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PubMed1986

[Current topics for occupational and environmental medicine and physiology in the U.S.A.--with special reference to occupational lung diseases].

Current topics for occupational and environmental medicine and physiology in the U.S.A., especially in the National Institute for Occupational Safety and Health (NIOSH), and the University of California, San Francisco, are reviewed. Reduction of the rate for occupational lung diseases is one of the national objectives for occupational safety and health in the U.S.A., and NIOSH has rated it as the top disease of ten-leading work-related diseases and injuries. Current topics for occupational lung diseases--asbestosis, byssinosis, silicosis, coal worker's pneumoconiosis, lung cancer, and occupational asthma & hyperreactivity, and for pathophysiology of airway hyperreactiveness and pulmonary edema are discussed.

Humans↗
PubMed1976

The trade unionist's view of occurpational cancer.

The Transport and General Workers' Union (UK) has an active programme devoted to monitoring the health of its 1.8 million members. Files on members who died of bladder cancer after exposure to beta-naphthylamine go back to the late 1920's. From the same period came data on members suffering from asbestosis which included same cases of lung cancer before the industrial cause of the disease was recognized. These and other more recent examples including Nonox S and vinyl chloride amply justify the need for setting up registers of all workers who are at risk from industrial exposure. The scientfic community has a responsibility for communicating data regarding hazards both to employers and employees who can then ensure that all who have been exposed can be notified and screened. The trade unions have a part to play in ensuring that industry accepts conditions of greater control under the new regulations in the United Kingdom. There must be a continuing tripartite discussion between industrial management, trade unions and the responsible governement official.

2-Naphthylamine↗
PubMedDate not supplied

[The mortality due to pulmonary silicosis in the Tuscany region in the last decade demonstrates that the health effects of work exposure to silica are still marked].

An analysis of death certificates from 1987 to 1996 among residents of the Tuscany Region identified 1518 deaths from pneumoconiosis, the large majority from silicosis, a disease explained by occupational exposure to silica dust. A dozen of deaths are from asbestosis, occurred at younger ages and are concentrated in a restricted area where a cement-asbestos factory was active. Deaths from pneumoconiosis occurred mainly among males, and the rates of the disease are decreasing only in the latest years. About 10% of deaths from silicosis are among subjects dying before 65 years of age. Mortality rates are very high in several areas of the Region, approximating those from lung cancer and ischaemic heart disease. For the above reasons the disease is still of concern from the point of view of public health and actions are suggested to obtain a description of prevalence and incidence of the disease.

Cause of Death↗
PubMed1999

[Contribution of high-resolution volume computed tomography (HRVCT) for the exploration of diffuse pulmonary infiltrative disorders].

AIM: To assess high-resolution volume computed tomography (HRVCT) for the investigation of diffuse pulmonary infiltrative disorders. PATIENTS AND METHODS: Thirty patients with diffuse interstitial disease (idiopathic fibrosis n = 7, silicosis n = 4, asbestosis n = 5, sarcoidosis n = 7, histiocytosis n = 2, lymphangitis carcinomatosa n = 2, tuberculosis n = 1, bronchiolitis obliterans n = 1) were explored using high-resolution computed tomography (HRCT) and HRVCT. All diagnoses were proven by fiberscopy, bronchoalveolar lavage and respiratory function tests and/or lung biopsy. The HRVCT protocol consisted of spiral tomography using 10 mm slices. Data were processed with a Windows Advantage workstation (GE Milwaukee). Two readers compared multiprojection volume reconstruction (MPVR) using maximal intensity projection (MIP) and minimal intensity projection (MINIP) displays with millimetric HRCT slices acquired at the same volume. RESULTS: Micronodules were detected better with HRVCT than with HRCT. MIP mode enabled better distinction between nodules and vessels. MINIP mode enabled better detection of cysts in the pulmonary parenchyma than HRCT. The honeycomb aspect of pulmonary fibrosis was differentiated better than super-infected central-lobar emphysema. MINIP mode enabled detection of ground glass opacities which were not visible on HRCT. Certain anomalies were however detected only on HRCT. HRVCT was very sensitive to movement effects which altered image quality, particularly in the MINIP mode. CONCLUSION: HRVCT is a new and promising approach for investigating diffuse pulmonary infiltrative disorders.

Adult↗
PubMed1999

[Occupational problems of serpentine asbestos in industry (history and trends)].

The article presents summarized data of long-standing research of work conditions, asbestosis occurrence, and epidemiology of malignancies in "URALASBEST" enterprises extracting and utilizing asbestos. The research served as a base to elaborate and put into practice a complex of sanitary, technical, medical and biologic measures in various asbestos enterprises. Those measures lowered occupational morbidity due to asbestos. Considering the experience accumulated, the authors set prospects for further studies on "Asbestos and Health" problem.

Asbestos, Serpentine↗
PubMed2000

[Genetic polymorphism and occupational diseases: results of 10-years studies].

The paper presents the results of investigations made at the Laboratory of Environmental Genetics, Medical Genetic Research Center, Russian Academy of Medical Sciences, to search for the markers of genetic predisposition or resistance to a number of occupational diseases (asbestosis, occupational fluorosis, silicosis, dust-induced bronchitis, bronchial asthma).

Diagnosis, Differential↗
PubMed2000

Occurrence of pulmonary diseases in steel mill workers.

The 'Sendzimir' Steel Mill, Cracow, Poland, gives employment to approximately 17,000 workers. During the years 1994-98, 1396 compensation claims for diseases related to occupational hazards were registered. After a scrupulous investigation, 851 cases were certified as occupation-related diseases. Of this number, 481 cases (56.5%) were diagnosed as pulmonary diseases, including silicosis (n = 225, 46.7%); chronic bronchitis (n = 138, 28.7%); lung carcinoma (n = 59, 12.3%); epithelial cancer (n = 42); adenocarcinoma (n = 12); microcellular carcinoma (n = 5); asthma, 12 atopic and 24 non-atopic (n = 36, 7.5%); and asbestosis (n = 23, 4.8%). Chronic bronchitis was diagnosed in patients exposed to industrial dusts, containing SiO2, NOx, and SO2. Asthma occurred most frequently among those exposed mainly to Cr+6, Co and Ni containing dusts, and lung carcinoma in those exposed to policyclic aromatic hydrocarbons, including benz(a)pyren, asbestos, chromium, vapours of oils and lubricants. In 1994-96, chronic bronchitis and silicosis, and in 1997-98, lung carcinoma and asthma were most frequently diagnosed in the workers under study. It is likely that the diminishing frequency of chronic bronchitis and silicosis was the consequence of technological progress, and greater concern for hygiene standards. Increasing incidence of lung cancer reflects long latency characteristic of this illness.

Adult↗
PubMed2000

[Chrysotile asbestos: biological effects, the work environment highest allowable concentration and neoplasm risk].

The authors present the most essential data on physical and chemical properties of chrysotile, sources of its emission, the extent of occupational exposure, and biological effect, used in setting MAC values for chrysotile-containing dusts. Exploitable asbestos deposits do not exist in Poland, but admixtures of asbestos minerals have been found in some deposits of mineral raw materials located in the area of Lower Silesia (melafir, gabbro, dolomite. ore, nickel, magnesite, serpentinite). In the 1970s, about 100,000 tonnes of asbestos, containing 90% of chrysotile, were used annually in Poland. This figure decreased to 30,000 tonnes in 1991. In 1985 the use of crocidolite asbestos was stopped, and in 1999, the use of asbestos-containing products was banned by the virtue of the legal act. At present, the Minister of Economy in agreement with the Minister of Environmental Protection sets regularly the list of asbestos-containing products permitted for the production or in the customs area. Nowadays, the range of dust concentrations in plants which use asbestos products amounts to 0.1-0.6 mg/m3 for total dust and 0.002-0.07 f/cm3 for respirable mineral fibres; and during exploitation of rock raw material deposits 0.7-280 mg/m3, and 0.01-3.3 f/cm3, respectively. During the years 1976-96, 1520 cases of asbestos-related occupational diseases were diagnosed. This figure included 1314 cases of asbestosis, 154 cases of lung cancer and 52 cases of pleura mesothelioma. MAC values for chrysotile and chrysotile-containing dusts are: 0.2 f/cm3 and 1 mg/m3.

Asbestos↗
PubMed2000

[Granulomatous lung lesions after occupational exposure to glass fibers].

39 years old man with granulomatous lesions in both lungs caused by occupational contact with glass fibers was described. He has been working as an bricklayer-plasterer for 18 years and was in contact with lime, cement, plaster, asbestos, dust of coal and wood and with glass fibers. For the last two years before admission in 1993 he has had frequent bronchial infections. On admission he was in good general condition, his spirometric examination and blood gases were within normal limits. On chest x-ray disseminated lesions were found. Those lesions were of the round shapes on chest CT. Many sputum cultures for tubercle bacilli were negative. ANA and ANCA were not found in the serum. ACE was within normal limits. No precipitins to environmental antigens were found. Cancer metastases were suspected and lung biopsy during videothoracoscopy was done. Many foreign body type granulomas were found throughout the specimen. The character of the lesions was not typical for tuberculosis, sarcoidosis, extrinsic allergic alveolitis, silicosis or asbestosis. There are some reports concerning the possibility of development of such lesions after the exposition to glass fibers. We suspect that case is an example of such pathology. His occupational exposition was stopped in 1993 and he was observed without treatment. During the 5 years of observation (up till 1998) he was in good health with stable chest x-ray picture and results of respiratory system function.

Adult↗
PubMedDate not supplied

Carcinogenicity of asbestos: convincing evidence, conflicting interests.

In spite of hard epidemiological and clinical evidence associating asbestos fibre with asbestosis and cancer, the issue is controversial and likely to remain so. The focus is now shifting to non-occupational exposure, differential risk to various asbestos fibre types and the relatively low level of carinogenicity of the chrysotile form. This creates further space for scientific debate and the opportunity to form a considered opinion. However, the situation may take a worrisome turn if some of these scientific inquiries are used by market forces to their advantage. A look at the history of corporate activities in asbestos-related research reveals a disturbing trend. Information that was made available, through legal interventions, clearly shows how for half a century the asbestos industry in collaboration with some academic leaders of occupational medicine successfully suppressed evidence against asbestos. In developing countries, extensive and aggressive marketing continues by chrysotile producers, mainly Canadian companies. There is renewed pressure on this part of the world since new use of asbestos has been almost completely discontinued in the developed countries as a result of public pressure and state prohibitions. In this scenario, relaxation of public health control over any form of asbestos should be opposed. It is extremely dangerous and scientifically untenable to say that chrysotile asbestos can be used without risk. It has been identified as a potent human carcinogen, and remains so. However, some restraint must be exercised while dealing with asbestos that has already been released into the environment. Disturbing it unnecessarily may cause more harm than good.

Asbestos↗
PubMed2000

[Clinical features of pulmonary diseases caused by chrysotile asbestos dust].

The authors studied clinical, roentgenologic and functional signs of asbestosis and chronic dust bronchitis in 57 workers engaged into extraction and processing of asbestos. Occupational peripheral lung cancer was revealed in 4 cases. Chronic dust bronchitis appeared to be diagnosed with delay, usually at I-II stages.

Adult↗
PubMedDate not supplied

[Incidence of malignant mesothelioma (1980-1999) and asbestos exposure in 190 cases diagnosed among residents of the province of Brescia].

Several cases of malignant mesothelioma (MM) previously unknown to the Occupational Health and Safety Service were recognised in the Province of Brescia after an active surveillance program carried out during the first nineteen years of operation; a large proportion of the cases involved workers occupationally exposed to asbestos. A local Mesothelioma Register was subsequently set up in 1993 and by the end of 1999, 190 MM cases had been collected. The annual incidence ratio (standardized on the Italian population, census 1981, x100,000 person-years) was calculated in the 1980-1999 period and showed an increasing trend for location in the pleura in both sexes; in the 1996-1999 period the incidence ratio was 2.95 for males and 1.35 for females. In the same period, this trend was not observed for peritoneal location, with an incidence ratio of 0.17 and 0.37 for males and females respectively. 161 pleural MM (84.7%) and 28 peritoneal MM (14.7%) are described; histopathologic diagnosis was performed in 161 cases (84.7%). Anamneses were collected for 88% of the cases but with direct information from patients only in 65% of these in the recent period. Only 7 cases of asbestosis were diagnosed in the MM cases, whereas 31 cases of pleural abnormalities were observed but only 17 of these were observed in workers occupationally exposed to asbestos. Occupational asbestos exposure was evaluated as certain, probable or possible in 45% of total cases and in 54% of recently (1996-1999) observed cases, which were ten times more frequent in males. Exposure occurred in sectors works where asbestos was not used as raw material, such as construction, iron and steel and metal working. MM's from environmental and non-occupational exposure to asbestos were very few, 1.5% and 0.5% respectively. In 65 MM's asbestos exposure was unknown (34.2%); 50% of these concerned females; for whom the industry and jobs are discussed. The distribution of histologic types of MM was similar in asbestos exposed and non exposed cases. No association between peritoneal mesotheliomas and heavy exposure to asbestos was observed. Ten cases of MM were diagnosed in subjects under 45 years old (5.2%) with only one case occupationally exposed. 2 cases were exposed to radiation therapy (1%) and 2 cases to thoracic trauma (1%). Although in Italy MM has been included in the list of compensatable occupational diseases by law since 1994, a large number of cases occupationally exposed to asbestos are still not recognised by the National Insurance Institute (INAIL). A number of problems limiting work of the Mesothelioma Register and its usefulness are discussed. The Lombardy Mesothelioma Register set up in January 2000 should be able to overcome the limits identified in the past.

Adult↗
PubMed2001

Occupational asthma in Singapore.

AIM: Since the first notified case of occupational asthma in 1983, a total of 90 cases were confirmed as on 31st December 1999. In this study, demographic data, causative agents and impact on the workers were described. METHODS: The data was derived from notifications to the Ministry of Manpower and referrals to the Occupational Lung Disease Clinic jointly run with Department of Respiratory Medicine, Tan Tock Seng Hospital. RESULTS: Of the 90 cases, 19 (21%) were females and 71 (79%) were males. There were 48 (53%) Chinese, 22 (24%) Malays, 14 (16%) Indians and 6 (7%) of other ethnic origins. The mean age at diagnosis was 35.8 +/- 9.3 yrs. The mean duration of exposure prior to onset of symptoms was 34.9 +/- 57.3 months. The most common causative agent was isocyanates (28 cases, 31%) followed by solder flux (12 cases, 13%) and welding fumes (8 cases, 9%) respectively. Thirteen (14.4%) workers were assessed to have permanent disability under the Workmen's Compensation Act. CONCLUSIONS: Since 1990, occupational asthma has overtaken silicosis and asbestosis as the most common occupational lung disease in Singapore. The most common causative agent is isocyanates. Occupational asthma is a condition associated with disability in the workplace and may still be largely under-reported.

Adult↗
PubMed2001

Fate of the miraculous mineral--ban asbestos worldwide campaign.

Asbestos is a generic term used to describe natural mineral fibers found in the ground in many regions of the world. This cheap material with special chemical and physical properties that make it virtually indestructible was widely used in the 20th century. Within twenty years of the first industrial production, the public health hazards associated with asbestos started to come to light. Asbestos has become one of the most worrying industrial pollutants, since it poses a health hazard of asbestosis, lung cancer, mesotheliomas, and benign changes in the pleura. In spite of the WHO recommendations, environmental health criteria and their revision, asbestos is still around.

Asbestos↗
PubMed2001

[Clinical utility and safety of diagnostic thoracoscopy].

The increasing use of thoracoscopy performed under local anesthesia has made contributions to the diagnosis of pleural disease with effusion. During the past 7 years, we have performed 100 such thoracoscopy procedures using a flexible fiberoptic bronchoscope. On the basis of our clinical findings, we are able to discuss the utility and safety of this procedure. The causes of pleural effusion were carcinomatous pleurisy in 72 cases, tuberculosis pleurisy in 15 cases, infection without tuberculosis in 4 cases, malignant pleural mesothelioma in 8 cases and one case of asbestosis. The success rate of thoracoscopic pleural biopsies were 97% for carcinomatous pleurisy, 100% for malignant pleural mesothelioma and 86% for tuberculosis pleurisy. This procedure was performed with no serious effect on blood pressure, oxygen saturation, monitored ECG or BGA data, and with no serious complications. Therefore, we concluded that this method is very useful for the diagnosis of pleural effusions and has few complications.

Adult↗
PubMed2002

[Clinical evaluation of rounded atelectasis induced by exposure to asbestos].

We encountered 15 patients with rounded atelectasis induced by exposure to asbestos from 1992 to 1999. All patients were men whose ages ranged from 42 to 85 years, with a mean age of 64.2 +/- 11.5 years. Rounded atelectasis was present only in the right lung and two patients had 2 rounded atelectasis in the right lung. In eight cases, the rounded atelectasis was found in segment 10, while in the others, it was found in segments 4, 5, 6, 8, and 9. Although evidence of symptoms was absent, rounded atelectasis was detected in six patients through medical examinations. Others complained of chest pain and dyspnea. Thirteen patients displayed pleural plaques and only 2 patients revealed asbestosis. Malignant complications were discovered in 4 patients, of whom 3 showed primary lung cancer and 1 suffered acute myelocytic leukemia. In their occupational histories, 7 patients had been exposed to asbestos in the shipyards and 5 in the construction field. The mean period of the exposure was 25.1 +/- 12.7 years, and the latency period from the first asbestos exposure to the detection of atelectasis was 35.1 +/- 8.8 years. Five autopsied patients had more than 10,000 asbestos bodies in the lung, which indicated heavy exposure to asbestos. These results suggest that rounded atelectasis may appear after high-dose exposure to asbestos.

Adult↗
PubMedDate not supplied

Asbestos-induced alveolar epithelial cell apoptosis: role of mitochondrial dysfunction caused by iron-derived free radicals.

Asbestos causes asbestosis and malignancies by mechanisms that are not fully understood. Alveolar epithelial cell (AEC) injury by iron-derived reactive oxygen species (ROS) is one important mechanism implicated. We previously showed that iron-catalyzed ROS in part mediate asbestos-inducedAEC DNA damage and apoptosis. Mitochondria have a critical role in regulating apoptosis after exposure to agents causing DNA damage but their role in regulating asbestos-induced apoptosis is unknown. To determine whether asbestos causes AEC mitochondrial dysfunction, we exposed A549 cells to amosite asbestos and assessed mitochondrial membrane potential changes (delta(psi)m) using a fluorometric technique involving tetremethylrhodamine ethyl ester (TMRE) and mitotracker green. We show that amosite asbestos, but not an inert particulate, titanium dioxide, reduces delta(psi)m after a 4 h exposure period. Further, the delta(psi)m after 4 h was inversely proportional to the levels of apoptosis noted at 24 h as assessed by nuclear morphology as well as by DNA nucleosome formation. A role for iron-derived ROS was suggested by the finding that phytic acid, an iron chelator, blocked asbestos-induced reductions in A549 cell delta(psi)m and attenuated apoptosis. Finally, overexpression of Bcl-xl, an anti-apoptotic protein that localizes to the mitochondria, prevented asbestos-induced decreases in A549 cell delta(psi)m after 4 h and diminished apoptosis. We conclude that asbestos alters AEC mitochondrial function in part by generating iron-derived ROS, which in turn can result in apoptosis. This suggests that the mitochondrial death pathway is important in regulating pulmonary toxicity from asbestos.

Apoptosis↗
PubMed1976

Fine structural morphometry of diffuse lung diseases with abnormal blood-air gas transfer.

Samples of lung biopsy tissue from nine patients with normal lungs, seven with pulmonary sarcoidosis, nine with diffuse interstitial pulmonary fibrosis, seven with histiocytosis X, and one with asbestosis were analyzed by morphometric techniques applied to electron micrographs, and the results were subjected to rank-sum analysis. Within the limits of the sampling method and the mathematical predictions of others, the general rejection of the constructed hypothesis in this study supports the conclusion that factors other than increase in the arithmetic of harmonic mean thickness of the blood-air barrier are critical to impaired gas transfer in the diseases studied.

Adult↗