IOM Report: Asbestos Can Cause Laryngeal Cancer

Report Online The report is available online at national-academies.org

WASHINGTON, DC-A committee of the Institute of Medicine (IOM) here has concluded that there is enough scientific evidence to state that exposure to asbestos causes cancer of the larynx. Asbestos-exposed smokers may be at even higher risk of laryngeal cancer because of the potential interaction between inhaled asbestos particles and smoking-triggered laryngeal irritation.

The IOM committee, chaired by Jonathan M. Samet, MD, MS, Professor and Chairman of the Department of Epidemiology at Johns Hopkins University’s Bloomberg School of Public Health, found that there is suggestive but insufficient evidence that asbestos exposure causes cancers of the pharynx, stomach, colon, and rectum.

As for esophageal cancer and asbestos exposure, the committee, which included former American Medical Association President Lonnie R. Bristow, MD, concluded in its pre-publication report, Asbestos: Selected Cancers, that the scientific evidence is not sufficient to draw any conclusions. The term asbestos is applied to several mineral species when they occur in a fibrous form. Asbestos particles can do damage when they are inhaled.

The new IOM study was funded by a contract with the National Institutes of Health at the request of Senator Arlen Specter (R-Pa.), a senior member of the Senate Appropriations Committee and a champion of miners’ health and safety. His state, Pennsylvania, has a history of mining.

Fairness in Asbestos Injury Resolution Act

Senate Bill 852, the Fairness in Asbestos Injury Resolution (FAIR) Act, was the impetus behind the IOM committee’s charge of determining whether asbestos was causal in the five cancers studied.

If passed, this bill would establish an industry-funded $140 billion trust fund for monetary compensation of people suffering from the adverse health effects of working with asbestos or of living in Libby, Mont., a high-exposure town. Laryngeal cancer is relatively uncommon: there will be about 9500 new cases this year, according to the American Cancer Society (ACS). About 3740 people will die of laryngeal cancer this year, according to ACS data.

During the 20th century (especially during the years of World War II), asbestos was used in many products, including home insulation and roofing products, and people are still exposed despite a drop in production since the 1980s.

Jonathan M. Samet, MD, MS, chaired the committee that wrote the report. The Institute of Medicine undertook the study to answer questions raised in congressional discussions about compensation for people with ailments associated with asbestos exposure. The study committee assessed the quality, limitations, and applicability of 120 epidemiological studies of asbestos exposure and cancers of the throat and digestive tract, as well as information from 200 experimental studies.

In 1973 the U.S. Environmental Protection Agency banned the spraying of asbestos insulation in housing, and other restrictions later followed. Asbestos fibers are known to be carcinogenic. Asbestos has already been shown to be causally linked to lung cancer and mesothelioma, a rare tumor of the pleural and peritoneal mesothelium.