The cigarette factor in asbestosis

Our plain-English summary of The cigarette factor in asbestosis, by W. Weiss (Chest, 1990).

The study

• Author: W. Weiss
• Journal: Chest
• Published: 1990;97(4):769-70
• Type of article: Editorial, Comment
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 003649).

In plain English

This is an editorial, not an original study. The author discussed whether cigarette smoking contributes to asbestosis as diagnosed from small irregular opacities on chest x-rays. The author noted that, since a small 1971 survey of asbestos factory workers, studies have repeatedly found asbestosis more often in smokers than in nonsmokers. The author discussed a separate study by Ducatman and colleagues in the same journal issue, which used US Navy medical surveillance data for personnel with any history of asbestos exposure. In that study, after age adjustment, these opacities were 2.23 times more common in smokers than in nonsmokers, and the ratio rose to 3.3 at a profusion of 2/1 or greater. The author wrote that such findings do not separate the effect of smoking from that of asbestos. The author also described an autopsy study of asbestos miners by Hnizdo and Sluis-Cremer that did not show an association between smoking and asbestosis seen in lung tissue, and said its results may be clouded by selection bias. The author concluded that more detailed investigation is needed, using existing monitoring data on asbestos-exposed workers.

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: editorial (commentary on other studies; no new data)
• Who was studied: No study population of its own. The editorial comments mainly on a study by Ducatman et al. of US Navy personnel with any history of asbestos exposure, and on an autopsy study of asbestos miners by Hnizdo and Sluis-Cremer.
• Exposure: Cigarette smoking combined with occupational asbestos exposure. No fiber type is specified.
• Main results:
  • The author noted that a small 1971 cross-sectional survey of asbestos factory workers found a higher prevalence of asbestosis in cigarette smokers than in nonsmokers, and that later studies confirmed this.
  • As reported by the author from the separate Ducatman et al. study of US Navy personnel: with age adjustment, small irregular opacities were 2.23 times more common in smokers than in nonsmokers, and the ratio was 3.3 at a profusion of 2/1 or greater.
  • The author's view was that these observations do not separate the contribution of smoking from that of asbestos in people exposed to both.
  • As described by the author, Hnizdo and Sluis-Cremer, in an autopsy study of asbestos miners, could not show an association between smoking and asbestosis diagnosed from lung tissue.
  • The author commented that the results of that autopsy study may be affected by selection bias, because the proportion of all deaths that came to autopsy is unknown.
  • The author noted that in the few studies that tried to adjust smoking comparisons for asbestos exposure, the results were inconsistent.
  • The author proposed that the large body of existing environmental and medical monitoring data on asbestos-exposed workers, including US Navy data, be organized, checked for validity and analyzed.
• The authors' conclusion: The author concluded that the question of how smoking contributes to asbestosis needs more detailed investigation.

Topics

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

Related studies

• Asbestosis: interstitial pulmonary fibrosis and pleural fibrosis in a cohort of asbestos insulation workers: influence of cigarette smoking — R. Lilis, I.J. Selikoff, et al. (1986)
• Absence of synergism between exposure to asbestos and cigarette smoking in asbestosis — J.M. Samet, G.R. Epler, et al. (1979)
• Cigarette smoking, asbestos, and pulmonary fibrosis — W. Weiss (1971)
• Cigarette smoking and small irregular opacities — W. Weiss (1991)
• Pleural plaques and cigarette smoking in asbestos workers — W. Weiss, R. Levin, et al. (1981)
• Asbestosis, not asbestos exposure, is the primary risk factor for lung cancer — R. Ross (2014)

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