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Groot Lipman KB, Boellaard TN, de Gooijer CJ, Bogveradze N, Hong EK, Landolfi F, Castagnoli F, Vakhidova N, Smesseim I, van der Heijden F, Beets-Tan RG, Wittenberg R, Bodalal Z, Burgers JA, Trebeschi S. Artificial Intelligence-based Quantification of Pleural Plaque Volume and Association With Lung Function in Asbestos-exposed Patients. J Thorac Imaging 2024; 39:165-172. [PMID: 37905941 PMCID: PMC11027965 DOI: 10.1097/rti.0000000000000759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
PURPOSE Pleural plaques (PPs) are morphologic manifestations of long-term asbestos exposure. The relationship between PP and lung function is not well understood, whereas the time-consuming nature of PP delineation to obtain volume impedes research. To automate the laborious task of delineation, we aimed to develop automatic artificial intelligence (AI)-driven segmentation of PP. Moreover, we aimed to explore the relationship between pleural plaque volume (PPV) and pulmonary function tests. MATERIALS AND METHODS Radiologists manually delineated PPs retrospectively in computed tomography (CT) images of patients with occupational exposure to asbestos (May 2014 to November 2019). We trained an AI model with a no-new-UNet architecture. The Dice Similarity Coefficient quantified the overlap between AI and radiologists. The Spearman correlation coefficient ( r ) was used for the correlation between PPV and pulmonary function test metrics. When recorded, these were vital capacity (VC), forced vital capacity (FVC), and diffusing capacity for carbon monoxide (DLCO). RESULTS We trained the AI system on 422 CT scans in 5 folds, each time with a different fold (n = 84 to 85) as a test set. On these independent test sets combined, the correlation between the predicted volumes and the ground truth was r = 0.90, and the median overlap was 0.71 Dice Similarity Coefficient. We found weak to moderate correlations with PPV for VC (n = 80, r = -0.40) and FVC (n = 82, r = -0.38), but no correlation for DLCO (n = 84, r = -0.09). When the cohort was split on the median PPV, we observed statistically significantly lower VC ( P = 0.001) and FVC ( P = 0.04) values for the higher PPV patients, but not for DLCO ( P = 0.19). CONCLUSION We successfully developed an AI algorithm to automatically segment PP in CT images to enable fast volume extraction. Moreover, we have observed that PPV is associated with loss in VC and FVC.
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Affiliation(s)
- Kevin B.W. Groot Lipman
- Department of Radiology
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam
- Technical Medicine, University of Twente, Enschede
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
| | | | | | - Nino Bogveradze
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
- Academic Pridon Todua Medical Center, Research Institute of Clinical Medicine, Tbilisi, GA
| | - Eun Kyoung Hong
- Department of Radiology
- Seoul National University Hospital, Seoul, South Korea
| | - Federica Landolfi
- Department of Radiology
- Radiology Unit, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Francesca Castagnoli
- Department of Radiology
- Department of Radiology, University of Brescia, Brescia, IT
- Department of Radiology, Royal Marsden Hospital, London, UK
- Division of Radiotherapy and Imaging, The Institute of Cancer Research, London, UK
| | | | - Illaa Smesseim
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam
| | - Ferdi van der Heijden
- Department of Robotics and Mechatronics, University of Twente, Enschede, The Netherlands
| | - Regina G.H. Beets-Tan
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
- Faculty of Health Sciences, University of Southern Denmark, Odense, DK
| | | | - Zuhir Bodalal
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
| | - Jacobus A. Burgers
- Department of Thoracic Oncology, Netherlands Cancer Institute, Amsterdam
| | - Stefano Trebeschi
- Department of Radiology
- GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht
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Eduardo A, SANTANA Vilma S, Felipe C, Leonardo S, SAITO Cézar A, Franciana C, CORREA-FILHO Heleno R. ANALYSIS OF MORTALITY FROM ASBESTOS-RELATED DISEASES IN BRAZIL USING MULTIPLE HEALTH INFORMATION SYSTEMS, 1996-2017. Saf Health Work 2022; 13:302-307. [PMID: 36156859 PMCID: PMC9482009 DOI: 10.1016/j.shaw.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/12/2022] [Accepted: 04/29/2022] [Indexed: 11/03/2022] Open
Abstract
Background Methods Results Conclusions
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Benlala I, De Senneville BD, Dournes G, Menant M, Gramond C, Thaon I, Clin B, Brochard P, Gislard A, Andujar P, Chammings S, Gallet J, Lacourt A, Delva F, Paris C, Ferretti G, Pairon JC, Laurent F. Deep Learning for the Automatic Quantification of Pleural Plaques in Asbestos-Exposed Subjects. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031417. [PMID: 35162440 PMCID: PMC8835296 DOI: 10.3390/ijerph19031417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/22/2022] [Accepted: 01/23/2022] [Indexed: 12/10/2022]
Abstract
Objective: This study aimed to develop and validate an automated artificial intelligence (AI)-driven quantification of pleural plaques in a population of retired workers previously occupationally exposed to asbestos. Methods: CT scans of former workers previously occupationally exposed to asbestos who participated in the multicenter APEXS (Asbestos PostExposure Survey) study were collected retrospectively between 2010 and 2017 during the second and the third rounds of the survey. A hundred and forty-one participants with pleural plaques identified by expert radiologists at the 2nd and the 3rd CT screenings were included. Maximum Intensity Projection (MIP) with 5 mm thickness was used to reduce the number of CT slices for manual delineation. A Deep Learning AI algorithm using 2D-convolutional neural networks was trained with 8280 images from 138 CT scans of 69 participants for the semantic labeling of Pleural Plaques (PP). In all, 2160 CT images from 36 CT scans of 18 participants were used for AI testing versus ground-truth labels (GT). The clinical validity of the method was evaluated longitudinally in 54 participants with pleural plaques. Results: The concordance correlation coefficient (CCC) between AI-driven and GT was almost perfect (>0.98) for the volume extent of both PP and calcified PP. The 2D pixel similarity overlap of AI versus GT was good (DICE = 0.63) for PP, whether they were calcified or not, and very good (DICE = 0.82) for calcified PP. A longitudinal comparison of the volumetric extent of PP showed a significant increase in PP volumes (p < 0.001) between the 2nd and the 3rd CT screenings with an average delay of 5 years. Conclusions: AI allows a fully automated volumetric quantification of pleural plaques showing volumetric progression of PP over a five-year period. The reproducible PP volume evaluation may enable further investigations for the comprehension of the unclear relationships between pleural plaques and both respiratory function and occurrence of thoracic malignancy.
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Affiliation(s)
- Ilyes Benlala
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
- Correspondence:
| | - Baudouin Denis De Senneville
- Mathematical Institute of Bordeaux (IMB), CNRS, INRIA, Bordeaux INP, UMR 5251, Université de Bordeaux, 33400 Talence, France;
| | - Gael Dournes
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
| | - Morgane Menant
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Celine Gramond
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Isabelle Thaon
- Centre de Consultation de Pathologies Professionnelles, CHRU de Nancy, Université de Lorraine, 54000 Nancy, France;
| | - Bénédicte Clin
- Service de Santé au Travail et Pathologie Professionnelle, CHU Caen, 14000 Caen, France;
- Faculté de Médecine, Université de Caen, 14000 Caen, France
| | - Patrick Brochard
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service de Médecine du Travail et de Pathologies Professionnelles, CHU de Bordeaux, 33000 Bordeaux, France
| | - Antoine Gislard
- Faculté de Médecine, Normandie Université, UNIROUEN, UNICAEN, ABTE, 76000 Rouen, France;
- Centre de Consultations de Pathologie Professionnelle, CHU de Rouen, CEDEX, 76031 Rouen, France
| | - Pascal Andujar
- Equipe GEIC20, INSERM U955, 94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, 94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, 94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - Soizick Chammings
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - Justine Gallet
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Aude Lacourt
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Fleur Delva
- Epicene Team, Bordeaux Population Health Research Center, INSERM UMR 1219, Université de Bordeaux, 33000 Bordeaux, France; (M.M.); (C.G.); (J.G.); (A.L.); (F.D.)
| | - Christophe Paris
- Service de Santé au Travail et Pathologie Professionnelle, CHU Rennes, 35000 Rennes, France;
- Institut de Recherche en Santé, Environnement et Travail, INSERM U1085, 35000 Rennes, France
| | - Gilbert Ferretti
- INSERM U 1209 IAB, 38700 La Tronche, France;
- Domaine de la Merci, Faculté de Médecine, Université Grenoble Alpes, 38706 La Tronche, France
- Service de Radiologie Diagnostique et Interventionnelle Nord, CHU Grenoble Alpes, CS 10217, 38043 Grenoble, France
| | - Jean-Claude Pairon
- Equipe GEIC20, INSERM U955, 94000 Créteil, France; (P.A.); (J.-C.P.)
- Faculté de Santé, Université Paris-Est Créteil, 94000 Créteil, France
- Service de Pathologies Professionnelles et de l’Environnement, Centre Hospitalier Intercommunal Créteil, Institut Santé-Travail Paris-Est, 94000 Créteil, France
- Institut Interuniversitaire de Médecine du Travail de Paris-Ile de France, 94000 Créteil, France;
| | - François Laurent
- Faculté de Médecine, Université de Bordeaux, 33000 Bordeaux, France; (G.D.); (P.B.); (F.L.)
- Service d’Imagerie Médicale Radiologie Diagnostique et Thérapeutique, CHU de Bordeaux, 33000 Bordeaux, France
- Centre de Recherche Cardio-Thoracique de Bordeaux, INSERM U1045, Université de Bordeaux, 33000 Bordeaux, France
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Musso V, Diotti C, Palleschi A, Tosi D, Aiolfi A, Mendogni P. Management of Pleural Effusion Secondary to Malignant Mesothelioma. J Clin Med 2021; 10:jcm10184247. [PMID: 34575358 PMCID: PMC8468347 DOI: 10.3390/jcm10184247] [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: 07/25/2021] [Revised: 09/09/2021] [Accepted: 09/14/2021] [Indexed: 11/16/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a highly aggressive pleural tumour which has been epidemiologically linked to occupational exposure to asbestos. MPM is often associated with pleural effusion, which is a common cause of morbidity and whose management remains a clinical challenge. In this review, we analysed the literature regarding the diagnosis and therapeutic options of pleural effusion secondary to mesothelioma. Our aim was to provide a comprehensive view on this subject, and a new algorithm was proposed as a practical aid to clinicians dealing with patients suffering from pleural effusion.
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Affiliation(s)
- Valeria Musso
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.M.); (C.D.); (A.P.); (D.T.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Cristina Diotti
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.M.); (C.D.); (A.P.); (D.T.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Alessandro Palleschi
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.M.); (C.D.); (A.P.); (D.T.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Davide Tosi
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.M.); (C.D.); (A.P.); (D.T.)
| | - Alberto Aiolfi
- Department of Biomedical Science for Health, University of Milan, 20133 Milan, Italy;
- Division of General Surgery, Istituto Clinico Sant’Ambrogio, 20149 Milan, Italy
| | - Paolo Mendogni
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (V.M.); (C.D.); (A.P.); (D.T.)
- Correspondence:
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Santana VS, Salvi L, Cavalcante F, Campos F, Algranti E. Underreporting of mesothelioma, asbestosis and pleural plaques in Brazil. Occup Med (Lond) 2021; 71:223-230. [PMID: 34291807 DOI: 10.1093/occmed/kqab073] [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] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Brazil has a long history of heavy asbestos consumption. However, the number of asbestos-related diseases (ARDs) falls far below the one expected compared with other asbestos consumer countries. AIMS To examine underreporting of ARDs, that is mesothelioma, asbestosis and pleural plaques, in Brazil's Mortality Information System (SIM). METHODS Health information systems (HIS) were mapped, datasets retrieved and records of ARD deaths extracted. Records were pair-matched using anonymous linkage to create a single database. ARD-reported cases missing in SIM were considered unreported. The study's period ranged from 2008 to 2014, when every HIS contributed to the ARD records pool. RESULTS A total of 1298 registered ARD deaths were found, 996 cases of mesothelioma (77%) and 302 (23%) of asbestosis and pleural plaques. SIM was the major single data source of ARD but 335 mesothelioma deaths were missing, an average underreporting of 33%, with no clear time trend. For asbestosis and pleural plaques, underreporting of ARD oscillated from 55% in 2010 to 25% in 2014, a declining trend. ARD underreporting was not associated with sex or age. CONCLUSIONS One-third of underreported ARD deaths in the universal SIM is unacceptably high and, apparently, it has not been improving substantially over time. After recoveries from multiple databases, the number of cases is still below, which could be expected based on asbestos consumption. Interoperability of multiple information systems could enhance case detection and improve the precision of mortality estimates, which are crucial for surveillance and for evaluation of remedial policies.
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Affiliation(s)
- V S Santana
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - L Salvi
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - F Cavalcante
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
| | - F Campos
- Institute of Collective Health, Federal University of Bahia, Salvador, Brazil
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Opitz I, Scherpereel A, Berghmans T, Psallidas I, Glatzer M, Rigau D, Astoul P, Bölükbas S, Boyd J, Coolen J, De Bondt C, De Ruysscher D, Durieux V, Faivre-Finn C, Fennell DA, Galateau-Salle F, Greillier L, Hoda MA, Klepetko W, Lacourt A, McElnay P, Maskell NA, Mutti L, Pairon JC, Van Schil P, van Meerbeeck JP, Waller D, Weder W, Putora PM, Cardillo G. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur J Cardiothorac Surg 2021; 58:1-24. [PMID: 32448904 DOI: 10.1093/ejcts/ezaa158] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force brought together experts to update previous 2009 ERS/ESTS guidelines on management of malignant pleural mesothelioma (MPM), a rare cancer with globally poor outcome, after a systematic review of the 2009-2018 literature. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach. The evidence syntheses were discussed and recommendations formulated by this multidisciplinary group of experts. Diagnosis: pleural biopsies remain the gold standard to confirm the diagnosis, usually obtained by thoracoscopy but occasionally via image-guided percutaneous needle biopsy in cases of pleural symphysis or poor performance status. Pathology: standard staining procedures are insufficient in ∼10% of cases, justifying the use of specific markers, including BAP-1 and CDKN2A (p16) for the separation of atypical mesothelial proliferation from MPM. Staging: in the absence of a uniform, robust and validated staging system, we advise using the most recent 2016 8th TNM (tumour, node, metastasis) classification, with an algorithm for pretherapeutic assessment. Monitoring: patient's performance status, histological subtype and tumour volume are the main prognostic factors of clinical importance in routine MPM management. Other potential parameters should be recorded at baseline and reported in clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM patients and only selected patients are candidates for radical surgery. New promising targeted therapies, immunotherapies and strategies have been reviewed. Because of limited data on the best combination treatment, we emphasize that patients who are considered candidates for a multimodal approach, including radical surgery, should be treated as part of clinical trials in MPM-dedicated centres.
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Affiliation(s)
- Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Arnaud Scherpereel
- Department of Pulmonary and Thoracic Oncology, French National Network of Clinical Expert Centers for Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France.,Department of Pulmonary and Thoracic Oncology, University Lille, CHU Lille, INSERM U1189, OncoThAI, Lille, France
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Markus Glatzer
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Philippe Astoul
- Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Servet Bölükbas
- Department of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen, Germany
| | | | - Johan Coolen
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte De Bondt
- Department of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Dirk De Ruysscher
- Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center+, GROW Research Institute, Maastricht, Netherlands
| | - Valerie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Corinne Faivre-Finn
- The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Dean A Fennell
- Leicester Cancer Research Centre, University of Leicester and University of Leicester Hospitals NHS Trust, Leicester, UK
| | - Francoise Galateau-Salle
- Department of Biopathology, National Reference Center for Pleural Malignant Mesothelioma and Rare Peritoneal Tumors MESOPATH, Centre Leon Berard, Lyon, France
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Inserm UMR1068, CNRS UMR7258, Marseille, France
| | - Mir Ali Hoda
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Walter Klepetko
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Aude Lacourt
- University Bordeaux, INSERM, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Bordeaux, France
| | | | - Nick A Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luciano Mutti
- Teaching Hospital Vercelli/Gruppo Italiano, Vercelli, Italy
| | - Jean-Claude Pairon
- INSERM U955, GEIC2O, Université Paris-Est Créteil, Service de Pathologies professionnelles et de l'Environnement, Institut Santé -Travail Paris-Est, CHI Créteil, Créteil, France
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Jan P van Meerbeeck
- Department of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - David Waller
- Barts Thorax Centre, St Bartholomew's Hospital, London, UK
| | - Walter Weder
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.,Department of Radiation Oncology, University of Bern, Bern, Switzerland
| | - Giuseppe Cardillo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
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The role of polymorphisms in glutathione-related genes in asbestos-related diseases. Radiol Oncol 2021; 55:179-186. [PMID: 33544514 PMCID: PMC8042823 DOI: 10.2478/raon-2021-0002] [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: 11/09/2020] [Accepted: 12/02/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The study investigated the influence of GCLC, GCLM, GSTM1, GSTT1 and GSTP1 polymorphisms, as well as the influence of interactions between polymorphism and interactions between polymorphisms and asbestos exposure, on the risk of developing pleural plaques, asbestosis and malignant mesothelioma (MM). SUBJECTS AND METHODS The cross sectional study included 940 asbestos-exposed subjects, among them 390 subjects with pleural plaques, 147 subjects with asbestosis, 225 subjects with MM and 178 subjects with no asbestos-related disease. GCLC rs17883901, GCLM rs41303970, GSTM1 null, GSTT1 null, GSTP1 rs1695 and GSTP1 rs1138272 genotypes were determined using PCR based methods. In statistical analysis, logistic regression was used. RESULTS GSTT1 null genotype was associated with the decreased risk for pleural plaques (OR = 0.63; 95% CI = 0.40-0.98; p = 0.026) and asbestosis (OR = 0.51; 95% CI = 0.28-0.93; p = 0.028), but not for MM. A positive association was found between GSTP1 rs1695 AG + GG vs. AA genotypes for MM when compared to pleural plaques (OR = 1.39; 95% CI = 1.00-1.94; p = 0.049). The interactions between different polymorphisms showed no significant influence on the risk of investigated asbestos-related diseases. The interaction between GSTT1 null polymorphism and asbestos exposure decreased the MM risk (OR = 0.17; 95% CI = 0.03-0.85; p = 0.031). CONCLUSIONS Our findings suggest that GSTT1 null genotype may be associated with a decreased risk for pleural plaques and asbestosis, may modify the association between asbestos exposure and MM and may consequently act protectively on MM risk. This study also revealed a protective effect of the interaction between GSTP1 rs1695 polymorphism and asbestos exposure on MM risk.
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Bartkowiak K, Casjens S, Andreas A, Ačkar L, Joosse SA, Raiko I, Brüning T, Geffken M, Peine S, Johnen G, Weber DG, Pantel K. Sensitive Blood-Based Detection of Asbestos-Associated Diseases Using Cysteine-Rich Angiogenic Inducer 61 as Circulating Protein Biomarker. Clin Chem 2020; 67:363-373. [PMID: 33336248 DOI: 10.1093/clinchem/hvaa232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Detection of asbestos-associated diseases like asbestosis or mesothelioma is still challenging. We sought to improve the diagnosis of benign asbestos-associated disease (BAAD) by detection of the protein cysteine-rich angiogenic inducer 61 (Cyr61) in human plasma. METHODS Plasma Cyr61 was quantified using an enzyme-linked immunosorbent assay. Plasma samples from males diagnosed with BAAD, but without a malignant disease (n = 101), and malignant mesothelioma (n = 21; 15 males, 6 females), as well as nonasbestos-exposed healthy control participants (n = 150; 58 males, 92 females) were analyzed. Clinical sensitivity and specificity of Cyr61 were determined by receiver operating characteristic analysis. RESULTS The median plasma Cyr61 concentration for healthy control participants was 0.27 ng/mL. Cytoplasmic Cyr61 in peripheral blood mononuclear cells from healthy control participants was evenly distributed, as detected by immunofluorescent staining. The increase in plasma Cyr61 concentrations in the BAAD study group was statistically significant compared to the healthy control participants (P < 0.0001). For the detection of BAAD vs male healthy control participants, clinical sensitivity was 88% and clinical specificity 95% with an area under the curve of 0.924 at maximal Youden Index. For a predefined clinical specificity of 100%, the clinical sensitivity was 76%. For male mesothelioma patients vs male healthy control participants, the clinical sensitivity at maximal Youden Index was 95% with a clinical specificity of 100% (area under the curve, 0.997) and for a predefined clinical specificity of 100%, the clinical sensitivity was 93%. CONCLUSIONS In our study, plasma Cyr61 protein concentrations showed to be a new biomarker for asbestos-associated diseases like BAAD and mesothelioma in men, which deserves further investigation in large-scale cohort studies.
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Affiliation(s)
- Kai Bartkowiak
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Swaantje Casjens
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Antje Andreas
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lucija Ačkar
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon A Joosse
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Irina Raiko
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Maria Geffken
- Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sven Peine
- Department of Transfusion Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Georg Johnen
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Daniel Gilbert Weber
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Klaus Pantel
- Department of Tumor Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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9
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The influence of genetic variability in IL1B and MIR146A on the risk of pleural plaques and malignant mesothelioma. Radiol Oncol 2020; 54:429-436. [PMID: 33085641 PMCID: PMC7585336 DOI: 10.2478/raon-2020-0057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 08/06/2020] [Indexed: 02/07/2023] Open
Abstract
Background Asbestos exposure is associated with the development of pleural plaques as well as malignant mesothelioma (MM). Asbestos fibres activate macrophages, leading to the release of inflammatory mediators including interleukin 1 beta (IL-1β). The expression of IL-1β may be influenced by genetic variability of IL1B gene or regulatory microRNAs (miRNAs). This study investigated the effect of polymorphisms in IL1B and MIR146A genes on the risk of developing pleural plaques and MM. Subjects and methods In total, 394 patients with pleural plaques, 277 patients with MM, and 175 healthy control subjects were genotyped for IL1B and MIR146A polymorphisms. Logistic regression was used in statistical analysis. Results We found no association between MIR146A and IL1B genotypes, and the risk of pleural plaques. MIR146A rs2910164 was significantly associated with a decreased risk of MM (OR = 0.31, 95% CI = 0.13–0.73, p = 0.008). Carriers of two polymorphic alleles had a lower risk of developing MM, even after adjustment for gender and age (OR = 0.34, 95% CI = 0.14–0.85, p = 0.020). Among patients with known asbestos exposure, carriers of at least one polymorphic IL1B rs1143623 allele also had a lower risk of MM in multivariable analysis (OR = 0.50, 95% CI = 0.28–0.92, p = 0.025). The interaction between IL1B rs1143623 and IL1B rs1071676 was significantly associated with an increased risk of MM (p = 0.050). Conclusions Our findings suggest that genetic variability of inflammatory mediator IL-1β could contribute to the risk of developing MM, but not pleural plaques.
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10
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Gelzinis TA. The 2019 ERS/ESTS/EACTS/ESTRO Guidelines on the Management of Patients With Malignant Pleural Mesothelioma. J Cardiothorac Vasc Anesth 2020; 35:378-388. [PMID: 32798169 DOI: 10.1053/j.jvca.2020.07.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/03/2020] [Indexed: 02/07/2023]
Abstract
Malignant pleural mesothelioma is a rare aggressive cancer, with insidious growth, and is associated with poor outcomes that have not improved over the years. A task force made up of members of the European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) societies, who are experts in the field of malignant mesothelioma, reviewed the literature from 2009 to 2018 to update the 2009 guidelines concerning epidemiology, diagnosis, staging, and treatment, including surgical, radiotherapy, and medical management, as well as palliative care to provide the best evidence-based recommendations for this patient population.
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11
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Scherpereel A, Opitz I, Berghmans T, Psallidas I, Glatzer M, Rigau D, Astoul P, Bölükbas S, Boyd J, Coolen J, De Bondt C, De Ruysscher D, Durieux V, Faivre-Finn C, Fennell D, Galateau-Salle F, Greillier L, Hoda MA, Klepetko W, Lacourt A, McElnay P, Maskell NA, Mutti L, Pairon JC, Van Schil P, van Meerbeeck JP, Waller D, Weder W, Cardillo G, Putora PM. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur Respir J 2020; 55:13993003.00953-2019. [PMID: 32451346 DOI: 10.1183/13993003.00953-2019] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/17/2019] [Indexed: 12/23/2022]
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force brought together experts to update previous 2009 ERS/ESTS guidelines on management of malignant pleural mesothelioma (MPM), a rare cancer with globally poor outcome, after a systematic review of the 2009-2018 literature. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach. The evidence syntheses were discussed and recommendations formulated by this multidisciplinary group of experts. Diagnosis: pleural biopsies remain the gold standard to confirm the diagnosis, usually obtained by thoracoscopy but occasionally via image-guided percutaneous needle biopsy in cases of pleural symphysis or poor performance status. Pathology: standard staining procedures are insufficient in ∼10% of cases, justifying the use of specific markers, including BAP-1 and CDKN2A (p16) for the separation of atypical mesothelial proliferation from MPM. Staging: in the absence of a uniform, robust and validated staging system, we advise using the most recent 2016 8th TNM (tumour, node, metastasis) classification, with an algorithm for pre-therapeutic assessment. Monitoring: patient's performance status, histological subtype and tumour volume are the main prognostic factors of clinical importance in routine MPM management. Other potential parameters should be recorded at baseline and reported in clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM patients and only selected patients are candidates for radical surgery. New promising targeted therapies, immunotherapies and strategies have been reviewed. Because of limited data on the best combination treatment, we emphasise that patients who are considered candidates for a multimodal approach, including radical surgery, should be treated as part of clinical trials in MPM-dedicated centres.
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Affiliation(s)
- Arnaud Scherpereel
- Pulmonary and Thoracic Oncology, Univ. Lille, CHU Lille, INSERM U1189, OncoThAI, Lille, France .,French National Network of Clinical Expert Centers for Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France
| | - Isabelle Opitz
- Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Markus Glatzer
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Philippe Astoul
- Dept of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Servet Bölükbas
- Dept of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen, Germany
| | | | - Johan Coolen
- Dept of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte De Bondt
- Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Dirk De Ruysscher
- Dept of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center+, GROW Research Institute, Maastricht, The Netherlands
| | - Valerie Durieux
- Bibliothèque des Sciences de la Santé, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Corinne Faivre-Finn
- The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Dean Fennell
- Leicester Cancer Research Centre, University of Leicester and University of Leicester Hospitals NHS Trust, Leicester, UK
| | - Francoise Galateau-Salle
- National Reference Center for Pleural Malignant Mesothelioma and Rare Peritoneal Tumors MESOPATH, Dept of Biopathology, Centre Leon Berard, Lyon, France
| | - Laurent Greillier
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Inserm UMR1068, CNRS UMR7258, Dept of Multidisciplinary Oncology and Therapeutic Innovations, Marseille, France
| | - Mir Ali Hoda
- Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Walter Klepetko
- Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Aude Lacourt
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, Bordeaux, France
| | | | - Nick A Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luciano Mutti
- Teaching Hosp. Vercelli/Gruppo Italiano Mesotelioma, Italy
| | - Jean-Claude Pairon
- INSERM U955, Equipe 4, Université Paris-Est Créteil, and Service de Pathologies professionnelles et de l'Environnement, Institut Santé-Travail Paris-Est, CHI Créteil, Créteil, France
| | - Paul Van Schil
- Dept Thoracic and Vascular Surgery, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Jan P van Meerbeeck
- Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - David Waller
- Barts Thorax Centre, St Bartholomew's Hospital, London, UK
| | - Walter Weder
- Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giuseppe Cardillo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Paul Martin Putora
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland.,Dept of Radiation Oncology, University of Bern, Bern, Switzerland
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12
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NLRP3 and CARD8 polymorphisms influence risk for asbestos-related diseases. J Med Biochem 2020; 39:91-99. [PMID: 32549782 DOI: 10.2478/jomb-2019-0025] [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: 03/20/2019] [Accepted: 04/26/2019] [Indexed: 11/21/2022] Open
Abstract
Background This study aimed to investigate the association between NLRP3 rs35829419 and CARD8 rs2043211 polymorphisms and the risk of developing pleural plaques, asbestosis, and malignant mesothelioma (MM), and to study the influence of the interactions between polymorphisms and asbestos exposure on the risk of developing these diseases. Methods The case-control study included 416 subjects with pleural plaques, 160 patients with asbestosis, 154 subjects with MM and 149 subjects with no asbestos disease. The NLRP3 rs35829419 and CARD8 rs2043211 polymorphisms were determined using real-time PCR-based methods. In the statistical analysis, standard descriptive statistics was followed by univariate and multivariate logistic regression modelling. Results Asbestos exposure (medium and high vs low) was associated with the risk for each studied asbestos-related disease. An increased risk of pleural plaques was found for CARD8 rs2043211 at + TT genotypes (OR = 1.48, 95% CI 1.01-2.16, p = 0.042). When the analysis was performed for MM patients as cases, and pleural plaques patients as controls, a decreased MM risk was observed for carriers of CARD8 rs2043211 TT genotype (OR = 0.52, 95% CI 0.27-1.00, p = 0.049). The interactions between NLRP3 rs35829419 and CARD8 rs2043211 genotypes did not influence the risk of any asbestos-related disease. However, when testing interactions with asbestos exposure, a decreased risk of asbestosis was found for NLRP3 CA+AA genotypes (OR = 0.09, 95% CI 0.01-0.60, p = 0.014). Conclusions The results of our study suggest that NLRP3 and CARD8 polymorphisms could affect the risk of asbestos-related diseases.
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13
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Poland CA, Duffin R. The toxicology of chrysotile-containing brake debris: implications for mesothelioma. Crit Rev Toxicol 2019; 49:11-35. [DOI: 10.1080/10408444.2019.1568385] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Craig A. Poland
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Institute of Occupational Medicine, Edinburgh, UK
| | - Rodger Duffin
- Centre for Inflammation Research, Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
- Concept Life Sciences, Dundee, UK
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14
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Maisonneuve P, Rampinelli C, Bertolotti R, Misotti A, Lococo F, Casiraghi M, Spaggiari L, Bellomi M, Novellis P, Solinas M, Dieci E, Alloisio M, Fontana L, Persechino B, Iavicoli S, Veronesi G. Low-dose computed tomography screening for lung cancer in people with workplace exposure to asbestos. Lung Cancer 2019; 131:23-30. [PMID: 31027694 DOI: 10.1016/j.lungcan.2019.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 02/15/2019] [Accepted: 03/05/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Smoking is the main risk factor for lung cancer, but environmental and occupational exposure to carcinogens also increase lung cancer risk. We assessed whether extending low-dose computed tomography (LDCT) screening to persons with occupational exposure to asbestos may be an effective way reducing lung cancer mortality. MATERIALS AND METHODS We conducted a nested case-control study within the COSMOS screening program, assessing past asbestos exposure with a questionnaire. LDCT scans of asbestos-exposed participants were reviewed to assess the presence of pulmonary, interstitial and pleural alterations in comparison to matched unexposed controls. We also performed an exhaustive review, with meta-analysis, of the literature on LDCT screening in asbestos-exposed persons. RESULTS Exposure to asbestos, initially self-reported by 9.8% of COSMOS participants, was confirmed in 216 of 544 assessable cases, corresponding to 2.6% of the screened population. LDCT of asbestos-exposed persons had significantly more pleural plaques, diaphragmatic pleural thickening and pleural calcifications, but similar frequency of parenchymal and interstitial alterations to unexposed persons. From 16 papers, including this study, overall lung cancer detection rates at baseline were 0.81% (95% CI 0.50-1.19) in asbestos-exposed persons, 0.94% (95% CI 0.47-1.53) in asbestos-exposed smokers (12 studies), and 0.11% (95% CI 0.00-0.43) in asbestos-exposed non-smokers (9 studies). CONCLUSION Persons occupationally exposed to asbestos should be monitored to gather more information about risks. Although LDCT screening is effective in the early detection lung cancer in asbestos-exposed smokers, our data suggest that screening of asbestos-exposed persons with no additional risk factors for cancer does is not viable due to the low detection rate.
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Affiliation(s)
- Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, Milan, Italy.
| | - Cristiano Rampinelli
- Department of Medical Imaging and Radiation Sciences, IEO, European Institute of Oncology IRCSS, Milan, Italy
| | - Raffaella Bertolotti
- Division of Thoracic Surgery, Data Management, IEO, European Institute of Oncology IRCSS, Milan, Italy
| | - Alessandro Misotti
- Dietetics and Clinical Nutrition, Hospital of Melegnano, ASST Melegnano-Martesana, Milan, Italy
| | - Filippo Lococo
- Department of Thoracic Surgery, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Monica Casiraghi
- Division of Thoracic Surgery, European Institute of Oncology IRCSS, Milan, Italy
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, European Institute of Oncology IRCSS, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Massimo Bellomi
- Department of Medical Imaging and Radiation Sciences, IEO, European Institute of Oncology IRCSS, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Pierluigi Novellis
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Michela Solinas
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Elisa Dieci
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
| | - Marco Alloisio
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy; Department of Biomedical Science, Humanitas University, Rozzano, Milan, Italy
| | - Luca Fontana
- Italian National Insurance Institute for Workplace Injuries (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Benedetta Persechino
- Italian National Insurance Institute for Workplace Injuries (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Sergio Iavicoli
- Italian National Insurance Institute for Workplace Injuries (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Giulia Veronesi
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Rozzano, Milan, Italy
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15
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Hassan M, Tsikrika S, Asciak R, Mercer RM, El-Ganady A, Rahman NM. Computed tomography abnormalities antedating mesothelioma diagnosis: a perspective on the natural history. Eur Respir J 2019; 53:13993003.00935-2018. [PMID: 30442717 DOI: 10.1183/13993003.00935-2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 11/02/2018] [Indexed: 11/05/2022]
Affiliation(s)
- Maged Hassan
- Oxford Pleural Unit, Oxford University Hospitals, Oxford, UK.,Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.,Chest Diseases Dept, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Stamatoula Tsikrika
- Pulmonary Division, Dept of Critical Care, Medical School, National and Kapodistrian University of Athens, Evangelismos General Hospital, Athens, Greece
| | - Rachelle Asciak
- Oxford Pleural Unit, Oxford University Hospitals, Oxford, UK.,Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
| | - Rachel M Mercer
- Oxford Pleural Unit, Oxford University Hospitals, Oxford, UK.,Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK
| | - Anwar El-Ganady
- Chest Diseases Dept, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Najib M Rahman
- Oxford Pleural Unit, Oxford University Hospitals, Oxford, UK.,Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.,Oxford NIHR Biomedical Research Centre, Oxford, UK
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16
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Utell MJ, Maxim L. Refractory ceramic fibers: Fiber characteristics, potential health effects and clinical observations. Toxicol Appl Pharmacol 2018; 361:113-117. [DOI: 10.1016/j.taap.2018.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 06/05/2018] [Accepted: 06/12/2018] [Indexed: 11/26/2022]
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17
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Maxim LD, Utell MJ. Review of refractory ceramic fiber (RCF) toxicity, epidemiology and occupational exposure. Inhal Toxicol 2018; 30:49-71. [PMID: 29564943 DOI: 10.1080/08958378.2018.1448019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This literature review on refractory ceramic fibers (RCF) summarizes relevant information on manufacturing, processing, applications, occupational exposure, toxicology and epidemiology studies. Rodent toxicology studies conducted in the 1980s showed that RCF caused fibrosis, lung cancer and mesothelioma. Interpretation of these studies was difficult for various reasons (e.g. overload in chronic inhalation bioassays), but spurred the development of a comprehensive product stewardship program under EPA and later OSHA oversight. Epidemiology studies (both morbidity and mortality) were undertaken to learn more about possible health effects resulting from occupational exposure. No chronic animal bioassay studies on RCF have been conducted since the 1980s. The results of the ongoing epidemiology studies confirm that occupational exposure to RCF is associated with the development of pleural plaques and minor decrements in lung function, but no interstitial fibrosis or incremental lung cancer. Evidence supporting a finding that urinary tumors are associated with RCF exposure remains, but is weaker. One reported, but unconfirmed, mesothelioma was found in an individual with prior occupational asbestos exposure. An elevated SMR for leukemia was found, but was absent in the highly exposed group and has not been observed in studies of other mineral fibers. The industry will continue the product stewardship program including the mortality study.
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Affiliation(s)
- L Daniel Maxim
- a Everest Consulting Associates , West Windsor , NJ , USA
| | - Mark J Utell
- b University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
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18
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Tamura A, Funakoshi M, J-P NA, Hasegawa K, Ishimine A, Koike A, Tannai N, Fujii M, Hattori M, Hirano H, Nakamura K, Funakoshi M, Satomi K, Yamashita Y, Fukuchi Y, Suganuma N. Potential asbestos exposure among patients with primary lung cancer in Japan. J Occup Health 2018; 60:236-245. [PMID: 29563365 PMCID: PMC5985347 DOI: 10.1539/joh.2017-0199-oa] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: To investigate the extent of asbestos exposure among patients with primary lung cancer in Japan. Methods: A retrospective estimation of potential asbestos-exposed individuals, as determined by the presence of pleural plaques identified on chest computed tomography (CT), was conducted on 885 pathologically confirmed primary lung cancer patients (mean age 71.3 years, 641 males). All patients were diagnosed at 29 hospitals across Japan between 2006 and 2007. Since these hospitals belong to the Japan Federation of Democratic Medical Institutions (MIN-IREN), an organization of medical institutions for workers, the study subjects may contain a higher proportion of workers than the general population. Results: Pleural plaques were identified in 12.8% of subjects (15.8% in males and 4.9% in females), consisting exclusively of cases older than 50 years. They were found most frequently on the chest wall pleura (96.5%), followed by the diaphragm (23.9%) and mediastinum (9.7%). Calcifications were seen in 47 cases (41.6%). The highest prevalence of pleural plaques was seen among workers from construction-related fields (37.7%). No distinct lung cancer histology was observed in patients with pleural plaques. Coexistence of pleural plaques and small irregular opacities was observed in 2.5% of subjects. Conclusion: In a Japanese population representing more workers than general Japanese, 12.8% of patients with primary lung cancer may have experienced asbestos exposure at some time in the past. Special medical attention should be paid to individuals with a history of employment in construction-related occupations, as workers in this sector showed the highest prevalence of pleural plaques.
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Affiliation(s)
- Akihiko Tamura
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kyushu Institute for Social Medicine
| | - Mitsuhiko Funakoshi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kyushu Institute for Social Medicine
| | - Naw Awn J-P
- Department of Environmental Medicine, Kochi Medical School, Kochi University
| | - Kichinori Hasegawa
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Chiba Kensei Hospital
| | - Atsushi Ishimine
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kin-ikyo Chuo Hospital
| | - Akio Koike
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Saitama Cooperative Hospital
| | - Noriyuki Tannai
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Tachikawa Sogo Hospital
| | - Masami Fujii
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Shiba Hospital
| | - Makoto Hattori
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Jouhoku Hospital
| | - Harukazu Hirano
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Koyo Seikyo Hospital
| | - Kenji Nakamura
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Osaka Institute of Social Medicine
| | - Masanobu Funakoshi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Shioe Clinic
| | - Kazuhiko Satomi
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Mizushima Kyodo Hospital
| | - Yoshihito Yamashita
- Japan Federation of Democratic Medical Institutions Multicenter Asbestos Study Group.,Kokubu Seikyo Hospital
| | | | - Narufumi Suganuma
- Department of Environmental Medicine, Kochi Medical School, Kochi University
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19
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Incidental and Underreported Pleural Plaques at Chest CT: Do Not Miss Them-Asbestos Exposure Still Exists. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6797826. [PMID: 28656146 PMCID: PMC5474542 DOI: 10.1155/2017/6797826] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 04/10/2017] [Indexed: 11/22/2022]
Abstract
Pleural plaques (PPs) may be a risk factor for mortality from lung cancer in asbestos-exposed workers and are considered to be a marker of exposure. Diagnosing PPs is also important because asbestos-exposed patients should be offered a health surveillance that is mandatory in many countries. On the other hand PPs are useful for compensation purposes. In this study we aimed to evaluate the prevalence, as incidental findings, and the underreporting rate of PPs in chest CT scans (CTs) performed in a cohort of patients (1512) who underwent chest CT with a slice thickness no more than 1.25 mm. PPs were found in 76 out of 1482 patients (5.1%); in 13 out of 76 (17,1%) CTs were performed because of clinical suspicion of asbestos exposure and 5 of them (38%) were underreported by radiologist. In the remaining 63 cases (82.9%) there was no clinical suspicion of asbestos exposure at the time of CTs (incidental findings) and in 38 of these 63 patients (60.3%) PPs were underreported. Reaching a correct diagnosis of PPs requires a good knowledge of normal locoregional anatomy and rigorous technical approach in chest CT execution. However the job history of the patient should always be kept in mind.
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20
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Ledda C, Costa C, Matera S, Puglisi B, Costanzo V, Bracci M, Fenga C, Rapisarda V, Loreto C. Immunomodulatory effects in workers exposed to naturally occurring asbestos fibers. Mol Med Rep 2017; 15:3372-3378. [PMID: 28339042 DOI: 10.3892/mmr.2017.6384] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 02/21/2017] [Indexed: 11/06/2022] Open
Abstract
Natural asbestiform fibers are defined 'naturally occurring asbestos' (NOA) and refer to the mineral as a natural component of soils or rocks. The release of NOA fibers into the air from rocks or soils by routine human activities or natural weathering processes represents a risk for human beings. Fluoro-edenite (FE) is a NOA fiber detected in the benmoreitic lava in the area of Biancavilla, South-west slope of Mt. Etna. The aim of the present study was to investigate FE immunotoxicity pathways in a group of 38 occupationally exposed construction workers, in order to find any biological markers of its effect. Subjects underwent respiratory function tests and HRCT total chest scanning. Serum IL-1β, IL-6, IL-8 and TNF-α were measured. The presence of PPs was significantly greater in subjects exposed than in the control (25 vs. 2). In subjects exposed to FE, IL-1β and TNF-α values were significantly higher than the controls. The previously observed increase of IL-1β and IL-18 showed a probable involvement of the proteic complex defined inflammosome by FE fibers.
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Affiliation(s)
- Caterina Ledda
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Chiara Costa
- Section of Occupational Medicine, Department of Biomedical, Odontoiatric, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Serena Matera
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Beatrice Puglisi
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Valentina Costanzo
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Massimo Bracci
- Section of Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Concettina Fenga
- Section of Occupational Medicine, Department of Biomedical, Odontoiatric, Morphological and Functional Images, University of Messina, Messina, Italy
| | - Venerando Rapisarda
- Section of Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Carla Loreto
- Section of Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
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Dodge DG, Beck BD. Historical state of knowledge of the health risks of asbestos posed to seamen on merchant ships. Inhal Toxicol 2016; 28:637-657. [DOI: 10.1080/08958378.2016.1244228] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Comment on “Exposure-response modeling of non-cancer effects in humans exposed to Libby Amphibole Asbestos; update” by Benson et al. (2015). Regul Toxicol Pharmacol 2016; 80:268-9. [DOI: 10.1016/j.yrtph.2016.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Revised: 03/01/2016] [Accepted: 05/11/2016] [Indexed: 11/17/2022]
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Ledda C, Pomara C, Bracci M, Mangano D, Ricceri V, Musumeci A, Ferrante M, Musumeci G, Loreto C, Fenga C, Santarelli L, Rapisarda V. Natural carcinogenic fiber and pleural plaques assessment in a general population: A cross-sectional study. ENVIRONMENTAL RESEARCH 2016; 150:23-29. [PMID: 27236568 DOI: 10.1016/j.envres.2016.05.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 05/09/2016] [Accepted: 05/17/2016] [Indexed: 06/05/2023]
Abstract
Natural carcinogenic fibers are asbestos and asbestiform fibers present as a natural component of soils or rocks. These fibers are released into the environment resulting in exposure of the general population. Environmental contamination by fibers are those cases occurred in: rural regions of Turkey, in Mediterranean countries and in other sites of the world, including northern Europe, USA and China. Fluoro-edenite(FE) is a natural mineral species first isolated in Biancavilla, Sicily. The fibers are similar in size and morphology to some amphibolic asbestos fibers, whose inhalation can cause chronic inflammation and cancer. The aim of the current study is to assess the presence and features of pleural plaques (PPs) in Biancavilla's general population exposed to FE through a retrospective cross-sectional study. All High-Resolution Computed Tomography (HRCT) chest scans carried out between June 2009 and June 2015 in Biancavilla municipality hospital site (exposed subjects) were reviewed. The exposed groups were 1:1 subjects, matched according to age and sex distributions, with unexposed subjects (n.1.240) randomly selected among HRCT chest scans carried out in a Hospital 30km away from Biancavilla. Subjects from Biancavilla with PPs were significantly more numerous than the control group ones (218 vs 38). Average age of either group was >60 years; the age of exposed subjects was significantly (p=0.0312) lesser than the unexposed group. In exposed subjects, in most PPs thickness ranged between 2 and 4.9cm(38%, n=83); while in unexposed ones PPs thickness was less than 2cm (55%, n=21). As to the size of PPs in exposed subjects, in most cases it ranged between 1cm and 24% of chest wall (53%, n=116); while in unexposed ones the size of PPs was lesser than 1cm (23%, n=58). Among exposed subjects, 36 cases (17%) PPs were detected with calcification, whereas in unexposed ones only three (8%) presented calcification. 137 lung parenchymal abnormalities were observed in exposed group; whereas, 12 lung parenchymal involvement were registered in unexposed subjects. The RR for PPs is 6,74 CI 95% (4,47-9,58) p<0,0001 in the exposed population. These findings, suggested the urge to extend the screening on the possible involvement of the respiratory tract to all Biancavilla's population, particularly in those aged more than 30. Besides, it seems essential to start indoor monitoring Biancavilla's municipality.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy.
| | - Cristoforo Pomara
- Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy; Department of Anatomy, School of Medicine, University of Malta, Msida, Malta
| | - Massimo Bracci
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Dario Mangano
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Vincenzo Ricceri
- Division of Radiology - Hospital of Biancavilla "Maria SS. Addolorata", ASP Catania, Biancavilla, Italy
| | - Andrea Musumeci
- Division of Radiology - University Hospital "Policlinico - Vittorio Emanuele", University of Catania, Catania, Italy
| | - Margherita Ferrante
- Hygiene and Public Health, Department Medical Sciences, Surgical and Advanced Technologies "GF Ingrassia", University of Catania, Catania, Italy
| | - Giuseppe Musumeci
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Carla Loreto
- Human Anatomy and Histology, Department of Biomedical and Biotechnology Sciences, University of Catania, Catania, Italy
| | - Concettina Fenga
- Occupational Medicine, Department of the Environment, Safety, Territory, Food and Health Sciences, University of Messina, Messina, Italy
| | - Lory Santarelli
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Nuyts V, Vanhooren H, Begyn S, Nackaerts K, Nemery B. Asbestos bodies in bronchoalveolar lavage in the 21st century: a time-trend analysis in a clinical population. Occup Environ Med 2016; 74:59-65. [PMID: 27550908 DOI: 10.1136/oemed-2016-103710] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/22/2016] [Accepted: 08/02/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Asbestos bodies (AB) in bronchoalveolar lavage (BAL) can be detected by light microscopy and their concentration is indicative of past cumulative asbestos exposure. We assessed clinical and exposure characteristics, as well as possible time trends, among patients in whom AB had been quantified in BAL. METHODS BAL samples obtained from 578 participants between January 1997 and December 2014 were available for analysis. The processing of samples and the microscopic analysis were performed by a single expert and 76% of samples came from a single tertiary care hospital, allowing clinical and exposure data to be extracted from patient files. RESULTS The study population (95% males) had a mean age of 62.5 (±12.4) years. AB were detected in 55.2% of the samples, giving a median concentration of 0.5 AB/mL (95th centile: 23.6 AB/mL; highest value: 164.5 AB/mL). The AB concentration exceeded 1 AB/mL in 39.4% and 5 AB/mL in 17.8%. A significant decrease from a geometric mean of 0.93 AB/mL in 1997 to 0.2 AB/mL in 2014 was apparent. High AB concentrations generally corresponded with occupations with (presumed) high asbestos exposure. AB concentrations were higher among patients with asbestosis and pleural plaques, when compared with other disease groups. Nevertheless, a substantial proportion of participants with likely exposure to asbestos did not exhibit high AB counts. CONCLUSIONS This retrospective study of a large clinical population supports the value of counting AB in BAL as a complementary approach to assess past exposure to asbestos.
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Affiliation(s)
- Valerie Nuyts
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Hadewijch Vanhooren
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Sarah Begyn
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium
| | - Kristiaan Nackaerts
- Department of Respiratory Diseases, University Hospitals Leuven, University of Leuven, Leuven, Belgium
| | - Benoit Nemery
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Leuven, Belgium.,Department of Respiratory Diseases, University Hospitals Leuven, University of Leuven, Leuven, Belgium
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