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Siefert E, Delva F, Paris C, Pairon JC, Thaon I. Quality of life in retired workers with past exposure to asbestos. Am J Ind Med 2024; 67:610-623. [PMID: 38734874 DOI: 10.1002/ajim.23592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/31/2024] [Accepted: 04/25/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND Asbestos causes cancer and non-cancerous lung and pleural diseases and can also have a negative psychological impact but little is known about its effect on health-related quality of life. OBJECTIVES The aim of this study is to describe the health-related quality of life (HRQoL) of retired men with a history of occupational exposure to asbestos and examine factors linked with low HRQoL. METHODS Retired male workers of the French Asbestos-Related Disease Cohort (ARDCO) completed self-questionnaires that included SF-36v2 and HAD scales, questions about their perception of asbestos (perceived dangers and level of exposure, expectations to fall ill, or knowing someone who is) and their respiratory symptoms. Asbestos exposure was assessed by industrial hygienists. A perceived risk score was created using factorial analysis. Multivariable regressions were performed for all SF-36 subscales. RESULTS A total of 1266 of 2075 questionnaires (61%) were returned complete and included in analysis. After adjustment for potential confounders, an increase in perceived risk score resulted in a decrease in physical component summary score (PCS), up to 10.7 points (p = 0.048) and in mental component summary score (MCS) (p = 0.044). Presence of respiratory symptoms was also associated with significantly decreased PCS and MCS (p < 0.001). Poor HRQoL was linked to higher perceived risk score with p ≤ 0.01 for all SF-36 dimensions. Asbestos exposure assessed by an expert was not associated with any outcome. CONCLUSIONS All dimensions of HRQoL appear to be affected by the perceived risk of incurring asbestos-related disease and respiratory symptoms.
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Affiliation(s)
- Emmanuelle Siefert
- INSPIIRE, Université de Lorraine, Inserm, Nancy, France
- Centre de consultations de pathologies professionnelles, CHRU-Nancy, Nancy, France
| | - Fleur Delva
- Epicene Team, I, INSERM U1219 - Bordeaux Population Health Research Center, Bordeaux, France
- Service Santé Travail Environnement, CHU Bordeaux, Bordeaux, France
| | - Christophe Paris
- Service de Santé au Travail et Pathologie Professionnelle, CHU Rennes, Rennes, France
- Equipe ESTER, Institut de Recherche en Santé, Environnement et Travail, Rennes, France
| | - Jean-Claude Pairon
- GEIC20 Team, INSERM U955, F-94000, Créteil, France
- Service de Pathologies Professionnelles et de l'Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, Créteil, France
| | - Isabelle Thaon
- INSPIIRE, Université de Lorraine, Inserm, Nancy, France
- Centre de consultations de pathologies professionnelles, CHRU-Nancy, Nancy, France
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2
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Cleven KL, Zeig-Owens R, Mueller AK, Vaeth B, Hall CB, Choi J, Goldfarb DG, Schecter DE, Weiden MD, Nolan A, Salzman SH, Jaber N, Cohen HW, Prezant DJ. Interstitial Lung Disease and Progressive Pulmonary Fibrosis: a World Trade Center Cohort 20-Year Longitudinal Study. Lung 2024; 202:257-267. [PMID: 38713420 PMCID: PMC11142940 DOI: 10.1007/s00408-024-00697-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/09/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE World Trade Center (WTC) exposure is associated with obstructive airway diseases and sarcoidosis. There is limited research regarding the incidence and progression of non-sarcoidosis interstitial lung diseases (ILD) after WTC-exposure. ILD encompasses parenchymal diseases which may lead to progressive pulmonary fibrosis (PPF). We used the Fire Department of the City of New York's (FDNY's) WTC Health Program cohort to estimate ILD incidence and progression. METHODS This longitudinal study included 14,525 responders without ILD prior to 9/11/2001. ILD incidence and prevalence were estimated and standardized to the US 2014 population. Poisson regression modeled risk factors, including WTC-exposure and forced vital capacity (FVC), associated with ILD. Follow-up time ended at the earliest of incident diagnosis, end of study period/case ascertainment, transplant or death. RESULTS ILD developed in 80/14,525 FDNY WTC responders. Age, smoking, and gastroesophageal reflux disease (GERD) prior to diagnosis were associated with incident ILD, though FVC was not. PPF developed in 40/80 ILD cases. Among the 80 cases, the average follow-up time after ILD diagnosis was 8.5 years with the majority of deaths occurring among those with PPF (PPF: n = 13; ILD without PPF: n = 6). CONCLUSIONS The prevalence of post-9/11 ILD was more than two-fold greater than the general population. An exposure-response gradient could not be demonstrated. Half the ILD cases developed PPF, higher than previously reported. Age, smoking, and GERD were risk factors for ILD and PPF, while lung function was not. This may indicate that lung function measured after respirable exposures would not identify those at risk for ILD or PPF.
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Affiliation(s)
- Krystal L Cleven
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Alexandra K Mueller
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
| | - Brandon Vaeth
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jaeun Choi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David G Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David E Schecter
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA
| | - Michael D Weiden
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
- New York University Grossman School of Medicine, New York, NY, USA
| | - Anna Nolan
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
- New York University Grossman School of Medicine, New York, NY, USA
| | - Steve H Salzman
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
| | - Nadia Jaber
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA
| | - Hillel W Cohen
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - David J Prezant
- Department of Medicine, Montefiore Medical Center, Bronx, NY, USA.
- Bureau of Health Services, Fire Department of the City of New York, 9 Metrotech Center, Brooklyn, NY, 11201, USA.
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.
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3
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Groot Lipman KB, Boellaard TN, de Gooijer CJ, Bogveradze N, Hong EK, Landolfi F, Castagnoli F, Vakhidova N, Smesseim I, van der Heijden F, Beets-Tan RG, Wittenberg R, Bodalal Z, Burgers JA, Trebeschi S. Artificial Intelligence-based Quantification of Pleural Plaque Volume and Association With Lung Function in Asbestos-exposed Patients. J Thorac Imaging 2024; 39:165-172. [PMID: 37905941 PMCID: PMC11027965 DOI: 10.1097/rti.0000000000000759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
PURPOSE Pleural plaques (PPs) are morphologic manifestations of long-term asbestos exposure. The relationship between PP and lung function is not well understood, whereas the time-consuming nature of PP delineation to obtain volume impedes research. To automate the laborious task of delineation, we aimed to develop automatic artificial intelligence (AI)-driven segmentation of PP. Moreover, we aimed to explore the relationship between pleural plaque volume (PPV) and pulmonary function tests. MATERIALS AND METHODS Radiologists manually delineated PPs retrospectively in computed tomography (CT) images of patients with occupational exposure to asbestos (May 2014 to November 2019). We trained an AI model with a no-new-UNet architecture. The Dice Similarity Coefficient quantified the overlap between AI and radiologists. The Spearman correlation coefficient ( r ) was used for the correlation between PPV and pulmonary function test metrics. When recorded, these were vital capacity (VC), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO). RESULTS We trained the AI system on 422 CT scans in 5 folds, each time with a different fold (n = 84 to 85) as a test set. On these independent test sets combined, the correlation between the predicted volumes and the ground truth was r = 0.90, and the median overlap was 0.71 Dice Similarity Coefficient. We found weak to moderate correlations with PPV for VC (n = 80, r = -0.40) and FVC (n = 82, r = -0.38), but no correlation for DLCO (n = 84, r = -0.09). When the cohort was split on the median PPV, we observed statistically significantly lower VC ( P = 0.001) and FVC ( P = 0.04) values for the higher PPV patients, but not for DLCO ( P = 0.19). CONCLUSION We successfully developed an AI algorithm to automatically segment PP in CT images to enable fast volume extraction. Moreover, we have observed that PPV is associated with loss in VC and FVC.
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Affiliation(s)
- Kevin B.W. Groot Lipman
- Department of Radiology
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam
- Technical Medicine, University of Twente, Enschede
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
| | | | | | - Nino Bogveradze
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
- Academic Pridon Todua Medical Center, Research Institute of Clinical Medicine, Tbilisi, GA
| | - Eun Kyoung Hong
- Department of Radiology
- Seoul National University Hospital, Seoul, South Korea
| | - Federica Landolfi
- Department of Radiology
- Radiology Unit, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Francesca Castagnoli
- Department of Radiology
- Department of Radiology, University of Brescia, Brescia, IT
- Department of Radiology, Royal Marsden Hospital, London, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | | | - Illaa Smesseim
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam
| | - Ferdi van der Heijden
- Department of Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
| | - Regina G.H. Beets-Tan
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
- Faculty of Health Sciences, University of Southern Denmark, Odense, DK
| | | | - Zuhir Bodalal
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
| | - Jacobus A. Burgers
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam
| | - Stefano Trebeschi
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
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Visonà SD, Bertoglio B, Capella S, Belluso E, Austoni B, Colosio C, Kurzhunbaeva Z, Ivic-Pavlicic T, Taioli E. Asbestos burden in lungs of mesothelioma patients with pleural plaques, lung fibrosis and/or ferruginous bodies at histology: a postmortem SEM-EDS study. Carcinogenesis 2024; 45:131-139. [PMID: 38069464 DOI: 10.1093/carcin/bgad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 03/12/2024] Open
Abstract
The causal attribution of asbestos-related diseases to past asbestos exposures is of crucial importance in clinical and legal contexts. Often this evaluation is made based on the history of exposure, but this method presents important limitations. To assess past asbestos exposure, pleural plaques (PP), lung fibrosis and histological evidence of ferruginous bodies (FB) can be used in combination with anamnestic data. However, such markers have never been associated with a threshold value of inhaled asbestos. With this study we attempted to shed light on the dose-response relationship of PP, lung fibrosis and FBs, investigating if their prevalence in exposed individuals who died from malignant mesothelioma (MM) is related to the concentration of asbestos in lungs assessed using scanning electron microscopy equipped with energy dispersive spectroscopy. Moreover, we estimated the values of asbestos concentration in lungs associated with PP, lung fibrosis and FB. Lung fibrosis showed a significant positive relationship with asbestos lung content, whereas PP and FB did not. We identified, for the first time, critical lung concentrations of asbestos related to the presence of PP, lung fibrosis and FB at histology (respectively, 19 800, 26 400 and 27 400 fibers per gram of dry weight), that were all well-below the background levels of asbestos identified in our laboratory. Such data suggest that PP, lung fibrosis and FB at histology should be used with caution in the causal attribution of MM to past asbestos exposures, while evaluation of amphibole lung content using analytical electron microscopy should be preferred.
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Affiliation(s)
- S D Visonà
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - B Bertoglio
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - S Capella
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates 'G. Scansetti', University of Torino, Torino, Italy
| | - E Belluso
- Department of Earth Sciences, University of Torino, Torino, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates 'G. Scansetti', University of Torino, Torino, Italy
| | - B Austoni
- Department of Public Health, Experimental and Forensic Medicine, Unit of Legal Medicine and Forensic Sciences, University of Pavia, Pavia, Italy
| | - C Colosio
- Department of Health Sciences, University of Milan, Milan, Italy
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
| | - Z Kurzhunbaeva
- Department of Health Sciences; Course of Research Doctorate in Public Health Sciences, University of Milan, Milan, Italy
| | - T Ivic-Pavlicic
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - E Taioli
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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5
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Katz SI, Straus CM, Roshkovan L, Blyth KG, Frauenfelder T, Gill RR, Lalezari F, Erasmus J, Nowak AK, Gerbaudo VH, Francis RJ, Armato SG. Considerations for Imaging of Malignant Pleural Mesothelioma: A Consensus Statement from the International Mesothelioma Interest Group. J Thorac Oncol 2023; 18:278-298. [PMID: 36549385 DOI: 10.1016/j.jtho.2022.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/13/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022]
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive primary malignancy of the pleura that presents unique radiologic challenges with regard to accurate and reproducible assessment of disease extent at staging and follow-up imaging. By optimizing and harmonizing technical approaches to imaging MPM, the best quality imaging can be achieved for individual patient care, clinical trials, and imaging research. This consensus statement represents agreement on harmonized, standard practices for routine multimodality imaging of MPM, including radiography, computed tomography, 18F-2-deoxy-D-glucose positron emission tomography, and magnetic resonance imaging, by an international panel of experts in the field of pleural imaging assembled by the International Mesothelioma Interest Group. In addition, modality-specific technical considerations and future directions are discussed. A bulleted summary of all technical recommendations is provided.
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Affiliation(s)
- Sharyn I Katz
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.
| | - Christopher M Straus
- Department of Radiology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
| | - Leonid Roshkovan
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Kevin G Blyth
- Institute of Cancer Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Thomas Frauenfelder
- Institute for Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Ritu R Gill
- Department of Radiology, Beth Israel Lahey Health, Harvard Medical School, Boston, Massachusetts
| | - Ferry Lalezari
- Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Jeremy Erasmus
- Department of Radiology, MD Anderson Cancer Center, Houston, Texas
| | - Anna K Nowak
- Medical School, University of Western Australia, Perth, Australia
| | - Victor H Gerbaudo
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Roslyn J Francis
- Medical School, University of Western Australia, Perth, Australia; Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Perth, Australia
| | - Samuel G Armato
- Department of Radiology, University of Chicago Pritzker School of Medicine, Chicago, Illinois
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6
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Barnes H, Glaspole I. Occupational Interstitial Lung Diseases. Immunol Allergy Clin North Am 2023; 43:323-339. [PMID: 37055091 DOI: 10.1016/j.iac.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Occupational exposures are directly causal or partially contributory to the development of interstitial lung diseases. A detailed occupational history, relevant high-resolution computed tomography findings, and where relevant additional histopathology, are required to make a diagnosis. Treatment options are limited, and further exposure avoidance is likely to reduce disease progression.
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Paris C, Thaon I, Laurent F, Saade A, Andujar P, Brochard P, Benoist J, Clin B, Ferretti G, Gislard A, Gramond C, Wild P, Lacourt A, Delva F, Pairon JC. Pleural Plaques and the Role of Exposure to Mineral Particles in the Asbestos Post-Exposure Survey. Chest 2023:S0012-3692(23)00176-9. [PMID: 36773934 DOI: 10.1016/j.chest.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
BACKGROUND Previous studies have inconsistently reported associations between refractory ceramic fibers (RCFs) or mineral wool fibers (MWFs) and the presence of pleural plaques (PPs). All these studies were based on chest radiographs, known to be associated with a poor sensitivity for the diagnosis of PP. RESEARCH QUESTION Does the risk of PPs increase with cumulative exposure to RCFs, MWFs, and silica? If the risk does increase, do these dose-response relationships depend on the co-exposure to asbestos or, conversely, are the dose-response relationships for asbestos modified by co-exposure to RCFs, MWFs, and silica? STUDY DESIGN AND METHODS Volunteer workers were invited to participate in a CT scan screening program for asbestos-related diseases in France. Asbestos exposure was assessed by industrial hygienists, and exposure to RCFs, MWFs, and silica was determined by using job-exposure matrices. A cumulative exposure index (CEI) was then calculated for each subject and separately for each of the four mineral particle exposures. All available CT scans were submitted to randomized, double reading by a panel of radiologists. RESULTS In this cohort of 5,457 subjects, significant dose-response relationships were determined after adjustment for asbestos exposure between CEI to RCF or MWF and the risk of PPs (ORs of 1.29 [95% CI, 1.00-1.67] and 1.84 [95% CI, 1.49-2.27] for the highest CEI quartile, respectively). Significant interactions were found between asbestos on one hand and MWF or RCF on the other. INTERPRETATION This study suggests the existence of a significant association between exposure to RCFs and MWFs and the presence of PPs in a large population previously exposed to asbestos and screened by using CT scans.
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Affiliation(s)
- Christophe Paris
- Centre de Pathologies Professionnelles et environnementales, CHU Pontchaillou, Rennes, France; INSERM, IRSET U1085, Equipe ESTER, Rennes, France.
| | - Isabelle Thaon
- CHRU de Nancy, Université de Lorraine, Centre de Consultation de Pathologies Professionnelles, Nancy, France
| | - François Laurent
- Service d'imagerie médicale diagnostique et thérapeutique, Unité d'imagerie thoracique CHHU de Bordeaux groupe hospitalier Sud Avenue de Magellan, Pessac, France; Centre de recherche cardiothoracique, INSERM U1045, Bordeaux, France
| | - Anastasia Saade
- Centre de Pathologies Professionnelles et environnementales, CHU Pontchaillou, Rennes, France; INSERM, IRSET U1085, Equipe ESTER, Rennes, France
| | - Pascal Andujar
- Univ Paris Est Créteil, INSERM, IMRB, Equipe GEIC2O, Creteil, France; Centre Hospitalier Intercommunal, Service de Pathologies professionnelles et de l'Environnement, Institut Santé-Travail Paris-Est, Creteil, France
| | - Patrick Brochard
- Université Bordeaux, INSERM, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux, France
| | - Julia Benoist
- Centre Hospitalier Intercommunal, Service de Pathologies professionnelles et de l'Environnement, Institut Santé-Travail Paris-Est, Creteil, France
| | - Benedicte Clin
- INSERM U1086, ANTICIPE, Caen, France; Université de Caen Normandie, Caen, France; CHU Caen, Service de santé au travail et pathologie professionnelle, Caen, France
| | - Gilbert Ferretti
- Service de radiologie diagnostique et thérapeutique, Hôpital Michallon, CHU Grenoble Alpes, Grenoble, France; Université Grenoble Alpes, La Tronche, France
| | - Antoine Gislard
- Centre de Pathologies Professionnelles et environnementales, CHU Rouen, Rouen, France
| | - Cecile Gramond
- Université Bordeaux, INSERM, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux, France
| | - Pascal Wild
- INRS, French Institute for Research and Safety, Vandoeuvre-Les-Nancy, France
| | - Aude Lacourt
- Université Bordeaux, INSERM, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux, France
| | - Fleur Delva
- Université Bordeaux, INSERM, Bordeaux Population Health Research Center, Epicene Team, UMR 1219, Bordeaux, France
| | - Jean-Claude Pairon
- Univ Paris Est Créteil, INSERM, IMRB, Equipe GEIC2O, Creteil, France; Centre Hospitalier Intercommunal, Service de Pathologies professionnelles et de l'Environnement, Institut Santé-Travail Paris-Est, Creteil, France
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8
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Cost-Effectiveness of an Organized Lung Cancer Screening Program for Asbestos-Exposed Subjects. Cancers (Basel) 2022; 14:cancers14174089. [PMID: 36077626 PMCID: PMC9454930 DOI: 10.3390/cancers14174089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Lung cancer screening experiments in smokers are underway in Europe, and data in populations with other risk factors for lung cancer, such as asbestos exposure, are expected. Our original article yielded a cost-effectiveness analysis of a lung cancer screening program in a population exposed to asbestos, based on the data from National Lung Cancer Screening trial and a French asbestos-exposed cohort (ARDCO cohort). Individual data from 14,218 subjects in the ARDCO cohort, followed for 20 years (2002–2022), have allowed several screening models to be established according to exposure level, smoking status and presence of radiological signs of asbestos exposure. For the whole cohort, an annual screening programme is not cost-effective, while screening every 2 years for smokers with high asbestos-exposure and subjects with asbestosis is cost-effective. This analysis has never been reported in the literature and could help in the establishment of inclusion criteria for future experiments in this population. Abstract Background: The National Lung Screening Trial (NLST) and NELSON study opened the debate on the relevance of lung cancer (LC) screening in subjects exposed to occupational respiratory carcinogens. This analysis reported the incremental cost-effectiveness ratios (ICER) of an organized LC screening program for an asbestos-exposed population. Methods: Using Markov modelization, individuals with asbestos exposure were either monitored without intervention or annual low-dose thoracic computed-tomography (LDTCT) scan LC screening. LC incidence came from a prospective observational cohort of subjects with occupational asbestos exposure. The intervention parameters were those of the NLST study. Utilities and LC-management costs came from published reports. A sensitivity analysis evaluated different screening strategies. Results: The respective quality-adjusted life year (QALY) gain, supplementary costs and ICER [95% confidence interval] were: 0.040 [0.010–0.065] QALY, 6900 [3700–11,800] € and 170,000 [75,000–645,000] €/QALY for all asbestos-exposed subjects; and 0.144 [0.071–0.216] QALY, 13,000 [5700–26,800] € and 90,000 [35,000–276,000] €/QALY for smokers with high exposure. When screening was based on biennial LDTCT scans, the ICER was 45,000 [95% CI: 15,000–116,000] €/QALY. Conclusions: Compared to the usual ICER thresholds, biennial LDTCT scan LC screening for smokers with high occupational exposure to asbestos is acceptable and preferable to annual scans.
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9
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Gallet J, Laurent F, Paris C, Clin B, Gislard A, Thaon I, Chammings S, Gramond C, Ogier G, Ferretti G, Andujar P, Brochard P, Delva F, Pairon JC, Lacourt A. Pleural plaques and risk of lung cancer in workers formerly occupationally exposed to asbestos: extension of follow-up. Occup Environ Med 2022; 79:oemed-2022-108337. [PMID: 35922129 DOI: 10.1136/oemed-2022-108337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 07/19/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Occupational asbestos exposure is associated with pleural plaques (PP), a benign disease often seen as a marker of past exposure to asbestos and lung cancer. The association between these two diseases has not been formally proved, the aim of this study was to evaluate this association in the asbestos-related disease cohort (ARDCO) cohort. METHODS ARDCO is a French multicentric cohort including workers formerly occupationally exposed to asbestos from 2003 to 2005. CT scan was performed to diagnose PP with double reading and lung cancer (incidence and mortality) was followed through health insurance data and death certificates. Cox models were used to estimate the association between PP and lung cancer adjusting for occupational asbestos exposure (represented by cumulative exposure index, time since first exposure and time since last exposure) and smoking status. RESULTS A total of 176 cases (of 5050 subjects) and 88 deaths (of 4938 subjects) of lung cancer were recorded. Smoking status was identified as an effect modifier. Lung cancer incidence and mortality were significantly associated with PP only in non-smokers, respectively, HR=3.13 (95% CI 1.04 to 9.35) and HR=16.83 (95% CI 1.87 to 151.24) after adjustment for age, occupational asbestos exposure and smoking status. CONCLUSIONS ARDCO study was the first to study this association considering equal asbestos exposure, and more specifically, our study is the first to test smoking as an effect modifier, so comparison with scientific literature is difficult. Our results seem to consolidate the hypothesis that PP may be an independent risk factor for lung cancer but they must be interpreted with caution.
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Affiliation(s)
- Justine Gallet
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
| | - François Laurent
- Université de Bordeaux, Faculté de Médecine, F-33000 Bordeaux, France
- Service d'imagerie médicale radiologie diagnostique et thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de recherche cardiothoracique de Bordeaux, INSERM U1045, F-33000 Bordeaux, France
| | - Christophe Paris
- Service de santé au travail et pathologie professionnelle, CHU Rennes, F-35000 Rennes, France
- Institut de recherche en santé, environnement et travail, INSERM U1085, F-35000 Rennes, France
| | - Bénédicte Clin
- Service de santé au travail et pathologie professionnelle, CHU Caen, F-14000 Caen, France
- Faculté de médecine, Université de Caen Normandie, F-14000 Caen, France
- U1086 « ANTICIPE », INSERM, F-14000 Caen, France
| | - Antoine Gislard
- Centre de consultations des pathologies professionnelles, CHU Rouen, F-76000 Rouen, France
| | - Isabelle Thaon
- Centre de consultations des pathologies professionnelles, CHRU Nancy, Université de Lorraine, F-54000 Nancy, France
| | - Soizick Chammings
- Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, CHI Créteil, F-94010 Créteil, France
| | - Celine Gramond
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
| | - Guy Ogier
- Echelon régional du service médical, Assurance maladie, F69000 Lyon, France
| | - Gilbert Ferretti
- Service de radiologie diagnostique et thérapeutique, CHU Grenoble, F-38000 Grenoble, France
- Université de Grenoble Alpes, F-38700 La Tranche, France
| | - Pascal Andujar
- INSERM, IMRB, Université Paris Est Créteil, F-94010 Créteil, France
- Service de Pathologies Professionnelles et de l'Environnement, CHI Créteil, F-94010 Créteil, France
| | - Patrick Brochard
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
| | - Fleur Delva
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
- Service Santé Travail Environnement, CHU Bordeaux, F-33000, France
| | - Jean-Claude Pairon
- INSERM, IMRB, Université Paris Est Créteil, F-94010 Créteil, France
- Service de Pathologies Professionnelles et de l'Environnement, CHI Créteil, F-94010 Créteil, France
| | - Aude Lacourt
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
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10
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Vidican P, Perol O, Fevotte J, Fort E, Treilleux I, Belladame E, Zavadil J, Fervers B, Charbotel B. Frequency of Asbestos Exposure and Histological Subtype of Ovarian Carcinoma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5383. [PMID: 35564776 PMCID: PMC9100164 DOI: 10.3390/ijerph19095383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 02/01/2023]
Abstract
The International Agency for Research on Cancer established a causal link between asbestos exposure and ovarian cancer. However, the exposure frequency and histological characteristics of asbestos-associated ovarian cancers remain to be investigated in detail. This multicenter case-case study assessed the asbestos exposure in ovarian carcinoma (OC) patients, alongside its association with histological subtype. Women were recruited in four hospitals in Lyon, France. Histological reports were reviewed by a pathologist. Patient and family members' data were collected by phone-based questionnaires. Asbestos exposure was defined as direct (occupational and environmental) and indirect (via parents, partners, and children). An industrial hygienist assessed the probability and level of exposure. The 254 enrolled patients (mean age 60 years) reported having an average of 2.3 different jobs (mean working duration 29 years). The prevalence of direct and indirect asbestos exposure was 13% (mean exposure duration 11 years) and 46%, respectively. High-grade serous carcinoma accounted for 73% of all OCs and 82% of histological subtypes in women with direct exposure. After adjustment on a familial history of OC, no significant associations between asbestos exposure (direct and/or indirect) and high-grade serous carcinoma were found. Women with OC had a high prevalence of asbestos exposure. Establishing risk profiles, as reported here, is important in facilitating compensation for asbestos-related OCs and for the surveillance of women at risk.
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Affiliation(s)
- Pauline Vidican
- Département Prévention Cancer Environnement, Centre Léon Bérard, 28 Rue Laennec, CEDEX 08, 69373 Lyon, France; (O.P.); (E.B.); (B.F.)
| | - Olivia Perol
- Département Prévention Cancer Environnement, Centre Léon Bérard, 28 Rue Laennec, CEDEX 08, 69373 Lyon, France; (O.P.); (E.B.); (B.F.)
- Inserm UMR1296, “Radiations: Défense, Santé, Environnement”, Centre Léon Bérard, 28 Rue Laennec, 69008 Lyon, France
| | - Joëlle Fevotte
- Université de Lyon, Université Lyon 1, Université Gustave Eiffel—Ifsttar, Umrestte, UMR T 9405, Domaine Rockefeller, 8 Avenue Rockefeller, 69008 Lyon, France; (J.F.); (E.F.)
| | - Emmanuel Fort
- Université de Lyon, Université Lyon 1, Université Gustave Eiffel—Ifsttar, Umrestte, UMR T 9405, Domaine Rockefeller, 8 Avenue Rockefeller, 69008 Lyon, France; (J.F.); (E.F.)
| | - Isabelle Treilleux
- Département D’anatomopathologie, Centre Léon Bérard, 28 Rue Laennec, 69008 Lyon, France;
| | - Elodie Belladame
- Département Prévention Cancer Environnement, Centre Léon Bérard, 28 Rue Laennec, CEDEX 08, 69373 Lyon, France; (O.P.); (E.B.); (B.F.)
| | - Jiri Zavadil
- Epigenomics and Mechanisms Branch, International Agency for Research on Cancer WHO, 150 Cours Albert Thomas, CEDEX 08, 69372 Lyon, France;
| | - Béatrice Fervers
- Département Prévention Cancer Environnement, Centre Léon Bérard, 28 Rue Laennec, CEDEX 08, 69373 Lyon, France; (O.P.); (E.B.); (B.F.)
- Inserm UMR1296, “Radiations: Défense, Santé, Environnement”, Centre Léon Bérard, 28 Rue Laennec, 69008 Lyon, France
- Faculté de médecine Lyon Est, Université de Lyon, Université Lyon 1, 8 Avenue Rockefeller, 69008 Lyon, France
| | - Barbara Charbotel
- Université de Lyon, Université Lyon 1, Université Gustave Eiffel—Ifsttar, Umrestte, UMR T 9405, Domaine Rockefeller, 8 Avenue Rockefeller, 69008 Lyon, France; (J.F.); (E.F.)
- CRPPE-Lyon, Centre Régional de Pathologies Professionnelles et Environnementales de Lyon, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, 69495 Pierre Bénite, France
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11
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Clin B, Gramond C, Thaon I, Brochard P, Delva F, Chammings S, Gislard A, Laurent F, Paris C, Lacourt A, Pairon JC. Head and neck cancer and asbestos exposure. Occup Environ Med 2022; 79:690-696. [PMID: 35393288 PMCID: PMC9484389 DOI: 10.1136/oemed-2021-108047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 03/19/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of this study was to analyse, within a French cohort of workers previously occupationally exposed to asbestos, incidence and mortality from various sites of head and neck cancers (larynx excluded) and to examine the potential link of these cancers with pleural plaques. METHODS A 10-year follow-up study was conducted in the 13 481 male subjects included in the cohort between October 2003 and December 2005. Asbestos exposure was assessed by industrial hygienist analysis of a standardised questionnaire. The final cumulative exposure index (CEI; in equivalent fibres.years/mL) for each subject was calculated as the sum of each employment period's four-level CEI. The number of head and neck cancers recorded by the National Health Insurance fund was collected in order to conduct an incidence study. Complementary analysis was restricted to men who had performed at least one chest CT scan (N=4804). A mortality study was also conducted. We used a Cox model with age as the time axis variable adjusted for smoking, time since first exposure, CEI of exposure to asbestos and pleural plaques on CT scans. RESULTS We reported a significant dose-response relationship between CEI of exposure to asbestos and head and neck cancers after exclusion of laryngeal cancers, in the mortality study (HR 1.03, 95% CI (1.01 to 1.06) for an increase of 10 f.years/mL) and a close to significant dose-response relationship in the incidence study (HR 1.02, 95% CI (1.00 to 1.04) for an increase of 10 f.years/mL). No statistically significant association between pleural plaques and head and neck cancer incidence was observed. CONCLUSIONS This large-scale study suggests a relationship between asbestos exposure and head and neck cancers, after exclusion of laryngeal cancers, regardless of whether associated pleural plaques were present.
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Affiliation(s)
- Bénédicte Clin
- CHU, Caen, France .,Université de Caen Normandie, Caen, France.,INSERM U1086 ANTICIPE, Caen, France
| | - Celine Gramond
- Epicene Team, UMR U1219 - Bordeaux Population Health Research Center, Bordeaux, France
| | - Isabelle Thaon
- INGRES, EA 7298, Université de Lorraine, Vandoeuvre les Nancy, France.,Centre de Consultations de Pathologie professionnelle, CHU de Nancy, Vandoeuvre les Nancy, France
| | | | - Fleur Delva
- Environmental Health Platform Dedicated to Reproduction, ARTEMIS Center, Bordeaux University Hospital, Bordeaux, France.,Bordeaux Population Health Research Center, Inserm UMR1219-EPICENE, University of Bordeaux, Talence, France
| | | | | | | | | | - Aude Lacourt
- Epicene Team, UMR U1219 - Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-Claude Pairon
- Pneumologie et Pathologie Professionnelle, Centre Hospitalier Intercommunal de Créteil, Créteil Cedex, France
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12
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Hyland RA, Chrzanowska A, Hannaford-Turner K, Davis A, Ke H, Bradbury L, Nagrial A, McCaughan B, Hui R, van Zandwijk N, Takahashi K, Kao SC. Asbestos-related lung cancer: Clinical characteristics and survival outcomes in an Australian cohort seeking workers compensation. Asia Pac J Clin Oncol 2022; 18:e448-e455. [PMID: 35100476 DOI: 10.1111/ajco.13664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVES Due to difficulties in identifying sufficient-sized cohorts there remains uncertainty about prognostic and clinical differences that may be unique to asbestos-related lung cancer (ARLC). In this study, we use the Helsinki Criteria to define a group of ex-workers with lung cancer attributable to asbestos exposure and investigate differences that may exist. METHODS A total of 529 patients seeking workers' compensation for their lung cancer were assigned to either ARLC or the non-ARLC based on parameters defined in the Helsinki Criteria. Clinical and survival details were collected and analyzed. RESULTS In our study population, ARLC patients were on average older (72.1 ± 7.8) than non-ARLC patients (66.5 ± 10.2, P < 0.001) and were more likely to be diagnosed as a result of incidental findings or screening program (P < 0.001). The groups were similar in terms of clinical characteristics with the only difference being that plaques were more prevalent among ARLC patients (P < 0.001). Differences were observed for median overall survival (OS), ARLC (9 months) and non-ARLC (13 months, P = 0.005), as well for treatment (P = 0.01). After adjusting for age, however, these differences disappeared. CONCLUSIONS Age at diagnosis, pleural plaques, and asymptomatic presentation were the attributes that we identified as significantly different between asbestos-related cancer and other lung cancers. In this cohort, ARLC patients were older diagnosis and with worse overall survival.
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Affiliation(s)
- Rebecca A Hyland
- Asbestos Diseases Research Institute, Rhodes, New South Wales, Australia
| | - Agata Chrzanowska
- Asbestos Diseases Research Institute, Rhodes, New South Wales, Australia.,Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kirsty Hannaford-Turner
- Research and Education Unit, Icare Dust Disease Authority, Sydney, New South Wales, Australia
| | - Alexander Davis
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Helen Ke
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Lauren Bradbury
- Department of Medical Oncology, The Crown Princess Mary Cancer Centre Westmead, Wentworthville, New South Wales, Australia
| | - Adnan Nagrial
- Department of Medical Oncology, The Crown Princess Mary Cancer Centre Westmead, Wentworthville, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Brian McCaughan
- Sydney Cardiothoracic Surgeons, RPAH Medical Centre, Newtown, New South Wales, Australia
| | - Rina Hui
- Department of Medical Oncology, The Crown Princess Mary Cancer Centre Westmead, Wentworthville, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Nico van Zandwijk
- Asbestos Diseases Research Institute, Rhodes, New South Wales, Australia
| | - Ken Takahashi
- Asbestos Diseases Research Institute, Rhodes, New South Wales, Australia
| | - Steven C Kao
- Asbestos Diseases Research Institute, Rhodes, New South Wales, Australia.,Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.,Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
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13
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Benlala I, De Senneville BD, Dournes G, Menant M, Gramond C, Thaon I, Clin B, Brochard P, Gislard A, Andujar P, Chammings S, Gallet J, Lacourt A, Delva F, Paris C, Ferretti G, Pairon JC, Laurent F. Deep Learning for the Automatic Quantification of Pleural Plaques in Asbestos-Exposed Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031417. [PMID: 35162440 PMCID: PMC8835296 DOI: 10.3390/ijerph19031417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 12/10/2022]
Abstract
Objective: This study aimed to develop and validate an automated artificial intelligence (AI)-driven quantification of pleural plaques in a population of retired workers previously occupationally exposed to asbestos. Methods: CT scans of former workers previously occupationally exposed to asbestos who participated in the multicenter APEXS (Asbestos PostExposure Survey) study were collected retrospectively between 2010 and 2017 during the second and the third rounds of the survey. A hundred and forty-one participants with pleural plaques identified by expert radiologists at the 2nd and the 3rd CT screenings were included. Maximum Intensity Projection (MIP) with 5 mm thickness was used to reduce the number of CT slices for manual delineation. A Deep Learning AI algorithm using 2D-convolutional neural networks was trained with 8280 images from 138 CT scans of 69 participants for the semantic labeling of Pleural Plaques (PP). In all, 2160 CT images from 36 CT scans of 18 participants were used for AI testing versus ground-truth labels (GT). The clinical validity of the method was evaluated longitudinally in 54 participants with pleural plaques. Results: The concordance correlation coefficient (CCC) between AI-driven and GT was almost perfect (>0.98) for the volume extent of both PP and calcified PP. The 2D pixel similarity overlap of AI versus GT was good (DICE = 0.63) for PP, whether they were calcified or not, and very good (DICE = 0.82) for calcified PP. A longitudinal comparison of the volumetric extent of PP showed a significant increase in PP volumes (p < 0.001) between the 2nd and the 3rd CT screenings with an average delay of 5 years. Conclusions: AI allows a fully automated volumetric quantification of pleural plaques showing volumetric progression of PP over a five-year period. The reproducible PP volume evaluation may enable further investigations for the comprehension of the unclear relationships between pleural plaques and both respiratory function and occurrence of thoracic malignancy.
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Affiliation(s)
- Ilyes Benlala
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
- Correspondence:
| | - Baudouin Denis De Senneville
- Mathematical Institute of Bordeaux (IMB), CNRS, INRIA, Bordeaux INP, UMR 5251, Université de Bordeaux, 33400 Talence, France;
| | - Gael Dournes
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
| | - Morgane Menant
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Celine Gramond
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Isabelle Thaon
- Centre de Consultation de Pathologies Professionnelles, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France;
| | - Bénédicte Clin
- Service de Santé au Travail et Pathologie Professionnelle, CHU Caen, 14000 Caen, France;
- Faculté de Médecine, Université de Caen, 14000 Caen, France
| | - Patrick Brochard
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service de Médecine du Travail et de Pathologies Professionnelles, CHU de Bordeaux, 33000 Bordeaux, France
| | - Antoine Gislard
- Faculté de Médecine, Normandie Université, UNIROUEN, UNICAEN, ABTE, 76000 Rouen, France;
- Centre de Consultations de Pathologie Professionnelle, CHU de Rouen, CEDEX, 76031 Rouen, France
| | - Pascal Andujar
- Equipe GEIC20, INSERM U955, 94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, 94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, 94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - Soizick Chammings
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - Justine Gallet
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Aude Lacourt
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Fleur Delva
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Christophe Paris
- Service de Santé au Travail et Pathologie Professionnelle, CHU Rennes, 35000 Rennes, France;
- Institut de Recherche en Santé, Environnement et Travail, INSERM U1085, 35000 Rennes, France
| | - Gilbert Ferretti
- INSERM U 1209 IAB, 38700 La Tronche, France;
- Domaine de la Merci, Faculté de Médecine, Université Grenoble Alpes, 38706 La Tronche, France
- Service de Radiologie Diagnostique et Interventionnelle Nord, CHU Grenoble Alpes, CS 10217, 38043 Grenoble, France
| | - Jean-Claude Pairon
- Equipe GEIC20, INSERM U955, 94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, 94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, 94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - François Laurent
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
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14
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Sandal A, Ecin SM, Koyuncu A, Durhan G, Akpinar MG, Demir AU, Cöplü L. Environmental asbestos exposure and nonmalignant pleural findings: a retrospective evaluation of a five-year chest CT repository. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:734-743. [PMID: 34817303 DOI: 10.1080/19338244.2021.2004987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This registry-based case-control study aimed to assess the association between asbestos deposits in the birthplace and/or residence and nonmalignant pleural findings, namely pleural plaques (PPs) and pleural thickening (PT), on chest CT scans. In total, 39,472 CT scans obtained over five years in a tertiary referral hospital in Ankara, Turkey, were evaluated. Cases involving patients with PP (n = 537), PT (n = 263), PP&PT (n = 69), and controls (n = 543) from the same study base without those conditions were included. Each case group was compared to controls using unconditional logistic regression. The presence of asbestos deposits in the district of birthplace (adjusted OR = 2.13, 95% CI: 1.35-3.37) and both birthplace and residence (aOR = 4.32, 95% CI: 2.26-8.27) was significantly related to the PPs. As the importance of environmental asbestos exposure in Turkey continues, future prospective studies could contribute to developing screening strategies.
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Affiliation(s)
- Abdulsamet Sandal
- Occupational Diseases Clinic, Ankara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Seval Müzeyyen Ecin
- Occupational Diseases Clinic, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Adem Koyuncu
- Occupational Diseases Clinic, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Gamze Durhan
- Department of Radiology, Hacettepe University, Ankara, Turkey
| | | | - Ahmet Ugur Demir
- Department of Chest Diseases, Hacettepe University, Ankara, Turkey
| | - Lütfi Cöplü
- Department of Chest Diseases, Hacettepe University, Ankara, Turkey
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15
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Laurent F, Benlala I, Dournes G, Gramond C, Thaon I, Clin B, Brochard P, Gislard A, Andujar P, Chammings S, Gallet J, Lacourt A, Delva F, Paris C, Ferretti G, Pairon JC. Interstitial Lung Abnormalities Detected by CT in Asbestos-Exposed Subjects Are More Likely Associated to Age. J Clin Med 2021; 10:jcm10143130. [PMID: 34300298 PMCID: PMC8307087 DOI: 10.3390/jcm10143130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/05/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: the aim of this study was to evaluate the association between interstitial lung abnormalities, asbestos exposure and age in a population of retired workers previously occupationally exposed to asbestos. Methods: previously occupationally exposed former workers to asbestos eligible for a survey conducted between 2003 and 2005 in four regions of France, underwent chest CT examinations and pulmonary function testing. Industrial hygienists evaluated asbestos exposure and calculated for each subject a cumulative exposure index (CEI) to asbestos. Smoking status information was also collected in this second round of screening. Expert radiologists performed blinded independent double reading of chest CT-scans and classified interstitial lung abnormalities into: no abnormality, minor interstitial findings, interstitial findings inconsistent with UIP, possible or definite UIP. In addition, emphysema was assessed visually (none, minor: emphysema <25%, moderate: between 25 and 50% and severe: >50% of the lung). Logistic regression models adjusted for age and smoking were used to assess the relationship between interstitial lung abnormalities and occupational asbestos exposure. Results: the study population consisted of 2157 male subjects. Interstitial lung abnormalities were present in 365 (16.7%) and emphysema in 444 (20.4%). Significant positive association was found between definite or possible UIP pattern and age (OR adjusted =1.08 (95% CI: 1.02–1.13)). No association was found between interstitial abnormalities and CEI or the level of asbestos exposure. Conclusion: presence of interstitial abnormalities at HRCT was associated to aging but not to cumulative exposure index in this cohort of former workers previously occupationally exposed to asbestos.
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Affiliation(s)
- François Laurent
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, F-33000 Bordeaux, France
- Correspondence: ; Tel.: +33-5-2454-9136
| | - Ilyes Benlala
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, F-33000 Bordeaux, France
| | - Gael Dournes
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, F-33000 Bordeaux, France
| | - Celine Gramond
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Isabelle Thaon
- Centre de Consultation de Pathologies Professionnelles, CHRU de Nancy, Université de Lorraine, F-54000 Nancy, France;
| | - Bénédicte Clin
- Service de Santé au Travail et Pathologie Professionnelle, CHU Caen, F-14000 Caen, France;
- Faculté de Médecine, Université de Caen, ANTICIPE, INSERM U1086, F-14000 Caen, France
| | - Patrick Brochard
- Faculté de Médecine, Université de Bordeaux, F-33000 Bordeaux, France; (I.B.); (G.D.); (P.B.)
- Service de Médecine du Travail et de Pathologies Professionnelles, CHU de Bordeaux, F-33000 Bordeaux, France
| | - Antoine Gislard
- Centre de Consultations de Pathologie Professionnelle, UNIROUEN, UNICAEN, ABTE, F-76000 Rouen, France;
- CHU de Rouen, Normandie Université, F-76031 Rouen, France
| | - Pascal Andujar
- Equipe GEIC20, INSERM U955, F-94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, F-94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, F-94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, F-94000 Créteil, France;
| | - Soizick Chammings
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, F-94000 Créteil, France;
| | - Justine Gallet
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Aude Lacourt
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Fleur Delva
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, F-33000 Bordeaux, France; (C.G.); (J.G.); (A.L.); (F.D.)
| | - Christophe Paris
- Service de Santé au Travail et Pathologie Professionnelle, CHU Rennes, F-35000 Rennes, France;
- Institut de Recherche en Santé, Environnement et Travail, INSERM U1085, F-35000 Rennes, France
| | - Gilbert Ferretti
- INSERM U 1209 IAB, F-38700 La Tronche, France;
- Domaine de la Merci, Université Grenoble Alpes, F-38706 La Tronche, France
- Service de Radiologie Diagnostique et Interventionnelle Nord, CHU Grenoble Alpes, CS 10217, F-38043 Grenoble, France
| | - Jean-Claude Pairon
- Equipe GEIC20, INSERM U955, F-94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, F-94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, F-94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, F-94000 Créteil, France;
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16
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Abramson MJ, Murambadoro T, Alif SM, Benke GP, Dharmage SC, Glaspole I, Hopkins P, Hoy RF, Klebe S, Moodley Y, Rawson S, Reynolds PN, Wolfe R, Corte TJ, Walters EH. Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Australia: case-control study. Thorax 2020; 75:864-869. [PMID: 32660982 DOI: 10.1136/thoraxjnl-2019-214478] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 05/08/2020] [Accepted: 06/10/2020] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Idiopathic pulmonary fibrosis (IPF) is a lung disease of unknown cause characterised by progressive scarring, with limited effective treatment and a median survival of only 2-3 years. Our aim was to identify potential occupational and environmental exposures associated with IPF in Australia. METHODS Cases were recruited by the Australian IPF registry. Population-based controls were recruited by random digit dialling, frequency matched on age, sex and state. Participants completed a questionnaire on demographics, smoking, family history, environmental and occupational exposures. Occupational exposure assessment was undertaken with the Finnish Job Exposure Matrix and Australian asbestos JEM. Multivariable logistic regression was used to describe associations with IPF as ORs and 95% CIs, adjusted for age, sex, state and smoking. RESULTS We recruited 503 cases (mean±SD age 71±9 years, 69% male) and 902 controls (71±8 years, 69% male). Ever smoking tobacco was associated with increased risk of IPF: OR 2.20 (95% CI 1.74 to 2.79), but ever using marijuana with reduced risk after adjusting for tobacco: 0.51 (0.33 to 0.78). A family history of pulmonary fibrosis was associated with 12.6-fold (6.52 to 24.2) increased risk of IPF. Occupational exposures to secondhand smoke (OR 2.1; 1.2 to 3.7), respirable dust (OR 1.38; 1.04 to 1.82) and asbestos (OR 1.57; 1.15 to 2.15) were independently associated with increased risk of IPF. However occupational exposures to other specific organic, mineral or metal dusts were not associated with IPF. CONCLUSION The burden of IPF could be reduced by intensified tobacco control, occupational dust control measures and elimination of asbestos at work.
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Affiliation(s)
- Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tsitsi Murambadoro
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sheikh M Alif
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Geza P Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shyamali C Dharmage
- School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ian Glaspole
- Respiratory Medicine, Alfred Hospital, Melbourne, Victoria, Australia
| | - Peter Hopkins
- School of Medicine, University of Queensland, St Lucia, Queensland, Australia.,Lung Transplant Service, Prince Charles Hospital, Chermside, Queensland, Australia
| | - Ryan F Hoy
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sonja Klebe
- Department of Anatomical Pathology, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - Yuben Moodley
- School of Pharmacology and Respiratory Medicine, Lung Institute of Western Australia, University of Western Australia, Perth, Western Australia, Australia.,Department of Respiratory and Sleep Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Shuli Rawson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Paul N Reynolds
- Department of Respiratory Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Tamera J Corte
- Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - E Haydn Walters
- School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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17
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Sesé L, Khamis W, Jeny F, Uzunhan Y, Duchemann B, Valeyre D, Annesi-Maesano I, Nunes H. Adult interstitial lung diseases and their epidemiology. Presse Med 2020; 49:104023. [PMID: 32437842 DOI: 10.1016/j.lpm.2020.104023] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 10/23/2019] [Indexed: 02/07/2023] Open
Affiliation(s)
- Lucile Sesé
- Service de pneumologie, centre de référence des maladies pulmonaires rares (site constitutif), centre de compétence des maladies auto-immunes et systémiques rares, hôpital Avicenne, assistance publique-Hôpitaux de Paris, 93000 Bobigny, France; Inserm 1272, « Hypoxie et Poumon: pneumopathies fibrosantes, modulations ventilatoires et circulatoires », université de Sorbonne Paris Nord, 93000 Bobigny, France; Service de physiologie, hôpital Avicenne, Assistance publique-Hôpitaux de Paris, 93000 Bobigny, France; Inserm, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Sorbonne Universités, UPMC Université Paris 06, 75013 Paris, France
| | - Warda Khamis
- Service de pneumologie, centre de référence des maladies pulmonaires rares (site constitutif), centre de compétence des maladies auto-immunes et systémiques rares, hôpital Avicenne, assistance publique-Hôpitaux de Paris, 93000 Bobigny, France; Inserm 1272, « Hypoxie et Poumon: pneumopathies fibrosantes, modulations ventilatoires et circulatoires », université de Sorbonne Paris Nord, 93000 Bobigny, France
| | - Florence Jeny
- Service de pneumologie, centre de référence des maladies pulmonaires rares (site constitutif), centre de compétence des maladies auto-immunes et systémiques rares, hôpital Avicenne, assistance publique-Hôpitaux de Paris, 93000 Bobigny, France; Inserm 1272, « Hypoxie et Poumon: pneumopathies fibrosantes, modulations ventilatoires et circulatoires », université de Sorbonne Paris Nord, 93000 Bobigny, France
| | - Yurdagul Uzunhan
- Service de pneumologie, centre de référence des maladies pulmonaires rares (site constitutif), centre de compétence des maladies auto-immunes et systémiques rares, hôpital Avicenne, assistance publique-Hôpitaux de Paris, 93000 Bobigny, France; Inserm 1272, « Hypoxie et Poumon: pneumopathies fibrosantes, modulations ventilatoires et circulatoires », université de Sorbonne Paris Nord, 93000 Bobigny, France
| | - Boris Duchemann
- Service de pneumologie, centre de référence des maladies pulmonaires rares (site constitutif), centre de compétence des maladies auto-immunes et systémiques rares, hôpital Avicenne, assistance publique-Hôpitaux de Paris, 93000 Bobigny, France
| | - Dominique Valeyre
- Service de pneumologie, centre de référence des maladies pulmonaires rares (site constitutif), centre de compétence des maladies auto-immunes et systémiques rares, hôpital Avicenne, assistance publique-Hôpitaux de Paris, 93000 Bobigny, France; Inserm 1272, « Hypoxie et Poumon: pneumopathies fibrosantes, modulations ventilatoires et circulatoires », université de Sorbonne Paris Nord, 93000 Bobigny, France
| | - Isabella Annesi-Maesano
- Inserm, Pierre Louis Institute of Epidemiology and Public Health (IPLESP UMRS 1136), Epidemiology of Allergic and Respiratory Diseases Department (EPAR), Saint-Antoine Medical School, Sorbonne Universités, UPMC Université Paris 06, 75013 Paris, France
| | - Hilario Nunes
- Service de pneumologie, centre de référence des maladies pulmonaires rares (site constitutif), centre de compétence des maladies auto-immunes et systémiques rares, hôpital Avicenne, assistance publique-Hôpitaux de Paris, 93000 Bobigny, France; Inserm 1272, « Hypoxie et Poumon: pneumopathies fibrosantes, modulations ventilatoires et circulatoires », université de Sorbonne Paris Nord, 93000 Bobigny, France.
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18
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Brims FJH, Kong K, Harris EJA, Sodhi-Berry N, Reid A, Murray CP, Franklin PJ, Musk AB, de Klerk NH. Pleural Plaques and the Risk of Lung Cancer in Asbestos-exposed Subjects. Am J Respir Crit Care Med 2020; 201:57-62. [PMID: 31433952 DOI: 10.1164/rccm.201901-0096oc] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Asbestos exposure is associated with a dose-dependent risk of lung cancer. The association between lung cancer and the presence of pleural plaques remains controversial. Objectives: To define the relationship between pleural plaques and lung cancer risk. Methods: Subjects were from two cohorts: 1) crocidolite mine and mill workers and Wittenoom Township residents and 2) a mixed-asbestos-fiber, mixed-occupation group. All subjects underwent annual review since 1990, chest X-ray or low-dose computed tomography scan, and outcome linkage to national cancer and mortality registry data. Cox regression, with adjustment for age (as the underlying matching time variable), was used to estimate hazard ratios (HRs) for lung cancer incidence by sex, tobacco smoking, asbestos exposure, presence of asbestosis, and pleural plaques. Measurements and Main Results: For all 4,240 subjects, mean age at follow up was 65.4 years, 3,486 (82.0%) were male, 1,315 (31.0%) had pleural plaques, and 1,353 (32.0%) had radiographic asbestosis. Overall, 3,042 (71.7%) were ever-smokers with mean tobacco exposure of 33 pack-years. In total, 200 lung cancers were recorded. Risk of lung cancer increased with cumulative exposure to cigarettes, asbestos, and presence of asbestosis. Pleural plaques did not confer any additional lung cancer risk in either cohort (cohort 1: HR, 1.03; 95% confidence interval, 0.64-1.67; P = 0.89; cohort 2: HR, 0.75; 95% confidence interval, 0.45-1.25; P = 0.28). Conclusions: The presence of pleural plaques on radiologic imaging does not confer additional increase in the risk of lung cancer. This result is consistent across two cohorts with differing asbestos fiber exposures and intensity.
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Affiliation(s)
- Fraser J H Brims
- Curtin Medical School and.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Karen Kong
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Ed J A Harris
- Curtin Medical School and.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | | | - Alison Reid
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Conor P Murray
- Perth Children's Hospital, Perth, Western Australia, Australia
| | | | | | - Nicholas H de Klerk
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia; and
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19
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Platenburg MG, Wiertz IA, van der Vis JJ, Crestani B, Borie R, Dieude P, Kannengiesser C, Burgers JA, Grutters JC, van Moorsel CH. The MUC5B promoter risk allele for idiopathic pulmonary fibrosis predisposes to asbestosis. Eur Respir J 2020; 55:13993003.02361-2019. [DOI: 10.1183/13993003.02361-2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/05/2020] [Indexed: 11/05/2022]
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20
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Kamiya H, Peters S, Sodhi-Berry N, Reid A, Gordon L, de Klerk N, Brims F, Musk AW, Franklin P. Validation of an Asbestos Job-Exposure Matrix (AsbJEM) in Australia: Exposure–Response Relationships for Malignant Mesothelioma. Ann Work Expo Health 2019; 63:719-728. [DOI: 10.1093/annweh/wxz038] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/03/2019] [Accepted: 05/01/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
An asbestos job-exposure matrix (AsbJEM) has been developed to systematically and cost-effectively evaluate occupational exposures in population-based studies. The primary aim of this study was to examine the accuracy of the AsbJEM in determining exposure–response relationships between asbestos exposure estimates and malignant mesothelioma (MM) incidence (indirect validation). The secondary aim was to investigate whether the assumptions used in the development of the original AsbJEM provided accurate asbestos exposure estimates.
Methods
The study population consisted of participants in an annual health surveillance program, who had at least 3-month occupational asbestos exposure. Calculated asbestos exposure indices included cumulative asbestos exposure and the average exposure intensity, estimated using the AsbJEM and duration of employment. Asbestos and MM exposure–response relationships were compared between the original AsbJEM and its variations based on manipulations of the intensity, duration and frequency of exposure. Twenty-four exposure estimates were calculated for both cumulative asbestos exposure and the average exposure intensity using three exposure intensities (50th, 75th and 90th percentile of the range of mode exposure), four peak durations (15, 30, 60 and 120 min) and two patterns of peak frequency (original and doubled). Cox proportional hazards models were used to describe the associations between MM incidence and each of the cumulative and average intensity estimates.
Results
Data were collected from 1602 male participants. Of these, 40 developed MM during the study period. There were significant associations between MM incidence and both cumulative and average exposure intensity for all estimates. The strongest association, based on the regression-coefficient from the models, was found for the 50th percentile of mode exposure, 15-min peak duration and the doubled frequency of peak exposure. Using these assumptions, the hazard ratios for mesothelioma were 1 (reference), 1.91, 3.24 and 5.37 for the quartiles of cumulative asbestos exposure and 1 (reference), 1.84, 2.31 and 4.40 for the quartiles of the average exposure intensity, respectively.
Conclusion
The well-known positive exposure–response relationship between MM incidence and both estimated cumulative asbestos exposure and average exposure intensity was confirmed. The strongest relationship was found when the frequency of peak exposure in the AsbJEM was doubled from the originally published estimates.
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Affiliation(s)
- Hiroyuki Kamiya
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Susan Peters
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Nita Sodhi-Berry
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Len Gordon
- Caltex Australia, Perth, Western Australia, Australia
| | - Nicholas de Klerk
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Fraser Brims
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Curtin Medical School, Curtin University, Perth, Western Australia, Australia
| | - Arthur W Musk
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Peter Franklin
- School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
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21
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Harris EJA, Musk A, de Klerk N, Reid A, Franklin P, Brims FJH. Diagnosis of asbestos-related lung diseases. Expert Rev Respir Med 2019; 13:241-249. [DOI: 10.1080/17476348.2019.1568875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Edward J. A. Harris
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Arthur Musk
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Nicholas de Klerk
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Peter Franklin
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Fraser J. H. Brims
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
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22
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Tamura A, Funakoshi M, J-P NA, Hasegawa K, Ishimine A, Koike A, Tannai N, Fujii M, Hattori M, Hirano H, Nakamura K, Funakoshi M, Satomi K, Yamashita Y, Fukuchi Y, Suganuma N. Potential asbestos exposure among patients with primary lung cancer in Japan. J Occup Health 2018; 60:236-245. [PMID: 29563365 PMCID: PMC5985347 DOI: 10.1539/joh.2017-0199-oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: To investigate the extent of asbestos exposure among patients with primary lung cancer in Japan. Methods: A retrospective estimation of potential asbestos-exposed individuals, as determined by the presence of pleural plaques identified on chest computed tomography (CT), was conducted on 885 pathologically confirmed primary lung cancer patients (mean age 71.3 years, 641 males). All patients were diagnosed at 29 hospitals across Japan between 2006 and 2007. Since these hospitals belong to the Japan Federation of Democratic Medical Institutions (MIN-IREN), an organization of medical institutions for workers, the study subjects may contain a higher proportion of workers than the general population. Results: Pleural plaques were identified in 12.8% of subjects (15.8% in males and 4.9% in females), consisting exclusively of cases older than 50 years. They were found most frequently on the chest wall pleura (96.5%), followed by the diaphragm (23.9%) and mediastinum (9.7%). Calcifications were seen in 47 cases (41.6%). The highest prevalence of pleural plaques was seen among workers from construction-related fields (37.7%). No distinct lung cancer histology was observed in patients with pleural plaques. Coexistence of pleural plaques and small irregular opacities was observed in 2.5% of subjects. Conclusion: In a Japanese population representing more workers than general Japanese, 12.8% of patients with primary lung cancer may have experienced asbestos exposure at some time in the past. Special medical attention should be paid to individuals with a history of employment in construction-related occupations, as workers in this sector showed the highest prevalence of pleural plaques.
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Affiliation(s)
- Akihiko Tamura
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kyushu Institute for Social Medicine
| | - Mitsuhiko Funakoshi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kyushu Institute for Social Medicine
| | - Naw Awn J-P
- Department of Environmental Medicine, Kochi Medical School, Kochi University
| | - Kichinori Hasegawa
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Chiba Kensei Hospital
| | - Atsushi Ishimine
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kin-ikyo Chuo Hospital
| | - Akio Koike
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Saitama Cooperative Hospital
| | - Noriyuki Tannai
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Tachikawa Sogo Hospital
| | - Masami Fujii
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Shiba Hospital
| | - Makoto Hattori
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Jouhoku Hospital
| | - Harukazu Hirano
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Koyo Seikyo Hospital
| | - Kenji Nakamura
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Osaka Institute of Social Medicine
| | - Masanobu Funakoshi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Shioe Clinic
| | - Kazuhiko Satomi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Mizushima Kyodo Hospital
| | - Yoshihito Yamashita
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kokubu Seikyo Hospital
| | | | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University
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23
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Silva M, Sverzellati N, Colombi D, Milanese G, La Vecchia C, Galeone C, Marchianò A, Pastorino U. Pleural plaques in lung cancer screening by low-dose computed tomography: prevalence, association with lung cancer and mortality. BMC Pulm Med 2017; 17:155. [PMID: 29178853 PMCID: PMC5702182 DOI: 10.1186/s12890-017-0506-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 11/16/2017] [Indexed: 11/10/2022] Open
Abstract
Background To report the prevalence of pleural plaques in a lung cancer screening trial by low-dose computed tomography (LDCT) and to test the association with incidence of lung cancer and mortality. Methods The LDCT of 2303 screenees were retrospectively reviewed with the specific aim of describing the prevalence and features of pleural plaques. Self-administered questionnaire was used to assess asbestos exposure. Frequency of lung cancer, lung cancer mortality, and overall mortality were detailed according to presence of pleural findings. Statistical analyses included comparison of mean or median, contingency tables, and Cox model for calculation of hazard ratio (HR) and its 95% confidence interval (CI). Results Among male screenees, 31/1570 (2%) showed pleural abnormalities, 128/1570 (8.2%) disclosed asbestos exposure, 23/31 (74.2%) subjects with pleural plaques consistently denied exposure to asbestos. There was a trend for higher frequency of lung cancer among subjects with pleural plaques (9.7% vs 4.2%). Lung cancer in subjects with pleural plaques was always diagnosed in advanced stage. Subjects with pleural plaques showed HR 5.48 (95% CI 1.61–18.70) for mortality from lung cancer. Conclusions Pleural plaques are a risk factor for lung cancer mortality that can be detected in lung cancer screening by LDCT, also in subjects that are not aware of asbestos exposure. Trial registration NCT02837809 - Retrospectively registered July 1, 2016 - Enrolment of first participant September 2005.
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Affiliation(s)
- Mario Silva
- Department of Medicine and Surgery (DiMeC), Section of Radiology, Unit of Surgical Sciences, University of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy. .,Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - Nicola Sverzellati
- Department of Medicine and Surgery (DiMeC), Section of Radiology, Unit of Surgical Sciences, University of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy.,Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Davide Colombi
- Department of Medicine and Surgery (DiMeC), Section of Radiology, Unit of Surgical Sciences, University of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy
| | - Gianluca Milanese
- Department of Medicine and Surgery (DiMeC), Section of Radiology, Unit of Surgical Sciences, University of Parma, Padiglione Barbieri, Via Gramsci 14, 43126, Parma, Italy.,Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Carlotta Galeone
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alfonso Marchianò
- Department of Radiology and Radiotherapy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Ugo Pastorino
- Department of Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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24
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Hoy RF, Brims F. Occupational lung diseases in Australia. Med J Aust 2017; 207:443-448. [PMID: 29129163 DOI: 10.5694/mja17.00601] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/15/2017] [Indexed: 01/19/2023]
Abstract
Occupational exposures are an important determinant of respiratory health. International estimates note that about 15% of adult-onset asthma, 15% of chronic obstructive pulmonary disease and 10-30% of lung cancer may be attributable to hazardous occupational exposures. One-quarter of working asthmatics either have had their asthma caused by work or adversely affected by workplace conditions. Recently, cases of historical occupational lung diseases have been noted to occur with new exposures, such as cases of silicosis in workers fabricating kitchen benchtops from artificial stone products. Identification of an occupational cause of a lung disease can be difficult and requires maintaining a high index of suspicion. When an occupational lung disease is identified, this may facilitate a cure and help to protect coworkers. Currently, very little information is collected regarding actual cases of occupational lung diseases in Australia. Most assumptions about many occupational lung diseases are based on extrapolation from overseas data. This lack of information is a major impediment to development of targeted interventions and timely identification of new hazardous exposures. All employers, governments and health care providers in Australia have a responsibility to ensure that the highest possible standards are in place to protect workers' respiratory health.
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Clin B, Thaon I, Boulanger M, Brochard P, Chamming's S, Gislard A, Lacourt A, Luc A, Ogier G, Paris C, Pairon JC. Cancer of the esophagus and asbestos exposure. Am J Ind Med 2017; 60:968-975. [PMID: 28884469 DOI: 10.1002/ajim.22769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Our study aimed at analyzing incidence and mortality from esophageal cancer within a cohort of workers with previous occupational asbestos exposure (ARDCo Program). METHODS A 10-year follow-up study was conducted in the 14 515 male subjects included in this program between October 2003 and December 2005. Follow-up began when exposure stopped. Asbestos exposure was analyzed by industrial hygienists using data from a standardized questionnaire. The Cox model was used, with age as the time axis variable adjusted for smoking, time since first exposure (TSFE) and cumulative exposure index (CEI) of exposure to asbestos. RESULTS We reported a significant dose-response relationship between CEI of exposure to asbestos and esophageal cancer, in both incidence (hazard ratio [HR] 1.26, 95% confidence interval [CI] 1.00-1.58), and mortality (HR 1.40, [95%CI 1.12-1.75]). CONCLUSIONS This large-scale study suggests the existence of a relationship between asbestos exposure and cancer of the esophagus.
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Affiliation(s)
- Bénédicte Clin
- INSERM U1086 « ANTICIPE »; Caen France
- CHU Caen; Service de santé au travail et pathologie professionnelle; Caen France
- Université de Caen Normandie; Caen France
| | | | - Mathilde Boulanger
- INSERM U1086 « ANTICIPE »; Caen France
- CHU Caen; Service de santé au travail et pathologie professionnelle; Caen France
- Université de Caen Normandie; Caen France
| | - Patrick Brochard
- INSERM U1219; Bordeaux Population Health; EPICENE, Univ. Bordeaux; Bordeaux France
- Univ. Bordeaux; ISPED, INSERM U1219; Bordeaux Population Health; Bordeaux France
- CHU Bordeaux; Bordeaux France
| | - Soizick Chamming's
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France; Créteil France
| | - Antoine Gislard
- CHU Rouen; Service des maladies professionnelles; Rouen France
| | - Aude Lacourt
- INSERM U1219; Bordeaux Population Health; EPICENE, Univ. Bordeaux; Bordeaux France
- Univ. Bordeaux; ISPED, INSERM U1219; Bordeaux Population Health; Bordeaux France
- CHU Bordeaux; Bordeaux France
| | - Amandine Luc
- EA7298 INGRES; Nancy France
- CHRU Nancy; Nancy France
| | - Guy Ogier
- ERSM Rhône-Alpes; Regional security insurance; Lyon France
| | | | - Jean-Claude Pairon
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France; Créteil France
- Centre Hospitalier Intercommunal Créteil; DHU A-TVB; Service de pneumologie et pathologie professionnelle; Créteil France
- Institut Santé-Travail Paris-Est; Université Paris-Est Créteil, Faculté de Médecine; Créteil France
- INSERM U955; Equipe 4; Créteil France
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Iliopoulou M, Bostantzoglou C, Nenna R, Skouras VS. Asbestos and the lung: highlights of a detrimental relationship. Breathe (Sheff) 2017; 13:235-237. [PMID: 28894485 PMCID: PMC5584723 DOI: 10.1183/20734735.010017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
“Asbestos” is a term used to characterise a number of natural mineral fibres of silica that can be categorised according to their structure in the serpentine-type fibres, mainly represented by chrysotile, and the amphibole-type fibres, which include crocidolite, amosite, anthophyllite, actinolite and tremolite [1]. Due to its remarkable durability and fire resistance, asbestos has been used in pottery and clothing since for at least 4500 years. However, modern commercial production of asbestos began during the second half of the 19th century when industry started to exploit its unique chemical characteristics for manufacturing various products, such as pipe insulation, brake linings, cement pipes, protective clothing, etc. With the increasing use of such materials, individuals working in the construction (e.g. builders, plumbers, etc.) and ship building (e.g. dockyard workers) industries began to be exposed to high concentrations of inhaled asbestos fibres. Approximately 50–70 years after the introduction of asbestos in commercial use, the first reports of asbestos-related diseases emerged [1]. Since then, multiple studies have connected asbestos exposure with a variety of malignant and non-malignant lung disorders. Novel aspects of the pathogenesis of asbestos-related diseases are still coming to lighthttp://ow.ly/EPDa30e8JqK
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Affiliation(s)
| | | | - Raffaella Nenna
- Dept of Paediatrics, "Sapienza" University of Rome, Rome, Italy
| | - Vasileios S Skouras
- Dept of Pulmonary Medicine, 401 General Army Hospital, Athens, Greece.,1st Dept of Pulmonary Medicine, HYGEIA Hospital, Athens, Greece
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Schikowsky C, Felten MK, Eisenhawer C, Das M, Kraus T. Lung function not affected by asbestos exposure in workers with normal Computed Tomography scan. Am J Ind Med 2017; 60:422-431. [PMID: 28370144 DOI: 10.1002/ajim.22717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND It has been suggested that asbestos exposure affects lung function, even in the absence of asbestos-related pulmonary interstitial or pleural changes or emphysema. METHODS We analyzed associations between well-known asbestos-related risk factors, such as individual cumulative asbestos exposure, and key lung function parameters in formerly asbestos-exposed power industry workers (N = 207) with normal CT scans. For this, we excluded participants with emphysema, fibrosis, pleural changes, or any combination of these. RESULTS The lung function parameters of FVC, FEV1, DLCO/VA, and airway resistance were significantly associated with the burden of smoking, BMI and years since end of exposure (only DLCO/VA). However, they were not affected by factors directly related to amount (eg, cumulative exposure) or duration of asbestos exposure. CONCLUSIONS Our results confirm the well-known correlation between lung function, smoking habits, and BMI. However, we found no significant association between lung function and asbestos exposure.
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Affiliation(s)
- Christian Schikowsky
- Institute for Occupational and Social Medicine; RWTH Aachen University; Aachen Germany
| | - Michael K. Felten
- Institute for Occupational and Social Medicine; RWTH Aachen University; Aachen Germany
| | - Christian Eisenhawer
- Institute for Occupational and Social Medicine; RWTH Aachen University; Aachen Germany
| | - Marco Das
- Department of Diagnostic Radiology; RWTH Aachen University; Aachen Germany
- Department of Radiology; Maastricht University Medical Center; Maastricht The Netherlands
| | - Thomas Kraus
- Institute for Occupational and Social Medicine; RWTH Aachen University; Aachen Germany
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Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, Coureau G, Brochard P, Chamming’s S, Gislard A, Galan P, Hercberg S, Wild P, Pairon JC, Andujar P. Occupational Asbestos Exposure and Incidence of Colon and Rectal Cancers in French Men: The Asbestos-Related Diseases Cohort (ARDCo-Nut). ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:409-415. [PMID: 27517294 PMCID: PMC5332175 DOI: 10.1289/ehp153] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 07/15/2016] [Accepted: 07/18/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND The relationships between asbestos exposure and colorectal cancer remain controversial. OBJECTIVES We examined the association between asbestos exposure and colorectal cancer incidence. METHODS Volunteer retired workers previously exposed to asbestos were invited to participate in the French ARDCo screening program between 2003 and 2005. Additional data on risk factors for colorectal cancer were collected from the ARDCo-Nut subsample of 3,769 participants in 2011. Cases of colon and rectal cancer were ascertained each year through 2014 based on eligibility for free medical care following a cancer diagnosis. Survival regression based on the Cox model was used to estimate the relative risk of colon and rectal cancer separately, in relation to the time since first exposure (TSFE) and cumulative exposure index (CEI) to asbestos, and with adjustment for smoking in the overall cohort and for smoking, and certain risk factors for these cancers in the ARDCo-Nut subsample. RESULTS Mean follow-up was 10.2 years among 14,515 men, including 181 colon cancer and 62 rectal cancer cases (41 and 17, respectively, in the ARDCo-Nut subsample). In the overall cohort, after adjusting for smoking, colon cancer was significantly associated with cumulative exposure (HR = 1.14; 95% CI: 1.04, 1.26 for a 1-unit increase in ln-CEI) and ≥ 20-40 years since first exposure (HR = 4.67; 95% CI: 1.92, 11.46 vs. 0-20 years TSFE), and inversely associated with 60 years TSFE (HR = 0.26; 95% CI: 0.10, 0.70). Although rectal cancer was also associated with TSFE 20-40 years (HR = 4.57; 95% CI: 1.14, 18.27), it was not associated with ln-CEI, but these findings must be interpreted cautiously due to the small number of cases. CONCLUSIONS Our findings provide support for an association between occupational exposure to asbestos and colon cancer incidence in men. Citation: Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, Coureau G, Brochard P, Chamming's S, Gislard A, Galan P, Hercberg S, Wild P, Pairon JC, Andujar P. 2017. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos-Related Diseases Cohort (ARDCo-Nut). Environ Health Perspect 125:409-415; http://dx.doi.org/10.1289/EHP153.
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Affiliation(s)
- Christophe Paris
- EA7298 INGRES (Interactions gènes-risques environnementaux et effets sur la santé), Faculté de Médecine, Université de Lorraine, Vandoeuvre Les Nancy, France
- CHU (Centre Hospitalier Universitaire) Nancy, Vandoeuvre Les Nancy, France
| | - Isabelle Thaon
- EA7298 INGRES (Interactions gènes-risques environnementaux et effets sur la santé), Faculté de Médecine, Université de Lorraine, Vandoeuvre Les Nancy, France
- CHU (Centre Hospitalier Universitaire) Nancy, Vandoeuvre Les Nancy, France
| | - Fabrice Hérin
- UMR (Unité Mixte de Recherche) 1027, Université de Toulouse, Toulouse, France
- CHU Toulouse, Toulouse, France
| | - Benedicte Clin
- INSERM (Institut national de la santé et de la recherche médicale) U1086, Cancers et Populations, Caen, France
| | - Aude Lacourt
- Université Segalen, Bordeaux, France
- INSERM 1219, EPICENE (Epidémiologie du cancer et expositions environnementales), Bordeaux, France
| | - Amandine Luc
- EA7298 INGRES (Interactions gènes-risques environnementaux et effets sur la santé), Faculté de Médecine, Université de Lorraine, Vandoeuvre Les Nancy, France
| | - Gaelle Coureau
- Université Segalen, Bordeaux, France
- INSERM 1219, EPICENE (Epidémiologie du cancer et expositions environnementales), Bordeaux, France
- CHU Bordeaux, Bordeaux, France
| | - Patrick Brochard
- Université Segalen, Bordeaux, France
- INSERM 1219, EPICENE (Epidémiologie du cancer et expositions environnementales), Bordeaux, France
- CHU Bordeaux, Bordeaux, France
| | - Soizick Chamming’s
- IIMTPIF (Institut Interuniversitaire de Médecine du Travail de Paris Ile de France), Créteil, France
| | - Antoine Gislard
- CHU Rouen, Service de Pathologie professionnelle, Rouen, France
| | - Pilar Galan
- INSERM U1153, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Serge Hercberg
- INSERM U1153, Nutritional Epidemiology Research Team (EREN), Bobigny, France
| | - Pascal Wild
- INRS (Institut national de recherche et de sécurité), Direction scientifique, Vandoeuvre Les Nancy, France
| | - Jean-Claude Pairon
- Institut Santé Travail Paris-Est, Université Paris-Est, Créteil, France
- Service de Pneumologie et Pathologie Professionnelle, DHU A-TVB (Ageing-Thorax-Vessels-Blood), CHI Créteil (Centre Hospitalier Intercommunal de Créteil), Créteil, France
- INSERM U955, Equipe 4, Créteil, France
- Faculté de Médecine, Université Paris-Est Créteil, Créteil, France
| | - Pascal Andujar
- Institut Santé Travail Paris-Est, Université Paris-Est, Créteil, France
- Service de Pneumologie et Pathologie Professionnelle, DHU A-TVB (Ageing-Thorax-Vessels-Blood), CHI Créteil (Centre Hospitalier Intercommunal de Créteil), Créteil, France
- INSERM U955, Equipe 4, Créteil, France
- Faculté de Médecine, Université Paris-Est Créteil, Créteil, France
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Smargiassi A, Pasciuto G, Pedicelli I, Lo Greco E, Calvello M, Inchingolo R, Schifino G, Capoluongo P, Patriciello P, Manno M, Cirillo A, Corbo GM, Soldati G, Iavicoli I. Chest ultrasonography in health surveillance of asbestos-related lung diseases. Toxicol Ind Health 2017; 33:537-546. [DOI: 10.1177/0748233716686916] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives: Exposure to asbestos fibers can lead to different lung diseases, such as pleural thickening and effusion, asbestosis, mesothelioma, and lung cancer. These diseases are expected to peak in the next few years. The aim of the study was to validate ultrasonography (US) as a diagnostic tool in the management of lung diseases in subjects with a history of occupational exposure to asbestos. Methods: Fifty-nine retired male workers previously exposed to asbestos were enrolled in the study. Chest US was performed in all the subjects. The US operator was blinded to earlier performed computed tomography (CT) scan reports and images. The sonographic pathological findings were pleural thickening (with or without calcifications), peripheral lung consolidation, and focal sonographic interstitial syndrome and diffuse pneumogenic sonographic interstitial syndrome (pulmonary asbestosis). Significant US findings were recorded, stored, and subsequently compared with CT scans. Results: With some patients falling into more than one category, on CT scan, pleural thickening was reported in 33 cases (56%, 26 with calcifications), focal interstitial peripheral alterations in 23 (39%), asbestosis in 6 (10%), and peripheral lung consolidation in 13 cases (22%). Comparing each pathological condition to CT scan reports, US findings had high levels of sensitivity, specificity, positive, and negative predictive values. US did not prove effective for the detection of central lung nodules or diaphragmatic pleural thickenings. Chest US was considered to be the best technique to detect minimal pleural effusions (six subjects, 10%). Conclusions: Chest US might be considered an additional tool to follow up subjects occupationally exposed to asbestos who have already undergone CT scan examination and whose pathology is detectable by US as well.
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Affiliation(s)
- Andrea Smargiassi
- Pulmonary Medicine Department, University Hospital “A. Gemelli”—Università Cattolica del Sacro Cuore, Rome, Italy
| | - Giuliana Pasciuto
- Pulmonary Medicine Department, University Hospital “A. Gemelli”—Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ilaria Pedicelli
- Pulmonary Medicine Department, OORR Area Nolana—ASL Napoli3 Sud, Pollena Trocchia, Italy
| | - Erminia Lo Greco
- Pulmonary Medicine Department, University Hospital “A. Gemelli”—Università Cattolica del Sacro Cuore, Rome, Italy
| | - Mariarosaria Calvello
- Pulmonary Medicine Department, University Hospital “A. Gemelli”—Università Cattolica del Sacro Cuore, Rome, Italy
| | - Riccardo Inchingolo
- Pulmonary Medicine Department, University Hospital “A. Gemelli”—Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gioacchino Schifino
- Pulmonary Medicine Department, University Hospital “A. Gemelli”—Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patrizio Capoluongo
- Department of Public Health, University of Naples—Federico II, Naples, Italy
| | - Pasquale Patriciello
- Pulmonary Medicine Department, OORR Area Nolana—ASL Napoli3 Sud, Pollena Trocchia, Italy
| | - Maurizio Manno
- Department of Public Health, University of Naples—Federico II, Naples, Italy
| | - Alfonso Cirillo
- Department of Prevention, Service of Hygiene and Occupational Medicine—ASL Napoli3 Sud, Pompei, Italy
| | - Giuseppe Maria Corbo
- Pulmonary Medicine Department, University Hospital “A. Gemelli”—Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gino Soldati
- Emergency Department, Valle del Serchio General Hospital, Castelnuovo Garfagnana, Italy
| | - Ivo Iavicoli
- Department of Public Health, University of Naples—Federico II, Naples, Italy
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Tsim S, Kelly C, Alexander L, McCormick C, Thomson F, Woodward R, Foster JE, Stobo DB, Paul J, Maskell NA, Chalmers A, Blyth KG. Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma (DIAPHRAGM) study: protocol of a prospective, multicentre, observational study. BMJ Open 2016; 6:e013324. [PMID: 27884852 PMCID: PMC5168514 DOI: 10.1136/bmjopen-2016-013324] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 10/24/2016] [Accepted: 10/25/2016] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Malignant pleural mesothelioma (MPM) is an asbestos-related cancer, which is difficult to diagnose. Thoracoscopy is frequently required but is not widely available. An accurate, non-invasive diagnostic biomarker would allow early specialist referral, limit diagnostic delays and maximise clinical trial access. Current markers offer insufficient sensitivity and are not routinely used. The SOMAmer proteomic classifier and fibulin-3 have recently demonstrated sensitivity and specificity exceeding 90% in retrospective studies. DIAPHRAGM (Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma) is a suitably powered, multicentre, prospective observational study designed to determine whether these markers provide clinically useful diagnostic and prognostic information. METHODS AND ANALYSIS Serum and plasma (for SOMAscan and fibulin-3, respectively) will be collected at presentation, prior to pleural biopsy/pleurodesis, from 83 to 120 patients with MPM, at least 480 patients with non-MPM pleural disease and 109 asbestos-exposed controls. Final numbers of MPM/non-MPM cases will depend on the incidence of MPM in the study population (estimated at 13-20%). Identical sampling and storage protocols will be used in 22 recruiting centres and histological confirmation sought in all cases. Markers will be measured using the SOMAscan proteomic assay (SomaLogic) and a commercially available fibulin-3 ELISA (USCN Life Science). The SE in the estimated sensitivity and specificity will be <5% for each marker and their performance will be compared with serum mesothelin. Blood levels will be compared with paired pleural fluid levels and MPM tumour volume (using MRI) in a nested substudy. The prognostic value of each marker will be assessed and a large bioresource created. ETHICS AND DISSEMINATION The study has been approved by the West of Scotland Research Ethics Committee (Ref: 13/WS/0240). A Trial Management Group meets on a monthly basis. Results will be published in peer-reviewed journals, presented at international meetings and disseminated to patient groups. TRIAL REGISTRATION NUMBER ISRCTN10079972, Pre-results.
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Affiliation(s)
- Selina Tsim
- Department of Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | | | - Rosie Woodward
- Glasgow Clinical Research Imaging Facility, Queen Elizabeth University Hospital, Glasgow, UK
| | - John E Foster
- Glasgow Clinical Research Imaging Facility, Queen Elizabeth University Hospital, Glasgow, UK
| | - David B Stobo
- Department of Radiology, Queen Elizabeth University Hospital, Glasgow, UK
| | - Jim Paul
- Cancer Research UK Glasgow Clinical Trials Unit, UK
| | - Nick A Maskell
- Academic Respiratory Unit, School of Clinical Sciences, University of Bristol, Bristol, UK
| | - Anthony Chalmers
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Kevin G Blyth
- Department of Respiratory Medicine, Queen Elizabeth University Hospital, Glasgow, UK
- Institute of Infection, Immunology and Inflammation, University of Glasgow, Glasgow, UK
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Ledda C, Pomara C, Bracci M, Mangano D, Ricceri V, Musumeci A, Ferrante M, Musumeci G, Loreto C, Fenga C, Santarelli L, Rapisarda V. Natural carcinogenic fiber and pleural plaques assessment in a general population: A cross-sectional study. ENVIRONMENTAL RESEARCH 2016; 150:23-29. [PMID: 27236568 DOI: 10.1016/j.envres.2016.05.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 05/09/2016] [Accepted: 05/17/2016] [Indexed: 06/05/2023]
Abstract
Natural carcinogenic fibers are asbestos and asbestiform fibers present as a natural component of soils or rocks. These fibers are released into the environment resulting in exposure of the general population. Environmental contamination by fibers are those cases occurred in: rural regions of Turkey, in Mediterranean countries and in other sites of the world, including northern Europe, USA and China. Fluoro-edenite(FE) is a natural mineral species first isolated in Biancavilla, Sicily. The fibers are similar in size and morphology to some amphibolic asbestos fibers, whose inhalation can cause chronic inflammation and cancer. The aim of the current study is to assess the presence and features of pleural plaques (PPs) in Biancavilla's general population exposed to FE through a retrospective cross-sectional study. All High-Resolution Computed Tomography (HRCT) chest scans carried out between June 2009 and June 2015 in Biancavilla municipality hospital site (exposed subjects) were reviewed. The exposed groups were 1:1 subjects, matched according to age and sex distributions, with unexposed subjects (n.1.240) randomly selected among HRCT chest scans carried out in a Hospital 30km away from Biancavilla. Subjects from Biancavilla with PPs were significantly more numerous than the control group ones (218 vs 38). Average age of either group was >60 years; the age of exposed subjects was significantly (p=0.0312) lesser than the unexposed group. In exposed subjects, in most PPs thickness ranged between 2 and 4.9cm(38%, n=83); while in unexposed ones PPs thickness was less than 2cm (55%, n=21). As to the size of PPs in exposed subjects, in most cases it ranged between 1cm and 24% of chest wall (53%, n=116); while in unexposed ones the size of PPs was lesser than 1cm (23%, n=58). Among exposed subjects, 36 cases (17%) PPs were detected with calcification, whereas in unexposed ones only three (8%) presented calcification. 137 lung parenchymal abnormalities were observed in exposed group; whereas, 12 lung parenchymal involvement were registered in unexposed subjects. The RR for PPs is 6,74 CI 95% (4,47-9,58) p<0,0001 in the exposed population. These findings, suggested the urge to extend the screening on the possible involvement of the respiratory tract to all Biancavilla's population, particularly in those aged more than 30. Besides, it seems essential to start indoor monitoring Biancavilla's municipality.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
| | - Cristoforo Pomara
- Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; Department of Anatomy, School of Medicine, University of Malta, Msida, Malta
| | - Massimo Bracci
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Dario Mangano
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Vincenzo Ricceri
- Division of Radiology - Hospital of Biancavilla "Maria SS. Addolorata", ASP Catania, Biancavilla, Italy
| | - Andrea Musumeci
- Division of Radiology - University Hospital "Policlinico - Vittorio Emanuele", University of Catania, Catania, Italy
| | - Margherita Ferrante
- Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Giuseppe Musumeci
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Carla Loreto
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Concettina Fenga
- Occupational Medicine, Department of the Environment, Safety, Territory, Food and Health Sciences, University of Messina, Messina, Italy
| | - Lory Santarelli
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Zu K, Tao G, Goodman JE. Pleural plaques and lung function in the Marysville worker cohort: a re-analysis. Inhal Toxicol 2016; 28:514-9. [DOI: 10.1080/08958378.2016.1210704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ke Zu
- Gradient, Cambridge, MA, USA
| | - Ge Tao
- Gradient, Cambridge, MA, USA
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Mounchetrou Njoya I, Paris C, Dinet J, Luc A, Lighezzolo-Alnot J, Pairon JC, Thaon I. Anxious and depressive symptoms in the French Asbestos-Related Diseases Cohort: risk factors and self-perception of risk. Eur J Public Health 2016; 27:359-366. [DOI: 10.1093/eurpub/ckw106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Benson R, Berry D, Lockey J, Brattin W, Hilbert T, LeMasters G. Response to comment on "Exposure-response modeling of non-cancer effects in humans exposed to Libby Amphibole Asbestos; update" by Benson et al. (2015) submitted by Goodman et al. (2016). Regul Toxicol Pharmacol 2016; 80:270-1. [PMID: 27191601 DOI: 10.1016/j.yrtph.2016.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/11/2016] [Indexed: 10/21/2022]
Affiliation(s)
- Robert Benson
- Environmental Protection Agency, 1595 Wynkoop St, Denver, CO 80202, United States.
| | - David Berry
- Environmental Protection Agency, 1595 Wynkoop St, Denver, CO 80202, United States.
| | - James Lockey
- University of Cincinnati, Department of Environmental Health, 160 Panzeca Way, Cincinnati, OH 45267, United States; University of Cincinnati, Department of Internal Medicine, Pulmonary Division, 160 Panzeca Way, Cincinnati, OH 45267, United States.
| | - William Brattin
- SRC Inc., Suite 1380, 999 18th St, Denver, CO 80202, United States.
| | - Timothy Hilbert
- University of Cincinnati, Department of Environmental Health, 160 Panzeca Way, Cincinnati, OH 45267, United States.
| | - Grace LeMasters
- University of Cincinnati, Department of Environmental Health, 160 Panzeca Way, Cincinnati, OH 45267, United States.
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Exposure-response modeling of non-cancer effects in humans exposed to Libby Amphibole Asbestos; update. Regul Toxicol Pharmacol 2015; 73:780-9. [PMID: 26524929 DOI: 10.1016/j.yrtph.2015.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/19/2015] [Accepted: 10/20/2015] [Indexed: 11/22/2022]
Abstract
The United States Environmental Protection Agency (EPA) developed a quantitative exposure-response model for the non-cancer effects of Libby Amphibole Asbestos (LAA) (EPA, 2014). The model is based on the prevalence of localized pleural thickening (LPT) in workers exposed to LAA at a workplace in Marysville, Ohio (Lockey et al., 1984; Rohs et al., 2008). Recently, Lockey et al. (2015a) published a follow-up study of surviving Marysville workers. The data from this study increases the number of cases of LPT and extends the observation period for a number of workers, thereby providing a strengthened data set to define and constrain the optimal exposure-response model for non-cancer effects from inhalation exposure to LAA. The new data were combined with the previous data to update the exposure-response modeling for LPT. The results indicate that a bivariate model using cumulative exposure and time since first exposure is appropriate, and the benchmark concentration is similar to the findings previously reported by EPA (2014). In addition, the data were also used to develop initial exposure-response models for diffuse pleural thickening (DPT) and small interstitial opacities (SIO).
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Maxim LD, Niebo R, Utell MJ. Are pleural plaques an appropriate endpoint for risk analyses? Inhal Toxicol 2015; 27:321-34. [DOI: 10.3109/08958378.2015.1051640] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yusa T, Hiroshima K, Sakai F, Kishimoto T, Ohnishi K, Usami I, Morikawa T, Wu D, Itoi K, Okamoto K, Shinohara Y, Kohyama N, Morinaga K. Significant relationship between the extent of pleural plaques and pulmonary asbestos body concentration in lung cancer patients with occupational asbestos exposure. Am J Ind Med 2015; 58:444-55. [PMID: 25676175 DOI: 10.1002/ajim.22430] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2014] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of this study was to elucidate whether there is a relationship between the extent of pleural plaques and pulmonary asbestos body concentration (PABC). METHODS The subjects were 207 lung cancer patients with occupational asbestos exposure. We determined the plaque extent by findings on chest images using our own criteria. PABCs were measured in resected or autopsy lung specimens. RESULTS There was a significant relationship between plaque extent and PABC. Seventy-five percent of the patients determined to have extensive plaques based on our criteria had a PABC of ≥5,000 asbestos bodies per gram of dry lung tissue, which is one of the certification criteria of lung cancer caused by asbestos for workers' compensation in Japan. CONCLUSIONS In lung cancer patients, the plaque extent had a significant positive relationship with the PABC. The plaque extent would be useful as a proxy for PABC for lung cancer compensation purposes.
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Affiliation(s)
- Toshikazu Yusa
- Department of General Thoracic Surgery and Asbestos Disease Center; Chiba Rosai Hospital; Ichihara Japan
| | - Kenzo Hiroshima
- Department of Pathology; Tokyo Women's Medical University Yachiyo Medical Center; Yachiyo Japan
| | - Fumikazu Sakai
- Department of Diagnostic Radiology; International Medical Center; Saitama Medical University; Hidaka Japan
| | - Takumi Kishimoto
- Department of Respiratory Medicine and Asbestos-related Disease Research Center; Okayama Rosai Hospital; Okayama Japan
| | - Kazuo Ohnishi
- Department of Respiratory Medicine and Asbestos Disease Bloc Center; Kobe Rosai Hospital; Kobe Japan
| | - Ikuji Usami
- Department of Respiratory Medicine and Asbestos Disease Bloc Center; Asahi Rosai Hospital; Owariasahi Japan
| | - Tetsuyuki Morikawa
- Department of Respiratory Medicine and Asbestos Disease Bloc Center; Yokohama Rosai Hospital; Yokohama Japan
| | - Di Wu
- Department of Pathology; Tokyo Women's Medical University Yachiyo Medical Center; Yachiyo Japan
| | - Kazumi Itoi
- Department of General Thoracic Surgery; Hyogo Prefectural Amagasaki Hospital; Amagasaki Japan
| | - Kenzo Okamoto
- Department of Pathology; Hokkaido Chuo Rosai Hospital; Iwamizawa Japan
| | - Yasushi Shinohara
- Work Environment Research Group; National Institute of Occupational Safety and Health; Kawasaki Japan
| | - Norihiko Kohyama
- Department of Environmental Research; Graduate School of Economics Toyo University; Tokyo Japan
| | - Kenji Morinaga
- Department of the Relief for Asbestos Related Diseases; Environmental Restoration and Conservation Agency; Kawasaki Japan
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Terra-Filho M, Bagatin E, Nery LE, Nápolis LM, Neder JA, de Souza Portes Meirelles G, Silva CI, Muller NL. Screening of miners and millers at decreasing levels of asbestos exposure: comparison of chest radiography and thin-section computed tomography. PLoS One 2015; 10:e0118585. [PMID: 25790222 PMCID: PMC4366170 DOI: 10.1371/journal.pone.0118585] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Accepted: 01/21/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Chest radiography (CXR) is inferior to Thin-section computed tomography in the detection of asbestos related interstitial and pleural abnormalities. It remains unclear, however, whether these limitations are large enough to impair CXR´s ability in detecting the expected reduction in the frequency of these asbestos-related abnormalities (ARA) as exposure decreases. METHODS Clinical evaluation, CXR, Thin-section CT and spirometry were obtained in 1418 miners and millers who were exposed to progressively lower airborne concentrations of asbestos. They were separated into four groups according to the type, period and measurements of exposure and/or procedures for controlling exposure: Group I (1940-1966/tremolite and chrysotile, without measurements of exposure and procedures for controlling exposure); Group II (1967-1976/chrysotile only, without measurements of exposure and procedures for controlling exposure); Group III (1977-1980/chrysotile only, initiated measurements of exposure and procedures for controlling exposure) and Group IV (after 1981/chrysotile only, implemented measurements of exposure and a comprehensive procedures for controlling exposure). RESULTS In all groups, CXR suggested more frequently interstitial abnormalities and less frequently pleural plaques than observed on Thin-section CT (p<0.050). The odds for asbestosis in groups of decreasing exposure diminished to greater extent at Thin-section CT than on CXR. Lung function was reduced in subjects who had pleural plaques evident only on Thin-section CT (p<0.050). In a longitudinal evaluation of 301 subjects without interstitial and pleural abnormalities on CXR and Thin-section CT in a previous evaluation, only Thin-section CT indicated that these ARA reduced as exposure decreased. CONCLUSIONS CXR compared to Thin-section CT was associated with false-positives for interstitial abnormalities and false-negatives for pleural plaques, regardless of the intensity of asbestos exposure. Also, CXR led to a substantial misinformation of the effects of the progressively lower asbestos concentrations in the occurrence of asbestos-related diseases in miners and millers.
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Affiliation(s)
- Mario Terra-Filho
- Pulmonary Division, Heart Institute, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Ericson Bagatin
- Occupational Health Area, Department of Social and Preventive Medicine, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, São Paulo, Brazil
- Department of Clinical Medicine, Faculdade de Medicina de Jundiaí, Jundiaí, São Paulo, Brazil
| | - Luiz Eduardo Nery
- Respiratory Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lara Maris Nápolis
- Respiratory Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - José Alberto Neder
- Respiratory Division, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gustavo de Souza Portes Meirelles
- Radiology Division, Department of Radiology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Radiology Division, Fleury Group, São Paulo, Brazil
| | - C. Isabela Silva
- Department of Radiology, Delfin Clinic and Portuguese Hospital, Salvador, Bahia, Brazil
| | - Nestor L. Muller
- Department of Radiology, University of British Columbia, Vancouver, B.C., Canada
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Abstract
Context US EPA proposed a Reference Concentration for Libby amphibole asbestos based on the premise that pleural plaques are adverse and cause lung function deficits. Objective We conducted a systematic review to evaluate whether there is an association between pleural plaques and lung function and ascertain whether results were dependent on the method used to identify plaques. Methods Using the PubMed database, we identified studies that evaluated pleural plaques and lung function. We assessed each study for quality, then integrated evidence and assessed associations based on the Bradford Hill guidelines. We also compared the results of HRCT studies to those of X-ray studies. Results We identified 16 HRCT and 36 X-ray studies. We rated six HRCT and 16 X-ray studies as higher quality based on a risk-of-bias analysis. Half of the higher quality studies reported small but statistically significant mean lung function decrements associated with plaques. None of the differences were clinically significant. Many studies had limitations, such as inappropriate controls and/or insufficient adjustment for confounders. There was little consistency in the direction of effect for the most commonly reported measurements. X-ray results were more variable than HRCT results. Pleural plaques were not associated with changes in lung function over time in longitudinal studies. Conclusion The weight of evidence indicates that pleural plaques do not impact lung function. Observed associations are most likely due to unidentified abnormalities or other factors.
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Pairon JC, Andujar P, Rinaldo M, Ameille J, Brochard P, Chamming’s S, Clin B, Ferretti G, Gislard A, Laurent F, Luc A, Wild P, Paris C. Asbestos Exposure, Pleural Plaques, and the Risk of Death from Lung Cancer. Am J Respir Crit Care Med 2014; 190:1413-20. [DOI: 10.1164/rccm.201406-1074oc] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Laurent F, Paris C, Ferretti GR, Beigelman C, Montaudon M, Latrabe V, Jankowski A, Badachi Y, Clin B, Gislard A, Letourneux M, Luc A, Schorlé E, Brochard P, Ameille J, Pairon JC. Inter-reader agreement in HRCT detection of pleural plaques and asbestosis in participants with previous occupational exposure to asbestos. Occup Environ Med 2014; 71:865-70. [PMID: 25286915 DOI: 10.1136/oemed-2014-102336] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To investigate inter-reader agreement for the detection of pleural and parenchymal abnormalities using CT in a large cross-sectional study comprising information on individual cumulative exposure to asbestos. METHODS The project was approved by the hospital ethics committee, and all patients received information on the study and gave their written informed consent. In 5511 CT scans performed in a cohort of retired workers previously exposed to asbestos and volunteering to participate in a multiregional survey programme (Asbestos Related Diseases Cohort, ARDCO), double randomised standardised readings, triple in case of disagreement, were performed by seven trained expert radiologists specialised in thoracic imaging and blind to the initial interpretation. Inter-reader agreement was evaluated by calculating the κ-weighted coefficient between pairs of expert readers and results of routine practice and final diagnosis after expert reading. RESULTS κ-Weighted coefficients between trained experts ranged from 0.28 to 0.52 (fair to good), 0.59 to 0.86 (good to excellent) and 0.11 to 0.66 (poor to good) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. κ-Weighted coefficients between results of routine practice and final diagnosis after expert reading were 0.13 (poor), 0.53 (moderate) and 0.11 (poor) for the diagnosis of asbestosis, pleural plaques and fibrosis of the visceral pleura, respectively. CONCLUSIONS Interpretation of benign asbestos-related thoracic abnormalities requires standardisation of the reading and trained readers, particularly for participants asking for compensation, and with a view to the longitudinal survey of asbestos-exposed workers.
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Affiliation(s)
- François Laurent
- Centre Cardiothoracique INSERM 1045, France Université de Bordeaux and CHU de Bordeaux, France
| | - Christophe Paris
- EA7298 Université de Lorraine, France Faculté de Médecine, and CHU Nancy, France
| | - Gilbert R Ferretti
- INSERM U823, and Université J Fourrier, and Clinique universitaire de radiologie et imagerie médicale, CHU, Grenoble, France
| | - Catherine Beigelman
- Service de Radiologie Asssistance-Publique Hôpitaux de Paris, 47-83 Boulevard de l'hôpital, Paris, France
| | - Michel Montaudon
- Centre Cardiothoracique INSERM 1045, France Université de Bordeaux and CHU de Bordeaux, France
| | - Valerie Latrabe
- Centre Cardiothoracique INSERM 1045, France Université de Bordeaux and CHU de Bordeaux, France
| | - A Jankowski
- INSERM U823, and Université J Fourrier, and Clinique universitaire de radiologie et imagerie médicale, CHU, Grenoble, France
| | - Yasmina Badachi
- Service de Radiologie Asssistance-Publique Hôpitaux de Paris, 47-83 Boulevard de l'hôpital, Paris, France
| | - Bénédicte Clin
- Cancers et Populations INSERM U1086, France Service de Santé au Travail et Pathologie Professionnelle, Faculté de Médecine and CHU de Caen, France
| | | | - Marc Letourneux
- Cancers et Populations INSERM U1086, France Service de Santé au Travail et Pathologie Professionnelle, Faculté de Médecine and CHU de Caen, France
| | | | | | | | - Jacques Ameille
- Unité de Pathologie Professionnelle, Assistance-Publique Hôpitaux de Paris, Hôpital Raymond Poincaré, Garches, France Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Paris, France
| | - Jean-Claude Pairon
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, Paris, France Service de Pneumologie et Pathologie Professionnelle, INSERM, U955 and Université Paris-Est Créteil, and Centre Hospitalier Intercommunal, Créteil, France
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Moolgavkar SH, Anderson EL, Chang ET, Lau EC, Turnham P, Hoel DG. A review and critique of U.S. EPA's risk assessments for asbestos. Crit Rev Toxicol 2014; 44:499-522. [DOI: 10.3109/10408444.2014.902423] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Eisenhawer C, Felten MK, Tamm M, Das M, Kraus T. Radiological surveillance of formerly asbestos-exposed power industry workers: rates and risk factors of benign changes on chest X-ray and MDCT. J Occup Med Toxicol 2014; 9:18. [PMID: 24808921 PMCID: PMC4012178 DOI: 10.1186/1745-6673-9-18] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 04/17/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine the prevalence of asbestos-related changes on chest X-ray (CXR) and low-dose multidetector-row CT (MDCT) of the thorax in a cohort of formerly asbestos-exposed power industry workers and to assess the importance of common risk factors associated with specific radiological changes. METHODS To assess the influence of selected risk factors (age, time since first exposure, exposure duration, cumulative exposure and pack years) on typical asbestos-related radiographic changes, we employed multiple logistic regression and receiver operating characteristic (ROC) analysis. RESULTS On CXR, pleural changes and asbestosis were strongly associated with age, years since first exposure and exposure duration. The MDCT results showed an association between asbestosis and age and between plaques and exposure duration, years since first exposure and cumulative exposure. Parenchymal changes on CXR and MDCT, and diffuse pleural thickening on CXR were both associated with smoking. Using a cut-off of 55 years for age, 17 years for exposure duration and 28 years for latency, benign radiological changes in the cohort with CXR could be predicted with a sensitivity of 82.0% for all of the three variables and a specificity of 47.4%, 39.0% and 40.6%, respectively. CONCLUSIONS Participants aged 55 years and older and those with an asbestos exposure of at least 17 years or 28 years since first exposure should be seen as having an increased risk of abnormal radiological findings. For implementing a more focused approach the routine use of low-dose MDCT rather than CXR at least for initial examinations would be justified.
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Affiliation(s)
- Christian Eisenhawer
- Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany
| | - Michael K Felten
- Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany
| | - Miriam Tamm
- Department of Medical Statistics, RWTH Aachen University, Aachen, Germany
| | - Marco Das
- Department of Radiology, Maastricht University Medical Center, Maastricht, The Netherlands ; GROW, School for Oncology & Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands ; Department of Diagnostic Radiology, RWTH Aachen University, Aachen, Germany
| | - Thomas Kraus
- Institute of Occupational and Social Medicine, RWTH Aachen University, Aachen, Germany
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Köksal N, Çelik M, Kahraman H, Ekerbiçer HÇ, Dağlı CE, Özkan F. Survey of environmental exposure to asbestos in the town of Buyuktatlar, Turkey. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 18:130-4. [DOI: 10.1179/1077352512z.00000000011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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45
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Pairon JC, Laurent F, Rinaldo M, Clin B, Andujar P, Ameille J, Brochard P, Chammings S, Ferretti G, Galateau-Sallé F, Gislard A, Letourneux M, Luc A, Schorlé E, Paris C. Pleural plaques and the risk of pleural mesothelioma. J Natl Cancer Inst 2013; 105:293-301. [PMID: 23355760 DOI: 10.1093/jnci/djs513] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The association between pleural plaques and pleural mesothelioma remains controversial. The present study was designed to examine the association between pleural plaques on computed tomography (CT) scan and the risk of pleural mesothelioma in a follow-up study of asbestos-exposed workers. METHODS Retired or unemployed workers previously occupationally exposed to asbestos were invited to participate in a screening program for asbestos-related diseases, including CT scan, organized between October 2003 and December 2005 in four regions in France. Randomized, independent, double reading of CT scans by a panel of seven chest radiologists focused on benign asbestos-related abnormalities. A 7-year follow-up study was conducted in the 5287 male subjects for whom chest CT scan was available. Annual determination of the number of subjects eligible for free medical care because of pleural mesothelioma was carried out. Diagnosis certification was obtained from the French mesothelioma panel of pathologists. Survival regression based on the Cox model was used to estimate the risk of pleural mesothelioma associated with pleural plaques, with age as the main time variable and time-varying exposure variables, namely duration of exposure, time since first exposure, and cumulative exposure index to asbestos. All statistical tests were two-sided. RESULTS A total of 17 incident cases of pleural mesothelioma were diagnosed. A statistically significant association was observed between mesothelioma and pleural plaques (unadjusted hazard ratio (HR) = 8.9, 95% confidence interval [CI] = 3.0 to 26.5; adjusted HR = 6.8, 95% CI = 2.2 to 21.4 after adjustment for time since first exposure and cumulative exposure index to asbestos). CONCLUSION The presence of pleural plaques may be an independent risk factor for pleural mesothelioma.
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Affiliation(s)
- Jean-Claude Pairon
- Service de pneumologie et pathologie professionnelle, Centre Hospitalier Intercommunal de Créteil, 40 avenue de Verdun, 94010 Créteil cedex, France.
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Low-Dose Computed Tomography (LDCT) in Workers Previously Exposed to Asbestos. J Comput Assist Tomogr 2013; 37:626-30. [PMID: 23863542 DOI: 10.1097/rct.0b013e31828e1b8e] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Lazarus A, Massoumi A, Hostler J, Hostler DC. Asbestos-related pleuropulmonary diseases: benign and malignant. Postgrad Med 2012; 124:116-30. [PMID: 22691906 DOI: 10.3810/pgm.2012.05.2555] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Asbestos is known for its desirable properties of thermal and heat resistance along with excellent strength and durability. It was widely used in many industries since the late 19th century, until its adverse effects on health were recognized. The occurrence of pleuropulmonary changes from exposure to asbestos often has a latency period of 20 to 30 years. The use of asbestos has been banned, regulated, and minimized in many countries, but in several developing countries, the use of asbestos in industries is still a common practice. In this article, the benign and malignant clinical manifestations of asbestos exposure are discussed.
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Affiliation(s)
- Angeline Lazarus
- Pulmonary Division, Walter Reed National Military Medical Center, Bethesda, MD 20889-5600, USA.
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Ameille J. Les différentes pathologies pleuropulmonaires liées à l’amiante : définitions, épidémiologie et évolution. Rev Mal Respir 2012; 29:1035-46. [DOI: 10.1016/j.rmr.2012.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Accepted: 02/17/2012] [Indexed: 01/09/2023]
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Christensen KY, Kopylev L. Localized pleural thickening: smoking and exposure to Libby vermiculite. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2012; 22:320-323. [PMID: 22534695 DOI: 10.1038/jes.2012.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 03/29/2012] [Indexed: 05/31/2023]
Abstract
There is limited research on the combined effects of smoking and asbestos exposure on risk of localized pleural thickening (LPT). This analysis uses data from the Marysville cohort of workers occupationally exposed to Libby amphibole asbestos (LAA). Workers were interviewed to obtain work and health history, including ever/never smoking and chest X-rays. Cumulative exposure estimates were developed on the basis of fiber measurements from the plant and work history. Benchmark concentration (BMC) methodology was used to evaluate the exposure-response relationship for exposure to LAA and a 10% increased risk of LPT, considering potential confounders and statistical model forms. There were 12 LPT cases among 118 workers in the selected study population. The mean exposure was 0.42 (SD=0.77) fibers/cc-year, and the prevalence of smoking history was 75.0% among cases and 51.9% among non-cases. When controlling for LAA exposure, smoking history was of borderline statistical significance (P-value=0.099), and its inclusion improved model fit, as measured by Akaike's Information Criterion. A comparison of BMC estimates was made to gauge the potential effect of smoking status. The BMC was 0.36 fibers/cc-year, overall. The BMC for non-smokers was approximately three times as high (1.02 fibers/cc-year) as that for the full cohort, whereas the BMC for smokers was about 1/2 that of the full cohort (0.17 fibers/cc-year).
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Affiliation(s)
- Krista Y Christensen
- National Center for Environmental Assessment, Office of Research and Development, United States Environmental Protection Agency, Washington, DC 20460, USA.
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50
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[Follow-up of subjects occupationally exposed to asbestos: MRI and PET scans]. Rev Mal Respir 2012; 29:529-36. [PMID: 22542410 DOI: 10.1016/j.rmr.2011.09.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 09/06/2011] [Indexed: 11/22/2022]
Abstract
MRI and PET scans are not normally used for screening and follow-up of patients following occupational exposure to asbestos. These examinations usually complement the investigation of a parenchymal mass, an effusion or pleural thickening. PET and MRI have an excellent ability to define a parenchymal lesion as malignant (cancer versus rounded atelectasis) or a pleural lesion (mesothelioma versus plaque). MRI distinguishes perfectly the involvement of sub-pleural fat by bronchial carcinoma or mesothelioma. MRI, taking account of its lack of irradiation, could be regarded as suitable for potentially repeated examinations following initial screeing by CT scan. A comparative study of multidetector scanner versus MRI, including diffusion MRI could be, nevertheless, interesting. PET cannot be proposed for the follow up or for screening on account of the irradiation induced and the difficulty of access. Pleural plaques do not take up FDG. There is no specific study of asbestos related fibrosis and there is discordance between studies of other types of pulmonary fibrosis.
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