Response to: 'Reanalysis of non-occupational exposure to asbestos and the risk of pleural mesothelioma' by Finkelstein

Our plain-English summary of Response to: 'Reanalysis of non-occupational exposure to asbestos and the risk of pleural mesothelioma' by Finkelstein, by G.M. Marsh, A.S. Riordan, K.A. Keeton, et al (Occupational and Environmental Medicine, 2018).

The study

• Authors: G.M. Marsh, A.S. Riordan, K.A. Keeton, S.M. Benson
• Journal: Occupational and Environmental Medicine
• Published: 2018;75(6):473-474
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

The authors replied by letter to Finkelstein's criticism of their earlier review and meta-analysis of pleural mesothelioma risk from non-occupational asbestos exposure. Finkelstein had cited pleural mesothelioma cases among women with neighbourhood exposure in the Quebec mining regions rising from 0 in 1980 and 7 in 1998 to 17 in 2004, the last from an unpublished Quebec Public Health report. They wrote that this report listed only 10 cases among women living in the mining region at diagnosis. Because it was uncertain whether exposure was solely domestic or included co-exposures, the report did not meet their inclusion criteria. It found no statistically elevated risk for the nine women considered domestically exposed (OR=5.1; 95% CI: 0.6 to 44.6), even including women with occupational co-exposures. The 17, they said, added 7 domestically exposed women not living in the region at diagnosis, from an unpublished 2001 Siemiatycki study. Siemiatycki confirmed this study was never published, and the authors judged Finkelstein's findings not reproducible based on the available information. They stood by their conclusion that non-occupational pleural mesothelioma risks are consistent with the fibre-type potency seen in occupational settings.

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 correspondence about their earlier review and meta-analysis); no new study was conducted
• Who was studied: No population was studied directly. The letter discusses a 2004 Quebec Public Health report on pleural mesothelioma among women with neighbourhood exposure in the Quebec mining regions.
• Exposure: Non-occupational asbestos exposure, described as neighbourhood, domestic or residential exposure. Fibre types are discussed only as 'fibre-type designations', without naming specific fibres.
• Main results:
  • According to the authors, the 2004 Quebec Public Health report listed a total of 10 cases of pleural mesothelioma among women living in the mining region at the time of diagnosis, not 17.
  • The authors stated that, because of uncertainty over whether exposure was solely domestic or included co-exposures, the Quebec report did not meet the inclusion criteria of their meta-analysis.
  • As reported from the Quebec report, there was no statistically elevated risk of pleural mesothelioma for the nine women considered domestically exposed (OR=5.1; 95% CI: 0.6 to 44.6), even when women with occupational co-exposures were included.
  • As reported from the Quebec report, cumulative asbestos exposure (fibre/mL-year) among women considered residentially exposed was not associated with a statistically significantly elevated risk (OR=1.05; 95% CI: 0.99 to 1.11).
  • The authors stated that the 17 cases cited by Finkelstein were the 10 cases from Quebec Public Health plus 7 women identified in an unpublished 2001 study by Siemiatycki et al. These 7 women were domestically exposed but were not living in the region at diagnosis.
  • Dr Siemiatycki confirmed to the authors that the 2001 report was neither published nor publicly disseminated. The authors stated that Finkelstein's findings are not reproducible based on the available information.
  • In response to Finkelstein's view that two of their fibre-type designations should be reclassified, the authors stated that their designations and findings were consistent with the original meta-analysis by Bourdès et al.
• The authors' conclusion: The authors stood by their conclusion that pleural mesothelioma risks from non-occupational asbestos exposure are consistent with the fibre-type potency response observed in occupational settings.

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: Non-Occupational Exposure, Pleural Mesothelioma.

Related studies

• Response to Murray M. Finkelstein, letter to the editor re Bernstein et al: Health risk of chrysotile revisited. Crit Rev Toxicol, 2013; 43(2): 154-183 — D. Bernstein, J. Dunnigan, et al. (2013)
• Reanalysis of non-occupational exposure to asbestos and the risk of pleural mesothelioma — M.M. Finkelstein (2018)
• Response to Letter to the Editor Regarding "Ambient Asbestos Fiber Concentrations and Long-Term Trends in Pleural Mesothelioma Incidence Between Urban and Rural Areas in the United States (1973-2012)" by Finkelstein — K.A. Keeton, M.E. Glynn, et al. (2018)
• Response to: 'Pleural mesothelioma and occupational and non-occupational asbestos exposure: a case-control study with quantitative risk assessment' by Ferrante et al — G.M. Marsh, S.M. Benson (2017)
• Non-occupational exposure to asbestos and risk of pleural mesothelioma: review and meta-analysis — G.M. Marsh, A.S. Riordan, et al. (2017)
• 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)

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