Risk of cancer associated with residential exposure to asbestos insulation: updated evidence

Our plain-English summary of Risk of cancer associated with residential exposure to asbestos insulation: updated evidence, by H.D. Law, M. Clements, N. Lazarevic, et al (The Lancet Regional Health. Western Pacific, 2025).

The study

• Authors: H.D. Law, M. Clements, N. Lazarevic, K. Smurthwaite, S. Trevenar, L. Newman, E. Chalker, M.D. Kirk, R.J. Korda
• Journal: The Lancet Regional Health. Western Pacific
• Published: 2025;63:101699
• Type of article: Letter
• Read it: PubMed · Publisher · Free full text

In plain English

This correspondence article reported an update of the authors' earlier cohort study of people in the Australian Capital Territory (ACT), Australia, whose homes had loose fill asbestos insulation installed in the roof between 1968 and 1979. Amosite was used in most homes, and crocidolite was later found in two. Using linked health records, the authors compared 16,757 people who had lived in an affected home between 1983 and 2019 with 1,207,626 ACT residents who had never lived in one. Among men who had lived in affected homes there were 12 cases of mesothelioma, a rate 2.72 times that expected (95% CI 1.41 to 4.76). Colorectal cancer rates were higher in women (SIR 1.46, 95% CI 1.15 to 1.83) and in men (SIR 1.24, 95% CI 0.99 to 1.54). Lung cancer rates were higher in women (SIR 1.39, 95% CI 1.00 to 1.88). Prostate cancer, which the authors used as a control outcome, was also raised. The authors had no data on smoking, workplace asbestos exposure or socioeconomic status, and could not estimate fibre levels in the homes. They concluded that living in such a house may be sufficient to cause cancer, in particular mesothelioma. They said they remained uncertain about the link with colorectal cancer.

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: Updated whole-population cohort study using linked administrative data (Medicare Consumer Directory linked to a register of affected homes, the Australian Cancer Database and the National Death Index), with standardised incidence ratios allowing a 10-year lag; published as a Correspondence
• Who was studied: Everyone in the Medicare Consumer Directory with an ACT address at any time between 1983 and 2019: 16,757 people who had lived in one of 1095 known affected residential properties (ARPs), compared with 1,207,626 people who had never lived in an ARP
• Exposure: Residence in a home with loose fill asbestos insulation installed in the roof by a private company between 1968 and 1979; amosite in most homes, crocidolite later found in two homes. Fibres were found in living spaces of many homes more than 20 years later.
• Main results:
  • Men who had lived in an ARP had 12 incident cases of mesothelioma (12 observed versus 4.41 expected).
  • Mesothelioma in men who had lived in an ARP: SIR 2.72 (95% CI 1.41 to 4.76).
  • Median time from first recorded exposure to mesothelioma diagnosis in these men was 26 years (Q1, Q3: 16, 30). The authors called this a minimum estimate.
  • Colorectal cancer among people who had lived in an ARP: SIR 1.24 (95% CI 0.99 to 1.54) in males and SIR 1.46 (95% CI 1.15 to 1.83) in females.
  • Lung cancer in women who had lived in an ARP: SIR 1.39 (95% CI 1.00 to 1.88). In men the lung cancer SIR was 1.27 (95% CI 0.95 to 1.66).
  • No statistically significant higher-than-expected rates were seen for the other candidate cancers examined, but statistical power to detect modest associations was low.
  • Prostate cancer, a control outcome, was raised in exposed males (SIR 1.36, 95% CI 1.19 to 1.55). The authors said control outcomes above one reflected a possible higher baseline cancer risk in ARP residents.
• The authors' conclusion: The authors concluded that their study confirms that living in a house with loose fill asbestos insulation may be sufficient to cause cancer, in particular mesothelioma. They said they remained uncertain about the link with colorectal cancer.
• Limitations the authors state:
  • No data on other risk factors, such as occupational asbestos exposure or other lung irritants, smoking, and socioeconomic status.
  • Without tobacco data, bias in the lung cancer SIRs could not be ruled out.
  • Historical fibre concentrations in the homes could not be estimated.
  • Low statistical power to detect modest associations.
  • Results with fewer than six observed cases were not reported, including mesothelioma in women and liver cancer in either sex.
  • The time to mesothelioma diagnosis is a minimum estimate, because 6 of the 12 men were already enrolled at an ARP address when the database began.

Related studies

• Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study — R.J. Korda, M.S. Clements, et al. (2017)
• Increased risk of malignant mesothelioma of the pleura after residential or domestic exposure to asbestos: a case-control study in Casale Monferrato, Italy — C. Magnani, P. Dalmasso, et al. (2001)
• Residential proximity to naturally occurring asbestos and mesothelioma risk in California — X.L. Pan, H.W. Day, et al. (2005)
• Residential radon and risk of lung cancer in Eastern Germany — M. Kreuzer, J. Heinrich, et al. (2003)
• Increased lung cancer risk due to residential radon in a pooled and extended analysis of studies in Germany — H.E. Wichmann, A.S. Rosario, et al. (2005)
• Residential proximity to naturally occurring asbestos: health risk or ecologic fallacy? — C.A. Brodkin, J.R. Balmes, et al. (2006)

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