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Miller A. Recognizing the pleura in asbestos-related pleuropulmonary disease: Known and new manifestations of pleural fibrosis. Am J Ind Med 2024; 67:73-80. [PMID: 38030592 DOI: 10.1002/ajim.23553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
Pleural thickening (PT) is a major consequence of exposure to all fiber types of asbestos. In recent decades, it is more prevalent than parenchymal asbestosis. Its manifestations occupy a full clinical and radiographic spectrum. Six major manifestations can be identified: (a) acute pleuritis generally with effusion; (b) diffuse PT or fibrous pleuritis; (c) rounded atelectasis; (d) circumscribed PT or plaques; (e) chronic pleuritic pain; and (f) mesothelioma. Review of the experience of workers and community members in Libby, MT to asbestiform fibers in vermiculite has confirmed the appearance of these previously known benign and malignant asbestos-related diseases as well as a unique pleuropulmonary disease characterized as lamellar PT and associated with progressive decline in pulmonary function and pleuritic pain. Despite previous literature asserting that PT represents a marker for asbestos exposure without significant effect on pulmonary function and physiology, the experience of Libby amphibole (LA) disease, along with other studies, indicates that PT plays a role in declining vital capacity in those with prolonged or unusual exposures such as those arising from LA.
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Affiliation(s)
- Albert Miller
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, USA
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Pietrofesa RA, Park K, Mishra OP, Johnson-McDaniel D, Myerson JW, Shuvaev VV, Arguiri E, Chatterjee S, Moorthy GS, Zuppa A, Hwang WT, Christofidou-Solomidou M. Copper Oxide Nanoparticle-Induced Acute Inflammatory Response and Injury in Murine Lung Is Ameliorated by Synthetic Secoisolariciresinol Diglucoside (LGM2605). Int J Mol Sci 2021; 22:9477. [PMID: 34502389 DOI: 10.3390/ijms22179477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/23/2021] [Accepted: 08/26/2021] [Indexed: 11/30/2022] Open
Abstract
Metal-oxide nanoparticles (MO-NPs), such as the highly bioreactive copper-based nanoparticles (CuO-NPs), are widely used in manufacturing of hundreds of commercial products. Epidemiological studies correlated levels of nanoparticles in ambient air with a significant increase in lung disease. CuO-NPs, specifically, were among the most potent in a set of metal-oxides and carbons studied in parallel regarding DNA damage and cytotoxicity. Despite advances in nanotoxicology research and the characterization of their toxicity, the exact mechanism(s) of toxicity are yet to be defined. We identified chlorination toxicity as a damaging consequence of inflammation and myeloperoxidase (MPO) activation, resulting in macromolecular damage and cell damage/death. We hypothesized that the inhalation of CuO-NPs elicits an inflammatory response resulting in chlorination damage in cells and lung tissues. We further tested the protective action of LGM2605, a synthetic small molecule with known scavenging properties for reactive oxygen species (ROS), but most importantly, for active chlorine species (ACS) and an inhibitor of MPO. CuO-NPs (15 µg/bolus) were instilled intranasally in mice and the kinetics of the inflammatory response in lungs was evaluated 1, 3, and 7 days later. Evaluation of the protective action of LGM2605 was performed at 24 h post-challenge, which was selected as the peak acute inflammatory response to CuO-NP. LGM2605 was given daily via gavage to mice starting 2 days prior to the time of the insult (100 mg/kg). CuO-NPs induced a significant inflammatory influx, inflammasome-relevant cytokine release, and chlorination damage in mouse lungs, which was mitigated by the action of LGM2605. Preventive action of LGM2605 ameliorated the adverse effects of CuO-NP in lung.
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Campopiano A, Cannizzaro A, Olori A, Angelosanto F, Bruno MR, Sinopoli F, Bruni BM, Casalinuovo F, Iavicoli S. Environmental contamination by naturally occurring asbestos (NOA): Analysis of sentinel animal lung tissue. Sci Total Environ 2020; 745:140990. [PMID: 32717604 DOI: 10.1016/j.scitotenv.2020.140990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/09/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
Ophiolites are known sources of naturally occurring asbestos (NOA). In Calabria (Southern Italy) NOA are mainly concentrated in the ophiolitic sequences cropping in the Mount Reventino area, in the southern part of the Sila massif, and along the Coastal Chain. The most common type of asbestos identified in the rocks of these areas belongs to the tremolite-actinolite series. Another identified asbestiform mineral is fibrous antigorite belonging to the serpentine mineral group with a minor amount of chrysotile. The purpose of the present study is to evaluate the diffusion of natural asbestiform fibers from NOA using sentinel animals. Fifteen lung samples of sheep, goats and wild boars from Mount Reventino area and two from an area free from NOA were collected. The lung samples were subjected to anatomopathological examination and lung fiber burden analysis by electron microscopy. Abundant tremolite and few antigorite fibers were detected in the lung samples coming from the NOA area. No corpuscle of asbestos was observed. No fiber was found in the two lung samples of sheet from the area free from NOA. These concentrations of fibers per gram of dry weight of lung tissue (f/gdw) ranged from 104 to 106 f/gdw. The asbestos fibers detected in the lungs of the examined animals reflect the geological features of the areas where they grazed and lived. The anatomopathological analysis showed that 60% of the examined animals had macroscopic lesions affecting their lungs. The presence of tremolite fibers in the lungs confirms the diffusion of mineral fibers in the environment and the real advantage of using animal populations in the study areas.
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Affiliation(s)
- Antonella Campopiano
- National Institute for Insurance against Accidents at Work (INAIL), Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy.
| | - Annapaola Cannizzaro
- National Institute for Insurance against Accidents at Work (INAIL), Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy.
| | - Angelo Olori
- National Institute for Insurance against Accidents at Work (INAIL), Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy.
| | - Federica Angelosanto
- National Institute for Insurance against Accidents at Work (INAIL), Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy.
| | - Maria Rosaria Bruno
- National Institute for Insurance against Accidents at Work (INAIL), Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, Lamezia Terme, Catanzaro, Italy.
| | - Francesco Sinopoli
- National Institute for Insurance against Accidents at Work (INAIL), Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, Lamezia Terme, Catanzaro, Italy.
| | - Biagio Maria Bruni
- National Health Institute (ISS), Department of Environment and Health, Rome, Italy.
| | | | - Sergio Iavicoli
- National Institute for Insurance against Accidents at Work (INAIL), Department of Medicine, Epidemiology, Occupational and Environmental Hygiene, via Fontana Candida 1, 00078 Monte Porzio Catone, Rome, Italy.
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Abstract
OBJECTIVE To evaluate mortality patterns among participants in a community-based screening program for asbestos-related disease. METHODS We calculated standardized mortality ratios (SMRs) and stratified results by exposure group (three occupational exposure groups, household contacts and residents without occupational asbestos exposure) and by radiographic abnormality presence. RESULTS All-cause mortality (15.8%; 1,429/8,043) was statistically lower than expected. Asbestosis was statistically elevated in all exposure groups. Lung cancer was moderately associated with vermiculite miner/miller employment. Mesothelioma was elevated in that same exposure group and among residents. Systemic autoimmune disease mortality was also elevated. Radiographic parenchymal abnormalities were associated with lung cancer mortality. CONCLUSION In addition to asbestos-related mortality in occupational exposure groups, this initial follow-up of this cohort also shows elevated mortality for some asbestos-related causes in non-occupational exposure groups.
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Affiliation(s)
- Theodore C Larson
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia (Mr Larson); Montana Department of Public Health and Human Services, Helena, Montana (Ms Williamson); Hospital for Special Surgery, New York, New York (Dr Antao)
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Winters CA, Kuntz SW. A Comparison of Environmental Concerns in Two Disparate Montana and Nevada Communities. Annu Rev Nurs Res 2019; 38:113-130. [PMID: 32102958 DOI: 10.1891/0739-6686.38.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Asbestos refers to six fibrous minerals that occur naturally in the environment in the United States and throughout the world. Deposits may be found in soil, rocks, and deposits of other minerals such as vermiculite and talc. These naturally occurring asbestos (NOA) minerals belong to the serpentine and amphibole family of minerals. This chapter reports shared components of community-driven environmental concerns related to exposure to NOA in a rural Montana and a suburban Nevada community. The specific aim is to establish an understanding of the community and community member's primary concern(s) related to NOA in both communities. The knowledge that NOA is commonly found in areas across the United States supports the need for additional research into the health effects of environmental exposure and best-practices to reduce exposure risk while allowing communities to thrive economically.
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Loewen G, Black B, McNew T, Miller A. Lung cancer screening in patients with Libby amphibole disease: High yield despite predominantly environmental and household exposure. Am J Ind Med 2019; 62:1112-1116. [PMID: 31535393 PMCID: PMC6899927 DOI: 10.1002/ajim.23042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 01/11/2019] [Accepted: 08/06/2019] [Indexed: 12/17/2022]
Abstract
Background Lung cancer screening with low‐dose computed tomography (CT) scanning (LDCT) is accepted as a screening tool, but its application to populations exposed to recognized occupational or environmental carcinogens is limited. We apply LDCT to a population with a predominantly nonoccupational exposure to a recognized human lung carcinogen, Libby amphibole asbestos (LA). Methods Patients in an asbestos disease clinic in Libby, Montana who were aged 50 to 84 years, greater than or equal to 20 pack‐year history of tobacco use (irrespective of quit date), and asbestos‐related pleuropulmonary disease on high‐resolution CT scan were offered free annual lung cancer screening over a 39‐month period. Results Of 2897 clinic patients, 1149 (39.7%) met eligibility criteria, and 567 (49%) were screened with 1014 low‐dose CT scans. Most screened patients had principally environmental (333 or 59%) or household exposure (145 or 25%) to LA. Seventeen primary lung cancers were identified, mostly in early stages: 10 at stage 1, two at stage 2, three at stages 3 to 4, and two at limited small‐cell cancers. The screening yield was 1.9 at baseline scan and 1.5% on the first annual scan. Conclusions Consistent with the guidelines of the National Comprehensive Cancer Network and American Association of Thoracic Surgery, LDCT for early lung cancer detection should be offered to people with significant exposure to occupational or environmental human lung carcinogens.
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Affiliation(s)
- Gregory Loewen
- Washington State University Spokane Washington
- Center for Asbestos‐Related Disease Libby Montana
| | - Brad Black
- Center for Asbestos‐Related Disease Libby Montana
| | - Tracy McNew
- Center for Asbestos‐Related Disease Libby Montana
| | - Albert Miller
- Barry Commoner Center for the Environment and Health, Queens CollegeCity University of New York Flushing New York
- Division of Pulmonary and Critical Care MedicineMount Sinai Beth Israel Medical Center New York New York
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Konen T, Johnson JE, Lindgren P, Williams A. Cancer incidence and mortality associated with non-occupational and low dose exposure to Libby vermiculite in Minnesota. Environ Res 2019; 175:449-456. [PMID: 31158563 DOI: 10.1016/j.envres.2019.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/02/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND A vermiculite processing plant in a Minneapolis, Minnesota neighborhood utilized asbestos-containing ore from Libby, Montana from the late 1930's until 1989. Multiple pathways of exposure to Libby asbestos were characterized in a cohort of over 6000 plant workers and residents living near the plant. OBJECTIVE We conducted a cohort linkage study to assess the impact of cumulative low dose exposure and the role of occupational history on asbestos-related mortality and cancer morbidity among cohort members residing near a vermiculite plant. METHODS Cohort members alive in 1988 (n = 5848) were linked to the Minnesota Cancer Surveillance System to identify incident cases of mesothelioma, lung cancer, and all-cancer diagnosed from 1988 to 2010. Proportional incidence ratios (PIRs) were calculated for mesothelioma and lung cancer. Vital status and cause of death were ascertained from Minnesota vital records and the National Death Index (1988-2011). Mortality rates of the cohort (2001-2011) for asbestos-related outcomes were compared to the Minnesota population to estimate standardized mortality ratios (SMRs) and stratified by gender, exposure, and occupational history categories. RESULTS We identified seven cases of mesothelioma, with elevated incidence only in females (PIR = 11.76, 95% CI: 3.17, 30.12). Lung cancer was elevated in both genders: PIR = 1.54 (95% CI: 1.19, 2.0) in males and 1.62 (95% CI: 1.21, 2.12) in females. We found elevated mortality from COPD, lung cancer, and mesothelioma among females (SMR for mesothelioma in females = 18.97, CI: 3.91, 55.45), among the 546 deaths identified. All four deaths from mesothelioma occurred in the >75th percentile of exposure (>0.0156 fiber/cc x months). The SMR for lung cancer and all respiratory cancer was elevated even after controlling for occupation. CONCLUSIONS Community exposure to Libby amphibole asbestos from a vermiculite processing plant is associated with increased risk of COPD, lung cancer and mesothelioma incidence and mortality, most notably among females, and is likely to remain a public health issue for years to come.
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Affiliation(s)
- Tess Konen
- Minnesota Department of Health, 85 East 7th Place, PO Box 64882, St. Paul, MN 55164, USA.
| | - Jean E Johnson
- Minnesota Department of Health, 85 East 7th Place, PO Box 64882, St. Paul, MN 55164, USA
| | - Paula Lindgren
- Minnesota Department of Health, 85 East 7th Place, PO Box 64882, St. Paul, MN 55164, USA
| | - Allan Williams
- Minnesota Department of Health, 85 East 7th Place, PO Box 64882, St. Paul, MN 55164, USA
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Odo NU, Mandel JH, Alexander BH, Perlman DM, MacLehose RF, Ramachandran G, Ryan AD, Shao Y. The impact of different approaches to exposure assessment on understanding non-malignant respiratory disease risk in taconite miners. Int Arch Occup Environ Health 2020; 93:77-85. [PMID: 31372718 DOI: 10.1007/s00420-019-01465-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 07/25/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION We examined the association between cumulative silica exposures in taconite mining and non-malignant respiratory disease (NMRD) using a comprehensive assessment of current and historical exposure measurements in a cross-sectional study of Minnesota taconite mining workers. We also explored the impact of exposure measurement methods by comparing estimated exposure risk from two different exposure measurement modeling approaches. METHODS Miners were screened with an occupational and medical history questionnaire, spirometry testing and chest x-rays per ILO guidelines. Current and historical occupational exposure assessments were obtained, the former measuring about 679 personal samples over the period of the study for respirable dusts, including silica, in 28 major job functions. Cumulative silica exposure ((mg/m3) × years) was estimated as a cumulative product of time worked and year-specific silica job exposure concentrations. Chest x-ray abnormalities were based on B-reader agreement with a third B-reader for arbitration. Forced vital capacity (FVC) less than lower limits of normal for age, height, race and gender was used to determine spirometric restrictive ventilatory defect (RVD). Prevalence ratios (PR) of exposure-outcome associations, with 95% confidence intervals (CI), were estimated using multivariate Poisson regression. RESULTS Cumulative silica exposure was associated with RVD prevalence (PR = 1.41, 95% CI = 1.09-1.81) and prevalence of parenchymal abnormalities on chest x-ray (PR = 1.30, 95% CI = 1.00-1.69) using exposure estimates based primarily on current study measurements, and assuming unchanged historical exposure trend. Conversely, when exposures were defined incorporating available actual historical values, no associations were observed between silica exposure and either RVD (PR = 0.76, 95% CI = 0.41-1.40) or parenchymal (PR = 0.87, 95% CI = 0.45-1.70) outcomes. CONCLUSIONS This study demonstrated that the estimated association between silica dust exposure and lung disease is highly sensitive to the approach used to estimate cumulative exposure. Cumulative values based on conservative estimates of past exposure, modeled from recently measured respirable silica, showed an association with restriction RVD on spirometry. Silica exposure was also significantly associated with increased parenchymal findings on chest x-ray using this approach. Conversely, these findings were absent when actual available historical data was used to estimate cumulative silica exposure. These differences highlight the challenges with estimating occupational dust exposure, the potential impact on calculated exposure risk and the need for long term quality exposure data gathering in industries prone to risk from inhaled respirable dusts.
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Christofidou-Solomidou M, Pietrofesa RA, Park K, Albelda SM, Serve KM, Keil DE, Pfau JC. Synthetic secoisolariciresinol diglucoside (LGM2605) inhibits Libby amphibole fiber-induced acute inflammation in mice. Toxicol Appl Pharmacol 2019; 375:81-93. [PMID: 31022494 DOI: 10.1016/j.taap.2019.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 04/16/2019] [Accepted: 04/21/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND Exposure to the Libby amphibole (LA) asbestos-like fibers found in Libby, Montana, is associated with inflammatory responses in mice and humans, and an increased risk of developing mesothelioma, asbestosis, pleural disease, and systemic autoimmune disease. Flaxseed-derived secoisolariciresinol diglucoside (SDG) has anti-inflammatory, anti-fibrotic, and antioxidant properties. We have previously identified potent protective properties of SDG against crocidolite asbestos exposure modeled in mice. The current studies aimed to extend those findings by evaluating the immunomodulatory effects of synthetic SDG (LGM2605) on LA-exposed mice. METHODS Male and female C57BL/6 mice were given LGM2605 via gavage initiated 3 days prior to and continued for 3 days after a single intraperitoneal dose of LA fibers (200 μg) and evaluated on day 3 for inflammatory cell influx in the peritoneal cavity using flow cytometry. RESULTS LA exposure induced a significant increase (p < 0.0001) in spleen weight and peritoneal influx of white blood cells, all of which were reduced with LGM2605 with similar trends among males and females. Levels of peritoneal PMN cells were significantly (p < 0.0001) elevated post LA exposure, and were significantly (p < 0.0001) blunted by LGM2605. Importantly, LGM2605 significantly ameliorated the LA-induced mobilization of peritoneal B1a B cells. CONCLUSIONS LGM2605 reduced LA-induced acute inflammation and WBC trafficking supporting its possible use in mitigating downstream LA fiber-associated diseases. SUMMARY Following acute exposure to Libby amphibole (LA) asbestos-like fibers, synthetic SDG (LGM2605), a small synthetic molecule, significantly reduced the LA-induced increase in spleen weight and peritoneal inflammation in C57BL/6 male and female mice. Our findings highlight that LGM2605 has immunomodulatory properties and may, thus, likely be a chemopreventive agent for LA-induced diseases.
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Affiliation(s)
- Melpo Christofidou-Solomidou
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Stemmler Hall, Office Suite 227, Philadelphia, PA 19104, United States of America.
| | - Ralph A Pietrofesa
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Stemmler Hall, Office Suite 227, Philadelphia, PA 19104, United States of America.
| | - Kyewon Park
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Stemmler Hall, Office Suite 227, Philadelphia, PA 19104, United States of America.
| | - Steven M Albelda
- Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, University of Pennsylvania Perelman School of Medicine, 3450 Hamilton Walk, Stemmler Hall, Office Suite 227, Philadelphia, PA 19104, United States of America.
| | - Kinta M Serve
- Department of Biological Sciences, Life Sciences 207, Idaho State University, Pocatello, ID 83209, United States of America.
| | - Deborah E Keil
- Department of Microbiology and Immunology, Montana State University, Health Sciences Building Rm 133, PO Box 173610, Bozeman, MT 59717, United States of America.
| | - Jean C Pfau
- Department of Microbiology and Immunology, Montana State University, Health Sciences Building Rm 133, PO Box 173610, Bozeman, MT 59717, United States of America.
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Abstract
An increased risk for Systemic Autoimmune Diseases (SAID) was reported in the population of Libby, Montana, where extensive exposure to asbestiform amphiboles occurred through mining and use of asbestiform fiber-laden vermiculite. High frequencies of antinuclear autoantibodies (ANA) were detected in individuals and mice exposed to Libby Asbestiform Amphiboles (LAA). Among the 6603 individuals who have undergone health screening at the Center for Asbestos Related Diseases (CARD, Libby MT), the frequencies of rheumatoid arthritis, systemic lupus erythematosus, sarcoidosis, and systemic sclerosis are significantly higher than expected prevalence in the United States. While these data support the hypothesis that LAA can trigger autoimmune responses, evidence suggests that chrysotile asbestos does not. Serological testing was therefore performed in subjects exposed to LAA or predominantly chrysotile (New York steamfitters) using multiplexed array technologies. Analyses were performed in order to determine a) autoantibody profiles in each cohort, and b) whether the two populations could be distinguished through predictive modeling. Analysis using perMANOVA testing confirmed a significant difference between autoantibody profiles suggesting differential pathways leading to autoantibody formation. ANA were more frequent in the LAA cohort. Specific autoantibodies more highly expressed with LAA-exposure were to histone, ribosomal P protein, Sm/Ribonucleoproteins, and Jo-1 (histidyl tRNA synthetase). Myositis autoantibodies more highly expressed in the LAA cohort were Jo-1, PM100, NXP2, and Mi2a. Predictive modeling demonstrated that anti-histone antibodies were most predictive for LAA exposure, and anti-Sm was predictive for the steamfitters' exposure. This emphasizes the need to consider fiber types when evaluating risk of SAID with asbestos exposure.
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Affiliation(s)
- Jean C. Pfau
- Department of Microbiology & Immunology, Montana State University, Bozeman MT 59718
| | - Christopher Barbour
- Statistical Consulting and Research Services, Montana State University, Bozeman MT 59718
| | - Brad Black
- Center for Asbestos Related Diseases, Libby MT 59923
| | - Kinta M. Serve
- Idaho State University, Department of Biological Sciences, Pocatello ID 83209
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Abstract
Amphibole asbestos exposure is associated with the production of mesothelial cell autoantibodies (MCAA). These MCAA have been linked with pleural fibrotic disease in the asbestos exposed community of Libby, Montana, and induce collagen deposition by cultured mesothelial cells. However, the exact intracellular mechanism by which these autoantibodies cause an increase in collagen deposition remains unknown. This study sought to gain insight into the transcription factors involved in the collagen production after human mesothelial cells are exposed to MCAA. In this study, transcription factor activation profiles were generated from human mesothelial cells (Met5A) treated with serum from Libby subjects, and were compared to cells treated with serum cleared of IgG, and therefore containing no MCAA. Analysis of those profiles indicated C/EBP-beta and hypoxia inducible factor 1 alpha (HIF-1α) are significantly increased in the nucleus, indicating activation, due to MCAA exposure compared to controls. Inhibition of either of these transcription factors significantly reduced collagen 1 deposition by these cells following exposure to MCAA. These data suggest autoantibodies are directly involved in type I collagen deposition and may elucidate potential therapeutic targets for autoantibody mediated fibrosis.
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Affiliation(s)
- John Gilmer
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Tanner Harding
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Linda Woods
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Brad Black
- b Center for Asbestos Related Diseases , Libby , MT , USA
| | - Raja Flores
- c Department of Thoracic Surgery , Icahn School of Medicine at Mt Sinai , New York , NY , USA
| | - Jean Pfau
- d Department of Microbiology and Immunology , Montana State University , Bozeman , MT , USA
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Pfau JC, Buck B, Metcalf RV, Kaupish Z, Stair C, Rodriguez M, Keil DE. Comparative health effects in mice of Libby amphibole asbestos and a fibrous amphibole from Arizona. Toxicol Appl Pharmacol 2017; 334:24-34. [PMID: 28870655 DOI: 10.1016/j.taap.2017.08.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/26/2017] [Accepted: 08/31/2017] [Indexed: 11/27/2022]
Abstract
This project developed from studies demonstrating that Libby Amphibole Asbestos (LAA) causes a non-typical set of health outcomes not generally reported for asbestos, including systemic autoimmunity and an unusual and devastating lamellar pleural thickening that progresses to severe pulmonary dysfunction and death. Further, mineral fiber mixtures with some similarities to LAA have recently been discovered in southern Nevada and northwestern Arizona, where the material exists in extensive recreational areas and is present in yards, roads, parking lots and school yards. The objective was to compare the health outcomes in mice exposed to either LAA or the fibrous amphiboles collected in Arizona at the Lake Mead National Recreational Area at very low doses to represent environmental exposures. In this study, the fibrous amphibole asbestos sample from Arizona (AzA) is composed of winchite (69%), actinolite (22%), and non-amphibole minerals (9%) and has a mean aspect ratio of 16.7±0.9. Fibrous amphibole asbestos from Libby (LAA) is composed of winchite (70%), richterite (9%), tremolite (5%), and non-amphibole minerals (16%) with a mean aspect ratio of 8.4±0.7. C57BL/6 mice were exposed by oropharyngeal aspiration to fiber suspensions at a very low dose of 3μg/mouse. After seven months, both LAA- and AzA-exposed mice had indices of chronic immune dysfunction related to a TH17 cytokine profile, with B cell activation, autoantibody production and proteinuria, suggesting kidney involvement. In addition, both exposures led to significant lung and pleural fibrosis. These data suggest that there is risk of pulmonary disease and autoimmune outcomes with environmental exposure to amphibole asbestos, and that this is not limited to Libby, Montana.
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Affiliation(s)
- Jean C Pfau
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA.
| | - Brenda Buck
- Department of Geoscience, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
| | - Rodney V Metcalf
- Department of Geoscience, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
| | - Zoie Kaupish
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Caleb Stair
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Maria Rodriguez
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Deborah E Keil
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA.
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Mazzei MA, Contorni F, Gentili F, Guerrini S, Mazzei FG, Pinto A, Cioffi Squitieri N, Sisinni AG, Paolucci V, Romeo R, Sartorelli P, Volterrani L. Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them-Asbestos Exposure Still Exists. Biomed Res Int 2017; 2017:6797826. [PMID: 28656146 DOI: 10.1155/2017/6797826] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/10/2017] [Indexed: 11/22/2022]
Abstract
Pleural plaques (PPs) may be a risk factor for mortality from lung cancer in asbestos-exposed workers and are considered to be a marker of exposure. Diagnosing PPs is also important because asbestos-exposed patients should be offered a health surveillance that is mandatory in many countries. On the other hand PPs are useful for compensation purposes. In this study we aimed to evaluate the prevalence, as incidental findings, and the underreporting rate of PPs in chest CT scans (CTs) performed in a cohort of patients (1512) who underwent chest CT with a slice thickness no more than 1.25 mm. PPs were found in 76 out of 1482 patients (5.1%); in 13 out of 76 (17,1%) CTs were performed because of clinical suspicion of asbestos exposure and 5 of them (38%) were underreported by radiologist. In the remaining 63 cases (82.9%) there was no clinical suspicion of asbestos exposure at the time of CTs (incidental findings) and in 38 of these 63 patients (60.3%) PPs were underreported. Reaching a correct diagnosis of PPs requires a good knowledge of normal locoregional anatomy and rigorous technical approach in chest CT execution. However the job history of the patient should always be kept in mind.
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Dement JM, Welch LS, Ringen K, Cranford K, Quinn P. Longitudinal decline in lung function among older construction workers. Occup Environ Med 2017; 74:701-708. [DOI: 10.1136/oemed-2016-104205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 04/12/2017] [Accepted: 04/21/2017] [Indexed: 11/04/2022]
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15
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Yu M, Lou J, Xia H, Zhang M, Zhang Y, Chen J, Zhang X, Ying S, Zhu L, Liu L, Jia G. Global DNA hypomethylation has no impact on lung function or serum inflammatory and fibrosis cytokines in asbestos-exposed population. Int Arch Occup Environ Health 2017; 90:265-74. [PMID: 28105512 DOI: 10.1007/s00420-017-1195-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 01/02/2017] [Indexed: 12/19/2022]
Abstract
PURPOSE To examine the effect of asbestos exposure on global DNA methylation and determine whether lung function and inflammatory and fibrosis biomarkers are correlated with the methylation state. METHODS A total of 26 healthy subjects without asbestos exposure (Group 1), 47 healthy subjects with exposure (Group 2), and 52 subjects with benign asbestos-related disorders (ARDs) (Group 3) participated in this cross-sectional study. Blood global 5-methylcytosine (5mC) and serum TNF-α, collagen IV, CCL5 and CC16 concentrations were analyzed using enzyme-linked immunosorbent assay-like assays. Spirometric maneuvers were performed to assess lung function. RESULTS Decreased 5mC levels were observed in Groups 2 and 3 compared to Group 1, irrespective of lung function (p < 0.01). There was no significant change in 5mC between Groups 2 and 3. Overall, 5mC was negatively correlated with CCL5 and collagen IV (p < 0.05), but no significant inverse relationship was found between 5mC and CCL5 or collagen IV in each group. Additionally, both 5mC and CC16 were inversely associated with FEV1/FVC% (p = 0.001, adjusted R 2 = 0.145) for non-smokers, and consistently significant inverse relationships were found between CC16 and FEV1/FVC%, independent of asbestos exposure. CONCLUSIONS Asbestos exposure causes global DNA hypomethylation. DNA hypomethylation has no influence on serum biomarkers and lung function in asbestos-exposed population with or without pleural and pulmonary parenchymal abnormalities.
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Szeinuk J, Noonan CW, Henschke CI, Pfau J, Black B, Miller A, Yankelevitz DF, Liang M, Liu Y, Yip R, Linker L, McNew T, Flores RM. Pulmonary abnormalities as a result of exposure to Libby amphibole during childhood and adolescence-The Pre-Adult Latency Study (PALS). Am J Ind Med 2017; 60:20-34. [PMID: 27859510 DOI: 10.1002/ajim.22674] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of Pre-Adult Latency Study was to evaluate lung findings among adults who had been environmentally exposed to Libby Amphibole only during childhood and adolescence. METHODS Recruitment was restricted to volunteers who attended primary and/or secondary school, lived in Libby, MT, prior to age 23 years for males and 21 years for females and subsequently left the area. Subjects completed exposure and respiratory questionnaires, underwent pulmonary function tests (PFTs), and chest CT scans. A Pleural Score was calculated for degree and extent of pleural thickening. Logistic regression and multivariate linear regression were used. RESULTS Of the 219 who met inclusion criteria, 198 participated. Pleural thickening was found in 96 (48%) of 198 participants. In almost half of these, it was of the lamellar type, not generally seen in exposure to other asbestos. Environmental Libby amphibole exposure was associated with pleural thickening, and the likelihood of pleural thickening increased with the number of years lived in the area. An inverse association between Pleural Score and PFT was found, which remained significant for FVC and DLco after additional sensitivity analyses. CONCLUSIONS Cumulative environmental exposure was associated with risk of pleural thickening. Among this cohort, quantitative measures of pleural thickening were associated with decreased PFT. Am. J. Ind. Med. 60:20-34, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jaime Szeinuk
- Department of Occupational Medicine; Epidemiology and Prevention; North Shore-LIJ Health System; New Hyde Park New York
| | - Curtis W. Noonan
- Center for Environmental Sciences; University of Montana; Missoula Montana
| | | | - Jean Pfau
- Montana State University; Bozeman Montana
| | - Brad Black
- Center for Asbestos Related Disease; Libby Montana
| | - Albert Miller
- Center for Environmental Sciences; University of Montana; Missoula Montana
| | | | - Mingzhu Liang
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Ying Liu
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Rowena Yip
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Laura Linker
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Tracy McNew
- Center for Asbestos Related Disease; Libby Montana
| | - Raja M. Flores
- Mount Sinai Health System; Icahn School of Medicine; New York New York
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Mikulski MA, Gerke AK, Newell JD, Murray AM, Smith CJ, Fuortes LJ. Lower limit of normal based spirometric abnormalities associated with radiographic abnormality in an elderly cohort at low risk for exposure. Int J Occup Environ Health 2016; 22:121-7. [PMID: 27142581 DOI: 10.1080/10773525.2016.1176328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Although the relation between radiographic abnormalities and spirometric impairment in people with asbestosis has been studied extensively, the extent of spirometric impairment associated with milder radiographic abnormalities is not established. OBJECTIVE To test associations between mild radiographic abnormalities and Lower Limit of Normal (LLN)-based spirometry interpretation. METHODS Spirometry and CXRs were collected for 1,026 at low risk of exposure to pneumoconiotic agents participants in a medical screening program. RESULTS Individuals with each type of isolated or combined International Labour Organization (ILO) abnormalities had up to over sixfold statistically significant increase in odds of LLN-based restrictive pattern physiology (OR = 1.96, 95%CI 1.03-3.73 for parenchymal to OR = 6.09, 95%CI 1.94-19.10 for parenchymal and pleural) compared to those with normal films. CONCLUSIONS The findings from this study confirm the association of mild profusion abnormalities with clinically relevant, LLN-based lung function abnormalities.
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Affiliation(s)
- Marek A Mikulski
- a Department of Occupational and Environmental Health, College of Public Health , The University of Iowa , 2213 Westlawn, Iowa City , IA 52242 , USA
| | - Alicia K Gerke
- b Department of Internal Medicine , The University of Iowa Hospitals and Clinics , Iowa City , IA , USA
| | - John D Newell
- c Department of Radiology , The University of Iowa Hospitals and Clinics , Iowa City , IA , USA
| | - Ann M Murray
- d Roy J. and Lucille Carver College of Medicine, The University of Iowa , Iowa City , IA , USA
| | - Carmen J Smith
- e Department of Biostatistics , College of Public Health, The University of Iowa , Iowa City , IA , USA
| | - Laurence J Fuortes
- a Department of Occupational and Environmental Health, College of Public Health , The University of Iowa , 2213 Westlawn, Iowa City , IA 52242 , USA
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Gilmer J, Serve K, Davis C, Anthony M, Hanson R, Harding T, Pfau JC. Libby amphibole-induced mesothelial cell autoantibodies promote collagen deposition in mice. Am J Physiol Lung Cell Mol Physiol 2016; 310:L1071-7. [PMID: 27106292 DOI: 10.1152/ajplung.00462.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/17/2016] [Indexed: 11/22/2022] Open
Abstract
Libby amphibole (LA) causes a unique progressive lamellar pleural fibrosis (LPF) that is associated with pulmonary function decline. Pleural fibrosis among the LA-exposed population of Libby, MT, has been associated with the production of anti-mesothelial cell autoantibodies (MCAA), which induce collagen production from cultured human mesothelial cells. We hypothesized that the progressive nature of LPF could be at least partially attributed to an autoimmune process and sought to demonstrate that LA-induced MCAA trigger collagen deposition in vivo. C57BL/6 mice were exposed to LA for 7 mo, and serum was tested for MCAA by cell-based ELISA on primary mouse mesothelial cells. When treated in vitro with serum from mice exposed to LA, mesothelial cells upregulated collagen matrix production. This effect was lost when the serum was cleared of IgG using protein G beads, implicating IgG autoantibodies. Using the peritoneal cavity as a surrogate for the pleural cavity, groups of naïve (non-asbestos-exposed) mice were injected intraperitoneally with 1) control serum, 2) one dose of serum from LA-exposed mice (LA serum), 3) two doses of LA serum, or 4) two doses of LA serum cleared of IgG. After 1 mo, analysis of collagen in peritoneal walls using two-photon confocal microscopy (SHG analysis) and a hydroxyproline assay demonstrated significant increases in collagen by LA serum but not control or cleared serum. These data support the hypothesis that MCAA in LA-exposed mice induce fibrotic responses in vivo, demonstrating that an autoimmune component may be contributing to the progressive pleural fibrosis seen in LA-exposed patients.
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Affiliation(s)
- John Gilmer
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Kinta Serve
- Department of Natural Sciences, Mars Hill University, Mars Hill, North Carolina
| | - Chad Davis
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Marti Anthony
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Robert Hanson
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Tanner Harding
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Jean C Pfau
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
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Gavett SH, Parkinson CU, Willson GA, Wood CE, Jarabek AM, Roberts KC, Kodavanti UP, Dodd DE. Persistent effects of Libby amphibole and amosite asbestos following subchronic inhalation in rats. Part Fibre Toxicol 2016; 13:17. [PMID: 27083413 PMCID: PMC4832450 DOI: 10.1186/s12989-016-0130-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/10/2016] [Indexed: 12/31/2022] Open
Abstract
Background Human exposure to Libby amphibole (LA) asbestos increases risk of lung cancer, mesothelioma, and non-malignant respiratory disease. This study evaluated potency and time-course effects of LA and positive control amosite (AM) asbestos fibers in male F344 rats following nose-only inhalation exposure. Methods Rats were exposed to air, LA (0.5, 3.5, or 25.0 mg/m3 targets), or AM (3.5 mg/m3 target) for 10 days and assessed for markers of lung inflammation, injury, and cell proliferation. Short-term results guided concentration levels for a stop-exposure study in which rats were exposed to air, LA (1.0, 3.3, or 10.0 mg/m3), or AM (3.3 mg/m3) 6 h/day, 5 days/week for 13 weeks, and assessed 1 day, 1, 3, and 18 months post-exposure. Fibers were relatively short; for 10 mg/m3 LA, mean length of all structures was 3.7 μm and 1 % were longer than 20 μm. Results Ten days exposure to 25.0 mg/m3 LA resulted in significantly increased lung inflammation, fibrosis, bronchiolar epithelial cell proliferation and hyperplasia, and inflammatory cytokine gene expression compared to air. Exposure to 3.5 mg/m3 LA resulted in modestly higher markers of acute lung injury and inflammation compared to AM. Following 13 weeks exposure, lung fiber burdens correlated with exposure mass concentrations, declining gradually over 18 months. LA (3.3 and 10.0 mg/m3) and AM produced significantly higher bronchoalveolar lavage markers of inflammation and lung tissue cytokines, Akt, and MAPK/ERK pathway components compared to air control from 1 day to 3 months post-exposure. Histopathology showed alveolar inflammation and interstitial fibrosis in all fiber-exposed groups up to 18 months post-exposure. Positive dose trends for incidence of alveolar epithelial hyperplasia and bronchiolar/alveolar adenoma or carcinoma were observed among LA groups. Conclusions Inhalation of relatively short LA fibers produced inflammatory, fibrogenic, and tumorigenic effects in rats which replicate essential attributes of asbestos-related disease in exposed humans. Fiber burden, inflammation, and activation of growth factor pathways may persist and contribute to lung tumorigenesis long after initial LA exposure. Fiber burden data are being used to develop a dosimetry model for LA fibers, which may provide insights on mode of action for hazard assessment. Electronic supplementary material The online version of this article (doi:10.1186/s12989-016-0130-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephen H Gavett
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA.
| | - Carl U Parkinson
- The Hamner Institutes for Health Sciences, Research Triangle Park, NC, 27711, USA
| | - Gabrielle A Willson
- Experimental Pathology Laboratories, Inc. (EPL®), Research Triangle Park, NC, 27711, USA
| | - Charles E Wood
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Annie M Jarabek
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Kay C Roberts
- The Hamner Institutes for Health Sciences, Research Triangle Park, NC, 27711, USA
| | - Urmila P Kodavanti
- National Health and Environmental Effects Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, NC, 27711, USA
| | - Darol E Dodd
- The Hamner Institutes for Health Sciences, Research Triangle Park, NC, 27711, USA
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Lopatin S, Tsay JC, Addrizzo-Harris D, Munger JS, Pass H, Rom WN. Reduced lung function in smokers in a lung cancer screening cohort with asbestos exposure and pleural plaques. Am J Ind Med 2016; 59:178-85. [PMID: 26815630 DOI: 10.1002/ajim.22571] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/10/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND While low dose computed tomography (LDCT) screening for lung cancer is recommended for high-risk smokers, ages 55-74 years, information about asbestos exposure may not be routinely elicited. Asbestos exposure is associated with declining respiratory function over time; however, the effect of a history of asbestos exposure in LDCT screening cohorts is limited. We report the relationship between asbestos exposure and pulmonary function in a cohort of heavy smokers with a history of occupational asbestos exposure, hypothesizing that these subjects will have additional decreased pulmonary function. We also examined relationships between spirometric measurements and the presence of isolated pleural plaques. METHODS A cross-sectional study was performed using data from the NYU Lung Cancer Biomarker Center cohort to compare study subjects with a history asbestos exposure primarily in the period since 1970 when tighter federal standards were in place (n = 359) to those without asbestos exposure (n = 1038) with respect to pulmonary function, LDCT lung imaging findings, and clinical symptoms. We further classified individuals with asbestos exposure by length of exposure time to examine the effect of duration of exposure on pulmonary function. Lastly, for asbestos-exposed participants, we examined the association of spirometric measurements with the presence of absence of isolated pleural plaques. RESULTS Individuals with asbestos exposure had decreased FVC % predicted compared to those with no asbestos exposure (76% vs. 85% predicted, P < 0.01) and FEV1 % predicted (64% vs. 67% predicted, P < 0.01). Since there was no change in FEV1 /FVC ratio, the findings are consistent with restrictive impairment. Those with ≥20 years of exposure had a lower mean FVC % predicted compared to those with less than 20 years of exposure (74% vs. 78% predicted, P = 0.017). Individuals with asbestos exposure were more likely to have pleural plaques (P < 0.001) on CT. Those with isolated pleural plaques had lower mean % predicted FEV1 (P = 0.005) and FVC (P = 0.001) compared to those without pleural plaques. CONCLUSIONS Occupational asbestos exposure in a cohort of heavy smokers was associated with a significant restrictive decline in pulmonary function, with longer duration of exposure associated with greater decline. The presence of isolated pleural plaques was also associated with reduced lung function.
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Affiliation(s)
- Sarah Lopatin
- Division of Pulmonary, Critical Care, and Sleep Medicine; Department of Medicine; New York University School of Medicine; New York New York
| | - Jun-Chieh Tsay
- Division of Pulmonary, Critical Care, and Sleep Medicine; Department of Medicine; New York University School of Medicine; New York New York
| | - Doreen Addrizzo-Harris
- Division of Pulmonary, Critical Care, and Sleep Medicine; Department of Medicine; New York University School of Medicine; New York New York
| | - John S. Munger
- Division of Pulmonary, Critical Care, and Sleep Medicine; Department of Medicine; New York University School of Medicine; New York New York
| | - Harvey Pass
- Division of Thoracic Surgery; Department of Cardiothoracic Surgery; New York University School of Medicine; New York New York
| | - William N. Rom
- Division of Pulmonary, Critical Care, and Sleep Medicine; Department of Medicine; New York University School of Medicine; New York New York
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Abstract
PURPOSE OF REVIEW Recent epidemiologic investigations suggest that occupational and environmental exposures contribute to the overall burden of idiopathic pulmonary fibrosis (IPF). This article explores the epidemiologic and clinical challenges to establishing exposure associations, the current literature regarding exposure disease relationships and the diagnostic work-up of IPF and asbestosis patients. RECENT FINDINGS IPF patients demonstrate a histopathologic pattern of usual interstitial pneumonia. In the absence of a known cause or association, a usual interstitial pneumonia pattern leads to an IPF diagnosis, which is a progressive and often terminal fibrotic lung disease. It has long been recognized that asbestos exposure can cause pathologic and radiographic changes indistinguishable from IPF. Several epidemiologic studies, primarily case control in design, have found that a number of other exposures that can increase risk of developing IPF include cigarette smoke, wood dust, metal dust, sand/silica and agricultural exposures. Lung mineralogic analyses have provided additional support to causal associations. Genetic variation may explain differences in disease susceptibility among the population. SUMMARY An accumulating body of literature suggests that occupational and environmental exposure can contribute to the development of IPF. The impact of exposure on the pathogenesis and clinical course of disease requires further study.
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Kim Y, Myong JP, Lee JK, Kim JS, Kim YK, Jung SH. CT Characteristics of Pleural Plaques Related to Occupational or Environmental Asbestos Exposure from South Korean Asbestos Mines. Korean J Radiol 2015; 16:1142-52. [PMID: 26357506 PMCID: PMC4559786 DOI: 10.3348/kjr.2015.16.5.1142] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 06/02/2015] [Indexed: 11/16/2022] Open
Abstract
Objective This study evaluated the CT characteristics of pleural plaques in asbestos-exposed individuals and compared occupational versus environmental exposure groups. Materials and Methods This study enrolled 181 subjects with occupational exposure and 98 with environmental exposure from chrysotile asbestos mines, who had pleural plaques confirmed by a chest CT. The CT scans were analyzed for morphological characteristics, the number and distribution of pleural plaques and combined pulmonary fibrosis. Furthermore, the CT findings were compared between the occupational and environmental exposure groups. Results Concerning the 279 subjects, the pleural plaques were single in 2.2% and unilateral in 3.6%, and showed variable widths (range, 1-20 mm; mean, 5.4 ± 2.7 mm) and lengths (5-310 mm; 72.6 ± 54.8 mm). The chest wall was the most commonly involved (98.6%), with an upper predominance on the ventral side (upper, 77.8% vs. lower, 55.9%, p < 0.001) and a lower predominance on the dorsal side (upper, 74.9% vs. lower, 91.8%, p = 0.02). Diaphragmatic involvement (78.1%) showed a right-side predominance (right, 73.8% vs. left, 55.6%, p < 0.001), whereas mediastinal plaques (42.7%) were more frequent on the left (right, 17.6% vs. left, 39.4%, p < 0.001). The extent and maximum length of plaques, and presence and severity of combined asbestosis, were significantly higher in the occupational exposure group (p < 0.05). Conclusion Pleural plaques in asbestos-exposed individuals are variable in number and size; and show a predominant distribution in the upper ventral and lower dorsal chest walls, right diaphragm, and left mediastinum. Asbestos mine workers have a higher extent of plaques and pulmonary fibrosis versus environmentally exposed individuals.
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Affiliation(s)
- Yookyung Kim
- Department of Radiology, School of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Jeong Kyong Lee
- Department of Radiology, School of Medicine, Ewha Womans University, Seoul 07985, Korea
| | - Jeung Sook Kim
- Department of Radiology, Dongguk University Ilsan Hospital, Goyang 10326, Korea
| | - Yoon Kyung Kim
- Department of Radiology, Gachon University Gil Medical Center, Incheon 21565, Korea
| | - Soon-Hee Jung
- Department of Pathology, Yonsei University Wonju College of Medicine, Wonju 26426, Korea
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Miller A. Pleural Plaques and Their Effect on Lung Function. Chest 2015; 147:e127-e128. [DOI: 10.1378/chest.14-2378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Lockey JE, Dunning K, Hilbert TJ, Borton E, Levin L, Rice CH, Mckay RT, Shipley R, Meyer CA, Perme C, Lemasters GK. HRCT/CT and Associated Spirometric Effects of Low Libby Amphibole Asbestos Exposure. J Occup Environ Med 2015; 57:6-13. [DOI: 10.1097/jom.0000000000000373] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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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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Miller A. "Not your grandfather's pleural disease": rapid progression, ventilatory impairment, and chronic pleuritic pain from Libby vermiculite/amphibole. Am J Ind Med 2014; 57:1195-6. [PMID: 25311931 DOI: 10.1002/ajim.22370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Albert Miller
- Mount Sinai School of Medicine; New York New York
- Center for the Biology of Natural Systems, Queens College; City University of New York; New York New York
- Pulmonary Critical Care Division, Department of Medicine; Mount Sinai Beth Israel Medical Center; New York NY
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Black B, Szeinuk J, Whitehouse AC, Levin SM, Henschke CI, Yankelevitz DF, Flores RM. Rapid progression of pleural disease due to exposure to Libby amphibole: "Not your grandfather's asbestos related disease". Am J Ind Med 2014; 57:1197-206. [PMID: 24898907 DOI: 10.1002/ajim.22330] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Residents and mine employees from Libby, Montana, have been exposed to asbestiform amphiboles from the vermiculite mine that operated in this location from the mid-1920s until 1990. Clinical observations show a different form of asbestos-related toxicity than other forms of asbestos. METHODS Five illustrative cases from the Center for Asbestos-Related Diseases in Libby were selected. All had clear exposure histories, multiple follow-up visits, illustrative chest radiographic studies, serial pulmonary function tests, and sufficient length of follow-up to characterize disease progression. RESULTS These cases developed increasing symptoms of dyspnea and chest pain, progressive radiological changes that were predominantly pleural, and a restrictive pattern of impaired spirometry that rapidly progressed with significant loss of pulmonary function. CONCLUSIONS LA exposure can cause a non-malignant pleural disease that is more rapidly progressive and more severe than the usual asbestos-related disease.
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Affiliation(s)
| | - Jaime Szeinuk
- Department of Thoracic Surgery; Icahn School of Medicine at Mount Sinai; New York New York
| | | | - Stephen M. Levin
- Department of Preventive Medicine; Icahn School of Medicine at Mount Sinai; New York New York
| | - Claudia I. Henschke
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York New York
| | - David F. Yankelevitz
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Raja M. Flores
- Department of Thoracic Surgery; Icahn School of Medicine at Mount Sinai; New York New York
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Clark KA, Flynn JJ, Goodman JE, Zu K, Karmaus WJ, Mohr LC. Pleural Plaques and Their Effect on Lung Function in Libby Vermiculite Miners. Chest 2014; 146:786-794. [DOI: 10.1378/chest.14-0043] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Goldade MP, O'Brien WP. Use of direct versus indirect preparation data for assessing risk associated with airborne exposures at asbestos-contaminated sites. J Occup Environ Hyg 2014; 11:67-76. [PMID: 24369928 DOI: 10.1080/15459624.2013.843779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
At asbestos-contaminated sites, exposure assessment requires measurement of airborne asbestos concentrations; however, the choice of preparation steps employed in the analysis has been debated vigorously among members of the asbestos exposure and risk assessment communities for many years. This study finds that the choice of preparation technique used in estimating airborne amphibole asbestos exposures for risk assessment is generally not a significant source of uncertainty. Conventionally, the indirect preparation method has been less preferred by some because it is purported to result in false elevations in airborne asbestos concentrations, when compared to direct analysis of air filters. However, airborne asbestos sampling in non-occupational settings is challenging because non-asbestos particles can interfere with the asbestos measurements, sometimes necessitating analysis via indirect preparation. To evaluate whether exposure concentrations derived from direct versus indirect preparation techniques differed significantly, paired measurements of airborne Libby-type amphibole, prepared using both techniques, were compared. For the evaluation, 31 paired direct and indirect preparations originating from the same air filters were analyzed for Libby-type amphibole using transmission electron microscopy. On average, the total Libby-type amphibole airborne exposure concentration was 3.3 times higher for indirect preparation analysis than for its paired direct preparation analysis (standard deviation = 4.1), a difference which is not statistically significant (p = 0.12, two-tailed, Wilcoxon signed rank test). The results suggest that the magnitude of the difference may be larger for shorter particles. Overall, neither preparation technique (direct or indirect) preferentially generates more precise and unbiased data for airborne Libby-type amphibole concentration estimates. The indirect preparation method is reasonable for estimating Libby-type amphibole exposure and may be necessary given the challenges of sampling in environmental settings. Relative to the larger context of uncertainties inherent in the risk assessment process, uncertainties associated with the use of airborne Libby-type amphibole exposure measurements derived from indirect preparation analysis are low. Use of exposure measurements generated by either direct or indirect preparation analyses is reasonable to estimate Libby-type Amphibole exposures in a risk assessment.
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Affiliation(s)
- Mary Patricia Goldade
- a Office of Technical and Management Services , United States Environmental Protection Agency Region 8 , Denver , Colorado
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Cyphert JM, Nyska A, Mahoney RK, Schladweiler MC, Kodavanti UP, Gavett SH. Sumas Mountain chrysotile induces greater lung fibrosis in Fischer344 rats than Libby amphibole, El Dorado tremolite, and Ontario ferroactinolite. Toxicol Sci 2012; 130:405-15. [PMID: 22903825 DOI: 10.1093/toxsci/kfs249] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The physical properties of different types of asbestos may strongly affect health outcomes in exposed individuals. This study was designed to provide understanding of the comparative toxicity of naturally occurring asbestos (NOA) fibers including Libby amphibole (LA), Sumas Mountain chrysotile (SM), El Dorado tremolite (ED), and Ontario ferroactinolite (ON) cleavage fragments. Rat-respirable fractions (PM₂.₅) were prepared by water elutriation. Surface area was greater for SM (64.1 m²/g) than all other samples (range: 14.1-16.2 m²/g), whereas mean lengths and aspect ratios (ARs) for LA and SM were comparable and greater than ED and ON. Samples were delivered via a single intratracheal (IT) instillation at doses of 0.5 and 1.5mg/rat. One day post-IT instillation, low-dose NOA exposure resulted in a 3- to 4-fold increase in bronchoalveolar lavage fluid (BALF) cellularity compared with dispersion media (DM) controls, whereas high-dose exposure had a more severe effect on lung inflammation which varied by source. Although inducing less neutrophilic inflammation than ON and ED, exposure to either LA or SM resulted in a greater degree of acute lung injury. Three months post-IT instillation, most BALF parameters had returned to control levels, whereas the development of fibrosis persisted and was greatest in SM-exposed rats (SM > LA > ON > ED). These data demonstrate that fiber length and higher AR are directly correlated with the severity of fibrosis and that, in the rat, exposure to SM is more fibrogenic than LA which suggests that there may be cause for concern for people at risk of being exposed to NOA from the Sumas Mountain landslide.
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Affiliation(s)
- Jaime M Cyphert
- Curriculum in Toxicology, UNC School of Medicine, Chapel Hill, North Carolina 27599, USA
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