Methodologies for determining the sources, characteristics, distribution, and abundance of asbestiform and nonasbestiform amphibole and serpentine in ambient air and water

Environmental asbestos exposure from nephrite jade mining and lung cancer

BACKGROUND

Nephrite is an asbestos mineral composed of tremolite and actinolite. Fengtian is a community where nephrite was mined between 1970 and 1980 and asbestos was mined between 1960 and 1985. The lung cancer risk to the surrounding community is unknown.

AIMS

To analyse the trend of lung cancer caused by environmental contamination from nephrite mining.

METHODS

We conducted a field survey of nephrite mines and tracked new cases of lung cancer from 1980 to 2019. We calculated the age-standardized incidence rates (ASIRs) and applied join-point regression to examine the lung cancer trend. We assessed the age effect, period effect, and birth cohort effect on lung cancer risk.

RESULTS

The nephrite mines were contaminated with chrysotile and tremolite/actinolite asbestos. A total of 278 new cases of lung cancer were reported during the study period. There was an apparent age effect and a slight period effect for lung cancer. After adjustment for the age and period effects, the birth cohort born between 1970 and 1980 during the period of nephrite mass production had the highest relative risk compared with other birth cohorts. The ASIR of lung cancer increased significantly from 1980 to 2010 (the annual percentage change = 6.8 %, 95 % CI: 4.0-9.7 %, P < 0.01) and then decreased 30 years after the cessation of nephrite jade mining.

CONCLUSION

Nephrite mining increases the risk of lung cancer in nearby communities.

Discriminant analysis of amphiboles: Additional considerations

Amphibole minerals are found throughout nature and could pose a respiratory hazard if these exist in the asbestiform growth habit. Though amphibole asbestos has not been used in commercial products as an added material for more than 30 years, these minerals could exist in other materials as trace contaminants as well as occurring in mines and earth-moving environments. It is necessary, then, that the asbestiform amphibole minerals be properly identified in order to appropriately use health-protective measures. Recent analyses of various amphibole data sets have been used to derive a discriminant function that can be used to differentiate asbestiform amphibole from non-asbestiform amphibole minerals. This paper expands on this function and examines the validity of the procedure for different size fractions of minerals. This analysis suggests that the derived function is appropriate for fibers 10 μm and longer. For fibers shorter than 10 μm, the data suggest that a broader acceptance limit may be needed. The data also suggest that current analytical procedures may require some adjustment to provide more accurate details on the widths of fibers. With additional samples, the accuracy of the discriminate function can be improved by calculating functions for each mineral.

Evaluation of asbestos exposure resulting from simulated application of spiked talcum powders

This study characterizes airborne asbestos exposures resulting from the adult application of cosmetic talc body powders spiked with known concentrations of tremolite. Raw talc ores were spiked with 0.005% and 0.1% asbestiform or non-asbestiform tremolite. Personal samples were collected during 16 simulated events, including puff and shaker application and associated clean-up activities. Airborne fiber levels (PCM) were not significantly different for simulations involving talc spiked with asbestiform and non-asbestiform tremolite (p = 0.6104). For application and clean-up of talc spiked with 0.005% asbestiform tremolite, 2 of 24 (8.3%) samples were above the LOD for TEM (0.003 f/cc). For application of talc spiked with 0.1% asbestiform tremolite, 21 of 24 (87.5%) were above the LOD for TEM. The corresponding mean PCME asbestos concentrations were 0.016 f/cc for puff and shaker for samples collected in the first 15 min, 0.002 f/cc for puff and 0.004 f/cc for shaker in the second 15 min, and 0.005 f/cc for puff and 0.013 f/cc for shaker for the full 30 min. Mean PCME concentrations for samples collected during clean-up following application of talc spiked with 0.1% asbestiform tremolite were 0.003 f/cc for samples collected in the first 15 min following puff application, 0.005 f/cc for samples collected in the second 15 min following shaker application, and 0 f/cc for the remaining clean-up samples. Using the EPA's exposure factors, we determined the range of cumulative asbestiform fiber exposures that would result from product use, assuming asbestiform tremolite was present at 0.1%.

Modeling mesothelioma risk factors from amphibole fiber dimensionality: mineralogical and epidemiological perspective

Amphiboles are common rock-forming minerals but when they form asbestos, they are known carcinogens. Mesothelioma mortality among miners and millers per the unit of asbestiform amphibole exposure varies significantly across cohorts when asbestos exposure measurements are based on the membrane filter method. Because the cohorts were exposed to different occurrences of asbestiform amphibole, variance in mesothelioma potency (R_M ) among cohorts is likely due to differences in exposure characteristics not reflected by the membrane filter method. In this paper using both linear and nonlinear models we correlate R_M from four mining and milling cohorts with two-dimensional parameters of the exposure. The parameters are based on the proportion of elongated minerals that are >5 μm in length from each occurrence that also have either (a) width ≤ 0.15 μm, or (b) width ≤ 0.25 μm. Based on the models we derived, it was possible to quantify R_M for the occurrences of asbestiform amphibole associated with mesothelioma excess but for which epidemiologically based R_M has not been published. It was demonstrated that modeled R_M for amphibole occurrences in nonasbestiform habits are lower (fibrous glaucophane) or not significant (cleavage fragments). The results of the study can be used in a risk assessment of elongated mineral particles and have implications for public policy and regulations.

The Concentration of Asbestos Fibers in Bulk Samples and Its Variation with Grain Size

The aim of this work was to establish whether asbestos fibers homogeneously occur in the different fractions ground from naturally occurring asbestos lithotypes, and to calculate the contribution of fibers from each fraction to the overall concentration in the sample. Serpentinite, metabasalt, calc-schist, clay, debris material, and soil, were addressed. Grain size fractions below 20 mm were sieved at 2 mm and 0.106 mm; they were then were mechanically milled to obtain powders below 0.106 mm. The three powdered fractions were characterized using a scanning electron microscope coupled with energy dispersive spectroscopy following M.D. 06/09/94. The still in use (in some cases), Italian normative M.D. 161/2012 specifies that analyses must be performed on the <2 mm fraction and the concentration (mg/kg) correlated with the weight of the whole sample <20 mm. However, the fiber counts yielded asbestos concentrations 50–60% lower compared with total asbestos analyses according to the new R.P.D. 120/2017. Consequently, there is a need to standardize the normative worldwide regulations for the management of asbestos-containing materials, by re-evaluation of sample preparation and quantification of asbestos.

New comprehensive approach for airborne asbestos characterisation and monitoring

High concentrations of airborne asbestos in the ambient air are still a serious problem of air quality in numerous localities around the world. Since 2002, elevated concentrations of asbestos minerals of unknown origin have been detected in the ambient air of Pilsen, Czech Republic. To determine the asbestos fibre sources in this urban air, a systematic study was conducted. First, 14 bulk dust samples were collected in Pilsen at nine localities, and 6 bulk samples of construction aggregates for gravel production were collected in a quarry in the Pilsen-Litice district. The quarry is the largest quarry in the Pilsen region and the closest quarry to the built-up urban area. X-ray diffraction of the asbestos minerals revealed that monoclinic amphibole (MA, namely actinolite based on subsequent SEM-EDX analysis) in the bulk samples accounted for < 1-33% of the mass and that the highest values were found in the bulk dust samples from the railway platform of the Pilsen main railway station. Simultaneously, 24-h samples of airborne particulate matter (PM) at three localities in Pilsen were collected. Actinolite was identified in 40% of the PM samples. The relationship between the meteorology and presence of actinolite in the 24 PM₁₀ samples was not proven, probably due to the long sampling integration time. Therefore, highly time-and-size-resolved PM sampling was performed. Second, sampling of size-segregated aerosols and measurements of the wind speed (WS), wind direction (WD), precipitation (P) and hourly PM₁₀, PM_2.5 and PM₁ were conducted in a suburban locality near the quarry in two monthly highly time-resolved periods (30, 60, 120 min). Three/eight PM size fractions were sampled by a Davis Rotating-drum Uniform-size-cut Monitor (3/8DRUM) and analysed for the presences of asbestos fibres by scanning electron microscopy with energy dispersive x-ray spectroscopy (SEM-EDX). Asbestos fibre detection in highly time-resolved PM samples and current WD and WS determination allows the apportionment directionality of asbestos fibre sources. The number of critical actinolite asbestos fibres (length ≥ 5 μm and width < 3 μm, 3:1) increased with the PM_1-10/PM₁₀ and PM_2.5-10/PM₁₀ ratios, WS > 2 m s^-1 and precipitation < 1 mm. Additionally, the number of critical actinolite asbestos fibres was not related to a specific WD. Therefore, we conclude that the sources of airborne critical actinolite asbestos fibres in Pilsen's urban area are omnipresent. Frequent use of construction aggregates and gravel from the metamorphic spilite quarries in the Pilsen region and in many localities around the urban area is a plausible explanation for the omnipresence of the critical actinolite asbestos fibres concentration in Pilsen's ambient air. Mitigation strategies to reduce the concentrations of critical actinolite asbestos fibres must be developed. Continuous monitoring and performing SEM-EDX analysis of highly time-and-size-resolved PM samples, correlated with fast changing WS and WD, seems to be a strong tool for efficiently controlling the mitigation strategies of critical actinolite asbestos fibres.

Identification and analysis of ambient EMPs

Mineral particles have long been observed in the ambient air and for >40 years, samples of these airborne particulate have been collected in attempt to identify and quantify the amount of asbestos particles in the air. For most of this time, regulated asbestos particles (in the shape of fibers) were the target for these analyses. However, since the turn of the century, more emphasis has been placed on finding and identifying elongate mineral particles (EMPs). For EMPs (particularly serpentine and amphibole minerals), these airborne particles have generally been associated with industrial activities and were reported as "asbestos". Recent monitoring around construction activities involving earth moving have reported concentrations of different mineral particles at sites of varying distance from the activity. The location of detected ambient elongate mineral particles (EMPs) is similar to the locations of soils that also contain EMPs. This close association indicates the necessity for proper mineral identification and valid morphological characterization to allow for source identification. Unfortunately, there continues to be problems with mineral identifications in many studies, regardless of the morphological habit of the particle. This paper addresses the issue of proper mineral identification in ambient air samples.

Recent Scientific Evidence Regarding Asbestos Use and Health Consequences of Asbestos Exposure

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.

Characterization of pulmonary responses in mice to asbestos/asbestiform fibers using gene expression profiles

Humans exposed to asbestos and/or asbestiform fibers are at high risk of developing many lung diseases including asbestosis, lung cancer, and malignant mesothelioma. However, the disease-causing potential and specific metabolic mechanisms and pathways associated with various asbestos/asbestiform fiber exposures triggering different carcinogenic and non-carcinogenic outcomes are still largely unknown. The aim of this this study was to investigate gene expression profiles and inflammatory responses to different asbestos/asbestiform fibers at the acute/sub-acute phase that may be related to delayed pathological outcomes observed at later time points. Mice were exposed to asbestos (crocidolite, tremolite asbestos), asbestiform fibers (erionite), and a low pathogenicity mineral fiber (wollastonite) using oropharyngeal aspiration. Similarities in inflammatory and tissue damage responses, albeit with quantitative differences, were observed at day 1 and 7 post treatment. Exposure to different fibers induced significant changes in regulation and release of a number of inflammatory cytokines/chemokines. Comparative analysis of changes in gene regulation in the lung on day 7 post exposure were interpretable in the context of differential biological responses that were consistent with histopathological findings at days 7 and 56 post treatment. Our results noted differences in the magnitudes of pulmonary responses and gene regulation consistent with pathological alterations induced by exposures to four asbestos/asbestiform fibers examined. Further comparative mechanistic studies linking early responses with the long-term endpoints may be instrumental to understanding triggering mechanisms underlying pulmonary carcinogenesis, that is lung cancer versus mesothelioma.

Comparative health effects in mice of Libby amphibole asbestos and a fibrous amphibole from Arizona

This project developed from studies demonstrating that Libby Amphibole Asbestos (LAA) causes a non-typical set of health outcomes not generally reported for asbestos, including systemic autoimmunity and an unusual and devastating lamellar pleural thickening that progresses to severe pulmonary dysfunction and death. Further, mineral fiber mixtures with some similarities to LAA have recently been discovered in southern Nevada and northwestern Arizona, where the material exists in extensive recreational areas and is present in yards, roads, parking lots and school yards. The objective was to compare the health outcomes in mice exposed to either LAA or the fibrous amphiboles collected in Arizona at the Lake Mead National Recreational Area at very low doses to represent environmental exposures. In this study, the fibrous amphibole asbestos sample from Arizona (AzA) is composed of winchite (69%), actinolite (22%), and non-amphibole minerals (9%) and has a mean aspect ratio of 16.7±0.9. Fibrous amphibole asbestos from Libby (LAA) is composed of winchite (70%), richterite (9%), tremolite (5%), and non-amphibole minerals (16%) with a mean aspect ratio of 8.4±0.7. C57BL/6 mice were exposed by oropharyngeal aspiration to fiber suspensions at a very low dose of 3μg/mouse. After seven months, both LAA- and AzA-exposed mice had indices of chronic immune dysfunction related to a T_H17 cytokine profile, with B cell activation, autoantibody production and proteinuria, suggesting kidney involvement. In addition, both exposures led to significant lung and pleural fibrosis. These data suggest that there is risk of pulmonary disease and autoimmune outcomes with environmental exposure to amphibole asbestos, and that this is not limited to Libby, Montana.

Airborne asbestos fibres monitoring in tunnel excavation

Tunnelling across ophiolitic formation with Naturally Occurring Asbestos (NOA) can release fibres into the environment, exposing workers, and the population, if fibres spread outside the tunnel, leading to increased risk of developing asbestos-related disease. Therefore, a careful plan of environmental monitoring is carried out during Terzo Valico tunnel excavation. In the present study, data of 1571 samples of airborne dust, collected between 2014 and 2016 inside the tunnels, and analyzed by SEM-EDS for quantification of workers exposure, are discussed. In particular, the engineering and monitoring management of 100 m tunnelling excavation across a serpentinite lens (Cravasco adit), intercalated within calcschists, is reported. At this chrysotile occurrence, 84% of 128 analyzed samples (from the zone closer to the front rock) were above 2 ff/l. However, thanks to safety measures implemented and tunnel compartmentation in zones, the asbestos fibre concentration did not exceed the Italian standard of occupational exposure (100 ff/l) and 100% of samples collected in the outdoor square were below 1 ff/l. During excavation under normal working conditions, asbestos concentrations were below 2 ff/l in 97.4% of the 668 analyzed samples. Our results showed that air monitoring can objectively confirm the presence of asbestos minerals at a rock front in relative short time and provide information about the nature of the lithology at the front. The present dataset, the engineering measures described and the operative conclusions are liable to support the improvement of legislation on workers exposure to asbestos referred to the tunnelling sector, lacking at present.

The Cappadocia mesothelioma epidemic: its influence in Turkey and abroad

The epidemic of mesothelioma in Cappadocia, Turkey, is unprecedented in medical history. In three Cappadocian villages, Karain, Tuzkoy and "old" Sarihidir, about 50% of all deaths (including neonatal deaths and traffic fatalities) have been caused by mesothelioma. No other epidemic in medical history has caused such a high incidence of death. This is even more unusual when considering that (I) epidemics are caused by infectious agents, not cancer, and (II) mesothelioma is a rare cancer. World-wide mesothelioma incidence varies between 1/10⁶ in areas with no asbestos industry to about 10-30/10⁶ in areas with asbestos industry. This article reviews how the mesothelioma epidemic was discovered in Cappadocia by Dr. Baris (my mentor), how we initially linked the epidemic to erionite exposure, and later (with Dr. Carbone) to the interaction between genetic predisposition and environmental exposure. Our team's work had an important positive impact on the lives of those living in Cappadocia and also in many genetically predisposed families living around the world. I will discuss how the work that started in three remote Cappadocian villages led to the award of a NCI P01 grant to support our studies. Our studies proved that genetics modulates mineral fiber carcinogenesis and led to the discovery that carriers of germline BAP1 mutations have a very high risk of developing mesothelioma and other malignancies. A new, very active field of research developed following our discoveries to elucidate the mechanism by which BAP1 modulates mineral fiber carcinogenesis as well as to identify additional genes that when mutated increase the risk of mesothelioma and other environmentally related cancers. I am the only surviving member of this research team who saw all the phases of this research and I believe it is important to provide an accurate report, which hopefully will inspire others.

Geological occurrence, mineralogical characterization, and risk assessment of potentially carcinogenic erionite in Italy

Erionite is a zeolite representing a well-known health hazard. In fact, exposure of humans to its fibers has been unequivocally associated with occurrence of malignant mesothelioma. For this reason, a multi-methodological approach, based upon field investigation, morphological characterization, scanning electron microscopy (SEM)/energy-dispersive spectroscopy (EDS) chemical analysis, and structure refinement through X-ray powder diffraction (XRPD), was applied to different samples of potentially carcinogenic erionite from Northern Italy. The studied crystals have a chemical composition ranging from erionite-Ca to erionite-Na and display variable morphologies, varying from prismatic, through acicular and fibrous, to extremely fibrous asbestiform habits. The fibrous samples were characterized by an unusual preferred partition of aluminum (Al) at tetrahedral site T1 instead of tetrahedral site T2. Further, a mismatch between the a-parameter of erionite-Ca and levyne-Ca that are intergrown in the asbestiform sample was detected. This misfit was coupled to a relevant micro-strain to maintain structure coherency at the boundary. Erionite occurs in 65% of the investigated sites, with an estimated quantity of 10 to 40 vol% of the associated minerals. The presence of this mineral is of concern for risk to human health, especially if one considers the vast number of quarries and mining-related activities that are operating in the zeolite host rocks. The discovery of fibrous and asbestiform erionite in Northern Italy suggests the need for a detailed risk assessment in all Italian areas showing the same potential hazard, with specific studies such as a quantification of the potentially respirable airborne fibers and targeted epidemiological surveillance.

Electron paramagnetic resonance and transmission electron microscopy study of the interactions between asbestiform zeolite fibers and model membranes

Different asbestiform zeolite fibers of the erionite (termed GF1 and MD8, demonstrated carcinogenic) and offretite (termed BV12, suspected carcinogenic) families were investigated by analyzing the electron paramagnetic resonance (EPR) spectra of selected surfactant spin probes and transmission electron microscopy (TEM) images in the presence of model membranes-cetyltrimethylammonium (CTAB) micelles, egg-lecithin liposomes, and dimyristoylphosphatidylcholine (DMPC) liposomes. This was undertaken to obtain information on interactions occurring at a molecular level between fibers and membranes which correlate with entrance of fibers into the membrane model or location of the fibers at the external or internal membrane interfaces. For CTAB micelles, all fibers were able to enter the micelles, but the hair-like structure and chemical surface characteristics of GF1 modified the micelle structure toward a bilayer-like organization, while MD8 and BV12, being shorter fibers and with a high density of surface interacting groups, partially destroyed the micelles. For liposomes, GF1 fibers partially penetrated the core solution, but DMPC liposomes showed increasing rigidity and organization of the bilayer. Conversely, for MD8 and BV12, the fibers did not cross the membrane demonstrating a smaller membrane structure perturbation. Scolecite fibers (termed SC1), used for comparison, presented poor interactions with the model membranes. The carcinogenicity of the zeolites, as postulated in the series SC1<BV12<MD8<GF1, may be related to the structural modifications of the model membranes when interacting with these zeolite fibers.

Multiwalled carbon nanotube-induced pulmonary inflammatory and fibrotic responses and genomic changes following aspiration exposure in mice: A 1-year postexposure study

Pulmonary exposure to multiwalled carbon nanotubes (MWCNT) induces an inflammatory and rapid fibrotic response, although the long-term signaling mechanisms are unknown. The aim of this study was to examine the effects of 1, 10, 40, or 80 μg MWCNT administered by pharyngeal aspiration on bronchoalveolar lavage (BAL) fluid for polymorphonuclear cell (PMN) infiltration, lactate dehydrogenase (LDH) activity, and lung histopathology for inflammatory and fibrotic responses in mouse lungs 1 mo, 6 mo, and 1 yr postexposure. Further, a 120-μg crocidolite asbestos group was incorporated as a positive control for comparative purposes. Results showed that MWCNT increased BAL fluid LDH activity and PMN infiltration in a dose-dependent manner at all three postexposure times. Asbestos exposure elevated LDH activity at all 3 postexposure times and PMN infiltration at 1 mo and 6 mo postexposure. Pathological changes in the lung, the presence of MWCNT or asbestos, and fibrosis were noted at 40 and 80 μg MWCNT and in asbestos-exposed mice at 1 yr postexposure. To determine potential signaling pathways involved with MWCNT-associated pathological changes in comparison to asbestos, up- and down-regulated gene expression was determined in lung tissue at 1 yr postexposure. Exposure to MWCNT tended to favor those pathways involved in immune responses, specifically T-cell responses, whereas exposure to asbestos tended to favor pathways involved in oxygen species production, electron transport, and cancer. Data indicate that MWCNT are biopersistent in the lung and induce inflammatory and fibrotic pathological alterations similar to those of crocidolite asbestos, but may reach these endpoints by different mechanisms.

Long-term toxicity of naturally occurring asbestos in male Fischer 344 rats

Naturally occurring asbestos (NOA) fibers are found in geologic deposits that may be disturbed by mining, earthworks, or natural processes, resulting in adverse health risks to exposed individuals. The toxicities of Libby amphibole and NOA samples including Sumas Mountain chrysotile (SM), El Dorado tremolite (ED), and Ontario ferroactinolite cleavage fragments (ON) were compared in male Fischer 344 (F344) rats 15 mo after exposure. Rat-respirable fractions of LA and SM displayed greater mean lengths and aspect ratios than ED and ON. After a single intratracheal (IT) instillation (0.5 or 1.5 mg/rat), persistent changes in ventilatory parameters and a significant increase in lung resistance at baseline and after methacholine aerosol dosing were found only in rats exposed to 1.5 mg SM. High-dose ED significantly elevated bronchoalveolar lavage lactate dehydrogenase (LDH) activity and protein levels, while high-dose SM increased γ-glutamyl transferase and LDH activities. A moderate degree of lung interstitial fibrosis after exposure to 1.5 mg SM persisted 15 mo after exposure, unchanged from previous findings at 3 mo. LA induced mild fibrosis, while ED and ON produced minimal and no apparent fibrosis, respectively. Bronchioloalveolar carcinoma was observed 15 mo after exposure to LA or ED. Data demonstrated that SM, given by bolus IT dosing on an equivalent mass basis, induced greater pulmonary function deficits, airway hyperresponsiveness, and interstitial fibrosis than other NOA, although unlike LA and ED, no apparent evidence for carcinogenicity was found. All NOA samples except ON cleavage fragments produced some degree of long-term toxicity.

Environmental risk of mesothelioma in the United States: An emerging concern-epidemiological issues

Despite predictions of decline in mesothelioma following the ban of asbestos in most industrial countries, the incidence is still increasing globally, particularly in women. Because occupational exposure to asbestos is the main cause of mesothelioma, it occurs four- to eightfold more frequently in men than women, at a median age of 74 years. When mesothelioma is due to an environmental exposure, the M:F sex ratio is 1:1 and the median age at diagnosis is ~60 years. Studying environmental risk of mesothelioma is challenging because of the long latency period and small numbers, and because this type of exposure is involuntary and unknown. Individual-based methods cannot be used, and new approaches need to be found. To better understand the most recent trends of mesothelioma in the United States, all mesothelioma deaths reported to the Centers for Disease Control and Prevention (CDC) during 1999-2010 were analyzed. Among all mesothelioma deaths in the United States, the 1920s birth cohort significantly predominated, and the proportion of younger cohorts constantly decreased with time, suggesting a decline in occupational exposure in these cohorts. The M:F mesothelioma sex ratio fell with time, suggesting an increased proportion of environmental cases. Environmental exposures occur in specific geographic areas. At the large scale of a state, mesotheliomas related to environmental exposure are diluted among occupational cases. The spatial analysis at a smaller scale, such as county, enables detection of areas with higher proportions of female and young mesothelioma cases, thus indicating possible environmental exposure, where geological and environmental investigations need to be carried out.

Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States

Mesothelioma, a rare tumor, is highly correlated with asbestos exposure. Mesothelioma, similar to all asbestos-related diseases, is dose/intensity dependent to some degree, and studies showed the risk of mesothelioma rises with cumulative exposures. Multiple processes occur in an individual before mesothelioma occurs. The impact of mesothelioma in the United States has been continuous over the last half century, claiming between 2,000 and 3,000 lives each year. Mesothelioma is a preventable tumor that is more frequently reported as associated with asbestos exposure among men than women. However, the rate of asbestos-associated mesothelioma is on the rise among women due to better investigation into their histories of asbestos exposure. It is of interest that investigators detected asbestos-associated cases of mesothelioma in women from nonoccupational sources-that is, bystander, incidental, or take-home exposures. It is postulated that asbestos-associated mesotheliomas, in both men and women, are likely underreported. However, with the implementation of the most recent ICD-10 coding system, the correlation of mesothelioma with asbestos exposure is expected to rise to approximately 80% in the United States. This study examined the demographic and etiological nature of asbestos-related mesothelioma.

Investigating palygorskite's role in the development of mesothelioma in southern Nevada: Insights into fiber-induced carcinogenicity

Similar to asbestos fibers, nonregulated mineral fibers can cause malignant mesothelioma (MM). Recently, increased proportions of women and young individuals with MM were identified in southern Nevada, suggesting that environmental exposure to carcinogenic fibers was causing the development of MM. Palygorskite, a fibrous silicate mineral with a history of possible carcinogenicity, is abundant in southern Nevada. In this study, our aim was to determine whether palygorskite was contributing to the development of MM in southern Nevada. While palygorskite, in vitro, displayed some cytotoxicity toward primary human mesothelial (HM) cells and reduced their viability, the effects were roughly half of those observed when using similar amounts of crocidolite asbestos. No Balb/c (0/19) or MexTAg (0/18) mice injected with palygorskite developed MM, while 3/16 Balb/c and 13/14 MexTAg mice injected with crocidolite did. Lack of MM development was associated with a decreased acute inflammatory response, as injection of palygorskite resulted in lower percentages of macrophages (p = .006) and neutrophils (p = .02) in the peritoneal cavity 3 d after exposure compared to injection of crocidolite. Additionally, compared to mice injected with crocidolite, palygorskite-injected mice had lower percentages of M2 (tumor-promoting) macrophages (p = .008) in their peritoneal cavities when exposed to fiber for several weeks. Our study indicates that palygorskite found in the environment in southern Nevada does not cause MM in mice, seemingly because palygorskite, in vivo, fails to elicit inflammation that is associated with MM development. Therefore, palygorskite is not a likely contributor to the MM cases observed in southern Nevada.

Five years update on relationships between malignant pleural mesothelioma and exposure to asbestos and other elongated mineral particles

Despite the reduction of global asbestos consumption and production due to the ban or restriction of asbestos uses in more than 50 countries since the 1970s, malignant mesothelioma remains a disease of concern. Asbestos is still used, imported, and exported in several countries, and the number of mesothelioma deaths may be expected to increase in the next decades in these countries. Asbestos exposure is the main risk factor for malignant pleural mesothelioma, but other types of exposures are linked to the occurrence of this type of cancer. Although recent treatments improve the quality of life of patients with mesothelioma, malignant pleural mesothelioma remains an aggressive disease. Recent treatments have not resulted in appreciable improvement in survival, and thus development of more efficient therapies is urgently needed. The development of novel therapeutic strategies is dependent on our level of knowledge of the physiopathological and molecular changes that mesothelial cells acquired during the neoplastic process. During the past 5 years, new findings have been published on the etiology, epidemiology, molecular changes, and innovative treatments of malignant pleural mesothelioma. This review aims to update the findings of recent investigations on etiology, epidemiology, and molecular changes with a focus on (1) attributable risk of asbestos exposure in men and women and (2) coexposure to other minerals and other elongated mineral particles or high aspect ratio nanoparticles. Recent data obtained on genomic and gene alterations, pathways deregulations, and predisposing factors are summarized.