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Franzoi IG, Sauta MD, De Luca A, Barbagli F, Granieri A. PSYCHOLOGICAL INTERVENTIONS FOR MESOTELIOMA PATIENTS AND THEIR CAREGIVERS: A SYSTEMATIC LITERATURE REVIEW. J Pain Symptom Manage 2024:S0885-3924(24)00855-8. [PMID: 39029809 DOI: 10.1016/j.jpainsymman.2024.07.004] [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: 02/26/2024] [Revised: 06/06/2024] [Accepted: 07/05/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE Malignant Mesothelioma (MM) has a striking impact on the somatopsychic balance of patients and their families, including physical, psychological, and interpersonal problems. The aim of this systematic literature review was to investigate what psychological interventions are offered to patients with MM and their caregivers worldwide. METHODS The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The literature search led to the identification of 12 articles. Results were categorized into five categories. 1. Individual psychological support, 2. Group psychological support, 3. Cognitive-behavioral group psychotherapy, 4. Brief psychoanalytic groups, 5. Multifamily group. RESULTS The interventions differed in terms of form, duration and resources used. Most of them were group-based and psychoanalytically oriented, although individual and cognitive-behavioral interventions were also described. Despite the differences, the interventions appeared to be fundamental in facilitating the processing of mental pain and anger related to the diagnosis. CONCLUSION Our study has shown that there are still few psychological interventions available for MM patients and their caregivers. The somatopsychic consequences of MM in patients and caregivers should encourage institutions and healthcare professionals to develop assessment and intervention models that address the different dimensions of their suffering and promote their residual vitality.
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Bonafede M, Franzoi IG, Sauta MD, Marinaccio A, Mensi C, Rugarli S, Migliore E, Cozzi I, Cavone D, Vimercati L, Grosso F, Bertolotti M, Raimondi G, Innamorati M, Granieri A. Confirmatory validation of the Mesothelioma Psychological Distress Tool-Patients: A brief patient-reported outcome measure assessing psychological distress in malignant mesothelioma patients. Psychooncology 2024; 33:e6371. [PMID: 38942736 DOI: 10.1002/pon.6371] [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: 03/04/2024] [Revised: 06/14/2024] [Accepted: 06/20/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool-Patients (MPDT-P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-P. METHODS The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT-P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach. RESULTS The two-factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three-factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future. CONCLUSIONS Integrating the MPDT-P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | | | | | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Carolina Mensi
- COR Lombardy, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | - Sabrina Rugarli
- COR Lombardy, Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico of Milan, Milan, Italy
| | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, AOU Città della Salute e della Scienza di Torino, CPO Piedmont and University of Turin, Turin, Italy
| | - Ilaria Cozzi
- Department of Epidemiology, COR Lazio, Lazio Regional Health Service, Local Health Unit 1, Rome, Italy
| | - Domenica Cavone
- Department of Interdisciplinary Medicine, Section of Occupational Medicine "B. Ramazzini", Regional Operating Center of Puglia (COR Puglia), University of Bari, Bari, Italy
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine, Section of Occupational Medicine "B. Ramazzini", Regional Operating Center of Puglia (COR Puglia), University of Bari, Bari, Italy
| | - Federica Grosso
- Mesothelioma and Rare Cancers Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Marinella Bertolotti
- Research Training Innovation Infrastructure, Research and Innovation Department (DAIRI), AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | - Giulia Raimondi
- Department of Psychology, University of Turin, Turin, Italy
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Roma, Italy
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Metintas M, Ak G, Metintas S. Environmental asbestos exposure and lung cancer. Lung Cancer 2024; 194:107850. [PMID: 38945005 DOI: 10.1016/j.lungcan.2024.107850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/21/2024] [Accepted: 06/06/2024] [Indexed: 07/02/2024]
Abstract
Apart from living near an asbestos industry site, mine, or in an asbestos-contaminated house, environmental asbestos exposure is observed in certain regions where the (natural) soil is 'contaminated' with asbestos (fibers). In this essay, we review the association between environmental asbestos exposure and lung cancer in Turkey. Other studies have also suggested that environmental asbestos exposure is able to increase the risk of lung cancer. Lung cancer associated with environmental asbestos exposure seems to be diagnosed at a younger age, and the risk for women is in the same range as that for men. Our data indicate that the relationship between exposure dose and risk is linear and that a safe threshold cannot be established. Therefore, people living in areas with increased chances of environmental asbestos exposure should be mentored to take part in smoking cessation programs and considered candidates for inclusion in lung cancer screening programs. There is an obvious need for additional studies on this topic.
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Affiliation(s)
- Muzaffer Metintas
- Eskisehir Osmangazi University Faculty of Medicine Department of Chest Diseases, Eskisehir, Turkey; Eskisehir Osmangazi University Lung and Pleural Cancers Clinical and Research Center, Turkey.
| | - Guntulu Ak
- Eskisehir Osmangazi University Faculty of Medicine Department of Chest Diseases, Eskisehir, Turkey; Eskisehir Osmangazi University Lung and Pleural Cancers Clinical and Research Center, Turkey
| | - Selma Metintas
- Eskisehir Osmangazi University Lung and Pleural Cancers Clinical and Research Center, Turkey; Eskisehir Osmangazi University Faculty of Medicine Department of Public Health, Turkey
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Weerarathne WBCP, Sewwandi M, Wijayasinghe AC, Madegedara RMD, Vithanage M, Magana-Arachchi DN. Impact of air quality on the health of present-day workers in an Asbestos roof manufacturing industry, Sri Lanka. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2024; 46:201. [PMID: 38696114 DOI: 10.1007/s10653-024-01973-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/27/2024] [Indexed: 06/17/2024]
Abstract
The study's objective was to determine the air quality in an asbestos-related industry and its impact on current workers' respiratory health. Seventy-seven air and 65 dust samples were collected at 5-day intervals in an asbestos roofing sheets production factory in Sri Lanka having two production facilities. Sampling was performed in ten sites: Defective sheets-storage, Production-plant, Pulverizer, Cement-silo, and Loading-area. A detailed questionnaire and medical screening were conducted on 264 workers, including Lung Function Tests (LFT) and chest X-rays. Asbestos fibres were observed in deposited dust samples collected from seven sites. Free chrysotile fibres were absent in the breathing air samples. Scanning Electron Microscopy confirmed the presence of asbestos fibres, and the Energy Dispersive X-ray analysis revealed Mg, O, and Si in depositions. The average concentrations of trace metals were Cd-2.74, Pb-17.18, Ni-46.68, Cr-81.01, As-7.12, Co-6.77, and Cu-43.04 mg/kg. The average Zn, Al, Mg, and Fe concentrations were within 0.2-163 g/kg. The highest concentrations of PM2.52.5 and PM1010, 258 and 387 µg/m3, respectively, were observed in the Pulverizer site. Forty-four workers had respiratory symptoms, 64 presented LFT abnormalities, 5 indicated chest irregularities, 35.98% were smokers, and 37.5% of workers with abnormal LFT results were smokers. The correlation coefficients between LFT results and work duration with respiratory symptoms and work duration and chest X-ray results were 0.022 and 0.011, respectively. In conclusion, most pulmonary disorders observed cannot directly correlate to Asbestos exposure due to negligible fibres in breathing air, but fibres in the depositions and dust can influence the pulmonary health of the employees.
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Affiliation(s)
- W B C P Weerarathne
- National Institute of Fundamental Studies, Hantana Rd, Kandy, 20000, Sri Lanka
| | - M Sewwandi
- Ecosphere Resilience Research Centre, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, 10250, Sri Lanka
| | - A C Wijayasinghe
- National Institute of Fundamental Studies, Hantana Rd, Kandy, 20000, Sri Lanka
| | | | - Meththika Vithanage
- National Institute of Fundamental Studies, Hantana Rd, Kandy, 20000, Sri Lanka.
- Ecosphere Resilience Research Centre, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, 10250, Sri Lanka.
| | - D N Magana-Arachchi
- National Institute of Fundamental Studies, Hantana Rd, Kandy, 20000, Sri Lanka.
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Gogou E, Hatzoglou C, Siachpazidou D, Zarogiannis SG, Gourgoulianis KI. Asbestos ban policies and mesothelioma mortality in Greece. BMC Public Health 2024; 24:1177. [PMID: 38671450 PMCID: PMC11055379 DOI: 10.1186/s12889-024-18030-x] [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: 09/19/2023] [Accepted: 02/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Malignant mesothelioma is a rare form of cancer that mostly affects the pleura and has a strong link to asbestos exposure. Greece banned the use of asbestos in 2005, however, the public was already aware of this substance in the 1980s. This research aims to present an overview of Greece's mesothelioma age-standardized mortality rates (ASMR) from 1983 to 2019 by age, gender, and geographic region and to determine whether the actions to ban asbestos impacted these rates. METHODS Data were retrieved by the Hellenic Statistical Authority (HSA) from death certificates that mentioned mesothelioma as the cause of death from 1983 to 2019 with details on the residence, gender, and age. Statistical analysis was performed using PRISM 6.0 software, a two-way ANOVA test, Trend analysis was conducted using Joinpoint Regression Program 5.0 software. The linear and non-linear model was used to calculate the age-standardized rates of annual percentage change (APC) and its 95% confidential interval (95% CI). RESULTS From 1983 to 2019, 850 total mesothelioma deaths were recorded, the majority of whom were males (634). A rate of 74.6% accounts for males and 25.4% for females, and the ratio of Males: Females was 3:1. Males' ASMR and the whole population's ASMR reached their highest levels in 2011 (0.93/100000person-years and 0.53/100000person-years, respectively). To look for potential changes between the first two decades of the 21st century, we compared the mean ASMR of each geographic region in Greece between two different 10-year subperiods (2000-2009 and 2010-2019). Except for Epirus, all regions of Greece had elevated regional ASMRs, particularly in those with the highest asbestos deposits. Notably, the ASMR in Epirus decreased from 0.54/100000person-years (2000-2009) to 0.31/100000person-years (2010-2019). After 2011, the ASMR for men and the general population stabilized. This stability is important since mesothelioma in men is associated with occupational asbestos exposure. The intriguing discovery of a lower ASMR in Epirus emphasizes the need to raise awareness of the condition and implement effective public health measures. CONCLUSIONS In Greece, the annual ASMR for males and the whole population reached its highest level in 2011, which is positive and encouraging and may be a sign that the rate will stabilize during the following years. Moreover, this study showed that the actions made in the 1980s regarding public awareness and surveillance directly impacted the decrease in Epirus rates. Future research, continual awareness, information, and recording are needed to monitor the mesothelioma epidemic. The possible benefit of a mesothelioma registry and the epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, need to be addressed. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Evdoxia Gogou
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece.
| | - Chryssi Hatzoglou
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece
| | - Dimitra Siachpazidou
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
| | - Sotirios G Zarogiannis
- Department of Physiology, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41500, Larissa, Greece
| | - Konstantinos I Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, School of Health Sciences, University of Thessaly, BIOPOLIS, 41110, Larissa, Greece
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Ledda C, Loreto C, Lombardo C, Cardile V, Rapisarda V. Mesothelin methylation, soluble mesothelin related protein levels and inflammation profiling in workers chronically exposed to naturally occurring asbestos fibers. Transl Oncol 2024; 40:101872. [PMID: 38134842 PMCID: PMC10751818 DOI: 10.1016/j.tranon.2023.101872] [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: 09/30/2023] [Revised: 12/10/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Exposure to asbestiform fibers, including chrysotile and amphibole, is carcinogenic, causing malignant pleural mesothelioma (MPM) when inhaled. Some populations globally face Naturally Occurring Asbestos (NOA) exposure, leading to MPM cases like in Biancavilla, Italy, from Fluoro-edenite (FE) contamination. Studies show NOA exposure causes epigenetic changes, focusing on mesothelin methylation, an MPM marker, and altered inflammation, emphasizing the health risks of FE and asbestos. This research, conducted from February 2022 to October 2022, studied 125 construction workers from Biancavilla and 125 controls from 40 km away without Biancavilla work history. With at least ten years in construction and no respiratory conditions, participants underwent medical assessments and gave blood samples for analysis, including inflammation markers, mesothelin methylation, and soluble mesothelin-related protein levels. The results showed similar demographics but differing inflammation and methylation levels in exposed workers, suggesting long-term cellular changes. Pearson correlation showed intricate biomarker relationships. Significant inflammatory differences were found between FE exposed and non-exposed workers, indicating potential health impacts from FE. This raises concerns for communities like Biancavilla, emphasizing the importance of extensive epigenetic research for public health.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
| | - Carla Loreto
- Human Anatomy and Histology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Claudia Lombardo
- Human Anatomy and Histology, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy
| | - Venera Cardile
- Physiology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Avilés-Salas A, Cabrera-Miranda L, Hernández-Pedro N, Vargas-Lías DS, Samtani S, Muñoz-Montaño W, Motola-Kuba D, Corrales-Rodríguez L, Martín C, Cardona AF, Palomares-Palomares CB, Arrieta O. PD-L1 expression complements CALGB prognostic scoring system in malignant pleural mesothelioma. Front Oncol 2023; 13:1269029. [PMID: 38111532 PMCID: PMC10725960 DOI: 10.3389/fonc.2023.1269029] [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: 07/28/2023] [Accepted: 10/30/2023] [Indexed: 12/20/2023] Open
Abstract
Background Programmed death ligand-1 (PD-L1) expression is a predictive biomarker in patients with lung cancer, but its role in malignant pleural mesothelioma (MPM) remains unclear. Evidence suggests that higher PD-L1 expression is correlated with worse survival. CALGB is the main scoring system used to predict the benefit of chemotherapy treatment. This study aimed to determine the prognostic value of PD-L1 expression and its addition to CALGB scoring system in patients with MPM. Methods In this retrospective analysis, we evaluated samples with confirmed locally advanced or metastatic MPM. PD-L1 Tumor Proportional Score (TPS) was determined by immunohistochemistry at diagnosis. Results 73 patients were included in this study. A cutoff value of 15 was set for a high or low PD-L1 TPS. In total, 71.2% (n=52) and 28.8% (n=21) of individuals harbored low or high PD-L1 expression, respectively. PD-L1High was associated with worse median progression-free Survival (mPFS) [4.9 vs. 10.8 months; HR 2.724, 95% CI (1.44-5.14); p = 0.002] and Overall Survival (OS) [6.0 vs. 20.9 months; HR 6.87, 95% CI (3.4-8.7); p<0.001] compared to patients with PD-L1Low. Multivariate analysis confirmed that PD-L1 expression was an independent factor for PFS and OS in patients with MPM and CALGB score of 5-6. Conclusion PD-L1 addition to CALGB scale improves its prognostic estimation of MPM survival and should be considered in future research.
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Affiliation(s)
| | - Luis Cabrera-Miranda
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Norma Hernández-Pedro
- Personalized Medicine Laboratory, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | | | - Suraj Samtani
- Medical Oncology Department, Clínica Las Condes Santiago, Santiago, Chile
| | - Wendy Muñoz-Montaño
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
| | - Daniel Motola-Kuba
- Departments of Biomedical Research and Gastroenterology and Liver Unit and Hemodialysis Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico
| | | | - Claudio Martín
- Department of Medicine, Western University, London, ON, Canada
| | - Andrés F. Cardona
- Thoracic Oncology Unit and Direction of Research, Science and Education, Luis Carlos Sarmiento Angulo Cancer Treatment and Research Center (CTIC), Bogotá, Colombia
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
- Molecular Oncology and Biology Systems Research Group (Fox-G), Universidad El Bosque, Bogotá, Colombia
| | | | - Oscar Arrieta
- Thoracic Oncology Unit, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico
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Camero G, Villamizar G, Pombo LM, Saba M, Frank AL, Teherán AA, Acero GM. Epidemiology of Asbestosis between 2010-2014 and 2015-2019 Periods in Colombia: Descriptive Study. Ann Glob Health 2023; 89:54. [PMID: 37637467 PMCID: PMC10453953 DOI: 10.5334/aogh.3963] [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: 09/15/2022] [Accepted: 06/26/2023] [Indexed: 08/29/2023] Open
Abstract
Background Asbestosis is a prevalent worldwide problem, but scarce data sourced from developing countries are available. We describe the sociodemographic characteristics and patterns in the occurrence of care provided for asbestosis in Colombia during the periods 2010-2014 and 2015-2019 to establish the behavior, trends, and variables associated with concentrations among people attended by asbestosis. Methods A retrospective descriptive study was carried out with data from the Integrated Social Protection Information System (SISPRO) for two 5-year periods. People attended by asbestosis (ICD-10: J61) were identified; the frequency of patient visits, sociodemographic characteristics, case distribution patterns, and trends in both five-year periods were described, as was the crude frequency (cFr, 95% CI) of asbestosis (1,000,000 people/year) in both five-year periods (cFr ratio, 95% CI). Results During the period 2010-2019, 765 people attended by asbestosis were identified; there were 308 people attended by asbestosis between 2010-2014 (cFr: 2.20, 1.96-2.47), and ther were 457 people attended by asbestos between 2015-2019 (cFr: 3.14, 2.92-3.50). In both periods, the estimated cFr in men was nine times the estimated cFr in women. The cFr increased in the 2015-2019 period (cFr_ratio: 1.23, 1.06-1.43). Compared with the 2010-2014 period, the cFr of asbestosis increased in women (cFr_ratio: 1.44, 1.03-2.01), in the Andean (cFr_ratio: 1.61, 1.35-1.95) and Caribbean regions (cFr_ratio: 1. 66, 1.21-2.30), in the urban area (cFr_ratio: 1.24, 1.05-1.48), and in the age groups 45-59 years (cFr_ratio: 1.34, 1.001-1.79) and ≥60 years (cFr_ratio: 1.43, 1.13-1.83). Discussion During two five-year periods, the cFr of asbestosis was higher in men; between the first and second five-year periods, it increased significantly, especially in urbanized geographic areas and in populations aged ≥45 years. The estimates possibly reflect the effect of disease latency or the expected impact of public health policies to monitor asbestos exposure and complications.
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Affiliation(s)
- Gabriel Camero
- Cruz Roja Colombiana—Seccional Cundinamarca-Bogotá, Grupo de Investigación Emergencias, Desastres y Ayuda Humanitaria, Cruz Roja Cundinamarca y Bogotá, USA
| | | | - Luis M. Pombo
- Fundación Universitaria Juan N. Corpas, Grupos de Investigación COMPLEXUS, GIFVTA, Colombia
| | - Manuel Saba
- Universidad de Cartagena, Facultad de Ingeniería. Grupo de Investigación de Modelación Ambiental (GIMA), Cartagena, Colombia
| | | | - Aníbal A. Teherán
- Fundación Universitaria Juan N. Corpas, Grupos de Investigación COMPLEXUS, GIFVTA, Colombia
- Cruz Roja Colombiana—Seccional Cundinamarca-Bogotá, Grupo de Investigación Emergencias, Desastres y Ayuda Humanitaria, Cruz Roja Cundinamarca y Bogotá, Colombia
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Ramezanifar S, Azimian A, Khadiv E, Naziri SH, Gharari N, Fazlzadeh M. Para-occupational exposure to chemical substances: a systematic review. REVIEWS ON ENVIRONMENTAL HEALTH 2023:reveh-2023-0019. [PMID: 37525484 DOI: 10.1515/reveh-2023-0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/18/2023] [Indexed: 08/02/2023]
Abstract
Today, many health problems related to work have overshadowed workers and their families. In the meantime, chemicals are among the risk factors that have created many problems due to para-occupational exposure. In para-occupational exposures, family members are exposed to work pollutants transferred to the home environment. This study was conducted to investigate para-occupational exposure to chemicals. To conduct this systematic review, databases such as "Web of Science", "Google Scholar", "Scopus", and "SID" were used. Relevant articles in these databases were extracted by searching keywords such as "take-home exposure", "para-occupational exposure", and "chemicals" from 2000 to 2022. To extract the required data, all parts of the articles were reviewed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020). Among the 44 identified articles, 23 were selected as final articles, of which 10 were related to agriculture workers and their families, and 13 were related to other occupations. These studies mainly investigated para-occupational exposure to pesticides (14 studies) and metals (four studies). Also, contaminated work clothes, the washing place of contaminated clothes, and storage of working clothes, equipment, and chemicals were proposed as the main routes of contamination transmission. As a result of these para-occupational exposures, problems like neuro-behavioral disorders in children, end-stage renal disease, black gingival borders, and autism spectrum disorder were created or aggravated. Limiting the transmission routes and taking measures such as training and providing facilities like devoting places for washing and storing clothes in the workplaces can decrease this type of exposure.
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Affiliation(s)
- Soleiman Ramezanifar
- Department of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Behest University of Medical Sciences, Tehran, Iran
| | - Afsane Azimian
- Department of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Behest University of Medical Sciences, Tehran, Iran
| | - Elahe Khadiv
- Department of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Behest University of Medical Sciences, Tehran, Iran
| | - Seyed Husein Naziri
- Department of Occupational Health and Safety Engineering, School of Public Health and Safety, Shahid Behest University of Medical Sciences, Tehran, Iran
| | - Noradin Gharari
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Department of Occupational Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mehdi Fazlzadeh
- Lung Diseases Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Tehran, Iran
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10
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Lieberman-Cribbin W, Taioli E. Epidemiologic roadblocks in studying elongated mineral particles and mesothelioma risk. ENVIRONMENTAL RESEARCH 2023; 230:115086. [PMID: 36965809 DOI: 10.1016/j.envres.2022.115086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/14/2022] [Indexed: 05/30/2023]
Abstract
Elongated mineral particles (EMPs) are a type of both occupational and environmental exposures that have generated interest in the scientific community due to their potential health effects. Their possible association with mesothelioma represents an area of concern. We provide an overview of the current challenges around epidemiological assessments of EMP exposure and mesothelioma risk, including methodological aspects that need to be addressed when designing and analyzing a study on EMP exposure and mesothelioma. Future work is needed to investigate the relationship between EMPs and mesothelioma, focused on an improved definition of EMP exposure and accounting for other concomitant sources of carcinogen exposure.
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Affiliation(s)
- Wil Lieberman-Cribbin
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 West 168th St. New York, NY, 10032, USA; Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY, 10029, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology and Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, New York, NY, 10029, USA.
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Fazzo L, Minelli G, De Santis M, Ceccarelli E, Iavarone I, Zona A. The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5957. [PMID: 37297561 PMCID: PMC10252364 DOI: 10.3390/ijerph20115957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
As part of a surveillance plan active since the early 1990s, this study evaluates malignant mesothelioma (MM) mortality for the time-window 2010-2019 in Italy, a country that banned asbestos in 1992. National and regional mortality rates for MM, and municipal standardized mortality ratios (all mesotheliomas, pleural (MPM) and peritoneal (MPeM)), by gender and age group were calculated. A municipal clustering analysis was also performed. There were 15,446 deaths from MM (11,161 males, 3.8 × 100,000; 4285 females, 1.1 × 100,000), of which 12,496 were MPM and 661 were MPeM. In the study period, 266 people ≤50 years died from MM. A slightly decreasing rate among males since 2014 was observed. The areas at major risk hosted asbestos-cement plants, asbestos mines (chrysotile in Balangero), shipyards, petrochemical and chemical plants, and refineries. Female mortality excesses particularly were found in municipalities with a fluoro-edenite-contaminated mine (Biancavilla) and textile facilities. Excesses were also found in a region with the presence of natural asbestos fibres and in males living in two small islands. The Italian National Prevention Plan stated recommendations to eliminate asbestos exposures and to implement health surveillance and healthcare for people exposed to asbestos.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Emiliano Ceccarelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
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12
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Moore A, Bennett B, Taylor-Stokes G, Daumont MJ. Caregivers of patients with malignant pleural mesothelioma: who provides care, what care do they provide and what burden do they experience? Qual Life Res 2023:10.1007/s11136-023-03410-4. [PMID: 37097405 PMCID: PMC10393857 DOI: 10.1007/s11136-023-03410-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE There are limited data on the impact of caregiving for patients with malignant pleural mesothelioma (MPM) on the caregiver. We aimed to identify the demographic characteristics of these caregivers, the caregiving activities they perform and how caregiving burden impacts their work productivity and overall activity. METHODS This cross-sectional study collected data from caregivers of patients with MPM across France, Italy, Spain and the United Kingdom January-June 2019. Caregiver demographics, daily caregiving tasks and the impact of caregiving on physical health was collected via questionnaire. The Zarit Burden Interview (ZBI) was used to assess caregiver burden and the Work Productivity and Activity Impairment questionnaire (WPAI) assessed impairment at work and during daily activities. Analyses were descriptive. RESULTS Overall, 291 caregivers provided data. Caregivers were mostly female (83%), living with the patient (82%) and their partner/spouse (71%). Caregivers provided over five hours of daily emotional/physical support to patients. ZBI scores indicated 74% of caregivers were at risk of developing depression. Employed caregivers had missed 12% of work in the past seven days, with considerable presenteeism (25%) and overall work impairment (33%) observed. Overall, the mean activity impairment was 40%. CONCLUSION Caregivers provide essential care for those with MPM. We show caregiving for patients with MPM involves a range of burdensome tasks that impact caregivers' emotional health and work reflected in ZBI and WPAI scores. Innovations in the management of MPM must account for how caregivers may be impacted and can be supported to carry out this important role.
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Cangemi M, Montico M, Trovo M, Minatel E, Di Gregorio E, Corona G, Giordari F, Comaro E, Colizzi F, Baboçi L, Steffan A, Revelant A, Muraro E. Emerging Role of Immunomonitoring to Predict the Clinical Outcome of Patients With Malignant Pleural Mesothelioma Treated With Radical Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 115:608-621. [PMID: 36202181 DOI: 10.1016/j.ijrobp.2022.09.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The present study aimed at evaluating the baseline immune profile and the immunomodulating effects of radical hemithoracic radiation therapy (RT) in patients affected by malignant pleural mesothelioma (MPM) to identify potential predictive biomarkers of therapy response, toxicity development, and eligibility for further immunotherapeutic treatments. METHODS AND MATERIALS Blood samples were collected from 55 patients with MPM, enrolled in a phase 3 trial comparing radical hemithoracic RT (interventional arm, n = 28) with local palliative RT (control arm, n = 27). Immunomonitoring was performed before RT, at the end of treatment, and 1 month after therapy, characterizing natural killer cells, B and T lymphocytes, activated CD4 and CD8 T cells, interferon-γ- and tumor necrosis factor-α-producing T helper (Th) 1 cells, regulatory T cells, and Th17 and Th22 lymphocytes, through flow cytometry. Serum levels of interleukin (IL)-6, -8, -10 and mesothelin were quantified through Enzyme-Linked Immunosorbent Assay (ELISA) assays at the same time points. Variations in the immune parameters were investigated by Friedman test and Wilcoxon signed rank post hoc test with Bonferroni correction for multiple testing, while the prognostic effect of immune biomarkers was evaluated through Kaplan-Meier method and Spearman's correlation analysis. RESULTS Major immune variations were noticed after radical RT compared with palliative treatment, in particular an improvement in activated T cells and in interferon-γ-producing Th1 cells after RT. In the interventional arm, baseline high levels of Th22 and IL-10 and an increase in T cells were associated with an improved survival, whereas a fold increase in serum mesothelin correlated with the development of severe toxicity. An improvement of immunosuppressive regulatory T cells was observed in both arms of treatment. CONCLUSIONS The immunomonitoring performed in patients with MPM revealed potential prognostic biomarkers for radical hemithoracic RT treatment and identified specific immune signatures induced by RT immunomodulation, which could suggest a synergistic effect with an immunotherapeutic treatment.
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Affiliation(s)
- Michela Cangemi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Marcella Montico
- Clinical Trial Office, Scientific Direction, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Marco Trovo
- Department of Radiation Oncology, Udine General Hospital, Udine, Italy
| | - Emilio Minatel
- Division of Radiation Oncology, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Emanuela Di Gregorio
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Giuseppe Corona
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Fabiana Giordari
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Elisa Comaro
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Francesca Colizzi
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Lorena Baboçi
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Alberto Revelant
- Division of Radiation Oncology, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Elena Muraro
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy.
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Buralli RJ, Pinheiro RDC, Susviela LL, Duracenko SRC, De Capitani EM, Savaris A, Algranti E. The Brazilian System for Monitoring Workers and General Population Exposed to Asbestos: Development, Challenges, and Opportunities for Workers' Health Surveillance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4295. [PMID: 36901302 PMCID: PMC10001436 DOI: 10.3390/ijerph20054295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/18/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED The lack of safe levels of asbestos exposure and the long latency of asbestos-related disease (ARD) makes workers' health surveillance challenging, especially in lower-income countries. This paper aims to present the recently developed Brazilian system for monitoring workers and general population exposed to asbestos (Datamianto), and to discuss the main challenges and opportunities for workers' health surveillance. METHODS a descriptive study of the Datamianto development process, examining all the stages of system planning, development, improvement, validation, availability, and training of health services for its use, in addition to presenting the main challenges and opportunities for its implementation. RESULTS The system was developed by a group of software developers, workers' health specialists, and practitioners, and it was recently incorporated by the Ministry of Health to be used for workers' health surveillance. It can facilitate the monitoring of exposed individuals, epidemiological data analysis, promote cooperation between health services, and ensure periodical medical screening guaranteed to workers by labor legislation. Moreover, the system has a Business Intelligence (BI) platform to analyze epidemiologic data and produce near real-time reports. CONCLUSIONS Datamianto can support and qualify the healthcare and surveillance of asbestos-exposed workers and ARD, promoting a better quality of life for workers and improving companies' compliance with legislation. Even so, the system's significance, applicability, and longevity will depend on the efforts aimed at its implementation and improvement.
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Affiliation(s)
- Rafael Junqueira Buralli
- Departamento de Vigilância em Saúde Ambiental e Saúde do Trabalhador, Ministério da Saúde, Brasil (CGSAT/DSAST/SVS/MS), SRTV 702, Via W5 Norte, Brasília 70723-040, DF, Brazil
| | - Regina Dal Castel Pinheiro
- Gerência em Saúde do Trabalhador, Diretoria de Vigilância Sanitária do Estado de Santa Catarina (GESAT/DIVS/SUV/SES), Av. Rio Branco, 152, Centro, Florianópolis 88015-200, SC, Brazil
| | - Laura Lima Susviela
- Gerência em Saúde do Trabalhador, Diretoria de Vigilância Sanitária do Estado de Santa Catarina (GESAT/DIVS/SUV/SES), Av. Rio Branco, 152, Centro, Florianópolis 88015-200, SC, Brazil
| | - Sandra Renata Canale Duracenko
- Centro de Referência em Saúde do Trabalhador de Piracicaba (Cerest Piracicaba/SMS/PMP), Rua do Trabalho, 634, 1º andar, Vila Independência, Piracicaba 13418-220, SP, Brazil
| | - Eduardo Mello De Capitani
- Departamento de Clínica Médica, Centro de Informação e Assistência Toxicológica (CIATox) de Campinas, FCM, Universidade Estadual de Campinas, Rua Vital Brasil 251, Campinas 13083-888, SP, Brazil
| | - Alexandre Savaris
- Fundação de Amparo à Pesquisa e Extensão Universitária (FAPEU), Rua Delfino Conti, S/N, Florianópolis 88040-370, SC, Brazil
| | - Eduardo Algranti
- Division of Applied Research, Fundacentro, Rua Capote Valente, 710, São Paulo 05409-002, SP, Brazil
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15
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Janosikova M, Nakladalova M, Stepanek L. Current causes of mesothelioma: how has the asbestos ban changed the perspective? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 36883200 DOI: 10.5507/bp.2023.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
The association of mesothelioma, a lethal lung disease, with asbestos has led to an absolute ban on asbestos in at least 55 countries worldwide. The purpose of this paper is to review residual exposure to asbestos as well as other emerging causes of mesothelioma outside asbestos. The review provides detailed description of asbestos minerals, their geographical locations, mesothelioma in these areas, as well as contemporary possible sources of asbestos exposure. Second, we examine other emerging causes of mesothelioma including: ionizing radiation as the second most important risk factor after asbestos, particularly relevant to patients undergoing radiotherapy, third, carbon nanotubes which are under investigation and fourth, Simian virus 40. In the case of asbestos per se, the greatest risk is from occupational exposure during mining and subsequent processing. Of the non-occupational exposures, environmental exposure is most serious, followed by exposure from indoor asbestos minerals and secondary familial exposure. Overall, asbestos is still a major risk factor, but alternative causes should not be neglected, especially in young people, in women and those with a history of radiotherapy or living in high-risk locations.
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Affiliation(s)
- Magdalena Janosikova
- Department of Occupational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
| | - Marie Nakladalova
- Department of Occupational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
| | - Ladislav Stepanek
- Department of Occupational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
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16
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Wang A, Gupta A, Grimm MD, Pressburger DT, Sparrow BR, Richey JS, Shaw JR, Elsass KE, Roberts GK, Yao PL, Stout MD, Ellis BJ, Ray RL. Natural mineral fibers: conducting inhalation toxicology studies-part B: development of a nose-only exposure system for repeat-exposure in vivo study of Libby amphibole aerosol. Inhal Toxicol 2023; 35:214-229. [PMID: 37339372 PMCID: PMC11059106 DOI: 10.1080/08958378.2023.2220735] [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: 02/01/2023] [Accepted: 05/17/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Exposure to asbestos is associated with malignant and nonmalignant respiratory disease. To strengthen the scientific basis for risk assessment on fibers, the National Institute of Environmental Health Sciences (NIEHS) has initiated a series of studies to address fundamental questions on the toxicology of naturally occurring asbestos and related mineral fibers after inhalation exposure. A prototype nose-only exposure system was previously developed and validated. The prototype system was expanded to a large-scale exposure system in this study for conducting subsequent in vivo rodent inhalation studies of Libby amphibole (LA) 2007, selected as a model fiber. RESULTS The exposure system consisting of six exposure carousels was able to independently deliver stable LA 2007 aerosol to individual carousels at target concentrations of 0 (control group), 0.1, 0.3, 1, 3, or 10 mg/m3. A single aerosol generator was used to provide aerosol to all carousels to ensure that exposure atmospheres were chemically and physically similar, with aerosol concentration as the only major variable among the carousels. Transmission electron microscopy (TEM) coupled with energy dispersive spectrometry (EDS) and selected area electron diffraction (SAED) analysis of aerosol samples collected at the exposure ports indicated the fiber dimensions, chemical composition, and mineralogy were equivalent across exposure carousels and were comparable to the bulk LA 2007 material. CONCLUSION The exposure system developed is ready for use in conducting nose-only inhalation toxicity studies of LA 2007 in rats. The exposure system is anticipated to have applicability for the inhalation toxicity evaluation of other natural mineral fibers of concern.
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Affiliation(s)
| | - Amit Gupta
- Battelle Memorial Institute, Columbus, OH, USA
| | | | | | | | | | | | | | - Georgia K. Roberts
- Division of Translational Toxicology, National Institute of Environmental Health Sciences of the U.S., RTP, NC, USA
| | - Pei-Li Yao
- Division of Translational Toxicology, National Institute of Environmental Health Sciences of the U.S., RTP, NC, USA
| | - Matthew D. Stout
- Division of Translational Toxicology, National Institute of Environmental Health Sciences of the U.S., RTP, NC, USA
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17
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Wang A, Gupta A, Grimm MD, Pressburger DT, Sparrow BR, Richey JS, Shaw JR, Elsass KE, Roberts GK, Yao PL, Stout MD, Ellis BJ, Ray RL. Natural mineral fibers: conducting inhalation toxicology studies - part A: Libby Amphibole aerosol generation and characterization method development. Inhal Toxicol 2023; 35:201-213. [PMID: 37339371 PMCID: PMC11062073 DOI: 10.1080/08958378.2023.2220737] [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: 02/01/2023] [Accepted: 05/17/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND Asbestos has been classified as a human carcinogen, and exposure may increase the risk of diseases associated with impaired respiratory function. As the range of health effects and airborne concentrations that result in health effects across asbestos-related natural mineral fiber types are not fully understood, the National Institute of Environmental Health Sciences has established a series of research studies to characterize hazards of natural mineral fibers after inhalation exposure. This paper presents the method development work of this research project. RESULTS A prototype nose-only exposure system was fabricated to explore the feasibility of generating natural mineral fiber aerosol for in vivo inhalation toxicity studies. The prototype system consisted of a slide bar aerosol generator, a distribution/delivery system and an exposure carousel. Characterization tests conducted using Libby Amphibole 2007 (LA 2007) demonstrated the prototype system delivered stable and controllable aerosol concentration to the exposure carousel. Transmission electron microscopy (TEM) analysis of aerosol samples collected at the exposure port showed the average fiber length and width were comparable to the bulk LA 2007. TEM coupled with energy dispersive spectrometry (EDS) and selected area electron diffraction (SAED) analysis further confirmed fibers from the aerosol samples were consistent with the bulk LA 2007 chemically and physically. CONCLUSIONS Characterization of the prototype system demonstrated feasibility of generating LA 2007 fiber aerosols appropriate for in vivo inhalation toxicity studies. The methods developed in this study are suitable to apply to a multiple-carousel exposure system for a rat inhalation toxicity testing using LA 2007.
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Affiliation(s)
| | - Amit Gupta
- Battelle Memorial Institute, Columbus, OH, USA
| | | | | | | | | | | | | | - Georgia K. Roberts
- Division of Translational Toxicology, National Institute of Environmental Health Sciences of the U.S., RTP, NC, USA
| | - Pei-Li Yao
- Division of Translational Toxicology, National Institute of Environmental Health Sciences of the U.S., RTP, NC, USA
| | - Matthew D. Stout
- Division of Translational Toxicology, National Institute of Environmental Health Sciences of the U.S., RTP, NC, USA
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18
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Guglielmucci F, Bonafede M, Azzolina D, Marinaccio A, Franzoi IG, Migliore E, Mensi C, Chellini E, Romeo E, Grosso F, Granieri A. Preliminary validation of a brief PROM assessing psychological distress in patients with malignant mesothelioma: The mesothelioma psychological distress tool-Patients. Front Psychol 2022; 13:974982. [PMID: 36506969 PMCID: PMC9732528 DOI: 10.3389/fpsyg.2022.974982] [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: 06/21/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Psychological suffering in malignant mesothelioma (MM) differs from that in other cancers because of its occupational etiology, and we aimed to develop specific patient-reported outcome measures to assess it. Methods We used a multi-method prospective observational multicentric study (N = 149), and a preliminary questionnaire validation was performed through a Bayesian approach. Results Item analysis showed a good internal consistency and reliability (Cronbach alpha = 0.79 [95% CI = 0.74-0.93]. Twenty of the 41 initial items were selected as posterior 95% highest density interval factor loading standardized effect size fell outside of the region of practical equivalence. Bayesian exploratory factor analysis showed a two-factor structure: (1) Trauma-related reactions (TR, 13 items) and (2) Claim for justice (CJ, 7 items), confirmed by the Bayesian confirmatory factor analysis. Latent factors were poorly correlated (Posterior median: 0.13; 95% CI = -0.079 to 0.323). The 90% root mean square error of approximation posterior median was 0.04 [90% CI = 0.03-0.58]; the 90% chi-square posterior median was 242 [90% CI = 209-287]. Conclusion Psychological suffering in MM patients implies negative cognitive, emotional, and somatic reactions related to the traumatic impact of the disease and the need to obtain justice through economic compensation. Our findings provide preliminary evidence that the Mesothelioma Psychological Distress Tool-Patients could be a promising and reliable instrument to assess MM patients' psychological distress.
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Affiliation(s)
- Fanny Guglielmucci
- Department of Philosophy, Communication and Performing Arts, University of Roma Tre, Rome, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy,*Correspondence: Michela Bonafede,
| | - Danila Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | | | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, University of Turin and CPO-Piedmont, Turin, Italy
| | - Carolina Mensi
- COR Lombardy, Epidemiology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Elisabetta Chellini
- COR Tuscany, Cancer Prevention and Research Institute, Unit of Environmental and Occupational Epidemiology, Florence, Italy
| | - Elisa Romeo
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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Gardiner C, Harrison M, Hargreaves S, Taylor B. Clinical nurse specialist role in providing generalist and specialist palliative care: A qualitative study of mesothelioma clinical nurse specialists. J Adv Nurs 2022; 78:2973-2982. [PMID: 35485237 PMCID: PMC9542160 DOI: 10.1111/jan.15277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 03/14/2022] [Accepted: 04/13/2022] [Indexed: 11/27/2022]
Abstract
Aim To explore perspectives of Mesothelioma UK clinical nurse specialists (CNSs) on their role in providing palliative care for patients with mesothelioma and their families. Design A qualitative descriptive approach using focus group and interview methods. Methods Focus groups and semi‐structured interviews were conducted with 16 Mesothelioma UK clinical nurse specialists using the online software Google Meet. Data collection was carried out in Jan‐Feb 2021 and data were analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) was used as the reporting guideline for this paper. Results Four main themes were identified from the data: Mesothelioma UK clinical nurse specialist role in relation to palliative care; joint working with specialist palliative care and community services; patients and family carer's willingness to engage with palliative care services; and the impact of COVID‐19 on palliative care for mesothelioma patients. Conclusion This study provides valuable insights into palliative care needs in mesothelioma. Patients with mesothelioma and their families have significant palliative care needs throughout the course of their illness from diagnosis to the end of life. Mesothelioma UK CNS's play a crucial role in supporting patients' and families palliative care needs, and are highly skilled in providing this care. Impact By acknowledging the role of Mesothelioma UK CNS's in palliative care provision, and supporting collaborative working between specialist and generalist palliative care providers, there is the capacity to significantly improve palliative care in mesothelioma and improve outcomes for patients and their families.
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Affiliation(s)
- Clare Gardiner
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
| | - Madeleine Harrison
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
| | - Sarah Hargreaves
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
| | - Beth Taylor
- Mesothelioma UK Research Centre, The University of Sheffield, Sheffield, England
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Wieland S, Balmes A, Bender J, Kitzinger J, Meyer F, Ramsperger AF, Roeder F, Tengelmann C, Wimmer BH, Laforsch C, Kress H. From properties to toxicity: Comparing microplastics to other airborne microparticles. JOURNAL OF HAZARDOUS MATERIALS 2022; 428:128151. [PMID: 35042167 DOI: 10.1016/j.jhazmat.2021.128151] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Microplastic (MP) debris is considered as a potentially hazardous material. It is omnipresent in our environment, and evidence that MP is also abundant in the atmosphere is increasing. Consequently, the inhalation of these particles is a significant exposure route to humans. Concerns about potential effects of airborne MP on human health are rising. However, currently, there are not enough studies on the putative toxicity of airborne MP to adequately assess its impact on human health. Therefore, we examined potential drivers of airborne MP toxicity. Physicochemical properties like size, shape, ζ-potential, adsorbed molecules and pathogens, and the MP's bio-persistence have been proposed as possible drivers of MP toxicity. Since their role in MP toxicity is largely unknown, we reviewed the literature on toxicologically well-studied non-plastic airborne microparticles (asbestos, silica, soot, wood, cotton, hay). We aimed to link the observed health effects and toxicology of these microparticles to the abovementioned properties. By comparing this information with studies on the effects of airborne MP, we analyzed possible mechanisms of airborne MP toxicity. Thus, we provide a basis for a mechanistic understanding of airborne MP toxicity. This may enable the assessment of risks associated with airborne MP pollution, facilitating effective policymaking and product design.
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Affiliation(s)
- Simon Wieland
- Biological Physics, University of Bayreuth, Bayreuth, Germany; Animal Ecology I and BayCEER, University of Bayreuth, Bayreuth, Germany
| | - Aylin Balmes
- Institute of Applied Physics, University of Tübingen, Tübingen, Germany
| | - Julian Bender
- Institute for Biochemistry and Biotechnology, Interdisciplinary Research Center HALOmem, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Jonas Kitzinger
- Department of Physics, Humboldt University of Berlin, Berlin, Germany
| | - Felix Meyer
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Anja Frm Ramsperger
- Biological Physics, University of Bayreuth, Bayreuth, Germany; Animal Ecology I and BayCEER, University of Bayreuth, Bayreuth, Germany
| | - Franz Roeder
- Institute of Optics and Quantum Electronics, Friedrich-Schiller-University Jena, Jena, Germany
| | - Caroline Tengelmann
- Medical Faculty, University of Würzburg, Würzburg, Germany; Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital of Würzburg, Würzburg, Germany
| | | | - Christian Laforsch
- Animal Ecology I and BayCEER, University of Bayreuth, Bayreuth, Germany.
| | - Holger Kress
- Biological Physics, University of Bayreuth, Bayreuth, Germany.
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21
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Avataneo C, Petriglieri JR, Capella S, Tomatis M, Luiso M, Marangoni G, Lazzari E, Tinazzi S, Lasagna M, De Luca DA, Bergamini M, Belluso E, Turci F. Chrysotile asbestos migration in air from contaminated water: An experimental simulation. JOURNAL OF HAZARDOUS MATERIALS 2022; 424:127528. [PMID: 34736189 DOI: 10.1016/j.jhazmat.2021.127528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
In Naturally Occurring Asbestos (NOA) rich areas, water flows through asbestos bearing rocks and soils and generates waterborne fibres that may migrate in air and become a risk for humans. Research on the migration and dispersion after water vaporisation has been so far only marginally evaluated. This study investigates the migration in air of asbestos from a set of suspensions contaminated by chrysotile from Balangero (Italy), under controlled laboratory conditions. We evaluated i) the morphological modifications that might occur to chrysotile during migration from water to air, and ii) the amount of airborne chrysotile mobilised from standardised suspensions. Morphological alteration of asbestos fibres occurred during water-air migration and impacted on the analytical response of electron microscopy. Waterborne asbestos concentration higher than 40 ∙ 106 f/L generates in air concentration higher than 1 fibre per litre [f/L], the alarm threshold limit set by World Health Organization for airborne asbestos. A possible correlation between the waterborne fibre concentration as mass or number of fibres per volume unit [μg/L or f/L] was observed.
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Affiliation(s)
- Chiara Avataneo
- Department of Earth Sciences, University of Turin, Via Valperga Caluso 35, I-10125 Turin, Italy; "G. Scansetti" Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy
| | - Jasmine R Petriglieri
- "G. Scansetti" Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy; Department of Chemistry, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy
| | - Silvana Capella
- Department of Earth Sciences, University of Turin, Via Valperga Caluso 35, I-10125 Turin, Italy; "G. Scansetti" Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy
| | - Maura Tomatis
- "G. Scansetti" Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy; Department of Chemistry, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy
| | - Mariagrazia Luiso
- RSA Srl, Società per il Risanamento e lo Sviluppo Ambientale dell'ex miniera di amianto di Balangero e Corio, Via Cave 24, I-10070 Balangero, TO, Italy
| | - Giuliana Marangoni
- RSA Srl, Società per il Risanamento e lo Sviluppo Ambientale dell'ex miniera di amianto di Balangero e Corio, Via Cave 24, I-10070 Balangero, TO, Italy
| | - Elisa Lazzari
- RSA Srl, Società per il Risanamento e lo Sviluppo Ambientale dell'ex miniera di amianto di Balangero e Corio, Via Cave 24, I-10070 Balangero, TO, Italy
| | - Silvio Tinazzi
- Microanalitica Srl, Via Reano 21/8, I-10098 Rivoli, TO, Italy
| | - Manuela Lasagna
- Department of Earth Sciences, University of Turin, Via Valperga Caluso 35, I-10125 Turin, Italy
| | - Domenico A De Luca
- Department of Earth Sciences, University of Turin, Via Valperga Caluso 35, I-10125 Turin, Italy
| | - Massimo Bergamini
- RSA Srl, Società per il Risanamento e lo Sviluppo Ambientale dell'ex miniera di amianto di Balangero e Corio, Via Cave 24, I-10070 Balangero, TO, Italy
| | - Elena Belluso
- Department of Earth Sciences, University of Turin, Via Valperga Caluso 35, I-10125 Turin, Italy; "G. Scansetti" Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy; Geosciences and Earth Resources (IGG) of the National Research Council of Italy (CNR), Operational Unit of Turin, Via Valperga Caluso 35, I-10125 Turin, Italy
| | - Francesco Turci
- "G. Scansetti" Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy; Department of Chemistry, University of Turin, Via Pietro Giuria 7, I-10125 Turin, Italy; Geosciences and Earth Resources (IGG) of the National Research Council of Italy (CNR), Operational Unit of Turin, Via Valperga Caluso 35, I-10125 Turin, Italy.
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22
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Dalsgaard SB, Würtz ET, Hansen J, Røe OD, Omland Ø. Cancer Incidence and Risk of Multiple Cancers after Environmental Asbestos Exposure in Childhood-A Long-Term Register-Based Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:268. [PMID: 35010531 PMCID: PMC8750751 DOI: 10.3390/ijerph19010268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To examine the asbestos-associated cancer incidence and the risk of multiple cancers in former school children exposed to environmental asbestos in childhood. METHODS A cohort of 12,111 former school children, born 1940-1970, was established using 7th grade school records from four schools located at a distance of 100-750 m in the prevailing wind direction from a large asbestos-cement plant that operated from 1928 to 1984 in Aalborg, Denmark. Using the unique Danish personal identification number, we linked information on employments, relatives' employments, date of cancer diagnosis, and type of cancer and vital status to data on cohortees extracted from the Supplementary Pension Fund Register (employment history), the Danish Cancer Registry, and the Danish Civil Registration System. We calculated standardized incidence rates (SIRs) for asbestos-associated cancers, all cancers, and multiple cancers using rates for a gender and five-year frequency-matched reference cohort. RESULTS The overall incidence of cancer was modestly increased for the school cohort (SIR 1.07, 95% confidence interval (CI) 1.02-1.12) compared with the reference cohort. This excess was driven primarily by a significantly increased SIR for malignant mesothelioma (SIR 8.77, 95% CI 6.38-12.05). Former school children who had combined childhood environmental and subsequent occupational exposure to asbestos had a significantly increased risk of lung cancer. Within this group, those with additional household exposure by a relative had a significantly increased SIR for cancer of the pharynx (SIR 4.24, 95% CI 1.59-11.29). We found no significant difference in the number of subjects diagnosed with multiple cancers between the two cohorts. CONCLUSIONS Our study confirms the strong association between environmental asbestos exposure and malignant mesothelioma and suggests that environmental asbestos exposure in childhood may increase the overall cancer risk later in life.
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Affiliation(s)
- Sofie Bünemann Dalsgaard
- Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
- Danish Ramazzini Centre, Department of Occupational and Environmental Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
- Danish Ramazzini Centre, Department of Occupational Medicine, University Research Clinic, Goedstrup Hospital, 7400 Herning, Denmark
| | - Else Toft Würtz
- Danish Ramazzini Centre, Department of Occupational and Environmental Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
- Danish Ramazzini Centre, Department of Occupational Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Johnni Hansen
- Danish Cancer Society Research Center, 2100 Copenhagen, Denmark
| | - Oluf Dimitri Røe
- Department of Oncology, Aalborg University Hospital, 9000 Aalborg, Denmark
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, 7491 Trondheim, Norway
- Department of Oncology, Levanger Hospital, Nord-Trøndelag Hospital Trust, 7600 Levanger, Norway
| | - Øyvind Omland
- Danish Ramazzini Centre, Department of Occupational and Environmental Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark
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23
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Using GIS to Estimate Population at Risk Because of Residence Proximity to Asbestos Processing Facilities in Colombia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413297. [PMID: 34948906 PMCID: PMC8703708 DOI: 10.3390/ijerph182413297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 12/02/2022]
Abstract
The recent enactment of the law banning asbestos in Colombia raises a significant number of challenges. The largest factories that have historically processed asbestos include five asbestos-cement facilities located in the cities of Sibaté (Cundinamarca), Cali (Valle del Cauca), and Barranquilla (Atlántico), and Manizales (Caldas), which has two, as well as a friction products facility in Bogotá D.C. An asbestos chrysotile mine has also operated in Colombia since 1980 in Campamento (Antioquia). In the framework of developing the National Asbestos Profile for Colombia, in this study, we estimated the population residing in the vicinity of asbestos processing plants or the mine and, therefore, potentially at risk of disease. Using a geographic information system, demographic data obtained from the last two general population censuses were processed to determine the number of people living within the concentric circles surrounding the asbestos facilities and the mine. In previous studies conducted in different countries of the world, an increased risk of asbestos-related diseases has been reported for people living at different distance bands from asbestos processing facilities. Based on these studies, circles of 500, 1000, 2000, 5000, and 10,000 m radii, centered on the asbestos processing facilities and the mine that operated in Colombia, were combined with the census data to estimate the number of people living within these radii. Large numbers of people were identified. It is estimated that in 2005, at the country level, 10,489 people lived within 500 m of an asbestos processing facility or mine. In 2018, and within a distance of 10,000 m, the number of people was 6,724,677. This information can aid public health surveillance strategies.
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Sandal A, Ecin SM, Koyuncu A, Durhan G, Akpinar MG, Demir AU, Cöplü L. Environmental asbestos exposure and nonmalignant pleural findings: a retrospective evaluation of a five-year chest CT repository. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2021; 77:734-743. [PMID: 34817303 DOI: 10.1080/19338244.2021.2004987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This registry-based case-control study aimed to assess the association between asbestos deposits in the birthplace and/or residence and nonmalignant pleural findings, namely pleural plaques (PPs) and pleural thickening (PT), on chest CT scans. In total, 39,472 CT scans obtained over five years in a tertiary referral hospital in Ankara, Turkey, were evaluated. Cases involving patients with PP (n = 537), PT (n = 263), PP&PT (n = 69), and controls (n = 543) from the same study base without those conditions were included. Each case group was compared to controls using unconditional logistic regression. The presence of asbestos deposits in the district of birthplace (adjusted OR = 2.13, 95% CI: 1.35-3.37) and both birthplace and residence (aOR = 4.32, 95% CI: 2.26-8.27) was significantly related to the PPs. As the importance of environmental asbestos exposure in Turkey continues, future prospective studies could contribute to developing screening strategies.
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Affiliation(s)
- Abdulsamet Sandal
- Occupational Diseases Clinic, Ankara Gazi Mustafa Kemal Occupational and Environmental Diseases Hospital, Ankara, Turkey
| | - Seval Müzeyyen Ecin
- Occupational Diseases Clinic, Mersin City Training and Research Hospital, Mersin, Turkey
| | - Adem Koyuncu
- Occupational Diseases Clinic, Ankara Kecioren Sanatorium Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Gamze Durhan
- Department of Radiology, Hacettepe University, Ankara, Turkey
| | | | - Ahmet Ugur Demir
- Department of Chest Diseases, Hacettepe University, Ankara, Turkey
| | - Lütfi Cöplü
- Department of Chest Diseases, Hacettepe University, Ankara, Turkey
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25
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Survival of Korean Patients with Malignant Pleural Mesothelioma Compensated for the Asbestos Injury Relief. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11209713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: The purpose of this study was to identify the epidemiologic characteristics and prognostic factors for malignant pleural mesothelioma in Korea, which are currently insufficient. The data were derived from malignant mesothelioma patients who registered under the Asbestos Injury Relief Act; Methods: A total of 728 patients received compensation from the Asbestos Injury Relief Act due to malignant mesothelioma between 2011 and 2015. Of these, 313 patients (43.0%) with malignant pleural mesothelioma were included in the study. The study variables were sex (male, female), age at diagnosis (<59, 60–69, ≥70), smoking history (yes, no), surgery (yes, no), chemotherapy (yes, no), occupational exposure to asbestos (yes, no), and histological subtype (epithelioid, nonepithelioid); Results: Median survival of mesothelioma was 8.0 months (95% confidence interval: 6.2 to 9.8). The 1-year, 2-year, and 5-year survival rates (%) were 43.5%, 23.6%, and 12.5%, respectively. In multivariate analysis of Cox’s proportional hazards model; sex, age, smoking history, occupational asbestos exposure, and histological subtype were not significant prognostic factors, but surgery and chemotherapy combined was a significant predictor; Conclusions: Although the representativeness of these data is limited, our study estimates the epidemiologic characteristics of malignant pleural mesothelioma. Non-occupational exposure had a similar prognosis to occupational asbestos exposure, and there was no sex difference. In addition, it was found that receiving a combination of surgery and chemotherapy affects the survival rate, but there is a limitation in that factors such as performance status, comorbidities, and stage that contribute to survival are not considered.
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26
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Brustugun OT, Nilssen Y, Eide IJZ. Epidemiology and outcome of peritoneal and pleural mesothelioma subtypes in Norway. A 20 year nation-wide study. Acta Oncol 2021; 60:1250-1256. [PMID: 34313510 DOI: 10.1080/0284186x.2021.1955971] [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: 12/29/2022]
Abstract
BACKGROUND Mesothelioma of the pleural or peritoneal cavities is one of the deadliest cancer types. The incidence of pleural subtypes has decreased over time due to decrease in asbestos exposure, and the current treatment landscape is changing due to introduction of novel therapies. In this study we have analysed contemporary epidemiological data of mesothelioma on a national level before the advent of immunotherapy. MATERIAL AND METHODS Complete national data on 1509 pleural and peritoneal malignant mesothelioma from the Cancer Registry of Norway from 2000 to 2019 are presented. Age standardised incidence and median survival were calculated. RESULTS The age-standardised incidence of pleural mesothelioma among males has decreased from 1.7 per 100 000 in 2000-2004 to 1.1 in 2015-2019, whereas the incidence for females has been stable, lower than 0.3 per 100 000 throughout the period. Incidence of peritoneal mesotheliomas remained low, below 0.08 per 100 000. The female to male ratio among pleural mesotheliomas was 1:7 with no differences among morphological subtypes, whereas this ratio was 1:1.2 in peritoneal mesotheliomas. Median age at diagnosis for pleural mesothelioma was 73 years and 76 years for females and males respectively in the last 5-year period, and 67 years for peritoneal mesotheliomas of both sexes. Median survival among pleural mesotheliomas has been stable, with significantly worse prognosis among sarcomatoid subtype (5.4 months) compared to epithelioid subtype (15.8 months). Peritoneal mesothelioma of the epithelioid subtype, representing 38% of cases, had a median survival of 43.3 months, contrasting the non-epithelioid subtype of 5.1 months. DISCUSSION Mesothelioma is still a significant disease with a dismal prognosis. Improvement in treatment is warranted.
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Affiliation(s)
- Odd Terje Brustugun
- Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Yngvar Nilssen
- Department of Registration, Cancer Registry of Norway, Oslo, Norway
| | - Inger Johanne Zwicky Eide
- Section of Oncology, Drammen Hospital, Vestre Viken Hospital Trust, Drammen, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Di Basilio D, Shigemura J, Guglielmucci F. Commentary: SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions? Front Psychol 2021; 12:720160. [PMID: 34566802 PMCID: PMC8458809 DOI: 10.3389/fpsyg.2021.720160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/04/2021] [Indexed: 02/03/2023] Open
Affiliation(s)
- Daniela Di Basilio
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jun Shigemura
- Faculty of Health Sciences, Mejiro University, Saitama, Japan
| | - Fanny Guglielmucci
- Department of Psychology, University of Turin, Turin, Italy
- Laboratory of Research and Interventions in Psychoanalysis (psiA), Department of Clinical Psychology, Institute of Psychology, University of São Paulo, São Paulo, Brazil
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Parada H, Vu AH, Pinheiro PS, Thompson CA. Comparing Age at Cancer Diagnosis between Hispanics and Non-Hispanic Whites in the United States. Cancer Epidemiol Biomarkers Prev 2021; 30:1904-1912. [PMID: 34321282 DOI: 10.1158/1055-9965.epi-21-0389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/24/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Population age structure may confound the comparison of age at cancer diagnosis across racial/ethnic groups. We compared age at cancer diagnosis for U.S. Hispanics, a population that is younger on average, and non-Hispanic whites (NHW), before and after adjustment for the age structure of the source population. METHODS We used Surveillance, Epidemiology, and End Results data from 18 U.S. regions in 2015 for 34 cancer sites to calculate crude and adjusted (using age- and sex-specific weights) mean ages at diagnosis. Differences in age at diagnosis comparing Hispanics to NHWs (δ) were assessed using independent sample t tests. RESULTS Crude mean ages at diagnosis were lower among Hispanic males and females for all sites combined and for most cancer sites. After age-adjustment, Hispanic (vs. NHW) males remained younger on average at diagnosis of chronic myeloid leukemia [δ = -6.1; 95% confidence interval (CI), -8.1 to -4.1 years], testicular cancer (δ =-4.7; 95% CI, -5.4 to -4.0), Kaposi sarcoma (δ =-3.6; 95% CI,-6.3 to -0.8), mesothelioma (δ =-3.0; 95% CI,-4.3 to -1.7), and anal cancer (δ =-2.4; 95% CI, -3.9 to -0.8), and older at diagnosis of gallbladder cancer (δ = +3.8; 95% CI, 1.8 to 5.7) and Hodgkin's lymphoma (δ = +7.5; 95% CI, 5.7 to 9.4), and Hispanic (vs. NHW) females remained younger at diagnosis of mesothelioma (δ = -3.7; 95% CI, -6.7 to -0.7) and gallbladder cancer (δ = -3.0; 95% CI, -4.3 to -1.7) and older at diagnosis of skin cancer (δ = +3.8; 95% CI, 3.1 to 4.5), cervical cancer (δ = +4.1; 95% CI, 3.3 to 4.8), and Hodgkin's lymphoma (δ = +7.0; 95% CI, 5.0 to 9.1). CONCLUSIONS On average, Hispanics are diagnosed with cancer at younger ages than NHWs; however, for many cancers these differences reflect the younger age structure in Hispanics. IMPACT Population age structure should be considered when comparing age at cancer diagnosis across racial/ethnic groups.
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Affiliation(s)
- Humberto Parada
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California. .,University of California, San Diego Moores Cancer Center, La Jolla, California.,Department of Radiation Medicine and Applied Science, University of California, San Diego, La Jolla, California
| | - Andrew H Vu
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California
| | - Paulo S Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Caroline A Thompson
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California.,University of California, San Diego Moores Cancer Center, La Jolla, California.,The Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego, La Jolla, California
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29
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Cazzolla Gatti R. Why We Will Continue to Lose Our Battle with Cancers If We Do Not Stop Their Triggers from Environmental Pollution. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6107. [PMID: 34198930 PMCID: PMC8201328 DOI: 10.3390/ijerph18116107] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/21/2021] [Accepted: 06/01/2021] [Indexed: 12/11/2022]
Abstract
Besides our current health concerns due to COVID-19, cancer is a longer-lasting and even more dramatic pandemic that affects almost a third of the human population worldwide. Most of the emphasis on its causes has been posed on genetic predisposition, chance, and wrong lifestyles (mainly, obesity and smoking). Moreover, our medical weapons against cancers have not improved too much during the last century, although research is in progress. Once diagnosed with a malignant tumour, we still rely on surgery, radiotherapy, and chemotherapy. The main problem is that we have focused on fighting a difficult battle instead of preventing it by controlling its triggers. Quite the opposite, our knowledge of the links between environmental pollution and cancer has surged from the 1980s. Carcinogens in water, air, and soil have continued to accumulate disproportionally and grow in number and dose, bringing us to today's carnage. Here, a synthesis and critical review of the state of the knowledge of the links between cancer and environmental pollution in the three environmental compartments is provided, research gaps are briefly discussed, and some future directions are indicated. New evidence suggests that it is relevant to take into account not only the dose but also the time when we are exposed to carcinogens. The review ends by stressing that more dedication should be put into studying the environmental causes of cancers to prevent and avoid curing them, that the precautionary approach towards environmental pollutants must be much more reactionary, and that there is an urgent need to leave behind the outdated petrochemical-based industry and goods production.
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Affiliation(s)
- Roberto Cazzolla Gatti
- Konrad Lorenz Institute for Evolution and Cognition Research, 3400 Klosterneuburg, Austria;
- Biological Institute, Tomsk State University, 634050 Tomsk, Russia
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30
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Harrison M, Gardiner C, Taylor B, Ejegi-Memeh S, Darlison L. Understanding the palliative care needs and experiences of people with mesothelioma and their family carers: An integrative systematic review. Palliat Med 2021; 35:1039-1051. [PMID: 33829930 PMCID: PMC8188997 DOI: 10.1177/02692163211007379] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND People with mesothelioma and their families have palliative care needs throughout the relatively short trajectory of their illness. AIM To describe the palliative care needs and experiences of people with mesothelioma and their family carers. DESIGN Integrative systematic review with narrative synthesis (PROSPERO: CRD42020190115). DATA SOURCES MEDLINE, CINAHL, PsycINFO and the Cochrane Library were searched for articles published between 01 January 2000 and 10 May 2020. Articles were included if they presented empirical studies or comprehensive reviews including information about the palliative care needs and experiences of people with mesothelioma and their family carers. RESULTS The search yielded 508 articles, 14 were included in the analysis. A cross cutting theme of 'uncertainty' was identified encompassing five themes: (1) organisation and co-ordination of services, (2) communication and information needs, (3) management of care needs and high symptom burden, (4) consideration of the impact of seeking compensation and (5) family carer needs. Our findings demonstrate that people with mesothelioma want a co-ordinated, team-based approach to palliative care with a named point of contact. Whilst carers value and benefit from early referral to specialist palliative care, this does not necessarily reflect the outcomes and views of patients. CONCLUSION The evidence base around the palliative care needs and experiences of people with mesothelioma and their carers needs to be strengthened. The results of this review support the need to develop a greater understanding about the role non-specialist palliative care clinicians' play in providing generalist palliative care for people with mesothelioma and their carers.
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Affiliation(s)
- Madeleine Harrison
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Clare Gardiner
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Bethany Taylor
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Stephanie Ejegi-Memeh
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Liz Darlison
- The Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK
- Mesothelioma UK, Leicester, UK
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31
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Bardelli F, Brun F, De Panfilis S, Cloetens P, Capella S, Belluso E, Bellis D, Di Napoli A, Cedola A. Chemo-physical properties of asbestos bodies in human lung tissues studied at the nano-scale by non-invasive, label free x-ray imaging and spectroscopic techniques. Toxicol Lett 2021; 348:18-27. [PMID: 34023437 DOI: 10.1016/j.toxlet.2021.05.002] [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: 02/04/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
In the lungs, asbestos develops an Fe-rich coating (Asbestos Body, AB) that becomes the actual interface between the foreign fibers and the host organism. Conventional approaches to study ABs require an invasive sample preparation that can alter them. In this work, a novel combination of x-ray tomography and spectroscopy allowed studying unaltered lung tissue samples with chrysotile and crocidolite asbestos. The thickness and mass density maps of the ABs obtained by x-ray tomography were used to derive a truly quantitative elemental analysis from scanning x-ray fluorescence spectroscopy data. The average mass density of the ABs is compatible with that of highly loaded ferritin, or hemosiderin. The composition of all ABs analyzed was similar, with only minor differences in the relative elemental fractions. Silicon concentration decreased in the core-to-rim direction, indicating a possible partial dissolution of the inner fiber. The Fe content in the ABs was higher than that possibly contained in chrysotile and crocidolite. This finding opens two opposite scenarios, the first with Fe coming from the fiber bulk and concentrating on the surface as long as the fiber dissolves, the second where the Fe that takes part to the formation of the AB originates from the host organism Fe-pool.
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Affiliation(s)
- Fabrizio Bardelli
- Institute of Nanotechnology - CNR-Nanotec, c/o Department of Physics, Sapienza University, Roma, Italy.
| | - Francesco Brun
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - Simone De Panfilis
- Center for Life Nano- & Neuro-Science, Fondazione Istituto Italiano di Tecnologia (IIT), Roma, Italy
| | - Peter Cloetens
- European Synchrotron Radiation Facility (ESRF), Grenoble, France
| | - Silvana Capella
- Department of Earth Sciences, University of Torino, Torino, Italy; Interdepartmental Centre for the Study of Asbestos and Other Toxic Particulate "G. Scansetti", University of Torino, Torino, Italy
| | - Elena Belluso
- Department of Earth Sciences, University of Torino, Torino, Italy; Interdepartmental Centre for the Study of Asbestos and Other Toxic Particulate "G. Scansetti", University of Torino, Torino, Italy
| | - Donata Bellis
- Interdepartmental Centre for the Study of Asbestos and Other Toxic Particulate "G. Scansetti", University of Torino, Torino, Italy; Department of Surgery, Pathological Anatomy, Ospedale degli Infermi, Biella, Italy
| | - Arianna Di Napoli
- Department of Clinical and Molecular Medicine, Pathology Unit, Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Alessia Cedola
- Institute of Nanotechnology - CNR-Nanotec, c/o Department of Physics, Sapienza University, Roma, Italy
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32
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Asbestos bodies count and morphometry in bulk lung tissue samples by non-invasive X-ray micro-tomography. Sci Rep 2021; 11:10608. [PMID: 34012032 PMCID: PMC8136473 DOI: 10.1038/s41598-021-90057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/06/2021] [Indexed: 02/03/2023] Open
Abstract
The number of the Asbestos Bodies (AB), i.e. asbestos that developed an iron-protein coating during its permanence in biological tissues, is one of the most accessible markers of asbestos exposure in individuals. The approaches developed to perform AB count in biological tissues are based on the manual examination of tissue digests or histological sections by means of light or electron microscopies. Although these approaches are well established and relatively accessible, manual examination is time-consuming and can be reader-dependent. Besides, approximations are applied because of the limitations of 2D readings and to speed up manual counts. In addition, sample preparation using tissue digests require an amount of tissue that can only be obtained by invasive surgery or post-mortem sampling. In this paper, we propose a new approach to AB counting based on non-destructive 3D imaging, which has the potential to overcome most of the limitations of conventional approaches. This method allows automating the AB count and determining their morphometry distribution in bulk tissue samples (ideally non-invasive needle biopsies), with minimal sample preparation and avoiding approximations. Although the results are promising, additional testing on a larger number of AB-containing biological samples would be required to fully validate the method.
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Lee S, Kang D, Kim Y, Kim YJ, Kim SY. Activity-Based Exposure Levels and Cancer Risk Assessment Due to Naturally Occurring Asbestos for the Residents Near Abandoned Asbestos Mines in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105225. [PMID: 34069013 PMCID: PMC8156354 DOI: 10.3390/ijerph18105225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 05/10/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022]
Abstract
This study aims to evaluate the overall asbestos exposure intensity and assess the health risk to residents due to naturally occurring asbestos (NOA) near abandoned asbestos mines in South Korea. Of 38 mines, we found 19 with measured concentrations of NOA. We evaluated the average of airborne NOA concentrations according to the environmental exposure category. When evaluated regionally by dividing into two clusters, the mean concentrations in activity-based sampling (ABS) scenarios exceeded the Korean exposure limit (0.01 f/cc) in both clusters. Moreover, airborne NOA concentrations in agricultural activity (5.49 × 10-2 f/cc) and daily activity (6.95 × 10-2 f/cc) had the highest values for clusters A and B, respectively. The excess lifetime cancer risk of one region (cluster A) by the ABS scenarios did not exceed the Korean Ministry of the Environment's criteria for soil purification (1 × 10-4). However, one of the ABS scenarios-the daily life activity of clusters centered on Chungcheongbuk-do (cluster B)-showed an exposure of 1.08 × 10-4, greater than the limit (1 × 10-4). This indicates non negligible health damage to residents living near the abandoned asbestos mines, and it is necessary to continuously monitor and clean up the asbestos contamination.
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Affiliation(s)
- Seungho Lee
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea; (S.L.); (D.K.); (Y.K.)
| | - Dongmug Kang
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea; (S.L.); (D.K.); (Y.K.)
- Department of Preventive and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Environmental Health Center of Asbestos, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
| | - Youngki Kim
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea; (S.L.); (D.K.); (Y.K.)
- Department of Preventive and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Environmental Health Center of Asbestos, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
| | - Yoon-Ji Kim
- Department of Preventive and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Environmental Health Center of Asbestos, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
| | - Se-Yeong Kim
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea; (S.L.); (D.K.); (Y.K.)
- Department of Preventive and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Correspondence: ; Tel.: +82-55-360-3173
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34
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Lee KM, Godderis L, Furuya S, Kim YJ, Kang D. Comparison of Asbestos Victim Relief Available Outside of Conventional Occupational Compensation Schemes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105236. [PMID: 34069196 PMCID: PMC8156294 DOI: 10.3390/ijerph18105236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/10/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022]
Abstract
The asbestos victim relief schemes were introduced to resolve the issue of victims of asbestos-related diseases not receiving compensation through conventional legal orders. This article seeks to derive the differences and commonalities of various asbestos victim relief schemes available outside of the conventional occupational compensation system along with a systematic understanding and to propose plans for improvement through a comparative study. After the degree of asbestos exposure, the population, and the period of implementation were corrected, the recognized claims of the total of conventional occupational compensation schemes and the asbestos victim relief schemes could be ranked in the order of South Korea (KOR) (1867, total), France (FRA) (1571), Japan (JPN) (966), KOR (847, asbestosis grade 2,3 excluded), the United Kingdom (GBR) (670), and the Netherlands (NLD) (95). The average amount of compensation per person, in the case of mesothelioma, was higher in the order of FRA (4.60 times), KOR (1.46 times), GBR (1.03 times), and NLD (0.73 times) of the median income per year. The differences between countries were largely caused by the purpose of institutional design and influenced by the level of qualification, the existence of an expiration date, type of disease, type of benefit, level of judgment criteria, the existence of a procedure for appeals, and recognition rate (GBR: 102%, FRA: 84%, NLD: 81%, JPN: 76%, KOR: 73%, and BEL: 54%). Based on this analysis, suggestions could be made regarding the expansion of disease types, benefit types, and the overall review of judgment criteria.
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Affiliation(s)
- Kwang Min Lee
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea;
| | - Lode Godderis
- Centre for Environment and Health, University of Leuven, 3000 Leuven, Belgium;
- IDEWE, Knowledge, Information and Research Center, 3001 Heverlee, Belgium
| | - Sugio Furuya
- Japan Occupational Safety and Health Resource Center, Tokyo 136-0071, Japan;
| | - Yoon Ji Kim
- Department of Preventive, and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Environmental Health Center of Asbestos, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
| | - Dongmug Kang
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Korea;
- Department of Preventive, and Occupational & Environmental Medicine, Medical College, Pusan National University, Yangsan 50612, Korea;
- Environmental Health Center of Asbestos, Pusan National University Yangsan Hospital, Yangsan 50612, Korea
- Correspondence: ; Tel.: +82-51-510-8034
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Kwak K, Kang D, Paek D. Environmental exposure to asbestos and the risk of lung cancer: a systematic review and meta-analysis. Occup Environ Med 2021; 79:207-214. [PMID: 33972375 DOI: 10.1136/oemed-2020-107222] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/31/2021] [Accepted: 04/11/2021] [Indexed: 01/11/2023]
Abstract
Asbestos is a carcinogen associated with lung cancer, but few studies have examined the increased risk of lung cancer due to environmental asbestos exposure. We performed a systematic review and meta-analysis to evaluate the association between environmental asbestos exposure and lung cancer. We searched for articles on non-occupational or environmental asbestos exposure and lung cancer in PubMed, EMBASE, CINAHL and Web of Science databases. Our review included 15 studies, and except studies on ingestion exposure we performed a meta-analysis for 13 studies with respect to the type of exposure (neighbourhood and domestic/household exposure). Subgroup analyses and meta-regression were also performed. A significant increase in the risk of lung cancer was found for neighbourhood exposure (1.48, 95% CI 1.18 to 1.86), while the risk was not significantly increased for domestic/household exposure (1.04, 95% CI 0.85 to 1.27). With regard to neighbourhood exposure, naturally occurring asbestos and women were both associated with a higher risk of lung cancer; however, such an increase was not significantly greater compared with that associated with other sources of asbestos exposure and men. Although cautious interpretation is needed due to the large degree of heterogeneity and the small number of included studies, our findings imply that living near the source of asbestos increases the risk of lung cancer.
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Affiliation(s)
- Kyeongmin Kwak
- Department of Occupational and Environmental Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea
| | - Dongmug Kang
- Department of Occupational and Environmental Medicine, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.,Department of Preventive, Occupational and Environmental Medicine, Pusan National University College of Medicine, Yangsan, Republic of Korea
| | - Domyung Paek
- Department of Environmental Health Sciences, Seoul National University Graduate School of Public Health, Seoul, Republic of Korea .,Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea
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36
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DeStefano A, Martin C, Huang A, Wallace D. Predicting Long-Term Asbestos Prevalence in Human Lungs, Lymph Nodes, and Remote Organs from Short-Term Murine Experiments. Bull Math Biol 2021; 83:54. [PMID: 33797617 DOI: 10.1007/s11538-021-00882-8] [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: 07/09/2020] [Accepted: 03/02/2021] [Indexed: 10/21/2022]
Abstract
Inhalation of asbestos fibers leads to a suite of fatal diseases that can manifest years, if not decades, after cessation of exposure. The first phase of disease progression occurs as fibers are transported from point of entry in the lungs throughout the entire body. A mathematical model is developed for the disposition of non-chrysotile asbestos in the body and, except for exposure levels, is parameterized by published data on short-term rat experiments. Asbestos exposure in individual humans is determined by matching published long-term lung data for nine patients. The resulting model predicts transport of fibers within the lymphatic system and prevalence of fibers in lymph nodes for these patients with reasonable accuracy. Model predictions for remote organs are compared against published observations. The model consists of a system of globally stable differential equations, and a sensitivity analysis was conducted. The model indicates that fiber density in lymph nodes is correlated with total exposure, level times duration, no matter whether there is a long-term, low-level exposure or short-term, high-level exposure. The model predicts that levels of sequestered asbestos reach steady state within five years of cessation of exposure, a timeline previously not known. The model suggests that the time to steady state is short compared to onset of disease, and that delayed onset of related disease may be a function of chemical and biological processes not in this model.
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Affiliation(s)
- Alisa DeStefano
- Department of Mathematics and Computer Science, College of the Holy Cross, Worcester, MA, 01610, USA.
| | - Clyde Martin
- Mathematics and Statistics Department, Texas Tech University, Lubbock, TX, 79409, USA
| | | | - Dorothy Wallace
- Department of Mathematics, Dartmouth College, Hanover, NH, 03755, USA
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37
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Murphy F, Dekkers S, Braakhuis H, Ma-Hock L, Johnston H, Janer G, di Cristo L, Sabella S, Jacobsen NR, Oomen AG, Haase A, Fernandes T, Stone V. An integrated approach to testing and assessment of high aspect ratio nanomaterials and its application for grouping based on a common mesothelioma hazard. NANOIMPACT 2021; 22:100314. [PMID: 35559971 DOI: 10.1016/j.impact.2021.100314] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 02/25/2021] [Accepted: 03/25/2021] [Indexed: 06/15/2023]
Abstract
Here we describe the development of an Integrated Approach to Testing and Assessment (IATA) to support the grouping of different types (nanoforms; NFs) of High Aspect Ratio Nanomaterials (HARNs), based on their potential to cause mesothelioma. Hazards posed by the inhalation of HARNs are of particular concern as they exhibit physical characteristics similar to pathogenic asbestos fibres. The approach for grouping HARNs presented here is part of a framework to provide guidance and tools to group similar NFs and aims to reduce the need to assess toxicity on a case-by-case basis. The approach to grouping is hypothesis-driven, in which the hypothesis is based on scientific evidence linking critical physicochemical descriptors for NFs to defined fate/toxicokinetic and hazard outcomes. The HARN IATA prompts users to address relevant questions (at decision nodes; DNs) regarding the morphology, biopersistence and inflammatory potential of the HARNs under investigation to provide the necessary evidence to accept or reject the grouping hypothesis. Each DN in the IATA is addressed in a tiered manner, using data from simple in vitro or in silico methods in the lowest tier or from in vivo approaches in the highest tier. For these proposed methods we provide justification for the critical descriptors and thresholds that allow grouping decisions to be made. Application of the IATA allows the user to selectively identify HARNs which may pose a mesothelioma hazard, as demonstrated through a literature-based case study. By promoting the use of alternative, non-rodent approaches such as in silico modelling, in vitro and cell-free tests in the initial tiers, the IATA testing strategy streamlines information gathering at all stages of innovation through to regulatory risk assessment while reducing the ethical, time and economic burden of testing.
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Affiliation(s)
- Fiona Murphy
- NanoSafety Group, Heriot-Watt University, Edinburgh, UK.
| | - Susan Dekkers
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Hedwig Braakhuis
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Lan Ma-Hock
- BASF SE, Dept. Material Physics and Dept of Experimental Toxicology & Ecology, Ludwigshafen, Germany
| | | | - Gemma Janer
- LEITAT Technological Center, Barcelona, Spain
| | | | | | | | - Agnes G Oomen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Andrea Haase
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Berlin, Germany
| | | | - Vicki Stone
- NanoSafety Group, Heriot-Watt University, Edinburgh, UK
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38
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Emmett EA. Asbestos in High-Risk Communities: Public Health Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1579. [PMID: 33562413 PMCID: PMC7915393 DOI: 10.3390/ijerph18041579] [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] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/19/2021] [Accepted: 01/31/2021] [Indexed: 02/07/2023]
Abstract
Asbestos-related diseases (ARDs)-mesothelioma, lung cancer, and asbestosis-are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.
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Affiliation(s)
- Edward A Emmett
- Occupational and Environmental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Di Gregorio E, Miolo G, Saorin A, Muraro E, Cangemi M, Revelant A, Minatel E, Trovò M, Steffan A, Corona G. Radical Hemithoracic Radiotherapy Induces Systemic Metabolomics Changes That Are Associated with the Clinical Outcome of Malignant Pleural Mesothelioma Patients. Cancers (Basel) 2021; 13:cancers13030508. [PMID: 33572739 PMCID: PMC7866164 DOI: 10.3390/cancers13030508] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/19/2021] [Accepted: 01/25/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Radical hemithoracic radiotherapy represents a promising new advance in the field of radiation oncology and encouraging results have been achieved in the treatment of malignant pleural mesothelioma patients. This study showed that this radiotherapy modality produces significant changes in serum metabolomics profile mainly affecting arginine and polyamine biosynthesis pathways. Interestingly, individual metabolomics alterations were found associated with the clinical overall survival outcome of the radiotherapy treatment. These results highlight metabolomics profile analysis as a powerful prognostic tool useful to better understand the mechanisms underlying the interpatients variability and to identify patients who may receive the best benefit from this specific radiotherapy treatment. Abstract Radical hemithoracic radiotherapy (RHRT) represents an advanced therapeutic option able to improve overall survival of malignant pleural mesothelioma patients. This study aims to investigate the systemic effects of this radiotherapy modality on the serum metabolome and their potential implications in determining the individual clinical outcome. Nineteen patients undergoing RHRT at the dose of 50 Gy in 25 fractions were enrolled. Serum targeted metabolomics profiles were investigated at baseline and the end of radiotherapy by liquid chromatography and tandem mass spectrometry. Univariate and multivariate OPLS-DA analyses were applied to study the serum metabolomics changes induced by RHRT while PLS regression analysis to evaluate the association between such changes and overall survival. RHRT was found to affect almost all investigated metabolites classes, in particular, the amino acids citrulline and taurine, the C14, C18:1 and C18:2 acyl-carnitines as well as the unsaturated long chain phosphatidylcholines PC ae 42:5, PC ae 44:5 and PC ae 44:6 were significantly decreased. The enrichment analysis showed arginine metabolism and the polyamine biosynthesis as the most perturbed pathways. Moreover, specific metabolic changes encompassing the amino acids and acyl-carnitines resulted in association with the clinical outcome accounting for about 60% of the interpatients overall survival variability. This study highlighted that RHRT can induce profound systemic metabolic effects some of which may have a significant prognostic value. The integration of metabolomics in the clinical assessment of the malignant pleural mesothelioma could be useful to better identify the patients who can achieve the best benefit from the RHRT treatment.
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Affiliation(s)
- Emanuela Di Gregorio
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (E.D.G.); (A.S.); (E.M.); (M.C.); (A.S.)
| | - Gianmaria Miolo
- Medical Oncology and Cancer Prevention Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy;
| | - Asia Saorin
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (E.D.G.); (A.S.); (E.M.); (M.C.); (A.S.)
| | - Elena Muraro
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (E.D.G.); (A.S.); (E.M.); (M.C.); (A.S.)
| | - Michela Cangemi
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (E.D.G.); (A.S.); (E.M.); (M.C.); (A.S.)
| | - Alberto Revelant
- Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (A.R.); (E.M.)
| | - Emilio Minatel
- Radiation Oncology Department, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (A.R.); (E.M.)
| | - Marco Trovò
- Radiation Oncology Department, Azienda Sanitaria Integrata, 33100 Udine, Italy;
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (E.D.G.); (A.S.); (E.M.); (M.C.); (A.S.)
| | - Giuseppe Corona
- Immunopathology and Cancer Biomarkers Unit, Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, 33081 Aviano, Italy; (E.D.G.); (A.S.); (E.M.); (M.C.); (A.S.)
- Correspondence: ; Tel.: +39-0434-659-666
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40
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Rossini M, Martini F, Torreggiani E, Fortini F, Aquila G, Sega FVD, Patergnani S, Pinton P, Maniscalco P, Cavallesco G, Rizzo P, Tognon M. Metformin Induces Apoptosis and Inhibits Notch1 in Malignant Pleural Mesothelioma Cells. Front Cell Dev Biol 2021; 8:534499. [PMID: 33537296 PMCID: PMC7849608 DOI: 10.3389/fcell.2020.534499] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive asbestos-related cancer arising from the mesothelial cells lining the pleural cavity. MPM is characterized by a silent clinical progression and a highly resistance to conventional chemo/radio-therapies. MPM patients die in a few months/years from diagnosis. Notch signaling is a well-conserved cell communication system, which regulates many biological processes. In humans, the dysregulation of Notch pathway potentially contributes to cancer onset/progression, including MPM. Metformin is the first-line drug used to treat type 2 diabetes mellitus. Metformin is proven to be an effective antitumor drug in preclinical models of different types of cancer. To date, clinical efficacy is being studied in many clinical trials. In this study, the anti-proliferative effect of metformin on MPM cells and the putative involvement of Notch1 as a mediator of metformin activities, were investigated. MPM cells showed high levels of Notch1 activation compared to normal pleural mesothelial cells. Furthermore, metformin treatment hampered MPM cell proliferation and enhanced the apoptotic process, accompanied by decreased Notch1 activation.
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Affiliation(s)
- Marika Rossini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Fernanda Martini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Laboratory for Technology of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Elena Torreggiani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Francesca Fortini
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giorgio Aquila
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | | | - Simone Patergnani
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Laboratory for Technology of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Paolo Pinton
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy.,Laboratory for Technology of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy
| | - Pio Maniscalco
- Surgery Unit, Sant'Anna University Hospital, Ferrara, Italy
| | | | - Paola Rizzo
- Laboratory for Technology of Advanced Therapies (LTTA), University of Ferrara, Ferrara, Italy.,Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy
| | - Mauro Tognon
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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41
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Barbieri PG, Somigliana A, Chen Y, Consonni D, Vignola R, Finotto L. Lung Asbestos Fibre Burden and Pleural Mesothelioma in Women with Non-occupational Exposure. Ann Work Expo Health 2021; 64:297-310. [PMID: 32065212 DOI: 10.1093/annweh/wxaa009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/16/2019] [Accepted: 01/23/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) due to environmental and familial (domestic) asbestos exposure is well recognized. However, information on cumulative asbestos dose in subjects affected by MPM is limited. OBJECTIVES To evaluate the residual lung asbestos fibre and asbestos body burden in women with MPM with past environmental and/or familial asbestos exposure. METHODS We collected lung samples from autopsies regarding 15 non-occupationally asbestos-exposed MPM cases, divided in three groups: (i) familial exposure from the Fincantieri shipyards in Monfalcone (No. 7), (ii) environmental and familial asbestos exposure from the asbestos-cement plant Fibronit in Broni (No. 6), and (iii) environmental exposure from the Fibronit plant (No. 2). Asbestos body (AB) and fibres (AF) per gram of dry lung tissue were counted by optical and scanning electron microscopy, respectively, and expressed as geometric means and standard deviations (GM, GSD). RESULTS GM/GSD of AB counts were 6123/9.6 (Group 1), 13 800/10.4 (Group 2), and 8400/1.1 (Group 3); GM/GSD of AF were 0.6/2.1 (Group 1), 7.9/2.1 (Group 2), and 6.0/2.3 (Group 3) million. Pleural plaques were observed in 12 cases. CONCLUSIONS Exclusive familial exposure to asbestos determined cumulative doses close to those observed in moderate occupational exposure circumstances. Our results also suggest that combined environmental and familial exposures may cause unexpectedly high cumulative fibre doses.
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Affiliation(s)
- Pietro Gino Barbieri
- Formerly Mesothelioma Registry, Occupational Health Unit, Local Health Authority, Brescia, Italy
| | - Anna Somigliana
- Centre of Electronic Microscopy, Lombardy Environmental Protection Agency (ARPA), Milan, Italy
| | - Yao Chen
- Public Health Department, Forensic Medical Unit, University of Pavia, Pavia, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Vignola
- Occupational Health Unit, Local Health Authority, Broni (PV), Italy
| | - Luigi Finotto
- Occupational Health Unit, Local Health Authority, Monfalcone (GO), Italy
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Granieri A, Bonafede M, Marinaccio A, Iavarone I, Marsili D, Franzoi IG. SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions? Front Psychol 2020; 11:584320. [PMID: 33414743 PMCID: PMC7782241 DOI: 10.3389/fpsyg.2020.584320] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/20/2020] [Indexed: 12/11/2022] Open
Abstract
Since its emergence, the novel coronavirus disease of 2019 (COVID-19) has had enormous physical, social, and psychological impacts worldwide. The aim of this article was to identify elements of our knowledge on asbestos exposure and malignant mesothelioma (MM) that can provide insight into the psychological impact of the COVID-19 pandemic and be used to develop adequate interventions. Although the etiology of Covid-19 and MM differs, their psychological impacts have common characteristics: in both diseases, there is a feeling of being exposed through aerial contagion to an "invisible killer" without boundaries that can strike even the strongest individuals. In both cases, affected persons can experience personality dysfunction, anxiety, depression, and posttraumatic symptoms; helplessness, hopelessness, and projection of destructive thoughts onto external forces often emerge, while defense mechanisms such as denial, splitting, repression, and reduced emotional expression are used by individuals to contain their overwhelming anxieties. We believe that in both diseases, an integrated multidimensional intervention offered by hospitals and other public health services is the most effective approach to alleviating patients' and caregivers' psychological distress. In particular, we emphasize that in the context of both MM and COVID-19, Brief Psychoanalytic Group therapy can help patients and caregivers attribute meaning to the significant changes in their lives related to the experience of the disease and identify adaptive strategies and more realistic relational modalities to deal with what has happened to them. We also highlight the importance of developing a surveillance system that includes individual anamnestic evaluation of occupational risk factors for COVID-19 disease.
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Affiliation(s)
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Ivano Iavarone
- Environmental and Social Epidemiology Unit, Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
| | - Daniela Marsili
- Environmental and Social Epidemiology Unit, Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy
- WHO Collaborating Centre for Environmental Health in Contaminated Sites, Rome, Italy
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Catelan D, Consonni D, Biggeri A, Dallari B, Pesatori AC, Riboldi L, Mensi C. Estimate of environmental and occupational components in the spatial distribution of malignant mesothelioma incidence in Lombardy (Italy). ENVIRONMENTAL RESEARCH 2020; 188:109691. [PMID: 32526494 DOI: 10.1016/j.envres.2020.109691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Measuring and mapping the occurrence of malignant mesothelioma (MM) is a useful means to monitor the impact of past asbestos exposure and possibly identify previously unknown sources of asbestos exposure. OBJECTIVE Our goal is to decompose the observed spatial pattern of incidence of MM in the Lombardy region (Italy) in gender-specific components linked to occupational exposure and a shared component linked to environmental exposure. MATERIALS AND METHODS We selected from the Lombardy Region Mesothelioma Registry (RML) all incident cases of MM (pleura, peritoneum, pericardium, and tunica vaginalis testis) with first diagnosis in the period 2000-2016. We mapped at municipality level crude incidence rates and smoothed rates using the Besag York and Mollié model separately for men and women. We then decomposed the spatial pattern of MM in gender-specific occupational components and a shared environmental component using a multivariate hierarchical Bayesian model. RESULTS We globally analyzed 6226 MM cases, 4048 (2897 classified as occupational asbestos exposure at interview) in men and 2178 (780 classified as occupational asbestos exposure at interview) in women. The geographical analysis showed a strong spatial pattern in the distribution of incidence rates in both genders. The multivariate hierarchical Bayesian model decomposed the spatial pattern in occupational and environmental components and consistently identified some known occupational and environmental hot spots. Other areas at high risk for MM occurrence were highlighted, contributing to better characterize environmental exposures from industrial sources and suggesting a role of natural sources in the Alpine region. CONCLUSION The spatial pattern highlights areas at higher risk which are characterized by the presence of industrial sources - asbestos-cement, metallurgic, engineering, textile industries - and of natural sources in the Alpine region. The multivariate hierarchical Bayesian model was able to disentangle the geographical distribution of MM cases in two components interpreted as occupational and environmental.
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Affiliation(s)
- Dolores Catelan
- Department of Statistics Computer Science Applications "G. Parenti", University of Florence, Florence, Italy.
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Annibale Biggeri
- Department of Statistics Computer Science Applications "G. Parenti", University of Florence, Florence, Italy
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela C Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
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Torres-Roman JS, Gomez-Rubio V, Sanchez-Trujillo L, Delgado-Rosas E, Puche-Vergara F, Sanz-Anquela JM, Ortega MA. Geographic study of mortality due to mesothelioma in Peru and its evolution. Cancer Epidemiol 2020; 68:101791. [PMID: 32823056 DOI: 10.1016/j.canep.2020.101791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Peru has a public health problem because of asbestos imports. We analyzed the mortality trends for mesothelioma in Peru and its provinces from 2005 to 2014 and estimated their relationship with the amount of asbestos imported previously. METHODS We computed age-standardized mortality rates (ASMRs) per 100,000 population (direct method and SEGI world standard population reference), and the standardized mortality ratio (SMR). The relationship between the amount of asbestos imported annually along the period 1965-2010 and the number of mesothelioma deaths per year from 2005 to 2014 was estimated by log-linear Poisson regression models and Pearson correlation calculations. RESULTS After correcting the number of deaths, Peru registered 428 cases (or 430 when corrected cases are rounded by sex) between 2005 and 2014. The highest ASMRs were in Arequipa and Callao (range: 0.40-0.41/100,000 population), followed by Huancavelica (0.36/100,000 population). This translates into approximately one death per each 68-111 of asbestos tons imported. The latency period for the higher level of positive correlation found was 8 years (r = 0.8). Male female sex ratio was lower in provinces such as Junin and Hunacavelica with geological asbestos risk. CONCLUSIONS Two patterns of mesothelioma risk have been detected, occupational and environmental. During the 2002-2006 years, Peru increased the asbestos use. If crocidolite imports were also increased, this could be behind the 8 years latency period detected. Peru should boost strategies towards the total ban of all forms of asbestos.
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Affiliation(s)
- J Smith Torres-Roman
- Universidad Católica Los Ángeles de Chimbote, Instituto de Investigación, Chimbote, Peru; Maestria en Epidemiología y Bioestadistica, Universidad Cientifica del Sur, Lima, Peru
| | | | - Lara Sanchez-Trujillo
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Alcalá de Henares, Madrid, Spain
| | | | | | - Jose Miguel Sanz-Anquela
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Alcalá de Henares, Madrid, Spain
| | - Miguel Angel Ortega
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Alcalá de Henares, Madrid, Spain; Ramón y Cajal Institute of Healthcare Research (IRYCIS), Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Alcalá de Henares, Madrid, Spain.
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Dragani TA. Difficulties in establishing a causal link between chemical exposures and cancer cannot be overcome by court assessments. Hum Exp Toxicol 2020; 39:1095-1107. [PMID: 32153198 DOI: 10.1177/0960327120911426] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Scientific data are often used in lawsuits to prove, or dismiss, causation by a claimed factor of a claimed disease. Recent media reports of million-dollar compensations awarded to some cancer patients who had been exposed to certain chemical substances motivated me to examine how solid the causal links really were. Here, I discuss the limitations of epidemiological research on cancer causation and highlight how new knowledge of cancer genetics makes it unrealistic to expect that cancer causation can be clearly demonstrated. I then present two exposure-cancer cases, namely talcum powder-ovarian cancer and glyphosate-non-Hodgkin lymphoma, that led to civil lawsuits decided, in the United States, in favor of the claimants. Both these cancers have several risk factors, among which the claimed exposure presents only a minor, if any, increased risk. Through these cases, I explain why the use of epidemiological data is inappropriate to define causal associations in complex diseases like cancer. I close by suggesting a fairer approach, called proportional liability, to resolving future cancer litigation cases.
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Affiliation(s)
- T A Dragani
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Abstract
BACKGROUND Pleural Mesothelioma (PM) is an unusual, belligerent tumor that rapidly develops into cancer in the pleura of the lungs. Pleural Mesothelioma is a common type of Mesothelioma that accounts for about 75% of all Mesothelioma diagnosed yearly in the U.S. Diagnosis of Mesothelioma takes several months and is expensive. Given the risk and constraints associated with PM diagnosis, early identification of this ailment is essential for patient health. OBJECTIVE In this study, we use artificial intelligence algorithms recommending the best fit model for early diagnosis and prognosis of Malignant Pleural Mesothelioma (MPM). METHODS We retrospectively retrieved patients' clinical data collected by Dicle University, Turkey and applied multilayered perceptron (MLP), voted perceptron (VP), Clojure classifier (CC), kernel logistic regression (KLR), stochastic gradient decent (SGD), adaptive boosting (AdaBoost), Hoeffding tree (VFDT), and primal estimated sub-gradient solver for support vector machine (s-Pegasos). We evaluated the models, compared and tested them using paired t-test (corrected) at 0.05 significance based on their respective classification accuracy, f-measure, precision, recall, root mean squared error, receivers' characteristic curve (ROC), and precision-recall curve (PRC). RESULTS In phase 1, SGD, AdaBoost.M1, KLR, MLP, VFDT generate optimal results with the highest possible performance measures. In phase 2, AdaBoost, with a classification accuracy of 71.29%, outperformed all other algorithms. C-reactive protein, platelet count, duration of symptoms, gender, and pleural protein were found to be the most relevant predictors that can prognosticate Mesothelioma. CONCLUSION This study confirms that data obtained from biopsy and imaging tests are strong predictors of Mesothelioma but are associated with a high cost; however, they can identify Mesothelioma with optimal accuracy.
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La Maestra S, Micale RT, Ferretti M, Izzotti A, Gaggero L. Attenuation of oxidative stress and chromosomal aberrations in cultured macrophages and pulmonary cells following self-sustained high temperature synthesis of asbestos. Sci Rep 2020; 10:8581. [PMID: 32444646 PMCID: PMC7244567 DOI: 10.1038/s41598-020-65620-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/28/2020] [Indexed: 01/06/2023] Open
Abstract
Inhalation of asbestos fibres can cause lung and pleural diseases in humans and constitutes a severe public health threat worldwide. The aim of the present study was to assess the biological effects induced in both pulmonary cells (A549) and monocyte/macrophage (RAW 264.7) cell lines by combustion slags obtained from asbestos through a self-sustained high-temperature synthesis (SHS) reaction. The SHS reaction involves rapid thermal treatment and displays great ability to neutralise asbestos. Cytotoxicity, redox status imbalance, lipid peroxide production, DNA strand breaks (comet assay) and chromosomal aberrations (cytokinesis block micronucleus test) were evaluated in cells exposed either to untreated asbestos fibres or to grinded SHS-generated slags of different granulometry, tested in cultured cells at varying doses and for varying exposure times. Our results show that asbestos fibres cause redox status imbalance, especially in monocyte/macrophage cell lines. Moreover, they promote lipid peroxidation and trigger genomic alterations. When the cells were exposed to slag powders, which are the products of SHS asbestos treatment, generation of lipid peroxides and induction of DNA strand breaks still persisted, due to the high content in iron and other metals detected in these samples. However, there was an attenuation of redox status imbalance and an absence of chromosomal aberrations, which probably reflects the loss of the asbestos fibrous structure following SHS reaction, as demonstrated by electron microscopy analyses. In conclusions, SHS-treated asbestos wastes can potentially have deleterious health effects due to the oxidative stress induced by inhaled powders but they loose the asbestos ability to induce chromosomal alterations.
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Affiliation(s)
- Sebastiano La Maestra
- Department of Health Sciences, University of Genoa, via A. Pastore, 1, 16132, Genoa, Italy.
| | - Rosanna T Micale
- Department of Health Sciences, University of Genoa, via A. Pastore, 1, 16132, Genoa, Italy
| | - Maurizio Ferretti
- Department of Chemistry and Industrial Chemistry, University of Genoa, Via Dodecaneso 31, 16146, Genoa, Italy
| | - Alberto Izzotti
- Department of Health Sciences, University of Genoa, via A. Pastore, 1, 16132, Genoa, Italy
- Mutagenesis and Cancer Prevention Unit, IRCCS Ospedale Policlinico San Martino, Largo R. Benzi, 10, 16132, Genoa, Italy
| | - Laura Gaggero
- Department of Earth, Environment and Life Sciences, University of Genoa, Corso Europa 26, 16132, Genoa, Italy
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van Zandwijk N, Reid G, Frank AL. Asbestos-related cancers: the 'Hidden Killer' remains a global threat. Expert Rev Anticancer Ther 2020; 20:271-278. [PMID: 32223452 DOI: 10.1080/14737140.2020.1745067] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Asbestos, the most frequent cause of occupational cancer, continues to be consumed on a massive scale, with millions of people exposed on a daily basis. This review explains why we have failed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestos victims are likely to remain high. Emerging and developed countries have to be reminded that asbestos exposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by the surge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking and stimulated by manufacturers.Areas covered: Underreporting of malignant mesothelioma and asbestos-induced lung cancer, frequently-used arguments in the amphibole/chrysotile debate and the conclusion from bona-fide research organizations, that all forms of asbestos are carcinogenic, are reviewed. Special attention is paid to the consequences of ubiquitous environmental asbestos and the 'changing face' of malignant mesothelioma in countries with heavy asbestos use in the past.Expert opinion: Experts in oncology, respiratory medicine, occupational and public health, and basic researchers must take responsibility and acknowledge the ongoing silent epidemic of asbestos-related diseases. The call for a world-wide asbestos ban is more urgent than ever.
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Affiliation(s)
- Nico van Zandwijk
- Concord (Sydney) Medical School, University of Sydney, Concord Repatriation General Hospital, Concord, Australia
| | - Glen Reid
- Department of Pathology, University of Otago, Dunedin, New Zealand
| | - Arthur L Frank
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Singh R, Cherrie JW, Rao B, Asolekar SR. Assessment of the future mesothelioma disease burden from past exposure to asbestos in ship recycling yards in India. Int J Hyg Environ Health 2020; 225:113478. [PMID: 32050148 DOI: 10.1016/j.ijheh.2020.113478] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/31/2020] [Accepted: 01/31/2020] [Indexed: 12/12/2022]
Abstract
The recycling of end-of-life vessels is a complex activity that generates an enormous amount of hazardous waste, including asbestos-containing materials (ACM). Efforts by the Government of India to comply with national and international regulations and improved standard operating procedures are expected to lower the exposure risk of the workforce to hazardous substances, including asbestos. The current workers are likely to face lesser risks than did those exposed in the past. The present study assesses the health risks from past exposure of asbestos for those workers engaged in handling and removing ACM in ship recycling yards before environmentally sound recycling of obsolete ships was introduced in the early 2000s. Estimates were made of the number of workers exposed, and the intensity of exposure and these data were used to estimate the likely number of mesothelioma deaths in the future. It was estimated that nearly 15% of the total workforce engaged in ship recycling will suffer from mesothelioma which translates to about 4,513 mesothelioma deaths among the total of 31,000 workers estimated to be ever employed in the yards from 1994 till 2002. Recommendations are made for a practical approach to the safe handling of ACMs in Indian ship recycling yards.
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Affiliation(s)
- Richa Singh
- Environmental Science and Engineering Department, Indian Institute of Technology Bombay, Mumbai, 400076, India
| | - John W Cherrie
- Heriot Watt University, Institute of Biological Chemistry, Biophysics and Bioengineering, Edinburgh, EH14 4AS, UK; Institute of Occupational Medicine, Research Avenue North, Edinburgh, EH14 4AP, UK.
| | - Bakul Rao
- Centre for Technology Alternatives for Rural Areas, Indian Institute of Technology Bombay, Mumbai 400 076, India
| | - Shyam R Asolekar
- Environmental Science and Engineering Department, Indian Institute of Technology Bombay, Mumbai, 400076, India
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50
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Alpert N, van Gerwen M, Taioli E. Epidemiology of mesothelioma in the 21 st century in Europe and the United States, 40 years after restricted/banned asbestos use. Transl Lung Cancer Res 2020; 9:S28-S38. [PMID: 32206568 PMCID: PMC7082259 DOI: 10.21037/tlcr.2019.11.11] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research has established a strong association between asbestos exposure and malignant mesothelioma, a deadly form of cancer. Since the early 1980’s many countries have restricted or banned the production of asbestos, leading to a decline of occupational asbestos exposure in many industrialized countries. However, some countries continue to use asbestos, and worldwide rates of mesothelioma are still increasing. Because of the long latency between exposure and mesothelioma occurrence and the persistence of environmental exposure, incidence rates (IR) may decrease very slowly for several years ahead. In this review, we examine estimates of asbestos consumption before widespread asbestos regulations and the trends in incidence and mortality rates, as well as changes over time for the United States and Europe. In some countries with earlier asbestos restrictions, mesothelioma incidence has been in a modest decline over time. However, asbestos exposure is still a burden worldwide and legislative action is needed to obtain a full ban. The pattern of mesothelioma is shifting from a mostly male disease to a disease that affects females as well in substantial numbers. Studies on unknown sources of asbestos exposure, of other sources of natural exposure to asbestos and asbestos-like fibers, as well as of individual genetic susceptibility to asbestos fibers are needed.
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Affiliation(s)
- Naomi Alpert
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Maaike van Gerwen
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Department of Thoracic Surgery, 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
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