1
|
Miller A. Recognizing the pleura in asbestos-related pleuropulmonary disease: Known and new manifestations of pleural fibrosis. Am J Ind Med 2024; 67:73-80. [PMID: 38030592 DOI: 10.1002/ajim.23553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/13/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023]
Abstract
Pleural thickening (PT) is a major consequence of exposure to all fiber types of asbestos. In recent decades, it is more prevalent than parenchymal asbestosis. Its manifestations occupy a full clinical and radiographic spectrum. Six major manifestations can be identified: (a) acute pleuritis generally with effusion; (b) diffuse PT or fibrous pleuritis; (c) rounded atelectasis; (d) circumscribed PT or plaques; (e) chronic pleuritic pain; and (f) mesothelioma. Review of the experience of workers and community members in Libby, MT to asbestiform fibers in vermiculite has confirmed the appearance of these previously known benign and malignant asbestos-related diseases as well as a unique pleuropulmonary disease characterized as lamellar PT and associated with progressive decline in pulmonary function and pleuritic pain. Despite previous literature asserting that PT represents a marker for asbestos exposure without significant effect on pulmonary function and physiology, the experience of Libby amphibole (LA) disease, along with other studies, indicates that PT plays a role in declining vital capacity in those with prolonged or unusual exposures such as those arising from LA.
Collapse
Affiliation(s)
- Albert Miller
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, USA
| |
Collapse
|
2
|
Ditzig Z, Wilson CM, Salas J, Serve KM. Plasminogen Binding and Activation at the Mesothelial Cell Surface Promotes Invasion through a Collagen Matrix. Int J Mol Sci 2022; 23:ijms23115984. [PMID: 35682663 PMCID: PMC9180734 DOI: 10.3390/ijms23115984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 01/04/2023] Open
Abstract
Plasminogen (Plg) activation to the serine protease plasmin (Pla) plays a key role in regulating wound healing and fibrotic responses, particularly when bound to cell surface receptors. Our previous work suggested that mesothelial cells bind Plg at the cell surface, though no Plg receptors were described for these cells. Since mesothelial cells contribute to injury responses, including cellular differentiation to a mesenchymal-like phenotype and extracellular matrix remodeling, we hypothesized that Plg binding would promote these responses. Here, we confirm that Plg binds to both pleural and peritoneal mesothelial cells via the lysine-binding domain present in Plg, and we demonstrate the presence of three Plg receptors on the mesothelial cell surface: α-Enolase, Annexin A2, and Plg-RKT. We further show that bound-Plg is activated to Pla on the cell surface and that activation is blocked by an inhibitor of urokinase plasminogen activator or by the presence of animal-derived FBS. Lastly, we demonstrate that Plg promotes mesothelial cell invasion through a type I collagen matrix but does not promote cellular differentiation or proliferation. These data demonstrate for the first time that mesothelial cells bind and activate Plg at the cell surface and that active Pla is involved in mesothelial cell invasion without cell differentiation.
Collapse
|
3
|
Miller A, Black CB, Loewen G, Noonan CW, McNew T, Whitehouse AC, Frank AL. Case-fatality study of workers and residents with radiographic asbestos disease in Libby, Montana. Am J Ind Med 2022; 65:196-202. [PMID: 34961951 PMCID: PMC9303583 DOI: 10.1002/ajim.23320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/17/2021] [Accepted: 12/06/2021] [Indexed: 12/19/2022]
Abstract
Background Vermiculite ore from Libby, Montana contains on average 24% of a mixture of toxic and carcinogenic amphibole asbestiform fibers. These comprise primarily winchite (84%), with smaller quantities of richterite (11%) and tremolite (6%), which are together referred to as Libby amphibole (LA). Methods A total of 1883 individuals who were occupationally and/or environmentally exposed to LA and were diagnosed with asbestos‐related pleuropulmonary disease (ARPPD) following participation in communitywide screening programs supported by the Agency for Toxic Substances and Disease Registry (ATSDR) and followed up at the Center for Asbestos Related Disease (CARD) between 2000 and 2010. There were 203 deaths of patients with sufficient records and radiographs. Best clinical and radiologic evidence was used to determine the cause of death, which was compared with death certificates. Results Asbestos‐related mortality was 55% (n = 112) in this series of 203 patients. Of the 203 deaths, 34 (17%) were from asbestos‐related malignancy, 75 (37%) were from parenchymal asbestosis, often with pleural fibrosis, and 3 (1.5%) were from respiratory failure secondary to pleural thickening. Conclusions Asbestos is the leading cause of mortality following both occupational and nonoccupational exposure to LA in those with asbestos‐related disease.
Collapse
Affiliation(s)
- Albert Miller
- Icahn School of Medicine at Mount Sinai New York New York USA
| | | | | | | | - Tracy McNew
- Center for Asbestos Related Disease Libby Montana USA
| | | | - Arthur L. Frank
- Department of Environmental and Occupational Health Drexel University School of Public Health, Philadelphia Pennsylvania USA
| |
Collapse
|
4
|
Badger R, Park K, Pietrofesa RA, Christofidou-Solomidou M, Serve KM. Late Inflammation Induced by Asbestiform Fibers in Mice Is Ameliorated by a Small Molecule Synthetic Lignan. Int J Mol Sci 2021; 22:ijms222010982. [PMID: 34681644 PMCID: PMC8537122 DOI: 10.3390/ijms222010982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Exposure to Libby amphibole (LA) asbestos-like fibers is associated with increased risk of asbestosis, mesothelioma, pulmonary disease, and systemic autoimmune disease. LGM2605 is a small molecule antioxidant and free radical scavenger, with anti-inflammatory effects in various disease models. The current study aimed to determine whether the protective effects of LGM2605 persist during the late inflammatory phase post-LA exposure. Male and female C57BL/6 mice were administered daily LGM2605 (100 mg/kg) via gel cups for 3 days before and 14 days after a 200 µg LA given via intraperitoneal (i.p.) injection. Control mice were given unsupplemented gel cups and an equivalent dose of i.p. saline. On day 14 post-LA treatment, peritoneal lavage was assessed for immune cell influx, cytokine concentrations, oxidative stress biomarkers, and immunoglobulins. During the late inflammatory phase post-LA exposure, we noted an alteration in trafficking of both innate and adaptive immune cells, increased pro-inflammatory cytokine concentrations, induction of immunoglobulin isotype switching, and increased oxidized guanine species. LGM2605 countered these changes similarly among male and female mice, ameliorating late inflammation and altering immune responses in late post-LA exposure. These data support possible efficacy of LGM2605 in the prolonged treatment of LA-associated disease and other inflammatory conditions.
Collapse
Affiliation(s)
- Reagan Badger
- Department of Biological Sciences, Idaho State University, Pocatello, ID 83209, USA;
| | - Kyewon Park
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.P.); (R.A.P.); (M.C.-S.)
| | - Ralph A. Pietrofesa
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.P.); (R.A.P.); (M.C.-S.)
| | - Melpo Christofidou-Solomidou
- Division of Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (K.P.); (R.A.P.); (M.C.-S.)
| | - Kinta M. Serve
- Department of Biological Sciences, Idaho State University, Pocatello, ID 83209, USA;
- Correspondence:
| |
Collapse
|
5
|
Emmett EA. Asbestos in High-Risk Communities: Public Health Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1579. [PMID: 33562413 PMCID: PMC7915393 DOI: 10.3390/ijerph18041579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/19/2021] [Accepted: 01/31/2021] [Indexed: 02/07/2023]
Abstract
Asbestos-related diseases (ARDs)-mesothelioma, lung cancer, and asbestosis-are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.
Collapse
Affiliation(s)
- Edward A Emmett
- Occupational and Environmental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| |
Collapse
|
6
|
Miller A, Loewen GM, Szeinuk J. Follow-Up of the Libby, Montana Screening Cohort: A 17-Year Mortality Study: Likely Underestimation of Nonmalignant Asbestos-Related Disease. J Occup Environ Med 2020; 62:e233-e234. [PMID: 32398507 DOI: 10.1097/jom.0000000000001838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Albert Miller
- Division of Pulmonary Critical Care and Sleep Medicine, Department of Medicine, Mount Sinai School of Medicine, New York, The Barry Commoner Center for Health and the Environment, Queens College, CUNY, Flushing, New York
| | - Gregory M Loewen
- The Center for Asbestos Related Disease, Libby, Montana, Division of Pulmonary Medicine, Arnold Ogden Medical Center, Elmira, New York
| | - Jaime Szeinuk
- Department of Occupational Medicine, Epidemiology, and Prevention, Northwell Health System, Manhasset, New York
| |
Collapse
|
7
|
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: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Asbestos exposure is associated with a dose-dependent risk of lung cancer. The association between lung cancer and the presence of pleural plaques remains controversial. Objectives: To define the relationship between pleural plaques and lung cancer risk. Methods: Subjects were from two cohorts: 1) crocidolite mine and mill workers and Wittenoom Township residents and 2) a mixed-asbestos-fiber, mixed-occupation group. All subjects underwent annual review since 1990, chest X-ray or low-dose computed tomography scan, and outcome linkage to national cancer and mortality registry data. Cox regression, with adjustment for age (as the underlying matching time variable), was used to estimate hazard ratios (HRs) for lung cancer incidence by sex, tobacco smoking, asbestos exposure, presence of asbestosis, and pleural plaques. Measurements and Main Results: For all 4,240 subjects, mean age at follow up was 65.4 years, 3,486 (82.0%) were male, 1,315 (31.0%) had pleural plaques, and 1,353 (32.0%) had radiographic asbestosis. Overall, 3,042 (71.7%) were ever-smokers with mean tobacco exposure of 33 pack-years. In total, 200 lung cancers were recorded. Risk of lung cancer increased with cumulative exposure to cigarettes, asbestos, and presence of asbestosis. Pleural plaques did not confer any additional lung cancer risk in either cohort (cohort 1: HR, 1.03; 95% confidence interval, 0.64-1.67; P = 0.89; cohort 2: HR, 0.75; 95% confidence interval, 0.45-1.25; P = 0.28). Conclusions: The presence of pleural plaques on radiologic imaging does not confer additional increase in the risk of lung cancer. This result is consistent across two cohorts with differing asbestos fiber exposures and intensity.
Collapse
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
| |
Collapse
|
8
|
Larson TC, Williamson L, Antao VC. Follow-Up of the Libby, Montana Screening Cohort: A 17-Year Mortality Study. J Occup Environ Med 2020; 62:e1-e6. [PMID: 31714372 PMCID: PMC8157313 DOI: 10.1097/jom.0000000000001760] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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.
Collapse
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)
| | | | | |
Collapse
|
9
|
Winters CA, Kuntz SW. A Comparison of Environmental Concerns in Two Disparate Montana and Nevada Communities. ANNUAL REVIEW OF NURSING RESEARCH 2019; 38:113-130. [PMID: 32102958 DOI: 10.1891/0739-6686.38.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Asbestos refers to six fibrous minerals that occur naturally in the environment in the United States and throughout the world. Deposits may be found in soil, rocks, and deposits of other minerals such as vermiculite and talc. These naturally occurring asbestos (NOA) minerals belong to the serpentine and amphibole family of minerals. This chapter reports shared components of community-driven environmental concerns related to exposure to NOA in a rural Montana and a suburban Nevada community. The specific aim is to establish an understanding of the community and community member's primary concern(s) related to NOA in both communities. The knowledge that NOA is commonly found in areas across the United States supports the need for additional research into the health effects of environmental exposure and best-practices to reduce exposure risk while allowing communities to thrive economically.
Collapse
|
10
|
Pfau JC, McNew T, Hanley K, Swan L, Black B. Autoimmune markers for progression of Libby amphibole lamellar pleural thickening. Inhal Toxicol 2019; 31:409-419. [PMID: 31814459 DOI: 10.1080/08958378.2019.1699616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Exposure to Libby Asbestiform Amphibole (LAA) is associated with asbestos-related diseases, including mesothelioma, pulmonary carcinoma, pleural fibrosis, and systemic autoimmune diseases. The pleural fibrosis can manifest as a rapidly progressing lamellar pleural thickening (LPT), which causes thoracic pain, dyspnea, and worsening pulmonary function tests (PFT). It is refractory to treatment and frequently fatal.Objective: Because of the immune dysfunction that has been described in the LAA-exposed population and the association of pleural manifestations with the presence of autoantibodies, this study tested whether specific immunological factors were associated with progressive LPT and whether they could be used as markers of progressive disease.Methods: Subjects were placed into three study groups defined as (1) progressive LPT, (2) stable LPT, (3) no LPT. Serum samples were tested for antinuclear autoantibodies, mesothelial cell autoantibodies, anti-plasminogen antibodies, IL1 beta, and IL17; which have all been shown to be elevated in mice and/or humans exposed to LAA.Results: Group 1 had significantly higher mean values for all of the autoantibodies, but not IL1 or IL-17, compared to the control Group 3. All three autoantibody tests had high specificity but low sensitivity, but ROC area-under-the-curve values for all three antibodies were over 0.7, statistically higher than a test with no value. When all LPT subjects were combined (Progressive plus Stable), no marker had predictive value for disease.Conclusion: The data support the hypothesis that progressive LPT is associated with immunological findings that may serve as an initial screen for progressive LPT.
Collapse
Affiliation(s)
- Jean C Pfau
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - Tracy McNew
- Center for Asbestos Related Diseases, Libby, MT, USA
| | | | - Lindsay Swan
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT, USA
| | - Brad Black
- Center for Asbestos Related Diseases, Libby, MT, USA
| |
Collapse
|
11
|
Loewen G, Black B, McNew T, Miller A. Lung cancer screening in patients with Libby amphibole disease: High yield despite predominantly environmental and household exposure. Am J Ind Med 2019; 62:1112-1116. [PMID: 31535393 PMCID: PMC6899927 DOI: 10.1002/ajim.23042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 01/11/2019] [Accepted: 08/06/2019] [Indexed: 12/17/2022]
Abstract
Background Lung cancer screening with low‐dose computed tomography (CT) scanning (LDCT) is accepted as a screening tool, but its application to populations exposed to recognized occupational or environmental carcinogens is limited. We apply LDCT to a population with a predominantly nonoccupational exposure to a recognized human lung carcinogen, Libby amphibole asbestos (LA). Methods Patients in an asbestos disease clinic in Libby, Montana who were aged 50 to 84 years, greater than or equal to 20 pack‐year history of tobacco use (irrespective of quit date), and asbestos‐related pleuropulmonary disease on high‐resolution CT scan were offered free annual lung cancer screening over a 39‐month period. Results Of 2897 clinic patients, 1149 (39.7%) met eligibility criteria, and 567 (49%) were screened with 1014 low‐dose CT scans. Most screened patients had principally environmental (333 or 59%) or household exposure (145 or 25%) to LA. Seventeen primary lung cancers were identified, mostly in early stages: 10 at stage 1, two at stage 2, three at stages 3 to 4, and two at limited small‐cell cancers. The screening yield was 1.9 at baseline scan and 1.5% on the first annual scan. Conclusions Consistent with the guidelines of the National Comprehensive Cancer Network and American Association of Thoracic Surgery, LDCT for early lung cancer detection should be offered to people with significant exposure to occupational or environmental human lung carcinogens.
Collapse
Affiliation(s)
- Gregory Loewen
- Washington State University Spokane Washington
- Center for Asbestos‐Related Disease Libby Montana
| | - Brad Black
- Center for Asbestos‐Related Disease Libby Montana
| | - Tracy McNew
- Center for Asbestos‐Related Disease Libby Montana
| | - Albert Miller
- Barry Commoner Center for the Environment and Health, Queens CollegeCity University of New York Flushing New York
- Division of Pulmonary and Critical Care MedicineMount Sinai Beth Israel Medical Center New York New York
| |
Collapse
|
12
|
Libby Amphibole Disease: Pulmonary Function and CT Abnormalities in Vermiculite Miners. J Occup Environ Med 2019; 60:167-173. [PMID: 29200190 DOI: 10.1097/jom.0000000000001178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This article describes radiologic and pulmonary function findings among miners exposed to Libby amphibole. Computed tomography (CT) permits the detection of the characteristic thin, lamellar pleural thickening (LPT). METHODS Individuals who worked at the mine for a minimum of 6 months had chest CT and pulmonary function tests. RESULTS Pleural thickening was noted in 223 (87%) of the 256 miners, parenchymal abnormalities in 49 (19%). LPT, found in 151 (68%), was associated with low values of forced vital capacity and diffusion capacity and significantly lower values in all pulmonary function tests when associated with parenchymal abnormalities. CONCLUSION Eighty-seven percent of miners exposed to Libby Amphibole had pleural abnormalities on CT. LPT alone, and more so with parenchymal abnormalities, resulted in decreased pulmonary function. The importance of this easily missed LPT is demonstrated by its high frequency and significant functional effects.
Collapse
|
13
|
Macedo RF, Cerqueira EMFP, Algranti E, Silva D, Capitani EM. High frequency and severity of pleural changes in former workers exposed to anthophyllite associated with other contaminating amphibole asbestos in Brazil. Am J Ind Med 2019; 62:503-510. [PMID: 31046142 DOI: 10.1002/ajim.22977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the frequency and severity of pleuropulmonary alterations in anthophyllite-exposed former workers in Itapira, São Paulo, Brazil. The amphibole anthophyllite, a magnesium-iron silicate, had its mining, marketing, and use forbidden in Brazil in 1995. METHODS Former workers were followed from 1999 to 2011. All completed chest X-ray interpreted using the International Labour Office (ILO) classification. High-resolution computed tomography was used at the final evaluation. Spirometry assessed forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC throughout the follow-up period. Samples from the mined ore were analyzed by X-ray diffraction (XRD) and scanning electron microscopy coupled to energy dispersive spectroscopy (SEM-EDS). RESULTS XRD and SEM-EDS confirmed the presence in ore of anthophyllite at a concentration of 75%, in addition to tremolite and other amphiboles in lower concentrations. Twenty-eight subjects were evaluated. Median time of exposure was 3 years (minimum = 1; maximum = 18; interquartile interval = 1-4). Twenty cases of pleural abnormalities were diagnosed in 26 evaluated (77%). The average latency time was 25.6 ± 7.4 years. Two individuals (7.7%) showed progressive worsening of diffuse pleural thickening (DPT) and exhibited an annual FVC decrease of 85 mL and 150 mL, respectively. CONCLUSION This small sample showed a very high index of nonmalignant pleural abnormalities in anthophyllite-exposed workers compared with workers exposed to other kinds of fibers. Rapidly progressive DPT, defined by the severity of pleural compromise, was possibly secondary to the presence of other amphibole types in the inhaled dust. No significant loss of FVC was found in the studied group as a whole. No cases of asbestosis, lung carcinoma, and mesothelioma were diagnosed in this cohort.
Collapse
Affiliation(s)
- Ronaldo Ferreira Macedo
- Department of Internal Medicine, Division of PulmonologySchool of Medicine, University of CampinasSão Paulo Brazil
| | | | - Eduardo Algranti
- Division of MedicineFUNDACENTRO, Ministry of Labor São Paulo Brazil
| | - Dailto Silva
- Laboratory of Mineral Quantification, Department of Geology and Natural ResourcesInstitute of Geosciences, University of CampinasSão Paulo Brazil
| | - Eduardo Mello Capitani
- Department of Internal Medicine, Division of PulmonologySchool of Medicine, University of CampinasSão Paulo Brazil
| |
Collapse
|
14
|
|
15
|
Diegel R, Black B, Pfau JC, McNew T, Noonan C, Flores R. Case series: rheumatological manifestations attributed to exposure to Libby Asbestiform Amphiboles. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2018; 81:734-747. [PMID: 29927712 DOI: 10.1080/15287394.2018.1485124] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED An increased risk for Systemic Autoimmune Diseases (SAID) has been reported in Libby, Montana, where extensive exposures to fibrous amphiboles occurred due to mining and use of asbestos-laden vermiculite. In addition, positive antinuclear autoantibody tests are associated with exposure to Libby Asbestiform Amphiboles (LAA) in both humans and mice. Among 6603 subjects who underwent health screening at the Center for Asbestos Related Diseases (CARD, Libby MT), 13.8% were diagnosed with an autoimmune disease, with prevalence values for the most common SAID being significantly higher than expected in the United States. Among the CARD screening population, serological and clinical profiles are diverse, representing symptoms and autoantibodies reflective of systemic lupus erythematosus (SLE), scleroderma, rheumatoid arthritis, and other rheumatic syndromes, including undifferentiated connective tissue disease (UCTD). Based upon screening of medical records by physicians with rheumatology expertise, the evolving nature of rheumatological disease in these patients is often atypical, with mixed diagnostic criteria and with a 1:1 male-to-female ratio. Through the Libby Epidemiology Research Program, cases were identified that illustrate clinical autoimmune outcomes with LAA exposure. Our goal was to better characterize SAID in Libby, MT in order to improve recognition of autoimmune outcomes associated with this exposure. In view of recent discoveries of widespread exposure to fibrous minerals in several areas of the U.S. and globally, it is critical to evaluate rheumatologic manifestations in other cohorts so that screening, surveillance, and diagnostic procedures are able to detect and recognize potential autoimmune outcomes of asbestos exposure. ABBREVIATIONS ANA, antinuclear autoantibody; ARD, Asbestos-Related Diseases; ATSDR, Agency for Toxic Substances & Disease Registry; CARD, Center for Asbestos Related Diseases; CCP, Cyclic citrullinated peptide antibody; CREST, limited cutaneous form of scleroderma; CT, computed tomography; DIP, Distal Interphalangeal Joint; DLCO, Diffusing Capacity of the Lung for CO2; DMARD, Disease Modifying Anti-Rheumatic Drugs; ENA, Extractable Nuclear Antigen antibodies; FVC, Forced Vital Capacity; LAA, Libby Asbestiform Amphiboles; LERP, Libby Epidemiology Research Program; MCP, Metacarpal Phalangeal Joint; PIP, Proximal Interphalangeal Joint; PIP, rheumatoid arthritis; RV, Residual Volume; SAID, Systemic autoimmune diseases; SLE, systemic lupus erythematosus; SSc, Systemic Sclerosis; TLC, Total Lung Capacity.
Collapse
Affiliation(s)
| | - Brad Black
- b Center for Asbestos Related Diseases , Libby , MT
| | - Jean C Pfau
- c Department of Microbiology and Immunology , Montana State University , Bozeman , MT
| | - Tracy McNew
- b Center for Asbestos Related Diseases , Libby , MT
| | - Curtis Noonan
- d Department of Biomedical and Pharmaceutical Sciences , University of Montana , Missoula , MT
| | - Raja Flores
- e Icahn School of Medicine at Mt Sinai , New York NY
| |
Collapse
|
16
|
Gilmer J, Harding T, Woods L, Black B, Flores R, Pfau J. Mesothelial cell autoantibodies upregulate transcription factors associated with fibrosis. Inhal Toxicol 2017; 29:10-17. [PMID: 28183202 DOI: 10.1080/08958378.2016.1271841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Amphibole asbestos exposure is associated with the production of mesothelial cell autoantibodies (MCAA). These MCAA have been linked with pleural fibrotic disease in the asbestos exposed community of Libby, Montana, and induce collagen deposition by cultured mesothelial cells. However, the exact intracellular mechanism by which these autoantibodies cause an increase in collagen deposition remains unknown. This study sought to gain insight into the transcription factors involved in the collagen production after human mesothelial cells are exposed to MCAA. In this study, transcription factor activation profiles were generated from human mesothelial cells (Met5A) treated with serum from Libby subjects, and were compared to cells treated with serum cleared of IgG, and therefore containing no MCAA. Analysis of those profiles indicated C/EBP-beta and hypoxia inducible factor 1 alpha (HIF-1α) are significantly increased in the nucleus, indicating activation, due to MCAA exposure compared to controls. Inhibition of either of these transcription factors significantly reduced collagen 1 deposition by these cells following exposure to MCAA. These data suggest autoantibodies are directly involved in type I collagen deposition and may elucidate potential therapeutic targets for autoantibody mediated fibrosis.
Collapse
Affiliation(s)
- John Gilmer
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Tanner Harding
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Linda Woods
- a Department of Biological Sciences , Idaho State University , Pocatello , ID , USA
| | - Brad Black
- b Center for Asbestos Related Diseases , Libby , MT , USA
| | - Raja Flores
- c Department of Thoracic Surgery , Icahn School of Medicine at Mt Sinai , New York , NY , USA
| | - Jean Pfau
- d Department of Microbiology and Immunology , Montana State University , Bozeman , MT , USA
| |
Collapse
|
17
|
Ryan PH, Rice CH, Lockey JE, Black B, Burkle J, Hilbert TJ, Levin L, Brokamp C, McKay R, Wolfe C, LeMasters GK. Childhood exposure to Libby amphibole asbestos and respiratory health in young adults. ENVIRONMENTAL RESEARCH 2017; 158:470-479. [PMID: 28697481 DOI: 10.1016/j.envres.2017.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 06/22/2017] [Accepted: 07/05/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Vermiculite ore containing Libby amphibole asbestos (LAA) was mined in Libby, MT, from the 1920s-1990. Recreational and residential areas in Libby were contaminated with LAA. This objective of this study was to characterize childhood exposure to LAA and investigate its association with respiratory health during young adulthood. METHODS Young adults who resided in Libby prior to age 18 completed a health and activity questionnaire, pulmonary function testing, chest x-ray and HRCT scan. LAA exposure was estimated based on participant report of engaging in activities with potential LAA exposure. Quantitative LAA estimates for activities were derived from sampling data and literature reports. RESULTS A total of 312 participants (mean age 25.1 years) were enrolled and reported respiratory symptoms in the past 12 months including pleuritic chest pain (23%), regular cough (17%), shortness of breath (18%), and wheezing or whistling in the chest (18%). Cumulative LAA exposure was significantly associated with shortness of breath (aOR = 1.12, 95% CI 1.01-1.25 per doubling of exposure). Engaging in recreational activities near Rainy Creek Road (near the former mine site) and the number of instances heating vermiculite ore to make it expand or pop were also significantly associated with respiratory symptoms. LAA exposure was not associated with pulmonary function or pleural or interstitial changes on either chest x-ray or HRCT. CONCLUSIONS Pleural or interstitial changes on x-ray or HRCT were not observed among this cohort of young adults. However, childhood exposure to LAA was significantly associated with respiratory symptoms during young adulthood. Pleuritic chest pain, in particular, has been identified as an early symptom associated with LAA exposure and therefore warrants continued follow-up given findings of progressive disease in other LAA exposed populations.
Collapse
Affiliation(s)
- Patrick H Ryan
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA.
| | - Carol H Rice
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - James E Lockey
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Brad Black
- Center for Asbestos-Related Disease, Libby, MT, USA
| | - Jeff Burkle
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Timothy J Hilbert
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Linda Levin
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Cole Brokamp
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Roy McKay
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Christopher Wolfe
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Grace K LeMasters
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA.
| |
Collapse
|
18
|
Pfau JC, Buck B, Metcalf RV, Kaupish Z, Stair C, Rodriguez M, Keil DE. Comparative health effects in mice of Libby amphibole asbestos and a fibrous amphibole from Arizona. Toxicol Appl Pharmacol 2017; 334:24-34. [PMID: 28870655 DOI: 10.1016/j.taap.2017.08.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/26/2017] [Accepted: 08/31/2017] [Indexed: 11/27/2022]
Abstract
This project developed from studies demonstrating that Libby Amphibole Asbestos (LAA) causes a non-typical set of health outcomes not generally reported for asbestos, including systemic autoimmunity and an unusual and devastating lamellar pleural thickening that progresses to severe pulmonary dysfunction and death. Further, mineral fiber mixtures with some similarities to LAA have recently been discovered in southern Nevada and northwestern Arizona, where the material exists in extensive recreational areas and is present in yards, roads, parking lots and school yards. The objective was to compare the health outcomes in mice exposed to either LAA or the fibrous amphiboles collected in Arizona at the Lake Mead National Recreational Area at very low doses to represent environmental exposures. In this study, the fibrous amphibole asbestos sample from Arizona (AzA) is composed of winchite (69%), actinolite (22%), and non-amphibole minerals (9%) and has a mean aspect ratio of 16.7±0.9. Fibrous amphibole asbestos from Libby (LAA) is composed of winchite (70%), richterite (9%), tremolite (5%), and non-amphibole minerals (16%) with a mean aspect ratio of 8.4±0.7. C57BL/6 mice were exposed by oropharyngeal aspiration to fiber suspensions at a very low dose of 3μg/mouse. After seven months, both LAA- and AzA-exposed mice had indices of chronic immune dysfunction related to a TH17 cytokine profile, with B cell activation, autoantibody production and proteinuria, suggesting kidney involvement. In addition, both exposures led to significant lung and pleural fibrosis. These data suggest that there is risk of pulmonary disease and autoimmune outcomes with environmental exposure to amphibole asbestos, and that this is not limited to Libby, Montana.
Collapse
Affiliation(s)
- Jean C Pfau
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA.
| | - Brenda Buck
- Department of Geoscience, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
| | - Rodney V Metcalf
- Department of Geoscience, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
| | - Zoie Kaupish
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Caleb Stair
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Maria Rodriguez
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA
| | - Deborah E Keil
- Department of Microbiology and Immunology, Montana State University, Bozeman, MT 59717, USA.
| |
Collapse
|
19
|
Hanson R, Evilia C, Gilmer J, Woods L, Black B, Flores R, Pfau JC. Libby amphibole-induced mesothelial cell autoantibodies bind to surface plasminogen and alter collagen matrix remodeling. Physiol Rep 2017; 4:4/15/e12881. [PMID: 27519611 PMCID: PMC4985547 DOI: 10.14814/phy2.12881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 07/13/2016] [Indexed: 01/01/2023] Open
Abstract
Lamellar pleural thickening (LPT) is a fibrotic disease induced by exposure to Libby amphibole (LA) asbestos that causes widespread scarring around the lung, resulting in deterioration of pulmonary function. Investigating the effects of autoantibodies to mesothelial cells (MCAA) present in the study populations has been a major part of the effort to understand the mechanism of pathogenesis. It has been shown in vitro that human mesothelial cells (Met5a) exposed to MCAA increase collagen deposition into the extracellular matrix (ECM). In this study, we sought to further elucidate how MCAA drive increased collagen deposition by identifying the protein targets bound by MCAA on the cellular surface using biotinylation to label and isolate surface proteins. Isolated surface protein fractions were identified as containing MCAA targets using ELISA. The fractions that demonstrated binding by MCAA were then analyzed by tandem mass spectrometry (MS/MS) and MASCOT analysis. The most promising result from the MASCOT analysis, plasminogen (PLG), was tested for MCAA binding using purified human PLG in an ELISA. We report that serum containing MCAA bound at an optical density (OD) 3 times greater than that of controls, and LA‐exposed subjects had a high frequency of positive tests for anti‐PLG autoantibodies. This work implicates the involvement of the plasminogen/plasmin system in the mechanism of excess collagen deposition in Met5a cells exposed to MCAA. Elucidating this mechanism could contribute to the understanding of LPT.
Collapse
Affiliation(s)
- Robert Hanson
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho
| | - Caryn Evilia
- Department of Chemistry, Idaho State University, Pocatello, Idaho
| | - John Gilmer
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho
| | - Linda Woods
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho
| | - Brad Black
- Center for Asbestos Related Diseases, Libby, Montana
| | - Raja Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mt Sinai, New York City, New York
| | - Jean C Pfau
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho Department of Thoracic Surgery, Icahn School of Medicine at Mt Sinai, New York City, New York
| |
Collapse
|
20
|
Szeinuk J, Noonan CW, Henschke CI, Pfau J, Black B, Miller A, Yankelevitz DF, Liang M, Liu Y, Yip R, Linker L, McNew T, Flores RM. Pulmonary abnormalities as a result of exposure to Libby amphibole during childhood and adolescence-The Pre-Adult Latency Study (PALS). Am J Ind Med 2017; 60:20-34. [PMID: 27859510 DOI: 10.1002/ajim.22674] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND The purpose of Pre-Adult Latency Study was to evaluate lung findings among adults who had been environmentally exposed to Libby Amphibole only during childhood and adolescence. METHODS Recruitment was restricted to volunteers who attended primary and/or secondary school, lived in Libby, MT, prior to age 23 years for males and 21 years for females and subsequently left the area. Subjects completed exposure and respiratory questionnaires, underwent pulmonary function tests (PFTs), and chest CT scans. A Pleural Score was calculated for degree and extent of pleural thickening. Logistic regression and multivariate linear regression were used. RESULTS Of the 219 who met inclusion criteria, 198 participated. Pleural thickening was found in 96 (48%) of 198 participants. In almost half of these, it was of the lamellar type, not generally seen in exposure to other asbestos. Environmental Libby amphibole exposure was associated with pleural thickening, and the likelihood of pleural thickening increased with the number of years lived in the area. An inverse association between Pleural Score and PFT was found, which remained significant for FVC and DLco after additional sensitivity analyses. CONCLUSIONS Cumulative environmental exposure was associated with risk of pleural thickening. Among this cohort, quantitative measures of pleural thickening were associated with decreased PFT. Am. J. Ind. Med. 60:20-34, 2017. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Jaime Szeinuk
- Department of Occupational Medicine; Epidemiology and Prevention; North Shore-LIJ Health System; New Hyde Park New York
| | - Curtis W. Noonan
- Center for Environmental Sciences; University of Montana; Missoula Montana
| | | | - Jean Pfau
- Montana State University; Bozeman Montana
| | - Brad Black
- Center for Asbestos Related Disease; Libby Montana
| | - Albert Miller
- Center for Environmental Sciences; University of Montana; Missoula Montana
| | | | - Mingzhu Liang
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Ying Liu
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Rowena Yip
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Laura Linker
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| | - Tracy McNew
- Center for Asbestos Related Disease; Libby Montana
| | - Raja M. Flores
- Mount Sinai Health System; Icahn School of Medicine; New York New York
| |
Collapse
|
21
|
Gilmer J, Serve K, Davis C, Anthony M, Hanson R, Harding T, Pfau JC. Libby amphibole-induced mesothelial cell autoantibodies promote collagen deposition in mice. Am J Physiol Lung Cell Mol Physiol 2016; 310:L1071-7. [PMID: 27106292 DOI: 10.1152/ajplung.00462.2015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 04/17/2016] [Indexed: 11/22/2022] Open
Abstract
Libby amphibole (LA) causes a unique progressive lamellar pleural fibrosis (LPF) that is associated with pulmonary function decline. Pleural fibrosis among the LA-exposed population of Libby, MT, has been associated with the production of anti-mesothelial cell autoantibodies (MCAA), which induce collagen production from cultured human mesothelial cells. We hypothesized that the progressive nature of LPF could be at least partially attributed to an autoimmune process and sought to demonstrate that LA-induced MCAA trigger collagen deposition in vivo. C57BL/6 mice were exposed to LA for 7 mo, and serum was tested for MCAA by cell-based ELISA on primary mouse mesothelial cells. When treated in vitro with serum from mice exposed to LA, mesothelial cells upregulated collagen matrix production. This effect was lost when the serum was cleared of IgG using protein G beads, implicating IgG autoantibodies. Using the peritoneal cavity as a surrogate for the pleural cavity, groups of naïve (non-asbestos-exposed) mice were injected intraperitoneally with 1) control serum, 2) one dose of serum from LA-exposed mice (LA serum), 3) two doses of LA serum, or 4) two doses of LA serum cleared of IgG. After 1 mo, analysis of collagen in peritoneal walls using two-photon confocal microscopy (SHG analysis) and a hydroxyproline assay demonstrated significant increases in collagen by LA serum but not control or cleared serum. These data support the hypothesis that MCAA in LA-exposed mice induce fibrotic responses in vivo, demonstrating that an autoimmune component may be contributing to the progressive pleural fibrosis seen in LA-exposed patients.
Collapse
Affiliation(s)
- John Gilmer
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Kinta Serve
- Department of Natural Sciences, Mars Hill University, Mars Hill, North Carolina
| | - Chad Davis
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Marti Anthony
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Robert Hanson
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Tanner Harding
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| | - Jean C Pfau
- Department of Biological Sciences, Idaho State University, Pocatello, Idaho; and
| |
Collapse
|
22
|
Carlin DJ, Larson TC, Pfau JC, Gavett SH, Shukla A, Miller A, Hines R. Current Research and Opportunities to Address Environmental Asbestos Exposures. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:A194-7. [PMID: 26230287 PMCID: PMC4529018 DOI: 10.1289/ehp.1409662] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Asbestos-related diseases continue to result in approximately 120,000 deaths every year in the United States and worldwide. Although extensive research has been conducted on health effects of occupational exposures to asbestos, many issues related to environmental asbestos exposures remain unresolved. For example, environmental asbestos exposures associated with a former mine in Libby, Montana, have resulted in high rates of nonoccupational asbestos-related disease. Additionally, other areas with naturally occurring asbestos deposits near communities in the United States and overseas are undergoing investigations to assess exposures and potential health risks. Some of the latest public health, epidemiological, and basic research findings were presented at a workshop on asbestos at the 2014 annual meeting of the Society of Toxicology in Phoenix, Arizona. The following focus areas were discussed: a) mechanisms resulting in fibrosis and/or tumor development; b) relative toxicity of different forms of asbestos and other hazardous elongated mineral particles (EMPs); c) proper dose metrics (e.g., mass, fiber number, or surface area of fibers) when interpreting asbestos toxicity; d) asbestos exposure to susceptible populations; and e) using toxicological findings for risk assessment and remediation efforts. The workshop also featured asbestos research supported by the National Institute of Environmental Health Sciences, the Agency for Toxic Substances and Disease Registry, and the U.S. Environmental Protection Agency. Better protection of individuals from asbestos-related health effects will require stimulation of new multidisciplinary research to further our understanding of what constitutes hazardous exposures and risk factors associated with toxicity of asbestos and other hazardous EMPs (e.g., nanomaterials).
Collapse
Affiliation(s)
- Danielle J Carlin
- Division of Extramural Research and Training, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Research Triangle Park, North Carolina, USA
| | | | | | | | | | | | | |
Collapse
|
23
|
Clark KA, Flynn JJ, Goodman JE, Zu K, Karmaus WJJ, Mohr LC. Response. Chest 2015; 147:e128-e129. [PMID: 25732472 DOI: 10.1378/chest.14-2635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Kathleen A Clark
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Julie E Goodman
- Gradient Corporation, Cambridge, MA; Department of Epidemiology, Harvard School of Public Health, Cambridge, MA
| | - Ke Zu
- Gradient Corporation, Cambridge, MA
| | - Wilfried J J Karmaus
- Division of Epidemiology, Biostatistics and Environmental Health, School of Public Health, University of Memphis, Memphis, TN
| | - Lawrence C Mohr
- Department of Medicine, the Department of Public Health Sciences, and the Environmental Biosciences Program, Medical University of South Carolina, Charleston, SC.
| |
Collapse
|
24
|
Miller A. Pleural Plaques and Their Effect on Lung Function. Chest 2015; 147:e127-e128. [DOI: 10.1378/chest.14-2378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
|
25
|
Miller A. "Not your grandfather's pleural disease": rapid progression, ventilatory impairment, and chronic pleuritic pain from Libby vermiculite/amphibole. Am J Ind Med 2014; 57:1195-6. [PMID: 25311931 DOI: 10.1002/ajim.22370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Albert Miller
- Mount Sinai School of Medicine; New York New York
- Center for the Biology of Natural Systems, Queens College; City University of New York; New York New York
- Pulmonary Critical Care Division, Department of Medicine; Mount Sinai Beth Israel Medical Center; New York NY
| |
Collapse
|