Research Perspectives Derived from Asbestos Experience

The unhappy experience with asbestos provides not only the stimulus for examination of potential toxicity of other fibers, but perhaps useful general guidelines to their clinical and epidemiological evaluation.

We know a good deal about the spectrum of disease with at least this one group of fibrous minerals (as well as with the zeolite, erionite) and, although different neoplasms and different diseases might well occur with other inorganic fibers that have been and will be proposed as asbestos replacements, there is a good chance that investigation of the increased incidence of the asbestos cancers will be helpful in evaluating substitutes for toxicity to humans.

Also, it is likely that the same sort of latency is involved (with concordant age distribution) and there may even be such multiple factor interaction as that seen between asbestos and cigarette smoking (51, 52).

Nevertheless, study of potential human toxicity of substitutes, while very important, is perhaps inadequate. Additionally, prevention of disease should be a concern, from the beginning. In this, I would include not merely primary prevention (avoidance of exposure), but secondary prevention of disease, even should substantial exposure sometimes occur (perhaps inevitable if a substance is to be used at all).

To review the references in Dr. Selikoff’s article see Pages 275-276 of his report.