Abstract
•The diagnosis Asbestos-Related Lung Cancer (ARLC) is much more frequent (2–6 times) than the mesothelioma diagnosis.•The largest interface between body and environment can be found in the lung and the pulmonary epithelium acts as a sieve for inhaled carcinogens.•To allow better attribution of lung cancer diagnoses to asbestos high- quality occupational and residential data is needed.•Research effort is needed to estimate the proportion of small asbestos fibres potentially contributing to ‘fine dust’ air pollution (PM2.5).
Asbestos, a group of class I (WHO) carcinogenic fibers, is the main cause of mesothelioma. Asbestos inhalation also increases the risk to develop other solid tumours with lung cancer as the most prominent example [91]. The incidence of asbestos-related lung cancer (ARLC) is estimated to be to six times larger than the mesothelioma incidence thereby becoming an important health issue [86]. Although the pivotal role of asbestos in inducing lung cancer is well established, the precise causal relationships between exposures to asbestos, tobacco smoke, radon and ‘particulate’ (PM2.5) air pollution remain obscure and new knowledge is needed to establish appropriate preventive measures and to tailor existing screening practices[22,61,65]. We hypothesize that a part of the increasing numbers of lung cancer diagnoses in never-smokers can be explained by (historic and current) exposures to asbestos as well as combinations of different forms of air pollution (PM2.5, asbestos and silica).