Assessing specific causation of mesothelioma following exposure to chrysotile asbestos-containing brake dust
Cette étude américaine fait le point sur l'association entre une exposition, dans l'industrie automobile, à l'amiante chrysotile contenue dans les poussières de plaquettes de frein et le risque de mésothéliome
The question of whether chrysotile asbestos-containing brake dust can plausibly serve as a cause of mesothelioma in an exposed individual has become a matter of heated debate in the medical literature despite multiple international, federal, and state governmental agencies acknowledging a causal association. We describe and provide an analysis of various industry and academic perspectives contributing to the debate. A framework is presented for evaluating the general and specific causal relationship between brake dust exposure and mesothelioma utilizing the principles of forensic epidemiology, and by applying the Bradford-Hill criteria. We conclude that there is a "net"of evidence favoring a causal relationship between brake dust-associated chrysotile exposure and mesothelioma. The industry-sponsored position that there is insufficient evidence to support a contiguous "chain"of causation is specious from both a methodologic and evidentiary perspective. Finally, we suggest a semiquantitative approach for the evaluation of individual causation in putative cases of mesothelioma with a history of significant brake dust exposure.
http://www.ingentaconnect.com/content/maney/oeh/2012/00000018/00000004/art00009