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Sahin ER, Koksal D. Asbestos: Mineralogical features and fiber analysis in biological materials. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2023; 78:369-378. [PMID: 37800384 DOI: 10.1080/19338244.2023.2264764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
Asbestos is a mineral with unique physical and chemical properties that make it highly resistant to heat, fire, and corrosion. Nevertheless, exposure to asbestos fibers has been linked to serious health problems, including lung cancer, mesothelioma, and asbestosis. Despite the ban on asbestos usage, asbestos-related diseases are still a major cause of morbidity and mortality worldwide. Analyzing the mineralogical features and fiber analysis of asbestos in biological materials is critical for scenarios where an asbestos exposure history cannot be obtained, a clinical diagnosis cannot be made, or legal aspects necessitate further investigation. This review outlines the mineralogical features and fiber analysis techniques of asbestos in biological materials.
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Affiliation(s)
- Elif Reyhan Sahin
- Department of Public Health, Department of Occupational Medicine, Hacettepe University Medical Faculty, Sihhiye/Altindag, Turkey
| | - Deniz Koksal
- Department of Chest Diseases, Director of Mesothelioma and Medical Geology Research Center, Hacettepe University Medical Faculty, Sihhiye/Altindag, Turkey
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2
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Somigliana AB, Barbieri PG, Cavallo A, Colombo R, Consonni D, Mirabelli D. Lung asbestos fiber burden analysis: effects of the counting rules for legal medicine evaluations. Inhal Toxicol 2023; 35:300-307. [PMID: 37995092 DOI: 10.1080/08958378.2023.2285789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVES The work shows the effect of counting rules, such as analysis magnification and asbestos fiber dimension to be count (with length ≥5 µm or also asbestos fibers with length <5 µm) in the lung asbestos fiber burden analysis for legal medicine evaluations. METHODS On the same lung tissue samples, two different analyses were carried out to count any asbestos fibers with length ≥1 µm and with length ≥5 µm. Results of the amphibole burden of the two analyses were compared by linear regression analysis on log10-transformed values. RESULTS The analysis should be carried out at an appropriate magnification and on samples prepared in such a way as they allow the counting of very fine fibers. If the analysis is limited to the asbestos fibers with length ≥5 µm, there is a high risk of not detecting possible residual chrysotile fiber burden and thinner crocidolite asbestos fibers. CONCLUSIONS On average we estimated that 1 amphibole fiber with length ≥5 µm corresponds to ∼8 amphibole fibers with length ≥1 µm in the lung. The values of the Helsinki criteria should be updated taking this into account.
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Affiliation(s)
- Anna Benedetta Somigliana
- Regional Electron Microscopy Centre-Environmental Protection Agency of Lombardy Region, Milan, Italy
| | - Pietro Gino Barbieri
- Formerly Occupational Health Unit, Local Health Authority and Mesothelioma Registry of Brescia, Brescia, Italy
| | - Alessandro Cavallo
- Department of Earth and Environmental Sciences-DISAT, University of Milano-Bicocca, Milan, Italy
| | - Roberto Colombo
- Biology and Biotechnology Department "L. Spallanzani", University of Pavia, Pavia, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Mirabelli
- Formerly Unit of Cancer Epidemiology, Department of Medical Sciences, CPO Piemonte and University of Turin, Turin, Italy
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3
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Zhang X, Wang S, Ling L, Hou G, Leng S, Ma N, Qiu M, Li X, Guo X. The distribution and structural fingerprints of metals from particulate matters (PM) deposited in human lungs. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 233:113324. [PMID: 35193030 DOI: 10.1016/j.ecoenv.2022.113324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/03/2022] [Accepted: 02/15/2022] [Indexed: 06/14/2023]
Abstract
This work investigated the distribution and chemical fingerprints of 24 metals in particulate matter (PM) deposited in nonoccupational human lungs. Metals in the pulmonary PM can be grouped by the mean concentration as > 5 × 103 μg/g (Al/Fe/Ca/Mg/Zn), 1-5 × 103 μg/g (Ti/Ba/Pb/Mn), 0.2-1 × 103 μg/g (Cu/Cr/As/V) and < 100 μg/g (Ni/Sn/Cd/Sb). Three parameters (LFL, LR, EFP) were defined to predict different metal leaching behaviors. The leaching factor (LFL) of metals was 10-60 for Pb/Sb/Cd/Co/Cu and decreased to 1-2 for Ni/Cr/Mg/Al/Fe. Metals showed a divergent extent of lung retention (LR), including high retention (LR>10, Al/Cd/Cr/Ba/Ni/Ti/Sn/V/Sb), moderate retention (2 <LR<10, Pb/Mn/Fe), minor retention (1 < LR <2, Cu/Co), and negligible retention (LR<1, Ca/Mg/Zn). V and Ti were found to be mainly from indoor PM sources and deserve a close attention in healthy individuals. C-, Al- and Ti-rich fine particles were the most common pulmonary particles imaged by spherical aberration-corrected scanning transmission electron microscopy (Cs-STEM). These data establish a foundation for classification and further risk assessment of the metal species in pulmonary PM.
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Affiliation(s)
- Xiangyuan Zhang
- State Key Laboratory of Environment Simulation, School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
| | - Shaodong Wang
- Department of Thoracic Surgery, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, China
| | - Lan Ling
- State Key Laboratory for Pollution Control and Resource Reuse, School of Environmental Science and Engineering, Tongji University, 1239 Siping Road, Shanghai 200092, China
| | - Guanyu Hou
- State Key Laboratory of Environment Simulation, School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
| | - Siwen Leng
- State Key Laboratory of Environment Simulation, School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
| | - Na Ma
- State Key Laboratory of Environment Simulation, School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
| | - Mantang Qiu
- Department of Thoracic Surgery, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, China
| | - Xiao Li
- Department of Thoracic Surgery, Peking University People's Hospital, 11 Xizhimen South Street, Beijing 100044, China
| | - Xuejun Guo
- State Key Laboratory of Environment Simulation, School of Environment, Beijing Normal University, No. 19 Xinjiekouwai Street, Beijing 100875, China
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Asbestos bodies count and morphometry in bulk lung tissue samples by non-invasive X-ray micro-tomography. Sci Rep 2021; 11:10608. [PMID: 34012032 PMCID: PMC8136473 DOI: 10.1038/s41598-021-90057-1] [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: 03/12/2021] [Accepted: 05/06/2021] [Indexed: 02/03/2023] Open
Abstract
The number of the Asbestos Bodies (AB), i.e. asbestos that developed an iron-protein coating during its permanence in biological tissues, is one of the most accessible markers of asbestos exposure in individuals. The approaches developed to perform AB count in biological tissues are based on the manual examination of tissue digests or histological sections by means of light or electron microscopies. Although these approaches are well established and relatively accessible, manual examination is time-consuming and can be reader-dependent. Besides, approximations are applied because of the limitations of 2D readings and to speed up manual counts. In addition, sample preparation using tissue digests require an amount of tissue that can only be obtained by invasive surgery or post-mortem sampling. In this paper, we propose a new approach to AB counting based on non-destructive 3D imaging, which has the potential to overcome most of the limitations of conventional approaches. This method allows automating the AB count and determining their morphometry distribution in bulk tissue samples (ideally non-invasive needle biopsies), with minimal sample preparation and avoiding approximations. Although the results are promising, additional testing on a larger number of AB-containing biological samples would be required to fully validate the method.
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Kuhn BK, Barresi F, Dressel H, Vrugt B. Discrepancies of asbestos body and fiber content between formalin-fixed and corresponding paraffin embedded lung tissue. Inhal Toxicol 2020; 33:18-24. [PMID: 33322958 DOI: 10.1080/08958378.2020.1860167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Formalin-fixed lung tissue and paraffin blocks containing peripheral lung tissue obtained from subjects with an occupational asbestos exposure are both regarded to be suitable to determine asbestos load. Because sample preparation of paraffin blocks requires a more intense treatment than formalin-fixed tissue, we tested whether asbestos analysis of formalin-fixed lung tissue and paraffin blocks obtained from the same patients deliver comparable results. MATERIALS AND METHODS We determined numbers of asbestos bodies (AB) and amphibole asbestos fibers (AF) in formalin-fixed lung tissue and corresponding paraffin blocks from 36 patients. For AB counts, samples were digested in sodium hypochlorite. For AF analysis, tissue was freeze-dried and then ashed. Results were reported as numbers of AB and AF per gram dry lung tissue. RESULTS Both AB counts as well as AF counts were lower in paraffin blocks than formalin-fixed lung tissue. Compared to formalin-fixed tissue, the limit of detection was higher for paraffin blocks, rendering more results from paraffin blocks not interpretable than from formalin-fixed tissue (8 samples versus 1 for AB and 15 samples versus 4 for AF). DISCUSSION AND CONCLUSION Asbestos analysis of paraffin blocks may lead to underestimation of asbestos exposure. This should be considered when assessing occupational asbestos exposure through lung dust analysis in medico-legal evaluation.
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Affiliation(s)
- Barbara K Kuhn
- Silag-Swiss Laboratory for Particle Analysis in Tissues, Zurich, Switzerland
| | - Fabio Barresi
- Division of Occupational and Environmental Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Holger Dressel
- Silag-Swiss Laboratory for Particle Analysis in Tissues, Zurich, Switzerland.,Division of Occupational and Environmental Medicine, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Bart Vrugt
- Silag-Swiss Laboratory for Particle Analysis in Tissues, Zurich, Switzerland.,Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
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Plesker R, Köhler K, von Gerlach S, Boller K, Vogt M, Feder IS. Reactive mesothelial hyperplasia mimicking mesothelioma in an African green monkey ( Chlorocebus aethiops). Primate Biol 2020; 7:5-12. [PMID: 32760782 PMCID: PMC7399384 DOI: 10.5194/pb-7-5-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 05/12/2020] [Indexed: 11/22/2022] Open
Abstract
A spontaneous reactive mesothelial hyperplasia occurred in a
female, 15.7-year-old African green monkey (grivet; Chlorocebus aethiops). At necropsy, massive
effusions were found in the abdomen, the thorax, and the pericardium.
Additionally, multiple small, beige-gray nodules were detected on the
serosal surfaces of the abdominal organs. Histopathologically, the
mesothelial cells resembled the epithelioid subtype of a mesothelioma, but
no infiltrative or invasive growth could be demonstrated. The mesothelial
cells on the thoracis, liver, and intestinal serosa were accompanied by
chronic serositis. Mesothelial cells expressed cytokeratin, vimentin,
calretinin, desmin, Wilms Tumor 1 (WT-1) protein, and epithelial membrane
antigen (EMA). Cells were negative for carcinoembryonic antigen (CEA),
cluster of differentiation 15 (CD15), and podoplanin. Ultrastructurally,
cells revealed a moderate amount of microvilli of medium length, perinuclear
tonofilament bundles, and long desmosomes. In fluorescence in situ
hybridization (FISH) for the detection of characteristic gene loss (p16;
CDKN2A), NF2, and MTAP, no deletions were detected. No asbestos fibers and no
presence of Simian virus 40 antigen (SV40) could be demonstrated.
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Affiliation(s)
- Roland Plesker
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - Kernt Köhler
- Institut für Veterinär-Pathologie, Justus-Liebig-Universität Gießen, Gießen, Germany
| | - Susanne von Gerlach
- ÜGP MVZ, Institut für Pathologie, Zytologie und Molekularpathologie GbR, Wettenberg, Germany
| | - Klaus Boller
- Paul-Ehrlich-Institut, Paul-Ehrlich-Str. 51-59, 63225 Langen, Germany
| | - Markus Vogt
- Institut für Pathologie, Ruhr-Universität Bochum, Bochum, Germany
| | - Inke S Feder
- Institut für Pathologie, Ruhr-Universität Bochum, Bochum, Germany
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Dong H, Zhang Y, Du Q, Li D, Feng D, Gao J, Wu S, Luan J. Roles of Ion-Exchangeable Sodium in the Conversion Process of Tar to Soot during Rapid Pyrolysis of Two Brown Coals in a Drop-Tube Reactor. ACS OMEGA 2020; 5:9078-9092. [PMID: 32363260 PMCID: PMC7191602 DOI: 10.1021/acsomega.9b03441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 04/09/2020] [Indexed: 06/11/2023]
Abstract
In this work, two series of brown coals (including acid-washed coal and ion-exchangeable Na-loaded coal) were pyrolyzed in a drop-tube reactor. The experimental results revealed that soot and tar yields of Na-loaded coals were significantly lower than that of acid-washed coals. Gasified Na can reduce the formation of big soot agglomerates. During coal primary pyrolysis, ion-exchangeable Na can reduce the amount and aromaticity of primary tar. Na released with volatiles can catalyze the cracking of aliphatic and aromatic compounds, inhibit the polymerization between aromatic rings, and promote the combination of soot/tar with oxygen-containing substances, resulting in the decrease of graphite crystallite size and the increase of amorphous carbon content. Na can also reduce the organization degree of soot by forming intercalation compounds.
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Affiliation(s)
- Heming Dong
- School
of Energy Science and Engineering, Harbin
Institute of Technology, 92, Xidazhi Street, Harbin, Heilongjiang 150001, China
| | - Yu Zhang
- School
of Energy Science and Engineering, Harbin
Institute of Technology, 92, Xidazhi Street, Harbin, Heilongjiang 150001, China
| | - Qian Du
- School
of Energy Science and Engineering, Harbin
Institute of Technology, 92, Xidazhi Street, Harbin, Heilongjiang 150001, China
| | - Dun Li
- School
of Energy Science and Engineering, Harbin
Institute of Technology, 92, Xidazhi Street, Harbin, Heilongjiang 150001, China
| | - Dongdong Feng
- School
of Energy Science and Engineering, Harbin
Institute of Technology, 92, Xidazhi Street, Harbin, Heilongjiang 150001, China
| | - Jianmin Gao
- School
of Energy Science and Engineering, Harbin
Institute of Technology, 92, Xidazhi Street, Harbin, Heilongjiang 150001, China
| | - Shaohua Wu
- School
of Energy Science and Engineering, Harbin
Institute of Technology, 92, Xidazhi Street, Harbin, Heilongjiang 150001, China
| | - Jiyi Luan
- School
of Mechanical Engineering, Jiamusi University, 258, Xuefu Street, Jiamusi, Heilongjiang 154007, China
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8
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Impacts of Organic Structures and Inherent Minerals of Coal on Soot Formation during Pyrolysis. ENERGIES 2019. [DOI: 10.3390/en12234410] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The pyrolysis of four pairs of raw and acid-washed coals under N2 atmosphere was carried out in a drop tube reactor at 1250 °C. The results show that both organic structures and metal elements have an important influence on the formation of soot. The total area of aromatic and aliphatic hydrogen absorption bands is positively correlated with soot yield. Aromatic compounds have a greater contribution to soot and tar formation. The absorption band area of oxygen structures in coal FTIR spectra is negatively correlated with the soot conversion rate of tar. During pyrolysis, metal substances in coal can catalyze the dehydrogenation and deoxygenation of tar, reduce the content and stability of the aliphatic compound, and catalyze aromatic ring rupturing. More importantly, gasified metals can inhibit the polymerization reaction of aromatic compounds.
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9
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Graham UM, Oberdörster G, Case B, Dozier A. A case study of the translocation, bioprocessing and tissue interactions of EMP following inhalation exposure. Toxicol Appl Pharmacol 2018; 361:81-88. [DOI: 10.1016/j.taap.2018.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2018] [Revised: 06/20/2018] [Accepted: 07/02/2018] [Indexed: 01/06/2023]
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10
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11
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Feder IS, Tischoff I, Theile A, Schmitz I, Merget R, Tannapfel A. The asbestos fibre burden in human lungs: new insights into the chrysotile debate. Eur Respir J 2017; 49:49/6/1602534. [PMID: 28663314 PMCID: PMC5898940 DOI: 10.1183/13993003.02534-2016] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 02/26/2017] [Indexed: 11/27/2022]
Abstract
The traceability of asbestos fibres in human lungs is a matter of discussion especially for chrysotile. This issue is of high significance for differential diagnosis, risk assessment and occupational compensation. At present no intra-individual longitudinal information is available. This study addresses the question whether the asbestos fibre burden in human lungs decreases with time after exposure cessation. The database of the German Mesothelioma Register was screened for patients with asbestos body counts of at least 500 fibres per gram of wet lung, which had been analysed twice from different tissue excisions at minimum intervals of 4 years. Twelve datasets with individual longitudinal information were discovered with a median interval of about 8 years (range 4–21 years). Both examinations were performed after exposure cessation (median: surgery, 9.5 years; autopsy, 22 years). Pulmonary asbestos fibre burden was stable between both examinations (median 1623/4269 asbestos bodies per gram wet lung). Electron microscopy demonstrated a preponderance of chrysotile (median 80%). This study is the first to present longitudinal intra-individual data about the asbestos fibre burden in living human lungs. The high biopersistence of amphiboles, but also of chrysotile, offers mechanistic explanations for fibre toxicity, especially the long latency period of asbestos-related diseases. Intra-individual longitudinal data display: the asbestos fibre burden in living human lungs is stable over many yearshttp://ow.ly/VtPF30bRETz
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Affiliation(s)
- Inke Sabine Feder
- Institute for Pathology of the Ruhr-University Bochum, Bochum, Germany
| | - Iris Tischoff
- Institute for Pathology of the Ruhr-University Bochum, Bochum, Germany
| | - Anja Theile
- Institute for Pathology of the Ruhr-University Bochum, Bochum, Germany
| | - Inge Schmitz
- Institute for Pathology of the Ruhr-University Bochum, Bochum, Germany
| | - Rolf Merget
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University (IPA), Bochum, Germany
| | - Andrea Tannapfel
- Institute for Pathology of the Ruhr-University Bochum, Bochum, Germany
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Vincent M, Chemarin C, Cavalin C, Catinon M, Rosental PA. From the definition of silicosis at the 1930 Johannesburg conference to the blurred boundaries between pneumoconioses, sarcoidosis, and pulmonary alveolar proteinosis (PAP). Am J Ind Med 2015; 58 Suppl 1:S31-8. [PMID: 26509752 DOI: 10.1002/ajim.22518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2015] [Indexed: 11/05/2022]
Abstract
The 1930 International Labour Office Conference on silicosis in Johannesburg identified silicosis by setting a medicolegal framework to its nosology: as with other occupational illnesses, its medical content was fixed under economic pressure. This article follows a reading of all the proceedings of this conference (debates and reports of experts) to examine their potential impact on the etiology and nosology of other diseases, specifically sarcoidosis and pulmonary alveolar proteinosis (PAP), "idiopathic" diseases in which inorganic particles may be involved. We propose renewed study of the role of inorganic particles in these diseases. To do this, we propose to mobilize detection means such as mineralogical analysis and electron microscopy and in depth interviewing that are currently seldom used in France, in order to establish diagnosis and the potential occupational and environmental origin of these diseases.
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Affiliation(s)
- Michel Vincent
- Pneumology Unit and Laboratory of mineral pathologies at the Centre Hospitalier Saint Joseph Saint Luc; Lyon France
- Centre for European Studies; ERC Grant Silicosis Sciences Po; Paris France
| | - Cecile Chemarin
- Pneumology Unit and Laboratory of mineral pathologies at the Centre Hospitalier Saint Joseph Saint Luc; Lyon France
| | - Catherine Cavalin
- Centre for European Studies; ERC Grant Silicosis Sciences Po; Paris France
- Interdisciplinary Laboratory for Evaluation of Public Policies (LIEPP); Sciences Po; Paris France
- Centre for Employment Studies; Noisy-le-Grand France
| | - Mikael Catinon
- Pneumology Unit and Laboratory of mineral pathologies at the Centre Hospitalier Saint Joseph Saint Luc; Lyon France
- Centre for European Studies; ERC Grant Silicosis Sciences Po; Paris France
| | - Paul-André Rosental
- Centre for European Studies; ERC Grant Silicosis Sciences Po; Paris France
- Interdisciplinary Laboratory for Evaluation of Public Policies (LIEPP); Sciences Po; Paris France
- National Institute for Demographic Studies (INED); Paris France
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Kambouchner M, Bernaudin JF. The pathologist's view of silicosis in 1930 and in 2015. The Johannesburg Conference legacy. Am J Ind Med 2015; 58 Suppl 1:S48-58. [PMID: 26509753 DOI: 10.1002/ajim.22506] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2015] [Indexed: 11/11/2022]
Abstract
The 1930 International Labour Office Conference on silicosis in Johannesburg was a turning point in the history of silicosis and in the recognition of the associated pathologic patterns. Since 1930, pneumoconioses such as silicosis have become much rarer in developed countries and can now be diagnosed at an early stage based on clinical and radiologic criteria. However, in spite of these advances, pathologists must remember to look for silica in tissues, particularly when clinical and radiologic findings are more uncertain. Furthermore, nowadays pathologists essentially observe silicotic lesions as incidental findings adjacent to lung cancers. In addition to identifying the characteristic lesions, pathologists must also try to identify their causative agent, in the case of crystalline silica firstly by using polarized light examination, followed as appropriate by more sophisticated devices. Finally, pathologists and clinicians must always keep in mind the various implications of exposure to silica compounds in a wide range of diseases.
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Takada T, Moriyama H, Suzuki E. Elemental analysis of occupational and environmental lung diseases by electron probe microanalyzer with wavelength dispersive spectrometer. Respir Investig 2013; 52:5-13. [PMID: 24388365 DOI: 10.1016/j.resinv.2013.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 04/26/2013] [Accepted: 05/08/2013] [Indexed: 11/29/2022]
Abstract
Occupational and environmental lung diseases are a group of pulmonary disorders caused by inhalation of harmful particles, mists, vapors or gases. Mineralogical analysis is not generally required in the diagnosis of most cases of these diseases. Apart from minerals that are encountered rarely or only in specific occupations, small quantities of mineral dusts are present in the healthy lung. As such when mineralogical analysis is required, quantitative or semi-quantitative methods must be employed. An electron probe microanalyzer with wavelength dispersive spectrometer (EPMA-WDS) enables analysis of human lung tissue for deposits of elements by both qualitative and semi-quantitative methods. Since 1993, we have analyzed 162 cases of suspected occupational and environmental lung diseases using an EPMA-WDS. Our institute has been accepting online requests for elemental analysis of lung tissue samples by EPMA-WDS since January 2011. Hard metal lung disease is an occupational interstitial lung disease that primarily affects workers exposed to the dust of tungsten carbide. The characteristic pathological findings of the disease are giant cell interstitial pneumonia (GIP) with centrilobular fibrosis, surrounded by mild alveolitis with giant cells within the alveolar space. EPMA-WDS analysis of biopsied lung tissue from patients with GIP has demonstrated that tungsten and/or cobalt is distributed in the giant cells and centrilobular fibrosing lesion in GIP. Pneumoconiosis, caused by amorphous silica, and acute interstitial pneumonia, associated with the giant tsunami, were also elementally analyzed by EPMA-WDS. The results suggest that commonly found elements, such as silicon, aluminum, and iron, may cause occupational and environmental lung diseases.
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Affiliation(s)
- Toshinori Takada
- Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| | - Hiroshi Moriyama
- Division of Respiratory Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| | - Eiichi Suzuki
- Department of General Medicine, Niigata University Medical and Dental Hospital, Niigata, Japan.
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15
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Billon-Galland MA. [Exposition markers: mineralogical analysis in the sputum and the bronchoalveolar lavage--asbestos bodies--uncoated fibres]. Rev Mal Respir 2012; 29:521-8. [PMID: 22542409 DOI: 10.1016/j.rmr.2012.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2011] [Accepted: 09/06/2011] [Indexed: 11/25/2022]
Abstract
The aim of mineralogical analysis of lung tissue, bronchoalveolar lavage (BAL) and sputum is to characterize individuals' exposure to asbestos fibres by identifying markers of this; asbestos bodies (AB) and uncoated fibres. The techniques of mineralogical analysis, habitually used to identify AB and uncoated fibres, are respectively optical microscopy (OM) and analytical electronic microscopy (EM). Correlations between levels of retention of AB in lung tissue, BAL and sputum have been established and validated threshold values indicating a high probability of significant exposure exist. These results must be interpreted in the context of clinical and occupational information. Mineralogical analysis is not suitable for use in routine medical screening but it can be considered when a source of exposure is not evident from the questionnaire since a positive analysis of BAL or of sputum is highly specific and thus useful to confirm an important retention of asbestos in the lung, which justifies medical follow-up. A negative result does not exclude previous significant asbestos exposure (frequent false negatives occur especially in sputum and biopersistence of chrysotile is lower than for amphiboles). Thus it can be a complementary tool for the assessment of asbestos exposure but its use imposes conditions for the collection and handling of samples.
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Affiliation(s)
- M-A Billon-Galland
- Laboratoire d'étude des particules inhalées (LEPI), DASES, département de Paris, 11 rue George-Eastman, Paris, France.
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16
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Paris C, Pairon JC, Billon-Galland MA, Vanoni-Espiand H, Godbert B, Martinet Y, Chabot F, Aymard B, Vignaud JM. Giant cell interstitial pneumonia: report of two cases with high titanium concentration in the lung. Am J Respir Crit Care Med 2012; 184:1315-7. [PMID: 22162891 DOI: 10.1164/ajrccm.184.11.1315a] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Neumann V, Löseke S, Tannapfel A. Mesothelioma and analysis of tissue fiber content. Recent Results Cancer Res 2011; 189:79-95. [PMID: 21479897 DOI: 10.1007/978-3-642-10862-4_6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The strong relationship between mesothelioma and asbestos exposure is well established. The analysis of lung asbestos burden by light and electron microscopy assisted to understand the increased incidence of mesothelioma in asbestos mining and consuming nations.The data on the occupational exposure to asbestos are important information for the purpose of compensation of occupational disease No. 4105 (asbestos-associated mesothelioma) in Germany.However, in many cases the patients have forgotten conditions of asbestos exposure or had no knowledge about the used materials with components of asbestos. Mineral fiber analysis can provide valuable information for the research of asbestos-associated diseases and for the assessment of exposure. Because of the variability of asbestos exposure and long latency periods, the analysis of asbestos lung content is a relevant method for identification of asbestos-associated diseases. Also, sources of secondary exposure, so called "bystander exposition" or environmental exposure can be examined by mineral fiber analysis.Household contacts to asbestos are known for ten patients (1987-2009) in the German mesothelioma register; these patients lived together with family members working in the asbestos manufacturing industry.Analysis of lung tissue for asbestos burden offers information on the past exposure. The predominant fiber-type identified by electron microscopy in patients with mesothelioma is amphibole asbestos (crocidolite or amosite). Latency times (mean 42.5 years) and mean age at the time of diagnose in patients with mesothelioma are increasing (65.5 years). The decrease of median asbestos burden of the lung in mesothelioma patients results in disease manifestation at a higher age.Lung dust analyses are a relevant method for the determination of causation in mesothelioma. Analysis of asbestos burden of the lung and of fiber type provides insights into the pathogenesis of malignant mesothelioma. The most important causal factor for the development of mesothelioma is still asbestos exposure.
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Affiliation(s)
- Volker Neumann
- German Mesothelioma Register, University Hospital Bergmannsheil, Bochum, Germany.
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Lotti M, Bergamo L, Murer B. Occupational toxicology of asbestos-related malignancies. Clin Toxicol (Phila) 2010; 48:485-96. [PMID: 20849338 DOI: 10.3109/15563650.2010.506876] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Asbestos is banned in most Western countries but related malignancies are still of clinical concern because of their long latencies. This review identifies and addresses some controversial occupational and clinical aspects of asbestos-related malignancies. METHODS Papers published in English from 1980 to 2009 were retrieved from PubMed. A total of 307 original articles were identified and 159 were included. ASSESSMENT OF EXPOSURE The retrospective assessment of exposure is usually performed by using questionnaires and job exposure matrices and by careful collection of medical history. In this way crucial information about manufacturing processes and specific jobs can be obtained. In addition, fibers and asbestos bodies are counted in lung tissue, broncho-alveolar lavage, and sputum, but different techniques and interlaboratory variability hamper the interpretation of reported measurements. SCREENING FOR MALIGNANCIES: The effectiveness of low-dose chest CT screening in exposed workers is debatable. Several biomarkers have also been considered to screen individuals at risk for lung cancer and mesothelioma but reliable signatures are still missing. ATTRIBUTION OF LUNG CANCER: Exposures correlating with lung cancer are high and in the same range where asbestosis occurs. However, the unresolved question is whether the presence of fibrosis is a requirement for the attribution of lung cancer to asbestos. The etiology of lung cancer is difficult to define in cases of low-level asbestos exposure and concurrent smoking habits. MESOTHELIOMA: The diagnosis of malignant mesothelioma may also be difficult, because of procedures in sampling, fixation, and processing, and uses of immunohistochemical probes. CONCLUSIONS Assessment of exposure is crucial and requires accurate medical and occupational histories. Quantitative analysis of asbestos body burden is better performed in digested lung tissues by counting asbestos bodies by light microscopy and/or uncoated fibers by transmission electron microscopy. The benefits of screenings for asbestos-related malignancies are equivocal. The attribution of lung cancer to asbestos exposure is difficult in a clinical setting because of the need to assess asbestos body burden and the fact that virtually all these patients are also tobacco smokers or former smokers. Given the premise that asbestosis is necessary to causally link lung cancer to asbestos, it follows that the assessment of both lung fibrosis and asbestos body burden is necessary.
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Affiliation(s)
- Marcello Lotti
- Dipartimento di Medicina Ambientale e Sanità Pubblica, Università degli Studi di Padova, Padova, Italy.
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Analytical characterization of cell–asbestos fiber interactions in lung pathogenesis. Anal Bioanal Chem 2010; 397:2079-89. [DOI: 10.1007/s00216-010-3773-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Revised: 04/15/2010] [Accepted: 04/22/2010] [Indexed: 10/19/2022]
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Sakai Y, Ohbayashi C, Itami H, Kajimoto K, Sakuma T, Uchino K, Yoshimura M, Matsumoto S, Idei Y, Oka T. Simple quantitative analysis of asbestos body using the sediment of formalin injected into surgically resected lung cancers. Pathol Int 2010; 60:78-86. [PMID: 20398191 DOI: 10.1111/j.1440-1827.2009.02488.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A simple screening method for quantitatively analyzing asbestos bodies that can be carried out even in community hospitals, is needed in order for laborers and neighborhoods in the vicinity of asbestos factories to apply for compensation for asbestos-related injury. Eighty-eight consecutive cases of surgically resected primary lung cancer were analyzed for asbestos bodies using two methods, and the correlation between them was statistically examined. The first was the conventional technique using lung tissue digestion and phase-contrast scanning, and the second was the authors' method using light microscopy to scan the sediment of formalin-injected lung specimens. The overall correlation coefficient of the concentration of asbestos bodies between the authors' method (C(AB/SED)) and the conventional method (C(AB/DLT)) was 0.4576, a weak statistically significant correlation; in patients with occupational asbestos exposure, however, the correlation coefficient was 0.7341. Despite the cost, it may be prudent to use the conventional method under the present law for patients with C(AB/SED)>or=3.5/mL. C(AB/DLT) >3000/g dry lung tissue when C(AB/SED) is >or=3.5/mL suggests the potential for the accumulation of asbestos absorption by lung tissue.
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Affiliation(s)
- Yasuhiro Sakai
- Department of Pathology, Hyogo Cancer Center, Hyogo, Japan
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Roggli VL, Gibbs AR, Attanoos R, Churg A, Popper H, Cagle P, Corrin B, Franks TJ, Galateau-Salle F, Galvin J, Hasleton PS, Henderson DW, Honma K. Pathology of asbestosis- An update of the diagnostic criteria: Report of the asbestosis committee of the college of american pathologists and pulmonary pathology society. Arch Pathol Lab Med 2010; 134:462-80. [PMID: 20196674 DOI: 10.5858/134.3.462] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED Asbestosis is defined as diffuse pulmonary fibrosis caused by the inhalation of excessive amounts of asbestos fibers. Pathologically, both pulmonary fibrosis of a particular pattern and evidence of excess asbestos in the lungs must be present. Clinically, the disease usually progresses slowly, with a typical latent period of more than 20 years from first exposure to onset of symptoms. DIFFERENTIAL DIAGNOSIS IDIOPATHIC PULMONARY FIBROSIS: The pulmonary fibrosis of asbestosis is interstitial and has a basal subpleural distribution, similar to that seen in idiopathic pulmonary fibrosis, which is the principal differential diagnosis. However, there are differences between the 2 diseases apart from the presence or absence of asbestos. First, the interstitial fibrosis of asbestosis is accompanied by very little inflammation, which, although not marked, is better developed in idiopathic pulmonary fibrosis. Second, in keeping with the slow tempo of the disease, the fibroblastic foci that characterize idiopathic pulmonary fibrosis are infrequent in asbestosis. Third, asbestosis is almost always accompanied by mild fibrosis of the visceral pleura, a feature that is rare in idiopathic pulmonary fibrosis. DIFFERENTIAL DIAGNOSIS RESPIRATORY BRONCHIOLITIS: Asbestosis is believed to start in the region of the respiratory bronchiole and gradually extends outward to involve more and more of the lung acinus, until the separate foci of fibrosis link, resulting in the characteristically diffuse pattern of the disease. These early stages of the disease are diagnostically problematic because similar centriacinar fibrosis is often seen in cigarette smokers and is characteristic of mixed-dust pneumoconiosis. Fibrosis limited to the walls of the bronchioles does not represent asbestosis. ROLE OF ASBESTOS BODIES Histologic evidence of asbestos inhalation is provided by the identification of asbestos bodies either lying freely in the air spaces or embedded in the interstitial fibrosis. Asbestos bodies are distinguished from other ferruginous bodies by their thin, transparent core. Two or more asbestos bodies per square centimeter of a 5- mu m-thick lung section, in combination with interstitial fibrosis of the appropriate pattern, are indicative of asbestosis. Fewer asbestos bodies do not necessarily exclude a diagnosis of asbestosis, but evidence of excess asbestos would then require quantitative studies performed on lung digests. ROLE OF FIBER ANALYSIS Quantification of asbestos load may be performed on lung digests or bronchoalveolar lavage material, employing either light microscopy, scanning electron microscopy, or transmission electron microscopy. Whichever technique is employed, the results are only dependable if the laboratory is well practiced in the method chosen, frequently performs such analyses, and the results are compared with those obtained by the same laboratory applying the same technique to a control population.
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Affiliation(s)
- Victor L Roggli
- Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.
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Berry G, Pooley F, Gibbs A, Harris JM, McDonald JC. Lung Fiber Burden in the Nottingham Gas Mask Cohort. Inhal Toxicol 2009; 21:168-72. [DOI: 10.1080/08958370802291304] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Fireman EM, Lerman Y, Ben Mahor M, Ganor E, Kramer MR. Redefining idiopathic interstitial lung disease into occupational lung diseases by analysis of chemical composition of inhaled dust particles in induced sputum and/or lung biopsy specimens. Toxicol Ind Health 2008; 23:607-15. [PMID: 18717519 DOI: 10.1177/0748233708090907] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There has been increased public awareness of the potential danger from exposure to hazardous dust in various occupations. This study aims to validate the qualitative analysis of scanning electron microscopy (SEM) of lung samples by 1) correlation of induced sputum (IS) findings to clinical findings, 2) comparing hazardous particles in IS to those in biopsied lung specimens, and 3) assessing whether the particles present in the lungs of transplanted patients correlate with occupational history of dust exposure. Forty patients with occupational history were included; of whom 35 filled in questionnaires. Twenty-four of them had SEM analysis of their IS, and 11 of these 24 also had SEM analysis of their lung tissue. Another 11 lung biopsies from patients with occupational history were scanned by SEM and compared with 10 lung biopsies from patients with no occupational history. SEM analysis of IS was as efficient for detecting hazardous particles as was SEM analysis of lung tissue; silica was detected better in sputum. Exposure to silica was the main chemical element associated with a high likelihood to show abnormalities in IS (Odds ratio 19.41 CI = 0.270-1398.33). The average number of detected hazardous chemical elements in patients with an occupational history of exposure was 4 +/- 1.61 in IS and 3.55 +/- 2.02 in lung tissue (P = 0.57); it was 1.5 +/- 0.85 from transplanted occupationally exposed patients compared with 0.36 +/- 0.67 in transplanted non-exposed patients (P = 0.003). SEM analysis of particles in IS and lung tissue can elucidate the causative agent(s) of otherwise idiopathic interstitial lung disease among occupationally exposed workers.
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Affiliation(s)
- E M Fireman
- Institute for Pulmonary and Allergic Diseases, Tel-Aviv Sourasky Medical Center, Tel Aviv University, Tel-Aviv, Israel.
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Wright CM, Bowman RV, Tan ME, Martins MU, McLachlan RE, Passmore LH, Windsor MN, Clarke BE, Duhig EE, Mahar AM, Fong K. Lung Asbestos Content in Lungs Resected for Primary Lung Cancer. J Thorac Oncol 2008; 3:569-76. [DOI: 10.1097/jto.0b013e318174e046] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dumortier P. Analyses minéralogiques et cancers thoraciques : intérêt et limites. Rev Mal Respir 2008; 25:252-3. [DOI: 10.1016/s0761-8425(08)71526-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Honma K, Abraham JL, Chiyotani K, De Vuyst P, Dumortier P, Gibbs AR, Green FHY, Hosoda Y, Iwai K, Williams WJ, Kohyama N, Ostiguy G, Roggli VL, Shida H, Taguchi O, Vallyathan V. Proposed criteria for mixed-dust pneumoconiosis: Definition, descriptions, and guidelines for pathologic diagnosis and clinical correlation1 1The NIKKO-Symposium on Mixed-Dust Pneumoconiosis was held October 18–19, 1997, in Nikko, Tochigi, Japan, to develop diagnostic criteria for mixed-dust pneumoconiosis under the auspices of Labour Welfare Corporation, Tokyo, Japan. The Organizing Committee included Keizo Chiyotani, Koichi Honma, Yutaka Hosoda, and Hisao Shida, and participants included Zoltán Adamis, Eduardo Algranti, Toshiharu Fuyuki, Kiyonobu Kimura, Otha Linton, Michihito Mishina, Hiroshi Morikubo, Alvaro R. Osornio-Vargas, Yoshiaki Saitoh, Yasushi Shinohara, and Hiroshi Watanabe. Hum Pathol 2004; 35:1515-23. [PMID: 15619211 DOI: 10.1016/j.humpath.2004.09.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
We defined mixed-dust pneumoconiosis (MDP) pathologically as a pneumoconiosis showing dust macules or mixed-dust fibrotic nodules (MDF), with or without silicotic nodules (SN), in an individual with a history of exposure to mixed dust. We defined the latter arbitrarily as a mixture of crystalline silica and nonfibrous silicates. According to our definition of MDP, therefore, MDF should outnumber SN in the lung to make a pathologic diagnosis of MDP. In the absence of confirmation of exposure, mineralogic analyses can be used to support the pathologic diagnosis. The clinical diagnosis of MDP requires the exclusion of other well-defined pneumoconioses, including asbestosis, coal workers' pneumoconiosis, silicosis, hematite miners' pneumoconiosis, welders' pneumoconiosis, berylliosis, hard metal disease, silicate pneumoconiosis, diatomaceous earth pneumoconiosis, carborundum pneumoconiosis, and corundum pneumoconiosis. Typical occupations associated with the diagnosis of MDP include metal miners, quarry workers, foundry workers, pottery and ceramics workers, and stonemasons. Irregular opacities are the major radiographic findings in MDP (ILO 1980), in contrast to silicosis, in which small rounded opacities predominate. Clinical symptoms of MDP are nonspecific. MDP must be distinguished from a variety of nonoccupational interstitial pulmonary disorders.
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Affiliation(s)
- Koichi Honma
- Department of Pathology, Dokkyo University School of Medicine, Mibu, Tochigi, Japan
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Abstract
Malignant mesothelioma (MM) is a very aggressive tumor that is caused by environmental, biologic, and genetic factors. Among these factors, asbestos plays a major role. The link between asbestos and MM has been firmly established through numerous epidemiologic studies conducted during the past 40 years. However, the causal role of chrysotile asbestos compared with crocidolite asbestos in MM, the method of correctly establishing asbestos exposure, the amount of asbestos necessary to cause MM, and the mechanisms of asbestos tumorigenicity are still being debated. Along with asbestos, Simian virus 40 (SV40), a DNA monkey virus, has recently been implicated in the etiology of MM. Simian virus 40 large T antigen (Tag) and small t antigen (tag) are largely responsible for the carcinogenicity of the virus, and it is possible that SV40 and asbestos are cocarcinogens. Finally, a genetic factor identified in 3 villages in Cappadocia, Turkey, where 50% of individuals die of MM, appears to be the cause of a high incidence of the disease. In these villages, genetic predisposition for MM works together with erionite, a nonasbestos fiber found in the stones used in construction of houses. The diagnosis of MM is made histologically and confirmed through electron microscopy and immunohistochemistry. Currently available therapies for MM prolong survival by a few months at most. An SV40 vaccine is being developed for human use and it is hoped that it may reduce the incidence of MM in asbestos workers.
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Affiliation(s)
- Michele Carbone
- Cancer Immunology Program, Department of Pathology, Cardinal Bernardin Cancer Center, Loyola University Chicago, Maywood, IL 60153, USA.
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Abstract
About 80% of malignant mesotheliomas (MM) in the Western World develop in individuals with higher than background exposure to asbestos. Only a fraction of those exposed to asbestos develop mesothelioma, indicating that additional factors play a role. Simian virus 40 (SV40), a DNA tumor virus that preferentially causes mesothelioma in hamsters, has been detected in several human mesotheliomas. The expression of the SV40 large tumor antigen in mesothelioma cells, and not in nearby stromal cells, and the capacity of antisense T-antigen treatment to arrest mesothelioma cell growth in vitro suggest that SV40 contributes to tumor development. The capacity of T-antigen to bind and inhibit cellular p53 and retinoblastoma (Rb)-family proteins in mesothelioma, together with the very high susceptibility of human mesothelial cells to SV40-mediated transformation in vitro, supports a causative role of SV40 in the pathogenesis of mesothelioma. Asbestos appears to increase SV40-mediated transformation of human mesothelial cells in vitro, suggesting that asbestos and SV40 may be cocarcinogens. p53 mutations are rarely found in mesothelioma; p16, p14ARF, and NF2 mutations/losses are frequent. Recent studies revealed the existence of a genetic factor that predisposes affected individuals to mesothelioma in the villages of Karain and Tuzkoy, in Anatolia, Turkey. Erionite, a type of zeolite, may be a cofactor in these same villages, where 50% of deaths are caused by mesothelioma. Mesothelioma appears to have a complex etiology in which environmental carcinogens (asbestos and erionite), ionizing radiation, viruses, and genetic factors act alone or in concert to cause malignancy.
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Affiliation(s)
- Michele Carbone
- Cancer Immunology Program, Cardinal Bernardin Cancer Center, Department of Pathology, Loyola University Chicago, USA
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Abstract
This article gives guidance for the handling and examination of various types of lung tissue specimens to provide: (1) accurate diagnosis and assessment of severity of disease; (2) sufficient information for the accurate staging of tumours; and (3) an assessment of the contribution of various occupational disorders to the cause of death.
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Affiliation(s)
- A R Gibbs
- Department of Histopathology, Llandough Hospital, Penarth, South Glamorgan, UK.
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Howel D, Gibbs A, Arblaster L, Swinburne L, Schweiger M, Renvoize E, Hatton P, Pooley F. Mineral fibre analysis and routes of exposure to asbestos in the development of mesothelioma in an English region. Occup Environ Med 1999; 56:51-8. [PMID: 10341747 PMCID: PMC1757652 DOI: 10.1136/oem.56.1.51] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the concentrations of inorganic fibres in the lungs in cases of mesothelioma and controls: to determine whether concentrations of retained asbestos fibres differ with the different exposures identified from interview; and to investigate the existence of a cut off point in concentrations of asbestos fibres that indicates occupational exposure. METHODS Case-control study; 147 confirmed cases of mesothelioma and 122 controls identified from deaths occurring in four districts of Yorkshire between 1979 and 1991. Surviving relatives were interviewed to determine lifetime exposure history to asbestos. Mineral fibre analysis was carried out on lung tissue from postmortem examinations. RESULTS Odds on high concentrations of retained asbestos fibres were greater in cases than controls. After excluding subjects with occupational and paraoccupational exposure, the odds on high concentrations were still greater in cases than controls, but only significantly so for amphiboles. There was only a weak relation between probability of occupational exposure to asbestos and concentrations of retained asbestos fibres, and no significant difference in fibre concentrations was found between subjects who had been exposed to asbestos through different routes: these comparisons were only based on small groups. There was considerable overlap in concentrations of retained asbestos fibres between cases and controls with and without histories of occupational exposure. CONCLUSIONS The study has confirmed previous results of higher concentrations of asbestos fibres in cases than controls, and has shown that this is still found in subjects with little evidence of occupational and para-occupational exposure. The overlap in concentrations of retained asbestos for different groups of subjects did not suggest a clear cut of value.
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Affiliation(s)
- D Howel
- Department of Epidemiology and Public Health, University of Newcastle upon Tyne, UK.
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Dumortier P, Coplü L, de Maertelaer V, Emri S, Baris I, De Vuyst P. Assessment of environmental asbestos exposure in Turkey by bronchoalveolar lavage. Am J Respir Crit Care Med 1998; 158:1815-24. [PMID: 9847273 DOI: 10.1164/ajrccm.158.6.9712119] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Environmental or domestic exposure to asbestos fibers originating from local soil is responsible for a high incidence of diseases in large rural areas of Turkey. Bronchoalveolar lavage fluids (BALF) were obtained for 65 Turkish subjects originating from these areas and for 42 Turkish controls. Asbestos bodies (ABs) and uncovered fibers (UFs) were quantified by phase contrast light microscopy. Total fiber burden was determined by transmission electron microscopy. The main asbestos types disclosed were tremolite and to a lesser extent chrysotile. AB and fiber concentrations were higher in environmentally exposed subjects (geometric mean [geometric standard deviation]: 5.20 [6.22] AB/ml, 444 [11.6] tremolite fibers/ml) than in control subjects (0.22 [1.45] AB/ml, 12.0 [15.4] tremolite fibers/ml) (p < 0.001). In subjects environmentally exposed in Turkey, AB burdens on tremolite were in the same range as those on commercial amphiboles in subjects occupationally exposed in Belgium. In Turkish subjects, values above either 1 AB/ml, 3 uncovered fiber/ml in light microscopy, or 300 fibers/ml in electron microscopy indicated usually an abnormal alveolar retention reflecting a significant cumulative exposure from environmental or domestic origin. These observations are probably valid for other areas in the world where diseases associated with environmental exposure to soil- derived asbestos fibers occur and for immigrants originating from these areas.
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Affiliation(s)
- P Dumortier
- Chest Department, Hôpital Erasme, and Biostatistics, IRIBHN, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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Mossman BT, Churg A. Mechanisms in the pathogenesis of asbestosis and silicosis. Am J Respir Crit Care Med 1998; 157:1666-80. [PMID: 9603153 DOI: 10.1164/ajrccm.157.5.9707141] [Citation(s) in RCA: 595] [Impact Index Per Article: 22.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- B T Mossman
- Department of Pathology, University of Vermont College of Medicine, Burlington 05405, USA.
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