Mineral fibres and cancer.

A synthesis is presented of the salient findings to date from laboratory and epidemiological research, on the health effects of asbestos and other natural and man-made mineral fibres. Experimental evidence suggests that all mineral fibres are capable of causing fibrosis and malignancy, with chrysotile at least as pathogenic as other fibres. However, penetration, retention and phagocytosis are affected by size and shape and reactivity and durability by physico-chemical properties. Thus it is not surprising that in man the results of exposure vary considerably with fibre type and industrial process. A considerable body of evidence suggests that chrysotile has seldom, if ever, caused peritoneal mesothelioma and that the great majority of pleural mesotheliomas are also attributable to crocidolite or amosite. Without more reliable information on intensity and duration of exposure by fibre type, the epidemiological evidence on this point cannot be wholly conclusive. There are stronger grounds from a limited number of cohort studies for believing that in relation to estimated exposure, the risk of lung cancer has been much higher in textile plants than in fibre production or in the manufacture of friction products, with asbestos-cement plants somewhere in between. The data on man-made fibre production remains equivocal. It is concluded that attempts to regulate asbestos without regard for fibre type, although perhaps adequate for lung cancer and fibrosis, may do little to reduce the risk of mesothelioma. The search for safe fibre substitutes for asbestos will remain difficult until the parameters of pathogenicity are better understood.