Cullen M R
Occup Med. 1987 Apr-Jun;2(2):259-72.
Despite clear agreement that asbestos exposure causes lung cancer and despite prodigious research efforts in clinical, epidemiologic, toxicologic and mineralogic aspects of the problem, wide disagreement exists in the scientific community on many crucial points. Put in the simplest way neither the biologically relevant measure of dose nor the full shape of the dose-response curve at either the high or (especially) low end is understood. Nor is the relationship between the carcinogenic potential of the fibers and their fibrogenic properties. In the long run, full resolution of these issues will probably require the unravelling of the basic mechanisms by which the fibers induce cancer; unfortunately, despite recent progress, this understanding is probably too far off to be of use in the solution to the very real, omnipresent clinical and public health cancer-control problems. Decisions will have to be made using data sets far less satisfactory. Hopefully, by pursuing some of the avenues suggested in the sections above, enough can be learned to facilitate more rational approaches to the problems at hand.
尽管人们明确一致认为接触石棉会导致肺癌，并且在该问题的临床、流行病学、毒理学和矿物学方面进行了大量研究工作，但科学界在许多关键问题上仍存在广泛分歧。用最简单的话来说，无论是剂量的生物学相关测量方法，还是高剂量或（尤其是）低剂量时剂量反应曲线的完整形态，都尚未明确。纤维的致癌潜力与其致纤维化特性之间的关系也不清楚。从长远来看，要全面解决这些问题可能需要弄清楚纤维诱发癌症的基本机制；不幸的是，尽管最近取得了进展，但这种理解可能还很遥远，无法用于解决非常现实、普遍存在的临床和公共卫生癌症控制问题。不得不使用远不那么令人满意的数据集来做出决策。希望通过探索上述各节中提出的一些途径，能够学到足够的知识，以便更合理地应对手头的问题。
