Asbestos Exposure and Smoking Interact to Greatly Increase the Risk of Lung Cancer and Other Breathing Diseases
Cigarette smoking and asbestos exposure are both associated with a higher risk for lung cancer.
However, scientists believe that people who have a history of both cigarette smoking and asbestos exposure are considerably more likely to develop lung cancer than people who have a history of only cigarette smoking or only asbestos exposure.
The Dangers of Asbestos Exposure and Cigarette Smoking
Asbestos and cigarettes are recognized public health hazards. According to the federal Centers for Disease Control and Prevention:
- Smoking is the leading cause of preventable death in the United States. Each year, more than 480,000 Americans die from combustible tobacco-related illnesses, while another 41,000 pass away from second-hand smoke exposure.
- Asbestos exposure is responsible for more occupational lung diseases than any other substance. An estimated 90,000 people around the world are killed by occupational asbestos exposure annually.
Asbestos, Tobacco, and Lung Cancer
Asbestos and cigarette smoking have both been tied to lung cancer.
People who have a history of cigarette smoking are:
- Between 15 and 30 times more likely to develop lung cancer than people who do not smoke.
- Have a 10 to 20 percent chance of developing lung cancer.
- Account for 80 percent of lung cancer diagnoses each year.
Similarly, asbestos exposure has been linked to:
- An elevated risk of lung cancer, with an estimated 4% of all lung cancer diagnoses being directly attributable to asbestos exposure.
- Other serious respiratory conditions, including asbestosis, pleural effusions, and aggressive cancers like mesothelioma.
Scientists have found that people who are no longer exposed to asbestos, or who have quit smoking, have a lower risk of developing lung cancer than people with recent histories of cigarette use or asbestos exposure.
How Asbestos Exposure and Tobacco Use Increase the Risk for Lung Cancer
Asbestos exposure and cigarette smoking are both associated with higher rates of lung cancer.
While former asbestos workers and ex-smokers can level their chances of getting lung cancer by staying away from these hazardous substances, researchers have uncovered alarming information:
- People who smoke are more likely to develop lung cancer than people who do not smoke; and
- People who a history of occupational or second-hand asbestos exposure are more likely to develop lung cancer than people with no history of asbestos exposure; but
- People who have histories of both cigarette smoking and asbestos exposure are far more likely to develop lung cancer than people who have a history of only cigarette smoking or only asbestos exposure.
How Cigarette Smoking makes Asbestos Exposure Worse
Scientists are still trying to understand the relationship between cigarette smoking, asbestos exposure, and serious medical conditions such as lung cancer.
Smoking could affect the clinical severity of asbestos-related illnesses by:
- Suppressing the body’s immune response. When asbestos fibers enter the respiratory system, they can get trapped inside the lungs and its pleural lining. However, cigarette smoking can suppress the immune system’s ability to attack asbestos fibers.
- Damaging lung tissue. Both cigarette smoking and asbestos fibers can scar lung tissue. Since smoking already suppresses the body’s ability to defend and repair itself, the lungs can develop even more scarring from asbestos exposure than they otherwise would.
- Impairing the lungs’ natural functions. Cigarette smoking can damage the tiny, brush-like cilia of the bronchus. Cilia help remove foreign particles, like dust and ash, from your airway. Tobacco smoke can also destroy other respiratory structures, making it more difficult for the lungs to circulate blood and oxygen.
Explaining the Synergistic Effect Between Tobacco Use and Asbestos
We know that smoking and exposure to asbestos can both erode the respiratory system’s ability to stay healthy and heal itself after injury.
However, researchers still do not understand exactly why people who have histories of both cigarette smoking and asbestos exposure are at such high risk for lung cancer. Consider this:
- Smoking increases an individual’s risk of lung cancer 10-fold; and
- Asbestos exposure increase an individual’s risk of lung cancer 5-fold; but
- Smoking and asbestos exposure increase an individual’s risk of lung cancer 50-fold.
The Multiplicative Effect of Cigarette Smoking and Asbestos Exposure on Health Problems
Researchers writing for the Journal of Environmental Research and Public Health call this a “multiplicative effect,” meaning that the separate risk factors of asbestos exposure and cigarette smoking seem to greatly enhance one another.
Why this happens is not understood. One theory suggests that asbestos fibers can act as a cancer-causing carcinogen by generating free radicals and reactive oxygen species. These tiny, highly reactive molecules can damage tissues and prompt the uncontrolled cellular growth characteristic of lung cancers.
Asbestos might also enhance inhaled tobacco’s cancerous properties.
Asbestos Workers and Tobacco Products
Many Americans were exposed to asbestos at work.
Asbestos was widely used in many industries between the 1920s and 1970s, before the dangers of asbestos became public knowledge.
Unfortunately, during this same period of time, the tobacco industry was also at its peak. Although cigarette smoking was known to be harmful by the mid-20th century, the Office of the U.S. Surgeon General did not issue its landmark report on smoking and health until 1964.
Consequently, many asbestos workers were also cigarette smokers. Some studies estimate that up to 80% also smoked cigarettes, meaning that millions of Americans are at elevated risk for lung cancer.
One of the most tragic ironies of the era is that some tobacco companies actually produced cigarette filters made from asbestos. Kent, for instance, used asbestos in its filters because asbestos was dense enough to contain tobacco particles and fumes but sufficiently porous to let smokers to inhale.
Kent’s use of asbestos filters exposed millions of smokers to asbestos—as well as hundreds of factory workers, who had to handle dangerous amounts of asbestos on Kent’s factory floors.
The Asbestos Industry and Big Tobacco
We know today that there is no safe level of asbestos exposure.
While the United States still does not have a full-scale asbestos ban, the Environmental Protection Agency restricted the manufacture, import, and sale of most asbestos products in the late 1980s.
However, the asbestos industry already knew that its products were dangerous. But instead of informing the public, they let American workers and American consumers continue to put their lives on the line.
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If you may have been exposed to asbestos, speak with your healthcare provider about tests and screening to help detect the presence of asbestos fibers and asbestos-related damage.
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