Exposure to asbestos and human disease

Our plain-English summary of Exposure to asbestos and human disease, by M.R. Becklake (The New England Journal of Medicine, 1982).

The study

• Author: M.R. Becklake
• Journal: The New England Journal of Medicine
• Published: 1982;306(24):1480-2
• Type of article: Editorial
• Cited by: 26 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. 000659).

In plain English

This editorial by the author, of McGill University in Montreal, discussed a review by Craighead and Mossman in the same issue on how asbestos-related diseases develop. Perhaps, the author wrote, the review's major contribution was its emphasis on the shortcomings of present knowledge. Most asbestos bodies in human lungs contain an amphibole fiber, the author noted, though chrysotile accounted for the greatest use. The epidemiologic evidence for fiber-type differences was described as strongest for mesothelioma, with crocidolite more strongly implicated than chrysotile and amosite probably in between. The evidence was also called reasonably strong for lung cancer, but minimal for lung fibrosis. Not all would agree, the author noted, with the review's view that malignant mesotheliomas are pathognomonic of asbestos exposure. For an individual patient with a disease known to be related to asbestos exposure, the author wrote, clinicians should avoid regarding any particular exposure as too short, too remote or too low to have accounted for it. Whether current dust limits will eliminate future asbestosis risk was said to remain unestablished. The author concluded that research into how asbestos causes ill health should be vigorously pursued.

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 commenting on a published review (Craighead and Mossman) of the pathogenesis of asbestos-related diseases; no original data
• Exposure: Asbestos in general, with discussion of chrysotile compared with the amphiboles crocidolite and amosite, and tremolite as an amphibole contaminant
• Main results:
  • The author wrote that perhaps the review's major contribution was its emphasis on the shortcomings of present knowledge of the pathogenesis of asbestos-related disease
  • The author stated that most asbestos bodies found in human lungs contain an amphibole fiber as a core, even though chrysotile accounts for the greatest use
  • In the author's account, the epidemiologic evidence for differences in pathogenic potential between fiber types (a fiber gradient) was strongest for mesothelioma, with crocidolite more strongly implicated than chrysotile and amosite probably in between
  • The author described this evidence as also reasonably strong for lung cancer, with crocidolite again more strongly implicated than chrysotile
  • For parenchymal (lung) fibrosis, the author described the evidence for a fiber gradient as minimal
  • The author noted that not all would agree with the review's view that malignant mesotheliomas are pathognomonic of asbestos exposure
  • In considering an individual patient with a disease known to be related to asbestos exposure, the author wrote, clinicians should avoid regarding any particular exposure as too short, too remote, or at too low a level to have accounted for the disease, even if environmental counts complied with present regulations
  • The author stated that whether dust concentrations permitted by current regulations will eliminate the future risk of asbestosis remains to be established, noting that similar suggestions in the 1930s proved premature
• The authors' conclusion: The author concluded that, until asbestos substitutes are shown not to carry health risks, research into the mechanisms by which asbestos particles produce ill health should be vigorously pursued. The author also called evaluation of present controls an urgent matter for research.

Related studies

• Inhaled particles in human disease and animal models: use of electron beam instrumentation — A.R. Brody (1984)
• Human disease consequences of fiber exposures: a review of human lung pathology and fiber burden data — V.L. Roggli (1990)
• Molecular profiling reveals primary mesothelioma cell lines recapitulate human disease — T. Chernova, X.M. Sun, et al. (2016)
• Inorganic particles in human tissues and their association with neoplastic disease — A.M. Langer (1974)
• Dendritic Cells in Human Lung Disease: Recent Advances — J.W. Upham, Y. Xi (2017)
• Effects of Chrysotile Exposure in Human Bronchial Epithelial Cells: Insights into the Pathogenic Mechanisms of Asbestos-Related Diseases — G.R. Gulino, M. Polimeni, et al. (2016)

Browse more research in The New England Journal of Medicine, or return to medical research.