1
|
Girardi P, Rigoni S, Ferrante D, Silvestri S, Angelini A, Cuccaro F, Oddone E, Vicentini M, Barone-Adesi F, Tunesi S, Migliore E, Roncaglia F, Sala O, Pirastu R, Chellini E, Miligi L, Perticaroli P, Bressan V, Merler E, Azzolina D, Marinaccio A, Massari S, Magnani C. Asbestos exposure and asbestosis mortality in Italian cement-asbestos cohorts: Dose-response relationship and the role of competing death causes. Am J Ind Med 2024; 67:813-822. [PMID: 38943482 DOI: 10.1002/ajim.23629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/17/2024] [Accepted: 06/09/2024] [Indexed: 07/01/2024]
Abstract
OBJECTIVES In Italy, asbestos was used intensively until its ban in 1992, which was extended for asbestos cement factories until 1994. The aim of this study was to evaluate the dose-response between asbestos exposure and asbestosis mortality across a pool of Italian occupational cohorts, taking into account the presence of competing risks. METHODS Cohorts were followed for vital status and the cause of death was ascertained by a linkage with mortality registers. Cause-specific (CS) Cox-regression models were used to evaluate the dose-exposure relationship between asbestosis mortality and the time-dependent cumulative exposure index (CEI) to asbestos. Fine and Gray regression models were computed to assess the effect of competing risks of death. RESULTS The cohort included 12,963 asbestos cement workers. During the follow-up period (1960-2012), of a total of 6961 deaths, we observed 416 deaths attributed to asbestosis, 879 to lung cancer, 400 to primary pleural cancer, 135 to peritoneal cancer, and 1825 to diseases of the circulatory system. The CS model showed a strong association between CEI and asbestosis mortality. Dose-response models estimated an increasing trend in mortality even below a CEI of 25 ff/mL-years. Lung cancer and circulatory diseases were the main competing causes of death. CONCLUSIONS Asbestos exposure among Italian asbestos-cement workers has led to a very high number of deaths from asbestosis and asbestos-related diseases. The increasing risk trend associated with excess deaths, even at low exposure levels, suggests that the proposed limit values would not have been adequate to prevent disability and mortality from asbestosis.
Collapse
Affiliation(s)
- Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venezia, Italy
| | - Sara Rigoni
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Daniela Ferrante
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Stefano Silvestri
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Alessia Angelini
- Institute for the Study, Prevention and Oncology Network (ISPRO), Firenze, Italy
| | - Francesco Cuccaro
- Epidemiology and Statistics Unit, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Enrico Oddone
- Department of Public Health and Experimental and Forensic Medicine, University of Pavia, Italy
- Hospital Occupational Medicine Unit, ICS Maugeri IRCCS, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Local Health Authority-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | | | - Sara Tunesi
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Enrica Migliore
- Cancer Epidemiology Unit, AOU Città della Salute e della Scienza di Torino, CPO Piedmont and University of Turin, Torino, Italy
| | - Francesca Roncaglia
- Epidemiology Unit, Local Health Authority-IRCCS of Reggio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- (former) Regional Asbestos Laboratory ARPAE Emilia-Romagna, Reggio Emilia, Italy
| | - Roberta Pirastu
- (former) "Charles Darwin" Department of Biology and Biotechnology, La Sapienza University, Roma, Italy
| | - Elisabetta Chellini
- (former) Institute for the Study, Prevention and Oncology Network (ISPRO), Firenze, Italy
| | - Lucia Miligi
- Institute for the Study, Prevention and Oncology Network (ISPRO), Firenze, Italy
| | | | | | - Enzo Merler
- (former) Veneto Register of Mesothelioma cases, Regional Epidemiological System, AULSS 6, Padova, Italy
| | - Danila Azzolina
- Department of Environmental Sciences and Prevention, University of Ferrara, Ferrara, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Italian Workers' Compensation Authority (INAIL), Roma, Italy
| | - Corrado Magnani
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| |
Collapse
|
2
|
Zandwijk NV, Frank AL, Reid G, Dimitri Røe O, Amos CI. Asbestos-Related lung Cancer: An underappreciated oncological issue. Lung Cancer 2024; 194:107861. [PMID: 39003938 DOI: 10.1016/j.lungcan.2024.107861] [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: 12/11/2023] [Revised: 06/19/2024] [Accepted: 06/22/2024] [Indexed: 07/16/2024]
Abstract
Asbestos, a group of class I (WHO) carcinogenic fibers, is the main cause of mesothelioma. Asbestos inhalation also increases the risk to develop other solid tumours with lung cancer as the most prominent example [91]. The incidence of asbestos-related lung cancer (ARLC) is estimated to be to six times larger than the mesothelioma incidence thereby becoming an important health issue [86]. Although the pivotal role of asbestos in inducing lung cancer is well established, the precise causal relationships between exposures to asbestos, tobacco smoke, radon and 'particulate' (PM2.5) air pollution remain obscure and new knowledge is needed to establish appropriate preventive measures and to tailor existing screening practices[22,61,65]. We hypothesize that a part of the increasing numbers of lung cancer diagnoses in never-smokers can be explained by (historic and current) exposures to asbestos as well as combinations of different forms of air pollution (PM2.5, asbestos and silica).
Collapse
Affiliation(s)
- Nico van Zandwijk
- Sydney Local Health District (SLHD), Department of Cell and Molecular Therapies, Royal, Prince Alfred Hospital, Camperdown, NSW 2050, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
| | - Arthur L Frank
- School of Public Health of Drexel, University, Philadelphia, PA, USA
| | - Glen Reid
- Department of Pathology, Otago Medical, School, University of Otago, Dunedin, New Zealand
| | - Oluf Dimitri Røe
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | | |
Collapse
|
3
|
Ke H, Kao S, van Zandwijk N, Rasko JEJ, Yeo D. Circulating tumor cell detection may offer earlier diagnosis in patients suspected of asbestos-related lung cancer. Lung Cancer 2024; 192:107829. [PMID: 38810528 DOI: 10.1016/j.lungcan.2024.107829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/21/2024] [Indexed: 05/31/2024]
Abstract
Asbestos-Related Lung Cancer (ARLC) presents ongoing diagnostic challenges despite improved imaging technologies. The long latency period, coupled with limited access to occupational and environmental data along with the confounding effects of smoking and other carcinogens adds complexity to the diagnostic process. Compounding these challenges is the absence of a specific histopathologic or mutational signature of ARLC. A correlation between PD-L1 expression and response to immune checkpoint inhibition has not yet been proven. Thus, new biomarkers are needed to allow accurate diagnoses of ARLC, to enable prognostication and to offer personalized treatments. Liquid biopsies, encompassing circulating DNA and circulating tumor cells (CTCs), have gained attention as novel diagnostic methods in lung cancer to screen high-risk populations including those exposed to asbestos. CTCs can be enumerated and molecularly profiled to provide predictive and prognostic information. CTC studies have not been undertaken in populations at risk of ARLC to date. The potential of CTCs to provide real-time molecular insight into ARLC biology may significantly improve the diagnosis and management of ARLC patients.
Collapse
Affiliation(s)
- Helen Ke
- Li Ka Shing Cell & Gene Therapy Program, The University of Sydney, Camperdown, 2050 NSW, Australia; Precision Oncology Laboratory, Gene and Stem Cell Therapy Program, Centenary Institute, The University of Sydney, Camperdown, 2050 NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, 2050 NSW, Australia; Medical Oncology, Chris O'Brien Lifehouse, NSW 2050 Camperdown, Australia
| | - Steven Kao
- Faculty of Medicine and Health, The University of Sydney, Camperdown, 2050 NSW, Australia; Medical Oncology, Chris O'Brien Lifehouse, NSW 2050 Camperdown, Australia; Asbestos Diseases Research Institute, NSW 2139 Concord, Australia
| | - Nico van Zandwijk
- Faculty of Medicine and Health, The University of Sydney, Camperdown, 2050 NSW, Australia; Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney Local Health District (SLHD), Camperdown, 2050 NSW, Australia
| | - John E J Rasko
- Li Ka Shing Cell & Gene Therapy Program, The University of Sydney, Camperdown, 2050 NSW, Australia; Precision Oncology Laboratory, Gene and Stem Cell Therapy Program, Centenary Institute, The University of Sydney, Camperdown, 2050 NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, 2050 NSW, Australia; Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney Local Health District (SLHD), Camperdown, 2050 NSW, Australia.
| | - Dannel Yeo
- Li Ka Shing Cell & Gene Therapy Program, The University of Sydney, Camperdown, 2050 NSW, Australia; Precision Oncology Laboratory, Gene and Stem Cell Therapy Program, Centenary Institute, The University of Sydney, Camperdown, 2050 NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Camperdown, 2050 NSW, Australia; Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney Local Health District (SLHD), Camperdown, 2050 NSW, Australia.
| |
Collapse
|
4
|
Łuniewski S, Rogowska W, Łozowicka B, Iwaniuk P. Plants, Microorganisms and Their Metabolites in Supporting Asbestos Detoxification-A Biological Perspective in Asbestos Treatment. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1644. [PMID: 38612157 PMCID: PMC11012542 DOI: 10.3390/ma17071644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 02/13/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024]
Abstract
Many countries banned asbestos due to its toxicity, but considering its colossal use, especially in the 1960s and 1970s, disposing of waste containing asbestos is the current problem. Today, many asbestos disposal technologies are known, but they usually involve colossal investment and operating expenses, and the end- and by-products of these methods negatively impact the environment. This paper identifies a unique modern direction in detoxifying asbestos minerals, which involves using microorganisms and plants and their metabolites. The work comprehensively focuses on the interactions between asbestos and plants, bacteria and fungi, including lichens and, for the first time, yeast. Biological treatment is a prospect for in situ land reclamation and under industrial conditions, which can be a viable alternative to landfilling and an environmentally friendly substitute or supplement to thermal, mechanical, and chemical methods, often characterized by high cost intensity. Plant and microbial metabolism products are part of the green chemistry trend, a central strategic pillar of global industrial and environmental development.
Collapse
Affiliation(s)
- Stanisław Łuniewski
- Faculty of Economics, L.N. Gumilyov Eurasian National University, Satpayev 2, Astana 010008, Kazakhstan; (S.Ł.); (B.Ł.)
- Faculty of Economic Sciences, The Eastern European University of Applied Sciences in Bialystok, Ciepła 40 St., 15-472 Białystok, Poland
| | - Weronika Rogowska
- Department of Environmental Engineering Technology and Systems, Faculty of Civil Engineering and Environmental Sciences, Białystok University of Technology, Wiejska 45E St., 15-351 Białystok, Poland
- Institute of Plant Protection—National Research Institute, Chełmońskiego 22 St., 15-195 Białystok, Poland;
| | - Bożena Łozowicka
- Faculty of Economics, L.N. Gumilyov Eurasian National University, Satpayev 2, Astana 010008, Kazakhstan; (S.Ł.); (B.Ł.)
- Institute of Plant Protection—National Research Institute, Chełmońskiego 22 St., 15-195 Białystok, Poland;
| | - Piotr Iwaniuk
- Institute of Plant Protection—National Research Institute, Chełmońskiego 22 St., 15-195 Białystok, Poland;
| |
Collapse
|
5
|
Markowitz S, Ringen K, Dement JM, Straif K, Christine Oliver L, Algranti E, Nowak D, Ehrlich R, McDiarmid MA, Miller A. Occupational lung cancer screening: A Collegium Ramazzini statement. Am J Ind Med 2024; 67:289-303. [PMID: 38440821 DOI: 10.1002/ajim.23572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 03/06/2024]
Affiliation(s)
- Steven Markowitz
- Barry Commoner Center for Health & the Environment, Queens College, City University of New York, New York, New York State, USA
| | - Knut Ringen
- CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - John M Dement
- Duke University School of Medicine, Division of Occupational & Environmental Medicine, Durham, North Carolina, USA
| | - Kurt Straif
- ISGlobal, Barcelona, Spain
- Boston College, Chestnut Hill, Massachusetts, USA
| | - L Christine Oliver
- Dalla Lana School of Public Health, Division of Occupational and Environmental Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU Klinikum, LMU Munich, CPC Munich, Comprehensive Pneumology Center Munich, #DZL, Deutsches Zentrum für Lungenforschung, Munich, Germany
| | - Rodney Ehrlich
- Division of occupational Medicine, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Melissa A McDiarmid
- Division of Occupational & Environmental Medicine, University of Maryland School of Medicine, USA
| | - Albert Miller
- Barry Commoner Center for Health & the Environment, Queens College, City University of New York, New York, New York State, USA
- Department of Medicine, Mount Sinai School of Medicine, New York, New York State, USA
| |
Collapse
|
6
|
Xiong X, Zhang S, Liao X, Du J, Zheng W, Hu S, Wei Q, Yang L. An umbrella review of the evidence associating occupational carcinogens and cancer risk at 19 anatomical sites. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 345:123531. [PMID: 38341059 DOI: 10.1016/j.envpol.2024.123531] [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: 04/19/2023] [Revised: 10/23/2023] [Accepted: 02/07/2024] [Indexed: 02/12/2024]
Abstract
Occupational exposure to carcinogens of increasing cancer risk have been extensively suggested. A robust assessment of these evidence is needed to guide public policy and health care. We aimed to classify the strength of evidence for associations of 13 occupational carcinogens (OCs) and risk of cancers. We searched PubMed and Web of Science up to November 2022 to identify potentially relevant studies. We graded the evidence into convincing, highly suggestive, suggestive, weak, or not significant according to a standardized classification based on: random-effects p value, number of cancer cases, 95% confidence interval of largest study, heterogeneity between studies, 95% prediction interval, small study effect, excess significance bias and sensitivity analyses with credibility ceilings. The quality of meta-analysis was evaluated by AMSTAR 2. Forty-eight articles yielded 79 meta-analyses were included in current umbrella review. Evidence of associations were convincing (class I) or highly suggeastive (class II) for asbestos exposure and increasing risk of lung cancer among smokers (RR = 8.79, 95%CI: 5.81-13.25 for cohort studies and OR = 8.68, 95%CI: 5.68-13.24 for case-control studies), asbestos exposure and increasing risk of mesothelioma (RR = 4.61, 95%CI: 2.57-8.26), and formaldehyde exposure and increasing risk of sinonasal cancer (RR = 1.68, 95%CI: 1.38-2.05). Fifteen associations were supported by suggestive evidence (class III). In summary, the current umbrella review found strong associations between: asbestos exposure and increasing risk of lung cancer among smokers; asbestos exposure and increasing risk of mesothelioma; and formaldehyde exposure and higher risk of sinonasal cancer. Other associations might be genuine, but substantial uncertainty remains.
Collapse
Affiliation(s)
- Xingyu Xiong
- Department of Urology, Center of Biomedical Big Data and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shiyu Zhang
- Department of Urology, Center of Biomedical Big Data and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xinyang Liao
- Department of Urology, Center of Biomedical Big Data and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jiajia Du
- State Key Laboratory of Biotherapy, National Clinical Research Center for Geriatrics, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Weitao Zheng
- Department of Urology, Center of Biomedical Big Data and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Siping Hu
- Department of Urology, Center of Biomedical Big Data and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiang Wei
- Department of Urology, Center of Biomedical Big Data and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lu Yang
- Department of Urology, Center of Biomedical Big Data and National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| |
Collapse
|
7
|
Lu J, Lin Y, Jiang J, Gao L, Shen Z, Yang C, Lin P, Kang M. Investigating the potential causal association between consumption of green tea and risk of lung cancer: a study utilizing Mendelian randomization. Front Nutr 2024; 11:1265878. [PMID: 38439922 PMCID: PMC10909932 DOI: 10.3389/fnut.2024.1265878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/05/2024] [Indexed: 03/06/2024] Open
Abstract
Background Lung cancer is the most common global cancer in terms of incidence and mortality. Its main driver is tobacco smoking. The identification of modifiable risk factors isa public health priority. Green tea consumption has been examined in epidemiological studies, with inconsistent findings. Thus, we aimed to apply Mendelian randomization to clarify any causal link between green tea consumption and the risk of lung cancer. Methods We utilized a two-sample Mendelian randomization (MR) approach. Genetic variants served as instrumental variables. The goal was to explore a causal link between green tea consumption and different lung cancer types. Green tea consumption data was sourced from the UK Biobank dataset, and the genetic association data for various types of lung cancer were sourced from multiple databases. Our analysis included primary inverse-variance weighted (IVW) analyses and various sensitivity test. Results No significant associations were found between green tea intake and any lung cancer subtypes, including non-small cell lung cancer (adenocarcinoma and squamous cell carcinoma) and small cell lung cancer. These findings were consistent when applying multiple Mendelian randomization methods. Conclusion Green tea does not appear to offer protective benefits against lung cancer at a population level. However, lung cancer's complex etiology and green tea's potential health benefitssuggest more research is needed. Further studies should include diverse populations, improved exposure measurements and randomized controlled trials, are warranted.
Collapse
Affiliation(s)
- Jieming Lu
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, China
| | - Ye Lin
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, China
| | - Junfei Jiang
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, China
| | - Lei Gao
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, China
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou, China
- Fujian Key Laboratory of Tumor Microbiology, Department of Medical Microbiology, Fujian Medical University, Fuzhou, China
| | - Zhimin Shen
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, China
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou, China
- Fujian Key Laboratory of Tumor Microbiology, Department of Medical Microbiology, Fujian Medical University, Fuzhou, China
| | - Changping Yang
- Fuqing City Hospital Affiliated to Fujian Medical University, Fuzhou, China
| | - Pinghua Lin
- Fuqing City Hospital Affiliated to Fujian Medical University, Fuzhou, China
| | - Mingqiang Kang
- Department of Thoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China
- Key Laboratory of Cardio-Thoracic Surgery, Fujian Medical University, Fuzhou, China
- Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou, China
- Fujian Key Laboratory of Tumor Microbiology, Department of Medical Microbiology, Fujian Medical University, Fuzhou, China
| |
Collapse
|
8
|
LoPiccolo J, Gusev A, Christiani DC, Jänne PA. Lung cancer in patients who have never smoked - an emerging disease. Nat Rev Clin Oncol 2024; 21:121-146. [PMID: 38195910 PMCID: PMC11014425 DOI: 10.1038/s41571-023-00844-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 01/11/2024]
Abstract
Lung cancer is the most common cause of cancer-related deaths globally. Although smoking-related lung cancers continue to account for the majority of diagnoses, smoking rates have been decreasing for several decades. Lung cancer in individuals who have never smoked (LCINS) is estimated to be the fifth most common cause of cancer-related deaths worldwide in 2023, preferentially occurring in women and Asian populations. As smoking rates continue to decline, understanding the aetiology and features of this disease, which necessitate unique diagnostic and treatment paradigms, will be imperative. New data have provided important insights into the molecular and genomic characteristics of LCINS, which are distinct from those of smoking-associated lung cancers and directly affect treatment decisions and outcomes. Herein, we review the emerging data regarding the aetiology and features of LCINS, particularly the genetic and environmental underpinnings of this disease as well as their implications for treatment. In addition, we outline the unique diagnostic and therapeutic paradigms of LCINS and discuss future directions in identifying individuals at high risk of this disease for potential screening efforts.
Collapse
Affiliation(s)
- Jaclyn LoPiccolo
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
- The Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
| | - Alexander Gusev
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- The Eli and Edythe L. Broad Institute, Cambridge, MA, USA
| | - David C Christiani
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
| | - Pasi A Jänne
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- The Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| |
Collapse
|
9
|
Krabbe J, Steffens KM, Drießen S, Kraus T. Lung cancer risk and occupational pulmonary fibrosis: systematic review and meta-analysis. Eur Respir Rev 2024; 33:230224. [PMID: 38355151 PMCID: PMC10865097 DOI: 10.1183/16000617.0224-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/31/2023] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Molecular pathways found to be important in pulmonary fibrosis are also involved in cancer pathogenesis, suggesting common pathways in the development of pulmonary fibrosis and lung cancer. RESEARCH QUESTION Is pulmonary fibrosis from exposure to occupational carcinogens an independent risk factor for lung cancer? STUDY DESIGN AND METHODS A comprehensive search of PubMed, Embase, Web of Science and Cochrane databases with over 100 search terms regarding occupational hazards causing pulmonary fibrosis was conducted. After screening and extraction, quality of evidence and eligibility criteria for meta-analysis were assessed. Meta-analysis was performed using a random-effects model. RESULTS 52 studies were identified for systematic review. Meta-analysis of subgroups identified silicosis as a risk factor for lung cancer when investigating odds ratios for silicosis in autopsy studies (OR 1.47, 95% CI 1.13-1.90) and for lung cancer mortality in patients with silicosis (OR 3.21, 95% CI 2.67-3.87). Only considering studies with an adjustment for smoking as a confounder identified a significant increase in lung cancer risk (OR 1.58, 95% CI 1.34-1.87). However, due to a lack of studies including cumulative exposure, no adjustments could be included. In a qualitative review, no definitive conclusion could be reached for asbestosis and silicosis as independent risk factors for lung cancer, partly because the studies did not take cumulative exposure into account. INTERPRETATION This systematic review confirms the current knowledge regarding asbestosis and silicosis, indicating a higher risk of lung cancer in exposed individuals compared to exposed workers without fibrosis. These individuals should be monitored for lung cancer, especially when asbestosis or silicosis is present.
Collapse
Affiliation(s)
- Julia Krabbe
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Katja Maria Steffens
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Sarah Drießen
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Thomas Kraus
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, RWTH Aachen University, Aachen, Germany
| |
Collapse
|
10
|
Ou Z, Li X, Cui J, Zhu S, Feng K, Ma J, Wu K, Chen Y, Su Y, Tang S, Duan D, Ren Y, Zhang X, Liang J, Wang Z. Global, regional, and national burden of asbestosis from 1990 to 2019 and the implications for prevention and control. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 904:166346. [PMID: 37591378 DOI: 10.1016/j.scitotenv.2023.166346] [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: 05/31/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
BACKGROUND Asbestosis is a common pneumoconiosis caused by long-term asbestos exposure. Analysis of the burden of asbestosis would help in creating informed public health strategies. METHODS Data on asbestosis were analyzed using the Global Burden of Disease study 2019. The estimated annual percentage change (EAPC) was calculated to demonstrate temporal trends in the age-standardized rate (ASR) of asbestosis from 1990 to 2019. RESULTS Globally, 36,339 incident cases of asbestosis, led to 3572 deaths and 71,225 disability adjusted life years (DALYs) in 2019. During 1990-2019, the overall ASRs of incidence and DALYs declined by an annual average of 0.29 % and 0.27 %, with the respective EAPCs being -0.29 (95 % confidence interval [CI]: -0.43, -0.14) and -0.27 (95%CI: -0.53, -0.01). The ASRs of mortality increased with EAPC of 0.65 (95%CI: 0.34, 0.96). Trends in incidence and prevalence rose in females, but declined in males. The asbestosis burden was heterogeneous across regions and countries. The heaviest burden of asbestosis was observed in the United States, India, and China. Trends in ASRs of asbestosis varied across countries/territories. Pronounced increasing trends in incidence and prevalence occurred in Georgia, Iran, and Croatia. CONCLUSIONS Decreasing incident trend of asbestosis was observed globally over the past three decades. However, the ongoing asbestosis burden highlighted that asbestosis remained a challenge to public health, and cost-effective measures were required to reduce the asbestosis burden.
Collapse
Affiliation(s)
- Zejin Ou
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Xin Li
- School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Jiaxin Cui
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Shaofang Zhu
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Kexin Feng
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Jialao Ma
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Kangyong Wu
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Yuquan Chen
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yiwei Su
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Shihao Tang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Danping Duan
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Yixian Ren
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Xing Zhang
- Institute of Occupational Diseases, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, China
| | - Jiabin Liang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China
| | - Zhi Wang
- Key Laboratory of Occupational Environment and Health, Guangzhou Twelfth People's Hospital, Guangzhou, China.
| |
Collapse
|
11
|
Beckett EM, Abelmann A, Roberts B, Lewis RC, Cheatham D, Miller EW, Hall E, Pierce JS. An updated evaluation of reported no-observed adverse effect levels for chrysotile, amosite, and crocidolite asbestos for lung cancer and mesothelioma. Crit Rev Toxicol 2023; 53:611-657. [PMID: 38126124 DOI: 10.1080/10408444.2023.2283169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 11/08/2023] [Indexed: 12/23/2023]
Abstract
This analysis updates two previous analyses that evaluated the exposure-response relationships for lung cancer and mesothelioma in chrysotile-exposed cohorts. We reviewed recently published studies, as well as updated information from previous studies. Based on the 16 studies considered for chrysotile (<10% amphibole), we identified the "no-observed adverse effect level" (NOAEL) for lung cancer and/or mesothelioma; it should be noted that smoking or previous or concurrent occupational exposure to amphiboles (if it existed) was not controlled for. NOAEL values ranged from 2.3-<11.5 f/cc-years to 1600-3200 f/cc-years for lung cancer and from 100-<400 f/cc-years to 800-1599 f/cc-years for mesothelioma. The range of best-estimate NOAELs was estimated to be 97-175 f/cc-years for lung cancer and 250-379 f/cc-years for mesothelioma. None of the six cohorts of cement or friction product manufacturing workers exhibited an increased risk at any exposure level, while all but one of the six studies of textile workers reported an increased risk at one or more exposure levels. This is likely because friction and cement workers were exposed to much shorter chrysotile fibers. Only eight cases of peritoneal mesothelioma were reported in all studies on predominantly chrysotile-exposed cohorts combined. This analysis also proposed best-estimate amosite and crocidolite NOAELs for mesothelioma derived by the application of relative potency estimates to the best-estimate chrysotile NOAELs for mesothelioma and validated by epidemiology studies with exposure-response information. The best-estimate amosite and crocidolite NOAELs for mesothelioma were 2-5 f/cc-years and 0.6-1 f/cc-years, respectively. The rate of peritoneal mesothelioma in amosite- and crocidolite-exposed cohorts was between approximately 70- to 100-fold and several-hundred-fold higher than in chrysotile-exposed cohorts, respectively. These findings will help characterize potential worker and consumer health risks associated with historical and current chrysotile, amosite, and crocidolite exposures.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Ethan Hall
- Benchmark Risk Group, Grand Rapids, MI, USA
| | | |
Collapse
|
12
|
Albano D, Dhamija A, Liao Y, Mclarty A, Talavera H, Kim EK, Ashamalla M. Lung cancer in nonsmokers- A risk factor analysis. Cancer Epidemiol 2023; 86:102439. [PMID: 37598649 DOI: 10.1016/j.canep.2023.102439] [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: 05/19/2023] [Revised: 08/01/2023] [Accepted: 08/05/2023] [Indexed: 08/22/2023]
Abstract
INSTITUTIONS STONY BROOK MEDICAL CENTERRATIONALE: Lung Cancer screening for the high-risk smoking population has been proven to save lives. However, in 2022, 20% of newly diagnosed lung cancers (47,300) were in nonsmokers. These patients were found to be diagnosed at later stages. This may be at least partly due to not meeting criteria for and participating in current lung cancer screening. This study aims to describe characteristics of a never smoker patient population to help identify common risk factors which might merit inclusion in lung cancer screening and thus improve patient outcomes. METHODS This retrospective single center study included never-smoker patients diagnosed with lung nodules and never-smoker patients diagnosed with lung cancer from 2016 to 2022. Data was obtained from the Stony Brook Medical Center electronic medical record. 16,056 patients were identified as never-smokers who were asked by the medical assistant if they ever smoked in their lifetime. Patients were eliminated if they had any smoking history up to first diagnosis date. Demographics, radiology, histology, diagnosis dates, comorbidities, smoking status, and exposures collected through ICD10 codes and not self-reported, were investigated. RESULTS Of 16,056 never-smoking patients, 9315 (58.02%) were females diagnosed with lung nodules and 6741 (41.98%) were males diagnosed with lung nodules. The univariate analysis showed significant differences between gender, age at nodule diagnosis, and patients with and without comorbidities including chronic obstructive pulmonary disease (COPD), hypertension (HTN), and family history (FHX) of lung cancer. The percentage of lung cancer patients among females was significantly higher than among males. Patients having lung cancer were older. The percentages of lung cancer patients with these comorbidities were significantly higher than those without. However, there was no significant difference found between patients with and without diabetes mellitus (DM). The multivariable logistic regression suggested that age at nodule diagnosis and comorbidities including COPD (which included asthma, emphysema and chronic bronchitis) and family history of lung cancer were significantly associated with lung cancer. Older patients and patients with those comorbidities had a higher risk of developing cancer than those who were younger or without those comorbidities. The study excluded HTN and included age at nodule diagnosis in the logistic regression model as HTN was found to be protective against lung cancer due to age at lung nodule diagnosis. Please refer to the appendix for further details. CONCLUSION Never-smoker patients who were older and with COPD and Family History of lung cancer had higher risk of developing lung cancer than younger patients without these comorbidities. In this study, gender had no impact on outcome.
Collapse
Affiliation(s)
- Denise Albano
- Department of Surgery, Stony Brook University Hospital, USA.
| | - Ankit Dhamija
- Department of Surgery, Stony Brook University Hospital, USA
| | - Yunhan Liao
- Biostatistician, Biostatistics Shared Resource, USA
| | | | | | - Esther K Kim
- Department of Surgery, Stony Brook University Hospital, USA
| | - Mark Ashamalla
- Department of Radiation Oncology, Stony Brook University Hospital, USA
| |
Collapse
|
13
|
Shehata SA, Toraih EA, Ismail EA, Hagras AM, Elmorsy E, Fawzy MS. Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk. Cancers (Basel) 2023; 15:4525. [PMID: 37760496 PMCID: PMC10526315 DOI: 10.3390/cancers15184525] [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: 04/30/2023] [Revised: 06/18/2023] [Accepted: 06/22/2023] [Indexed: 09/29/2023] Open
Abstract
Lung cancer (LC) is the second-most prevalent tumor worldwide. According to the most recent GLOBOCAN data, over 2.2 million LC cases were reported in 2020, with an estimated new death incident of 1,796,144 lung cancer cases. Genetic, lifestyle, and environmental exposure play an important role as risk factors for LC. E-cigarette, or vaping, products (EVPs) use has been dramatically increasing world-wide. There is growing concern that EVPs consumption may increase the risk of LC because EVPs contain several proven carcinogenic compounds. However, the relationship between EVPs and LC is not well established. E-cigarette contains nicotine derivatives (e.g., nitrosnornicotine, nitrosamine ketone), heavy metals (including organometal compounds), polycyclic aromatic hydrocarbons, and flavorings (aldehydes and complex organics). Several environmental toxicants have been proven to contribute to LC. Proven and plausible environmental carcinogens could be physical (ionizing and non-ionizing radiation), chemicals (such as asbestos, formaldehyde, and dioxins), and heavy metals (such as cobalt, arsenic, cadmium, chromium, and nickel). Air pollution, especially particulate matter (PM) emitted from vehicles and industrial exhausts, is linked with LC. Although extensive environmental exposure prevention policies and smoking reduction strategies have been adopted globally, the dangers remain. Combined, both EVPs and toxic environmental exposures may demonstrate significant synergistic oncogenicity. This review aims to analyze the current publications on the importance of the relationship between EVPs consumption and environmental toxicants in the pathogenesis of LC.
Collapse
Affiliation(s)
- Shaimaa A. Shehata
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.A.S.); (A.M.H.)
| | - Eman A. Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA;
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Ezzat A. Ismail
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt;
| | - Abeer M. Hagras
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt; (S.A.S.); (A.M.H.)
| | - Ekramy Elmorsy
- Department of Pathology, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia;
- Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Manal S. Fawzy
- Department of Biochemistry, Faculty of Medicine, Northern Border University, Arar 73213, Saudi Arabia
| |
Collapse
|
14
|
Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol 2023; 20:624-639. [PMID: 37479810 DOI: 10.1038/s41571-023-00798-3] [Citation(s) in RCA: 114] [Impact Index Per Article: 114.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/23/2023]
Abstract
Lung cancer is the leading cause of cancer-related death worldwide. However, lung cancer incidence and mortality rates differ substantially across the world, reflecting varying patterns of tobacco smoking, exposure to environmental risk factors and genetics. Tobacco smoking is the leading risk factor for lung cancer. Lung cancer incidence largely reflects trends in smoking patterns, which generally vary by sex and economic development. For this reason, tobacco control campaigns are a central part of global strategies designed to reduce lung cancer mortality. Environmental and occupational lung cancer risk factors, such as unprocessed biomass fuels, asbestos, arsenic and radon, can also contribute to lung cancer incidence in certain parts of the world. Over the past decade, large-cohort clinical studies have established that low-dose CT screening reduces lung cancer mortality, largely owing to increased diagnosis and treatment at earlier disease stages. These data have led to recommendations that individuals with a high risk of lung cancer undergo screening in several economically developed countries and increased implementation of screening worldwide. In this Review, we provide an overview of the global epidemiology of lung cancer. Lung cancer risk factors and global risk reduction efforts are also discussed. Finally, we summarize lung cancer screening policies and their implementation worldwide.
Collapse
Affiliation(s)
- Amanda Leiter
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Rajwanth R Veluswamy
- Division of Hematology and Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
15
|
Liang H, Zhang L, Rong J. Potential roles of exosomes in the initiation and metastatic progression of lung cancer. Biomed Pharmacother 2023; 165:115222. [PMID: 37549459 DOI: 10.1016/j.biopha.2023.115222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023] Open
Abstract
Lung cancer (LC) incidence and mortality continue to increase annually worldwide. LC is insidious and readily metastasizes and relapses. Except for its early diagnosis and surgical resection, there is no effective cure for advanced metastatic LC, and the prognosis remains dismal. Exosomes, a class of nano-sized extracellular vesicles produced by healthy or diseased cells, are coated with a bilayer lipid membrane and contain various functional molecules such as proteins, lipids, and nucleic acids. They can be used for intracellular or intercellular signaling or the transportation of biological substances. A growing body of evidence supports that exosomes play multiple crucial roles in the occurrence and metastatic progression of many malignancies, including LC. The elucidation of the potential roles of exosomes in the initiation, invasion, and metastasis of LC and their underlying molecular mechanisms may contribute to improved early diagnosis and treatment.
Collapse
Affiliation(s)
- Hongyuan Liang
- Department of Radiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, PR China
| | - Lingyun Zhang
- Department of Medical Oncology, the First Hospital of China Medical University, No. 210 Baita Street, Hunnan District, Shenyang 110001, PR China.
| | - Jian Rong
- Department of Pediatrics, PICU, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, PR China.
| |
Collapse
|
16
|
Wu X, Huang G, Li W, Chen Y. Ethnicity-specific association between TERT rs2736100 (A > C) polymorphism and lung cancer risk: a comprehensive meta-analysis. Sci Rep 2023; 13:13271. [PMID: 37582820 PMCID: PMC10427644 DOI: 10.1038/s41598-023-40504-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 08/11/2023] [Indexed: 08/17/2023] Open
Abstract
The rs2736100 (A > C) polymorphism of the second intron of Telomerase reverse transcriptase (TERT) has been confirmed to be closely associated with the risk of Lung cancer (LC), but there is still no unified conclusion on the results of its association with LC. This study included Genome-wide association studies (GWAS) and case-control studies reported so far on this association between TERT rs2736100 polymorphism and LC to clarify such a correlation with LC and the differences in it between different ethnicities and different types of LC. Relevant literatures published before May 7, 2022 on 'TERT rs2736100 polymorphism and LC susceptibility' in PubMed, EMbase, CENTRAL, MEDLINE databases were searched through the Internet, and data were extracted. Statistical analysis of data was performed in Revman5.3 software, including drawing forest diagrams, drawing funnel diagrams and so on. Sensitivity and publication bias analysis were performed in Stata 12.0 software. The C allele of TERT rs2736100 was associated with the risk of LC (Overall population: [OR] = 1.21, 95%CI [1.17, 1.25]; Caucasians: [OR] = 1.11, 95%CI [1.06, 1.17]; Asians: [OR] = 1.26, 95%CI [1.21, 1.30]), and Asians had a higher risk of LC than Caucasians (C vs. A: Caucasians: [OR] = 1.11 /Asians: [OR]) = 1.26). The other gene models also showed similar results. The results of stratified analysis of LC patients showed that the C allele was associated with the risk of Non-small-cell lung carcinoma (NSCLC) and Lung adenocarcinoma (LUAD), and the risk of NSCLC and LUAD in Asians was higher than that in Caucasians. The C allele was associated with the risk of Lung squamous cell carcinoma (LUSC) and Small cell lung carcinoma(SCLC) in Asians but not in Caucasians. NSCLC patients ([OR] = 1.27) had a stronger correlation than SCLC patients ([OR] = 1.03), and LUAD patients ([OR] = 1.32) had a stronger correlation than LUSC patients ([OR] = 1.09).In addition, the C allele of TERT rs2736100 was associated with the risk of LC, NSCLC and LUAD in both smoking groups and non-smoking groups, and the risk of LC in non-smokers of different ethnic groups was higher than that in smokers. In the Asians, non-smoking women were more at risk of developing LUAD. The C allele of TERT rs2736100 is a risk factor for LC, NSCLC, and LUAD in different ethnic groups, and the Asian population is at a more common risk. The C allele is a risk factor for LUSC and SCLC in Asians but not in Caucasians. And smoking is not the most critical factor that causes variation in TERT rs2736100 to increase the risk of most LC (NSCLC, LUAD). Therefore, LC is a multi-etiological disease caused by a combination of genetic, environmental and lifestyle factors.
Collapse
Affiliation(s)
- Xiaozheng Wu
- Department of Preclinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, 510025, China
| | - Gao Huang
- Department of Preclinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, 510025, China
| | - Wen Li
- Department of Preclinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, 510025, China
| | - Yunzhi Chen
- Department of Preclinical Medicine, Guizhou University of Traditional Chinese Medicine, Guiyang, 510025, China.
| |
Collapse
|
17
|
Moitra S, Tabrizi AF, Khadour F, Henderson L, Melenka L, Lacy P. Exposure to insulating materials and risk of coronary artery diseases: a cross-sectional study. Front Public Health 2023; 11:1235189. [PMID: 37608979 PMCID: PMC10441239 DOI: 10.3389/fpubh.2023.1235189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 07/18/2023] [Indexed: 08/24/2023] Open
Abstract
Background Although previous reports link exposure to insulating materials with an increased risk of mesothelioma and chronic respiratory diseases, studies evaluating their associations with the risk of coronary artery diseases (CAD) are lacking. Aims We aimed at evaluating the associations between exposure to insulating materials and the 10-year risk of CAD among insulators. Methods In this cross-sectional study, we recruited 643 adults (≥18 years), full-time insulators from the Local 110 Heat and Frost Insulators and Allied Workers Union in Edmonton, Alberta. We obtained demographic information, personal and family history, and job-exposure history, including experience (years) and types of exposure to insulating materials. Clinical profiling including Framingham risk scores (FRS) was assessed. Results Of all insulators, 89% were men (mean ± SD age: 47 ± 12 years), 27% had a parental history of cardiac diseases, and 22% had a comorbid chronic respiratory disease. In total, 53% reported exposure to asbestos, while 61, 82, and 94% reported exposure to ceramic fibers, fiberglass, and mineral fibers, respectively. In single-exposure multivariable regression models adjusted for experience, marital status, and body mass index (BMI), asbestos was found to be associated with higher FRS (β: 1.004; 95%CI: 0.003-2.00). The association remained consistent in multi-exposure models and a higher association was found between asbestos exposure and FRS among insulators with comorbid chronic respiratory disease. Conclusion Our study demonstrates that apart from cancer and chronic respiratory diseases, asbestos exposure may also have a cardiac effect, thus warranting the need for systematic surveillance to protect workers from the adverse effects of these materials.
Collapse
Affiliation(s)
- Subhabrata Moitra
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Ali Farshchi Tabrizi
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Fadi Khadour
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Linda Henderson
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Lyle Melenka
- Synergy Respiratory and Cardiac Care, Sherwood Park, AB, Canada
| | - Paige Lacy
- Alberta Respiratory Centre and Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
18
|
Wang J, Huang X, Ma R, Zhang Q, Wu N, Du X, Ye Q. The incidence of malignancies in asbestosis with chrysotile exposure: a large Chinese prospective cohort study. Front Oncol 2023; 13:1172496. [PMID: 37483507 PMCID: PMC10359706 DOI: 10.3389/fonc.2023.1172496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/12/2023] [Indexed: 07/25/2023] Open
Abstract
Background Asbestos exposure is closely related to the occurrence and development of various malignancies. This prospective cohort study aimed to evaluate the incidence rate and potential risk factors in a cohort of asbestosis patients in China. Methods The incidence of malignancies was determined in patients who had been exposed to chrysotile asbestos and diagnosed with asbestosis sequentially at Beijing Chaoyang Hospital from 1 January 2007 to 31 December 2019. Cox regression analyses were used to analyze the correlations between clinical variables and asbestosis combined with malignancies. Results A total of 618 patients with asbestosis were identified, of whom 544 were eligible for analysis. Among them, 89 (16.36%) were diagnosed with various malignancies. The standardized incidence ratios (SIRs) of patients with asbestosis combined with malignancies were 16.61, 175, 5.23, and 8.77 for lung cancer, mesothelioma, breast cancer, and endometrial carcinoma, respectively. The risks of all malignancies and lung cancer increased with initial exposure before 17 years old, longer asbestos exposure, and smoking. Conclusions The SIRs of patients with asbestosis-related malignancies were significantly increased in lung cancer, mesothelioma, breast cancer, and endometrial carcinoma in a hospital-based Chinese cohort. Smoking and the duration of asbestos exposure increased the risk of lung cancer.
Collapse
Affiliation(s)
- Jingwei Wang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiaoyun Huang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Department of Respiratory Medicine, Civil Aviation General Hospital, Beijing, China
| | - Ruimin Ma
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qian Zhang
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Na Wu
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xuqin Du
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Qiao Ye
- Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
19
|
Cani M, Turco F, Butticè S, Vogl UM, Buttigliero C, Novello S, Capelletto E. How Does Environmental and Occupational Exposure Contribute to Carcinogenesis in Genitourinary and Lung Cancers? Cancers (Basel) 2023; 15:2836. [PMID: 37345174 PMCID: PMC10216822 DOI: 10.3390/cancers15102836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/23/2023] Open
Abstract
Environmental and occupational exposures have been associated with an increased risk of different types of cancers, although the exact mechanisms of higher carcinogenesis risk are not always well understood. Lung cancer is the leading cause of global cancer mortality, and, also, genitourinary neoplasms are among the main causes of cancer-related deaths in Western countries. The purpose of this review is to describe the main environmental and occupational factors that increase the risk of developing lung and genitourinary cancers and to investigate carcinogenesis mechanisms that link these agents to cancer onset. Further objectives are to identify methods for the prevention or the early detection of carcinogenic agents and, therefore, to reduce the risk of developing these cancers or to detect them at earlier stages.
Collapse
Affiliation(s)
- Massimiliano Cani
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (M.C.); (F.T.); (C.B.); (E.C.)
| | - Fabio Turco
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (M.C.); (F.T.); (C.B.); (E.C.)
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland
| | - Simona Butticè
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (M.C.); (F.T.); (C.B.); (E.C.)
| | - Ursula Maria Vogl
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), 6500 Bellinzona, Switzerland
| | - Consuelo Buttigliero
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (M.C.); (F.T.); (C.B.); (E.C.)
| | - Silvia Novello
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (M.C.); (F.T.); (C.B.); (E.C.)
| | - Enrica Capelletto
- Oncology Unit, Department of Oncology, University of Turin, S. Luigi Gonzaga Hospital, 10043 Orbassano, Italy; (M.C.); (F.T.); (C.B.); (E.C.)
| |
Collapse
|
20
|
Peña-Castro M, Montero-Acosta M, Saba M. A critical review of asbestos concentrations in water and air, according to exposure sources. Heliyon 2023; 9:e15730. [PMID: 37305461 PMCID: PMC10256854 DOI: 10.1016/j.heliyon.2023.e15730] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 04/20/2023] [Indexed: 06/13/2023] Open
Abstract
Asbestos, a group of minerals with unique physical and chemical properties, has been widely used in various industries. However, extensive exposure to asbestos fibers, present in the environment, has been linked to several types of cancer, mesothelioma, and asbestosis. Despite worldwide regulations prohibiting or regulating the use of this material, the uncertainty surrounding the concentrations of asbestos fibers in the environment (air and water) from different sources of exposure persists. The objective of this review paper is to identify the levels of asbestos in air and water reported in the literature based on the source of exposure in diverse contexts to assess conformity with the reference limits for this mineral. Initially, the review delineates various forms of exposure and the origin of fiber generation in the environment, whether direct or indirect. Regarding the presence of asbestos in the environment, high concentrations were identified in natural water bodies known as Naturally Occurring Asbestos (NOA), and there is a risk in the process of distributing drinking water due to the presence of asbestos-cement pipes. In the air, studies to determine asbestos concentrations vary based on the sources of exposure in each region or city studied. The presence of asbestos mines around the city and the intensity of vehicular traffic are some of the most relevant sources found to be related to high concentrations of asbestos fibers in the air. The present review paper features a critical review section in each chapter to highlight critical points found in the literature and suggest new methodologies/ideas to standardize future research. It emphasizes the necessity to standardize methods for measuring asbestos concentrations in air and water arising from diverse sources of exposure to enable comparisons between different regions and countries.
Collapse
Affiliation(s)
| | | | - Manuel Saba
- Corresponding author. Avenida del Consulado #Calle 30 No. 48-152, Cartagena de Indias, Colombia.
| |
Collapse
|
21
|
Weissman DN, Radonovich LJ. Importance of and Approach to Taking a History of Exposures to Occupational Respiratory Hazards. Semin Respir Crit Care Med 2023; 44:396-404. [PMID: 37015287 DOI: 10.1055/s-0043-1766120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Occupational respiratory diseases are caused by exposure to respiratory hazards at work. It is important to document those exposures and whether they are causing or exacerbating disease because these determinations can have important impacts on diagnosis, treatment, job restrictions, and eligibility for benefits. Without investigation, it is easy to miss clinically relevant exposures, especially in those with chronic diseases that can have work and nonwork causes. The first and most important step in identifying exposures to respiratory hazards at work is to take an appropriate history. For efficiency, this is a two-step process. An initial quick screening history is done by asking only a few questions. Follow-up questions are asked if there are positive responses to the screening questions or if an occupational etiology is suspected based on the clinical presentation. Electronic health records have promise for facilitating this process. Follow-up to the screening history may include additional questions, evaluating additional sources of information about workplace exposures, and medical testing. Radiographic findings or tests conducted on noninvasive samples or lung tissue can be used as biomarkers. Online resources can be used to learn more about exposures associated with occupations and industries and to see if investigations evaluating exposures were performed in the patient's own workplace. It is important to adhere to the patient's wishes about contacting the employer. With patient consent, the employer can be an important source of information about exposures and, if a problem exists, has an important role in taking corrective action. Consultation for challenging cases is available from a variety of professional and governmental entities. If a clinician identifies a significant public health issue, such as an occupational disease outbreak, it is important to notify relevant public health authorities so that steps can be taken to prevent additional exposures and appropriately care for those already exposed.
Collapse
Affiliation(s)
- David N Weissman
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Lewis J Radonovich
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| |
Collapse
|
22
|
Keskitalo E, Salonen J, Nurmi H, Vähänikkilä H, Kaarteenaho R. Comorbidities and Causes of Death of Patients With Asbestosis. J Occup Environ Med 2023; 65:349-353. [PMID: 36728947 DOI: 10.1097/jom.0000000000002777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Comorbidities are common and affect the prognosis of patients with interstitial lung diseases, but few previous studies have investigated patients with asbestosis. METHODS We collected comorbidities and death causes of 116 patients with asbestosis treated in Oulu University Hospital. Causes of death were confirmed by autopsy in 68% of the cases. RESULTS The most common comorbidities of asbestosis patients were pleural plaques (96%) and coronary artery disease (CAD; 67%). The prevalence of rheumatoid arthritis was 8.6%. The most common underlying causes of death were asbestosis (36%), CAD (24%), and lung cancer (LC) (10%). CAD and LC were associated with shorter survival in adjusted analyses. CONCLUSIONS Patients with asbestosis have multiple comorbidities. Prevention and treatment of CAD and LC may influence the prognosis of asbestosis patients.
Collapse
Affiliation(s)
- Eerika Keskitalo
- From the ResearchUnit of InternalMedicine, University of Oulu, Oulu, Finland (E.K., J.S., R.K.); Center of Internal and Respiratory Medicine, Medical Research Center (MRC) Oulu, Oulu, Finland (E.K., J.S., R.K.); Division of Respiratory Medicine, Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland (H.N.); Center of Medicine and Clinical Research, Department of Respiratory Medicine, Kuopio University Hospital, Kuopio, Finland (H.N.); Northern Finland Birth Cohorts, Arctic Biobank, Infrastructure for Population studies, Faculty of Medicine, University of Oulu, Oulu, Finland (H.V.)
| | | | | | | | | |
Collapse
|
23
|
Liquid Biopsy for Lung Cancer: Up-to-Date and Perspectives for Screening Programs. Int J Mol Sci 2023; 24:ijms24032505. [PMID: 36768828 PMCID: PMC9917347 DOI: 10.3390/ijms24032505] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 01/31/2023] Open
Abstract
Lung cancer is the deadliest cancer worldwide. Tissue biopsy is currently employed for the diagnosis and molecular stratification of lung cancer. Liquid biopsy is a minimally invasive approach to determine biomarkers from body fluids, such as blood, urine, sputum, and saliva. Tumor cells release cfDNA, ctDNA, exosomes, miRNAs, circRNAs, CTCs, and DNA methylated fragments, among others, which can be successfully used as biomarkers for diagnosis, prognosis, and prediction of treatment response. Predictive biomarkers are well-established for managing lung cancer, and liquid biopsy options have emerged in the last few years. Currently, detecting EGFR p.(Tyr790Met) mutation in plasma samples from lung cancer patients has been used for predicting response and monitoring tyrosine kinase inhibitors (TKi)-treated patients with lung cancer. In addition, many efforts continue to bring more sensitive technologies to improve the detection of clinically relevant biomarkers for lung cancer. Moreover, liquid biopsy can dramatically decrease the turnaround time for laboratory reports, accelerating the beginning of treatment and improving the overall survival of lung cancer patients. Herein, we summarized all available and emerging approaches of liquid biopsy-techniques, molecules, and sample type-for lung cancer.
Collapse
|
24
|
Munson P, Shukla A. Potential Roles of Exosomes in the Development and Detection of Malignant Mesothelioma: An Update. Int J Mol Sci 2022; 23:15438. [PMID: 36499762 PMCID: PMC9741247 DOI: 10.3390/ijms232315438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Malignant mesothelioma (MM) is a devastating cancer of mesothelial cells, caused by asbestos exposure. Limited knowledge regarding the detection of asbestos exposure and the early diagnosis of MM, as well as a lack of successful treatment options for this deadly cancer, project an immediate need to understand the mechanism(s) of MM development. With the recent discovery of nano-vesicles, namely exosomes, and their enormous potential to contain signature molecules representative of different diseases, as well as to communicate with distant targets, we were encouraged to explore their role(s) in MM biology. In this review, we summarize what we know so far about exosomes and MM based on our own studies and on published literature from other groups in the field. We expect that the information contained in this review will help advance the field of MM forward by revealing the mechanisms of MM development and survival. Based on this knowledge, future therapeutic strategies for MM can potentially be developed. We also hope that the outcome of our studies presented here may help in the detection of MM.
Collapse
Affiliation(s)
| | - Arti Shukla
- Department of Pathology and Laboratory Medicine, College of Medicine, University of Vermont, Burlington, VT 05405, USA
| |
Collapse
|
25
|
Thives LP, Ghisi E, Thives Júnior JJ, Vieira AS. Is asbestos still a problem in the world? A current review. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2022; 319:115716. [PMID: 35863303 DOI: 10.1016/j.jenvman.2022.115716] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 06/27/2022] [Accepted: 07/08/2022] [Indexed: 06/15/2023]
Abstract
Asbestos has been used by automobile, construction, manufacturing, power, and chemical industries for many years due to its particular properties, i.e. high tensile strength, non-flammable, thermal and electrical resistance and stability, and chemical resistance. However, such a mineral causes harmful effects to human health, including different types of cancer (e.g., mesothelioma). As a result, the use of asbestos has been banned since the 1980s in many countries. Nonetheless, asbestos is still part of the daily life of the population as asbestos-containing materials (ACMs) are still present in many buildings constructed and renovated before the 1990s. This work aims to present a current literature review about asbestos. The literature review was composed mainly of research articles published in international journals from the medical and engineering disciplines to provide an overview of asbestos use effects reported in interdisciplinary areas. The literature review comprised asbestos characteristics and its relationship to the risks of human exposure, countries where asbestos use is permitted or banned, reducing asbestos in the built environment, and environmental impact due to use and disposal of asbestos. The main findings were that ACMs are still responsible for severe human diseases, particularly in areas where there is a lack of coordinated asbestos management plans, reduced awareness about asbestos health risks, or even a delay in the implementation of asbestos-ban. Such issues may be more prevailing in developing countries. The current research in many countries contemplates several methodologies and techniques to process ACMs into inert and recyclable materials. The identification and coordinated management of ACM hazardous waste is a significant challenge to be faced by countries, and its inadequate disposal causes severe risk of exposure to asbestos fibres. Based on this work, it was concluded that banning asbestos is indicated in all countries in the world.
Collapse
Affiliation(s)
- Liseane P Thives
- Civil Engineering Department, Federal University of Santa Catarina - UFSC, Brazil
| | - Enedir Ghisi
- Civil Engineering Department, Federal University of Santa Catarina - UFSC, Brazil.
| | | | - Abel Silva Vieira
- Urban Analytics and Complex Systems (UACS) Consulting, Queensland, Australia; Griffith School of Engineering and Built Environment, Griffith University, Australia
| |
Collapse
|
26
|
Grier W, Abbas H, Gebeyehu RR, Singh AK, Ruiz J, Hines S, Alghanim F, Deepak J. Military exposures and lung cancer in United States veterans. Semin Oncol 2022; 49:S0093-7754(22)00050-1. [PMID: 35882571 DOI: 10.1053/j.seminoncol.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 06/24/2022] [Accepted: 06/25/2022] [Indexed: 11/11/2022]
Abstract
Lung cancer screening begins at age 50, with yearly low dose computed tomography (LDCT) scans until age 80, for patients determined to be high risk due to tobacco smoking. Veterans serving from World War II to the Gulf War are now at the age where LDCT is recommended. This recommendation from the United States Preventative Service Task Force includes patients who have a 20-pack year tobacco history and currently smoke or quit within the last 15 years. This recommendation does not consider additional risk factors such as exposures to lung carcinogens. We discuss unique operational and occupational exposures encountered while serving in the armed forces, which may potentially increase the risk of lung cancers in the Veteran population. The additional risk of lung cancer due to military exposure history is unclear and more work is needed to identify and quantify risk at an individual level. Increasing awareness at the provider level regarding the carcinogenic exposures encountered may allow a larger population of Veterans, not meeting traditional LDCT criteria, to benefit from lung cancer screening.
Collapse
Affiliation(s)
- William Grier
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Hatoon Abbas
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Rediet Regassa Gebeyehu
- Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Ankur Kumar Singh
- Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jimmy Ruiz
- Department of Medicine (Hematology & Oncology), Wake Forest School of Medicine, Winston-Salem, NC, United States; Department of Medicine, W.G. (Bill) Hefner Veteran Administration Medical Center, Cancer Center, Salisbury, NC, United States
| | - Stella Hines
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States; Baltimore VA Medical Center, Department of Medicine, Baltimore, MD, United States
| | - Fahid Alghanim
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States
| | - Janaki Deepak
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Maryland Medical Center, Baltimore, MD, United States; Baltimore VA Medical Center, Department of Medicine, Baltimore, MD, United States.
| |
Collapse
|
27
|
Taeger D, Wichert K, Lehnert M, Casjens S, Pesch B, Weber DG, Brüning T, Johnen G, Behrens T. Lung cancer and mesothelioma risks in a prospective cohort of workers with asbestos-related lung or pleural diseases. Am J Ind Med 2022; 65:652-659. [PMID: 35642773 DOI: 10.1002/ajim.23401] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND Asbestos causes mesothelioma and lung cancer. In the European Union, asbestos was banned in 2005, but it is still in use in many other countries. The aim of this study was to estimate the lung cancer and mesothelioma incidence risk of men with benign asbestos-related lung or pleural diseases. METHODS Between 2008 and 2018, 2439 male participants of a German surveillance program for asbestos workers were included in the cohort. All participants had a recognized occupational asbestos-related disease of the pleura or lung. We estimated the mesothelioma and lung cancer risks by calculating standardized incidence ratios (SIR) with corresponding 95% confidence intervals (95% CI). RESULTS We observed 64 incident lung cancer and 40 mesothelioma cases in the cohort. An SIR of 17.60 (95% CI: 12.57-23.96) was estimated for mesothelioma and 1.27 (95% CI: 0.98-1.62) for lung cancer. The presence of pleural plaques was associated with a strongly increased risk (SIR: 13.14; 95% CI: 8.51-19.40) for mesothelioma, but not for lung cancer (SIR: 1.05; 95% CI: 0.76-1.41). The highest lung-cancer risk (SIR: 2.56; 95% CI 1.10-5.04) was revealed for cohort members with less than 40 years since first asbestos exposure. Lung cancer risks by duration of asbestos exposure did not show a consistent time trend, but for time since last exposure a trend for mesothelioma was seen. CONCLUSIONS Compared to the general population, we demonstrated an association between benign asbestos-related lung or pleural disease and mesothelioma risk in workers with a history of occupational asbestos exposure. Because lung-cancer risk is dominated by smoking habits, a possible effect of asbestos exposure may have been masked. Efforts should be made to ban production and use of asbestos worldwide and to establish safe handling rules of legacy asbestos.
Collapse
Affiliation(s)
- Dirk Taeger
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Katharina Wichert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Martin Lehnert
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Swaantje Casjens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Beate Pesch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Daniel G. Weber
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Georg Johnen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| | - Thomas Behrens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA) Bochum Germany
| |
Collapse
|
28
|
Motta O, Pironti C, Venier M, Proto A. An Innovative Filtering System for the Handling of Asbestos-Based Products: Improvement of Safety and Quality of Work in Analysis Laboratories. TOXICS 2022; 10:toxics10060281. [PMID: 35736889 PMCID: PMC9227179 DOI: 10.3390/toxics10060281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/21/2022] [Accepted: 05/23/2022] [Indexed: 12/24/2022]
Abstract
Although being banned or restricted in many countries since the early 1990s, large quantities of asbestos are still used or present in building materials all over the world and its removal or handling requires specific systems that limit exposure to airborne fibers The exposure to asbestos causes chronic diseases such as asbestosis and lung cancer with an incubation period of 20 to 50 years. Among the operators most exposed to contamination are those who handle and analyze the materials in laboratories. For this reason, our work focused on an innovative method for removing a filter unit from a laboratory extraction hood, in order to improve the safety conditions for the operators and the surrounding environment. The hood has a particular construction technology with a mechanism that allows the spraying of a special encapsulating liquid on the ULPA filters below the work-bench, which is capable of forming a film and blocking the fibers on the surface of the same filter. The fibers are irreversibly bounded and can no longer be released into the surrounding environment. The monitoring of activity highlighted the absence of asbestos fibers in the air after installation of the filter and workers feel safer performing their activities. The introduction of an innovative filtering system enhanced the safety of work activities involving asbestos exposure, moreover, the time spent on the hood’s maintenance and the risk perception of workers were improved.
Collapse
Affiliation(s)
- Oriana Motta
- Dipartimento di Medicina, Chirurgia e Odontoiatria “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy;
- Correspondence: ; Tel.: +39-089963083
| | - Concetta Pironti
- Dipartimento di Medicina, Chirurgia e Odontoiatria “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy;
| | - Marta Venier
- O’Neill School of Public and Environmental Affairs, Indiana University, Bloomington, IN 47405, USA;
| | - Antonio Proto
- Dipartimento di Chimica e Biologia, University of Salerno, Via Giovanni Paolo II, 132, 84084 Fisciano, Italy;
| |
Collapse
|
29
|
Su Z, Jia XH, Zhao FH, Zhou QH, Fan YG, Qiao YL. Effect of Time Since Smoking Cessation on Lung Cancer Incidence: An Occupational Cohort With 27 Follow-Up Years. Front Oncol 2022; 12:817045. [PMID: 35299746 PMCID: PMC8921458 DOI: 10.3389/fonc.2022.817045] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 01/28/2022] [Indexed: 02/05/2023] Open
Abstract
Background This special cohort reveals the effect of smoking cessation in occupational miners exposed to radon and arsenic. Methods A total of 9,134 tin miners with at least 10 years of underground radon and arsenic exposure were enrolled beginning in 1992 and followed for up to 27 years. Detailed smoking information was collected at baseline, and information on smoking status was consecutively collected from 1992 to 1996. The Cox proportional hazards model was used to explore the relationship between time since smoking cessation and lung cancer. Results A total of 1,324 lung cancer cases occurred in this cohort over 167,776 person-years of follow-up. Among populations exposed to radon and arsenic, miners after quitting smoking for 10 years or more had almost halved their lung cancer risk [adjusted hazard ratio (HR) = 0.55, 95% CI: 0.38-0.79], compared with current smokers. Among miners after quitting smoking for 5 years or more, lung cancer incidence approximately halved (HR = 0.52, 95% CI: 0.30-0.92) for squamous cell lung carcinoma, while it showed no significant decline for adenocarcinoma (HR = 0.79, 95% CI: 0.34-1.85). Conclusion Smoking cessation for 10 years or more halved lung cancer incidence among miners exposed to radon and arsenic, and the benefit was more pronounced among squamous cell lung carcinoma.
Collapse
Affiliation(s)
- Zheng Su
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Hua Jia
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.,The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, China
| | - Fang-Hui Zhao
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing-Hua Zhou
- Sichuan Lung Cancer Institute, Sichuan Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China.,Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Ya-Guang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - You-Lin Qiao
- Center for Global Health, School of Population Medicine and Public Health Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
30
|
Salagay OO, Bukhtiyarov IV, Kuzmina LP, Bezrukavnikova LM, Khotuleva AG, Anvarul RA. The influence of smoking on the formation of occupational lung diseases in workers who come into contact with industrial aerosols. Public Health 2021. [DOI: 10.21045/2782-1676-2021-1-3-32-41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The formation of a healthy lifestyle is one of the most important tasks of disease prevention. Among the factors that negatively affect the health of the population, smoking is of great importance. The influence of smoking on the formation of occupational diseases in workers in harmful and (or) dangerous working conditions has not been sufficiently studied. Based on the knowledge of the pathogenesis of common diseases, it can be assumed with a high degree of probability that smoking can provoke the development of occupational pathology of the respiratory organs, malignant neoplasms, vascular pathology.The aim of the work was to study the clinical manifestations of chronic bronchitis, characterizing the state of the bronchopulmonary system, in smokers and non-smokers who had long-term contact with industrial dust, as well as to analyze the literature data on the impact of smoking on the development of occupational lung diseases in workers exposed to asbestos dust.Materials and methods of research. In the clinic “Research Institute of Occupational Medicine named after Academician N.F. Izmerov”, 55 workers were examined under the influence of industrial aerosols of fibrogenic action. The group of smokers consisted of 45 people: 25 people were coal miners, 20 people were foundry workers. The group of non-smokers consisted of 10 people: 6 coal miners and 4 foundry workers. The severity of the course of professional and non-professional chronic bronchitis in patients was assessed taking into account the clinical manifestations and frequency of exacerbations of the disease, as well as taking into account the severity of respiratory disorders and gas exchange disorders.Results and discussion. In the group of smoking patients, 93,3% had occupational chronic bronchitis, 6.7% had no such pathology. In the group of non-smoking patients with and without occupational chronic bronchitis, there were equally – 50,0%. In the group of smoking patients, 55,5 of the examined patients had respiratory insufficiency of the II degree; 15,5% were diagnosed with respiratory insufficiency of the III degree; cases without respiratory function impairment (DN0 art.) were only 8,8%. In the group of non-smoking patients, grade II DN was more than three times less frequent, amounting to 20,0%, while 40,0% had grade 0 DN and 40,0% had grade I DN; grade III DN was never diagnosed in this group of patients.Conclusion. Smoking, as an independent factor, can play a significant, and in some cases, obviously, a determining role in the development and progression of chronic bronchitis in people exposed to industrial aerosols.The health risks associated with tobacco should be taken into account as an integral part of the assessment of the risks of developing occupational diseases.
Collapse
Affiliation(s)
| | - I. V. Bukhtiyarov
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”
| | - L. P. Kuzmina
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”
| | - L. M. Bezrukavnikova
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”
| | - A. G. Khotuleva
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”
| | - R. A. Anvarul
- Federal State Budgetary Scientific Institution “Izmerov Research Institute of Occupational Health”
| |
Collapse
|
31
|
Fernandes GA, Algranti E, Wunsch‐Filho V, Silva LF, Toporcov TN. Causes of death in former asbestos-cement workers in the state of São Paulo, Brazil. Am J Ind Med 2021; 64:952-959. [PMID: 34379326 DOI: 10.1002/ajim.23279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 06/04/2021] [Accepted: 07/15/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND In low- and middle-income countries, such as Brazil, studies on the causes of death in asbestos-exposed workers are scarce. METHODS A cohort study was performed involving 988 males who had worked in the asbestos-cement industry in the state of São Paulo, with a total of 12,217 person-years of observation between 1995 and 2016. The standardized mortality ratio (SMR) stratified by age was calculated as the ratio between the observed rate and the expected rate in the state of São Paulo. RESULTS Increased SMRs were observed for overall mortality (SMR 1.1, 95% confidence interval [CI], 0.98-1.23) and mortality due to pleural malignant neoplasms (MN) (SMR, 69.4; 95% CI, 22.55-162.1), asbestosis (SMR, 975.7; 95% CI, 396.4-2031), peritoneal MN (SMR, 5.0; 95% CI, 0.13-27.78), laryngeal MN (SMR, 1.4; 95% CI, 0.30-4.20), and pulmonary MN (SMR, 1.5; 95% CI, 0.82-2.64). CONCLUSION The present study highlights the damage caused by asbestos exposure and reinforces the existing evidence of a causal association between exposure and increased mortality due to pleural MN, pulmonary MN, and asbestosis.
Collapse
Affiliation(s)
- Gisele A. Fernandes
- Department Epidemiology University of São Paulo São Paulo Brazil
- Group of Epidemiology and Statistics on Cancer AC Camargo Cancer São Paulo Brazil
| | - Eduardo Algranti
- Division of Medicine Fundação Jorge Duprat e Figueiredo (Fundacentro) São Paulo Brazil
| | | | - Luiz F. Silva
- Institute of Natural Resources Federal University of Itajubá Itajubá Brazil
| | | |
Collapse
|
32
|
Paustenbach D, Brew D, Ligas S, Heywood J. A critical review of the 2020 EPA risk assessment for chrysotile and its many shortcomings. Crit Rev Toxicol 2021; 51:509-539. [PMID: 34651555 DOI: 10.1080/10408444.2021.1968337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
From 2018 to 2020, the United States Environmental Protection Agency (EPA) performed a risk evaluation of chrysotile asbestos to evaluate the hazards of asbestos-containing products (e.g. encapsulated products), including brakes and gaskets, allegedly currently sold in the United States. During the public review period, the EPA received more than 100 letters commenting on the proposed risk evaluation. The Science Advisory Committee on Chemicals (SACC), which peer reviewed the document, asked approximately 100 questions of the EPA that they expected to be addressed prior to publication of the final version of the risk assessment on 30 December 2020. After careful analysis, the authors of this manuscript found many significant scientific shortcomings in both the EPA's draft and final versions of the chrysotile risk evaluation. First, the EPA provided insufficient evidence regarding the current number of chrysotile-containing brakes and gaskets being sold in the United States, which influences the need for regulatory oversight. Second, the Agency did not give adequate consideration to the more than 200 air samples detailed in the published literature of auto mechanics who changed brakes in the 1970-1989 era. Third, the Agency did not consider more than 15 epidemiology studies indicating that exposures to encapsulated chrysotile asbestos in brakes and gaskets, which were generally in commerce from approximately 1950-1985, did not increase the incidence of any asbestos-related disease. Fourth, the concern about chrysotile asbestos being a mesothelioma hazard was based on populations in two facilities where mixed exposure to chrysotile and commercial amphibole asbestos (amosite and crocidolite) occurred. All 8 cases of pleural cancer and mesothelioma in the examined populations arose in facilities where amphiboles were present. It was therefore inappropriate to rely on these cohorts to predict the health risks of exposure to short fiber chrysotile, especially of those fibers filled with phenolic resins. Fifth, the suggested inhalation unit risk (IUR) for chrysotile asbestos was far too high since it was not markedly different than for amosite, despite the fact that the amphiboles are a far more potent carcinogen. Sixth, the approach to low dose modeling was not the most appropriate one in several respects, but, without question, it should have accounted for the background rate of mesothelioma in the general population. Just one month after this assessment was published, the National Academies of Science notified the EPA that the Agency's systematic review process was flawed. The result of the EPA's chrysotile asbestos risk evaluation is that society can expect dozens of years of scientifically unwarranted litigation. Due to an aging population and because some fraction of the population is naturally predisposed to mesothelioma given the presence of various genetic mutations in DNA repair mechanisms (e.g. BAP1 and others), the vast majority of mesotheliomas in the post-2035 era are expected to be spontaneous and unrelated in any way to exposure to asbestos. Due to the EPA's analysis, it is our belief that those who handled brakes and gaskets in the post-1985 era may now believe that those exposures were the cause of their mesothelioma, when a risk assessment based on the scientific weight of evidence would indicate otherwise.
Collapse
Affiliation(s)
| | - David Brew
- Paustenbach and Associates, Jackson, WY, USA
| | | | | |
Collapse
|
33
|
Ngema LM, Adeyemi SA, Marimuthu T, Choonara YE. A review on engineered magnetic nanoparticles in Non-Small-Cell lung carcinoma targeted therapy. Int J Pharm 2021; 606:120870. [PMID: 34245844 DOI: 10.1016/j.ijpharm.2021.120870] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/25/2021] [Accepted: 07/05/2021] [Indexed: 02/07/2023]
Abstract
There are growing appeals forthe design of efficacious treatment options for non-small-cell lung carcinoma (NSCLC) as it accrues to ~ 85% cases of lung cancer. Although platinum-based doublet chemotherapy has been the main therapeutic intervention in NSCLC management, this leads to myriad of problems including intolerability to the doublet regimens and detrimental side effects due to high doses. A new approach is therefore needed and warrants the design of targeted drug delivery systems that can halt tumor proliferation and metastasis by targeting key molecules, while exhibiting minimal side effects and toxicity. This review aims to explore the rational design of magnetic nanoparticles for the development of tumor-targeting systems for NSCLC. In the review, we explore the anticancer merits of conjugated linoleic acid (CLA) and provide a concise incursion into its application for the invention of functionalized magnetic nanoparticles in the targeted treatment of NSCLC. Recent nanoparticle-based targeted chemotherapies for targeting angiogenesis biomarkers in NSCLC will also be reviewed to further highlight versatility of magnetic nanoparticles. These developments through molecular tuning at the nanoscale and supported by comprehensive pre-clinical studies could lead to the establishment of precise nanosystems for tumor-homing cancer therapy.
Collapse
Affiliation(s)
- Lindokuhle M Ngema
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown 2193, South Africa
| | - Samson A Adeyemi
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown 2193, South Africa
| | - Thashree Marimuthu
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown 2193, South Africa
| | - Yahya E Choonara
- Wits Advanced Drug Delivery Platform Research Unit, Department of Pharmacy and Pharmacology, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 7 York Road, Parktown 2193, South Africa.
| |
Collapse
|
34
|
Zunarelli C, Godono A, Visci G, Violante FS, Boffetta P. Occupational exposure to asbestos and risk of kidney cancer: an updated meta-analysis. Eur J Epidemiol 2021; 36:927-936. [PMID: 34195879 PMCID: PMC8502743 DOI: 10.1007/s10654-021-00769-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
Limited information is available on carcinogenicity of asbestos on non-respiratory organs. We aimed at conducted an updated systematic review and meta-analysis of cohort studies on occupational exposure to asbestos and risk of kidney cancer. We searched through three databases, PubMed, Embase and Scopus for article published after 2000, and after eliminating duplicates and non-relevant studies, we identified 13 studies. We combined their results with those of 31 non-overlapping studies included in a previous review up to 2000. We conducted a meta-analysis based on random-effects models. The pooled relative risk of kidney cancer for asbestos exposure was 0.94 (95% confidence interval, 0.84–1.04), with no differences according to type of asbestos fiber, geographic region, period of exposure, or estimated quality of the study. Our results showed a lack of association between occupational asbestos exposure and risk of kidney cancer.
Collapse
Affiliation(s)
- Carlotta Zunarelli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alessandro Godono
- Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Giovanni Visci
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
- Stony Brook Cancer Center, Stony Brook University, Lauterbur Dr, Stony Brook, NY, 11794, USA.
| |
Collapse
|
35
|
Wilk E, Krówczyńska M. Malignant mesothelioma and asbestos exposure in Europe: Evidence of spatial clustering. GEOSPATIAL HEALTH 2021; 16. [PMID: 34000787 DOI: 10.4081/gh.2021.951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 02/25/2021] [Indexed: 06/12/2023]
Abstract
Exposure to asbestos causes a wide range of diseases, such as asbestosis, malignant mesothelioma (MM) and other types of cancer. Many European countries have reduced production and use of asbestos and some have banned it altogether. Based on data derived from the World Health Organisation (WHO) Cancer Mortality Database, we investigated whether some regions in Europe could have a higher relative risk of MM incidence than others. The data were compared, including the number of MM deaths per million inhabitants and aged-standardized mortality rates. Applying Moran's I and Getis-Ord Gi statistic on the agedstandardized mortality rates of MM cases assisted the spatial analysis of the occurrence of health events leading to an assessment of the heterogeneity of distribution and cluster detection of MM. We found a statistically significant positive autocorrelation for the male population and also the general population, while there was no statistically significant positive one for the female population. Hotspots of relative risk of developing MM were found in northwestern Europe. For the general population, Great Britain and the Netherlands stood out with high levels at the 99% and 95% confidence levels, respectively. For the male population, the results were similar, but with addition of risk also in Belgium and Switzerland. However, in many European countries with high asbestos use per capita, the MM incidence was found to still be low. The reasons for this are not yet clear, but part of the problem is certainly due to incomplete data in registers and databases. The latency time can be longer than 40 years and is related to the intensity and time of exposure (occupational, para-occupational and environmental). In Europe, even though peak production occurred in the 1960s and 1970s, a significant decrease in production did not occur until 25 years later, which means that the impact will continue for as late as The mid 2030s.
Collapse
Affiliation(s)
- Ewa Wilk
- Department of Geoinformatics, Cartography and Remote Sensing, Faculty of Geography and Regional Studies, University of Warsaw, Warsaw.
| | - Małgorzata Krówczyńska
- Department of Geoinformatics, Cartography and Remote Sensing, Faculty of Geography and Regional Studies, University of Warsaw, Warsaw.
| |
Collapse
|
36
|
Abstract
Lung cancer is the leading cause of global cancer incidence and mortality, accounting for an estimated 2 million diagnoses and 1.8 million deaths. Neoplasms of the lungs are the second most common cancer diagnosis in men and women (after prostate and breast cancer, respectively). With increasing access to tobacco and industrialization in developing nations, lung cancer incidence is rising globally. The average age of diagnosis is 70 years old. Men are twice as likely to be diagnosed with lung cancer, which largely reflects differences in tobacco consumption, although women may be more susceptible due to higher proportions of epidermal growth factor receptor mutations and the effects of oestrogen. African American men in the US are at the highest risk of lung cancer. Family history increases risk by 1.7-fold, with a greater risk among first-degree relatives. Tobacco smoking is the greatest preventable cause of death worldwide, accounting for up to 90% of lung cancer cases, and continued consumption is projected to increase global cancer incidence, particularly in developing nations such as China, Russia, and India. Second-hand smoke among children and spouses has likewise been implicated. Radon from natural underground uranium decay is the second leading cause of lung cancer in the developed world. Occupational hazards such as asbestos and environmental exposures such as air pollution, arsenic, and HIV and Tb infection have all been implicated in lung carcinogenesis, while cannabis smoking, electronic cigarettes, heated tobacco products, and COVID-19 have been hypothesized to increase risk.
Collapse
|
37
|
Abstract
Selected occupational populations are at the highest risk of lung cancer, because they smoke at increased rates and are concurrently exposed to workplace lung carcinogens. Low-dose computed tomography (CT)-based lung cancer screening has an enormous potential to reduce lung cancer mortality in these populations, as shown both in the lung cancer screening studies in the general population and in studies of workers at high risk of lung cancer. Pulmonologists can play a key role in identifying workers at high risk of lung cancer and ensuring that they are offered annual low-dose CT scans for early lung cancer detection.
Collapse
Affiliation(s)
- Steven B Markowitz
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, 65-30 Kissena Boulevard, Remsen Hall, Queens, NY 11367, USA.
| | - Brittany Dickens
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, 65-30 Kissena Boulevard, Remsen Hall, Queens, NY 11367, USA
| |
Collapse
|
38
|
Performance of Risk Factor-Based Guidelines and Model-Based Chest CT Lung Cancer Screening in World Trade Center-Exposed Fire Department Rescue/Recovery Workers. Chest 2020; 159:2060-2071. [PMID: 33279511 DOI: 10.1016/j.chest.2020.11.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/20/2020] [Accepted: 11/28/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Lung cancer is a leading cause of cancer incidence and death in the United States. Risk factor-based guidelines and risk model-based strategies are used to identify patients who could benefit from low-dose chest CT (LDCT) screening. Few studies compare guidelines or models within the same cohort. We evaluate lung cancer screening performance of two risk factor-based guidelines (US Preventive Services Task Force 2014 recommendations [USPSTF-2014] and National Comprehensive Cancer Network Group 2 [NCCN-2]) and two risk model-based strategies, Prostate Lung Colorectal and Ovarian Cancer Screening (PLCOm2012) and the Bach model) in the same occupational cohort. RESEARCH QUESTION Which risk factor-based guideline or model-based strategy is most accurate in detecting lung cancers in a highly exposed occupational cohort? STUDY DESIGN AND METHODS Fire Department of City of New York (FDNY) rescue/recovery workers exposed to the September 11, 2001 attacks underwent LDCT lung cancer screening based on smoking history and age. The USPSTF-2014, NCCN-2, PLCOm2012 model, and Bach model were retrospectively applied to determine how many lung cancers were diagnosed using each approach. RESULTS Among the study population (N = 3,953), 930 underwent a baseline scan that met at least one risk factor or model-based LDCT screening strategy; 73% received annual follow-up scans. Among the 3,953, 63 lung cancers were diagnosed, of which 50 were detected by at least one LDCT screening strategy. The NCCN-2 guideline was the most sensitive (79.4%; 50/63). When compared with NCCN-2, stricter age and smoking criteria reduced sensitivity of the other guidelines/models (USPSTF-2014 [44%], PLCOm2012 [51%], and Bach[46%]). The 13 missed lung cancers were mainly attributable to smoking less and quitting longer than guideline/model eligibility criteria. False-positive rates were similar across all four guidelines/models. INTERPRETATION In this cohort, our findings support expanding eligibility for LDCT lung cancer screening by lowering smoking history from ≥30 to ≥20 pack-years and age from 55 years to 50 years old. Additional studies are needed to determine its generalizability to other occupational/environmental exposed cohorts.
Collapse
|
39
|
Ferrante P. Asbestosis and silicosis hospitalizations in Italy (2001-2015): results from the National Hospital Discharge Registry. Eur J Public Health 2020; 29:876-882. [PMID: 30753424 DOI: 10.1093/eurpub/ckz003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This work is aimed at evaluating the quality of Italian hospitalizations data about asbestosis and silicosis, assessing the impact of these diseases on the national health system and providing advice related to public health. METHODS Italian hospital discharge data (2001-15) with diagnosis of asbestosis or silicosis were analysed by the multiple correspondence analysis and diseases epidemics were evaluated through hospitalization rates. RESULTS Hospitalizations were concentrated in the northwestern area, referred mainly to males and oldest people, the most treated tumors were lung cancer and mesothelioma (for asbestosis) and cares were aimed at reducing symptoms and increasing blood oxygenation. Overall adjusted Italian hospitalization rates of asbestosis and silicosis were, respectively, 25.2 and 74.9 per 1 000 000 residents. With respect to asbestosis, hospitalizations treating silicosis reported doubled mortality (10.5 vs. 5.7%), longer stays (10.4 vs. 8.6 mean days) and older patients (77 vs. 72 years on average). Diseases rates reduced over time (with a steeper slope for silicosis) and in both fibroses increased hospital mortality (92.1% in asbestoses, 59.5% in silicoses) and percentage of urgent hospitalizations (116.0% in asbestoses, 56.6% in silicoses). CONCLUSION Hospitalizations data regarding asbestosis and silicosis are consistent. Silicosis had a higher impact than asbestosis on the Italian health system. Although data show decreasing incidence of both fibroses, multiple correspondence analysis highlights that levels of illness severity were higher in silicosis and increased over time in both diseases. Further studies investigating the effectiveness of the current health surveillance programs concerning these diseases are suggested.
Collapse
Affiliation(s)
- Pierpaolo Ferrante
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian National Workers' Compensation Authority (INAIL), Rome, Italy
| |
Collapse
|
40
|
Girardi P, Merler E, Ferrante D, Silvestri S, Chellini E, Angelini A, Luberto F, Fedeli U, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mirabelli D, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Azzolina D, Tunesi S, Miligi L, Perticaroli P, Pettinari A, Cuccaro F, Nannavecchia AM, Bisceglia L, Marinaccio A, Pavone VLM, Magnani C. Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy. Ann Work Expo Health 2020; 64:622-635. [PMID: 32328661 DOI: 10.1093/annweh/wxaa037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/10/2020] [Accepted: 03/19/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study was performed with the aim of investigating the temporal patterns and determinants associated with mortality from asbestosis among 21 cohorts of Asbestos-Cement (AC) workers who were heavily exposed to asbestos fibres. METHODS Mortality for asbestosis was analysed for a cohort of 13 076 Italian AC workers (18.1% women). Individual cumulative asbestos exposure index was calculated by factory and period of work weighting by the different composition of asbestos used (crocidolite, amosite, and chrysotile). Two different approaches to analysis, based on Standardized Mortality Ratios (SMRs) and Age-Period-Cohort (APC) models were applied. RESULTS Among the considered AC facilities, asbestos exposure was extremely high until the end of the 1970s and, due to the long latency, a peak of asbestosis mortality was observed after the 1990s. Mortality for asbestosis reached extremely high SMR values [SMR: males 508, 95% confidence interval (CI): 446-563; females 1027, 95% CI: 771-1336]. SMR increased steeply with the increasing values of cumulative asbestos exposure and with Time Since the First Exposure. APC analysis reported a clear age effect with a mortality peak at 75-80 years; the mortality for asbestosis increased in the last three quintiles of the cumulative exposure; calendar period did not have a significant temporal component while the cohort effect disappeared if we included in the model the cumulative exposure to asbestos. CONCLUSIONS Among heaviest exposed workers, mortality risk for asbestosis began to increase before 50 years of age. Mortality for asbestosis was mainly determined by cumulative exposure to asbestos.
Collapse
Affiliation(s)
- Paolo Girardi
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Daniela Ferrante
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Stefano Silvestri
- CPO-Piedmont, Novara, Italy.,Occupational Hygienists, Unit of Medical Statistics and Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Alessia Angelini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Ferdinando Luberto
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Ugo Fedeli
- Mesothelioma Register of the Veneto Region, Regional Epidemiological System, Azienda Zero, Padua, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesco Barone-Adesi
- CPO-Piedmont, Novara, Italy.,Department of 'Scienze del Farmaco', University of Eastern Piedmont, Novara, Italy
| | - Tiziana Cena
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Mangone
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Francesca Roncaglia
- Epidemiology Service, Azienda Unità Sanitaria Locale-IRCCS, Montecchio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- Occupational Hygienist, Formerly: Regional Agency for Prevention, Environment and Energy Emilia-Romagna, Provincial Office of Reggio Emilia, Reggio Emilia, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Naples, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies 'Charles Darwin', Sapienza University, Rome, Italy
| | - Danila Azzolina
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| | - Sara Tunesi
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy.,Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Aldo Pettinari
- Prevention Department, ASUR Marche, Senigallia, Ancona, Italy
| | - Francesco Cuccaro
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Anna Maria Nannavecchia
- Unit of Epidemiology and Statistics-Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | | | - Alessandro Marinaccio
- Italian Workers' Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Rome, Italy
| | - Venere Leda Mara Pavone
- Department of Public Health, Prevention and Security Area Work Environments, Local Health Authority, San Lazzaro di Savena, Italy
| | - Corrado Magnani
- Unit of Medical Statistics and Cancer Epidemiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy.,CPO-Piedmont, Novara, Italy
| |
Collapse
|
41
|
Brims FJH, Kong K, Harris EJA, Sodhi-Berry N, Reid A, Murray CP, Franklin PJ, Musk AB, de Klerk NH. Pleural Plaques and the Risk of Lung Cancer in Asbestos-exposed Subjects. Am J Respir Crit Care Med 2020; 201:57-62. [PMID: 31433952 DOI: 10.1164/rccm.201901-0096oc] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Asbestos exposure is associated with a dose-dependent risk of lung cancer. The association between lung cancer and the presence of pleural plaques remains controversial. Objectives: To define the relationship between pleural plaques and lung cancer risk. Methods: Subjects were from two cohorts: 1) crocidolite mine and mill workers and Wittenoom Township residents and 2) a mixed-asbestos-fiber, mixed-occupation group. All subjects underwent annual review since 1990, chest X-ray or low-dose computed tomography scan, and outcome linkage to national cancer and mortality registry data. Cox regression, with adjustment for age (as the underlying matching time variable), was used to estimate hazard ratios (HRs) for lung cancer incidence by sex, tobacco smoking, asbestos exposure, presence of asbestosis, and pleural plaques. Measurements and Main Results: For all 4,240 subjects, mean age at follow up was 65.4 years, 3,486 (82.0%) were male, 1,315 (31.0%) had pleural plaques, and 1,353 (32.0%) had radiographic asbestosis. Overall, 3,042 (71.7%) were ever-smokers with mean tobacco exposure of 33 pack-years. In total, 200 lung cancers were recorded. Risk of lung cancer increased with cumulative exposure to cigarettes, asbestos, and presence of asbestosis. Pleural plaques did not confer any additional lung cancer risk in either cohort (cohort 1: HR, 1.03; 95% confidence interval, 0.64-1.67; P = 0.89; cohort 2: HR, 0.75; 95% confidence interval, 0.45-1.25; P = 0.28). Conclusions: The presence of pleural plaques on radiologic imaging does not confer additional increase in the risk of lung cancer. This result is consistent across two cohorts with differing asbestos fiber exposures and intensity.
Collapse
Affiliation(s)
- Fraser J H Brims
- Curtin Medical School and.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Karen Kong
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Ed J A Harris
- Curtin Medical School and.,Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | | | - Alison Reid
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Conor P Murray
- Perth Children's Hospital, Perth, Western Australia, Australia
| | | | | | - Nicholas H de Klerk
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia; and
| |
Collapse
|
42
|
Jha P. The hazards of smoking and the benefits of cessation: a critical summation of the epidemiological evidence in high-income countries. eLife 2020; 9:49979. [PMID: 32207405 PMCID: PMC7093109 DOI: 10.7554/elife.49979] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 02/14/2020] [Indexed: 12/15/2022] Open
Abstract
In high-income countries, the biggest cause of premature death, defined as death before 70 years, is smoking of manufactured cigarettes. Smoking-related disease was responsible for about 41 million deaths in the United States, United Kingdom and Canada, cumulatively, from 1960 to 2020. Every million cigarettes smoked leads to one death in the US and Canada, but slightly more than one death in the UK. The 21st century hazards reveal that smokers who start smoking early in adult life and do not quit lose a decade of life expectancy versus non-smokers. Cessation, particularly before age 40 years, yields large reductions in mortality risk. Up to two-thirds of deaths among smokers are avoidable at non-smoking death rates, and former smokers have about only a quarter of the excess risk of death compared to current smokers. The gap between scientific and popular understanding of smoking hazards is surprisingly large.
Collapse
Affiliation(s)
- Prabhat Jha
- Centre for Global Health Research, Dalla Lana School of Public Health and Unity Health, Toronto, University of Toronto, Ontario, Canada
| |
Collapse
|
43
|
Platenburg MG, Wiertz IA, van der Vis JJ, Crestani B, Borie R, Dieude P, Kannengiesser C, Burgers JA, Grutters JC, van Moorsel CH. The MUC5B promoter risk allele for idiopathic pulmonary fibrosis predisposes to asbestosis. Eur Respir J 2020; 55:13993003.02361-2019. [DOI: 10.1183/13993003.02361-2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/05/2020] [Indexed: 11/05/2022]
|
44
|
Klebe S, Leigh J, Henderson DW, Nurminen M. Asbestos, Smoking and Lung Cancer: An Update. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:ijerph17010258. [PMID: 31905913 PMCID: PMC6982078 DOI: 10.3390/ijerph17010258] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 12/17/2019] [Accepted: 12/24/2019] [Indexed: 01/19/2023]
Abstract
This review updates the scientific literature concerning asbestos and lung cancer, emphasizing cumulative exposure and synergism between asbestos exposure and tobacco smoke, and proposes an evidence-based and equitable approach to compensation for asbestos-related lung cancer cases. This update is based on several earlier reviews written by the second and third authors on asbestos and lung cancer since 1995. We reevaluated the peer-reviewed epidemiologic studies. In addition, selected in vivo and in vitro animal studies and molecular and cellular studies in humans were included. We conclude that the mechanism of lung cancer causation induced by the interdependent coaction of asbestos fibers and tobacco smoke at a biological level is a multistage stochastic process with both agents acting conjointly at all times. The new knowledge gained through this review provides the evidence for synergism between asbestos exposure and tobacco smoke in lung cancer causation at a biological level. The evaluated statistical data conform best to a multiplicative model for the interaction effects of asbestos and smoking on the lung cancer risk, with no requirement for asbestosis. Any asbestos exposure, even in a heavy smoker, contributes to causation. Based on this information, we propose criteria for the attribution of lung cancer to asbestos in smokers and non-smokers.
Collapse
Affiliation(s)
- Sonja Klebe
- Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia
- Correspondence: ; Tel.: +61-08-820-439-36
| | - James Leigh
- Asbestos Diseases Research Institute, University of Sydney, Concord, NSW 2139, Australia;
| | - Douglas W. Henderson
- Department of Anatomical Pathology, SA Pathology and Flinders University, Adelaide, SA 5042, Australia
| | - Markku Nurminen
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland;
- MarkStat Consultancy, 00250 Helsinki, Finland
| |
Collapse
|
45
|
Celsi F, Crovella S, Moura RR, Schneider M, Vita F, Finotto L, Zabucchi G, Zacchi P, Borelli V. Pleural mesothelioma and lung cancer: the role of asbestos exposure and genetic variants in selected iron metabolism and inflammation genes. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:1088-1102. [PMID: 31755376 DOI: 10.1080/15287394.2019.1694612] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Two of the major cancerous diseases associated with asbestos exposure are malignant pleural mesothelioma (MPM) and lung cancer (LC). In addition to asbestos exposure, genetic factors have been suggested to be associated with asbestos-related carcinogenesis and lung genotoxicity. While genetic factors involved in the susceptibility to MPM were reported, to date the influence of individual genetic variations on asbestos-related lung cancer risk is still poorly understood. Since inflammation and disruption of iron (Fe) homeostasis are hallmarks of asbestos exposure affecting the pulmonary tissue, this study aimed at investigating the association between Fe-metabolism and inflammasome gene variants and susceptibility to develop LC or MPM, by comparing an asbestos-exposed population affected by LC with an "asbestos-resistant exposed population". A retrospective approach similar to our previous autopsy-based pilot study was employed in a novel cohort of autoptic samples, thus giving us the possibility to corroborate previous findings obtained on MPM by repeating the analysis in a novel cohort of autoptic samples. The protective role of HEPH coding SNP was further confirmed. In addition, the two non-coding SNPs, either in FTH1 or in TF, emerged to exert a similar protective role in a new cohort of LC exposed individuals from the same geographic area of MPM subjects. No association was found between NLRP1 and NLRP3 polymorphisms with susceptibility to develop MPM and LC. Further research into a specific MPM and LC "genetic signature" may be needed to broaden our knowledge of the genetic landscape attributed to result in MPM and LC.
Collapse
Affiliation(s)
- F Celsi
- Lega Italiana per la Lotta contro i Tumori (LILT), Italy
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - S Crovella
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
- Department of Medical, Surgical and Health Sciences, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | - R R Moura
- Department of Genetics, Federal University of Pernambuco, Recife, Brazil
| | - M Schneider
- Laboratory of Pathological Anatomy, AAS2 "Bassa Friulana-Isontina" - S. Polo General Hospital, Monfalcone, Italy
| | - F Vita
- Laboratory of Pathological Anatomy, AAS2 "Bassa Friulana-Isontina" - S. Polo General Hospital, Monfalcone, Italy
| | - L Finotto
- Workplace Safety and Prevention, AAS2 "Bassa Friulana-Isontina" - S. Polo General Hospital, Monfalcone, Italy
| | - G Zabucchi
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - P Zacchi
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - V Borelli
- Department of Life Sciences, University of Trieste, Trieste, Italy
| |
Collapse
|
46
|
Wood DE, Kazerooni EA, Baum SL, Eapen GA, Ettinger DS, Hou L, Jackman DM, Klippenstein D, Kumar R, Lackner RP, Leard LE, Lennes IT, Leung ANC, Makani SS, Massion PP, Mazzone P, Merritt RE, Meyers BF, Midthun DE, Pipavath S, Pratt C, Reddy C, Reid ME, Rotter AJ, Sachs PB, Schabath MB, Schiebler ML, Tong BC, Travis WD, Wei B, Yang SC, Gregory KM, Hughes M. Lung Cancer Screening, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019; 16:412-441. [PMID: 29632061 DOI: 10.6004/jnccn.2018.0020] [Citation(s) in RCA: 379] [Impact Index Per Article: 75.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Lung cancer is the leading cause of cancer-related mortality in the United States and worldwide. Early detection of lung cancer is an important opportunity for decreasing mortality. Data support using low-dose computed tomography (LDCT) of the chest to screen select patients who are at high risk for lung cancer. Lung screening is covered under the Affordable Care Act for individuals with high-risk factors. The Centers for Medicare & Medicaid Services (CMS) covers annual screening LDCT for appropriate Medicare beneficiaries at high risk for lung cancer if they also receive counseling and participate in shared decision-making before screening. The complete version of the NCCN Guidelines for Lung Cancer Screening provides recommendations for initial and subsequent LDCT screening and provides more detail about LDCT screening. This manuscript focuses on identifying patients at high risk for lung cancer who are candidates for LDCT of the chest and on evaluating initial screening findings.
Collapse
|
47
|
Yu S, Choi HH, Kim IW, Kim TJ. Conditioned medium from asbestos-exposed fibroblasts affects proliferation and invasion of lung cancer cell lines. PLoS One 2019; 14:e0222160. [PMID: 31491033 PMCID: PMC6730856 DOI: 10.1371/journal.pone.0222160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 08/22/2019] [Indexed: 12/28/2022] Open
Abstract
The importance of the role of fibroblasts in cancer microenvironment is well-recognized. However, the relationship between fibroblasts and asbestos-induced lung cancer remains underexplored. To investigate the effect of the asbestos-related microenvironment on lung cancer progression, lung cancer cells (NCI-H358, Calu-3, and A549) were cultured in media derived from IMR-90 lung fibroblasts exposed to 50 mg/L asbestos (chrysotile, amosite, and crocidolite) for 24 h. The kinetics and migration of lung cancer cells in the presence of asbestos-exposed lung fibroblast media were monitored using a real-time cell analysis system. Proliferation and migration of A549 cells increased in the presence of media derived from asbestos-exposed lung fibroblasts than in the presence of media derived from normal lung fibroblasts. We observed no increase in proliferation and migration in lung cancer cells cultured in asbestos-exposed lung cancer cell medium. In contrast, increased proliferation and migration in lung cancer cells exposed to media from asbestos-exposed lung fibroblasts was observed for all types of asbestos. Media derived from lung fibroblasts exposed to other stressors, such as hydrogen peroxide and UV radiation didn't show as similar effect as asbestos exposure. An enzyme-linked immunosorbent assay (ELISA)-based cytokine array identified interleukin (IL)-6 and IL-8, which show pleiotropic regulatory effects on lung cancer cells, to be specifically produced in higher amounts by the three types of asbestos-exposed lung fibroblasts than normal lung fibroblasts. Thus, the present study demonstrated that interaction of lung fibroblasts with asbestos may support the growth and metastasis of lung cancer cells and that chrysotile exposure can lead to lung cancer similar to that caused by amphibole asbestos (amosite and crocidolite).
Collapse
Affiliation(s)
- Seunghye Yu
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Chemical Engineering, Soongsil University, Seoul, Korea
| | - Hee-Hyun Choi
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Il Won Kim
- Department of Chemical Engineering, Soongsil University, Seoul, Korea
| | - Tae-Jung Kim
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail:
| |
Collapse
|
48
|
Whittaker Brown SA, Padilla M, Mhango G, Powell C, Salvatore M, Henschke C, Yankelevitz D, Sigel K, de-Torres JP, Wisnivesky J. Interstitial Lung Abnormalities and Lung Cancer Risk in the National Lung Screening Trial. Chest 2019; 156:1195-1203. [PMID: 31404527 DOI: 10.1016/j.chest.2019.06.041] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 06/11/2019] [Accepted: 06/25/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Some interstitial lung diseases are associated with lung cancer. However, it is unclear whether asymptomatic interstitial lung abnormalities convey an independent risk. OBJECTIVES The goal of this study was to assess whether interstitial lung abnormalities are associated with an increased risk of lung cancer. METHODS Data from all participants in the National Lung Cancer Trial were analyzed, except for subjects with preexisting interstitial lung disease or prevalent lung cancers. The primary analysis included those who underwent low-dose CT imaging; those undergoing chest radiography were included in a confirmatory analysis. Participants with evidence of reticular/reticulonodular opacities, honeycombing, fibrosis, or scarring were classified as having interstitial lung abnormalities. Lung cancer incidence and mortality in participants with and without interstitial lung abnormalities were compared by using Poisson and Cox regression, respectively. RESULTS Of the 25,041 participants undergoing low-dose CT imaging included in the primary analysis, 20.2% had interstitial lung abnormalities. Participants with interstitial lung abnormalities had a higher incidence of lung cancer (incidence rate ratio, 1.61; 95% CI, 1.30-1.99). Interstitial lung abnormalities were associated with higher lung cancer incidence on adjusted analyses (incidence rate ratio, 1.33; 95% CI, 1.07-1.65). Lung cancer-specific mortality was also greater in participants with interstitial lung abnormalities. Similar findings were obtained in the analysis of participants undergoing chest radiography. CONCLUSIONS Asymptomatic interstitial lung abnormalities are an independent risk factor for lung cancer that can be incorporated into risk score models.
Collapse
Affiliation(s)
- Stacey-Ann Whittaker Brown
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Maria Padilla
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Grace Mhango
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Charles Powell
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mary Salvatore
- Division of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Claudia Henschke
- Division of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David Yankelevitz
- Division of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Keith Sigel
- Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Juan P de-Torres
- Division of Respiratory Medicine, Clínica Universidad de Navarra, Pamplona, Spain
| | - Juan Wisnivesky
- Division of Pulmonary, Critical Care, and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY; Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
49
|
Hung RJ, Spitz MR, Houlston RS, Schwartz AG, Field JK, Ying J, Li Y, Han Y, Ji X, Chen W, Wu X, Gorlov IP, Na J, de Andrade M, Liu G, Brhane Y, Diao N, Wenzlaff A, Davies MPA, Liloglou T, Timofeeva M, Muley T, Rennert H, Saliba W, Ryan BM, Bowman E, Barros-Dios JM, Pérez-Ríos M, Morgenstern H, Zienolddiny S, Skaug V, Ugolini D, Bonassi S, van der Heijden EHFM, Tardon A, Bojesen SE, Landi MT, Johansson M, Bickeböller H, Arnold S, Le Marchand L, Melander O, Andrew A, Grankvist K, Caporaso N, Teare MD, Schabath MB, Aldrich MC, Kiemeney LA, Wichmann HE, Lazarus P, Mayordomo J, Neri M, Haugen A, Zhang ZF, Ruano-Raviña A, Brenner H, Harris CC, Orlow I, Rennert G, Risch A, Brennan P, Christiani DC, Amos CI, Yang P, Gorlova OY. Lung Cancer Risk in Never-Smokers of European Descent is Associated With Genetic Variation in the 5 p15.33 TERT-CLPTM1Ll Region. J Thorac Oncol 2019; 14:1360-1369. [PMID: 31009812 PMCID: PMC6833942 DOI: 10.1016/j.jtho.2019.04.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/30/2019] [Accepted: 04/11/2019] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Inherited susceptibility to lung cancer risk in never-smokers is poorly understood. The major reason for this gap in knowledge is that this disease is relatively uncommon (except in Asians), making it difficult to assemble an adequate study sample. In this study we conducted a genome-wide association study on the largest, to date, set of European-descent never-smokers with lung cancer. METHODS We conducted a two-phase (discovery and replication) genome-wide association study in never-smokers of European descent. We further augmented the sample by performing a meta-analysis with never-smokers from the recent OncoArray study, which resulted in a total of 3636 cases and 6295 controls. We also compare our findings with those in smokers with lung cancer. RESULTS We detected three genome-wide statistically significant single nucleotide polymorphisms rs31490 (odds ratio [OR]: 0.769, 95% confidence interval [CI]: 0.722-0.820; p value 5.31 × 10-16), rs380286 (OR: 0.770, 95% CI: 0.723-0.820; p value 4.32 × 10-16), and rs4975616 (OR: 0.778, 95% CI: 0.730-0.829; p value 1.04 × 10-14). All three mapped to Chromosome 5 CLPTM1L-TERT region, previously shown to be associated with lung cancer risk in smokers and in never-smoker Asian women, and risk of other cancers including breast, ovarian, colorectal, and prostate. CONCLUSIONS We found that genetic susceptibility to lung cancer in never-smokers is associated to genetic variants with pan-cancer risk effects. The comparison with smokers shows that top variants previously shown to be associated with lung cancer risk only confer risk in the presence of tobacco exposure, underscoring the importance of gene-environment interactions in the etiology of this disease.
Collapse
Affiliation(s)
- Rayjean J Hung
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | | | | | | | - John K Field
- University of Liverpool, Liverpool, United Kingdom
| | - Jun Ying
- University of Texas McGovern Medical School, Houston, Texas
| | - Yafang Li
- Baylor College of Medicine, Houston, Texas
| | | | - Xuemei Ji
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Wei Chen
- The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Xifeng Wu
- The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Ivan P Gorlov
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Jie Na
- Mayo Clinic, Rochester, Minnesota
| | | | - Geoffrey Liu
- Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Yonathan Brhane
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Nancy Diao
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | | | - Maria Timofeeva
- German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Edinburgh, Edinburgh, United Kingdom
| | - Thomas Muley
- German Center for Lung Research, Heidelberg, Germany; University Hospital Heidelberg, Heidelberg, Germany
| | - Hedy Rennert
- Technion-Israel Institute of Technology, Haifa, Israel
| | - Walid Saliba
- Technion-Israel Institute of Technology, Haifa, Israel
| | - Bríd M Ryan
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Elise Bowman
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | | | - Mónica Pérez-Ríos
- University of Santiago de Compostela, Praza do Obradoiro, Coruña, Spain
| | | | | | - Vidar Skaug
- National Institute of Occupational Health (STAMI), Oslo, Norway
| | | | - Stefano Bonassi
- San Raffaele University, Rome, Italy; San Raffaele Pisana - Scientific Hospitalization and Care Insitution, Rome, Italy
| | | | | | | | | | | | | | | | | | | | | | | | | | - M Dawn Teare
- University of Sheffield, Sheffield, United Kingdom
| | | | | | | | - H-Erich Wichmann
- Helmholtz Zentrum Munchen, German Research Center for Environmental Health (GmbH), Bavaria, Germany
| | | | | | - Monica Neri
- San Raffaele Pisana - Scientific Hospitalization and Care Insitution, Rome, Italy
| | - Aage Haugen
- National Institute of Occupational Health (STAMI), Oslo, Norway
| | - Zuo-Feng Zhang
- University of California - Los Angeles, Los Angeles, California
| | | | | | - Curtis C Harris
- Center for Cancer Research, National Cancer Institute, Bethesda, Maryland
| | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gadi Rennert
- Technion-Israel Institute of Technology, Haifa, Israel
| | - Angela Risch
- German Cancer Research Center (DKFZ), Heidelberg, Germany; University of Salzburg, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | | | | | | | - Olga Y Gorlova
- Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
| |
Collapse
|
50
|
Fernandes GA, Algranti E, Conceição GMDS, Wünsch Filho V, Toporcov TN. Lung Cancer Mortality Trends in a Brazilian City with a Long History of Asbestos Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142548. [PMID: 31319477 PMCID: PMC6679146 DOI: 10.3390/ijerph16142548] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 06/26/2019] [Accepted: 07/04/2019] [Indexed: 12/13/2022]
Abstract
There are scarce epidemiological studies on lung cancer mortality in areas exposed to asbestos in developing countries. We compared the rates and trends in mortality from lung cancer between 1980 and 2016 in a municipality that made extensive use of asbestos, Osasco, with rates from a referent municipality with lower asbestos exposure and with the rates for the State of São Paulo. We retrieved death records for cases of lung cancer (ICD-9 C162) (ICD-10 C33 C34) from 1980 to 2016 in adults aged 60 years and older. The join point regression and age-period-cohort models were fitted to the data. Among men, there was an increasing trend in lung cancer mortality in Osasco of 0.7% (CI: 0.1; 1.3) in contrast to a mean annual decrease for Sorocaba of -1.5% (CI: -2.4; -0.6) and a stable average trend for São Paulo of -0.1 (IC: -0.3; 0.1). Similar increasing trends were seen in women. The age-period-cohort model showed an increase in the risk of death from 1996 in Osasco and a reduction for Sorocaba and São Paulo State during the same period. Our results point to a need for a special monitoring regarding lung cancer incidence and mortality in areas with higher asbestos exposure.
Collapse
Affiliation(s)
- Gisele Aparecida Fernandes
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo-SP 01246-904, Brazil.
| | - Eduardo Algranti
- Division of Medicine, Fundação Jorge Duprat e Figueiredo (Fundacentro), São Paulo-SP 05409-002, Brazil
| | | | - Victor Wünsch Filho
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo-SP 01246-904, Brazil
| | - Tatiana Natasha Toporcov
- Department Epidemiology, School of Public Health, University of São Paulo, São Paulo-SP 01246-904, Brazil
| |
Collapse
|