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Am J Ind Med. 1999 Sep;36(3):331-47.

A study of lung cancer mortality in asbestos workers: Doll, 1955.


Between 1935 and 1953, a series of publications appeared in England, Germany and America reporting cases of lung cancer amongst asbestos workers. As early as 1943, the German scientific consensus was that the evidence was strong enough to deem the association to be causal. On reviewing a more extensive bibliography, this view was shared by an American cancer expert. The results of industry sponsored experiments, in which lung tumors had been induced in mice by asbestos, were circulated in confidence to its scientists, but being unpublished were unknown to the general scientific community. There were also cancer mortality data recorded for populations of exposed asbestos workers, but these were confidential and remained to be analyzed. To deal with the persistent allegations of a lung cancer hazard, in 1953 Dr. Richard Doll was asked by Turner Brothers Asbestos ("the Company"), whose in-house analyses had been reassuring, to study the mortality data of a group of its workers. Despite the limitations of the data, Doll convincingly demonstrated so substantial an excess of lung-cancer in heavily exposed long-term asbestos workers as to overcome honest doubt. Despite determined attempts made to dissuade them, Doll and the editor of the journal to which he submitted his paper, courageously went ahead and published the paper. Industry overestimated the harm that publication of the paper would do to their immediate interests. It produced so profound a lack of sense of urgency, that legislation addressed to the control of lung cancer specifically had to wait 20 years, and asbestos workers contracting it were to wait 25 years, before they might be considered for compensation, and even then, only under extremely limiting conditions.

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