Author's reply: Clarification of data on the etiological role of cigarette smoking in pulmonary fibrosis
✍ Scribed by Kaye H. Kilburn
- Publisher
- John Wiley and Sons
- Year
- 1984
- Tongue
- English
- Weight
- 84 KB
- Volume
- 5
- Category
- Article
- ISSN
- 0271-3586
No coin nor oath required. For personal study only.
✦ Synopsis
Author's Reply: Clarification of Data on the Etiological Role of Cigarette Smoking in Pulmonary Fibrosis
As predicted, Dr. Weiss has leaped to repeat and thus hopefully to defend his original illogical conclusions concerning an etiological role of cigarette smoking in pulmonary fibrosis [Weiss, 19691. We should thank him for noting the mix-up in references, but this has long since been corrected [Kilburn, 19811. The Auerbach studies on beagles used a "microscope to appraise fibrosis on tissue section." Even if this is microscopic fibrosis, these observations cannot be taken to support the thesis of experimental production of fibrosis, which can be seen by X-ray. I am pleased to see Dr. Weiss admit to grave observer error problems with photofluorograms, which should not be used to appraise fibrosis-or any other pulmonary problem because of the excessive dosage of radiation that they entail.
Lastly, increased death rates in cigarette smokers exposed to asbestos [Hammond, Selikoff, and Seidman, 19791 should not be interpreted as a causal proof of asbestosis (as pulmonary fibrosis). Indeed, everyone knows that cigarette smokers have a higher overall mortality as well as a greater death rate from respiratory diseases. Thus to have died with asbestosis may not mean to have died of asbestosis. Weiss appears influenced unduly by the Samet et a1 [1979] conclusion, as he quoted: "Their data showed as summarized in [Kilburn, 19811 that the regression coefficients for radiological signs of asbestosis against increased exposure were the same for nonsmokers, past smokers and present smokers." Thus the protests and objections raised are trivial and immaterial and do not threaten to invalidate the conclusion that cigarette smoking does not produce or enhance the radiologic appearance of pulmonary fibrosis. It will take meticulous new investigation of large enough numbers to determine the relationship. A causal relationship cannot be inferred from present data.