1/8/2009
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In stating that a threshold of effect has never been found for asbestos, Rall stands behind the outdated one fiber can kill theory of carcinogenesis. However, Rall fails to mention data supporting a threshold for chrysotile in lung cancer (11, asbestosis (12), and mesothelioma (13) as well as a panel report from the Health Effects Institute-Asbestos Research (HEI-AR) detailing animal and in vitro dose-response studies exhibiting no-observed adverse effect levels (NOAELs) for asbestos (14). Our recent work documents a dose-dependent increase in asbestos-induced proto-oncogene activation in mesothelial cells with no induction at lowest concentrations of fibers tested and an enhanced potency of crocidolite asbestos in comparison to chrysotile (15).
Dr. Finkelstein also cited five cases of mesothelioma among former Holmes workers. Three of the five workers died at less than fifty years of age and all were less than sixty years old!
The analysis of 335 cases of mesothelioma observed at the Ramazzini Foundation and the Bologna Institute of Oncology has shown: 1) a high percentage of correlation of these tumours with asbestos exposure; 2) a large number of population categories potentially exposed to asbestos fibres and therefore at risk of developing mesothelioma; and 3) the high risk of mesothelioma among people exposed in various circumstances to asbestos used in railroads and sugar refinery plants. ______________________________________________________ Med Lav 1997 Jul-Aug;88(4):316-20
Following the finding of an unexpected cluster of mesotheliomas in textile workers, a surveillance system of malignant mesotheliomas was implemented in the region of Tuscany, Italy. This article reports on the investigation of 124 cases of mesothelioma diagnosed and reviewed by the Institutes of Morbid Anatomy and Histopathology at the Universities of Florence, Pisa, and Siena between 1970 and 1988. A complete occupational and asbestos exposure history was assessed through a semi-structured questionnaire directly administered to resident cases of Tuscany or, if deceased, to their closest living relatives, for a total of 100 interviews. The hypothesis of past occupational asbestos exposure was verified and documented. Seventy-two cases have been classified as occupationally exposed to asbestos; four were classified in the category of possible domestic exposure to asbestos. For two others, the role of other risk .
Our 1990 article reported on recent papers in the peer-reviewed literature and two international symposia, one at the International Agency for Research on Cancer (2) and the other at Harvard University (3), all concluding that chrysotile fibers are less active than amphibole types (crocidolite, amosite, tremolite) of asbestos in the causation of mesothelioma in man. In his summary of the IARC meeting, Sir Richard Doll, an eminent epidemiologist, concluded there is the difference between the effects of chrysotile and amphiboles, which is so great in relation to mesothelioma that it is possible to argue that chrysotile does not cause mesothelioma at all (2). This observation has been supported by numerous peer-reviewed papers and working groups subsequently (4-6).
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