Discussion of An Epidemiologic Appraisal of the Health Effects of Ambient Air

Our plain-English summary of Discussion of An Epidemiologic Appraisal of the Health Effects of Ambient Air, by I.J. Selikoff, F. Speizer (1969).

The study

• Authors: I.J. Selikoff, F. Speizer
• Published: The Annual Meeting of the Air Pollution Control Association. June 24, 1969
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This is not a research paper. It is the remarks of I.J. Selikoff at a 1969 Air Pollution Control Association meeting, given as discussant of a review by F.E. Speizer on sulfur oxides and particulates. The author argued that cigarette smoking can overwhelm other factors in such studies and might be used to reveal weaker effects. As an example, the author described 632 asbestos workers in New York followed since 1943. Of 380 deaths, 72 were from bronchogenic carcinoma and 22 from mesothelioma. In 1963 to 1967, none of 87 workers who had not smoked cigarettes died of bronchogenic carcinoma (fewer than one was expected). Among 283 cigarette-smoking workers, 24 died of lung cancer where 3 were expected. A 92-fold increased risk of dying of lung cancer for the combination, compared with people who neither smoked cigarettes nor worked with asbestos, was cited from an earlier paper. The author also showed air samples taken near a New York building site, with fine asbestos particles attached to clay and diatom particles.

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: Conference discussion (commentary) on another author's review. It presents data from the author's group, partly cited from an earlier publication. It is not a new study.
• Who was studied: 632 asbestos workers in New York City followed from 1943. From 1963, 370 surviving men were observed: 87 who had not smoked cigarettes and 283 cigarette smokers.
• Exposure: Occupational asbestos exposure for 30 to 40 years, with or without cigarette smoking; the fiber type is not named. Also airborne asbestos particles sampled near a building under construction.
• Main results:
  • Among 380 consecutive deaths in the 632 asbestos workers, 72 were from bronchogenic carcinoma.
  • Among the same 380 deaths, 22 were from mesothelioma (site not specified).
  • Among the 370 surviving men observed from 1963, 47 deaths were expected and about twice as many occurred.
  • Among the 370 survivors, two or three bronchogenic carcinoma deaths were expected and 27 occurred.
  • Among 87 asbestos workers who had not smoked cigarettes (1963 to 1967), none died of bronchogenic carcinoma; fewer than one was expected.
  • Among 283 cigarette-smoking asbestos workers, there were 24 lung cancer deaths where 3 were expected, given their smoking habits.
  • A cited earlier paper by the author and colleagues calculated that the combination of asbestos work and smoking increased the risk of dying of lung cancer 92 times, compared with people who neither smoked cigarettes nor worked with asbestos.
  • Air samples on 53rd Street near a building site showed very fine asbestos particles, some as small as 250 angstrom units in diameter, attached to diatomaceous earth and bentonite clay particles.
• The authors' conclusion: The author suggested that the strong effect of cigarette smoking could be used to uncover effects too weak to detect otherwise. The author called for more precise sampling and identification of particles. The author also argued that the selection explanation for heavily exposed sulfur dioxide workers was unproven and needed study.

Topics

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

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