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Asbestos, Smoking and Lung Cancer: An Update
Sonja Klebe1, James Leigh2, Douglas W Henderson1
1Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia.
Summary
Asbestos exposure and tobacco smoke synergistically cause lung cancer through a multistage biological process. Even minimal asbestos exposure contributes to lung cancer risk in smokers and non-smokers.
Area of Science:
- Occupational Health
- Environmental Toxicology
- Cancer Epidemiology
Background:
- Asbestos exposure is a known risk factor for lung cancer.
- The interaction between asbestos and tobacco smoke in lung cancer development requires further clarification.
Purpose of the Study:
- To update the scientific literature on asbestos and lung cancer.
- To investigate the synergistic effects of asbestos and tobacco smoke on lung cancer.
- To propose an equitable compensation framework for asbestos-related lung cancer.
Main Methods:
- Re-evaluation of peer-reviewed epidemiologic studies.
- Inclusion of in vivo, in vitro animal studies, and human molecular/cellular studies.
- Statistical analysis to model interaction effects.
Main Results:
- Asbestos and tobacco smoke act conjointly in a multistage stochastic process for lung cancer causation.
- Evidence supports a synergistic relationship between asbestos exposure and tobacco smoke at a biological level.
- A multiplicative model best describes the interaction effects on lung cancer risk, irrespective of asbestosis.
Conclusions:
- Any asbestos exposure contributes to lung cancer risk, even in heavy smokers.
- New evidence supports biological synergism between asbestos and smoking in lung cancer.
- Proposed criteria for attributing lung cancer to asbestos in both smokers and non-smokers.
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