Study of lung cancer in MMVF workers

Our plain-English summary of Study of lung cancer in MMVF workers, by P. Boffetta, K. Kjaerheim, J. Hansen, et al (International Journal of Occupational and Environmental Health, 2003).

The study

• Authors: P. Boffetta, K. Kjaerheim, J. Hansen, J. Cherrie, J. Chang-Claude, J.H. Olsen, R. Saracci, P. Westerholm, A. Andersen
• Journal: International Journal of Occupational and Environmental Health
• Published: 2003;9(2):169-70
• 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. The authors replied to comments by Dr. Eva Hansen on their earlier case-control study of lung cancer among man-made vitreous fiber (MMVF) production workers in Europe. The letter's references describe these as rock and slag wool production workers. The letter reported no new data or risk figures. The authors stated that asbestos exposure was very limited inside the MMVF industry and happened mostly in jobs outside it. They acknowledged that exposure assessment for those outside jobs, based mainly on questionnaires, was of lower quality. They defended their lung cancer diagnoses, noting that most cases in Denmark, Norway and Sweden (83% of all cases) were documented from more than one source. They also defended excluding tobacco-related diseases from controls and said exposures were lagged by 15 years. They acknowledged that exposure misclassification and incomplete blinding of expert panels were possible. The authors concluded that their study provides evidence against the hypothesis that MMVF exposure, as experienced by European production workers over the last four to five decades, increases lung cancer risk.

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 (authors' reply to criticism of their earlier nested case-control study)
• Who was studied: European MMVF production workers from the authors' earlier study (described in the letter's references as rock and slag wool production workers). The letter gives no case or control counts; cases from Denmark, Norway and Sweden made up 83% of all cases.
• Exposure: Man-made vitreous fibers (MMVFs). Asbestos exposure was also estimated; the authors state it was very limited within the MMVF industry and mostly occurred in employment outside it.
• Main results:
  • The authors restated that their earlier study did not find an increased lung cancer risk according to estimated asbestos exposure.
  • Responding to criticism about lack of histological verification, the authors stated that most cases in Denmark, Norway and Sweden, which represented 83% of all cases, were documented from more than one source.
  • The authors argued that excluding tobacco-related diseases or causes of death from controls makes smoking prevalence among controls reflect the underlying population.
  • The authors stated that exposures were lagged by 15 years, so cancers occurring in the first 15 years after exposure began were ignored in the latency analysis.
  • The authors stated that improved exposure assessment identified a small number of factory- and time-specific jobs in which MMVF exposure was not likely, explaining why some MMVF production workers were classified as unexposed.
• The authors' conclusion: The authors concluded that their study is informative and provides evidence against the hypothesis that MMVF exposure, as experienced by European production workers over the last four to five decades, increases lung cancer risk.
• Limitations the authors state:
  • Exposure assessment for jobs outside the MMVF industry was based mainly on questionnaires and was of lower quality than for jobs within the industry.
  • The deceased control group was not representative of the underlying population.
  • Misclassification of exposure might have occurred.
  • Expert panels may not have been completely blind to the case or control status of study subjects.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer.

Related studies

• Lung cancer in MMVF workers--viewpoints on a null-result study — E.S. Hansen (2003)
• Lung fibre burden in lung cancer cases employed in the rock and slag wool industry — K. Soldan, F.D. Pooley, et al. (2006)
• Cytotoxic and oxidative effects induced by man-made vitreous fibers (MMVFs) in a human mesothelial cell line — D. Cavallo, A. Campopiano, et al. (2004)
• Testing of fibrous particles: short-term assays and strategies — D. Bernstein, V. Castranova, et al. (2005)
• A case-control study of lung cancer nested in a cohort of European asphalt workers — A. Olsson, H. Kromhout, et al. (2010)
• Occupational exposure to asbestos and man-made vitreous fibres and risk of lung cancer: a multicentre case-control study in Europe — R. Carel, A.C. Olsson, et al. (2007)

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