Suchergebnisse

The risk of malignant pleural mesothelioma
Although the use of asbestos-containing building materials was banned in the UK in 1999, this carcinogenic mineral continues to be a serious health threat. Daniel J. Murphy from the University of Glasgow tells us more. The UK currently endures the highest incidence of Mesothelioma worldwide: 45 annual fatalities/million population; 1/212 male lifetime risk (1), making asbestos the leading cause of occupation-related mortality in the UK. (2) Although the use of asbestos-containing building materials was banned in the UK in 1999, an estimated 1.5 million UK buildings are thought to contain up to six million tons of asbestos – including 94% of hospitals, 80% of schools and 74% of university buildings. (3)

The objectives of this study was to review many epidemiological risk factors on the occurrence of malignant pleural mesothelioma among occupational and non- occupational asbestos-exposed men and women mentioned in several previous studies. Asbestos exposure is a well-documented etiological factor of malignant pleural mesothelioma. The majority of cases are men and only 40% of female cases are occupational exposure. Many western and developing countries are currently suffering malignant pleural mesothelioma epidemic due to their extensive use of asbestos. Exposure to all types of asbestos can induce malignant mesothelioma, including cancer of lung, larynx, ovary, and gastrointestinal organs, particularly, colorectal region. Approximately, 125 million people expose to asbestos in their workplaces worldwide. There are several limitations of the studies on association of the asbestos exposures, both occupational and para-occupational or non-occupational causes, such as inability to take into account confounding by occupational asbestos exposure, difficulties in retrace past exposures, inadequacy of the length of follow-up, various exposure levels at different factories, and unavailability of data regarding the type of asbestos used and measurements of the air-borne asbestos dust concentration in each factory. Currently, there are many governmental asbestos-use-control organizations, including malignant pleural mesothelioma database in many countries, such as The Italian National Institute for Occupational Safety and Health, The Environmental Protection Administration of Taiwan, The French National Mesothelioma Surveillance Program, etc. to protect their people from malignant pleural mesothelioma.

Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy that most commonly affects the pleural lining of the lungs. It has a strong association with exposure to biopersistent fibers, mainly asbestos (80% of cases) and—in specific geographic regions—erionite, zeolites, ophiolites, and fluoro-edenite. Individuals with a chronic exposure to asbestos generally have a long latency with no or few symptoms. Then, when patients do become symptomatic, they present with advanced disease and a worse overall survival (about 13/15 months). The fibers from industrial production not only pose a substantial risk to workers, but also to their relatives and to the surrounding community. Modern targeted therapies that have shown benefit in other human tumors have thus far failed in MPM. Overall, MPM has been listed as orphan disease by the European Union. However, molecular high-throughput profiling is currently unveiling novel biomarkers and actionable targets. We here discuss the natural evolution, mainly focusing on the novel concept of molecular epidemiology. The application of innovative endpoints, quantification of genetic damages, and definition of genetic susceptibility are reviewed, with the ultimate goal to point out new tools for screening of exposed subject and for designing more efficient diagnostic and therapeutic strategies.

Background: Malignant pleural mesothelioma (MPM) is a rare but fatal cancer, which is largely caused by exposure to asbestos. Reliable information about the incidence of MPM prior the influence of asbestos is lacking. The nationwide regional incidence trends for MPM remain poorly characterized. We use nationwide MPM data for Denmark (DK), Finland (FI), Norway (NO) and Sweden (SE) to assess incidence, mortality and survival trends for MPM in these countries.Methods: We use the NORDCAN database for the analyses: incidence data were available from 1943 in DK, 1953 in FI and NO and 1958 in SE, through 2016. Survival data were available from 1967 through 2016. World standard population was used in age standardization.Results: The lowest incidence that we recorded for MPM was 0.02/100,000 for NO women and 0.05/100,000 for FI men in 1953-57, marking the incidence before the influence of asbestos. The highest rate of 1.9/100,000 was recorded for DK in 1997. Female incidence was much lower than male incidence. In each country, the male incidence trend for MPM culminated, first in SE around 1990. The regional incidence trends matched with earlier asbestos-related industrial activity, shipbuilding in FI and SE, cement manufacturing and shipbuilding in DK and seafaring in NO. Relative 1-year survival increased from about 20 to 50% but 5-year survival remained at or below 10%.Conclusion: In the Nordic countries, the male incidence trends for MPM climaxed and started to decrease, indicating that the prevention of exposure was beneficial. Survival in MPM has improved for both sexes but long-term survival remains dismal. ; Supported by the European Union's Horizon 2020 research and innovation programme, grant No 856620 (Chaperon), Jane and Aatos Erkko Foundation, Sigrid Juselius Foundation, Finnish Cancer Organizations, Biomedicum Helsinki Foundation, University of Helsinki, Helsinki University Central Hospital, Novo Nordisk Foundation, Päivikki and Sakari Sohlberg Foundation. Open Access funding enabled and organized by ...

Abstract

Background
Malignant pleural mesothelioma (MPM) due to environmental and familial (domestic) asbestos exposure is well recognized. However, information on cumulative asbestos dose in subjects affected by MPM is limited.


Objectives
To evaluate the residual lung asbestos fibre and asbestos body burden in women with MPM with past environmental and/or familial asbestos exposure.


Methods
We collected lung samples from autopsies regarding 15 non-occupationally asbestos-exposed MPM cases, divided in three groups: (i) familial exposure from the Fincantieri shipyards in Monfalcone (No. 7), (ii) environmental and familial asbestos exposure from the asbestos-cement plant Fibronit in Broni (No. 6), and (iii) environmental exposure from the Fibronit plant (No. 2). Asbestos body (AB) and fibres (AF) per gram of dry lung tissue were counted by optical and scanning electron microscopy, respectively, and expressed as geometric means and standard deviations (GM, GSD).


Results
GM/GSD of AB counts were 6123/9.6 (Group 1), 13 800/10.4 (Group 2), and 8400/1.1 (Group 3); GM/GSD of AF were 0.6/2.1 (Group 1), 7.9/2.1 (Group 2), and 6.0/2.3 (Group 3) million. Pleural plaques were observed in 12 cases.


Conclusions
Exclusive familial exposure to asbestos determined cumulative doses close to those observed in moderate occupational exposure circumstances. Our results also suggest that combined environmental and familial exposures may cause unexpectedly high cumulative fibre doses.