Session 5: Assessment Of Health Risk Associated With Exposure To Nonasbestiform Amphiboles Including Ingestion Studies: Rapporteus?s Report

Paper 1: Risk of gastrointestinal cancers from inhalation and ingestion of asbestos, John F. Gamble Selikoff suggested the hypothesis that asbestos exposure is causally associated with increased risk of gastrointestinal (GI) cancers in an early study of insulation workers. In this paper, John Gamble reports on his extensive review and reanalysis studies that address the relationship between asbestos exposure and GI cancers. The purpose of the review was to evaluate the association between asbestos exposure and risks of stomach, colorectal, colon, and rectal cancers separately. Gamble evaluated exposure?response (E?R) relationships using surrogate exposure methods ??because few individual studies of GI cancer have reported exposure? response analyses.?? The principal asbestos exposure surrogates are: (1) the rate ratio (RR) for lung cancer; and (2) the percent of mesothelioma among exposed workers. Analyzing SMRs for GI cancers from individual studies versus the risk of lung cancer and mesothelioma provides crude estimates of E?Rs for asbestos exposure and GI cancer. Briefly, Gamble justifies the surrogate approach as follows: