What every physician should know about environmental health

Our plain-English summary of What every physician should know about environmental health, by C. Carlsten, J. Croke (Wilderness & Environmental Medicine, 1997).

The study

• Authors: C. Carlsten, J. Croke
• Journal: Wilderness & Environmental Medicine
• Published: 1997;8(4):250-2
• Type of article: Letter
• Read it: PubMed · Publisher

In plain English

This item was a letter to the editors, not an original study. The authors searched MEDLINE for the years 1970-1996 and chose textbooks, journal articles and government documents, favoring recent ones and those relevant to general practitioners. From these they listed what they called the top ten environmental health threats in the United States, including asbestos. They also discussed possible future threats such as climate change and ozone depletion. Their asbestos section was two sentences long. Citing a 1992 document from the U.S. Agency for Toxic Substances and Disease Registry, it stated that friable asbestos insulation or soundproofing in 35 000 U.S. schools puts 15 million children and 1.4 million adults at risk for asbestosis, lung cancer and mesothelioma. A second sentence, with no source given, said asbestos is associated with hypertension, infertility, spontaneous abortion and stillbirth among women with high lead exposure. The letter named no asbestos fiber types and collected no new data. The authors concluded that most environmentally related disease is preventable and that recognition is the key. They said a careful exposure history can aid recognition.

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 editors giving a narrative overview of selected literature found through a MEDLINE search; no original data
• Who was studied: No study population; the letter drew on references from a MEDLINE search covering 1970-1996, focused on environmental health threats in the United States
• Exposure: Ten environmental health threats, one of which was asbestos, described as friable asbestos insulation or soundproofing in U.S. schools; no fiber types named
• Main results:
  • Citing a 1992 Agency for Toxic Substances and Disease Registry document (its reference 10), the letter stated that friable asbestos insulation or soundproofing in 35 000 U.S. schools puts 15 million children and 1.4 million adults at risk for asbestosis, lung cancer and mesothelioma. These figures come from that cited document, not from new research by the authors.
  • With no reference given, the letter stated that asbestos is associated with hypertension, infertility, spontaneous abortion and stillbirth among women with high lead exposure
  • Citing an Agency for Toxic Substances and Disease Registry document (its reference 30) on a primary care practice in an academic setting, the letter reported that only 24% of 625 charts mentioned the patient's occupation
• The authors' conclusion: The authors concluded that most environmentally related disease is preventable, that recognition is the key, and that a careful exposure history can aid recognition

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