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Gallet J, Laurent F, Paris C, Clin B, Gislard A, Thaon I, Chammings S, Gramond C, Ogier G, Ferretti G, Andujar P, Brochard P, Delva F, Pairon JC, Lacourt A. Pleural plaques and risk of lung cancer in workers formerly occupationally exposed to asbestos: extension of follow-up. Occup Environ Med 2022; 79:oemed-2022-108337. [PMID: 35922129 DOI: 10.1136/oemed-2022-108337] [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: 03/10/2022] [Accepted: 07/19/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Occupational asbestos exposure is associated with pleural plaques (PP), a benign disease often seen as a marker of past exposure to asbestos and lung cancer. The association between these two diseases has not been formally proved, the aim of this study was to evaluate this association in the asbestos-related disease cohort (ARDCO) cohort. METHODS ARDCO is a French multicentric cohort including workers formerly occupationally exposed to asbestos from 2003 to 2005. CT scan was performed to diagnose PP with double reading and lung cancer (incidence and mortality) was followed through health insurance data and death certificates. Cox models were used to estimate the association between PP and lung cancer adjusting for occupational asbestos exposure (represented by cumulative exposure index, time since first exposure and time since last exposure) and smoking status. RESULTS A total of 176 cases (of 5050 subjects) and 88 deaths (of 4938 subjects) of lung cancer were recorded. Smoking status was identified as an effect modifier. Lung cancer incidence and mortality were significantly associated with PP only in non-smokers, respectively, HR=3.13 (95% CI 1.04 to 9.35) and HR=16.83 (95% CI 1.87 to 151.24) after adjustment for age, occupational asbestos exposure and smoking status. CONCLUSIONS ARDCO study was the first to study this association considering equal asbestos exposure, and more specifically, our study is the first to test smoking as an effect modifier, so comparison with scientific literature is difficult. Our results seem to consolidate the hypothesis that PP may be an independent risk factor for lung cancer but they must be interpreted with caution.
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Affiliation(s)
- Justine Gallet
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
| | - François Laurent
- Université de Bordeaux, Faculté de Médecine, F-33000 Bordeaux, France
- Service d'imagerie médicale radiologie diagnostique et thérapeutique, CHU de Bordeaux, F-33000 Bordeaux, France
- Centre de recherche cardiothoracique de Bordeaux, INSERM U1045, F-33000 Bordeaux, France
| | - 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
| | - Bénédicte Clin
- Service de santé au travail et pathologie professionnelle, CHU Caen, F-14000 Caen, France
- Faculté de médecine, Université de Caen Normandie, F-14000 Caen, France
- U1086 « ANTICIPE », INSERM, F-14000 Caen, France
| | - Antoine Gislard
- Centre de consultations des pathologies professionnelles, CHU Rouen, F-76000 Rouen, France
| | - Isabelle Thaon
- Centre de consultations des pathologies professionnelles, CHRU Nancy, Université de Lorraine, F-54000 Nancy, France
| | - Soizick Chammings
- Institut Interuniversitaire de Médecine du Travail de Paris Ile de France, CHI Créteil, F-94010 Créteil, France
| | - Celine Gramond
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
| | - Guy Ogier
- Echelon régional du service médical, Assurance maladie, F69000 Lyon, France
| | - Gilbert Ferretti
- Service de radiologie diagnostique et thérapeutique, CHU Grenoble, F-38000 Grenoble, France
- Université de Grenoble Alpes, F-38700 La Tranche, France
| | - Pascal Andujar
- INSERM, IMRB, Université Paris Est Créteil, F-94010 Créteil, France
- Service de Pathologies Professionnelles et de l'Environnement, CHI Créteil, F-94010 Créteil, France
| | - Patrick Brochard
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
| | - Fleur Delva
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
- Service Santé Travail Environnement, CHU Bordeaux, F-33000, France
| | - Jean-Claude Pairon
- INSERM, IMRB, Université Paris Est Créteil, F-94010 Créteil, France
- Service de Pathologies Professionnelles et de l'Environnement, CHI Créteil, F-94010 Créteil, France
| | - Aude Lacourt
- Bordeaux Population Health Research Center, Equipe EPICENE, Université de Bordeaux, INSERM U1219, F-33000 Bordeaux, France
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Falaschi F, Romei C, Fiorini S, Lucchi M. Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?-a systematic review about the use of screening programs in a population of asbestos exposed workers. J Thorac Dis 2018; 10:S262-S268. [PMID: 29507794 DOI: 10.21037/jtd.2017.12.57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Malignant pleural mesothelioma (MPM) in an uncommon neoplasia with high mortality rate, mostly related to professional asbestos exposure. Clinical manifestations are not specific so that diagnosis is performed at advanced stage and screening protocols are not feasible now. On the other hand, asbestos-exposed workers have a high incidence of developing lung cancer. Low-dose computed tomography (LDCT) is a volumetric acquisition technique with high spatial resolution and a low dose exposure; it is used in many trials to detect lung tumours at an early stage in screening protocols, reducing mortality rate in smoker subjects. In recent papers, the possibly role of lung cancer screening was evaluated and recommended also in subjects exposed to asbestos. This article summarizes previous and present clinical trials validated for lung cancer screening, to discuss the possibility of early diagnosis or screening programs in a population of asbestos exposed workers by LDCT.
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Affiliation(s)
- Fabio Falaschi
- Radiology Department, 2nd Radiology Unit, Pisa University Hospital, Pisa, Italy
| | - Chiara Romei
- Radiology Department, 2nd Radiology Unit, Pisa University Hospital, Pisa, Italy
| | - Sara Fiorini
- Division of Diagnostic and Interventional Radiology, Department of Translational Research and New Technologies in Medicine, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
| | - Marco Lucchi
- Division of Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Area, University of Pisa, Pisa, Italy
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Moshkin MP, Petrovski DV, Akulov AE, Romashchenko AV, Gerlinskaya LA, Ganimedov VL, Muchnaya MI, Sadovsky AS, Koptyug IV, Savelov AA, Troitsky SY, Moshkn YM, Bukhtiyarov VI, Kolchanov NA, Sagdeev RZ, Fomin VM. Nasal aerodynamics protects brain and lung from inhaled dust in subterranean diggers, Ellobius talpinus. Proc Biol Sci 2015; 281:rspb.2014.0919. [PMID: 25143031 DOI: 10.1098/rspb.2014.0919] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Inhalation of air-dispersed sub-micrometre and nano-sized particles presents a risk factor for animal and human health. Here, we show that nasal aerodynamics plays a pivotal role in the protection of the subterranean mole vole Ellobius talpinus from an increased exposure to nano-aerosols. Quantitative simulation of particle flow has shown that their deposition on the total surface of the nasal cavity is higher in the mole vole than in a terrestrial rodent Mus musculus (mouse), but lower on the olfactory epithelium. In agreement with simulation results, we found a reduced accumulation of manganese in olfactory bulbs of mole voles in comparison with mice after the inhalation of nano-sized MnCl2 aerosols. We ruled out the possibility that this reduction is owing to a lower transportation from epithelium to brain in the mole vole as intranasal instillations of MnCl2 solution and hydrated nanoparticles of manganese oxide MnO · (H2O)x revealed similar uptake rates for both species. Together, we conclude that nasal geometry contributes to the protection of brain and lung from accumulation of air-dispersed particles in mole voles.
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Affiliation(s)
- M P Moshkin
- Institute of Cytology and Genetics, Siberian Branch of RAS, Novosibirsk 630090, Russia Department of Physiology, Novosibirsk State University, Novosibirsk 630090, Russia Department of Zoology and Animal Ecology, Tomsk State University, Tomsk 634050, Russia
| | - D V Petrovski
- Institute of Cytology and Genetics, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - A E Akulov
- Institute of Cytology and Genetics, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - A V Romashchenko
- Institute of Cytology and Genetics, Siberian Branch of RAS, Novosibirsk 630090, Russia Design Technological Institute of Digital Techniques, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - L A Gerlinskaya
- Institute of Cytology and Genetics, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - V L Ganimedov
- Khristianovich Institute of Theoretical and Applied Mechanics, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - M I Muchnaya
- Khristianovich Institute of Theoretical and Applied Mechanics, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - A S Sadovsky
- Khristianovich Institute of Theoretical and Applied Mechanics, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - I V Koptyug
- International Tomographic Center, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - A A Savelov
- International Tomographic Center, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - S Yu Troitsky
- Boreskov Institute of Catalysis, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - Y M Moshkn
- Department of Biochemistry, Erasmus Medical Center, Dr. Molewaterplein 50, Rotterdam 3015GE, The Netherlands
| | - V I Bukhtiyarov
- Boreskov Institute of Catalysis, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - N A Kolchanov
- Institute of Cytology and Genetics, Siberian Branch of RAS, Novosibirsk 630090, Russia Department of Physiology, Novosibirsk State University, Novosibirsk 630090, Russia
| | - R Z Sagdeev
- International Tomographic Center, Siberian Branch of RAS, Novosibirsk 630090, Russia
| | - V M Fomin
- Khristianovich Institute of Theoretical and Applied Mechanics, Siberian Branch of RAS, Novosibirsk 630090, Russia
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Greim H, Utell MJ, Maxim LD, Niebo R. Perspectives on refractory ceramic fiber (RCF) carcinogenicity: comparisons with other fibers. Inhal Toxicol 2014; 26:789-810. [PMID: 25264933 PMCID: PMC4245174 DOI: 10.3109/08958378.2014.953276] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In 2011, SCOEL classified RCF as a secondary genotoxic carcinogen and supported a practical threshold. Inflammation was considered the predominant manifestation of RCF toxicity. Intrapleural and intraperitoneal implantation induced mesotheliomas and sarcomas in laboratory animals. Chronic nose-only inhalation bioassays indicated that RCF exposure in rats increased the incidence of lung cancer and similar exposures resulted in mesothelioma in hamsters, but these studies may have been compromised by overload. Epidemiological studies in the US and Europe showed an association between exposure and prevalence of respiratory symptoms and pleural plaques, but no interstitial fibrosis, mesotheliomas, or increased numbers of lung tumors were observed. As the latency of asbestos induced mesotheliomas can be up to 50 years, the relationship between RCF exposure and respiratory malignances has not been fully determined. Nonetheless, it is possible to offer useful perspectives. RCF and rock wool have similar airborne fiber dimensions and biopersistence. Therefore, it is likely that these fibers have similar toxicology. Traditional rock wool has been the subject of numerous cohort and case control studies. For rock wool, IARC (2002) concluded that the epidemiological studies did not provide evidence of carcinogenicity. Based on analogies with rock wool (read across), it is reasonable to believe that increases in lung cancer or any mesotheliomas are unlikely to be found in the RCF-exposed cohort. RCF producers have developed a product stewardship program to measure and control fiber concentrations and to further understand the health status of their workers.
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Affiliation(s)
- Helmut Greim
- Institute of Molecular Pharmacology and Toxicology, Technical University , Munich , Germany
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