Excerpt

The committee was charged with reviewing evidence on a widely used material that is known to cause respiratory malignancy. Asbestos has been extensively investigated, epidemiologically and experimentally, as a cause of mesothelioma and lung cancer. However, its potential to cause malignancy at other sites that may also receive a substantial dose of asbestos fibers has not been as extensively investigated.

The committee considered the existing evidence from in vitro and animal experimentation to gain an understanding of mechanisms of carcinogenesis that might plausibly apply to the tissues in question and to determine the extent of toxicologic support for the development of cancers at the specified sites following asbestos exposure. Much of the information reviewed by the committee came from cohort studies of workers that focused on investigating respiratory effects and that reported information on risks of other diseases, including the cancers covered by this committee's charge, only incidentally. Other evidence came from case-control studies that were directed at the causes of the cancers of interest but that were not specifically designed to address asbestos exposure, and their exposure assessments were of varied quality.

Contents

• The National Academies
• Committee on Asbestos: Selected Health Effects
• Reviewers
• Summary
  • INTRODUCTION
  • COMMITTEE APPROACH
  • COMMITTEE FINDINGS
  • CLOSING COMMENTS
• 1. Introduction
  • STATEMENT OF CHARGE
  • CURRENT LEGISLATION
  • OVERVIEW OF PATTERNS OF ASBESTOS USE AND RECOGNITION OF ITS HEALTH CONSEQUENCES
  • COMMITTEE’S APPROACH TO ITS CHARGE
  • REFERENCES
• 2. Committee’s Approach to Its Charge and Methods Used in Evaluation
  • GENERAL APPROACH TO EVIDENCE REVIEW
  • EVIDENCE CONSIDERED
  • CRITERIA FOR EVIDENCE EVALUATION
  • METHODS USED FOR QUANTITATIVE META-ANALYSIS
  • INTEGRATION OF DATA
  • REFERENCES
• 3. Background Information on Asbestos
  • INTRODUCTION
  • “FIBROUS” AND “ASBESTIFORM”
  • SERPENTINE ASBESTOS (CHRYSOTILE) MINERALOGY
  • AMPHIBOLE ASBESTOS MINERALOGY
  • PROPERTIES OF POTENTIALLY HAZARDOUS FIBROUS MINERALS
  • REFERENCES
• 4. Exposure and Disposition
  • EXPOSURE
  • DOSIMETRY
  • REFERENCES
• 5. Biological Aspects of Asbestos-Related Diseases
  • ASBESTOS-RELATED PULMONARY DISEASES AND THEIR MECHANISMS
  • INFORMATION FROM ANIMAL STUDIES
  • BIOMARKERS
  • REFERENCES
• 6. Description of Epidemiologic Studies Included in Evidentiary Dataset
  • COHORT STUDIES
  • CASE-CONTROL STUDIES
  • INTEGRATION OF EPIDEMIOLOGIC EVIDENCE WITH NON-EPIDEMIOLOGIC EVIDENCE
  • REFERENCES
• 7. Pharyngeal Cancer and Asbestos
  • NATURE OF THIS CANCER TYPE
  • EPIDEMIOLOGIC EVIDENCE CONSIDERED
  • EVIDENCE INTEGRATION AND CONCLUSION
  • REFERENCES
• 8. Laryngeal Cancer and Asbestos
  • NATURE OF THIS CANCER TYPE
  • EPIDEMIOLOGIC EVIDENCE CONSIDERED
  • EVIDENCE INTERGRATION AND CONCLUSION
  • REFERENCES
• 9. Esophageal Cancer and Asbestos
  • NATURE OF THIS CANCER TYPE
  • EPIDEMIOLOGIC EVIDENCE CONSIDERED
  • EVIDENCE INTEGRATION AND CONCLUSION
  • Conclusion
  • REFERENCES
• 10. Stomach Cancer and Asbestos
  • NATURE OF THIS CANCER TYPE
  • EPIDEMIOLOGIC EVIDENCE CONSIDERED
  • EVIDENCE INTERGRATION AND CONCLUSION
  • REFERENCES
• 11. Colorectal Cancer and Asbestos
  • NATURE OF THIS CANCER TYPE
  • EPIDEMIOLOGIC EVIDENCE CONSIDERED
  • EVIDENCE INTEGRATION AND CONCLUSION
  • REFERENCES
• 12. Summary and Recommendations
  • SUMMARY
  • RECOMMENDATIONS
• Appendixes
  • A Agendas of Public Meetings Held by the Committee on Asbestos: Selected Health Effects
  • B Lineage and Design Properties of Studies on Cohorts Informative for Selected Cancers
  • C Description of Case-Control Studies of All Selected Cancers as Related to Exposure to Asbestos
  • D Cohort Results Tables
  • E Case-Control Results Tables
  • F Initial Analyses of Available Data Concerning Cancers of Colon and/or Rectum and Asbestos Exposure
  • G Committee on Asbestos: Selected Health Effects

This study was supported by Contract N01-OD-4-2139 between the National Academy of Sciences and the National Institutes of Health. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.