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Asbestos, Smoking and Lung Cancer: An Update

Author

Listed:
  • Sonja Klebe

    (Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia)

  • James Leigh

    (Asbestos Diseases Research Institute, University of Sydney, Concord, NSW 2139, Australia)

  • Douglas W. Henderson

    (Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia
    Professor Henderson is deceased while writing the paper.)

  • Markku Nurminen

    (Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
    MarkStat Consultancy, 00250 Helsinki, Finland)

Abstract

This review updates the scientific literature concerning asbestos and lung cancer, emphasizing cumulative exposure and synergism between asbestos exposure and tobacco smoke, and proposes an evidence-based and equitable approach to compensation for asbestos-related lung cancer cases. This update is based on several earlier reviews written by the second and third authors on asbestos and lung cancer since 1995. We reevaluated the peer-reviewed epidemiologic studies. In addition, selected in vivo and in vitro animal studies and molecular and cellular studies in humans were included. We conclude that the mechanism of lung cancer causation induced by the interdependent coaction of asbestos fibers and tobacco smoke at a biological level is a multistage stochastic process with both agents acting conjointly at all times. The new knowledge gained through this review provides the evidence for synergism between asbestos exposure and tobacco smoke in lung cancer causation at a biological level. The evaluated statistical data conform best to a multiplicative model for the interaction effects of asbestos and smoking on the lung cancer risk, with no requirement for asbestosis. Any asbestos exposure, even in a heavy smoker, contributes to causation. Based on this information, we propose criteria for the attribution of lung cancer to asbestos in smokers and non-smokers.

Suggested Citation

  • Sonja Klebe & James Leigh & Douglas W. Henderson & Markku Nurminen, 2019. "Asbestos, Smoking and Lung Cancer: An Update," IJERPH, MDPI, vol. 17(1), pages 1-23, December.
    • Handle: RePEc:gam:jijerp:v:17:y:2019:i:1:p:258-:d:303285
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    References listed on IDEAS

    as
    1. Greenland, S., 1999. "Relation of probability of causation to relative risk and doubling dose: A methodologic error that has become a social problem," American Journal of Public Health, American Public Health Association, vol. 89(8), pages 1166-1169.
    2. Yuwadee Ngamwong & Wimonchat Tangamornsuksan & Ornrat Lohitnavy & Nathorn Chaiyakunapruk & C Norman Scholfield & Brad Reisfeld & Manupat Lohitnavy, 2015. "Additive Synergism between Asbestos and Smoking in Lung Cancer Risk: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(8), pages 1-19, August.
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    Cited by:

    1. Fabrizio Minichilli & Francesca Gorini & Giovanni De Filippis & Elisa Bustaffa & Anna Maria Raho & Anna Melcarne & Fabrizio Quarta & Giuseppe Maggiore & Adele Idolo & Francesca Serio & Tiziana Grassi , 2022. "Risk Factors for Lung Cancer in the Province of Lecce: Results from the PROTOS Case–Control Study in Salento (Southern Italy)," IJERPH, MDPI, vol. 19(14), pages 1-22, July.
    2. Olivia Pérol & Nadège Lepage & Hugo Noelle & Pierre Lebailly & Benoit de Labrusse & Bénédicte Clin & Mathilde Boulanger & Delphine Praud & Françoise Fournié & Géraud Galvaing & Frédéric Dutheil & Brig, 2023. "A Multicenter Study to Assess a Systematic Screening of Occupational Exposures in Lung Cancer Patients," IJERPH, MDPI, vol. 20(6), pages 1-15, March.

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