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PubMed1975

Topographic distribution of asbestos fibres in human lung in relation to occupational and non-occupational exposure.

A topographic study of asbestos fibre content of lung and pleura of diversely exposed cases has been carried out. For heavily exposed cases with lung fibrosis, this study has stressed the distinctive behaviour of the peripheral lower lobe in the retention of asbestos fibres in the lung. In these areas were found the smallest asbestos concentrations but the largest fibres. For cases without lung fibrosis, the results clearly demonstrated an accumulation of asbestos fibres, especially of chrysotile type, in peripheral areas. These findings are to be related to the incidence of pleural mesothelioma associated with moderate or low exposure. The small variation of fibre concentration in the pleural plaques of diversely exposed subjects is pointed out.

Adult↗

PubMed2002

Respiratory conditions in Malaysian asbestos cement workers.

A cross-sectional study was conducted to determine the prevalence and type of respiratory conditions including asbestos-related diseases among Malaysian asbestos cement workers. The study population consisted of 1164 workers who had undergone medical surveillance from 1995 to 1997, including full history, physical examination, chest radiography and spirometry. More than half the male workers were smokers or ex-smokers, with smokers having more respiratory symptoms and signs, and reduced FEV1 compared with non smokers. The five most common respiratory conditions diagnosed were bronchial asthma, chronic bronchitis, pulmonary tuberculosis, upper respiratory tract infections and allergic rhinitis. On follow-up, there were also two cases of asbestosis and one case of bronchial carcinoma. The asbestosis cases were probably related to heavy occupational exposure to asbestos fibres in the past, before governmental regulations were gazetted in 1986. Further follow-up is essential for continued monitoring of the health status of asbestos workers.

Adolescent↗

PubMed2002

Interphase fish analysis of cell cycle genes in asbestos-treated human mesothelial cells (HMC), SV40-transformed HMC (MeT-5A) and mesothelioma cells (COLO).

The epidemiologic association between asbestos exposure and human malignant mesothelioma is well established. However, the molecular mechanisms linking asbestos exposure of humans and the subsequent mesothelioma formation is not well understood. The most frequent genetic changes found so far in human malignant mesothelioma (HMM) are deletions and point mutations in the tumor suppressor genes p16INK4a and NF2. Whereas homozygous deletions appear to be the predominant mechanism leading to p16/CDKN2A inactivation, inactivating point mutations coupled with allelic loss mainly occur at the NF2 locus. In the present study, asbestos-treated human mesothelial cells (HMC), SV40-transformed human mesothelial cells (MeT-5A) and a human mesothelioma cell line (COLO) were investigated for genetic changes of cell cycle genes (cyclin D1, p16INK4a, RB1, CDK2) using multicolor fluorescence in situ hybridization (mFISH) in interphase cells. The results show that cyclin D1 is unaffected in all investigated cells. The p16INK4a gene locus was shown to be mutated in COLO cells but not in HMC. After labeling of CDK2 and RB1, hemizygous loss of one allele of each gene was observed in asbestos-treated HMC whereas gene amplification of these genes was detectable in MeT-5A and COLO cells. Our data indicate that disarrangement of the RB1 dependent pathway seems to be involved in mesothelioma formation.

Asbestos↗

PubMed2003

[A case of triple malignancies (gastric cancer, lung cancer and malignant pleural mesothelioma) after asbestos exposure].

This case study centers on a seventy-eight-year-old man with triple malignancies, namely, gastric cancer, lung cancer and malignant pleural mesothelioma, all of which developed at different times. The histological types were adenocarcinoma of the stomach, squamous cell carcinoma of the lung and sarcomatous malignant pleural mesothelioma. Gastric cancer was treated by endoscopic mucosal resection 2 years ago. The patient presented with a chief complaint of dyspnea, and right pleural effusion was found on chest radiography. The right-side effusion disappeared spontaneously, but a small mass on the left side was diagnosed as lung cancer, and so left inferior lobe resection was performed. Malignant pleural mesothelioma appeared after one year of pleural effusion and the patient died of mesothelioma one year after diagnosis. At autopsy, the gastric cancer and lung cancer had not relapsed and malignant pleural mesothelioma had metastasized to the lung, liver, adrenal gland and small intestine. He was a sailor by profession and it was obvious that he had been exposed to asbestos, because 538 asbestos bodies per 5 g of wet lung tissue were detected. His advanced age was one of the risk factors for the multiple malignancies, and the asbestos exposure was considered to have compounded these hazards to cause the triple malignancies. It is well known that lung cancer and malignant mesothelioma are induced by asbestos exposure, but multiple cancers including lung cancer and malignant mesothelioma are extremely rare.

Adenocarcinoma↗

PubMedDate not supplied

Immunocytological and mineralogical study of bronchoalveolar lavage in a group of subjects exposed to asbestos.

Twenty-five subjects (24 males and 1 female, mean age 57.4 years) who have been exposed to asbestos underwent chest radiography, high resolution computed tomography (HRCT) of the chest, lung function tests and bronchoalveolar lavage (BAL) for evaluation of cell components (total cell count, percentages of macrophages, lymphocytes, neutrophil and eosinophil granulocytes and the lymphocyte subpopulations CD3+, CD4+, CD8+, CD19+ and HLADR+), soluble factors (IL-8, IL-10, IL-12 and MCP-1 in the supernatant) and concentration of asbestos fibre. The subjects were subdivided according to the degree of their exposure, to the concentration of asbestos fibres in the BAL and to chest X-ray findings using the I.L.O. classification (0/0pl, 0/1 and 1/0 and above). According to the exposure index, we showed statistically significant (p < 0.05) higher lymphocytes percentage in the BAL of subjects with moderate exposure and significantly higher levels of IL-10 (p < 0.05) in the supernatant of subjects showing an absence of asbestos fibres in their BAL. In the group of subjects with a 0/0 and 0/1 radiological profile, the cellular component of the BAL was characterised by a higher percentage of lymphocytes (p < 0.02), whereas a trend toward an increase in the number of neutrophils was noted in subjects with obvious pulmonary fibrosis. The percentage of neutrophils was inversely correlated with some parameters of respiratory function such as vital capacity (p = 0.03) and the partial pressure of oxygen (p = 0.05) in the blood. Investigating the cytokines in the supernatant of the BAL, we found a trend toward lower concentration of IL-10 in the group showing the worst radiological picture (I.L.O. > or = 1/0), and a statistically significant negative correlation between this cytokine and pO2 (p = 0.048). Concerning the other cytokines and chemokines studied (MCP-1, IL-8 and IL-12), no significant differences were found to be associated with the radiological profiles. There were, however, positive correlations between the concentration of IL-8 and the percentage of neutrophils (p = 0.038) and between the concentration of MCP-1 and the percentage of lymphocytes (p = 0.006). A negative relationship between the concentrations of IL-12 and IL-10 has been also observed (p = 0.028). This research allows us to hypothesise that IL-10 may have a pathogenetic role in the evolution of asbestosis.

Adult↗

PubMedDate not supplied

[Surveillance of malignant mesothelioma cases and definition of asbestos exposure: 1997 ReNaM data].

The main objectives of the National Mesothelioma Register (ReNaM), set up by the National Institute for Prevention and Occupational Safety (ISPESL), are: (a) the estimate of malignant mesothelioma incidence in Italy, (b) the definition of exposure to asbestos, (c) the identification of unknown contamination sources, still present on the territory. Cased diagnosed in 1997 in Piedmont, Liguria, Emilia-Romagna, Tuscany and Apulia are reported, regions with more than 17 million inhabitants (30% of national population). ReNaM has facilitated the identification of mesothelioma cases and the description of the previous asbestos exposure in a large geographical area of the country, even though in some regions the definition of exposure to asbestos is not complete. 429 cases are recorded, of which 326 (76%) have been defined as definite malignant mesothelioma. The standardized annual incidence rate just for pleural definite mesothelioma is 1.51 x 100,000 inhabitants (2.26 for males and 0.79 for females). The exposure to asbestos has been defined for 198 mesothelioma cases with histological diagnosis: 125 cases (63%) refer to professional exposure, 10 (5%) to environmental exposure, 5 (2.5%) to domestic exposure. The adoption of a well-constructed national database, the up-date of guidelines and the recent starting up of ReNaM in other italian regions (Lombardy, Veneto, Marche, Campania, Basilicata and Sicily) will shortly lead to obtaining a major representativeness of the Italian situation.

Aged↗

PubMed2002

Asbestos an important insulating material; its varieties, properties and safe uses.

Asbestos, a naturally occurring mineral, has been widely utilized in industries producing cement, pipes, roofing sheet and insulating materials. In spite of sharp decrease in the production of asbestos worldwide, the use of asbestos in various products is increasing in the developing countries of Asian-African region, due to their magical properties of commercial importance. This paper describes the various physical & chemical properties, health hazards of the asbestos fibre and its utilization in various product development.

Asbestos↗

PubMedDate not supplied

Haemorrhagic pericardial effusion in an asbestos worker.

BACKGROUND: Occupational exposure to asbestos may cause pleural and lung disorders and, less frequently, diseases of the peritoneum and pericardium. An exceedingly small number of cases of benign pericardial effusion have been described so far in the medical literature. OBJECTIVES: To report a rare case of haemorrhagic pericardial effusion caused by occupational asbestos exposure in a patient with pre-existent aortic regurgitation, bilateral pleural plaques and no signs of interstitial lung involvement due to asbestosis. METHODS: A thorough clinical and instrumental evaluation (laboratory tests, tuberculin skin test, chest X-rays, transthoracic and transesophageal echocardiography, contrast coronary and aortic angiography, a histological examination of pericardial and pleural surgical specimens) was performed to examine all the known causes of pericardial effusion. RESULTS: The tests performed did not demonstrate any specific cause of pericardial effusion. Surgical assessment three months later, during an aortic valve replacement, showed no signs of aortic dissection or intraparietal hematoma. A nine-year follow up did not reveal any reoccurrence of pericardial effusion. CONCLUSIONS: Asbestos related pericardial effusion is rarely described in the medical literature but must be considered in patients with previous occupational asbestos exposure. There are no specific clinical or pathological aspects indicative of this etiology and the diagnosis remains one of exclusion. A thorough occupational history should be obtained in patients with pericardial effusion of unknown etiology.

Aortic Valve Insufficiency↗

PubMed2003

[Constrictive pericarditis due to asbestos exposure].

INTRODUCTION: Constrictive pericarditis is a rare complication of asbestos exposure and few cases have been reported in the literature. CASE REPORT: We report two cases of constrictive pericarditis in subjects previously exposed to asbestos. The first case, a 62 years old man, had occupational asbestos exposure whilst working for seven years in an electric plant 23 years before the diagnosis. The second case, a 76 years old man, had worked 21 years as a lagger up until 20 years before. The initial presentation in both cases was of sub-acute right heart failure. Both underwent pericardectomy which revealed pericardial thickening due to collagen fibrosis. Both patients died, one and five years respectively after surgery. Eight other cases of pericardial effusion and/or thickening, some with calcification, have been reported in association with previous asbestos exposure. Most of these cases had coexisting pleural lesions. CONCLUSIONS: As the prognosis is guarded (three of the eight reported cases died), making an early diagnosis is desirable.

Aged↗

PubMed1992

[Biodemographic parameters as indicators of genetic adaptation to harmful occupational factors (e.g. asbestos)].

A total of 129 women working at asbestos-concentrating factories and asbestos articles manufacture plant, including 87 of them facing asbestosis and 42 exposed to asbestos without asbestosis were examined. There was no marked shifts in the reproductive function and pregnancy results of women facing asbestosis and those exposed to asbestos without asbestosis. Women facing asbestosis has infant mortality higher than other women. Parameters of potential selection (index Crow) in the studied population showed an unfavourable demographic situation in women facing asbestosis. Analysis of biodemographic data helped to suggest the possibility of genetic predisposition to asbestosis.

Abortion, Spontaneous↗

PubMedDate not supplied

[Benign pleuropathies due to asbestos: their clinical prognostic significance and the medicolegal aspects].

Benign pleural disease due to asbestos, which at present is frequently the sole lesion in asbestos-exposed subjects due to the fall in full-blown asbestosis, consists of a series of phenomena of increasing severity, from minor manifestations without functional impairment, to manifestations associated with proven functional damage due directly to or as a consequence of as yet undiagnosed parenchymal asbestosis. In assessing individual cases from a medico-legal viewpoint, benign pleural disease must always be considered as a morbid manifestation of asbestos exposure. The implications for prognosis and insurance purposes must, however, take account of various factors such as internal dose, whenever detectable, time elapsed since beginning of exposure, presence and extent of functional damage. The tendency of assessing pleural disease merely as an indicator of past asbestos exposure should in any case be abandoned.

Asbestos↗

PubMed2004

[Asbestos-related occupational cancers].

Due to its remarkable physical properties asbestos has been widely used in the industry. It is estimated that 25% of present French retired workers have been occupationally exposed to asbestos. A causal relationship between asbestos exposure and respiratory cancers is established since 1955 for lung cancer, and since 1960 for pleural mesothelioma. A causal relationship is also demonstrated for peritoneal and pericardic mesotheliomas, and strongly suspected for laryngeal cancers. It is estimated that occupational exposure to asbestos could be responsible for 5 to 20% of lung cancers and 80 to 90% of pleural mesothelioma, in men, in industrialized countries. The risk of cancer is positively correlated to cumulated exposure. No threshold has been demonstrated below which there is no increased risk of respiratory cancer.

Asbestos↗

PubMedDate not supplied

Development of malignant mesothelioma during treatment for prolymphocytic leukemia: is asbestos or simian virus 40 a link?

A patient with a history of heavy asbestos exposure presented with B-prolymphocytic leukemia/lymphoma (B-PLL). Soon after, he developed rapidly progressing malignant peritoneal mesothelioma. The concurrent development of both relatively uncommon diseases raised the possibility that a common causative factor might exist. Since asbestos, simian virus 40 (SV40), or both have been associated with lymphoproliferative disease and mesothelioma, we investigated both possible links in our patient. Imaging studies provided evidence for asbestos exposure because bilateral pleural plaques were identified. Tissues from bone marrow (involved with B-PLL) and from a peritoneal nodule (involved with mesothelioma) were examined for SV40 DNA using polymerase chain reaction (PCR): no SV40 DNA was detected. We conclude that asbestos remains the sole possible connection to both malignancies in this patient. It seems possible that fludarabine, an immunosuppressive chemotherapy, accelerated the occurrence and progression of malignant mesothelioma during the therapy for his B-PLL.

Aged↗

PubMed1992

Asbestos and the histogenesis of lung carcinoma.

Individuals exposed to asbestos develop and die of bronchogenic carcinoma at rates well above individuals not exposed, but there is disagreement as to what factors other than the asbestos may be important in the histogenesis of the carcinoma. This report discusses the various theories as to how and why asbestos, cigarette smoke, asbestosis, and pleural disease may be involved in the development of the carcinoma. The authors conclude that other disease processes may mark individuals particularly likely to develop carcinoma of the lung, but that asbestos fibers have an independent role in the histogenesis of carcinoma of the lung.

Asbestos↗

PubMedDate not supplied

[Poliomyelitis vaccine contaminated with SV40 and prior exposure to asbestos: cognitive study in a group of car repair workers].

Pleural and pulmonary malignancies are usually associated with previous asbestos exposure and the presence of simian virus 40 (SV40) has been detected in these neoplasms. Our study aimed to investigate the health situation among mechanics servicing buses, ex-exposed to asbestos, who received polio vaccines contaminated by SV 40. We conducted a descriptive study and so we recruited, on the basis of birth date and duration in the current job, 39 mechanics, born since 1950 until 1965, with length of service above 15 years. Of all subjects a clinical examination, a lung function test and a chest radiograph were obtained. More than 30% of sample showed pharynx and larynx clinical alterations and radiological signs of previous exposure to asbestos. We didn't find pleural or pulmonary malignancies; besides 4 doubtful neoplasms required further investigations. Although exiguity of sample, these findings provide a lack of mesothelioma and lung cancer among mechanics, previously exposed to asbestos and infected by SV40.

Adult↗

PubMedDate not supplied

Medical surveillance of workers previously exposed to asbestos.

According to current Italian law health surveillance of workers exposed to asbestos in the past must be maintained even after cessation of asbestos exposure (D.Lgs. 277/91). The law, however, makes no reference to timescales or time limits for clinical monitoring, nor to who is responsible. The main aims of health surveillance of individuals formerly exposed to asbestos can be summarized as follows: early diagnosis of the principal diseases associated with asbestos; counselling for workers; work-related disease certification; epidemiological studies. Medical check-ups entail a complete personal and work history, Chest X-Ray, respiratory function tests, TLCO. In all cases the worker must undergo a LDCT. We propose two new possible biological markers for the health surveillance of past-exposed patients: serum mesothelin and osteopontin.

Asbestos↗

PubMed1991

Macrophage activity in asbestos related diseases.

This paper indicates some immunological aspects of asbestos-related diseases and especially concerns the activity of macrophages--cells of immunological surveillance. Macrophages establish a very important population of cells which initiate or suppress specific immune response; they are responsible for effective T-cell activation, express antitumour activity. The process of lung fibrosis generated by the inhalation and deposition of asbestos fibres is also closely related to macrophage activity. An open question which is still to be resolved concerns asbestos-induced fibrosis; it may arise as a consequence of tissue injury and repair or change collagen synthesis. Another question is, to what extent macrophages may be protective cells and when they become undesirable? Since their overstimulation or damage in the case of chronic exposure to asbestos dust may be the reason of the increased release of inflammatory mediators, reactive oxygen intermediates which may in turn cause tissue injury, fibrosis or, in final effect, cancer. If so, we could then say that lung response (expressed by e.g. alveolar macrophage activity) to chemical insult may cause further damage to this tissue.

Asbestos↗

PubMedDate not supplied

[Dispersion of asbestos fibers and artificial mineral fibers (MMMF) inside truck cabs: a possible exposure of truck drivers].

Tests on samples of braided asbestos cord used in truck exhaust systems revealed a constant presence of chrysotile. Amosite fibres were also observed in many of the samples. Following a case of asbestosis in a truck driver, it was assumed that asbestos fibres could reach the driver's cab through the openings of the ventilation and heating system and also through the spaces between the bonnet and the floor of the driver's cab. Dust samples taken in the driver's cab of 10 (no.) trucks revealed the presence of asbestos fibres in 3 cases; MMMF were present in 7 cases, very likely originating from the noise insulation panelling. It is therefore suggested that there is a possible risk for truck drivers of exposure to asbestos and MMMF fibres dispersed inside the driver's cab.

Asbestos↗