Lung cancer in naval personnel linked to asbestos exposure

New research from Oxford University and the University of Adelaide found that asbestos exposure has led to a higher incidence of asbestos-related lung cancers in British and Australian naval personnel. The study published November 14 in the journal Scientific Reports estimates that the proportion of lung cancers related to onboard asbestos exposure was 27 percent in Australian naval personnel and 12 percent in British servicemembers.

[Related: The US never banned asbestos. These workers are paying the price.]

Toxic exposure

This study is a reminder of the continuing need for protections against exposure to harmful airborne dusts and other dangerous substances from sources like toxic burn pits. According to the United States Department of Veterans Affairs, nearly 300,000 United States veterans have reported exposure to pollution from burn pits since the early 2000s. The chemical pollutants that were released during these burns include volatile organic compounds associated with cancer, kidney disease, and nervous system damage. In August 2022, President Joe Biden signed the PACT Act into law to address the health concerns related to burn pits like these.

Illnesses related to asbestos exposure persist, despite the mineral being a known carcinogen. Asbestos has been used in a wide variety of building materials for their strength, flexibility, and electrical and heat resistant properties. Breathing it in can cause mesothelioma, lung cancer, and a non-cancerous condition called asbestosis. About 1,290 Americans die annually from asbestos-related causes, according to the Centers for Disease Control and Prevention (CDC).

Australia currently has a ban and strict control on asbestos-containing materials, they still pose a risk to some workers. A 2021-2022 New South Wales Dust Disease Register report found that there were 142 cases of asbestosis and 111 deaths related to the illness. 

In the United States, asbestos use is not completely banned. The Environmental Protection Agency (EPA) proposed another ban in April of 2022 that has yet to be finalized. 

An increased risk to sailors

For this study, researchers collected data from 30,085 United Kingdom and Australian personnel who served during the 1950s and 1960s. During this time period, asbestos-containing materials were still present in British and Australian naval vessels. Earlier studies of one Australian and two British cohorts also involved in this new research found that increased rates of lung cancer could not be attributed to radiation exposure from nuclear testing. The team used a separate study of Australian Korean War veterans as a comparison in this new research.

The team found that all four cohorts had an elevated incidence of mesothelioma among naval veterans. This same rate was not not statistically significant among sailors from the Korean War. British and Australian personnel involved in nuclear testing also saw higher rates of lung cancers.

Additionally, the rates of pulmonary disease and heart disease were similar between naval and army personnel. This suggests that smoking was not driving higher lung cancer rates among sailors.

[Related: The PACT Act will take the burden of proof off US veterans exposed to burn pits.]

“We found the lung cancer rate was higher overall in naval personnel than in the other armed services, and, while smoking remains the dominant cause of lung cancer, it is unlikely the excess could be explained by a higher smoking rate in the navy,” study co-author and University of Adelaide medical doctor Richard Gun said in a statement.  “Although actual measurements of airborne asbestos levels were not available, and estimates are difficult, we have concluded that the higher lung cancer rate in sailors was most probably caused by onboard asbestos exposure.”

The high occurrence of deaths in sailors from asbestosis also strengthened the team’s conclusion. The team believes that the effects of asbestos exposure are likely underestimated, unless lung cancer is considered alongside mesothelioma and asbestosis.

“Although it remains true that smoking causes most lung cancers, other agents such as asbestos can contribute to the incidence of cancer in an exposed population,” Gun said. “Moreover, we know from other studies that the combination of smoking and asbestos exposure has an enhanced influence on lung cancer risk; this interactive effect would have contributed to the observed lung cancer excess.”