An Unjustified Prognosis of the Number of Asbestos-Related Lung Cancer Cases Caused by an Increase in Airborne Asbestos Concentrations as a Result of Removing of Asbestos-Cement Products

We have read the recently published article under an interesting title " Environmentally Related Diseases and the Possibility of Valuation of Their Social Costs " by I. Hajok et al. [1], the main objective of which was " to estimate the risks of the morbidity of the asbestos-related lung cancer in the general population of Poles as the result of increased exposure to asbestos fibers which occurs during the removal and disposal of asbestos-cement products in Poland. " Contrary to mesothelioma, considered to be a neoplasm specific to environmental exposure to asbestos [2–6], the risk of lung cancer is rarely a subject of analysis in the context of environmental exposure of residents. It is, among others, due to having no features of neoplasm that enable the indication of asbestos as a causative factor, as well as numerous competitive factors of the incidence of this neoplasm. According to the recommendations of the experts of WHO, in the case of this kind of neoplasm, the only practical approach is to use the population attributable fraction (PAF) [7, 8]. Therefore, the published article is even more noteworthy; its contents raise a number of questions and doubts concerning both substantive bases and methodological approach to the analysis. Firstly, the statement " increased exposure to asbestos fibers which occurs during the removal and disposal of asbestos-cement products in Poland " does not find its confirmation in the published papers. The size of asbestos fibers concentrations during removal of asbestos-cement products was in Poland a subject of numerous measurements taken on various work posts as well as in the atmospheric air. The published results do not confirm the thesis concerning both high concentrations of asbestos fibers during products dismantling as well as, related to these works, a considerable increase in the concentration of asbestos fibers in the atmospheric air, provided safe and legally regulated methods of work are applied [9–13]. Secondly, description of the method is limited to a very vague statement: " Taking into consideration the concentration of asbestos fibers in the air of particular administrative area and the number and type of former plants producing asbestos-cement products, as well as standardized incidence rates (SIR) of asbestos-dependent diseases (.. .) three zones of the country with varying degrees of risk of asbestos-related disease were isolated. " In order to make it possible for the readers to get familiar with the method applied, a reference number …