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Gilham and colleagues conclude that there is a linear dose–response relationship between lung asbestos burden and the development of mesothelioma, and that the lung burden should be considered a reliable tool to predict future mesothelioma rates in participants born since 1965.
The paper and commentary are based on incorrect assumptions that generate both an invalid analysis and invalid conclusions:
The authors exclusively rely on asbestos fibre counts measured in lung tissue decades after exposures had taken place, as an indicator of asbestos dose.
Only 2% of the fibres identified were chrysotile, while chrysotile represented as much as 90% of the asbestos used in the UK. Chrysotile is not lung biopersistent; but biopersistence correlates with neither lung …