourt et al study did not come from the same population and time period. They noted that no controls were selected between 2000 and 2006, when most cases were enrolled.
  • The authors stated that cases were selected from studies in areas with a high prevalence of asbestos exposure, which they said was not likely true of the studies used to select controls.
  • The authors noted that different questionnaires were used for cases and controls, and that Lacourt et al reported no sensitivity or validation analyses. The authors considered this a likely source of information bias.
  • The authors stated that Lacourt et al provided no evidence for their claims that the cases were representative of French cases and that exposure prevalence among controls was similar to that of the general French population.
  • The authors stated that analyses to detect and quantify possible bias have been recommended for studies using unorthodox ways of selecting participants and gathering exposure information.
• The authors' conclusion: The authors concluded that the Lacourt et al study did not satisfy two fundamental requirements of case–control design. In their view, these limitations invalidate its results and those of other reports based on the same dataset, and overshadow any other sources of bias.

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: Asbestos Exposure, Pleural Mesothelioma.

Related studies

• Dose-time-response association between occupational asbestos exposure and pleural mesothelioma — A. Lacourt, E. Lévêque, et al. (2017)
• Dose-time response association between occupational asbestos exposure and pleural mesothelioma: authors' response — A. Lacourt, E. Leveque, et al. (2018)
• Pleural plaques and asbestosis: dose- and time-response relationships based on HRCT data — C. Paris, S. Thierry, et al. (2009)
• Hierarchical latency models for dose-time-response associations — D.B. Richardson, R.F. MacLehose, et al. (2011)
• Nonlinear dose-time-response functions and health-protective exposure limits for inflammation-mediated diseases — L.A. Cox (2020)
• Occupational Exposure to Diesel Motor Exhaust and Lung Cancer: A Dose-Response Relationship Hidden by Asbestos Exposure Adjustment? The ICARE Study — M. Matrat, F. Guida, et al. (2015)

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