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Carney JM, Sporn TA, Roggli VL, Pavlisko EN. The diagnosis of asbestosis in the 21 st century: a clinicopathological correlation of 102 cases. Ultrastruct Pathol 2024; 48:137-148. [PMID: 38192052 DOI: 10.1080/01913123.2023.2299874] [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: 02/07/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024]
Abstract
Asbestosis, defined as diffuse pulmonary fibrosis caused by inhalation of asbestos fibers, occurs after heavy exposures to asbestos dust over several decades. Because workplace exposures have been significantly curtailed since the banning of asbestos in insulation products, we were interested in examining the clinicopathological characteristics of cases diagnosed in the 21st century. The consultation files of one of the authors (VLR) were reviewed for cases of asbestosis diagnosed since 1/1/2001. 102 cases were identified, with a median age of 75 years (range: 45-89). There were 100 men and 2 women. The women were from Turkey and Brazil (none from the United States). Malignancies were present in 78 cases, including 38 lung cancers, 29 pleural mesotheliomas, and 8 peritoneal mesotheliomas. The grade of asbestosis was available in 88 cases (median severity of 2; scale: 1-4). Pleural plaque was present in 94% of cases. The most common exposure categories were insulators (39), shipyard workers (16), asbestos manufacturing (9), boiler workers (8) and pipefitter/welders (6). The median duration of exposure was 33 years (range: 2-49 years). Lung fiber burden analysis was performed in 34 cases, with amosite being the predominant fiber type. Results were compared with similar information for 475 cases diagnosed prior to 1/1/2001.
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Affiliation(s)
- John M Carney
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Thomas A Sporn
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
| | - Victor L Roggli
- Department of Pathology, Duke University Medical Center, Durham, NC, USA
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Fazzo L, Grande E, Zona A, Minelli G, Crialesi R, Iavarone I, Grippo F. Mortality rates from asbestos-related diseases in Italy during the first year of the COVID-19 pandemic. Front Public Health 2024; 11:1243261. [PMID: 38292377 PMCID: PMC10824953 DOI: 10.3389/fpubh.2023.1243261] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/07/2023] [Indexed: 02/01/2024] Open
Abstract
Background and aim Patients with interstitial lung diseases, including asbestosis, showed high susceptibility to the SARS-CoV-2 virus and a high risk of severe COVID-19 symptoms. Italy, highly impacted by asbestos-related diseases, in 2020 was among the European countries with the highest number of COVID-19 cases. The mortality related to malignant mesotheliomas and asbestosis in 2020 and its relationship with COVID-19 in Italy are investigated. Methods All death certificates involving malignant mesotheliomas or asbestosis in 2010-2020 and those involving COVID-19 in 2020 were retrieved from the National Registry of Causes of Death. Annual mortality rates and rate ratios (RRs) of 2020 and 2010-2014 compared to 2015-2019 were calculated. The association between malignant pleural mesothelioma (MPM) and asbestosis with COVID-19 in deceased adults ≥80 years old was evaluated through a logistic regression analysis (odds ratios: ORs), using MPM and asbestosis deaths COVID-19-free as the reference group. The hospitalization for asbestosis in 2010-2020, based on National Hospital Discharge Database, was analyzed. Results In 2020, 746,343 people died; out of them, 1,348 involved MPM and 286 involved asbestosis. Compared to the period 2015-2019, the mortality involving the two diseases decreased in age groups below 80 years; meanwhile, an increasing trend was observed in subjects aged 80 years and older, with a relative mortality risks of 1.10 for MPM and 1.17 for asbestosis. In subjects aged ≥80 years, deaths with COVID-19 were less likely to have MPM in both genders (men: OR = 0.22; women: OR = 0.44), while no departure was observed for asbestosis. A decrease in hospitalization in 2020 with respect to those in 2010-2019 in all age groups, both considering asbestosis as the primary or secondary diagnosis, was observed. Conclusions The increasing mortality involving asbestosis and, even if of slight entity, MPM, observed in people aged over 80 years during the 1st year of the COVID-19 pandemic, aligned in part with the previous temporal trend, could be due to several factors. Although no positive association with COVID-19 mortality was observed, the decrease in hospitalizations for asbestosis among individuals aged over 80 years, coupled with the increase in deaths, highlights the importance of enhancing home-based assistance during the pandemic periods for vulnerable patients with asbestos-related conditions.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, Rome, Italy
| | - Roberta Crialesi
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- World Health Organization Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Francesco Grippo
- Integrated System for Health, Social Assistance and Welfare, Italian National Institute of Statistics, Rome, Italy
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Spagnolo P, Ryerson CJ, Guler S, Feary J, Churg A, Fontenot AP, Piciucchi S, Udwadia Z, Corte TJ, Wuyts WA, Johannson KA, Cottin V. Occupational interstitial lung diseases. J Intern Med 2023; 294:798-815. [PMID: 37535448 DOI: 10.1111/joim.13707] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Millions of workers are exposed to substances known to cause occupational interstitial lung diseases (ILDs), particularly in developing countries. However, the burden of the disease is likely to be underestimated due to under-recognition, under-reporting or both. The diagnosis of occupational ILD requires a high level of suspicion and a thorough occupational history, as occupational and non-occupational ILDs may be clinically, functionally and radiologically indistinguishable, leading to delayed diagnosis and inappropriate management. A potential occupational aetiology should always be considered in the differential diagnosis of ILD, as removal from the workplace exposure, with or without treatment, is a key therapeutic intervention and may lead to significant improvement. In this article, we provide an overview of the 'traditional' inorganic dust-related ILDs but also address idiopathic pulmonary fibrosis and the immunologically mediated chronic beryllium disease, sarcoidosis and hypersensitivity pneumonitis, with emphasis on the importance of surveillance and prevention for reducing the burden of these conditions. To this end, health-care professionals should be specifically trained about the importance of occupational exposures as a potential cause of ILD.
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Affiliation(s)
- Paolo Spagnolo
- Respiratory, Disease Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Christopher J Ryerson
- Department of Medicine, St. Paul's Hospital, University of British Columbia and Centre for Heart Lung Innovation, Vancouver, Canada
| | - Sabina Guler
- Department of Pulmonary Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johanna Feary
- Department of Occupational and Environmental Medicine, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Andrew Churg
- Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Andrew P Fontenot
- Department of Medicine, University of Colorado Anschutz Medical Campus Aurora, Aurora, Colorado, USA
- Department of Immunology and Microbiology, University of Colorado Anschutz Medical Campus Aurora, Aurora, Colorado, USA
| | - Sara Piciucchi
- Department of Radiology, G.B. Morgagni Hospital/University of Bologna, Forlì, Italy
| | - Zarir Udwadia
- Hinduja Hospital and Research Center, Breach Candy Hospital, Mumbai, Maharashtra, India
| | - Tamera J Corte
- NHMRC Centre of Research Excellence in Pulmonary Fibrosis, Camperdown, New South Wales, Australia
- Department of Respiratory Medicine, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Wim A Wuyts
- Unit for Interstitial Lung Diseases, University of Leuven, Leuven, Belgium
| | - Kerri A Johannson
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Vincent Cottin
- Department of Respiratory Medicine, National Reference Coordinating Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France
- Université de Lyon, Université Claude Bernard Lyon 1, UMR754, IVPC, Lyon, France
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Sassorossi C, Chiappetta M, Congedo MT, Flamini S, Campanella A, Evangelista J, Iuliano R, Boccuto L, Lococo F. Commentary: Case report: Mesothelioma and BAP1 tumor predisposition syndrome: implications for public health. Front Oncol 2023; 13:1279786. [PMID: 37909022 PMCID: PMC10613964 DOI: 10.3389/fonc.2023.1279786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 09/25/2023] [Indexed: 11/02/2023] Open
Affiliation(s)
- Carolina Sassorossi
- Unità Operativa di Chirurgia Toracica, Fondazione Policlinico Agostino Gemelli, Istituto di ricovero e cura a carattere scientifico (IRCCS), Roma, Italy
| | - Marco Chiappetta
- Unità Operativa di Chirurgia Toracica, Fondazione Policlinico Agostino Gemelli, Istituto di ricovero e cura a carattere scientifico (IRCCS), Roma, Italy
| | - Maria Teresa Congedo
- Unità Operativa di Chirurgia Toracica, Fondazione Policlinico Agostino Gemelli, Istituto di ricovero e cura a carattere scientifico (IRCCS), Roma, Italy
| | - Sara Flamini
- Unità Operativa di Chirurgia Toracica, Fondazione Policlinico Agostino Gemelli, Istituto di ricovero e cura a carattere scientifico (IRCCS), Roma, Italy
| | - Annalisa Campanella
- Unità Operativa di Chirurgia Toracica, Fondazione Policlinico Agostino Gemelli, Istituto di ricovero e cura a carattere scientifico (IRCCS), Roma, Italy
| | - Jessica Evangelista
- Unità Operativa di Chirurgia Toracica, Fondazione Policlinico Agostino Gemelli, Istituto di ricovero e cura a carattere scientifico (IRCCS), Roma, Italy
- Department of Thoracic Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Rodolfo Iuliano
- Unità di Genetica Medica, Università Magna Graecia di Catanzaro, Catanzaro, Italy
| | - Luigi Boccuto
- Healthcare Genetics and Genomics, School of Nursing, Clemson University, Clemson, SC, United States
| | - Filippo Lococo
- Unità Operativa di Chirurgia Toracica, Fondazione Policlinico Agostino Gemelli, Istituto di ricovero e cura a carattere scientifico (IRCCS), Roma, Italy
- Department of Thoracic Surgery, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Kurth L, Casey ML, Mazurek JM, Blackley DJ. Pneumoconiosis incidence and prevalence among US Medicare beneficiaries, 1999-2019. Am J Ind Med 2023; 66:831-841. [PMID: 37482966 PMCID: PMC10924676 DOI: 10.1002/ajim.23519] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Pneumoconiosis is a group of occupational lung diseases caused by dust and fiber exposure. This study analyzes Medicare claims to estimate the burden of pneumoconiosis among fee-for-service (FFS; Medicare Parts A and B) Medicare beneficiaries during 1999-2019 in the United States. METHODS Claim and enrollment information from 81 million continuously enrolled FFS Medicare beneficiaries were analyzed. Beneficiaries with any pneumoconiosis and cause-specific pneumoconiosis (e.g., asbestosis, silicosis) were identified using three case definitions (broad, intermediate, and narrow) with varying diagnostic criteria based on claim International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes and Healthcare Common Procedure Coding System codes. Results are presented as ranges of values for the three case definitions. RESULTS The 21-year prevalence range for any pneumoconiosis was 345,383-677,361 (412-833 per 100,000 beneficiaries) using the three case definitions. The highest prevalence was among those ≥75 years of age, males, Whites, and North American Natives. Most claims (70.0%-72.5%) included an ICD-CM diagnosis code for asbestosis. The broad pneumoconiosis prevalence rate increased significantly (p < 0.001) during 2002-2009 by 3%-10% annually and declined significantly by 3%-5% annually starting in 2009. The average annual broad incidence rate declined significantly by 7% annually during 2009-2019. CONCLUSIONS Despite the decline in rate for any pneumoconiosis among Medicare beneficiaries, which is primarily attributed to a decline in asbestosis, pneumoconiosis is prevalent among FFS Medicare beneficiaries.
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Affiliation(s)
- Laura Kurth
- Surveillance Branch, Centers for Disease Control and Prevention, Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Megan L. Casey
- National Personal Protective Technology Laboratory, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Jacek M. Mazurek
- Surveillance Branch, Centers for Disease Control and Prevention, Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - David J. Blackley
- Surveillance Branch, Centers for Disease Control and Prevention, Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Wang J, Huang X, Ma R, Zhang Q, Wu N, Du X, Ye Q. The incidence of malignancies in asbestosis with chrysotile exposure: a large Chinese prospective cohort study. Front Oncol 2023; 13:1172496. [PMID: 37483507 PMCID: PMC10359706 DOI: 10.3389/fonc.2023.1172496] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023] Open
Abstract
Background Asbestos exposure is closely related to the occurrence and development of various malignancies. This prospective cohort study aimed to evaluate the incidence rate and potential risk factors in a cohort of asbestosis patients in China. Methods The incidence of malignancies was determined in patients who had been exposed to chrysotile asbestos and diagnosed with asbestosis sequentially at Beijing Chaoyang Hospital from 1 January 2007 to 31 December 2019. Cox regression analyses were used to analyze the correlations between clinical variables and asbestosis combined with malignancies. Results A total of 618 patients with asbestosis were identified, of whom 544 were eligible for analysis. Among them, 89 (16.36%) were diagnosed with various malignancies. The standardized incidence ratios (SIRs) of patients with asbestosis combined with malignancies were 16.61, 175, 5.23, and 8.77 for lung cancer, mesothelioma, breast cancer, and endometrial carcinoma, respectively. The risks of all malignancies and lung cancer increased with initial exposure before 17 years old, longer asbestos exposure, and smoking. Conclusions The SIRs of patients with asbestosis-related malignancies were significantly increased in lung cancer, mesothelioma, breast cancer, and endometrial carcinoma in a hospital-based Chinese cohort. Smoking and the duration of asbestos exposure increased the risk of lung cancer.
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Affiliation(s)
- Jingwei Wang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiaoyun Huang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
| | - Ruimin Ma
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qian Zhang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Na Wu
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xuqin Du
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qiao Ye
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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7
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Alejo AL, Patel RA, Pandya KK, Bodrya K, Goldstein L, Hemrock L. Asbestos Exposure and Development of Pulmonary Pleomorphic Carcinoma in a Non-smoker: A Rare Non-small Cell Lung Cancer. Cureus 2023; 15:e37860. [PMID: 37213984 PMCID: PMC10199346 DOI: 10.7759/cureus.37860] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/23/2023] Open
Abstract
Pulmonary pleomorphic carcinoma (PPC) is a subtype of non-small cell lung cancer that is extremely rare and carries a poor prognosis due to its inadequate response to treatment. Patients that present with PPC often exhibit similar symptoms of other malignancies of the lung, making it hard for clinicians to distinguish between each type. However, cytology and gene mutation testing are two approaches that can aid physicians in an accurate and definitive diagnosis. We present a case of an 88-year-old male patient with a diagnosis of pulmonary pleomorphic carcinoma after experiencing recurrent sanguineous pleural effusions. The patient had no smoking history but did have a history of asbestos exposure and pulmonary fibrosis. The patient underwent thoracotomy with pleurodesis and analysis of the surgical pleural biopsy specimen stained positive for markers indicative of PPC. The pathology report was also consistent with the associated cell morphology. Lung cancer is the leading cause of mortality due to cancer in the United States, and exposure to certain substances contributes to the development of these poorly treatable lung malignancies. Smoking and asbestos exposure are well known to act synergistically with each other as risk factors in developing these lung malignancies. In addition to clinical suspicion, screening for these risk factors with laboratory values and imaging is important to diagnose these rare cases of lung malignancies.
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Affiliation(s)
- Andrew L Alejo
- College of Medicine, Northeast Ohio Medical University, Rootstown, USA
| | - Riya A Patel
- Internal Medicine, Trumbull Regional Medical Center, Warren, USA
| | | | - Krishna Bodrya
- Internal Medicine, Trumbull Regional Medical Center, Warren, USA
| | | | - Lori Hemrock
- Internal Medicine, Trumbull Regional Medical Center, Warren, USA
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8
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Singh R, Frank AL. Does the Presence of Asbestos-Containing Materials in Buildings Post-construction and Before Demolition Have an Impact on the Exposure to Occupants in Non-occupational Settings? Cureus 2023; 15:e37305. [PMID: 37168168 PMCID: PMC10166626 DOI: 10.7759/cureus.37305] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2023] [Indexed: 05/13/2023] Open
Abstract
This narrative review aims to determine if asbestos-containing materials in buildings pose a hazard to building occupants in non-occupational settings. This paper is limited to the post-construction and pre-demolition stages of a building. The researchers selected 19 studies from the 126 studies screened, concerning exposure to asbestos fibers in non-occupational building settings, with a focus on post-construction and pre-demolition phases. The literature review found that certain conditions, such as the measurement techniques, standards, and previous data availability, prevent a conclusive answer to the research question. Some studies have pointed towards an effect of asbestos-containing materials on health of occupants in non-occupational settings. But, there are some that do not suggest a positive relationship between non-occupational exposure and the presence of asbestos-containing materials, and therefore these provide scope for further research, as these studies also do not rule out the relationship completely. The present study highlights the gaps in current knowledge and indicates areas for further research. Until conclusive evidence based on revised threshold standards and accurate measurement techniques is available, asbestos-containing materials may be considered unsafe for use in non-occupational settings, especially ones that young people and children occupy.
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Affiliation(s)
- Raja Singh
- Architecture, School of Planning and Architecture, New Delhi, IND
- Built Environment and Public Health Research Fellowship Program, Tathatara Foundation, Bobbili, IND
- Centre for Built Environment Policy, Information Sharing and Analysis Center (ISAC), New Delhi, IND
| | - Arthur L Frank
- Environmental and Occupational Health, Drexel University College of Medicine, Philadelphia, USA
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Buralli RJ, Pinheiro RDC, Susviela LL, Duracenko SRC, De Capitani EM, Savaris A, Algranti E. The Brazilian System for Monitoring Workers and General Population Exposed to Asbestos: Development, Challenges, and Opportunities for Workers' Health Surveillance. Int J Environ Res Public Health 2023; 20:4295. [PMID: 36901302 PMCID: PMC10001436 DOI: 10.3390/ijerph20054295] [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] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/18/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The lack of safe levels of asbestos exposure and the long latency of asbestos-related disease (ARD) makes workers' health surveillance challenging, especially in lower-income countries. This paper aims to present the recently developed Brazilian system for monitoring workers and general population exposed to asbestos (Datamianto), and to discuss the main challenges and opportunities for workers' health surveillance. METHODS a descriptive study of the Datamianto development process, examining all the stages of system planning, development, improvement, validation, availability, and training of health services for its use, in addition to presenting the main challenges and opportunities for its implementation. RESULTS The system was developed by a group of software developers, workers' health specialists, and practitioners, and it was recently incorporated by the Ministry of Health to be used for workers' health surveillance. It can facilitate the monitoring of exposed individuals, epidemiological data analysis, promote cooperation between health services, and ensure periodical medical screening guaranteed to workers by labor legislation. Moreover, the system has a Business Intelligence (BI) platform to analyze epidemiologic data and produce near real-time reports. CONCLUSIONS Datamianto can support and qualify the healthcare and surveillance of asbestos-exposed workers and ARD, promoting a better quality of life for workers and improving companies' compliance with legislation. Even so, the system's significance, applicability, and longevity will depend on the efforts aimed at its implementation and improvement.
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Affiliation(s)
- Rafael Junqueira Buralli
- Departamento de Vigilância em Saúde Ambiental e Saúde do Trabalhador, Ministério da Saúde, Brasil (CGSAT/DSAST/SVS/MS), SRTV 702, Via W5 Norte, Brasília 70723-040, DF, Brazil
| | - Regina Dal Castel Pinheiro
- Gerência em Saúde do Trabalhador, Diretoria de Vigilância Sanitária do Estado de Santa Catarina (GESAT/DIVS/SUV/SES), Av. Rio Branco, 152, Centro, Florianópolis 88015-200, SC, Brazil
| | - Laura Lima Susviela
- Gerência em Saúde do Trabalhador, Diretoria de Vigilância Sanitária do Estado de Santa Catarina (GESAT/DIVS/SUV/SES), Av. Rio Branco, 152, Centro, Florianópolis 88015-200, SC, Brazil
| | - Sandra Renata Canale Duracenko
- Centro de Referência em Saúde do Trabalhador de Piracicaba (Cerest Piracicaba/SMS/PMP), Rua do Trabalho, 634, 1º andar, Vila Independência, Piracicaba 13418-220, SP, Brazil
| | - Eduardo Mello De Capitani
- Departamento de Clínica Médica, Centro de Informação e Assistência Toxicológica (CIATox) de Campinas, FCM, Universidade Estadual de Campinas, Rua Vital Brasil 251, Campinas 13083-888, SP, Brazil
| | - Alexandre Savaris
- Fundação de Amparo à Pesquisa e Extensão Universitária (FAPEU), Rua Delfino Conti, S/N, Florianópolis 88040-370, SC, Brazil
| | - Eduardo Algranti
- Division of Applied Research, Fundacentro, Rua Capote Valente, 710, São Paulo 05409-002, SP, Brazil
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Harris EJ, Franklin P, Brims FJH. Harris et al. respond. Am J Ind Med 2022; 65:427. [PMID: 35220607 DOI: 10.1002/ajim.23339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Edward J. Harris
- Curtin Medical School Curtin University 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
| | - Fraser JH Brims
- Curtin Medical School Curtin University Perth Western Australia Australia
- Department of Respiratory Medicine Sir Charles Gairdner Hospital Perth Western Australia Australia
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Wojcik NC, Gallagher EM, Alexander MS, Lewis RJ. Mortality of 196,826 Men and Women Working in U.S.-Based Petrochemical and Refinery Operations: Update 1979 to 2010. J Occup Environ Med 2022; 64:250-262. [PMID: 34670258 PMCID: PMC8887844 DOI: 10.1097/jom.0000000000002416] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVE To describe mortality trends of men and women working in various petrochemical and refinery operations of a U.S.-based company. METHODS The cohort consists of full-time employees with at least 1 day of service during 1979 through 2010. Standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) were calculated for 111 possible causes of death studied. RESULTS SMRs for malignant mesothelioma and asbestosis were highest for the 1940s decade of hire. Increased SMRs were observed for malignant melanoma and motor neuron disease with no obvious work patterns. Decreasing mortality patterns were observed for aplastic anemia and acute nonlymphocytic leukemia. CONCLUSIONS Mortality surveillance of this large established cohort aids in assessing the chronic health status of the workforce. Identifying methods for incorporating job-exposure matrices and nonoccupational risk factors could further enhance interpretations for some findings such as motor neuron disease.
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Affiliation(s)
- Nancy C Wojcik
- ExxonMobil Biomedical Sciences, Inc., Annandale, New Jersey (Ms Wojcik, Ms Gallagher, Dr Alexander, and Dr Lewis)
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Fazzo L, Binazzi A, Ferrante D, Minelli G, Consonni D, Bauleo L, Bruno C, Bugani M, De Santis M, Iavarone I, Magnani C, Romeo E, Zona A, Alessi M, Comba P, Marinaccio A. Burden of Mortality from Asbestos-Related Diseases in Italy. Int J Environ Res Public Health 2021; 18:10012. [PMID: 34639316 PMCID: PMC8508095 DOI: 10.3390/ijerph181910012] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
Asbestos is one of the major worldwide occupational carcinogens. The global burden of asbestos-related diseases (ARDs) was estimated around 231,000 cases/year. Italy was one of the main European asbestos producers until the 1992 ban. The WHO recommended national programs, including epidemiological surveillance, to eliminate ARDs. The present paper shows the estimate of the burden of mortality from ARDs in Italy, established for the first time. National standardized rates of mortality from mesothelioma and asbestosis and their temporal trends, based on the National Institute of Statistics database, were computed. Deaths from lung cancer attributable to asbestos exposure were estimated using population-based case-control studies. Asbestos-related lung and ovarian cancer deaths attributable to occupational exposure were estimated, considering the Italian occupational cohort studies. In the 2010-2016 period, 4400 deaths/year attributable to asbestos were estimated: 1515 from mesothelioma, 58 from asbestosis, 2830 from lung and 16 from ovarian cancers. The estimates based on occupational cohorts showed that each year 271 deaths from mesothelioma, 302 from lung cancer and 16 from ovarian cancer were attributable to occupational asbestos exposure in industrial sectors with high asbestos levels. The important health impact of asbestos in Italy, 10-25 years after the ban, was highlighted. These results suggest the need for appropriate interventions in terms of prevention, health care and social security at the local level and could contribute to the global estimate of ARDs.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Daniela Ferrante
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy;
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy;
| | - Lisa Bauleo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Marcella Bugani
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Corrado Magnani
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Elisa Romeo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Mariano Alessi
- Department of Prevention, Ministry of Health, 00100 Roma, Italy;
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
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Abstract
BACKGROUND Brazil has a long history of heavy asbestos consumption. However, the number of asbestos-related diseases (ARDs) falls far below the one expected compared with other asbestos consumer countries. AIMS To examine underreporting of ARDs, that is mesothelioma, asbestosis and pleural plaques, in Brazil's Mortality Information System (SIM). METHODS Health information systems (HIS) were mapped, datasets retrieved and records of ARD deaths extracted. Records were pair-matched using anonymous linkage to create a single database. ARD-reported cases missing in SIM were considered unreported. The study's period ranged from 2008 to 2014, when every HIS contributed to the ARD records pool. RESULTS A total of 1298 registered ARD deaths were found, 996 cases of mesothelioma (77%) and 302 (23%) of asbestosis and pleural plaques. SIM was the major single data source of ARD but 335 mesothelioma deaths were missing, an average underreporting of 33%, with no clear time trend. For asbestosis and pleural plaques, underreporting of ARD oscillated from 55% in 2010 to 25% in 2014, a declining trend. ARD underreporting was not associated with sex or age. CONCLUSIONS One-third of underreported ARD deaths in the universal SIM is unacceptably high and, apparently, it has not been improving substantially over time. After recoveries from multiple databases, the number of cases is still below, which could be expected based on asbestos consumption. Interoperability of multiple information systems could enhance case detection and improve the precision of mortality estimates, which are crucial for surveillance and for evaluation of remedial policies.
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Affiliation(s)
- V S Santana
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - L Salvi
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - F Cavalcante
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - F Campos
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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14
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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] [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: 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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Harris EJA, Lim KP, Moodley Y, Adler B, Sodhi‐Berry N, Reid A, Murray CP, Franklin PJ, Musk AW(B, Klerk NH, Brims FJH. Low dose CT detected interstitial lung abnormalities in a population with low asbestos exposure. Am J Ind Med 2021; 64:567-575. [PMID: 33942336 DOI: 10.1002/ajim.23251] [Citation(s) in RCA: 2] [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] [Received: 02/01/2021] [Revised: 03/04/2021] [Accepted: 03/26/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND The use of low dose CT (LDCT) chest is becoming more widespread in occupationally exposed populations. There is a knowledge gap as to heterogeneity in severity and the natural course of asbestosis after low levels of exposure. This study reports the characteristics of LDCT-detected interstitial lung abnormalities (ILA). METHODS The Asbestos Review Program offers annual LDCT, health assessments, and pulmonary function tests to an asbestos-exposed cohort. Asbestosis was defined using the Helsinki Consensus statement and the presence of ILA defined using a protocol for occupational CT reports. At least two of three pulmonary function tests: forced expiratory volume in 1 s (FEV1 ); forced vital capacity (FVC); and diffusion capacity for carbon monoxide (DLco) were required for analysis of physiological decline. RESULTS From 1513 cases, radiological ILA was present in 485 (32%). The cohort was 83.5% male with a median age of 68.3 years and a median (IQR) asbestos exposure of 0.7 (0.09-2.32) fiber/ml-year. A mixed occupation, mixed asbestos fiber cohort comprised the majority of the cohort (65.8%). Of those with ILA, 40 (8.2%) had an FVC decline of ≥10% and 30 (6.2%) had a DLco decline of ≥15% per year. Time since first exposure, increasing tobacco exposure and reported dyspnea were independently associated with the presence of ILA. CONCLUSIONS In this population with relatively low asbestos exposure, LDCT-detected ILA that fits criteria for asbestosis is common, but physiological decline is not. This mild chronic stable phenotype of asbestos-associated ILA contrasts with the traditionally accepted views that asbestosis requires high exposures.
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Affiliation(s)
- Edward J. A. Harris
- Curtin Medical School Curtin University Perth Western Australia
- Department of Respiratory Medicine Sir Charles Gairdner Hospital Perth Washington USA
| | - Kuan P. Lim
- Department of Respiratory Medicine Sir Charles Gairdner Hospital Perth Washington USA
| | - Yuben Moodley
- Department of Respiratory Medicine Fiona Stanley Hospital Perth Washington USA
| | | | - Nita Sodhi‐Berry
- School of Population and Global Health University of Western Australia Perth Western Australia
| | - Alison Reid
- School of Public Health Curtin University Perth Western Australia
| | | | - Peter J. Franklin
- School of Population and Global Health University of Western Australia Perth Western Australia
| | - AW (Bill) Musk
- School of Population and Global Health University of Western Australia Perth Western Australia
| | - Nicholas H. Klerk
- School of Population and Global Health University of Western Australia Perth Western Australia
- Telethon Kids Institute Nedlands Western Australia Australia
| | - Fraser J. H. Brims
- Curtin Medical School Curtin University Perth Western Australia
- Department of Respiratory Medicine Sir Charles Gairdner Hospital Perth Washington USA
- National Centre for Asbestos Related Diseases Institute for Respiratory Health Perth Western Australia
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DeBono NL, Warden H, Logar‐Henderson C, Shakik S, Dakouo M, MacLeod J, Demers PA. Incidence of mesothelioma and asbestosis by occupation in a diverse workforce. Am J Ind Med 2021; 64:476-487. [PMID: 33834530 DOI: 10.1002/ajim.23245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/09/2021] [Accepted: 03/02/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We sought to characterize detailed patterns of mesothelioma and asbestosis incidence in the workforce as part of an occupational disease surveillance program in Ontario, Canada. METHODS The Occupational Disease Surveillance System (ODSS) cohort was established using workers' compensation claims data and includes 2.18 million workers employed from 1983 to 2014. Workers were followed for mesothelioma and asbestosis diagnoses in Ontario Cancer Registry, physician, hospital, and ambulatory care records through 2016. Trends in incidence rates were estimated over the study period. Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS A total of 854 mesothelioma and 737 asbestosis cases were diagnosed during follow-up. Compared with all other workers in the ODSS, those employed in construction trades occupations had the greatest adjusted incidence rate of both mesothelioma (223 cases; HR, 2.38; 95% CI: 2.03-2.78) and asbestosis (261 cases; HR, 3.64; 95% CI: 3.11-4.25). Rates were particularly elevated for insulators, pipefitters and plumbers, and carpenters. Workers in welding and flame cutting, boiler making, and mechanic and machinery repair occupations, as well as those in industrial chemical and primary metal manufacturing industries, had strongly elevated rates of both diseases. Rates were greater than anticipated for workers in electrical utility occupations and education and related services. CONCLUSIONS Results substantiate the risk of mesothelioma and asbestosis in occupation and industry groups in the Ontario workforce with known or suspected asbestos exposure. Sustained efforts to prevent the occurrence of additional cases of disease in high-risk groups are warranted.
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Affiliation(s)
- Nathan L. DeBono
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Hunter Warden
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
- Faculty of Medicine University of Toronto Toronto Ontario Canada
| | | | - Sharara Shakik
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Jill MacLeod
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Paul A. Demers
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
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García Martínez A, Pavón Guerrero I, Campos Gonzaga L. "Omental Cake" in a Patient With Asbestosis Leading to the Diagnosis of Malignant Peritoneal Mesothelioma. Cureus 2021; 13:e15116. [PMID: 34159018 PMCID: PMC8212920 DOI: 10.7759/cureus.15116] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/18/2022] Open
Abstract
We report a case of a 68-year-old man with medical history of pleural asbestosis and diagnosed with malignant peritoneal mesothelioma. This neoplasm is rare, has a poor prognosis, and is associated with asbestosis in many cases. It manifests clinically insidiously and in relation to the intra-abdominal locoregional effect. Radiological findings are variable, although the finding of "omental cake" by CT scan is characteristic but not pathognomonic, as seen in our case. A biopsy is required for the diagnosis, which can be guided by radiology or surgery. Treatment options available are cytoreductive surgery with intraperitoneal hyperthermic chemotherapy or systemic chemotherapy. However, new therapeutic options are emerging, which are still under development and research.
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Affiliation(s)
| | | | - Lidia Campos Gonzaga
- Digestive Diseases, Hospital Universitario de Jerez de la Frontera, Jerez de la Frontera, ESP
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18
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An J, Song M, Chang B. Asbestosis Mimicking Metastatic Lung Cancer: Case Report. Medicina (Kaunas) 2021; 57:402. [PMID: 33919345 PMCID: PMC8143341 DOI: 10.3390/medicina57050402] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 04/20/2021] [Indexed: 11/17/2022]
Abstract
The clinical diagnosis of asbestosis is primarily based on chest radiographic evidence of pleural thickening and interstitial fibrosis combined with a history of exposure to asbestos. We report herein the case of a 65-year-old man with asbestosis pathologically diagnosed after surgical lung biopsy. He had a work history including farming, cementing, and casting and was admitted with dyspnea. Chest computed tomography revealed multiple well-defined nodules in both lungs and a 4.1 cm peribronchial consolidation with fibrotic changes in the right lower lobe. We suspected metastatic lung cancer and video-assisted thoracoscopic biopsy was performed in the lung lesion of the right lower lobe. Asbestosis was confirmed following histological examination. The patient is currently completing outpatient visits without significant changes.
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Affiliation(s)
- Jin An
- Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea;
| | - Minjeong Song
- Department of Pathology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea;
| | - Boksoon Chang
- Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 05278, Korea;
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Franko A, Goricar K, Dodic Fikfak M, Kovac V, Dolzan V. The role of polymorphisms in glutathione-related genes in asbestos-related diseases. Radiol Oncol 2021; 55:179-86. [PMID: 33544514 DOI: 10.2478/raon-2021-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 12/02/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The study investigated the influence of GCLC, GCLM, GSTM1, GSTT1 and GSTP1 polymorphisms, as well as the influence of interactions between polymorphism and interactions between polymorphisms and asbestos exposure, on the risk of developing pleural plaques, asbestosis and malignant mesothelioma (MM). SUBJECTS AND METHODS The cross sectional study included 940 asbestos-exposed subjects, among them 390 subjects with pleural plaques, 147 subjects with asbestosis, 225 subjects with MM and 178 subjects with no asbestos-related disease. GCLC rs17883901, GCLM rs41303970, GSTM1 null, GSTT1 null, GSTP1 rs1695 and GSTP1 rs1138272 genotypes were determined using PCR based methods. In statistical analysis, logistic regression was used. RESULTS GSTT1 null genotype was associated with the decreased risk for pleural plaques (OR = 0.63; 95% CI = 0.40-0.98; p = 0.026) and asbestosis (OR = 0.51; 95% CI = 0.28-0.93; p = 0.028), but not for MM. A positive association was found between GSTP1 rs1695 AG + GG vs. AA genotypes for MM when compared to pleural plaques (OR = 1.39; 95% CI = 1.00-1.94; p = 0.049). The interactions between different polymorphisms showed no significant influence on the risk of investigated asbestos-related diseases. The interaction between GSTT1 null polymorphism and asbestos exposure decreased the MM risk (OR = 0.17; 95% CI = 0.03-0.85; p = 0.031). CONCLUSIONS Our findings suggest that GSTT1 null genotype may be associated with a decreased risk for pleural plaques and asbestosis, may modify the association between asbestos exposure and MM and may consequently act protectively on MM risk. This study also revealed a protective effect of the interaction between GSTP1 rs1695 polymorphism and asbestos exposure on MM risk.
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Bartkowiak K, Casjens S, Andreas A, Ačkar L, Joosse SA, Raiko I, Brüning T, Geffken M, Peine S, Johnen G, Weber DG, Pantel K. Sensitive Blood-Based Detection of Asbestos-Associated Diseases Using Cysteine-Rich Angiogenic Inducer 61 as Circulating Protein Biomarker. Clin Chem 2020; 67:363-373. [PMID: 33336248 DOI: 10.1093/clinchem/hvaa232] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Detection of asbestos-associated diseases like asbestosis or mesothelioma is still challenging. We sought to improve the diagnosis of benign asbestos-associated disease (BAAD) by detection of the protein cysteine-rich angiogenic inducer 61 (Cyr61) in human plasma. METHODS Plasma Cyr61 was quantified using an enzyme-linked immunosorbent assay. Plasma samples from males diagnosed with BAAD, but without a malignant disease (n = 101), and malignant mesothelioma (n = 21; 15 males, 6 females), as well as nonasbestos-exposed healthy control participants (n = 150; 58 males, 92 females) were analyzed. Clinical sensitivity and specificity of Cyr61 were determined by receiver operating characteristic analysis. RESULTS The median plasma Cyr61 concentration for healthy control participants was 0.27 ng/mL. Cytoplasmic Cyr61 in peripheral blood mononuclear cells from healthy control participants was evenly distributed, as detected by immunofluorescent staining. The increase in plasma Cyr61 concentrations in the BAAD study group was statistically significant compared to the healthy control participants (P < 0.0001). For the detection of BAAD vs male healthy control participants, clinical sensitivity was 88% and clinical specificity 95% with an area under the curve of 0.924 at maximal Youden Index. For a predefined clinical specificity of 100%, the clinical sensitivity was 76%. For male mesothelioma patients vs male healthy control participants, the clinical sensitivity at maximal Youden Index was 95% with a clinical specificity of 100% (area under the curve, 0.997) and for a predefined clinical specificity of 100%, the clinical sensitivity was 93%. CONCLUSIONS In our study, plasma Cyr61 protein concentrations showed to be a new biomarker for asbestos-associated diseases like BAAD and mesothelioma in men, which deserves further investigation in large-scale cohort studies.
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Affiliation(s)
- Kai Bartkowiak
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Swaantje Casjens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Antje Andreas
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lucija Ačkar
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon A Joosse
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Irina Raiko
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Maria Geffken
- Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Peine
- Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georg Johnen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Daniel Gilbert Weber
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Klaus Pantel
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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21
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Girardi P, Merler E, Ferrante D, Silvestri S, Chellini E, Angelini A, Luberto F, Fedeli U, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mirabelli D, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Azzolina D, Tunesi S, Miligi L, Perticaroli P, Pettinari A, Cuccaro F, Nannavecchia AM, Bisceglia L, Marinaccio A, Pavone VLM, Magnani C. Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy. Ann Work Expo Health 2020; 64:622-635. [PMID: 32328661 DOI: 10.1093/annweh/wxaa037] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/10/2020] [Accepted: 03/19/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study was performed with the aim of investigating the temporal patterns and determinants associated with mortality from asbestosis among 21 cohorts of Asbestos-Cement (AC) workers who were heavily exposed to asbestos fibres. METHODS Mortality for asbestosis was analysed for a cohort of 13 076 Italian AC workers (18.1% women). Individual cumulative asbestos exposure index was calculated by factory and period of work weighting by the different composition of asbestos used (crocidolite, amosite, and chrysotile). Two different approaches to analysis, based on Standardized Mortality Ratios (SMRs) and Age-Period-Cohort (APC) models were applied. RESULTS Among the considered AC facilities, asbestos exposure was extremely high until the end of the 1970s and, due to the long latency, a peak of asbestosis mortality was observed after the 1990s. Mortality for asbestosis reached extremely high SMR values [SMR: males 508, 95% confidence interval (CI): 446-563; females 1027, 95% CI: 771-1336]. SMR increased steeply with the increasing values of cumulative asbestos exposure and with Time Since the First Exposure. APC analysis reported a clear age effect with a mortality peak at 75-80 years; the mortality for asbestosis increased in the last three quintiles of the cumulative exposure; calendar period did not have a significant temporal component while the cohort effect disappeared if we included in the model the cumulative exposure to asbestos. CONCLUSIONS Among heaviest exposed workers, mortality risk for asbestosis began to increase before 50 years of age. Mortality for asbestosis was mainly determined by cumulative exposure to asbestos.
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Affiliation(s)
- Paolo Girardi
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Daniela Ferrante
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Stefano Silvestri
- CPO-Piedmont, Novara, Italy.,Occupational Hygienists, Unit of Medical Statistics and Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Alessia Angelini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Ferdinando Luberto
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Ugo Fedeli
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesco Barone-Adesi
- CPO-Piedmont, Novara, Italy.,Department of 'Scienze del Farmaco', University of Eastern Piedmont, Novara, Italy
| | - Tiziana Cena
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Mangone
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesca Roncaglia
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- Occupational Hygienist, Formerly: Regional Agency for Prevention, Environment and Energy Emilia-Romagna, Provincial Office of Reggio Emilia, Reggio Emilia, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Naples, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies 'Charles Darwin', Sapienza University, Rome, Italy
| | - Danila Azzolina
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Sara Tunesi
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy.,Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Aldo Pettinari
- Prevention Department, ASUR Marche, Senigallia, Ancona, Italy
| | - Francesco Cuccaro
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Anna Maria Nannavecchia
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | | | - Alessandro Marinaccio
- Italian Workers' Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Rome, Italy
| | - Venere Leda Mara Pavone
- Department of Public Health, Prevention and Security Area Work Environments, Local Health Authority, San Lazzaro di Savena, Italy
| | - Corrado Magnani
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
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22
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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23
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Salonen J, Purokivi M, Bloigu R, Kaarteenaho R. Prognosis and causes of death of patients with acute exacerbation of fibrosing interstitial lung diseases. BMJ Open Respir Res 2020; 7:e000563. [PMID: 32265195 PMCID: PMC7254157 DOI: 10.1136/bmjresp-2020-000563] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The aim of this study was to compare the clinical characteristics, causes of death and factors impacting on the prognosis of patients with idiopathic pulmonary fibrosis (IPF) and other fibrosing interstitial lung disease (FILD) with a history of acute exacerbation (AE) of IPF or FILD. METHODS Retrospective data of hospital treatment periods caused by AE-IPF and AE-FILD were collected from medical records. Clinical features and survival data of IPF and non-IPF cases were evaluated and compared. The underlying and immediate causes of death were gathered from death certificates. RESULTS A total of 128 patients fulfilled the criteria for inclusion. IPF (n=79/62%), rheumatoid arthritis-associated interstitial lung disease (RA-ILD; n=17/14%) and asbestosis (n=11/8.6%) were the most common FILD subgroups in the study. The median survival after hospitalisation in AE-IPF was 2.6 months compared with 21 months in other AE-FILDs (p<0.001). The survival difference was not explained by age, gender or pulmonary function test results at the time of hospitalisation. Patients with non-specific interstitial pneumonia and RA-ILD had the most favourable prognosis. ILD was the most common underlying cause of death in both patients with IPF and with other FILD accounting for 87% and 78% of deaths, respectively. CONCLUSIONS We detected a significantly longer survival in AE of patients with non-IPF compared with that of AE-IPFs. The prognosis of patients was affected by the underlying lung disease since pulmonary fibrosis was the underlying cause of death in the majority of all patients with FILD having experienced an AE.
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Affiliation(s)
- Johanna Salonen
- Respiratory Medicine, Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Minna Purokivi
- The Center of Medicine and Clinical Research, Division of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Risto Bloigu
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - Riitta Kaarteenaho
- Respiratory Medicine, Research Unit of Internal Medicine, University of Oulu, Oulu, Finland
- Medical Research Center, Oulu University Hospital, Oulu, Finland
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24
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Ferrante D, Mirabelli D, Silvestri S, Azzolina D, Giovannini A, Tribaudino P, Magnani C. Mortality and mesothelioma incidence among chrysotile asbestos miners in Balangero, Italy: A cohort study. Am J Ind Med 2020; 63:135-145. [PMID: 31821579 DOI: 10.1002/ajim.23071] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 10/31/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND We studied cancer mortality and mesothelioma incidence in 974 male workers employed at least 6 months at the Balangero mine (Italy), the largest chrysotile mine in Western Europe, active from 1917 to 1985. METHODS Vital status as of 31 May 2013, causes of deaths and mesothelioma incidence from 1990 were ascertained. Past exposure to asbestos by working area and calendar period was estimated, based on historical data of fibers concentrations. Individual cumulative exposure was assessed by applying estimates to the job history of cohort members. Standardized mortality ratios (SMRs) for selected causes and standardized incidence ratios for malignant mesothelioma (MM) were calculated based on regional reference rates. Poisson regression analysis was used to study MM and lung cancer risk by latency, duration, and cumulative exposure. RESULTS Mortality was increased for all causes (SMR = 1.28; 95% confidence interval [CI] = 1.17-1.40), pleural cancer (SMR = 4.30; 95% CI = 1.58-9.37), asbestosis (SMR = 375.06; 95% CI = 262.68-519.23). An increase was also found for lung cancer (SMR = 1.14; 95% CI = 0.81-1.55) and peritoneal cancer (SMR = 3.25; 95% CI = 0.39-11.75). The risk of both pleural and peritoneal cancer mortality and of mesothelioma incidence increased with increasing cumulative exposure, duration, and latency. Poisson regression analyses showed an increase in mesothelioma risk with cumulative asbestos exposure and suggest a similar trend for lung cancer. Asbestosis mortality also increased with cumulative exposure. CONCLUSIONS Among Balangero chrysotile miners and millers, the occurrence of malignant and nonmalignant asbestos-related diseases was increased by exposure, with dose-response relation. The study confirms the carcinogenicity of chrysotile asbestos, in particular for pleural mesothelioma.
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Affiliation(s)
- Daniela Ferrante
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational MedicineUniversity of Eastern Piedmont and CPO Piemonte Novara Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, Department of Medical SciencesCPO Piemonte and University of Turin Turin Italy
- Interdepartmental Centre G. Scansetti for Studies on Asbestos and other Toxic ParticulatesUniversity of Turin Turin Italy
| | | | - Danila Azzolina
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational MedicineUniversity of Eastern Piedmont and CPO Piemonte Novara Italy
| | | | | | - Corrado Magnani
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational MedicineUniversity of Eastern Piedmont and CPO Piemonte Novara Italy
- Interdepartmental Centre G. Scansetti for Studies on Asbestos and other Toxic ParticulatesUniversity of Turin Turin Italy
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25
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Franko A, Goricar K, Kovac V, Dodic-Fikfak M, Dolzan V. NLRP3 and CARD8 polymorphisms influence risk for asbestos-related diseases. J Med Biochem 2020; 39:91-9. [PMID: 32549782 DOI: 10.2478/jomb-2019-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 04/26/2019] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to investigate the association between NLRP3 rs35829419 and CARD8 rs2043211 polymorphisms and the risk of developing pleural plaques, asbestosis, and malignant mesothelioma (MM), and to study the influence of the interactions between polymorphisms and asbestos exposure on the risk of developing these diseases. Methods The case-control study included 416 subjects with pleural plaques, 160 patients with asbestosis, 154 subjects with MM and 149 subjects with no asbestos disease. The NLRP3 rs35829419 and CARD8 rs2043211 polymorphisms were determined using real-time PCR-based methods. In the statistical analysis, standard descriptive statistics was followed by univariate and multivariate logistic regression modelling. Results Asbestos exposure (medium and high vs low) was associated with the risk for each studied asbestos-related disease. An increased risk of pleural plaques was found for CARD8 rs2043211 at + TT genotypes (OR = 1.48, 95% CI 1.01-2.16, p = 0.042). When the analysis was performed for MM patients as cases, and pleural plaques patients as controls, a decreased MM risk was observed for carriers of CARD8 rs2043211 TT genotype (OR = 0.52, 95% CI 0.27-1.00, p = 0.049). The interactions between NLRP3 rs35829419 and CARD8 rs2043211 genotypes did not influence the risk of any asbestos-related disease. However, when testing interactions with asbestos exposure, a decreased risk of asbestosis was found for NLRP3 CA+AA genotypes (OR = 0.09, 95% CI 0.01-0.60, p = 0.014). Conclusions The results of our study suggest that NLRP3 and CARD8 polymorphisms could affect the risk of asbestos-related diseases.
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26
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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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27
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Candura SM, Marradi I. Imaging and imagination in the diagnostics of asbestosis. Med Lav 2020; 111:411-412. [PMID: 33124613 PMCID: PMC7809973 DOI: 10.23749/mdl.v111i5.10240] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 08/25/2020] [Indexed: 11/18/2022]
Abstract
Two cases of asbestosis diagnosed on the basis of anamnestic, clinical, and instrumental criteria, were not confirmed by forensic autopsy ordered by the public prosecutor to ascertain the cause of death. The two cases demonstrate that a suggestive working history can be misleading, in the absence of clear radiological signs and histopathological findings, and that asbestosis must be diagnosed following the criteria consolidated in the scientific literature, as any diagnostic errors can have serious legal consequences.
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Affiliation(s)
- Stefano M. Candura
- Occupational Medicine Unit, Department of Public Health, Experimental and Forensic Sciences, University of Pavia and Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
| | - Ilaria Marradi
- Forensic Medicine Specialist, Guamo, Capannori (Lucca), Italy
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28
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Klebe S, Leigh J, Henderson DW, Nurminen M. Asbestos, Smoking and Lung Cancer: An Update. Int J Environ Res Public Health 2019; 17:ijerph17010258. [PMID: 31905913 PMCID: PMC6982078 DOI: 10.3390/ijerph17010258] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/17/2019] [Accepted: 12/24/2019] [Indexed: 01/19/2023]
Abstract
This review updates the scientific literature concerning asbestos and lung cancer, emphasizing cumulative exposure and synergism between asbestos exposure and tobacco smoke, and proposes an evidence-based and equitable approach to compensation for asbestos-related lung cancer cases. This update is based on several earlier reviews written by the second and third authors on asbestos and lung cancer since 1995. We reevaluated the peer-reviewed epidemiologic studies. In addition, selected in vivo and in vitro animal studies and molecular and cellular studies in humans were included. We conclude that the mechanism of lung cancer causation induced by the interdependent coaction of asbestos fibers and tobacco smoke at a biological level is a multistage stochastic process with both agents acting conjointly at all times. The new knowledge gained through this review provides the evidence for synergism between asbestos exposure and tobacco smoke in lung cancer causation at a biological level. The evaluated statistical data conform best to a multiplicative model for the interaction effects of asbestos and smoking on the lung cancer risk, with no requirement for asbestosis. Any asbestos exposure, even in a heavy smoker, contributes to causation. Based on this information, we propose criteria for the attribution of lung cancer to asbestos in smokers and non-smokers.
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Affiliation(s)
- Sonja Klebe
- Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia
- Correspondence: ; Tel.: +61-08-820-439-36
| | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Concord, NSW 2139, Australia;
| | - Douglas W. Henderson
- Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia
| | - Markku Nurminen
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland;
- MarkStat Consultancy, 00250 Helsinki, Finland
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29
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Świątkowska B. [The occurrence of asbestos-related diseases among former employees of asbestos processing plants in Poland]. Med Pr 2019; 70:723-731. [PMID: 31682242 DOI: 10.13075/mp.5893.00890] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Despite the fact that asbestos is no longer used in production in Poland, there are still new cases of asbestos-related diseases among workers previously exposed to asbestos dust. This situation is related to the specificity of the biological activity of this mineral; the health consequences of asbestos can manifest not only during the exposure but also many years after exposure cessation. The aim of the analysis was to assess the occurrence of occupational diseases among people exposed to asbestos dust, who were examined under the Amiantus program. MATERIAL AND METHODS The research material consisted of the program cards filled by the doctors conducting the examinations as well as radiological images stored on the International Labour Organization form. The analysis covered 8049 people, including 37% of women surveyed in the years 2000-2017. RESULTS In the group of former employees of asbestos processing plants, the occupational disease was diagnosed in 1993 people (25%), including 584 women (19%). The most common was asbestosis (76% of occupational diseases) and pleural disease (17%). Malignant neoplasms accounted for 7% of all cases in this group. The analysis showed an increase in the incidence of respiratory system diseases along with the age of the surveyed persons, their seniority at asbestos processing plants and an increase in cumulative exposure. The chest radiographs revealed radiological changes among 75% of the examined cases, whereas the changes entitling to diagnose asbestosis, according to the criteria applicable in Poland, occurred in 23% of the workers. The adoption of international criteria would increase the incidence of asbestosis as an occupational disease by 19% in the study group. CONCLUSIONS The increase in the percentage of people with a diagnosed occupational disease provides evidence for the worsening health status of the former workers as well as a good detection of asbestos-related diseases among employees exposed to asbestos dust in the past. The results of the analysis indicate the need for undertaking a discussion in Poland on the implementation of international criteria for the diagnosis of asbestosis. Med Pr. 2019;70(6):723-31.
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Affiliation(s)
- Beata Świątkowska
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Institute of Occupational Medicine, Łódź, Poland (Zakład Epidemiologii Środowiskowej / Department of Environmental Epidemiology)
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30
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West GH, Sokas RK, Welch LS. Change in prevalence of asbestos-related disease among sheet metal workers 1986 to 2016. Am J Ind Med 2019; 62:609-615. [PMID: 31168870 DOI: 10.1002/ajim.22998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/06/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND A medical screening program began in 1986 for sheet metal workers exposed to asbestos, primarily while working alongside insulators applying spray-on asbestos materials, a practice banned in 1973. Exposure continues during maintenance, renovation, and repair. METHODS Radiographic abnormalities among 26 397 sheet metal workers examined from 1986 to 2016 were analyzed by year of entry into the trade. Logistic regression was used to examine risk factors for parenchymal and pleural abnormalities among the overall study population and among the subcohort who entered the trade after 1973. RESULTS Prevalence of parenchymal disease was 17.4% for those starting work before 1950 compared with 0.8% for those starting work after 1973 (adjusted prevalence odds ratio [pOR] = 26.65, 95% confidence interval [CI] = 18.46-38.46). For each calendar year after 1973, entering the trade 1 year later was associated with an estimated 12.7% decreased odds of acquiring asbestos-related disease (adjusted pOR = 0.873, 95% CI = 0.832-0.916). CONCLUSION Sheet metal workers who began work after the US implemented environmental and occupational regulations develop asbestos-related disease at much reduced rates, consistent with regulatory projections made for nonmalignant asbestos-related disease by the Occupational Safety and Health Administration at the time. Cancer remains a concern among this cohort, and lung cancer screening recommendations should consider year of entry into the trade. This study highlights the importance of regulatory intervention and of continued surveillance.
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Affiliation(s)
- Gavin H. West
- CPWR—The Center for Construction Research and TrainingSilver Spring Maryland
| | - Rosemary K. Sokas
- CPWR—The Center for Construction Research and TrainingSilver Spring Maryland
- Department of Human Science, School of Nursing and Health StudiesGeorgetown UniversityWashington District of Columbia
| | - Laura S. Welch
- CPWR—The Center for Construction Research and TrainingSilver Spring Maryland
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31
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Zajaczkowska M, Johnson A, Gallur L, Shin J, Henderson C, Williamson J. Transbronchial lung cryobiopsy: a novel confirmatory tool to diagnose asbestos-related pulmonary fibrosis. Respirol Case Rep 2019; 7:e00380. [PMID: 30455954 PMCID: PMC6226387 DOI: 10.1002/rcr2.380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/28/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 11/16/2022] Open
Abstract
Asbestosis is diagnosed with a combination of historical, clinical and radiological findings in the absence of another cause. Histology is required when uncertainty exists, with lung biopsy via VATs being gold standard. Transbronchial cryobiopsy is becoming increasingly popular for diagnosing interstitial lung disease and may provide sufficient lung sample to demonstrate asbestosis. A 73 year old man presented with dyspnoea on a background of rheumatoid arthritis, previous methotrexate use and asbestos exposure. Examination revealed fine crackles in the mid and lower zones bilaterally without signs of pulmonary hypertension. The presence of pleural plaques and basal interstitial reticulation on HRCT was suggestive of asbestosis but histology was required to differentiate this from rheumatoid or methotrexate associated ILD. Samples of lung tissue were obtained via transbronchial cryobiopsy, demonstrating fibrosis and asbestos fibres consistent with asbestosis. Transbronchial cryobiopsy appears effective in obtaining sufficient parenchymal lung samples to diagnose asbestosis when clinical uncertainty exists.
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Affiliation(s)
- Marta Zajaczkowska
- Department of Respiratory and Sleep MedicineLiverpool HospitalSydney, New South WalesAustralia
| | - Anthony Johnson
- Respiratory, Sleep and Environmental and Occupational Health (RSEOH)The Ingham Institute of Applied Medical ResearchSydney, New South WalesAustralia
| | - Luis Gallur
- Department of AnaesthesiaLiverpool HospitalSydney, New South WalesAustralia
| | - Joo Shin
- Department of Anatomical PathologyLiverpool HospitalSydney, New South WalesAustralia
| | - Christopher Henderson
- Department of Anatomical PathologyLiverpool HospitalSydney, New South WalesAustralia
- School of Medicine, University of Western SydneySydney, New South WalesAustralia
- South Western Clinical School, University of New South WalesSydney, New South WalesAustralia
| | - Jonathan Williamson
- Department of Respiratory and Sleep MedicineLiverpool HospitalSydney, New South WalesAustralia
- Respiratory, Sleep and Environmental and Occupational Health (RSEOH)The Ingham Institute of Applied Medical ResearchSydney, New South WalesAustralia
- MQ Respiratory and SleepMacquarie University Hospital and Clinic, Macquarie UniversitySydney, New South WalesAustralia
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Joubert KD, Awori Hayanga J, Strollo DC, Lendermon EA, Yousem SA, Luketich JD, Ensor CR, Shigemura N. Outcomes after lung transplantation for patients with occupational lung diseases. Clin Transplant 2018; 33:e13460. [PMID: 30506808 DOI: 10.1111/ctr.13460] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 06/28/2018] [Revised: 11/19/2018] [Accepted: 11/25/2018] [Indexed: 11/28/2022]
Abstract
Occupational lung diseases (OLD) including silicosis, asbestosis, and pneumoconiosis progress to end stage lung disease requiring lung transplantation (LT). Prognosis and treatment of OLDs are poorly understood and a paucity of data exists regarding LT outcomes. Additionally, transplant operative complexity for patients with OLD is high. A single center retrospective review of all single and bilateral LT recipients between May 2005 and Oct 2016 was performed. Patients were grouped by OLD, and nearest neighbor matching was performed at a ratio of 1:3 cases to controls. Thirty cases were matched to 88 controls. Seventeen patients (57%) with OLD required intraoperative support with either extra-corporeal membrane oxygenation (ECMO) or cardiopulmonary bypass (P = 0.02), and 5 (17%) required delayed chest closure (P = 0.05) which was more frequent than matched controls. In addition, operative time was significantly longer in patients with OLD (P = 0.03). Despite these factors, there were no significant differences in immediate post-operative outcomes including mechanical ventilator support, post-operative ECMO, and tracheostomy. Chronic lung allograft dysfunction and long-term survival were also similar between cases and controls. OLDs should not preclude LT. The operation should be performed at experienced centers.
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Affiliation(s)
- Kyla D Joubert
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - J Awori Hayanga
- Heart and Vascular Institute, West Virginia Universiy J.W. Rudy Memorial Hospital, Morgantown, West Virginia
| | - Diane C Strollo
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Elizabeth A Lendermon
- Department of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Samuel A Yousem
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - James D Luketich
- Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Norihisa Shigemura
- Division of Lung Failure and Lung Transplantation, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
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Yotsumoto T, Sano A, Fukuda T. Clinical study of asbestos-related lung cancer diagnosed by asbestos medical examination. Cancer Rep (Hoboken) 2018; 1:e1124. [PMID: 32721086 DOI: 10.1002/cnr2.1124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 03/09/2018] [Revised: 06/01/2018] [Accepted: 06/11/2018] [Indexed: 01/04/2023] Open
Abstract
AIM People with occupational exposure to asbestos demonstrate a high incidence of lung cancer. Asbestos medical examination for those at risk was implemented as a national policy in Japan. This study aimed to characterize patients with asbestos-related lung cancer who were diagnosed by these examinations. METHODS We retrospectively investigated 120 individuals exposed to asbestos who were examined from 2008 to 2016 at our institution. Clinical data, including CT findings and time-related exposure variables, were evaluated. Each asbestos-related change was assigned 1 point if present, and the scores were compared between patients with and without asbestos-related lung cancer using the Mann-Whitney U test and Fisher's exact test. RESULTS Five patients were diagnosed with lung cancer, and four underwent surgical treatment. At the time of writing, three of four operated patients were alive without recurrence, with a similar prognosis to patients with lung cancer unrelated to asbestos. Average scores for asbestos-related findings on CT Scan were 1.8 (9/5) for patients with lung cancer and 0.79 (91/115) for those without lung cancer. CONCLUSION Patients with lung cancer had significantly more asbestos-related changes on CT scan than those without lung cancer. Concurrent calcified plaque and interstitial changes might be a predictor of lung cancer incidence. Although further investigation with a larger study group is needed, regular medical examination and CT scan every 6 months might contribute to the early detection of lung cancer with asbestos-related changes on CT.
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Affiliation(s)
- Takuma Yotsumoto
- Department of Thoracic Surgery, Chigasaki Municipal Hospital, Chigasaki, Kanagawa, Japan
| | - Atsushi Sano
- Department of Thoracic Surgery, Chigasaki Municipal Hospital, Chigasaki, Kanagawa, Japan
| | - Tsutomu Fukuda
- Department of Respiratory Medicine, Chigasaki Municipal Hospital, Chigasaki, Kanagawa, Japan
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Baur X. Review on the adverse health effects of asbestiform antigorite, a non-regulated asbestiform serpentine mineral. Am J Ind Med 2018; 61:625-630. [PMID: 29733442 DOI: 10.1002/ajim.22857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 04/03/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Although antigorite is generally described as platy, its fibrous (asbestiform) variant is present widespread in serpentinite rocks. In addition to its primarily fibrous occurrence, asbestiform antigorite may also be formed from serpentinite with massive appearance during tunneling and mining. It is not of commercial interest, but exposure may occur in the certain environments. METHODS AND RESULTS Detailed studies of the structural features of this antigorite type revealed characteristics closely related to those of chrysotile. Therefore, it is plausible that this serpentine mineral may present a similar health risk for exposed subjects. This is in agreement with results from clinical and animal studies, as well as in vitro experiments showing the cytotoxic, fibrogenic, and carcinogenic potential of antigorite, similar to that of chrysotile and amphibole asbestos. CONCLUSIONS Current evidence supports a need for an update to existing regulations to include unregulated asbestiform antigorite, similar to regulatory measures taken for asbestos.
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Affiliation(s)
- Xaver Baur
- European Society for Environmental and Occupational Medicine; Berlin Germany
- Institute for Occupational Medicine, University of Hamburg; University Clinic Hamburg-Eppendorf; Hamburg Germany
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Soeberg M, Vallance DA, Keena V, Takahashi K, Leigh J. Australia's Ongoing Legacy of Asbestos: Significant Challenges Remain Even after the Complete Banning of Asbestos Almost Fifteen Years Ago. Int J Environ Res Public Health 2018; 15:ijerph15020384. [PMID: 29473898 PMCID: PMC5858453 DOI: 10.3390/ijerph15020384] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 01/28/2018] [Accepted: 02/13/2018] [Indexed: 11/17/2022]
Abstract
The most effective way of reducing the global burden of asbestos-related diseases is through the implementation of asbestos bans and minimising occupational and non-occupational exposure to respirable asbestos fibres. Australia’s asbestos consumption peaked in the 1970s with Australia widely thought to have had among the highest per-capita asbestos consumption level of any country. Australia’s discontinuation of all forms of asbestos and asbestos-containing products and materials did not occur at a single point of time. Crocidolite consumption ceased in the late 1960s, followed by amosite consumption stopping in the mid 1980s. Despite significant government reports being published in 1990 and 1999, it was not until the end of 2003 that a complete ban on all forms of asbestos (crocidolite, amosite, and chrysotile) was introduced in Australia. The sustained efforts of trade unions and non-governmental organisations were essential in forcing the Australian government to finally implement the 2003 asbestos ban. Trade unions and non-government organisations continue to play a key role today in monitoring the government’s response to Australian asbestos-related disease epidemic. There are significant challenges that remain in Australia, despite a complete asbestos ban being implemented almost fifteen years ago. The Australian epidemic of asbestos-related disease has only now reached its peak. A total of 16,679 people were newly diagnosed with malignant mesothelioma between 1982 and 2016, with 84% of cases occurring in men. There has been a stabilisation of the age-standardised malignant mesothelioma incidence rate in the last 10 years. In 2016, the incidence rate per 100,000 was 2.5 using the Australian standard population and 1.3 using the Segi world standard population. Despite Australia’s complete asbestos ban being in place since 2003, public health efforts must continue to focus on preventing the devastating effects of avoidable asbestos-related diseases, including occupational and non-occupational groups who are potentially at risk from exposure to respirable asbestos fibres.
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Affiliation(s)
- Matthew Soeberg
- Asbestos Diseases Research Institute, P.O. Box 3628, Rhodes, NSW 2138, Australia.
| | - Deborah A Vallance
- Australian Manufacturing Workers' Union, P.O. Box 160, Granville, NSW 2142, Australia.
| | - Victoria Keena
- Asbestos Diseases Research Institute, P.O. Box 3628, Rhodes, NSW 2138, Australia.
| | - Ken Takahashi
- Asbestos Diseases Research Institute, P.O. Box 3628, Rhodes, NSW 2138, Australia.
| | - James Leigh
- Asbestos Diseases Research Institute, P.O. Box 3628, Rhodes, NSW 2138, Australia.
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Baur X. Asbestos-Related Disorders in Germany: Background, Politics, Incidence, Diagnostics and Compensation. Int J Environ Res Public Health 2018; 15:E143. [PMID: 29337930 PMCID: PMC5800242 DOI: 10.3390/ijerph15010143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/19/2017] [Accepted: 01/11/2018] [Indexed: 11/16/2022]
Abstract
There was some limited use of asbestos at end of the 19th century in industrialized countries including Germany, but its consumption dramatically increased after World War II. The increase in use and exposure was followed by the discovery of high numbers of asbestos-related diseases with a mean latency period of about 38 years in Germany. The strong socio-political pressure from the asbestos industry, its affiliated scientists and physicians has successfully hindered regulatory measures and an asbestos ban for many years; a restrictive stance that is still being unravelled in compensation litigation. This national experience is compared with the situation in other industrialized countries and against the backdrop of the constant efforts of the WHO to eliminate asbestos-related diseases worldwide.
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Affiliation(s)
- Xaver Baur
- European Society for Occupational and Environmental Medicine, EOM, Berlin, Germany.
- Emeritus, Institute for Occupational and Maritime Medicine, University of Hamburg, D-20246 Hamburg, Germany.
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Yang X, Yan Y, Xue C, Du X, Ye Q. Association between increased small airway obstruction and asbestos exposure in patients with asbestosis. Clin Respir J 2017; 12:1676-1684. [PMID: 29087047 DOI: 10.1111/crj.12728] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 10/18/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Asbestos exposure may cause asbestos-related lung diseases including asbestosis, pleural abnormalities and malignancies. The role of asbestos exposure in the development of small airway obstruction remains controversial. Anatomic and physiologic small airway abnormalities may develop as part of the pathophysiologic process of asbestosis. We hypothesized that inhalation of asbestos may induce small airway defects in addition to asbestosis and pleural abnormalities. METHODS In total, 281 patients with newly diagnosed asbestosis were evaluated. Clinical data were collected from the patients' medical charts. The patients were classified into various stages according to their chest X-ray findings using the International Labour Organization classification. Pulmonary function was evaluated by plethysmography and the forced oscillation technique. RESULTS Expiratory flow, including the predicted values of the maximum expiratory flow between 25% and 50% of the forced vital capacity (MEF25-50 ), was significantly lower in the different stages of asbestosis. Accordingly, the predicted percentage of R5 -R20 was significantly higher with increasing stages of asbestosis. Furthermore, the duration of exposure to asbestos was significantly associated with the forced expiratory volume in the first second (FEV1 )/forced vital capacity (FVC) ratio and the predicted percentage of MEF25 or MEF50 according to the regression analysis in non-smoking patients with asbestosis. The predicted percentage of FEV1 or the FEV1 /FVC ratio was significantly lower and the predicted percentage of R5 -R20 was significantly higher in smokers than non-smokers. CONCLUSIONS The patients with asbestosis have small airway obstructive defects that are significantly associated with asbestos exposure.
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Affiliation(s)
- Xiaoli Yang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yongji Yan
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Changjiang Xue
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Xuqin Du
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Qiao Ye
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
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Westerholm P, Remaéus B, Svartengren M. The Tale of Asbestos in Sweden 1972-1986-The Pathway to a Near-Total Ban. Int J Environ Res Public Health 2017; 14:E1433. [PMID: 29165392 DOI: 10.3390/ijerph14111433] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/02/2017] [Accepted: 11/15/2017] [Indexed: 12/02/2022]
Abstract
This paper provides a narrative of the national intervention strategy in Sweden aimed to restrict the industrial use of asbestos. For many years, asbestos was imported for widespread industrial use, resulting in large amounts throughout Swedish society. In 1972, the whistle was blown in a Communist Party parliamentary motion describing asbestos as a health hazard and requesting action to prohibit its use. Although the motion was rejected, it initiated the extensive charting of asbestos sources on a tripartite basis, involving government agencies, and employer and trade-union organizations. Restrictive asbestos management practices were enforced from July 1982. The year 1985 saw the Government Asbestos Commission review, covering use-determining factors, international regulations, and assessments of cancer risks. The relative risks of chrysotile and amphibole were considered internationally (by the IARC), since chrysotile (a Canadian export) was regarded as unharmful in Canada at that time. Prohibiting asbestos use resulted in its virtual disappearance as an import to Sweden from the early 1980s. However, asbestos has undergone a transition from an occupational to a public-health hazard (although some work-related hazards, such as handling and disposal, remain). The transition reflects the public’s exposure to existing stocks, in homes, workplaces, etc. Mesothelioma incidence has come to be regarded as an indicator of prevention effectiveness.
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Tashiro J, Rubio GA, Limper AH, Williams K, Elliot SJ, Ninou I, Aidinis V, Tzouvelekis A, Glassberg MK. Exploring Animal Models That Resemble Idiopathic Pulmonary Fibrosis. Front Med (Lausanne) 2017; 4:118. [PMID: 28804709 PMCID: PMC5532376 DOI: 10.3389/fmed.2017.00118] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [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: 05/10/2017] [Accepted: 07/11/2017] [Indexed: 02/03/2023] Open
Abstract
Large multicenter clinical trials have led to two recently approved drugs for patients with idiopathic pulmonary fibrosis (IPF); yet, both of these therapies only slow disease progression and do not provide a definitive cure. Traditionally, preclinical trials have utilized mouse models of bleomycin (BLM)-induced pulmonary fibrosis—though several limitations prevent direct translation to human IPF. Spontaneous pulmonary fibrosis occurs in other animal species, including dogs, horses, donkeys, and cats. While the fibrotic lungs of these animals share many characteristics with lungs of patients with IPF, current veterinary classifications of fibrotic lung disease are not entirely equivalent. Additional studies that profile these examples of spontaneous fibroses in animals for similarities to human IPF should prove useful for both human and animal investigators. In the meantime, studies of BLM-induced fibrosis in aged male mice remain the most clinically relevant model for preclinical study for human IPF. Addressing issues such as time course of treatment, animal size and characteristics, clinically irrelevant treatment endpoints, and reproducibility of therapeutic outcomes will improve the current status of preclinical studies. Elucidating the mechanisms responsible for the development of fibrosis and disrepair associated with aging through a collaborative approach between researchers will promote the development of models that more accurately represent the realm of interstitial lung diseases in humans.
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Affiliation(s)
- Jun Tashiro
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Gustavo A Rubio
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Andrew H Limper
- Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States
| | - Kurt Williams
- Department Pathobiology and Diagnostic Investigations, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Sharon J Elliot
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ioanna Ninou
- Division of Immunology, Biomedical Sciences Research Center "Alexander Fleming", Athens, Greece
| | - Vassilis Aidinis
- Division of Immunology, Biomedical Sciences Research Center "Alexander Fleming", Athens, Greece
| | - Argyrios Tzouvelekis
- Division of Immunology, Biomedical Sciences Research Center "Alexander Fleming", Athens, Greece
| | - Marilyn K Glassberg
- Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
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Cwynar E, Świątkowska B, Tomczyk J. [Analysis of changes in radiographic lung image and lung ventilation disorders in workers occupationally exposed to chrysotile in the past]. Med Pr 2017; 68:247-258. [PMID: 28345684 DOI: 10.13075/mp.5893.00501] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND The adverse health effects of occupational exposure to asbestos dust may occur several years after first exposure. The objective of the study was to assess the relationship between lesions in the respiratory system and the factors contributing to occupational exposure to asbestos described in the first medical examination as well as to analyze the factors responsible for the progression of these changes in further medical tests. MATERIAL AND METHODS The study group comprised 591 former workers of asbestos processing plant "Gambit" in Lubawka. The results of medical examinations carried out in 2001-2012 were assessed. Statistical inference was performed based on bilateral significance tests at the 0.05 level of significance. RESULTS A higher risk of interstitial lung changes along with an increase in the cumulative concentration of asbestos was indicated; for the employees with the highest exposure, the adjusted odds ratio (OR) was 1.63 (95% confidence interval (CI): 0.99-2.71), while for changes with the severity degree qualifying for asbestosis diagnosis, the risk was significantly increased, over fivefold higher, compared to subjects employed in the lowest exposure. The analysis of the relationship between the progression of interstitial changes and the exposure to asbestos dust showed a fourfold higher risk of the progression in workers employed in the highest exposure. Mean values of FEV1 (forced expiratory volume in 1 s), FVC (forced vital capacity), FEV1/FVC (forced expiratory volume in 1 s to forced vital capacity) were significantly lower in the subjects working in a higher asbestos exposure. The effect of tobacco smoking on the occurrence of interstitial lung changes and their progression was also confirmed. CONCLUSIONS The results of prophylactic medical examinations of the health status of workers formerly employed in the plants using chrysotile indicate the importance andthe need for a long-term clinical follow-up and the promotion of anti-smoking prevention in this group of former employees. Med Pr 2017;68(2):247-258.
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Affiliation(s)
- Elżbieta Cwynar
- Dolnośląski Wojewódzki Ośrodek Medycyny Pracy we Wrocławiu, Oddział Jelenia Góra / Regional Centre of Occupational Medicine, Jelenia Góra Department, Wrocław, Poland (Dyrektor Oddziału / Head of the Department).
| | - Beata Świątkowska
- Instytut Medycyny Pracy im. prof. J. Nofera / Nofer Insttitute of Occupational Medicine, Łódź, Poland (Zakład Epidemiologii Środowiskowej / Department of Environmental Epidemiology).
| | - Jarosław Tomczyk
- Dolnośląski Wojewódzki Ośrodek Medycyny Pracy we Wrocławiu / Regional Centre of Occupational Medicine, Wrocław, Poland (Dyrektor Ośrodka / Head of the Centre).
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Naik SL, Lewin M, Young R, Dearwent SM, Lee R. Mortality from asbestos-associated disease in Libby, Montana 1979-2011. J Expo Sci Environ Epidemiol 2017; 27:207-213. [PMID: 27025411 PMCID: PMC5318660 DOI: 10.1038/jes.2016.18] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/13/2016] [Indexed: 06/05/2023]
Abstract
Research on asbestos exposure in Libby, MT, has focused on occupational exposure in vermiculite mining and processing, but less attention has been paid to asbestos-related mortality among community members without vermiculite mining occupational history. Our study reports on asbestos-related mortality in Libby over 33 years (1979-2011) while controlling for occupational exposure. We calculated sex-specific 33-year standardized mortality ratios (SMRs) for Libby residents who died from 1979 to 2011 with an asbestos-related cause of death. Decedent address at time of death was geocoded to confirm inclusion in the Libby County Division. We controlled for past W.R. Grace employment by including and then removing them from the SMR analysis. Six hundred and ninety-four decedents were identified as having at least one asbestos-related cause of death and residing in our study area boundary. Statistically significant (P<0.05) 33-year SMRs, both before and after controlling for W.R. Grace employment, were found for: male and female non-malignant respiratory diseases, female COPD, and asbestosis for both sexes combined. Eighty-five men and two women were matched to employment records. We observed elevated asbestos-related mortality rates among males and females. SMR results for asbestosis were high for both sexes, even after controlling for past W.R. Grace employment. These results suggest that the general population may be experiencing asbestos-related effects, not just former vermiculite workers. Additional research is needed to determine whether SMRs remain elevated after controlling for secondary exposure, such as living with vermiculite workers.
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Affiliation(s)
- Samantha Lampert Naik
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
| | - Michael Lewin
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
| | - Rand Young
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
| | - Steve M Dearwent
- Office of Extramural Programs, National Institute for Occupational Safety and Health, Atlanta, Georgia, USA
| | - Robin Lee
- Division of Toxicology and Human Health Sciences, Agency for Toxic Substances and Disease Registry, Atlanta, Georgia, USA
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GARCÍA-GÓMEZ M, GARRIDO RURBANOS, LÓPEZ RCASTAÑEDA, MENÉNDEZ-NAVARRO A. Medical costs of asbestos-related diseases in Spain between 2004 and 2011. Ind Health 2017; 55:3-12. [PMID: 27334423 PMCID: PMC5285309 DOI: 10.2486/indhealth.2016-0021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 06/14/2016] [Indexed: 06/06/2023]
Abstract
The objective of this article was to estimate the medical costs derived from malignant ARD treatment in the Spanish National Health System (NHS) between 2004 and 2011. Estimation of direct healthcare costs was based on national primary data on the cost of specialized care for inpatients and outpatients treated at NHS hospitals and on national and regional secondary data on costs of primary healthcare and pharmaceutical prescriptions. A prevalence approach was used to estimate the overall burden of ARDs. Direct medical costs of 37,557 ARDs attended in Spanish NHS facilities in 2004-2011 were estimated at 464 million euros; specialist care accounted for 50.9% of total costs, primary healthcare 10.15%, and drug prescription 38.9%. The cost was 27.8-fold higher in males than in females. Bronchopulmonary cancers represented the greatest healthcare cost, 281 million euros. The cost of delivering healthcare to ARDs victims in Spain has a negative economic impact on the NHS due to the gross under-recognition of occupational victims under the Spanish National Insurance System.
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Abstract
Isoprostanes are a recently discovered group of prostaglandin isomers. Results of previous studies suggest that they can be used as oxidative stress markers, because in a number of cardiovascular, pulmonary and neurological diseases their levels in biological samples considerably increase. It has been found that people suffering from diabetes, obesity, homozygous familial hypercholesterolemia, moderate hypercholesterolemia, and smokers have higher levels of isoprostanes in urine. The same refers to patients with asthma, Alzheimer disease and Down syndrome. This paper reviews the results of relevant studies.
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Affiliation(s)
- Marta Czerska
- Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Toxicology and Carcinogenesis).
| | - Marek Zieliński
- Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Toxicology and Carcinogenesis).
| | - Jolanta Gromadzińska
- Nofer Institute of Occupational Medicine, Łódź, Poland (Department of Toxicology and Carcinogenesis).
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Abstract
Borel v. Fibreboard Paper Products Corporation is the 1973 landmark case that paved the way for successful litigation against the asbestos industry. Clarence Borel's granddaughter shares recollections of the reluctant man behind the court case.
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Affiliation(s)
- Linda Reinstein
- 1 Asbestos Disease Awareness Organization, Redondo Beach, CA, USA
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Abstract
BACKGROUND The generic term asbestos refers to a group of crystalline mineral silicates that occur naturally in various forms. Because of their properties of strength, heat and electrical resistance and their ability to withstand corrosion by acids and sea water, asbestos was used extensively both in the UK and worldwide. AIMS To provide a historical perspective of this ubiquitous occupational hazard, consider the key changes in UK legislation aimed at improving the management of this occupational health risk and describe the evidence from the scientific literature concerning asbestos and disease. METHODS Original articles, reviews (including reference textbooks) and scientific literature in PubMed and other principal medical science databases, 1960-2014, were searched. Publications by regulatory agencies and by governmental organizations were also considered and included where relevant. RESULTS Asbestos remains the biggest cause of cancer deaths worldwide. For malignant mesothelioma deaths alone, it is estimated that in the UK, between 2015 and 2020, the number of cases will peak at 2500 cases annually. It is not clear whether there is a safe level of asbestos fibres in air. Evidence for the efficacy of health surveillance is lacking. CONCLUSIONS Although the use of asbestos was banned in the UK in 1985 (amosite and crocidolite) and 1999 (chrysotile), it remains a significant occupational risk factor for work-related morbidity and mortality, causing both benign and malignant diseases, often with long latency. Further research is needed regarding exposure levels and health surveillance.
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Affiliation(s)
- D Sen
- Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK.
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Baur X, Frank AL, Budnik LT, Woitowitz HJ, Oliver LC, Welch LS, Landrigan P, Lemen R. Collegium Ramazzini: Comments on the 2014 Helsinki consensus report on asbestos. Am J Ind Med 2016; 59:591-4. [PMID: 27184082 DOI: 10.1002/ajim.22595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/28/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Xaver Baur
- Institute for Occupational Medicine; Charite University Medicine Berlin; Berlin Germany
| | - Arthur L. Frank
- Department of Environmental and Occupational Health; Drexel Univeristy School of Public Health; Philadelphia Pennsylvania
| | - Lygia Therese Budnik
- Institute for Occupational and Maritime Medicine (ZfAM); University Medical Center Hamburg-Eppendorf, University of Hamburg; Hamburg Germany
| | - Hans Joachim Woitowitz
- Institut und Poliklinik für Arbeits- und Sozialmedizin, Universitätsklinikum; Giessen Germany
| | | | | | - Philip Landrigan
- Community and Preventive Medicine; Mount Sinai School of Medicine; New York New York
| | - Richard Lemen
- United States Public Health Service, Environmental and Occupational Health, Rollins School of Public Health, Emory University in Atlanta; Canton Georgia
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Courtice MN, Wang X, Lin S, Yu ITS, Berman DW, Yano E. Exposure-response estimate for lung cancer and asbestosis in a predominantly chrysotile-exposed Chinese factory cohort. Am J Ind Med 2016; 59:369-78. [PMID: 26969815 DOI: 10.1002/ajim.22579] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 01/28/2016] [Indexed: 11/05/2022]
Abstract
BACKGROUND Cumulative fiber exposures, predominantly chrysotile, were estimated in a Chinese asbestos worker cohort and exposure-response relationships with lung cancer mortality and cumulative incidence of asbestosis were determined. METHODS Individual time-dependent cumulative exposures were estimated for 577 asbestos workers, followed prospectively for 37 years. Occupational history and smoking data were obtained from company records and personal interviews; vital status and causes of death were ascertained from death registries and hospital records. Hazard ratios were generated for disease outcomes, with adjustments for smoking and age. RESULTS Median cumulative fiber exposure for the cohort was 132.6 fiber-years/ml (IQR 89.3-548.4). Exposure-response relationships were demonstrated for both disease outcomes, with nearly sixfold and threefold increased risks seen at the highest exposure level for lung cancer deaths and asbestosis, respectively. CONCLUSION Evidence using quantitative exposure estimates was provided for increased risks of lung cancer mortality and development of asbestosis in a predominantly chrysotile-exposed cohort.
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Affiliation(s)
- Midori N. Courtice
- Division of Occupational and Environmental Health, JC School of Public Health and Primary Care; The Chinese University of Hong Kong; Hong Kong China
- IOM Singapore
| | - Xiaorong Wang
- Hong Kong Occupational and Environmental Health Academy; Hong Kong China
| | - Sihao Lin
- Division of Occupational and Environmental Health, JC School of Public Health and Primary Care; The Chinese University of Hong Kong; Hong Kong China
| | | | | | - Eiji Yano
- Division of Public Health; Teikyo University Graduate School of Public Health; Tokyo Japan
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Attanoos RL, Alchami FS, Pooley FD, Gibbs AR. Usual interstitial pneumonia in asbestos-exposed cohorts - concurrent idiopathic pulmonary fibrosis or atypical asbestosis? Histopathology 2016; 69:492-8. [PMID: 26864248 DOI: 10.1111/his.12951] [Citation(s) in RCA: 19] [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] [Received: 08/28/2015] [Accepted: 02/09/2016] [Indexed: 01/13/2023]
Abstract
AIMS To determine whether usual interstitial pneumonia (UIP) pattern fibrosis is seen in asbestosis. METHODS AND RESULTS The occurrence of UIP pattern fibrosis was studied in four asbestos cohorts systematically referred following postmortem to the UK Pneumoconiosis Unit, Cardiff. The combined exposed workforce comprised >25 000 persons. Over the 17-year period, 233 subjects were identified; 210 had degrees of interstitial fibrosis with a fibrotic non-specific interstitial pneumonia pattern and subpleural accentuation, and three showed UIP pattern fibrosis. All three of these cases showed grade 4 fibrosis (honeycombing) with no asbestos fibre dose-response correlation. A Poisson distribution of probability analysis indicated that the observed cases of UIP in this workforce could be wholly accounted for by the prevalence of idiopathic pulmonary fibrosis (IPF) in the population. CONCLUSIONS UIP pattern fibrosis is rarely observed in asbestos-exposed subjects, and shows no dose-response correlation with asbestos fibres on mineral analysis; this points to an alternative disease, such as IPF. The results indicate that UIP pattern fibrosis should not be regarded as genuine asbestosis, irrespective of the status of asbestos biomarkers, and this impacts upon the postmortem handling of asbestos-related deaths.
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Affiliation(s)
- Richard L Attanoos
- Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | - Fouad S Alchami
- Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
| | | | - Allen R Gibbs
- Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK
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Akira M, Morinaga K. The comparison of high-resolution computed tomography findings in asbestosis and idiopathic pulmonary fibrosis. Am J Ind Med 2016; 59:301-6. [PMID: 26901505 DOI: 10.1002/ajim.22573] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND To determine whether the HRCT findings are useful to differentiate asbestosis from idiopathic pulmonary fibrosis (IPF). METHODS We assessed HRCT scans from patients with asbestosis (n = 96) and IPF (n = 65). The frequencies and extent of parenchymal abnormalities and the frequencies of pleural changes were evaluated by consensus of two chest radiologists. RESULTS There was a significant difference between IPF and asbestosis in pleural changes. In addition, there were significant differences between IPF and asbestosis in several parenchymal abnormalities on CT, especially in the less advanced stage of both diseases. On multivariate analysis, HRCT features that distinguished asbestosis from IPF were subpleural lines at a distance of less than 5 mm from the inner chest wall, subpleural dots and parenchymal bands. CONCLUSIONS There are significant differences between IPF and asbestosis in the parenchymal and pleural abnormalities on CT.
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Affiliation(s)
- Masanori Akira
- Department of Radiology; NHO Kinki-Chuo Chest Medical Center; Sakai Osaka Japan
| | - Kenji Morinaga
- Department of the Relief for Asbestos Related Diseases; Environmental Restoration and Conservation Agency; Kawasaki Japan
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50
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Hammar SP, Abraham JL. Commentary on pathologic diagnosis of asbestosis and critique of the 2010 Asbestosis Committee of the College of American Pathologists (CAP) and Pulmonary Pathology Society's (PPS) update on the diagnostic criteria for pathologic asbestosis. Am J Ind Med 2015; 58:1034-9. [PMID: 26374489 DOI: 10.1002/ajim.22512] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 07/15/2015] [Indexed: 11/07/2022]
Abstract
We reviewed the 2010 Asbestosis Committee's update on the diagnostic criteria for pathologic asbestosis. We must respectfully disagree with many of the criteria set forth therein, especially for recognizing asbestosis at its earliest stages; with statements focusing on the number of asbestos bodies needed in order to make a pathologic diagnosis of asbestosis; and regarding the benefits and pitfalls of relying on fiber analysis for diagnostic purposes, especially where chrysotile asbestos is concerned, including the methodology used for fiber determination. This critique has become even more relevant with the 2014 Helsinki criteria publication, which adopted the 2010 CAP/PPS criteria. Based on our review of these newer criteria and our experience in this field, we find that the CAP-NIOSH 1982 criteria is still the most acceptable method for the pathologic diagnosis and grading of asbestosis, which can be described as pulmonary fibrosis caused by inhalation of asbestos fibers.
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Affiliation(s)
- Samuel P. Hammar
- Diagnostic Specialties Laboratory, Inc. P.S; 700 Lebo Blvd., Bremerton; Washington 98310
| | - Jerrold L. Abraham
- SUNY Upstate Medical University; 750 E. Adams St., Syracuse; New York 13210
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