Response to Kottek and Kilpatrick, 'Estimating Occupational Exposure to Asbestos in Australia'

Our plain-English summary of Response to Kottek and Kilpatrick, 'Estimating Occupational Exposure to Asbestos in Australia', by S. Peters, S.C. van Oyen, H. Alfonso, et al (The Annals of Occupational Hygiene, 2016).

The study

• Authors: S. Peters, S.C. van Oyen, H. Alfonso, L. Fritschi, N.H. de Klerk, A. Reid, P. Franklin, L. Gordon, G. Benke, A.W. Musk
• Journal: The Annals of Occupational Hygiene
• Published: 2016;60(4):533-5
• Type of article: Letter, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor reports no new data. The authors built AsbJEM, a tool assigning typical asbestos exposure levels to jobs in Australia. Here they replied to Kottek and Kilpatrick, who argued that peak exposures were underestimated for some jobs. The authors explained that peak exposure duration was arbitrarily set at 15 minutes. If long high-exposure tasks were typical of a job, their expert panel would have considered such tasks for that job's usual ('mode') exposure. They defended using experts rather than workers' own reports to estimate how often peaks occurred. They argued that the critics' patients were likely at the upper end of exposure, and that people may have difficulty recalling past tasks, especially how often they did them. Experts assigned intensity in categories whose midpoints set annual average levels, from 0.05 fibres per millilitre for low (range 0.01 to 0.1) to 37.5 for very high (range 25 to 50). The authors said these ranges should be considered when interpreting estimates. They acknowledged that such a tool cannot capture differences within an occupation. They rejected the suggestion that AsbJEM is inadequate but urged caution when applying it to individuals.

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: the authors' reply to criticism of their earlier article describing a job-exposure matrix (AsbJEM); no new study data
• Who was studied: No population was studied; the letter concerns AsbJEM, a general-population job-exposure matrix for Australian work situations
• Exposure: Occupational asbestos exposure as estimated by AsbJEM (no fiber types specified), including the definition of peak exposures, whose duration was set at 15 minutes
• Main results:
  • The authors stated that a high-exposure task lasting up to a whole shift would generally not be considered a peak exposure. If such longer high-exposure tasks were typical for a job, the expert panel would have considered them for the mode exposure.
  • The authors disagreed with the critics' preference for patients' own reports. They argued that the critics' patients were likely at the upper end of the exposure distribution.
  • The authors argued that people may have difficulty recalling their past tasks. In particular, how often tasks were done appears hard to report correctly.
  • Experts assigned exposure intensity above background in categories. The midpoints of those categories were used for AsbJEM's annual average exposure levels: low 0.05 fibres per millilitre (range 0.01 to 0.1), medium 0.5 (0.1 to 1), high 12 (1 to 25), very high 37.5 (25 to 50).
• The authors' conclusion: The authors disagreed with the suggestion that AsbJEM is inadequate for retrospectively assessing asbestos exposure in Australian work situations. They stated confidence that it estimates typical exposures for occupations.
• Limitations the authors state:
  • A job-exposure matrix assignment does not cover the full range of exposure levels for all workers in a job.
  • Differences in exposure within an occupation could not be captured.
  • Assigned exposure levels are category midpoints, so the category ranges should be taken into account when interpreting them.
  • The authors urged caution when results from AsbJEM are applied to individual workers.

Topics

Medical terms in this study, explained in our Lexicon: Occupational Exposure.

Related studies

• Development of a Job-Exposure Matrix (AsbJEM) to Estimate Occupational Exposure to Asbestos in Australia — S.C. van Oyen, S. Peters, et al. (2015)
• Estimating Occupational Exposure to Asbestos in Australia — M. Kottek, D.J. Kilpatrick (2016)
• The future excess fraction of occupational cancer among those exposed to carcinogens at work in Australia in 2012 — R.N. Carey, S.J. Hutchings, et al. (2017)
• Pattern of malignant mesothelioma incidence and occupational exposure to asbestos in Western Australia — A.W. Musk, N. Olsen, et al. (2015)
• 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)
• Malignant pleural and peritoneal mesotheliomas in former miners and millers of crocidolite at Wittenoom, Western Australia — G. Berry, N.H. de Klerk, et al. (2004)

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