Cancer In Relation To Environmental Exposure

Our plain-English summary of Cancer In Relation To Environmental Exposure, by H. Bohlig, E. Hain (1973).

The study

• Authors: H. Bohlig, E. Hain
• Published: Biological Effects Of Asbestos (J.C. Wagner, Editor), Lyon: Iarc Scientific Publications, Volume 8, Pp. 217-221 (1973)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library, J-M no. 002382. The article is still under copyright, so we describe it here rather than post it.

In plain English

This 1973 conference paper was mainly a review of published reports of cancer after non-occupational ("environmental") asbestos exposure, such as living near mines, factories or shipyards, or contact through family members. The authors proposed criteria for judging whether an environmental tumour was asbestos-induced, which they called only a basis for discussion. They also described 38 non-occupational mesothelioma cases, from 1958 to 1968, in the neighbourhood of one asbestos processing factory in Hamburg, Germany. Cases in former asbestos workers were left out. Patients reported that before World War II the factory blew dust-laden air into the atmosphere. Over the past decade, the mesothelioma incidence rate in that residential area was printed as 0.96, against 0.056 for Hamburg's general population in 1969. The unit symbol is garbled in the scan. The cases appeared to follow the prevailing wind direction, and latency times ranged from 20 to 48 years. A further 251 mesotheliomas had been collected for later publication, with histories found for 150. The authors concluded that similar retrospective investigations were needed in other cities as soon as possible.

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: Review of published reports on non-occupational asbestos-related cancer, with a brief description of a local case series (mapping of non-occupational mesothelioma cases around one factory in Hamburg)
• Who was studied: 38 patients with non-occupational mesothelioma who lived near a single asbestos processing plant in Hamburg, Federal Republic of Germany, 1958 to 1968. Cases in former asbestos workers were excluded.
• Exposure: Neighbourhood (non-occupational) exposure to asbestos dust from a factory that, according to patients, emitted visible, snowfall-like dust pollution before World War II. The fiber type processed at this factory is not stated.
• Main results:
  • The mesothelioma incidence rate in the general population of Hamburg in 1969 was printed as 0.056. The unit symbol is garbled in the scan.
  • For the past decade, the mesothelioma incidence rate in the residential area near the factory was printed as 0.96. The unit symbol is garbled in the scan.
  • The distribution of the 38 non-occupational cases around the factory appeared to depend on the prevailing wind direction.
  • Most of the 38 cases met at least criteria 1 to 4 of the authors' proposed criteria (histology, history of asbestos contact, latency, frequency).
  • Latency times among the cases ranged from 20 to 48 years, with medium latent periods of 30 to 40 years.
  • An additional 251 proved mesotheliomas were collected from pathology departments of large city hospitals, and histories were found for 150. Mapping of occupational and environmental cases was under way and had not yet been published.
  • From the literature, the authors estimated that environmental asbestos-induced tumours numbered on the order of several hundred cases. They said an exact number could not be deduced.
• The authors' conclusion: The authors felt sure that similar retrospective investigations in other cities would give similar results. They considered such investigations necessary as soon as possible, before dust control removes neighbourhood pollution.
• Limitations the authors state:
  • The authors said their proposed criteria for an asbestos-induced environmental tumour were only a basis for discussion, and that precise knowledge needed to establish causation is still lacking.
  • The authors said information on environmentally induced cancers is not entirely reliable.
  • The authors noted that occupational and non-occupational exposure often cannot be separated with certainty in published reports.
  • Because asbestos fibers are a small part of environmental pollution containing many other potential carcinogens, the authors said it has been difficult to establish them as a direct cause of a specific cancer.

Topics

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

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