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Smoking, Asbestos Exposure, and Lung Cancer

By far, smoking cigarettes is the leading cause of lung cancer in the United States. Accounting for nearly 90 percent of all lung cancer cases, smoking is the leading cause of preventable death and accounts for one out of every five deaths each year. But smokers that experience exposure to asbestos are at an even greater risk of developing lung cancer than smokers who never experience asbestos exposure.

According to the American Cancer Society, a relationship between asbestos exposure and lung cancer was documented as early as 1925, and confirmed by many epidemiologic studies of asbestos-exposed workers over the next 70 years. In comparison to the general nonsmoking public, nonsmokers exposed to asbestos are five times more likely to develop lung cancer.

As early as the 1950s, the medical industry began to note an apparent relationship between the development of lung cancer and the combined effects caused by both smoking and receiving exposure to asbestos. Though the carcinogenic affects of asbestos and cigarettes independently cause lung cancer, exposure to both results in an increased risk that is greater than the additive sum of the two risks. This is known as multiplicative synergism, which suggests the attributable risks for asbestos exposure and smoking exceed the total risk of their sum.

As a result of this multiplicative synergism, smokers who are exposed to asbestos are 50 to 84 times more likely to develop lung cancer, and some studies have even found these figures to lie closer to 80 to 90 times the risk of control populations. They are also at a greater risk of developing both asbestosis and mesothelioma cancer.

Exposure to all six regulated types of asbestos has shown to increase one's risk of developing lung cancer. Even unregulated forms of asbestos, such as winchite and richterite, which compose the bulk of asbestos contamination at the infamous vermiculite mine in Libby, Montana, have proven to cause lung cancer among those exposed.

A study published in 2001, which reviewed 22 cohort studies regarding the relationship between smoking, asbestos exposure, and lung cancer, found that asbestos exposure increases the risk of lung cancer in both smokers and nonsmokers. The study also found the relationship between smoking and asbestos is best explained by a multiplicative model rather than an additive model. Researchers noted"the increased risk [for lung cancer] from smoking varies by amount of cigarettes smoked, duration of smoking, inhalation, and product smoked," and"the increase for asbestos also depends on many factors, not only extent and duration of exposure, but also types of asbestos and nature of exposure."

However, there is hope for smokers who have experienced asbestos exposure. According to the National Cancer Institute, evidence has suggested that asbestos-exposed workers who quit smoking can effectively reduce their risk of developing lung cancer by up to 50 percent within five years of quitting. Anyone who has experienced asbestos exposure should not smoke, and those who do smoke should quit immediately. These individuals should also seek a medical exam from their physician and should have regular checkups to monitor the health of their lungs.

Sources:

1. http://www.cdc.gov/tobacco/data_statistics/factsheets/adult_cig_smoking.htm
2. http://www.cancer.org/docroot/PED/content/PED_1_3X_Asbestos.asp?sitearea=PED
3. http://www.cancer.gov/cancertopics/factsheet/Risk/asbestos
4. http://www.atsdr.cdc.gov/asbestos/asbestos/health_effects/
5. http://www.emedicine.com/med/topic1333.htm
6. Lee, P. Relation between exposure to asbestos and smoking jointly and the risk of lung cancer. Occupational Environmental Medicine. 2001 March; 58(3): 145–153. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1740104.
7. Castleman, Barry. Asbestos: Medical and Legal Aspects. Aspen Publishers: New York. 2005.
8. R., Dodson, S. Hammar. Asbestos: Risk Assessment, Epidemiology, and Health Effects. Taylor & Francis: Boca Raton. 2006.

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