Reviewer: John T. Pierce, MBBS (MD) PhD(Navy Environmental Health Center)
Description: Dr. Dorsett Smith has written what can be considered a relatively unbiased review of the medical literature on the health effects of asbestos, by considering more than 5,000 bibliographic entries. His perspective is that of a practicing pulmonologist considering many counterpart reviews usually prepared by pathologists or toxicologists.
Purpose: It appears Dr. Smith's later chapters devoted to government agency interventions in the manner of safety standards, his discussion of a possible safe or risk-free level of asbestos exposure, and his questioning of risk provide us with a clue as to why he has devoted so much of his professional life to the health effects of asbestos.
Audience: Occupational and environmental medicine practitioners, as well as those working in allied disciplines such as industrial hygiene and occupational epidemiology, will constitute the core readership.
Features: The 22 chapters include critical reading, limitations of epidemiology, clinical toxicology, history of commercial use, defining asbestosis, association of lung cancer and asbestos, effect of smoking and lung cancer, asbestos-related pleural disease, disability and impairment in asbestosis, evolution of workers' compensation, additional malignancies, asbestos exposure and mesothelioma, other causes of mesothelioma, mesothelioma and asbestos fiber type, chrysotile and mesothelioma, the tremolite hypothesis, mesothelioma latency and risk, household and neighborhood exposures, U.S. Navy issues, government interventions, and questions of risk-free levels.
Assessment: What Dr. Smith outlines as an evidence-based approach is likely as relevant to other key toxic materials as it is to asbestos. His first chapter, devoted to reading and finding truth in the medical scientific literature, is instructive in many fields. An understanding of the health effects of asbestos has remained as refractory as the mineral itself. I'll return to these pages many times, as much to understand how we have proceeded, as to review the specific health-related effects of asbestos.
"What Dr. Smith outlines as an evidence-based approach is likely as relevant to other key toxic materials as it is to asbestos. His first chapter, devoted to reading and finding truth in the medical scientific literature, is instructive
in many fields. An understanding of the health effects of asbestos has remained as refractory as the mineral itself. I'll return to these pages many times, as much to understand how we have proceeded, as to review the specific health-related effects of asbestos." - J. Thomas Pierce, MBBS PhD (Navy Environmental Health Center)
"What Dr. Smith outlines as an evidence-based approach is likely as relevant to other key toxic materials as it is to asbestos. His first chapter, devoted to reading and finding truth in the medical scientific literature, is instructive in many fields. An understanding of the health effects of asbestos has remained as refractory as the mineral itself. I'll return to these pages many times, as much to understand how we have proceeded, as to review the specific health-related effects of asbestos."
—4 stars (95/100), J. Thomas Pierce, MBBS PhD (Navy Environmental Health Center), Doody's Book Review Service
