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Metintas M, Ak G, Metintas S. Environmental asbestos exposure and lung cancer. Lung Cancer 2024; 194:107850. [PMID: 38945005 DOI: 10.1016/j.lungcan.2024.107850] [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: 11/16/2023] [Revised: 05/21/2024] [Accepted: 06/06/2024] [Indexed: 07/02/2024]
Abstract
Apart from living near an asbestos industry site, mine, or in an asbestos-contaminated house, environmental asbestos exposure is observed in certain regions where the (natural) soil is 'contaminated' with asbestos (fibers). In this essay, we review the association between environmental asbestos exposure and lung cancer in Turkey. Other studies have also suggested that environmental asbestos exposure is able to increase the risk of lung cancer. Lung cancer associated with environmental asbestos exposure seems to be diagnosed at a younger age, and the risk for women is in the same range as that for men. Our data indicate that the relationship between exposure dose and risk is linear and that a safe threshold cannot be established. Therefore, people living in areas with increased chances of environmental asbestos exposure should be mentored to take part in smoking cessation programs and considered candidates for inclusion in lung cancer screening programs. There is an obvious need for additional studies on this topic.
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Affiliation(s)
- Muzaffer Metintas
- Eskisehir Osmangazi University Faculty of Medicine Department of Chest Diseases, Eskisehir, Turkey; Eskisehir Osmangazi University Lung and Pleural Cancers Clinical and Research Center, Turkey.
| | - Guntulu Ak
- Eskisehir Osmangazi University Faculty of Medicine Department of Chest Diseases, Eskisehir, Turkey; Eskisehir Osmangazi University Lung and Pleural Cancers Clinical and Research Center, Turkey
| | - Selma Metintas
- Eskisehir Osmangazi University Lung and Pleural Cancers Clinical and Research Center, Turkey; Eskisehir Osmangazi University Faculty of Medicine Department of Public Health, Turkey
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2
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Seewoo BJ, Wong EV, Mulders YR, Goodes LM, Eroglu E, Brunner M, Gozt A, Toshniwal P, Symeonides C, Dunlop SA. Impacts associated with the plastic polymers polycarbonate, polystyrene, polyvinyl chloride, and polybutadiene across their life cycle: A review. Heliyon 2024; 10:e32912. [PMID: 39022097 PMCID: PMC11253235 DOI: 10.1016/j.heliyon.2024.e32912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/23/2024] [Accepted: 06/11/2024] [Indexed: 07/20/2024] Open
Abstract
Polymers are the main building blocks of plastic, with the annual global production volume of fossil carbon-based polymers reaching over 457 million metric tons in 2019 and this figure is anticipated to triple by 2060. There is potential for environmental harm and adverse human health impacts associated with plastic, its constituent polymers and the chemicals therein, at all stages of the plastic life cycle, from extraction of raw materials, production and manufacturing, consumption, through to ultimate disposal and waste management. While there have been considerable research and policy efforts in identifying and mitigating the impacts associated with problematic plastic products such as single-use plastics and hazardous chemicals in plastics, with national and/or international regulations to phase out their use, plastic polymers are often overlooked. In this review, the polymer dimension of the current knowledge on environmental release, human exposure and health impacts of plastic is discussed across the plastic life cycle, including chemicals used in production and additives commonly used to achieve the properties needed for applications for which the polymers are generally used. This review focuses on polycarbonate, polystyrene, polyvinyl chloride, and polybutadiene, four common plastic polymers made from the hazardous monomers, bisphenol, styrene, vinyl chloride and 1,3-butadiene, respectively. Potential alternative polymers, chemicals, and products are considered. Our findings emphasise the need for a whole system approach to be undertaken for effective regulation of plastics whereby the impacts of plastics are assessed with respect to their constituent polymers, chemicals, and applications and across their entire life cycle.
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Affiliation(s)
- Bhedita J. Seewoo
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
- School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Enoch V.S. Wong
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
- School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Yannick R. Mulders
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
- School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Louise M. Goodes
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
- School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Ela Eroglu
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
| | - Manuel Brunner
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
| | - Aleksandra Gozt
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
| | - Priyanka Toshniwal
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
- School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Christos Symeonides
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Rd, Parkville, VIC 3052, Australia
| | - Sarah A. Dunlop
- Minderoo Foundation, 171 - 173 Mounts Bay Road, Perth, WA 6000, Australia
- School of Biological Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
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3
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van Zandwijk N, Frank AL. A multidisciplinary review of several aspects of Asbestos-Related Lung Cancer (ARLC). Lung Cancer 2024; 189:107474. [PMID: 38341295 DOI: 10.1016/j.lungcan.2024.107474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Affiliation(s)
- Nico van Zandwijk
- Department of Cell and Molecular Therapies, Royal Prince Alfred Hospital, Missenden Rd, 2050 NSW, Camperdown, Australia; University of Sydney, Faculty of Medicine and Health, Australia.
| | - Arthur L Frank
- School of Public Health of Drexel University, Philadelphia, USA
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4
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Lee FSW, Chen YH, Tran ND, Lin CK, Pham LA. Association between Asbestos Exposure and the Incidence of Kidney Cancer: a Weight-of-Evidence Evaluation and Meta-analysis. Curr Environ Health Rep 2023; 10:394-409. [PMID: 37889448 DOI: 10.1007/s40572-023-00415-6] [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] [Indexed: 10/28/2023]
Abstract
PURPOSE OF REVIEW Occupational asbestos exposure has been extensively linked to various cancers, with ongoing debates regarding its association with kidney cancer. This study aims to investigate the correlation between occupational asbestos exposure and kidney cancer incidence. Additionally, potential influencing factors are analyzed to enhance the comprehension of the relationship between asbestos exposure and kidney cancer. RECENT FINDING While asbestos has established strong associations with malignant mesothelioma and lung cancer, its connection to other malignancies such as gastric, colorectal, and kidney cancers remains under scrutiny. The current study presents mixed opinions on the relationship between asbestos exposure and kidney cancer. Our analysis revealed a potential association between asbestos exposure and the incidence of kidney cancer. Notably, among different types of asbestos, exposure to amphibole appeared to be particularly linked to a higher incident risk of kidney cancer.
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Affiliation(s)
- Fu-Shiuan Whitney Lee
- Department of Health Policy and Management, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Yu-Han Chen
- Department of Internal Medicine, Englewood Hospital and Medical Center, Englewood, NJ, USA
| | - Ngoc Dang Tran
- Department of Environmental and Occupational Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Grant and Innovation Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Cheng-Kuan Lin
- School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA.
- University Medical Shing Mark Hospital, Bien Hoa, Dong Nai, Vietnam.
| | - Le An Pham
- Grant and Innovation Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Family Medicine, Hospital of University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh, Vietnam
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5
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Gun RT, Kendall GM. Asbestos-related cancer in naval personnel: findings from participants in the British nuclear tests 1952-1967. Sci Rep 2023; 13:18842. [PMID: 37963950 PMCID: PMC10646006 DOI: 10.1038/s41598-023-44847-4] [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: 05/15/2023] [Accepted: 10/12/2023] [Indexed: 11/16/2023] Open
Abstract
Asbestos-containing materials (ACM) were present in British and Australian naval vessels throughout the twentieth century. The aim of this study was to identify and quantify the incidence of cancer in naval personnel from onboard asbestos exposure. Subjects were four cohorts of subjects who had served in the armed forces of the United Kingdom and Australia in the 1950s and 1960s. All cohorts had previously been studied, three of them in relation to radiation exposures from British nuclear testing. Comparisons of SIRs between services were made to identify cancers attributable to asbestos exposure. Excess mesotheliomas were found in naval personnel in all cohorts. In all but one cohort the lung cancer incidence was highest in navy personnel. Comparison of other smoking-related conditions indicated that the excess in navy personnel was not smoking-related. The relatively high SIRs for mesothelioma and the occurrence of deaths from asbestosis were indicative of high levels of asbestos exposure, with an expectation of cases of asbestos-related lung cancer. The findings are consistent with the occurrence of significant excesses of mesotheliomas. In addition, notwithstanding some inconsistencies in the results between the cohorts, we estimated that approximately 27% of lung cancers in Australian seamen and 12% in British seamen were related to onboard asbestos exposure.
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Affiliation(s)
- Richard T Gun
- School of Public Health, University of Adelaide, Adelaide, SA, Australia.
| | - Gerry M Kendall
- Cancer Epidemiology Unit, Oxford Population Health, University of Oxford Old Road Campus, Oxford, OX3 7LF, UK
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van Zandwijk N, Marshall HM, Fong KM. Lung cancer: Removing toxic dust from our environment. Respirology 2023; 28:511-512. [PMID: 37105901 DOI: 10.1111/resp.14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 04/29/2023]
Affiliation(s)
- Nico van Zandwijk
- Department of Cell and Molecular Therapies, Royal Prince Alfred Hospital/Sydney Local Health District, Camperdown, New South Wales, Australia
- Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Henry M Marshall
- The Prince Charles Hospital and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Kwun M Fong
- The Prince Charles Hospital and Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Lai H, Hu C, Qu M, Liu X, Xue Y, Xu P, Hao D. Mesothelioma Due to Workplace Exposure: A Comprehensive Bibliometric Analysis of Current Situation and Future Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2833. [PMID: 36833533 PMCID: PMC9956900 DOI: 10.3390/ijerph20042833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
Background: This article provides an overview of the current status and research progress of mesothelioma. Methods: A total of 2638 documents published from 1 January 2004 to 30 November 2022 were retrieved from the Web of Science Core Collection and analyzed via Microsoft Office Excel 2019, VOSviewer 1.6.18, and Tableau 2022.2. Results: There was an obvious increase in the number of publications regarding mesothelioma in the last 18 years, with the United States dominating the research field with 715 publications and 23,882 citations, while the University of Turin contributed the most (118). Occupational & Environmental Medicine was the most popular journal (80), with Corrado Magnani being the most prolific author (52) and Michele Carbone obtaining the most citations (4472). "Oncology" and "Health Science of Environment & Occupation" were the two main subjects, while the keywords "asbestos", "lung cancer", "gene expression", "apoptosis", "survival", and "cisplatin" were the most popular. Conclusions: The containment of mesothelioma calls for more participation from low- and middle-income countries, and further attention needs to be paid to clinical research.
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Affiliation(s)
- Hanpeng Lai
- Department of Occupational and Environmental Health, School of Public Health, Yangzhou University, Yangzhou 225009, China
| | - Chenglei Hu
- Department of Occupational and Environmental Health, School of Public Health, Yangzhou University, Yangzhou 225009, China
| | - Man Qu
- Department of Occupational and Environmental Health, School of Public Health, Yangzhou University, Yangzhou 225009, China
| | - Xing Liu
- Department of Occupational and Environmental Health, School of Public Health, Yangzhou University, Yangzhou 225009, China
| | - Yu Xue
- Department of Radiology and Functional Examination, Nanjing Prevention and Treatment Center for Occupational Diseases, Nanjing 210018, China
| | - Ping Xu
- Department of Radiology and Functional Examination, Nanjing Prevention and Treatment Center for Occupational Diseases, Nanjing 210018, China
| | - Dongdong Hao
- Lanzhou 7th Rest Center for Retired Cadre, Gansu Military Region, Lanzhou 730000, China
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Gualtieri AF. Journey to the centre of the lung. The perspective of a mineralogist on the carcinogenic effects of mineral fibres in the lungs. JOURNAL OF HAZARDOUS MATERIALS 2023; 442:130077. [PMID: 36209608 DOI: 10.1016/j.jhazmat.2022.130077] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/23/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
This work reviews the bio-chemical mechanisms leading to adverse effects produced when mineral fibres are inhaled and transported in the lungs from the perspective of a mineralogist. The behaviour of three known carcinogenic mineral fibres (crocidolite, chrysotile, and fibrous-asbestiform erionite) during their journey through the upper respiratory tract, the deep respiratory tract and the pleural cavity is discussed. These three fibres have been selected as they are the most socially and economically relevant mineral fibres representative of the classes of chain silicates (amphiboles), layer silicates (serpentine), and framework silicates (zeolites), respectively. Comparison of the behaviour of these fibres is made according to their specific crystal-chemical assemblages and properties. Known biological and subsequent pathologic effects which lead and contribute to carcinogenesis are critically reviewed under the mineralogical perspective and in relation to recent progress in this multidisciplinary field of research. Special attention is given to the understanding of the cause-effect relationships for lung cancer and malignant mesothelioma. Comparison with interstitial pulmonary fibrosis, or "asbestosis", will also be made here. This overview highlights open issues, data gaps, and conflicts in the literature for these topics, especially as regards relative potencies of the three mineral fibres under consideration for lung cancer and mesothelioma. Finally, an attempt is made to identify future research lines suitable for a general comprehensive model of the carcinogenicity of mineral fibres.
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Affiliation(s)
- Alessandro F Gualtieri
- Department of Chemical and Geological Sciences, University of Modena and Reggio Emilia, Via G. Campi 103, Modena I-41125, Italy.
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Ainagulova G, Bulgakova O, Ilderbayev O, Manekenova K, Tatayeva R, Bersimbaev R. Molecular and immunological changes in blood of rats exposed to various doses of asbestos dust. Cytokine 2022; 159:156016. [DOI: 10.1016/j.cyto.2022.156016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 11/03/2022]
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Payne NWS, Brown KF, Delon C, Kotrotsios Y, Soerjomataram I, Shelton J. Socio-economic deprivation and cancer incidence in England: Quantifying the role of smoking. PLoS One 2022; 17:e0272202. [PMID: 36129905 PMCID: PMC9491592 DOI: 10.1371/journal.pone.0272202] [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: 02/09/2022] [Accepted: 07/15/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND More deprived populations typically experience higher cancer incidence rates and smoking prevalence compared to less deprived populations. We calculated the proportion of cancer cases attributable to smoking by socio-economic deprivation in England and estimated the impact smoking has on the deprivation gap for cancer incidence. METHODS Data for cancer incidence (2013-2017), smoking prevalence (2003-2007) and population estimates (2013-2017) were split by sex, age-group and deprivation quintile. Relative risk estimates from meta-analyses were used to estimate the population attributable fraction (PAF) for 15 cancer types associated with smoking. The deprivation gap was calculated using age-specific incidence rates by deprivation quintile. RESULTS Smoking-related cancer PAFs in England are 2.2 times larger in the most deprived quintile compared to the least deprived quintile (from 9.7% to 21.1%). If everyone had the same smoking prevalence as the least deprived quintile, 20% of the deprivation gap in cancer incidence could have been prevented. If nobody smoked, 61% of the deprivation gap could have been prevented. CONCLUSIONS The majority of the deprivation gap in cancer incidence could have been prevented in England between 2013-2017 if nobody had smoked. Policy makers should ensure that tobacco control policies reduce overall smoking prevalence by tackling smoking inequalities.
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Affiliation(s)
- Nick W. S. Payne
- Policy, Information and Communication Directorate, Cancer Research UK, London, United Kingdom
| | - Katrina F. Brown
- Policy, Information and Communication Directorate, Cancer Research UK, London, United Kingdom
| | - Christine Delon
- Policy, Information and Communication Directorate, Cancer Research UK, London, United Kingdom
| | - Yannis Kotrotsios
- Policy, Information and Communication Directorate, Cancer Research UK, London, United Kingdom
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Jon Shelton
- Policy, Information and Communication Directorate, Cancer Research UK, London, United Kingdom
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Grier W, Abbas H, Gebeyehu RR, Singh AK, Ruiz J, Hines S, Alghanim F, Deepak J. Military exposures and lung cancer in United States veterans. Semin Oncol 2022; 49:S0093-7754(22)00050-1. [PMID: 35882571 DOI: 10.1053/j.seminoncol.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/11/2022]
Abstract
Lung cancer screening begins at age 50, with yearly low dose computed tomography (LDCT) scans until age 80, for patients determined to be high risk due to tobacco smoking. Veterans serving from World War II to the Gulf War are now at the age where LDCT is recommended. This recommendation from the United States Preventative Service Task Force includes patients who have a 20-pack year tobacco history and currently smoke or quit within the last 15 years. This recommendation does not consider additional risk factors such as exposures to lung carcinogens. We discuss unique operational and occupational exposures encountered while serving in the armed forces, which may potentially increase the risk of lung cancers in the Veteran population. The additional risk of lung cancer due to military exposure history is unclear and more work is needed to identify and quantify risk at an individual level. Increasing awareness at the provider level regarding the carcinogenic exposures encountered may allow a larger population of Veterans, not meeting traditional LDCT criteria, to benefit from lung cancer screening.
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Affiliation(s)
- William Grier
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Hatoon Abbas
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Rediet Regassa Gebeyehu
- Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Ankur Kumar Singh
- Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jimmy Ruiz
- Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, United States; Department of Medicine, W.G. (Bill) Hefner Veteran Administration Medical Center, Cancer Center, Salisbury, NC, United States
| | - Stella Hines
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States; Baltimore VA Medical Center, Department of Medicine, Baltimore, MD, United States
| | - Fahid Alghanim
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Janaki Deepak
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States; Baltimore VA Medical Center, Department of Medicine, Baltimore, MD, United States.
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Saito CA, Bussacos MA, Salvi L, Mensi C, Consonni D, Fernandes FT, Campos F, Cavalcante F, Algranti E. Sex-Specific Mortality from Asbestos-Related Diseases, Lung and Ovarian Cancer in Municipalities with High Asbestos Consumption, Brazil, 2000-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3656. [PMID: 35329341 PMCID: PMC8949971 DOI: 10.3390/ijerph19063656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 01/09/2023]
Abstract
The aim of this study is to compare the mortality rates for typical asbestos-related diseases (ARD-T: mesothelioma, asbestosis, and pleural plaques) and for lung and ovarian cancer in Brazilian municipalities where asbestos mines and asbestos-cement plants had been operating (areas with high asbestos consumption, H-ASB) compared with in other municipalities. The death records for adults aged 30+ years were retrieved from multiple health information systems. In the 2000-2017 time period, age-standardized mortality rates (standard: Brazil 2010) and standardized rate ratios (SRR; H-ASB vs. others) were estimated. The SRRs for ARD-T were 2.56 for men (257 deaths in H-ASB municipalities) and 1.19 for women (136 deaths). For lung cancer, the SRRs were 1.33 for men (32,604 deaths) and 1.19 for women (20,735 deaths). The SRR for ovarian cancer was 1.34 (8446 deaths). Except for ARD-T and lung cancer in women, the SRRs were higher in municipalities that began using asbestos before 1970 than in municipalities that began utilizing asbestos from 1970 onwards. In conclusion, the mortality rates for ARD-T, and lung and ovarian cancer in municipalities with a history of asbestos mining and asbestos-cement production exceed those of the whole country. Caution is needed when interpreting the results of this ecological study. Analytical studies are necessary to document the impact of asbestos exposure on health, particularly in the future given the long latency of asbestos-related cancers.
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Affiliation(s)
- Cézar Akiyoshi Saito
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
| | - Marco Antonio Bussacos
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
| | - Leonardo Salvi
- Programa de Saúde Ambiental e de Saúde do Trabalhador, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, Brazil; (L.S.); (F.C.); (F.C.)
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Fernando Timoteo Fernandes
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
| | - Felipe Campos
- Programa de Saúde Ambiental e de Saúde do Trabalhador, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, Brazil; (L.S.); (F.C.); (F.C.)
| | - Franciana Cavalcante
- Programa de Saúde Ambiental e de Saúde do Trabalhador, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, Brazil; (L.S.); (F.C.); (F.C.)
| | - Eduardo Algranti
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
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Lung Cancer Screening in Asbestos-Exposed Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052688. [PMID: 35270380 PMCID: PMC8910511 DOI: 10.3390/ijerph19052688] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 12/19/2022]
Abstract
Asbestos exposure is the most important cause of occupational lung cancer mortality. Two large randomized clinical trials in the U.S. and Europe conclusively demonstrate that annual low-dose chest CT (LDCT) scan screening reduces lung cancer mortality. Age and smoking are the chief risk factors tested in LDCT studies, but numerous risk prediction models that incorporate additional lung cancer risk factors have shown excellent performance. The studies of LDCT in asbestos-exposed populations shows favorable results but are variable in design and limited in size and generalizability. Outstanding questions include how to: (1) identify workers appropriate for screening, (2) organize screening programs, (3) inform and motivate people to screen, and (4) incorporate asbestos exposure into LDCT decision-making in clinical practice. Conclusion: Screening workers aged ≥50 years with a history of ≥5 years asbestos exposure (or fewer years given intense exposure) in combination with either (a) a history of smoking at least 10 pack-years with no limit on time since quitting, or (b) a history of asbestos-related fibrosis, chronic lung disease, family history of lung cancer, personal history of cancer, or exposure to multiple workplace lung carcinogens is a reasonable approach to LDCT eligibility, given current knowledge. The promotion of LDCT-based screening among asbestos-exposed workers is an urgent priority.
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Fazzo L, Binazzi A, Ferrante D, Minelli G, Consonni D, Bauleo L, Bruno C, Bugani M, De Santis M, Iavarone I, Magnani C, Romeo E, Zona A, Alessi M, Comba P, Marinaccio A. Burden of Mortality from Asbestos-Related Diseases in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10012. [PMID: 34639316 PMCID: PMC8508095 DOI: 10.3390/ijerph181910012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
Asbestos is one of the major worldwide occupational carcinogens. The global burden of asbestos-related diseases (ARDs) was estimated around 231,000 cases/year. Italy was one of the main European asbestos producers until the 1992 ban. The WHO recommended national programs, including epidemiological surveillance, to eliminate ARDs. The present paper shows the estimate of the burden of mortality from ARDs in Italy, established for the first time. National standardized rates of mortality from mesothelioma and asbestosis and their temporal trends, based on the National Institute of Statistics database, were computed. Deaths from lung cancer attributable to asbestos exposure were estimated using population-based case-control studies. Asbestos-related lung and ovarian cancer deaths attributable to occupational exposure were estimated, considering the Italian occupational cohort studies. In the 2010-2016 period, 4400 deaths/year attributable to asbestos were estimated: 1515 from mesothelioma, 58 from asbestosis, 2830 from lung and 16 from ovarian cancers. The estimates based on occupational cohorts showed that each year 271 deaths from mesothelioma, 302 from lung cancer and 16 from ovarian cancer were attributable to occupational asbestos exposure in industrial sectors with high asbestos levels. The important health impact of asbestos in Italy, 10-25 years after the ban, was highlighted. These results suggest the need for appropriate interventions in terms of prevention, health care and social security at the local level and could contribute to the global estimate of ARDs.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Daniela Ferrante
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy;
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy;
| | - Lisa Bauleo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Marcella Bugani
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Corrado Magnani
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Elisa Romeo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Mariano Alessi
- Department of Prevention, Ministry of Health, 00100 Roma, Italy;
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
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15
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Baur X, Frank AL. Ongoing downplaying of the carcinogenicity of chrysotile asbestos by vested interests. J Occup Med Toxicol 2021; 16:6. [PMID: 33622366 PMCID: PMC7901213 DOI: 10.1186/s12995-021-00295-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 02/09/2021] [Indexed: 11/10/2022] Open
Abstract
Industries that mine, manufacture and sell asbestos or asbestos-containing products have a long tradition of promoting the use of asbestos, while placing the burden of economic and health costs on workers and society. This has been successfully done in recent years and decades in spite of the overwhelming evidence that all asbestos types are carcinogenic and cause asbestosis. In doing so, the asbestos industry has undermined the WHO campaign to reach a worldwide ban of asbestos and to eliminate asbestos-related diseases. Even worse, in recent years they succeeded in continuing asbestos mining and consuming in the range of about 1.3 million tons annually. Nowadays, production takes place predominantly in Russia, Kazakhstan and China. Chrysotile is the only asbestos type still sold and represents 95% of asbestos traded over the last century.The asbestos industry, especially its PR agency, the International Chrysotile Association, ICA, financed by asbestos mining companies in Russia, Kazakhstan and Zimbabwe and asbestos industrialists in India and Mexico, continues to be extremely active by using slogans such as chrysotile can be used safely.Another approach of the asbestos industry and of some of its insurance agencies is to broadly defeat liability claims of asbestos victims.In doing so they systematically use inappropriate science produced by their own and/or by industry-affiliated researchers. Some of the latter were also engaged in producing defense material for other industries including the tobacco industry. Frequent examples of distributing such disinformation include questioning or denying established scientific knowledge about adverse health effects of asbestos. False evidence continues to be published in scientific journals and books.The persisting strong influence of vested asbestos-related interests in workers and public health issues including regulations and compensation necessitate ongoing alertness, corrections and appropriate reactions in scientific as well as public media and policy advisory bodies.
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Affiliation(s)
- Xaver Baur
- Chair Em. of Occupational Medicine, University of Hamburg, Hamburg, Germany.
- European Society for Environmental and Occupational Medicine, P.O. Box 370514, D-14135, Berlin, Germany.
| | - Arthur L Frank
- Chair Em. of Environmental & Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
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16
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Abstract
Selected occupational populations are at the highest risk of lung cancer, because they smoke at increased rates and are concurrently exposed to workplace lung carcinogens. Low-dose computed tomography (CT)-based lung cancer screening has an enormous potential to reduce lung cancer mortality in these populations, as shown both in the lung cancer screening studies in the general population and in studies of workers at high risk of lung cancer. Pulmonologists can play a key role in identifying workers at high risk of lung cancer and ensuring that they are offered annual low-dose CT scans for early lung cancer detection.
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Affiliation(s)
- Steven B Markowitz
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, 65-30 Kissena Boulevard, Remsen Hall, Queens, NY 11367, USA.
| | - Brittany Dickens
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, 65-30 Kissena Boulevard, Remsen Hall, Queens, NY 11367, USA
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17
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Fontana L, Massari S, Maisonneuve P, Persechino B, Marinaccio A, Rampinelli C, Spaggiari L, Veronesi G, Iavicoli S. An innovative approach to identify past exposure to asbestos integrating questionnaire information and administrative data. Health Policy 2020; 125:246-253. [PMID: 33358598 DOI: 10.1016/j.healthpol.2020.11.013] [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: 01/29/2020] [Revised: 11/06/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
Reconstruction of work history of subjects exposed to occupational carcinogens might be extremely challenging and provide unreliable results. This study, carried out in Italy from February to November 2014, aimed to explore the validity of an innovative approach to reconstruct the occupational history of workers who have previously been exposed to asbestos combining the administration of structured questionnaire with the use of administrative data. Subjects recruited in this study were enrolled in the cohorts of COSMOS 1 and 2 studies. Participants indicating an exposure to asbestos were contacted and a structured questionnaire was administered to them to verify the validity of the self-reported asbestos exposure. Subsequently, work histories of respondents were investigated using administrative information. The record linkage with social security archives allowed the reassembling of the complete work history of 487 participants. In detail, administrative files allow the retrieval of 98 % of workers declaring not to be exposed, versus 77 % using the questionnaire. Furthermore, the percentage of retrieved cases is not relevant for high risk sectors but it is almost double for industries with probable presence of asbestos. The combined and integrated use of structured questionnaire with administrative data proved effective in accurately identifying subjects who actually had an asbestos exposure. This innovative strategy, being cost-effective and easily adaptable to other carcinogens, could be particularly useful in selecting subjects to recruit in specific screening and control programs for the early diagnosis of occupational cancers.
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Affiliation(s)
- Luca Fontana
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy; Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141, Milan, Italy.
| | - Benedetta Persechino
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
| | - Cristiano Rampinelli
- Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCSS, via Ripamonti 435, 20141, Milan, Italy.
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, IEO European Institute of Oncology IRCSS, via Ripamonti 435, 20141, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Via Festa Del Perdono 7, 20122, Milan, Italy.
| | - Giulia Veronesi
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Via Alessandro Manzoni 56, 20089, Rozzano (Milan), Italy.
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
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18
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Orriols R, Tarrés J, Albertí‐Casas C, Rosell‐Murphy M, Abós‐Herràndiz R, Canela‐Soler J. Malignant asbestos-related disease in a population exposed to asbestos. Am J Ind Med 2020; 63:796-802. [PMID: 32515059 DOI: 10.1002/ajim.23141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The first asbestos fiber cement plant in Spain operated in Cerdanyola, in the Barcelona metropolitan area, between 1907 and 1997. We describe clinical and epidemiological characteristics of patients diagnosed with the malignant asbestos-related disease (ARD) in the area of the plant between 2007 and 2016. METHODS A prospective, descriptive study was undertaken in the 12 municipalities of the county of Barcelona most proximate to the plant. We describe malignant ARD cases by time of diagnosis, source of exposure, periods of exposure and latency, and distribution by sex. Cumulative incidence and age-standardized incidence rates (ASIR) are calculated. RESULTS Of 477 patients diagnosed with ARD between 2007 and 2016, 128 (26%) presented with asbestos-associated malignancy. Pleural mesothelioma was noted in 105 patients (82.0%) with a linear trend Z-score of -0.2 (NS) in men and 2.7 (P < .01) in women. The highest ASIRs for malignant ARD (6.1/100 000 residents/year; 95% confidence interval [CI], 2.2-13.3) and pleural mesothelioma (4.8/100 000 residents/year; 95% CI, 1.5-11.6) occurred in municipalities closest to the focal point of contamination. The origin of malignant ARD was nonoccupational in 32.2% of men and 81.6% of women (P < .001). CONCLUSIONS More than 20 years after the closure of the fiber cement plant, the grave consequences of exposure to asbestos remain. The detection of cases of pleural mesothelioma in men seems to have plateaued whereas in women an ascending trend continues, which principally has its origin in nonoccupational exposures.
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Affiliation(s)
- Ramon Orriols
- Department of PulmonologHospital of Girona, Santa Caterina, Hospital of Salt and the Girona Biomedical, Research Institute (IDIBGI), Dr. Josep Trueta University Girona Spain
- CIBER of Respiratory Diseases Balearic Islands Spain
| | - Josep Tarrés
- Primary Care Division, Department of HealthCatalan Health Institute Catalonia Spain
| | | | | | | | - Jaume Canela‐Soler
- Department of Basic Clinical PracticeUniversity of Barcelona Catalonia Spain
- Department of Epidemiology and BiostatisticsCollege of Public Health, University of South Florida Tampa Florida
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19
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Schüz J, Bukhtiyarov I, Olsson A, Moissonnier M, Ostroumova E, Feletto E, Schonfeld SJ, Byrnes G, Tskhomariia I, McCormack V, Straif K, Kashanskiy S, Morozova T, Kromhout H, Kovalevskiy E. Occupational cohort study of current and former workers exposed to chrysotile in mine and processing facilities in Asbest, the Russian Federation: Cohort profile of the Asbest Chrysotile Cohort study. PLoS One 2020; 15:e0236475. [PMID: 32726334 PMCID: PMC7390538 DOI: 10.1371/journal.pone.0236475] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 07/03/2020] [Indexed: 02/04/2023] Open
Abstract
A historical cohort study in workers occupationally exposed to chrysotile was set up in the town of Asbest, the Russian Federation, to study their cause-specific mortality, with a focus on cancer. Chrysotile has different chemical and physical properties compared with other asbestos fibres; therefore it is important to conduct studies specifically of chrysotile and in different geographical regions to improve the knowledge about its carcinogenicity. Setting was the town of Asbest, Sverdlovsk oblast, the Russian Federation. Participants were all current and former employees with at least one year of employment between 1/1/1975 and 31/12/2010 in the mine, enrichment factories, auto-transport and external rail transportation departments, the central laboratory, and the explosives unit of the company. Of the 35,837 cohort members, 12,729 (35.5%) had died (2,373 of them of cancer, including 10 of mesothelioma), 18,799 (52.5%) were known to be alive at the end of the observation period (2015), and 4,309 (12.0%) were censored before the end of 2015. Mean follow-up duration was 21.7 years in men and 25.9 years in women. The mean age at death was 59.4 years in men and 66.5 years in women. This is the largest occupational cohort of chrysotile workers to date, and the only one with a large proportion of exposed female workers.
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Affiliation(s)
- Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Igor Bukhtiyarov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health” (IRIOH), Moscow, the Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, the Russian Federation
| | - Ann Olsson
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | | | | | - Eleonora Feletto
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
- Cancer Council New South Wales, Cancer Research Division, Woolloomooloo, Australia
| | - Sara J Schonfeld
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Graham Byrnes
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Iraklii Tskhomariia
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health” (IRIOH), Moscow, the Russian Federation
| | - Valerie McCormack
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Kurt Straif
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Sergey Kashanskiy
- Yekaterinburg Medical Research Center for Prophylaxis and Health Protection in Industrial Workers, Yekaterinburg, the Russian Federation
| | - Tatiana Morozova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, the Russian Federation
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Evgeny Kovalevskiy
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health” (IRIOH), Moscow, the Russian Federation
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, the Russian Federation
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20
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Harris EC, D'Angelo S, Darnton A, Coggon D. Relative burden of lung and pleural cancers from exposure to asbestos: a cross-sectional analysis of occupational mortality in England and Wales. BMJ Open 2020; 10:e036319. [PMID: 32273321 PMCID: PMC7245407 DOI: 10.1136/bmjopen-2019-036319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES To explore the extent to which asbestos-exposed jobs vary in the ratio of excess mortality from lung cancer to deaths from pleural cancer. DESIGN Using data on underlying cause of death and last full-time occupation for 3 688 916 deaths among men aged 20-74 years in England and Wales during 1979-2010, we calculated proportional mortality ratios (PMRs), standardised for age and social class, with all occupations combined as reference. For each of 22 asbestos-exposed job groups with significantly elevated PMRs for pleural cancer, we calculated excess mortality from lung cancer (observed minus expected deaths) and its ratio to number of deaths from pleural cancer. To reduce confounding effects of smoking, we adjusted expected deaths from lung cancer in each job group, according to a formula based on its PMR for chronic obstructive pulmonary disease. SETTING England and Wales. PARTICIPANTS 3 688 916 men who died aged 20-74 years during 1979-2010. OUTCOME MEASURES Ratios of excess mortality from lung cancer to deaths from pleural cancer by job group. RESULTS Adjusted PMRs for lung cancer were elevated in all but 4 of the 22 asbestos-exposed job groups, but the ratio of excess lung cancer to deaths from pleural cancer varied widely between job groups, being significantly greater than the overall ratio in six, and significantly less in seven. Analysis for 2001-2010, when (because of changes in coding) ascertainment of pleural tumours was more reliable, showed similar variation between job groups, and indicated an overall ratio of 0.28. CONCLUSIONS Excess lung cancer in asbestos-exposed jobs is not in a simple proportion to deaths from pleural cancer, and the ratio may vary importantly according to intensity of exposure to different types of asbestos and concomitant smoking habits. The current burden of lung cancer from occupational exposure to asbestos in Britain may not be so high as previously thought.
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Affiliation(s)
- Elizabeth Clare Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Andrew Darnton
- Statistics and Epidemiology Unit, Science Directorate, Health and Safety Executive Bootle Headquarters, Bootle, UK
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
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21
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Mofidi A, Tompa E, Mortazavi SB, Esfahanipour A, Demers PA. A probabilistic approach for economic evaluation of occupational health and safety interventions: a case study of silica exposure reduction interventions in the construction sector. BMC Public Health 2020; 20:210. [PMID: 32046683 PMCID: PMC7014628 DOI: 10.1186/s12889-020-8307-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 01/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Construction workers are at a high risk of exposure to various types of hazardous substances such as crystalline silica. Though multiple studies indicate the evidence regarding the effectiveness of different silica exposure reduction interventions in the construction sector, the decisions for selecting a specific silica exposure reduction intervention are best informed by an economic evaluation. Economic evaluation of interventions is subjected to uncertainties in practice, mostly due to the lack of precise data on important variables. In this study, we aim to identify the most cost-beneficial silica exposure reduction intervention for the construction sector under uncertain situations. METHODS We apply a probabilistic modeling approach that covers a large number of variables relevant to the cost of lung cancer, as well as the costs of silica exposure reduction interventions. To estimate the societal lifetime cost of lung cancer, we use an incidence cost approach. To estimate the net benefit of each intervention, we compare the expected cost of lung cancer cases averted, with expected cost of implementation of the intervention in one calendar year. Sensitivity analysis is used to quantify how different variables affect interventions net benefit. RESULTS A positive net benefit is expected for all considered interventions. The highest number of lung cancer cases are averted by combined use of wet method, local exhaust ventilation and personal protective equipment, about 107 cases, with expected net benefit of $45.9 million. Results also suggest that the level of exposure is an important determinant for the selection of the most cost-beneficial intervention. CONCLUSIONS This study provides important insights for decision makers about silica exposure reduction interventions in the construction sector. It also provides an overview of the potential advantages of using probabilistic modeling approach to undertake economic evaluations, particularly when researchers are confronted with a large number of uncertain variables.
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Affiliation(s)
- Amirabbas Mofidi
- Institute for Work & Health, 481 University Ave Suite 800, Toronto, ON, M5G 2E9, Canada
- School of Medical Science, Tarbiat Modares University, PO: 14115-111, Tehran, Iran
| | - Emile Tompa
- Institute for Work & Health, 481 University Ave Suite 800, Toronto, ON, M5G 2E9, Canada
- Department of Economics, McMaster University, Hamilton, Ontario, Canada
| | - Seyed Bagher Mortazavi
- Institute for Work & Health, 481 University Ave Suite 800, Toronto, ON, M5G 2E9, Canada.
- School of Medical Science, Tarbiat Modares University, PO: 14115-111, Tehran, Iran.
| | - Akbar Esfahanipour
- Department of Industrial Engineering and Management Systems, Amirkabir University of Technology, Tehran, Iran
| | - Paul A Demers
- Occupational Cancer Research Centre, Toronto, Ontario, Canada
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22
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Cheng YY, Rath EM, Linton A, Yuen ML, Takahashi K, Lee K. The Current Understanding Of Asbestos-Induced Epigenetic Changes Associated With Lung Cancer. LUNG CANCER (AUCKLAND, N.Z.) 2020; 11:1-11. [PMID: 32021524 PMCID: PMC6955579 DOI: 10.2147/lctt.s186843] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 11/08/2019] [Indexed: 12/19/2022]
Abstract
Asbestos is a naturally occurring mineral consisting of extremely fine fibres that can become trapped in the lungs after inhalation. Occupational and environmental exposures to asbestos are linked to development of lung cancer and malignant mesothelioma, a cancer of the lining surrounding the lung. This review discusses the factors that are making asbestos-induced lung cancer a continuing problem, including the extensive historic use of asbestos and decades long latency between exposure and disease development. Genomic mutations of DNA nucleotides and gene rearrangements driving lung cancer are well-studied, with biomarkers and targeted therapies already in clinical use for some of these mutations. The genes involved in these mutation biomarkers and targeted therapies are also involved in epigenetic mechanisms and are discussed in this review as it is hoped that identification of epigenetic aberrations in these genes will enable the same gene biomarkers and targeted therapies to be used. Currently, understanding of how asbestos fibres trapped in the lungs leads to epigenetic changes and lung cancer is incomplete. It has been shown that oxidoreduction reactions on fibre surfaces generate reactive oxygen species (ROS) which in turn damage DNA, leading to genetic and epigenetic alterations that reduce the activity of tumour suppressor genes. Epigenetic DNA methylation changes associated with lung cancer are summarised in this review, and some of these changes will be due to asbestos exposure. So far, little research has been carried out to separate the asbestos driven epigenetic changes from those due to non-asbestos causes of lung cancer. Asbestos-associated lung cancers exhibit less methylation variability than lung cancers in general, and in a large proportion of samples variability has been found to be restricted to promoter regions. Epigenetic aberrations in cancer are proving to be promising biomarkers for diagnosing cancers. It is hoped that further understanding of epigenetic changes in lung cancer can result in useful asbestos-associated lung cancer biomarkers to guide treatment. Research is ongoing into the detection of lung cancer epigenetic alterations using non-invasive samples of blood and sputum. These efforts hold the promise of non-invasive cancer diagnosis in the future. Efforts to reverse epigenetic aberrations in lung cancer by epigenetic therapies are ongoing but have not yet yielded success.
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Affiliation(s)
- Yuen Yee Cheng
- Asbestos Disease Research Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Emma M Rath
- Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Anthony Linton
- Asbestos Disease Research Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Man Lee Yuen
- Asbestos Disease Research Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Ken Takahashi
- Asbestos Disease Research Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Kenneth Lee
- Asbestos Disease Research Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Concord Repatriation General Hospital, Sydney, New South Wales, Australia
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23
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Fernandes GA, Algranti E, Conceição GMDS, Wünsch Filho V, Toporcov TN. Lung Cancer Mortality Trends in a Brazilian City with a Long History of Asbestos Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142548. [PMID: 31319477 PMCID: PMC6679146 DOI: 10.3390/ijerph16142548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/26/2019] [Accepted: 07/04/2019] [Indexed: 12/13/2022]
Abstract
There are scarce epidemiological studies on lung cancer mortality in areas exposed to asbestos in developing countries. We compared the rates and trends in mortality from lung cancer between 1980 and 2016 in a municipality that made extensive use of asbestos, Osasco, with rates from a referent municipality with lower asbestos exposure and with the rates for the State of São Paulo. We retrieved death records for cases of lung cancer (ICD-9 C162) (ICD-10 C33 C34) from 1980 to 2016 in adults aged 60 years and older. The join point regression and age-period-cohort models were fitted to the data. Among men, there was an increasing trend in lung cancer mortality in Osasco of 0.7% (CI: 0.1; 1.3) in contrast to a mean annual decrease for Sorocaba of -1.5% (CI: -2.4; -0.6) and a stable average trend for São Paulo of -0.1 (IC: -0.3; 0.1). Similar increasing trends were seen in women. The age-period-cohort model showed an increase in the risk of death from 1996 in Osasco and a reduction for Sorocaba and São Paulo State during the same period. Our results point to a need for a special monitoring regarding lung cancer incidence and mortality in areas with higher asbestos exposure.
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Affiliation(s)
- Gisele Aparecida Fernandes
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo-SP 01246-904, Brazil.
| | - Eduardo Algranti
- Division of Medicine, Fundação Jorge Duprat e Figueiredo (Fundacentro), São Paulo-SP 05409-002, Brazil
| | | | - Victor Wünsch Filho
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo-SP 01246-904, Brazil
| | - Tatiana Natasha Toporcov
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo-SP 01246-904, Brazil
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Cui Y, Huang L, Huo T, Dong F, Wang G, Zhang Q. Man-made mineral fiber effects on the expression of anti-oncogenes P53 and P16 and oncogenes C-JUN and C-FOS in the lung tissue of Wistar rats. Toxicol Ind Health 2019; 35:431-444. [PMID: 31131716 DOI: 10.1177/0748233719851699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Man-made mineral fibers (MMMFs) are substitutes for asbestos. MMMFs are widely used as insulation, but their molecular mechanisms underlying the tumorigenic effects in vivo have been poorly studied. For this reason, this work aimed to explore the properties and carcinogenic molecular mechanisms of MMMFs. The three MMMFs, rock wool (RW), glass fibers (GFs), and ceramic fibers (CFs), were prepared into respirable dust. Particle size, morphology, and chemical composition were analyzed by laser particle analyzer, scanning electron microscope, and X-ray fluorescence spectrometer, respectively. The Wistar rats were administered multiple intratracheal instillations of three MMMFs once a month. Then, several parameters (e.g. body mass, lung mass, and lung histology) were measured at 1, 3, and 6 months. After that, levels of P53, P16, C-JUN, and C-FOS mRNA and protein were measured by quantitative real-time reverse transcription polymerase chain reaction and Western blotting. This work found that exposure to MMMFs could influence the growth of body mass and increase lung mass. General conditions showed white nodules and irregular atrophy. In addition, MMMFs could lead to inactivation of anti-oncogene P16 and activation of proto-oncogenes (C-JUN and C-FOS) in the mRNA and protein levels, in which GF and CF were more obvious compared with RW. The effect of MMMFs was different, which may be related to the physical and chemical characteristics of different MMMFs. In conclusion, MMMFs (GF and CF) could induce an unbalanced expression of cancer-related genes in the lung tissues of rats. The understanding of the determinants of toxicity and carcinogenicity provides a scientific basis for developing and introducing new safer MMMF products, and the present study provides some useful insights into the carcinogenic mechanism of MMMFs.
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Affiliation(s)
- Yan Cui
- 1 School of Public Health, Southwest Medical University, Luzhou, China
| | - Liuwen Huang
- 2 School of Pharmacy, Southwest Medical University, Luzhou, China
| | - Tingting Huo
- 3 Key Laboratory of Solid Waste Treatment and the Resource Recycle, Southwest University of Science and Technology, Mianyang, China
| | - Faqin Dong
- 3 Key Laboratory of Solid Waste Treatment and the Resource Recycle, Southwest University of Science and Technology, Mianyang, China
| | - Guojun Wang
- 4 Department of Pharmacy, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Qingbi Zhang
- 1 School of Public Health, Southwest Medical University, Luzhou, China
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Algranti E, Ramos-Bonilla JP, Terracini B, Santana VS, Comba P, Pasetto R, Mazzeo A, Cavariani F, Trotta A, Marsili D. Prevention of Asbestos Exposure in Latin America within a Global Public Health Perspective. Ann Glob Health 2019; 85:49. [PMID: 30924615 PMCID: PMC6634328 DOI: 10.5334/aogh.2341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Asbestos consumption in Latin America (LA) amounts to 10% of yearly global production. Little is known about the impact of asbestos exposure in the region. OBJECTIVE To discuss scientific and socio-economic issues and conflicts of interest and to summarize epidemiological data of asbestos health effects in LA. DISCUSSION Recent data on chrysotile strengthened the evidence of its carcinogenicity and showed an excessive risk of lung cancer at cumulative exposure levels as low as 1.5 fibre-years/ml. Technology for substitution is available for all asbestos-containing products and ceasing asbestos production and manufacturing will not result in unemployment and loss of income, except for the mining industry. The flawed arguments used by the industry to maintain its market, both to the public and in courtrooms, strongly relies on the lack of local evidence of the ill effects and on the invisibility of asbestos-related diseases in LA, due to the limited number of studies and the exposed workers' difficulty accessing health services. The few epidemiological studies available show clear evidence of clusters of mesothelioma in municipalities with a history of asbestos consumption and a forecasted rise in its incidence in Argentina and Brazil for the next decade. In Brazil, non-governmental organizations of asbestos workers were pivotal to counterbalance misinformation and inequities, ending recently in a Supreme Court decision backing an asbestos ban. In parallel, continuous efforts should be made to stimulate the growth of competent and ethical researchers to convey adequate information to the scientific community and to the general public.
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Affiliation(s)
| | | | | | - Vilma S. Santana
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BR
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, IT
| | - Roberto Pasetto
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, IT
| | - Agata Mazzeo
- School of Arts, Humanities, and Cultural Heritage, University of Bologna, Bologna, IT
| | - Fulvio Cavariani
- Centro Regionale Amianto Lazio Dipartimento di Prevenzione, Unità Sanitaria Locale, Viterbo, IT
| | - Andrés Trotta
- Instituto de Salud Colectiva (ISCo)/Institute of Collective Health, Universidad Nacional de Lanús (UNLa)/National University of Lanús, Buenos Aires, AR
| | - Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, IT
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Harris EJA, Musk A, de Klerk N, Reid A, Franklin P, Brims FJH. Diagnosis of asbestos-related lung diseases. Expert Rev Respir Med 2019; 13:241-249. [DOI: 10.1080/17476348.2019.1568875] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Edward J. A. Harris
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Arthur Musk
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Nicholas de Klerk
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Peter Franklin
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Fraser J. H. Brims
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
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Abstract
Significant advances in the management of both early and advanced stage lung cancer have not yet led to the scale of improved outcomes which have been achieved in other cancers over the last 40 years. Diagnosis of lung cancer at the earliest stage of disease is strongly associated with improved survival. Therefore, although recent advances in oncology may herald breakthroughs in effective treatment, achieving early diagnosis will remain crucial to obtaining optimal outcomes. This is challenging, as most lung cancer symptoms are non-specific or are common respiratory symptoms which usually represent benign disease. Identification of patients at risk of lung cancer who require further investigation is an important responsibility for general practitioners (GPs). Diagnosis has historically relied upon plain chest X-ray (CXR), organised in response to symptoms. The sensitivity of this modality, however, compares unfavourably with that of computed tomography (CT). In some jurisdictions screening high-risk individuals with low dose CT (LDCT) is now recommended. However uptake remains low and the eligibility for screening programmes is restricted. Therefore, even if screening is widely adopted, most patients will continue to be diagnosed after presenting with symptoms. Achieving early diagnosis requires GPs to maintain an appropriate level of suspicion and readiness to investigate in high-risk patients or those with non-resolving symptoms. This article discusses the early detection of lung cancer from a primary care perspective. We outline risk factors and epidemiology, the role of screening and offer guidance on the recognition of symptomatic presentation and the investigation and referral of suspected lung cancer.
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Jadhav AV, Gawde NC. Current Asbestos Exposure and Future Need for Palliative Care in India. Indian J Palliat Care 2019; 25:587-591. [PMID: 31673217 PMCID: PMC6812430 DOI: 10.4103/ijpc.ijpc_51_19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Asbestos-related diseases (ARDs) are incurable but entirely preventable. Due to India's continuing use of asbestos, ARD patients will increase to a high number in the next three to four decades. This will increase the burden on palliative care system which is in nascent stage presently. Palliative care is the mainstay of the management of ARDs. Unfortunately, the burden on palliative care is likely to increase due to multiple factors contributed by India's demographic and economic changes. In the near future, there will be at least 12.5 million ARD patients and 1.25 million asbestos-related cancer patients worldwide, and half of these will be in India. It is high time to introspect about our ability to engage with this future problem. The paper also discusses the organization of this future problem of ARDs and possible action points toward future access to palliative care for ARD patients.
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Affiliation(s)
- Abhijeet Vasant Jadhav
- Centre for Public Health, School of Health Systems Studies, Tata Institute of Social Sciences, Vikas Anvesh Foundation, Pune, Maharashtra, India
| | - Nilesh C Gawde
- Centre for Public Health, School of Health Systems Studies, Tata Institute of Social Sciences, Vikas Anvesh Foundation, Pune, Maharashtra, India
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Abstract
The incidence and mortality rates of lung cancer, the leading cause of cancer death in China, have significantly increased in recent years, and present geographic and gender differences as a result of diversity in lifestyles and socioeconomic development. A series of attribute risk analyses have shown that factors such as smoking, air pollution, and occupational factors are all related to lung cancer. Behavioral intervention, such as smoking cessation and screening, could effectively reduce lung cancer incidence and mortality.
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Affiliation(s)
- Maomao Cao
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Wanqing Chen
- Office of Cancer Screening, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Kanchanachitra C, Tangcharoensathien V, Patcharanarumol W, Posayanonda T. Multisectoral governance for health: challenges in implementing a total ban on chrysotile asbestos in Thailand. BMJ Glob Health 2018; 3:e000383. [PMID: 30364381 PMCID: PMC6195151 DOI: 10.1136/bmjgh-2017-000383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 03/05/2018] [Accepted: 03/11/2018] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Interest in multisectoral governance for health has grown in recent years in response to the limitations of government-centric policy formulation and implementation. This study describes multisectoral governance associated with policy formulation and implementation of a total ban on chrysotile asbestos in Thailand. METHODS Qualitative methods were applied, including analysis of related literature and media, and in-depth interviews with key informants. Consent was obtained for interview and tape recording; protection of confidentiality was fully assured. RESULTS An agenda on total ban of chrysotile asbestos was proposed to the National Health Assembly, where a resolution was adopted in 2010. The resolution was endorsed by the Cabinet in 2011, which mandated the Ministry of Industry to implement the ban immediately. There was uneven interest and ownership by stakeholders in the policy formulation process. Long delays in implementation have been observed. Furthermore, while the policy is likely to affect relatively few industries there has been misinformation on the safe use of chrysotile, and delaying tactics and pressure from major chrysotile-exporting countries. CONCLUSION The National Health Assembly is a useful platform for policy formulation on complex policy issues requiring multisectoral action. However, policy implementation is challenging due to lack of clear policy across sectors. Success in protecting people's health requires participatory policy-making and effective governance of multisectoral action throughout implementation. The Assembly is not designed to enforce implementation, especially when power and authority lie with state actors, but monitoring and public reporting would be powerful tools to drive this agenda.
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Boffetta P, Mundt KA, Thompson WJ. The epidemiologic evidence for elongate mineral particle (EMP)-related human cancer risk. Toxicol Appl Pharmacol 2018; 361:100-106. [PMID: 30240694 DOI: 10.1016/j.taap.2018.09.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 08/30/2018] [Accepted: 09/16/2018] [Indexed: 01/28/2023]
Abstract
Epidemiologic research on the role of fibers and other elongate mineral particles (EMP) and human diseases including cancers has generated a large body of literature over the last decades: nevertheless, there remain some questions for which the scientific community appears unable to reach consensus. Reasons for genuine differences in opinion include (i) ways in which exposures have been classified; (ii) methodological limitations of the available studies, (iii) criteria for the interpretation of study results, including potential underlying biological mechanisms, and (iv) methodology for integrating the evidence. Various approaches have been proposed in recent years to address these issues, which will be illustrated using examples from asbestos, talc, taconite, synthetic mineral fibers and silicon carbide, with emphasis on potential carcinogenic effects. Potential solutions include improved exposure and outcome assessment - including use of biomarkers and other molecular approaches, consideration of potential confounding and other sources of bias, implementation of guidelines for study quality assessment and evidence evaluation and integration.
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Affiliation(s)
- Paolo Boffetta
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Yano E. Adverse health effects of asbestos: solving mysteries regarding asbestos carcinogenicity based on follow-up survey of a Chinese factory. Environ Health Prev Med 2018; 23:35. [PMID: 30089452 PMCID: PMC6083519 DOI: 10.1186/s12199-018-0726-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 07/25/2018] [Indexed: 11/29/2022] Open
Abstract
The present review summarizes the results of several follow-up studies assessing an asbestos product manufacturing plant in Chongqing, China, and discusses three controversial issues related to the carcinogenicity of asbestos. The first issue is the amphibole hypothesis, which asserts that the carcinogenicity of asbestos is limited to amphiboles, such as crocidolite, but not serpentines, such as chrysotile. However, considering the possible multiple component of asbestos carcinogenicity in the presence of tobacco smoke or other carcinogens, chrysotile cannot be regarded as non-carcinogenic. Additionally, in a practical sense, it is not possible to assume "pure" chrysotile due to its ubiquitous contamination with tremolite, which is a type of amphibole. Thus, as the International Agency for Research on Cancer (IARC) assessed, all forms of asbestos including chrysotile should be regarded carcinogenic to humans (Group 1). The second issue is the chrysotile/tremolite paradox, which is a phenomenon involving predominant levels of tremolite in the lung tissues of individuals who worked in locations with negligible levels of tremolite due to the exclusive use of chrysotile. Four possible mechanisms to explain this paradox have been proposed but this phenomenon does not support the claim that amphibole is inert. The final issue discussed is the textile mystery, i.e., the higher incidence of cancer in asbestos textile plants compared to asbestos mines where the same asbestos was produced and the exposure levels were comparable. This phenomenon was first reported in North America followed by UK and then in the present observations from China. Previously, levels of fiber exposure were calculated using a universal converting coefficient to estimate the mass concentration versus fiber concentration. However, parallel measurements of fiber and mass concentrations in the workplace and exposed air indicated that there are wide variations in the fiber/mass ratio, which unjustifies the universal conversion. It is possible that contamination by airborne non-fibrous particles in mines with mass fiber conversion led to the overestimation of fiber concentrations and resulted in the textile mystery. Although the use and manufacturing of asbestos has been banned in Japan, more than 10 million tons of asbestos had been imported and the majority remains in existing buildings. Thus, efforts to control asbestos exposure should be continued.
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Affiliation(s)
- Eiji Yano
- Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.
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Global Asbestos Disaster. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15051000. [PMID: 29772681 PMCID: PMC5982039 DOI: 10.3390/ijerph15051000] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 11/16/2022]
Abstract
Introduction: Asbestos has been used for thousands of years but only at a large industrial scale for about 100–150 years. The first identified disease was asbestosis, a type of incurable pneumoconiosis caused by asbestos dust and fibres. The latest estimate of global number of asbestosis deaths from the Global Burden of Disease estimate 2016 is 3495. Asbestos-caused cancer was identified in the late 1930’s but despite today’s overwhelming evidence of the strong carcinogenicity of all asbestos types, including chrysotile, it is still widely used globally. Various estimates have been made over time including those of World Health Organization and International Labour Organization: 107,000–112,000 deaths. Present estimates are much higher. Objective: This article summarizes the special edition of this Journal related to asbestos and key aspects of the past and present of the asbestos problem globally. The objective is to collect and provide the latest evidence of the magnitude of asbestos-related diseases and to provide the present best data for revitalizing the International Labor Organization/World Health Organization Joint Program on Asbestos-related Diseases. Methods: Documentation on asbestos-related diseases, their recognition, reporting, compensation and prevention efforts were examined, in particular from the regulatory and prevention point of view. Estimated global numbers of incidence and mortality of asbestos-related diseases were examined. Results: Asbestos causes an estimated 255,000 deaths (243,223–260,029) annually according to latest knowledge, of which work-related exposures are responsible for 233,000 deaths (222,322–242,802). In the European Union, United States of America and in other high income economies (World Health Organization regional classification) the direct costs for sickness, early retirement and death, including production losses, have been estimated to be very high; in the Western European countries and European Union, and equivalent of 0.70% of the Gross Domestic Product or 114 × 109 United States Dollars. Intangible costs could be much higher. When applying the Value of Statistical Life of 4 million EUR per cancer death used by the European Commission, we arrived at 410 × 109 United States Dollars loss related to occupational cancer and 340 × 109 related to asbestos exposure at work, while the human suffering and loss of life is impossible to quantify. The numbers and costs are increasing practically in every country and region in the world. Asbestos has been banned in 55 countries but is used widely today; some 2,030,000 tons consumed annually according to the latest available consumption data. Every 20 tons of asbestos produced and consumed kills a person somewhere in the world. Buying 1 kg of asbestos powder, e.g., in Asia, costs 0.38 United States Dollars, and 20 tons would cost in such retail market 7600 United States Dollars. Conclusions: Present efforts to eliminate this man-made problem, in fact an epidemiological disaster, and preventing exposures leading to it are insufficient in most countries in the world. Applying programs and policies, such as those for the elimination of all kind of asbestos use—that is banning of new asbestos use and tight control and management of existing structures containing asbestos—need revision and resources. The International Labor Organization/World Health Organization Joint Program for the Elimination of Asbestos-Related Diseases needs to be revitalized. Exposure limits do not protect properly against cancer but for asbestos removal and equivalent exposure elimination work, we propose a limit value of 1000 fibres/m3.
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Valenzuela M, Giraldo M, Gallo-Murcia S, Pineda J, Santos L, Ramos-Bonilla JP. Recent Scientific Evidence Regarding Asbestos Use and Health Consequences of Asbestos Exposure. Curr Environ Health Rep 2018; 3:335-347. [PMID: 27696225 DOI: 10.1007/s40572-016-0109-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To justify the continuous use of two million tons of asbestos every year, it has been argued that a safe/controlled use can be achieved. The aim of this review was to identify recent scientific studies that present empirical evidence of: 1) health consequences resulting from past asbestos exposures and 2) current asbestos exposures resulting from asbestos use. Articles with evidence that could support or reject the safe/controlled use argument were also identified. A total of 155 articles were included in the review, and 87 % showed adverse asbestos health consequences or high asbestos exposures. Regarding the safe/controlled use, 44 articles were identified, and 82 % had evidence suggesting that the safe/controlled use is not being achieved. A large percentage of articles with evidence that support the safe/controlled use argument have a conflict of interest declared. Most of the evidence was developed in high-income countries and in countries that have already banned asbestos.
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Affiliation(s)
- Manuela Valenzuela
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Margarita Giraldo
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Sonia Gallo-Murcia
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Juliana Pineda
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Laura Santos
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia
| | - Juan Pablo Ramos-Bonilla
- Department of Civil and Environmental Engineering, Universidad de los Andes, Cra 1ª Este No. 19A-40, Bogotá, Colombia.
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Barbiero F, Zanin T, Pisa FE, Casetta A, Rosolen V, Giangreco M, Negro C, Bovenzi M, Barbone F. Mortality in a cohort of asbestos-exposed workers undergoing health surveillance. LA MEDICINA DEL LAVORO 2018; 109:83-86. [PMID: 29701625 PMCID: PMC7682175 DOI: 10.23749/mdl.v109i2.5865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 01/17/2018] [Indexed: 11/18/2022]
Abstract
Background: The coastal area of Friuli Venezia Giulia (FVG) region, north-eastern Italy, was characterized by work activities in which asbestos was used until the early 1990s, particularly in shipbuilding. A public health surveillance program (PHSP) for asbestos-exposed workers was established, although limited evidence exists about the efficacy of such programs in reducing disease occurrence and mortality. Objectives: To compare mortality in a cohort of 2,488 men occupationally exposed to asbestos, enrolled in a PHSP in FVG between the early 1990s and 2008, with that of the general population of FVG and Italy. Methods: Standardized Mortality Ratios (SMR), with 95% Confidence Interval (95% CI), for all causes, all cancers, lung (LC) and pleural cancer (PC) were estimated in the cohort and in subgroups of workers with the first hire in shipbuilding that caused asbestos exposure (<1974, 1974-1984, 1985-1994). Results: A strong excess in mortality for PC with reference to FVG (SMR=6.87, 95% CI 4.45-10.17) and Italian population (SMR=13.95, 95% CI 9.02-20.64) was observed. For LC, the FVG-based SMR was 1.49 (95% CI 1.17-1.89) and the Italy-based 1.43 (95% CI 1.12-1.81). Mortality among workers with the first hire in shipbuilding before 1974 was high for PC (FVG-based SMR=8.98, 95% CI 5.56-13.75; Italy-based SMR=18.41, 95% CI 11.40-28.17) and for LC (FVG-based SMR =1.60, 95% CI 1.18-2.11; Italy-based SMR=1.54, 95% CI 1.14-2.03). Further, for LC between 1974 and 1984, the FVG-based SMR was 2.45 (95% CI 1.06-4.82), and the Italy-based SMR was 2.33 (95% CI 1.01-4.60). Conclusions: This cohort experienced an excess mortality for pleural and lung cancer, compared with regional and national populations. For lung cancer, the excess was stronger in workers with the first hire in shipbuilding before 1985, suggesting a key role of asbestos exposure.
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Affiliation(s)
- Fabiano Barbiero
- Department of Medical Area (DAME), University of Udine, Udine, Italy Health and Health and Safety at Work Department (SPISAL), Local Health Authority N. 12, Region of Veneto, Mestre, Italy.
| | - Tina Zanin
- Health and Safety at Work Department. Local Health Authority No 2 (ASS2), Region of Friuli Venezia Giulia, Gorizia, Italy.
| | - Federica Edith Pisa
- Department Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology BIPS, Bremen, Germany and Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy.
| | - Anica Casetta
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
| | - Valentina Rosolen
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
| | - Manuela Giangreco
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy.
| | - Massimo Bovenzi
- Clinical Unit of Occupational Medicine, Department of Medical Sciences, University of Trieste, Trieste, Italy.
| | - Fabio Barbone
- Department of Medical Area (DAME), University of Udine, Udine, Italy.
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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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Tompa E, Kalcevich C, McLeod C, Lebeau M, Song C, McLeod K, Kim J, Demers PA. The economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure. Occup Environ Med 2017; 74:816-822. [PMID: 28756416 PMCID: PMC5740539 DOI: 10.1136/oemed-2016-104173] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 05/10/2017] [Accepted: 05/20/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada. METHODS We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs. RESULTS There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively. CONCLUSIONS The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation.
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Affiliation(s)
- Emile Tompa
- Institute for Work and Health, Toronto, Ontario, Canada.,Department of Economics, McMaster University, Hamilton, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Chris McLeod
- Institute for Work and Health, Toronto, Ontario, Canada.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Lebeau
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
| | - Chaojie Song
- Occupation Cancer Research Centre, Toronto, Ontario, Canada
| | - Kim McLeod
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joanne Kim
- Occupation Cancer Research Centre, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupation Cancer Research Centre, Toronto, Ontario, Canada
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Abós-Herràndiz R, Rodriguez-Blanco T, Garcia-Allas I, Rosell-Murphy IM, Albertí-Casas C, Tarrés J, Krier-Günther I, Martinez-Artés X, Orriols R, Grimau-Malet I, Canela-Soler J. Risk Factors of Mortality from All Asbestos-Related Diseases: A Competing Risk Analysis. Can Respir J 2017; 2017:9015914. [PMID: 28680295 PMCID: PMC5478817 DOI: 10.1155/2017/9015914] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 05/08/2017] [Accepted: 05/17/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The mortality from all malignant and nonmalignant asbestos-related diseases remains unknown. The authors assessed the incidence and risk factors for all asbestos-related deaths. METHODS The sample included 544 patients from an asbestos-exposed community in the area of Barcelona (Spain), between Jan 1, 1970, and Dec 31, 2006. Competing risk regression through a subdistribution hazard analysis was used to estimate risk factors for the outcomes. RESULTS Asbestos-related deaths were observed in 167 (30.7%) patients and 57.5% of these deaths were caused by some type of mesothelioma. The incidence rate after diagnosis was 3,600 per 100,000 person-years. In 7.5% of patients death was non-asbestos-related, while pleural and peritoneal mesothelioma were identified in 87 (16.0%) and 18 (3.3%) patients, respectively. CONCLUSIONS Age, sex, household exposure, cumulative nonmalignant asbestos-related disease, and single malignant pathology were identified as risk factors for asbestos-related death. These findings suggest the need to develop a preventive approach to the community and to improve the clinical follow-up process of these patients.
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Affiliation(s)
- Rafael Abós-Herràndiz
- Catalan Health Institute (ICS), Division of Primary Health Care, Department of Health, Barcelona, Catalonia, Spain
| | - Teresa Rodriguez-Blanco
- Primary Care Research Institute (IDIAP Jordi Gol) and Research Associate, Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Isabel Garcia-Allas
- Catalan Health Institute (ICS), Division of Primary Health Care, Department of Health, Barcelona, Catalonia, Spain
| | | | | | - Josep Tarrés
- Catalan Health Institute (ICS), Division of Primary Health Care, Department of Health, Barcelona, Catalonia, Spain
| | - Illona Krier-Günther
- Catalan Health Institute (ICS), Division of Primary Health Care, Department of Health, Barcelona, Catalonia, Spain
| | - Xavier Martinez-Artés
- Catalan Health Institute (ICS), Division of Primary Health Care, Department of Health, Barcelona, Catalonia, Spain
| | - Ramon Orriols
- Pneumology Unit, Hospitals de Girona i Salt, Institut d'Investigació Biomèdica de Girona (IDIBGI), Girona, Catalonia, Spain
- Ciber de Enfermedades Respiratorias (CIBERES), Palma de Mallorca, Baleares, Spain
| | | | - Jaume Canela-Soler
- Department of Public Health, University of Barcelona (UB), Barcelona, Spain
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, Tampa, FL, USA
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Kang DM, Kim JE, Kim JY, Lee HH, Hwang YS, Kim YK, Lee YJ. Environmental asbestos exposure sources in Korea. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2016; 22:307-314. [PMID: 27726756 PMCID: PMC5137559 DOI: 10.1080/10773525.2016.1231948] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background Because of the long asbestos-related disease latencies (10–50 years), detection, diagnosis, and epidemiologic studies require asbestos exposure history. However, environmental asbestos exposure source (EAES) data are lacking. Objectives To survey the available data for past EAES and supplement these data with interviews. Methods We constructed an EAES database using a literature review and interviews of experts, former traders, and workers. Exposure sources by time period and type were visualized using a geographic information system (ArcGIS), web-based mapping (Google Maps), and OpenWeatherMap. The data were mounted in the GIS to show the exposure source location and trend. Results The majority of asbestos mines, factories, and consumption was located in Chungnam; Gyeonggi, Busan, and Gyeongnam; and Gyeonggi, Daejeon, and Busan, respectively. Shipbuilding and repair companies were mostly located in Busan and Gyeongnam. Conclusions These tools might help evaluate past exposure from EAES and estimate the future asbestos burden in Korea.
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Affiliation(s)
- Dong-Mug Kang
- a Occupational and Environmental Medicine , Pusan National University Yangsan Hospital Environmental Health Center for Asbestos , Yangsan-si , South Korea.,b Preventive and Occupational Medicine , School of Medicine, Pusan National University , Yangsan-si , South Korea
| | - Jong-Eun Kim
- a Occupational and Environmental Medicine , Pusan National University Yangsan Hospital Environmental Health Center for Asbestos , Yangsan-si , South Korea
| | - Ju-Young Kim
- a Occupational and Environmental Medicine , Pusan National University Yangsan Hospital Environmental Health Center for Asbestos , Yangsan-si , South Korea.,b Preventive and Occupational Medicine , School of Medicine, Pusan National University , Yangsan-si , South Korea
| | - Hyun-Hee Lee
- a Occupational and Environmental Medicine , Pusan National University Yangsan Hospital Environmental Health Center for Asbestos , Yangsan-si , South Korea
| | - Young-Sik Hwang
- b Preventive and Occupational Medicine , School of Medicine, Pusan National University , Yangsan-si , South Korea
| | - Young-Ki Kim
- a Occupational and Environmental Medicine , Pusan National University Yangsan Hospital Environmental Health Center for Asbestos , Yangsan-si , South Korea.,b Preventive and Occupational Medicine , School of Medicine, Pusan National University , Yangsan-si , South Korea
| | - Yong-Jin Lee
- c Asbestos Environmental Health Center , SoonChunhyang University Hospital Cheonan , Cheonan-si , South Korea
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Boffetta P, La Vecchia C. Re: Asbestos and product defence science: Table 1. Int J Epidemiol 2016; 45:1690-1691. [DOI: 10.1093/ije/dyw257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2016] [Indexed: 11/14/2022] Open
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Oliver LC, Welch L, Frank AL, Lemen RA, Mutti L. New standard for assessing asbestos exposure and its consequences? Occup Environ Med 2016; 73:709-10. [PMID: 27466614 DOI: 10.1136/oemed-2016-103693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/19/2016] [Indexed: 11/03/2022]
Affiliation(s)
- L Christine Oliver
- Massachusetts General Hospital/Harvard Medical School, Occupational Health Initiatives, Inc, Brookline, Massachusetts, USA
| | - Laura Welch
- Center for Construction Research and Training, Washington DC, USA
| | - Arthur L Frank
- Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Richard A Lemen
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Luciano Mutti
- University of Salford, Salford, Greater Manchester, UK
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Tomasson K, Gudmundsson G, Briem H, Rafnsson V. Malignant mesothelioma incidence by nation-wide cancer registry: a population-based study. J Occup Med Toxicol 2016; 11:37. [PMID: 27462362 PMCID: PMC4960893 DOI: 10.1186/s12995-016-0127-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 07/18/2016] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Malignant mesothelioma caused by asbestos exposure has a long latency period. A ban on asbestos use may not be apparent in decreased incidence in the population until after several decades. The aim was to evaluate changes in the incidence of malignant mesothelioma, and the possible impact of the asbestos ban implemented in Iceland in 1983. METHODS This is a population study on aggregate level; the source of data was the Icelandic Cancer Registry, the National Cause-of-Death Registry, and the National Register. Volume of asbestos import was obtained from Customs Tariff. The import figures reflect fairly accurately the amount used, as there are no mines in the country. RESULTS Asbestos import peaked in 1980 at 15.0 kg/capita/year, diminishing to 0.3 kg/capita/year ten years after the ban in 1983, and to zero in the most recent years. Seventy-nine per cent of the cases of malignant mesothelioma were men, and 72 % were of pleural origin. Mesothelioma incidence increased steadily from 1965 to 2014, when it reached 21.4 per million among men, and 5.6 among women. Mortality in 2014 was 22.2 per million among men, and 4.8 among women. CONCLUSION Malignant mesothelioma incidence and mortality increased in the population during the period, despite the ban on asbestos use from 1983. This is in agreement with the long latency time for malignant mesothelioma. In line with the previously high per capita volume of asbestos import, many buildings, equipment, and structures contain asbestos, so there is an on-going risk of asbestos exposure during maintenance, renovations and replacements. It is thus difficult to predict when the incidence of malignant mesothelioma will decrease in the future. During the last ten-year period, the incidence in Iceland was higher than the recently reported incidence in neighbouring countries.
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Affiliation(s)
- Kristinn Tomasson
- Department of Occupational Medicine, Administration of Occupational Safety and Health, Reykjavik, Iceland
| | - Gunnar Gudmundsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland ; Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Fossvogur, 108 Reykjavik, Iceland
| | - Haraldur Briem
- Centre for Health Security and Communicable Disease Control, Directorate of Health, Reykjavik, Iceland
| | - Vilhjalmur Rafnsson
- Department of Preventive Medicine, University of Iceland, Stapi/ Hringbraut, Reykjavik, Iceland
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Andersson M, Selin F, Järvholm B. Asbestos exposure and the risk of sinonasal cancer. Occup Med (Lond) 2016; 66:326-31. [PMID: 26940471 DOI: 10.1093/occmed/kqw018] [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: 02/03/2023] Open
Abstract
BACKGROUND While the increased risk of lung cancer and mesothelioma is well established, the relationship between exposure to asbestos dust and sinonasal cancer is less clear. AIMS To study the risk of sinonasal cancer in relation to asbestos dust exposure. METHODS A retrospective cohort study of construction workers, linked to the Swedish Cancer Registry. Participants were classified into four exposure groups; heavy, medium, low or very low exposure to asbestos, according to the incidence of pleural mesothelioma in their occupational group. Standardized incidence ratios (SIRs) and relative risks (RRs) were analysed, adjusted for age and smoking habits. The risks of adenocarcinoma and squamous cell carcinoma were investigated separately. RESULTS Among the 280222 subjects, there was no increased risk of sinonasal cancer compared to the general population [SIR 0.85, 95% confidence interval (CI) 0.68-1.03], or any dose-response relationship with exposure to asbestos. The highest RR was found in the low exposure group (RR 1.25, 95% CI 0.69-2.28) and the lowest RR was found in the group with the highest exposure to asbestos (RR 0.71, 95% CI 0.33-1.53). No significantly increased risk or dose-response association could be found for adenocarcinoma or squamous cell carcinoma when analysed separately. CONCLUSIONS This study did not find an increased risk of developing sinonasal cancer after asbestos exposure.
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Affiliation(s)
- M Andersson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90185 Umeå, Sweden.
| | - F Selin
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90185 Umeå, Sweden
| | - B Järvholm
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90185 Umeå, Sweden
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Egilman D, Bird T. Short fiber tremolite free chrysotile mesothelioma cohort revealed. Am J Ind Med 2016; 59:196-9. [PMID: 26725926 DOI: 10.1002/ajim.22552] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2015] [Indexed: 11/07/2022]
Abstract
In 1995, Dell and Teta published a cohort mortality study of asbestos molding compound workers at a Union Carbide Corporation (UCC) plastics manufacturing plant in Bound Brook, New Jersey. They reported that the factory workers were exposed to "asbestos (mostly chrysotile)," implying that the asbestos used at the Bound Brook plant occasionally contained amphiboles. However, UCC statements and testimony from recent litigation indicate that the Bound Brook plant exclusively used short fiber chrysotile asbestos. These recent documents also point to lower exposures than those reported by Dell and Teta. This chrysotile-only cohort should be included in analyses of chrysotile potency.
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Affiliation(s)
- David Egilman
- Clinical Professor of Family Medicine; Alpert School of Medicine at Brown University; Attleboro Massachusetts
| | - Tess Bird
- Never Again Consulting; Attleboro Massachusetts
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Van der Bij S, Vermeulen RCH, Portengen L, Moons KGM, Koffijberg H. Expected number of asbestos-related lung cancers in the Netherlands in the next two decades: a comparison of methods. Occup Environ Med 2016; 73:342-9. [PMID: 26858099 DOI: 10.1136/oemed-2014-102614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/20/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Exposure to asbestos fibres increases the risk of mesothelioma and lung cancer. Although the vast majority of mesothelioma cases are caused by asbestos exposure, the number of asbestos-related lung cancers is less clear. This number cannot be determined directly as lung cancer causes are not clinically distinguishable but may be estimated using varying modelling methods. METHODS We applied three different modelling methods to the Dutch population supplemented with uncertainty ranges (UR) due to uncertainty in model input values. The first method estimated asbestos-related lung cancer cases directly from observed and predicted mesothelioma cases in an age-period-cohort analysis. The second method used evidence on the fraction of lung cancer cases attributable (population attributable risk (PAR)) to asbestos exposure. The third method incorporated risk estimates and population exposure estimates to perform a life table analysis. RESULTS The three methods varied substantially in incorporated evidence. Moreover, the estimated number of asbestos-related lung cancer cases in the Netherlands between 2011 and 2030 depended crucially on the actual method applied, as the mesothelioma method predicts 17 500 expected cases (UR 7000-57 000), the PAR method predicts 12 150 cases (UR 6700-19 000), and the life table analysis predicts 6800 cases (UR 6800-33 850). CONCLUSIONS The three different methods described resulted in absolute estimates varying by a factor of ∼2.5. These results show that accurate estimation of the impact of asbestos exposure on the lung cancer burden remains a challenge.
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Affiliation(s)
- Sjoukje Van der Bij
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lützen Portengen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Karel G M Moons
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Hendrik Koffijberg
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
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Schwartz AG, Cote ML. Epidemiology of Lung Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 893:21-41. [PMID: 26667337 DOI: 10.1007/978-3-319-24223-1_2] [Citation(s) in RCA: 122] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Lung cancer continues to be one of the most common causes of cancer death despite understanding the major cause of the disease: cigarette smoking. Smoking increases lung cancer risk 5- to 10-fold with a clear dose-response relationship. Exposure to environmental tobacco smoke among nonsmokers increases lung cancer risk about 20%. Risks for marijuana and hookah use, and the new e-cigarettes, are yet to be consistently defined and will be important areas for continued research as use of these products increases. Other known environmental risk factors include exposures to radon, asbestos, diesel, and ionizing radiation. Host factors have also been associated with lung cancer risk, including family history of lung cancer, history of chronic obstructive pulmonary disease and infections. Studies to identify genes associated with lung cancer susceptibility have consistently identified chromosomal regions on 15q25, 6p21 and 5p15 associated with lung cancer risk. Risk prediction models for lung cancer typically include age, sex, cigarette smoking intensity and/or duration, medical history, and occupational exposures, however there is not yet a risk prediction model currently recommended for general use. As lung cancer screening becomes more widespread, a validated model will be needed to better define risk groups to inform screening guidelines.
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Affiliation(s)
- Ann G Schwartz
- Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA.
| | - Michele L Cote
- Department of Oncology, Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
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Järvholm B, Burdorf A. Emerging evidence that the ban on asbestos use is reducing the occurrence of pleural mesothelioma in Sweden. Scand J Public Health 2015; 43:875-81. [PMID: 26194352 PMCID: PMC4638313 DOI: 10.1177/1403494815596500] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2015] [Indexed: 11/17/2022]
Abstract
AIMS Several countries have banned the use of asbestos. The future health impacts of previous use have been modeled but there are to our knowledge no convincing studies showing a decreased occurrence of asbestos-related diseases due to a ban. The aim of our study was to estimate the effects of the ban and other measures to decrease the use of asbestos in Sweden. METHODS The effect was measured through comparing the incidence of pleural malignant mesothelioma in birth cohorts who started to work before and after the decrease in the use of asbestos, i.e. in mid-1970s. Cases were identified through the Swedish Cancer Registry and the analysis was restricted to persons born in Sweden. RESULTS Men and women born 1955-79 had a decreased risk of malignant pleural mesothelioma compared to men and women born 1940-49 (RR 0.16, 95% CI 0.11-0.25; and RR 0.47, 95% CI 0.23-0.97 respectively). The decreased use of asbestos prevented each year about 10 cases in men and two cases in women below the age of 57 years in 2012. CONCLUSIONS The ban and decreased use of asbestos in Sweden can be measured today in birth cohorts that started their working career after the decrease.
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Affiliation(s)
- Bengt Järvholm
- Occupational Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Alex Burdorf
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Lortet-Tieulent J, Renteria E, Sharp L, Weiderpass E, Comber H, Baas P, Bray F, Coebergh JW, Soerjomataram I. Convergence of decreasing male and increasing female incidence rates in major tobacco-related cancers in Europe in 1988-2010. Eur J Cancer 2015; 51:1144-63. [PMID: 24269041 DOI: 10.1016/j.ejca.2013.10.014] [Citation(s) in RCA: 94] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 10/18/2013] [Accepted: 10/22/2013] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Smoking prevalence has been declining in men all over Europe, while the trend varies in European regions among women. To study the impact of past smoking prevalence, we present a comprehensive overview of the most recent trends in incidence, during 1988-2010, in 26 countries, of four of the major cancers in the respiratory and upper gastro-intestinal tract associated with tobacco smoking. METHODS Data from 47 population-based cancer registries for lung, laryngeal, oral cavity and pharyngeal, and oesophageal cancer cases were obtained from the newly developed data repository within the European Cancer Observatory (http://eco.iarc.fr/). Truncated age-standardised incidence rates (35-74 years) by calendar year, average annual percentage change in incidence over 1998-2007 were calculated. Smoking prevalence in selected countries was extracted from the Organisation for Economic Co-operation and Development and the World Health Organization databases. RESULTS There remained great but changing variation in the incidence rates of tobacco-related cancers by European region. Generally, the high rates among men have been declining, while the lower rates among women are increasing, resulting in convergence of the rates. Female lung cancer rates were above male rates in Denmark, Iceland and Sweden (35-64 years). In lung and laryngeal cancers, where smoking is the main risk factor, rates were highest in central and eastern Europe, southern Europe and the Baltic countries. Despite a lowering of female smoking prevalence, female incidence rates of lung, laryngeal and oral cavity cancers increased in most parts of Europe, but were stable in the Baltic countries. Mixed trends emerged in oesophageal cancer, probably explained by differing risk factors for the two main histological subtypes. CONCLUSIONS This data repository offers the opportunity to show the variety of incidence trends by sex among European countries. The diverse patterns of trends reflect varied exposure to risk factors. Given the heavy cancer burden attributed to tobacco and the fact that tobacco use is entirely preventable, tobacco control remains a top priority in Europe. Prevention efforts should be intensified in central and eastern Europe, southern Europe and the Baltic countries.
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Affiliation(s)
- Joannie Lortet-Tieulent
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France; Surveillance & Health Services Research, American Cancer Society, Atlanta, United States
| | - Elisenda Renteria
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | | | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Samfundet Folkhälsan, Helsinki, Finland
| | | | - Paul Baas
- Department of Thoracic Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Freddie Bray
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France
| | - Jan Willem Coebergh
- Erasmus University Medical Centre, Department of Public Health, Rotterdam, The Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Centre South, Eindhoven, The Netherlands
| | - Isabelle Soerjomataram
- Section of Cancer Information, International Agency for Research on Cancer, Lyon, France.
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Lippmann M. Toxicological and epidemiological studies on effects of airborne fibers: coherence and public [corrected] health implications. Crit Rev Toxicol 2015; 44:643-95. [PMID: 25168068 DOI: 10.3109/10408444.2014.928266] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Airborne fibers, when sufficiently biopersistent, can cause chronic pleural diseases, as well as excess pulmonary fibrosis and lung cancers. Mesothelioma and pleural plaques are caused by biopersistent fibers thinner than ∼0.1 μm and longer than ∼5 μm. Excess lung cancer and pulmonary fibrosis are caused by biopersistent fibers that are longer than ∼20 μm. While biopersistence varies with fiber type, all amphibole and erionite fibers are sufficiently biopersistent to cause pathogenic effects, while the greater in vivo solubility of chrysotile fibers makes them somewhat less causal for the lung diseases, and much less causal for the pleural diseases. Most synthetic vitreous fibers are more soluble in vivo than chrysotile, and pose little, if any, health pulmonary or pleural health risk, but some specialty SVFs were sufficiently biopersistent to cause pathogenic effects in animal studies. My conclusions are based on the following: 1) epidemiologic studies that specified the origin of the fibers by type, and especially those that identified their fiber length and diameter distributions; 2) laboratory-based toxicologic studies involving fiber size characterization and/or dissolution rates and long-term observation of biological responses; and 3) the largely coherent findings of the epidemiology and the toxicology. The strong dependence of effects on fiber diameter, length, and biopersistence makes reliable routine quantitative exposure and risk assessment impractical in some cases, since it would require transmission electronic microscopic examination, of representative membrane filter samples, for determining statistically sufficient numbers of fibers longer than 5 and 20 μm, and those thinner than 0.1 μm, based on the fiber types.
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Affiliation(s)
- Morton Lippmann
- Department of Environmental Medicine, New York University School of Medicine , Tuxedo, NY , USA
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50
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Pasetto R, Terracini B, Marsili D, Comba P. Occupational Burden of Asbestos-related Cancer in Argentina, Brazil, Colombia, and Mexico. Ann Glob Health 2014; 80:263-8. [DOI: 10.1016/j.aogh.2014.09.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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