Risk from exposure to asbestos

Our plain-English summary of Risk from exposure to asbestos, by J. Aroesty, K. Wolf (Science, 1986).

The study

• Authors: J. Aroesty, K. Wolf
• Journal: Science
• Published: 1986;234(4779):923
• Type of article: Letter
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M nos. 002561, 004721).

In plain English

This item is a letter to the editor of Science, not a study of people. It is followed by a reply from the National Research Council (NRC) committee whose 1984 report, Asbestiform Fibers: Nonoccupational Health Risks, it criticized. The letter writers, from the Rand Corporation, reported a calculation error in that report's mesothelioma risk assessment. They wrote that the report had used a death-rate formula from an earlier analysis by Peto and colleagues as if it were a cumulative formula. As a result, they said, lifetime mesothelioma risk was underestimated by a factor approaching 20. The report's example was one the letter writers called an admittedly hazardous exposure profile. In that example, total lifetime mesothelioma risk from school plus background exposure rose from 67 per million to 1199 per million after their correction. The committee agreed and put the increase at a factor of 17.4. It disagreed that mesothelioma risk would now outweigh lung cancer risk, because lung cancer risks had also been understated, by a factor of 4.5. Its corrected table gave lifetime mesothelioma risks, for all groups, of 156 per million at a continuous exposure of 0.0004 fiber/cm3 and 780 per million at 0.002 fiber/cm3.

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 reporting a calculation error in a published risk assessment, followed by a reply from the NRC committee that wrote the report; no new data were collected
• Who was studied: No people were studied. The letter re-examined the mesothelioma risk model in the 1984 NRC report, whose constants came from Peto et al.'s fitting of several data sets, including Selikoff's 1979 data on insulation workers
• Exposure: Low-level, nonoccupational asbestos exposure (fiber type not specified). The corrected table covers continuous exposure at 0.0004 fiber/cm3 (median dose) or 0.002 fiber/cm3 (high dose)
• Main results:
  • The letter writers stated that the NRC report misread Peto et al.'s analysis, using a death-rate function in place of the cumulative incidence function, so lifetime mesothelioma risk was consistently underestimated by a factor approaching 20
  • For the report's example, which the letter writers described as an admittedly hazardous exposure profile, the NRC lifetime mesothelioma figures were school risk 21 x 10-6, background risk 46 x 10-6 and total risk 67 x 10-6. After the letter writers' correction these became school risk 399 x 10-6, background risk 800 x 10-6 and total risk 1199 x 10-6
  • The NRC committee agreed there was an error and stated that using the correct function increases estimated lifetime mesothelioma risks by a factor of 17.4
  • The committee stated that published lung cancer risks were also understated. A multiplier of 4.56, used for mesothelioma to convert 1920-hour occupational exposure years to 8760-hour environmental exposure years, had not been applied to lung cancer. Applying it increases lung cancer projections by a factor of 4.5
  • In the corrected table 7.2, estimated individual lifetime mesothelioma risk for all groups was 156 per million at the median dose (0.0004 fiber/cm3) and 780 per million at the high dose (0.002 fiber/cm3)
  • In the corrected table, estimated lifetime lung cancer risks per million (median dose, then high dose) were: male smokers 292 and 1459, female smokers 105 and 524, male nonsmokers 27 and 132, female nonsmokers 14 and 68
• The authors' conclusion: The letter writers concluded that estimated lifetime mesothelioma risks are nearly 20 times larger than shown in the NRC report and would appear to dominate lung cancer risks. The NRC committee replied that this was not the case because lung cancer risks were also understated. It regretted the errors and urged users to note the corrected values

Topics

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

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