The ticking time-bomb of asbestos: its insidious role in the development of malignant mesothelioma

Our plain-English summary of The ticking time-bomb of asbestos: its insidious role in the development of malignant mesothelioma, by A. Linton, J. Vardy, S. Clarke, et al (Critical Reviews in Oncology/hematology, 2012).

The study

• Authors: A. Linton, J. Vardy, S. Clarke, N. van Zandwijk
• Journal: Critical Reviews in Oncology/hematology
• Published: 2012;84(2):200-12
• Type of article: Review
• Cited by: 39 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The relationship between asbestos exposure and malignant mesothelioma (MM) has been well established. Despite bans on asbestos use in an increasing number of nations, the prolonged latency from exposure to diagnosis, and the ongoing presence and use of these dangerous fibres, have led to the increasing prevalence of this deadly disease worldwide. Whilst occupational contact has been implicated in the bulk of diagnosed cases over the past 50 years, a significant proportion of disease has been linked to para-occupational, domestic and environmental exposure. In this review, we will provide an update on the impact of historical and ongoing asbestos contact in both occupational and non-occupational settings. Furthermore, we will address the unresolved controversies surrounding the use of chrysotile asbestos, the effect of gender and genetics on development of this disease, childhood mesothelioma and co-aetiological factors including SV40 exposure.

Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

In plain English

This article was a narrative review, not a new study. The authors summarised published research on asbestos exposure and malignant mesothelioma. It covered occupational, para-occupational and domestic, and environmental exposure, the debate over chrysotile asbestos, gender, genetics, latency, childhood mesothelioma and simian virus 40 (SV40). Among the studies they cited, the Great Britain Asbestos Survey of more than 98,000 asbestos workers reported a standardised mortality ratio of 13.5 for mesothelioma. A cited meta-analysis of household exposure gave a summary risk estimate of 8.1 (95% CI 5.3–12). A cited review of 25 cohorts described the potency of chrysotile, amosite and crocidolite for causing mesothelioma as 1:100:500. A cited study of Balangero, Italy, miners exposed to chrysotile free of tremolite contamination found 6 pleural mesotheliomas against 1.5 expected. A cited review of 21 studies found a median latency of 32 years. The authors described epidemiological data on SV40 as inconclusive. They concluded that no safe level of asbestos had been established and that there was an ongoing need for a universal ban.

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: Narrative review of published literature (no systematic search method described)
• Who was studied: No population of its own. The review drew on published studies of asbestos workers, household contacts, residents near mines and factories, and people exposed to naturally occurring asbestos and erionite in several countries.
• Exposure: Occupational, para-occupational, domestic and environmental asbestos exposure, including chrysotile and amphiboles (amosite, crocidolite, tremolite), naturally occurring tremolite and erionite, and SV40 as a possible co-factor
• Main results:
  • Cited Great Britain Asbestos Survey (more than 98,000 asbestos workers, 1971–2005): standardised mortality ratio 13.5 for mesothelioma and 51.3 for asbestosis
  • Cited meta-analysis: summary risk estimate for household exposure 8.1 (95% CI 5.3–12)
  • Cited review of 25 asbestos-exposed cohorts: exposure-specific mesothelioma potency of 1:100:500 for chrysotile, amosite and crocidolite
  • Cited study of Balangero, Italy, miners exposed to chrysotile free of tremolite contamination: 6 pleural mesothelioma cases against 1.5 expected
  • Cited review of 21 studies (1690 mesothelioma cases): median latency 32 years
  • The authors described epidemiological evidence on SV40 as inconclusive
• The authors' conclusion: The authors concluded that no safe level had been established to justify asbestos use and that there was an ongoing need for a universal ban of asbestos

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Asbestos Exposure, Latency, Environmental Exposure, Chrysotile, SV40.

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