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PubMedDate not supplied

[Mortality study of asbestos cement workers in Emilia-Romagna].

OBJECTIVE: The present study updates to 06/30/1998 the cohort mortality study of 3358 workers employed in 10 asbestos cement production plants in the Italian region Emilia-Romagna. PARTICIPANTS: The cohort includes 2712 males and 646 females. RESULTS: Overall mortality was significantly increased (SMR=131, IC95%:108-127). Excess mortality has been observed for all malignant neoplasms (SMR=131, IC95%: 115-149, 250 observed) and for respiratory diseases (SMR=153, IC: 105-216, 32 observed), 3 deaths due to asbestosis. Mortality for all respiratory tract neoplasms (SMR=179, IC: 148-215, 114 observed), pulmonary cancer (SMR=157, IC: 126-192, 90 observed) and pleural cancer (SMR=1922, IC: 1139-3038, 18 observed) are significantly increased. DISCUSSION: This study confirms the previous cohort study observation of increased mortality for all causes, all neoplasm and cancer affecting lungs and pleura.

Asbestos↗
PubMed2005

[Wonder matter and assassin. The perception of the asbestos danger as a mirror of the time 1930-1990].

In the seventies and eighties of the twentieth century the ideas of the dangers concerning the use of asbestos changed dramatically. The mineral, which had, more than half a century before been introduced in the Netherlands as a miraculous mineral, was completely banned from use. Asbestos became known as a 'silent killer' and 'the blue sand of death', and as a symbol of the hidden hazards of a deteriorating environment caused by unscrupulous companies and indolent authorities. Asbestos seems to fit perfectly into the ubiquitous hazards which Ulrich Beck defines in his concept of the 'risk society' as the dangerous side effects of industrial production. Yet the perception of the risk associated with asbestos depended more on socio-cultural characteristics than on scientifically risk assessments. In the first half of the twentieth century the use of asbestos was limited and therefore did not cause any concern. Economic crisis and war silenced the first alarming signals of asbestos related disease from foreign experts and a handful of Dutch physicians. The asbestos workers themselves were held responsible for their own health and safety. In the 1951 asbestosis became recognised as an industrial disease. Preventive measures with regard to the industrial use of asbestos were prescribed by law. Workers shared the responsibilities for a safe use with employers and authorities. However, during this period, all the attention was directed towards economic growth. Supervision by the labour inspection was scarce and workers and employers were not very interested in upholding the safety measures. Among asbestos workers the use of protective clothes and dust masks was generally seen as unmanly. In the sixties the foreign literature on the connection between the exposure to asbestos and the occurrence of lung cancer and mesothelioma became known among Dutch specialists. The results of these studies were confirmed by research among Dutch insulation workers. At the same time the trade unions rejected the idea of a shared responsibility and formulated the unilateral 'right to a safe working environment', with the implication that, in their view, all unhealthy and unsafe procedures should unconditionally be banned from the workshops, including the use of asbestos. Concerned civilians, environmental lobbyists, progressive political parties and concerned scientists transformed this idea into a 'right to a safe living environment', while mass media spread the message. Asbestos was pointed out as a threat to the public health, tracked down all of its hiding places and ultimately removed. The ban on asbestos was one of the results of democratisation and emancipation movement of the late sixties and seventies. The emancipation expressed itself in an increasing intolerance to risks brought about by powerful companies and bureaucratic authorities.

Asbestos↗
PubMed1992

Asbestos and the histogenesis of lung carcinoma.

Individuals exposed to asbestos develop and die of bronchogenic carcinoma at rates well above individuals not exposed, but there is disagreement as to what factors other than the asbestos may be important in the histogenesis of the carcinoma. This report discusses the various theories as to how and why asbestos, cigarette smoke, asbestosis, and pleural disease may be involved in the development of the carcinoma. The authors conclude that other disease processes may mark individuals particularly likely to develop carcinoma of the lung, but that asbestos fibers have an independent role in the histogenesis of carcinoma of the lung.

Asbestos↗
PubMed2005

[Studies on insulin-like growth factor-I expression in human lower airways].

UNLABELLED: Antisense techniques that inhibit intracellular expression of insulin-like growth factor-I (IGF-I) were efficient in gene therapy of some tumor diseases. IGF-I in the airways is considered to induce lung fibrosis in interstitial lung diseases, inhibit apoptosis of epithelial cells and participate in local carcinogenesis. AIM OF THE STUDY: The aim of the study was--by examining the IGF-I expression in the lower airways--to evaluate preliminary the efficacy of anti-IGF-I antisense technicques in the treatment of airways diseases. MATERIAL AND METHODS: The IGF-I expression was examined in the reverse transcriptase--polimerase chain reaction (RT-PCR) applied to A549 human cell line, that is representative for lower airway epithelium and exemplifies the model of bronchioloalveolar adenocarcinoma. IGF-I expression in non-neoplastic lower airways cells was assessed by immunocytochemical staining (anti-IGF-I) in cytological materials originating from bronchoalveolar lavage (BAL) of sarcoidosis and asbestosis patients and in individuals free of lung pathology. RESULTS: The IGF-I expression was detected in A549 cells with use of RT-PCR method (3 independent probes). In BAL cytological specimens the appearance of IGF-I was found, mainly in alveolar macrophages (62 +/- 6, 5 in sarcoidosis vs. 36 +/- 6 in controls, p=0,09), as well as in BAL lymphocytes. CONCLUSIONS: Summing up, the antisense technicques, blocking the intracellular IGF-I expression may be potentially useful in treatment of selected lower airways, both tumor (non-small cell lung carcinoma) and non-tumor (ILD complicated with lung fibrosis) conditions.

Asbestosis↗
PubMed1991

[Pleural mesothelioma: etiology and practical consequences].

In the course of the past few decades there has been a heavy world-wide increase in the incidence of mesotheliomas among the industrialised nations. A characteristic feature of this is an extremely great difference in respect of the expected incidence of the tumour between persons who had been in contact--even though a long time back--with asbestos fibre dust, or who worked or resided near sources of asbestos emission, or who had contact with asbestos fibres in their household, on the one hand, and with the rest of the population on the other. Hence, pleuromesothelioma is not only a tumour signalling the risk brought about by the presence of asbestos or of zeolites in the environment, it is also so to say the environmental tumour par excellence. Among the members of those artisan professions where products containing asbestos are being employed, pleuromesotheliomas have been a far more frequent source of professionally conditioned cancer than among the workers of the asbestos industry proper. Since the latency period is as a rule 30 years, the physician must go back scrupulously 20 to 60 years in the patient's previous history to find out whether there had been an exposure to asbestos at any time that would induce tumour formation, the more so since a mere couple of weeks' exposure can be enough to induce a tumour so many years later. On account of the pleurotropy of inhaled asbestos fibres, pointers to an asbestosis of the lungs and/or pleura should be followed up on-target. Further practical consequences are discussed.

Asbestos↗
PubMed1991

[The effect of oral N-acetylcysteine on glutathione concentration in bronchoalveolar lavage of patients with fibrosing lung diseases].

Glutathione (GSH) is an important constituent in protecting the cellular elements within the lower respiratory tract against oxydants. We measured GSH in bronchoalveolar lavage fluid (BAL) in twelve patients with lung fibrosis and compared the data to eight healthy controls. GSH in BAL was 0.71 +/- 0.34 mumol/l in patients with lung fibrosis and 0.88 +/- 0.35 mumol/l in the controls (p greater than 0.05). After relating GSH on the volume of the epithelial lining fluid (ELF), determined by the urea method, GSH/ELF was 93 +/- 71 mumol/l in lung fibrosis and significantly different (p less than 0.005) from 387 +/- 240 mumol/l in the controls. In seven patients (four lung fibrosis, one desquamative pneumonitis, two asbestosis) GSH in BAL was determined before and after seven days of medication with 1800 mg N-acetylcysteine/day. We observed a significant increase of GSH in BAL from 0.93 +/- 0.46 to 1.56 +/- 0.92 mumol/l. Our observations confirm that in patients with lung fibrosis the protective ability against oxydants is diminished and that one parameter of the antioxydative capacity (GSH) can be increased in BAL by oral administration of N-acetylcysteine. Further studies are necessary to investigate the clinical and therapeutic implications of our findings.

Acetylcysteine↗
PubMedDate not supplied

Correlation between radiological and functional findings in workers exposed to chrysotile asbestos.

The relationship between the extent of respiratory disease from chest radiographs and the severity of functional impairment was assessed in 185 workers with long-term exposure to asbestos in an asbestos-cement factory. The workers were divided into seven subgroups according to functional abnormality findings (restrictive, obstructive, mixed restrictive-obstructive, reduced diffusion capacity, increased diffusion capacity, small airway disease and normal). Restrictive functional abnormality was present in 29% of the workers, obstructive and mixed in 3% small airway disease in 4%, reduced diffusion capacity in 4% increased diffusion capacity in 7%, while the remaining 49% were normal. The subjects with radiological diffuse pleural disease were characterized by FVC reduction, whereas in those with mixed pleural-parenchymal radiological abnormalities both FVC and DLCO were reduced. FVC and DLCO decrements correlated well with the increasing grades of profusion according to the ILO classification. In the group of workers with normal chest radiographs and normal spirometry, a decrease or increase in lung diffusion capacity for CO (DLCO) was an isolated finding. In addition, a correlation existed between the length of exposure and functional parameters (reduced FVC and DLCO, while FEV1/FVC increased with longer exposure). The study shows that reduced lung function indices can be found in subjects without radiological evidence for parenchymal asbestosis (ILO grade 1/1 profusion or greater). The results suggest that asbestos exposure, in addition to lung diffusion capacity decrease, can be accompanied by an increase in lung diffusion capacity.

Adult↗
PubMed1991

Computed tomography of asbestos-related pulmonary parenchymal and pleural diseases.

Computed tomography has acquired an increasingly central role in the evaluation of asbestos-exposed individuals. The advantages of increased contrast resolution and axial image display have extended our ability to interrogate areas of the pulmonary parenchyma and pleura that are inadequately seen on chest radiographs. The additional information to be gained from CT evaluation must be balanced by the additional expense and time required, particularly in view of the large numbers of asbestos-exposed individuals who will undergo screening over the coming decades. Ideally, imaging strategies that include CT should emphasize those problematic situations in which additional information will serve a differential or diagnostic function, alter the management or habits of the individuals, modify the working environment, or improve our understanding of asbestos-induced diseases. The chest radiograph is the mainstay in the imaging evaluation of asbestos-exposed individuals, providing an inexpensive and rapid appraisal of the presence of both focal and diffuse abnormalities of the pleura and lung parenchyma. Conventional (whole-thorax) CT may be an important adjunct in the following situations: (1) to clarify the presence of pleural thickening, particularly in distinguishing pleural disease from normal extrapleural soft tissues; (2) to stage and determine tumor extent in malignant pleural mesothelioma; (3) to identify optimal sites for biopsy of suspicious pleural changes; and (4) to detect and characterize lung cancers or other focal masses that may be obscured by extensive pleural or parenchymal fibrosis. Limited HRCT studies are roughly competitive in time and cost with four-view radiographic examinations. There is growing evidence that HRCT can detect interstitial disease in advance of conventional clinical or radiographic studies. However, the application of limited HRCT for large-scale screening is controversial. This issue will be resolved as we gain greater understanding of the specificity of HRCT and establish guidelines for standardizing the technique and image interpretation. At present, limited HRCT scans can supplement the evaluation of subjects in whom there is equivocal parenchymal or pleural disease on radiographs or unexplained abnormalities on pulmonary function tests. In individuals with significant pleural disease, HRCT can effectively define the presence and extent of interstitial fibrosis. In individuals with combined cigarette smoking-asbestos exposure in whom symptoms or functional abnormalities are present, HRCT may play a central role in distinguishing emphysematous lung destruction from the peripheral interstitial changes of asbestosis.

Asbestosis↗
PubMedDate not supplied

Asbestos bodies in fine needle aspirates of lung masses. Markers of underlying pathology.

Analysis of 52 transthoracic-mass aspirates that contained asbestos bodies (ABs) showed the mass to be due to pathology other than (or superimposed upon) asbestosis in every case. Malignancy accounted for 30 masses, all of which were carcinomas except for one mesothelioma. The remaining 22 lesions were benign, with tuberculosis or lung abscesses accounting for the majority. Fine needle aspiration (FNA) detection of the pathology (benign or malignant) associated with ABs was diminished, probably due to asbestos-induced fibrosis. Other diagnostic methods, including bronchial studies, mediastinoscopy and even exploratory thoracotomy, were required to document 20% of the neoplasms and 50% of the benign lesions. The results of this series support the view that ABs in FNA specimens from localized or dominant parenchymal lung masses are significant markers of underlying pathology, whether or not cellular evidence of that pathology is observed in the aspirated material.

Asbestosis↗
PubMed1991

Toxic substances in the environment affecting respiratory function of people in Hawaii.

In this trilogy we have collected data from authors who are concerned with patients with respiratory complaints. Surprisingly there are unique problems in the residents of our State. The full impact of problems known to cause respiratory illnesses, such as asbestosis, will not be known for years to come. Other problems such as the effect of sugarcane burning are just now being identified and may show a parallel to the inhalation of asbestos dust. VOG may be simply an irritant or it may explain in part the high incidence of asthma in our State. Clearly more work needs to be done to explain the pathophysiology, the risk and possible treatment for the consequences on people of these putative toxic substances.

Air Pollutants↗
PubMed1990

Asbestos bodies in pulmonary hilar lymph nodes.

Asbestos bodies (AB) have long been recognized in light microscopic (LM) sections of pulmonary hilar lymph nodes (LN) from patients with asbestos-related diseases, but the presence of AB on LM has not been correlated with the lung AB burden. The purpose of the present study was to determine whether AB in histologic sections of LN are indicative of heavy lung asbestos burdens. Twenty cases (17 with asbestosis, 15 with carcinoma of the lung, and two with malignant pleural mesothelioma) with at least one AB on a hilar LN section were identified. Bleach digestion of lung tissue in 15 cases demonstrated a median of 24,000 AB/g by LM and 44,000 AB/g by scanning electron microscopy. Digestion of hilar nodes demonstrated 21,800, 15,500, and 3,200 AB/g by LM in three cases which had lung burdens of 22,000, 481,000, and 5470 AB/g, respectively. A fourth LN specimen contained 322,000 AB/g in a case with no lung available to digest. Mean AB lengths in the LN in three cases were 48, 45, and 27 microns. Fourteen control cases of men over 50 without known asbestos exposure or asbestos-related disease had no AB in LN sections even after staining for iron. Among fourteen patients with parietal pleural plaques and an elevated lung asbestos body content, AB were observed in iron-stained LN sections in only two cases. These two patients had 3240 and 610 AB/g lung tissue, respectively (normal range 0 to 20 AB/g). We conclude that the finding of AB on a histologic section of hilar LN is generally indicative of a heavy lung AB burden.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[Roentgen microanalysis of dust particles in histologic sections of pneumoconiosis].

We investigated the significance of X-ray element analysis of histological sections obtained from 26 patients with pneumoconiosis (occupations, etc. mining, quartz processing, metal polishing, exposure to aluminium dust, exposure to asbestos dust). Aluminium-containing or, in the case of asbestosis, magnesium-containing silicates were the most commonly found minerals. Iron and titanium were detected in particular in the sections obtained from metal polishers. X-ray micro-analysis permits a more accurate determination of dust exposure, and an improvement in the description of the pneumoconiosis presenting.

Asbestosis↗
PubMed1989

[Comparison of two exercise tests with various loads].

In 30 males of a mean age 45.6 years suspected of asbestosis the author compared maximal oxygen consumption symptom limited, ventilation during consumption of oxygen (1 L per min) VE1.0 pulse rate on this level (HR1.0) and respiratory volume during ventilation 30 L X min.-1 (VT30) registered during exercise tests with an increasing load of 30 W every 3 minutes (group A) and 15 W every 1 minute (group B). Although both tests were judged to be equally stsrenuous the B test was shorter by one third and produced significantly higher VO2SL 1.89 L X min.-1, A: 1.71 L X min.-1 (p 0.01). Important diagnostical tests evaluating respiratory VE1.0, VT30 and circulatory (HR30) cost did not differ between groups. The author corroborated earlier studies that VE1.0 is one of the most sensitive tests of unequal ventilation and/or diffusion disorders in patients with slightly abnormal respiratory parameters: VC = 83% pred. FEV = 84% pred., FEV1% = 71%, DLCO = 82% pred. The results of this study show that test B is better than test A, being mich better tolerated.

Adult↗
PubMed1989

Asbestos-associated disease: a review.

Asbestos and its potential for adversely affecting health remain a source of concern to several sectors of society. Since it rarely occurs in the absence of occupational exposure to asbestos, and because it is potentially preventable, asbestosis was recently defined as a reportable occupational disease in Texas. An overview of the cardinal characteristics of the asbestos minerals and their associated health effects is presented. The role of the primary physician in diagnosis and counseling of individuals with asbestos-associated diseases is addressed.

Asbestosis↗
PubMed1989

[Significance of the presence of mastocytes in bronchoalveolar lavage in the diagnostic evaluation of diffuse interstitial lung diseases].

The cell preparations of 199 bronchoalveolar lavages (BAL) were reviewed to evaluate the meaning of the presence of mastocytes for the diagnosis of diffuse interstitial lung diseases. The study population consisted of 41 control individuals, 10 with extrinsic allergic alveolitis (EAA), 55 with sarcoidosis 38 with asbestosis, 25 with pulmonary fibrosis associated to collagen diseases, 18 with idiopathic pulmonary fibrosis and 12 with carcinomatous lymphangitis. Mastocytes were predominantly found in patients with EAA (8 of 10 cases) and in some cases of sarcoidosis and idiopathic pulmonary fibrosis. The rate of mastocytes in the patients with EAA was significantly higher than in the other groups (p less than 0.001). The presence of mastocytes in the BAL is particularly suggestive of EAA; rates higher than 3% are only found in this condition.

Alveolitis, Extrinsic Allergic↗
PubMedDate not supplied

[Functional and radiologic changes in workers in the asbestos-cement industry].

The influence of asbestos fibers on the radiologic and functional parameters in workers from the asbestos-cement factory was analyzed. 202 workers were examined each year for the last three years, while some of the workers were followed up to the last 10 years. It was found that the lung damage due to asbestos exposure is expressed highly individually. Some examinees had abnormal chest x-ray and normal lung function, some had abnormal function and normal x-ray, while only in advanced cases we found both radiologic and functional abnormalities. In addition to previously described lung function abnormalities, the authors found that some examinees had an increase in diffusing capacity in the early phase of asbestosis. The importance of dynamic lung functional measurements in workers exposed to asbestos is discussed.

Adult↗
PubMed1988

Comparisons of the pathogenicity of long and short fibres of chrysotile asbestos in rats.

Long-term inhalation and intraperitoneal injection studies were undertaken with laboratory rats treated with a specially prepared short-fibre sample of Canadian chrysotile asbestos. This was compared, at an equal mass dose, to dust generated from the same chrysotile batch so as to contain the highest possible number of long fibres. The long-fibre cloud contained roughly five times more fibres greater than 5 micron in length as seen by phase contrast optical microscopy (PCOM). For increasing lengths, the ratio between the dust clouds increased progressively, reaching over 80: 1 for fibres greater than 30 microns in length. Rats treated with long-fibre chrysotile developed six times more advanced interstitial fibrosis (asbestosis) than animals treated with short-fibre chrysotile and three times more pulmonary tumours. At the end of the 12-month dusting period, three times more short chrysotile than long had been retained in the rat lung tissues. During the following 6 months, however, the short-fibre chrysotile was removed from the lungs much more rapidly than the long. Following intraperitoneal injection at a mass dose of 25mg of dust, both long and short chrysotile produced mesotheliomas in more than 90% of rats. At a dose level of 2.5mg of dust, the short-fibre chrysotile produced mesotheliomas in only one-third as many rats as the long-fibre dust which still produced mesotheliomas in more than 90% of animals injected. At a dose level of 0.25mg of dust, the short-fibre chrysotile produced no mesotheliomas while the long-fibre chrysotile still produced these tumours in 66% of rats. In the two highest doses, where short-fibre chrysotile produced mesotheliomas, the mean tumour induction period was significantly longer than for tumours produced by long chrysotile.

Animals↗
PubMed1985

Benign and malignant pleural effusions in former Wittenoom crocidolite millers and miners.

Serial plain chest radiographs taken between 1943 and 1982 for 280 claimants for compensation for asbestosis and 32 claimants for malignant pleural mesothelioma from the Wittenoom asbestos industry were reviewed by two observers to identify diffuse pleural thickening and pleural effusion. A pleural effusion which appeared and resolved within two years without radiographic or clinical evidence of underlying malignancy, infection or cardiac failure was seen in 15 cases by reader 1 and 24 cases by reader 2. Eighteen cases of effusion, determined from clinical records to be caused by malignant pleural mesothelioma, were seen by reader 1 and 20 by reader 2. The latent periods between commencing work and the first radiograph showing effusion were much shorter for subjects with benign asbestos pleural effusion than for subjects with effusion due to malignant pleural mesothelioma, although there was considerable overlap in the range. The longest latent period for benign asbestos pleural effusion was 22 years and the shortest period for effusion due to malignant pleural mesothelioma was 12 years. The latent period for benign asbestos pleural effusion was inversely related to total cumulative exposure, whereas that for effusion due to malignant pleural mesothelioma was significantly shorter for subjects who had worked in the mill than for those who had worked in the mine. A long latent period and a history of working in the mill were significant discriminators for a malignant as opposed to a benign basis for an effusion. The appearance of a benign asbestos pleural effusion appeared to be a risk factor for the severity of subsequent diffuse pleural thickening.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗