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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 …
Comment on the original article: Gilham C, Rake C, Burdett G, et al. Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden. Occup Environ Med 2016;73:290–299.
Twitter Follow David Egilman at @degilman
Competing interests DE and CLS have testified at the request of injured workers, their spouses and others. DE has testified and consulted in litigation at the request of asbestos mining and product manufacturing companies. XB has prepared expert opinions for social courts and statutory accident insurance institutions.
Provenance and peer review Not commissioned; internally peer reviewed.