Asbestos Exposure Research Articles

Awareness and Profiling of High-Risk Asbestos Exposure Groups in Australia

The increase in home improvement activity during the COVID-19 pandemic gave rise to concerns of increased asbestos exposure risk. This paper describes high-risk asbestos exposure groups based on current home improvement trends in Australia. A series of quantitative and qualitative studies were commissioned to better understand the attitudes, motivations, and behaviours of home improvers in Australia. In 2021, two in three Australian adults were inclined to undertake home improvement projects—big or small—with or without professional help, underscoring the importance of improving the asbestos safety knowledge and capacity of this cohort. The studies commissioned across 2020 and 2021 provide a deep analysis into this cohort, defining who they are and the segments that make up home improvers, their behaviours, and their asbestos awareness and attitudes. This knowledge enables the development and implementation of a range of targeted campaigns to increase asbestos awareness and prevent potential exposure to asbestos fibres.

Occupational asbestos exposure and survival among lung cancer patients

ObjectiveThis study investigated the association between occupational asbestos exposure (OAE) and survival in patients with histologically confirmed lung cancer (LC). MethodsThis monocentric study was conducted in the Comprehensive Cancer Centre Léon Bérard, Lyon, France. A systematic screening has been in place since 2014 for occupational exposure to carcinogens using a self-assessment questionnaire sent to all patients newly diagnosed with histologically confirmed LC identified through the multidisciplinary LC board from 2014 to 2019. When the physician suspected a work-related exposure from the questionnaire including job history, an occupational cancer consultation was carried out to detail carcinogen exposures and assess if the LC was work-related. Demographics, clinical characteristics and survival data were extracted from medical records. The association between asbestos exposure and overall survival (hazard ratio and 95% confidence intervals) was estimated by Cox proportional hazards regression. ResultsOverall, 702 patients were eligible to the present study, including 180 patients with OAE. In the crude analysis, LCs assessed as moderately or highly attributable to OAE were associated with decreased overall survival (HR = 1.32, 95 %CI 1.04–1.67) compared to LC without OAE or with a low degree of imputability to OAE (median follow-up 28.8 months). After adjustment for confounding (age at diagnosis, smoking status, stage, brain metastasis at diagnosis, and histology), the association of OAE with overall survival was no longer statistically significant (HR = 1.21, 95 %CI 0.94–1.56). ConclusionOverall survival in occupationally asbestos exposed LC patients may be decreased in comparison with non-exposed LC patients, warranting further investigations in larger studies.

Chronological trends in the causation of malignant mesothelioma: Fiber burden analysis of 619 cases over four decades

Malignant mesothelioma is a relatively rare malignancy with a strong association with prior asbestos exposure. A percentage of cases is not related to asbestos, and fiber analysis of lung tissue is a useful methodology for identifying idiopathic or spontaneous cases. We have performed fiber analyses in more than 600 cases of mesothelioma over the past four decades and were interested in looking for trends in terms of fiber types and concentrations as well as percentages of cases not related to asbestos. Demographic information was also considered including patient age, gender, and tumor location (pleural vs. peritoneal). The histologic pattern of the tumor and the presence or absence of pleural plaques or asbestosis were noted. Fiber analysis was performed in 619 cases, using the sodium hypochlorite technique for digestion of lung tissue samples. Asbestos bodies were counted by light microscopy (LM) and coated and uncoated fibers by scanning electron microscopy (EM). The results were stratified over four decades. Trends that were observed included increasing patient age, increasing percentage of women, increasing percentage of peritoneal cases, and increasing percentage of epithelial histological type. There was a decreasing trend in the percentage of patients with concomitant asbestosis (p < 0.001). The percentage of cases with an elevated lung asbestos content decreased from 90.5% in the 1980s to 54.1% in the 2010s (p < 0.001). This trend also held when the analysis was limited to 490 cases of pleural mesothelioma in men (91.8% in the 1980s vs. 65.1% in the 2010s). There was a decrease in the median asbestos body count by LM from 1390 asbestos bodies per gram of wet lung in the 1980s to 38 AB/gm in the 2010s. Similar trends were observed for each of the asbestos fiber types as detected by EM. We conclude that there has been a progressive decrease in lung fiber content of mesothelioma patients during the past four decades, with an increasing percentage of cases not related to asbestos and an increase in median patient age.

Industry, occupation, and exposure history of mesothelioma patients in the U.S. National Mesothelioma Virtual Bank, 2006–2022

BackgroundMalignant mesothelioma is associated with environmental and occupational exposure to certain mineral fibers, especially asbestos. This study aims to examine work histories of mesothelioma patients and their survival time. MethodUsing the NIOSH Industry and Occupation Computerized Coding System, we mapped occupations and industries recorded for 748 of 1444 patients in the U.S. National Mesothelioma Virtual Bank (NMVB) during the period 2006–2022. Descriptive and survival analyses were conducted. ResultsAmong the 1023 industries recorded for those having mesothelioma, the most frequent cases were found for those in manufacturing (n = 225, 22.0%), construction (138, 13.5%), and education services (66, 6.5%); among the 924 occupation records, the most frequent cases were found for those in construction and extraction (174, 18.8%), production (145, 15.7%), and management (84, 9.1%). Males (583) or persons aged >40 years (658) at the time of diagnosis tended to have worked in industries traditionally associated with mesothelioma (e.g., construction), while females (163) or persons aged 20–40 years (27) tended to have worked in industries not traditionally associated with mesothelioma (e.g., health care). Asbestos, unknown substances, and chemical solvents were the most frequently reported exposure, with females most often reporting an unknown substance. A multi-variable Cox Hazard Regression analysis showed that significant prognostic factors associated with decreased survival in mesothelioma cases are sex (male) and work experience in utility-related industry, while factor associated with increased survival are epithelial or epithelioid histological type, prior history of surgery and immunotherapy, and industry experience in accommodation and food services. ConclusionThe NMVB has the potential of serving as a sentinel surveillance mechanism for identifying industries and occupations not traditionally associated with mesothelioma. Results indicate the importance of considering all potential sources of asbestos exposures including occupational, environmental, and extra-occupational exposures when evaluating mesothelioma patients and advising family members.

Asbestos-related Cancer: Exaggerated Risk Perception

Health risks from exposure to asbestos fibers have been evaluated based on professional histories, when fiber concentrations at workplaces were greater than today. A linear no-threshold model was used for risk estimation, although its relevance has not been proven. Asbestos fibers are often detected in lungs and pleura during autopsy, but finding evidence of fibers does not prove that a disease has been caused by asbestos. Thus, targeted detection of mesothelioma and other conditions associated with asbestos exposures has resulted in an increase in the reported incidence of mesothelioma among high-risk groups. Histological and immunochemical characteristics of malignant mesothelioma partially overlap with other cancers, which may also contribute to the overdiagnosis in exposed populations. Differences in carcinogenicity of various asbestos types are discussed here. Prohibitions of asbestos in some developed countries must be reconsidered on the basis of independent research. Life-long bioassays are the most promising way to obtain reliable information regarding asbestos-related malignancy. It should be stressed that non-use of asbestos contributes to an increase of harm from fires, armed conflicts, and traffic accidents.

Malignant peritoneal mesothelioma with unresolving haemorrhagic ascites- A case report

Peritoneal mesothelioma being a rare tumor is difficult to diagnose and start treatment. Pleura is the most common area being affected by mesothelioma, peritoneum being the second common site, and in some cases synchronous pleural and peritoneal mesotheliomas are observed (30–45% of the cases). The presentation of mesothelioma is not up to mark leading to difficulty in diagnosis due to lack of specific symptoms and clinical findings. In addition, in the absence of previous asbestos exposure a delay in the diagnosis is not rare. Here we report a case of malignant peritoneal mesotheliomas. The diagnostic and therapeutic approaches for these rare neoplasms are discussed. A 24 year old male patient was admitted with complaints of pain abdomen (on &amp; off) and abdominal distension since 15 days, with no inhalational exposure to asbestos, causing diagnostic confusion. He had history of unresolving haemorrhagic ascites. No drug allergy was noted. Diagnostic laproscopy was done, shows multiple omental nodules. Omental biopsy along with immunohistochemistry leads to diagnosis of malignant peritoneal mesothelioma. Peritoneal mesotheliomas are infrequent clinical entities. However, patients presenting with prolonged abdominal pain and ascitis should be considered to have atypical pathologies with peritoneal mesotheliomas being one of the differentials.

Laying the Foundation for a Mesothelioma Patient Registry: Development of Data Collection Tools.

Mesothelioma, a cancer of mesothelial cells that line the chest, lungs, heart, and abdomen, is a relatively rare disease. In the United States, approximately 3000 individuals are diagnosed with mesothelioma annually. The primary risk factor for mesothelioma is occupational asbestos exposure which can occur decades prior to disease development, though in approximately 20% of cases, known asbestos exposure is lacking. While several other countries have developed mesothelioma registries to collect key clinical and exposure data elements to allow better estimation of incidence, prevalence, and risk factors associated with disease development, no national mesothelioma registry exists in the U.S. Therefore, as part of a larger feasibility study, a patient exposure questionnaire and a clinical data collection tool were created using a series of key informant interviews. Findings suggest that risk factor and clinical data collection via an on-line questionnaire is feasible, but specific concerns related to confidentiality, in the context of employer responsibility for exposure in the unique U.S. legal environment, and timing of enrollment must be addressed. Lessons learned from piloting these tools will inform the design and implementation of a mesothelioma registry of national scope.

Validation and Recalibration of the Asbestos Removal Exposure Assessment Tool (AREAT).

The Asbestos Removal Exposure Assessment Tool (AREAT) was previously developed to estimate exposure to respirable asbestos fibres during abatement processes. The current study describes the validation and recalibration of the AREAT model with external data. During model validation, the AREAT model was expanded to be able to estimate asbestos exposure from an additional source category: 'unspecified asbestos remnants'. The validation dataset (n = 281) was derived from exposure measurement studies where for each exposure measurement the AREAT model parameters were coded and estimates were calculated. Pearson correlation coefficients (r) and intra class correlation coefficients (icc) were calculated as an indication of the agreement between the AREAT estimates and measured concentrations. In addition, the bias and the proportion of measurements with higher concentrations than model estimates were calculated. To expand and investigate model performance on exposure from 'unspecified asbestos remnants', a separate dataset was created with measurements collected during working with unspecified asbestos remnants, and similar validation comparisons were performed. Lastly, linear regression techniques were used to investigate possible improvements in model parameters. The model was recalibrated on a combined dataset consisting of the validation dataset and the original calibration dataset to increase model robustness. The validation comparisons showed good relative agreement (r) between AREAT estimates and measurements (r = 0.73) and a moderate absolute agreement (icc = 0.53). The overall relative bias was 108%, indicating an overall overestimation of exposure, and 4% of the estimated concentrations were higher than the actual measured concentrations. For the data subset concerning unspecified asbestos remnants, a moderate correlation between model estimates and measurement outcomes was found (r = 0.63). However, based on the low number of data in this subset, and moderate r, it was decided that cleaning of unspecified asbestos remnants is out of scope until more data are available. The results of this validation study suggested that two input parameters (product type friable material, efficacy of control measure foam) underestimated exposure. The effects of these parameters were updated to improve model performance. Compared to the original model, the recalibrated model resulted in slightly higher explained variance (62% compared to 56%) and lower uncertainty (15 compared to 17.3). The original AREAT model provided reliable asbestos exposure estimates with a sufficient level of conservatism taking into account the 90-percentile estimates. The model was further improved via the addition of a new feature and recalibration to predict asbestos exposure during the clean-up of unspecified asbestos remnants.

Siderophore production in fungi from asbestos biofilms: The first step towards bioremediation of a carcinogenic mineral

Asbestos refers to six types of fibrous, silicate minerals, historically used for a wide range of household, commercial and industrial applications. Asbestos exposure is known to cause diseases such as asbestosis, pleural mesothelioma and lung cancer, and is responsible for around 220 deaths per year in Aotearoa / New Zealand. Asbestos is disposed of using a designated hazardous landfill facility, an expensive and unsustainable practice. As an alternative, research has focused on bioremediation to manage asbestos contamination. Bioremediation research has shown that asbestos fibres can be partially degraded, and surface reactivity decreased, by the activity of iron-chelating siderophores, produced by some fungi and bacteria. This paper presents initial results of siderophore-detecting chrome azurol S (CAS)-agar plate assays on mycobiota collected from biofilms from asbestos-containing building products in Tāmaki Makaurau / Auckland and natural asbestos mineral deposits in Kahurangi National Park, northwest of Whakatū / Nelson.

Investigation and outcomes in patients with nonspecific pleuritis: results from the International Collaborative Effusion database.

We present findings from the International Collaborative Effusion database, a European Respiratory Society clinical research collaboration. Nonspecific pleuritis (NSP) is a broad term that describes chronic pleural inflammation. Various aetiologies lead to NSP, which poses a diagnostic challenge for clinicians. A significant proportion of patients with this finding eventually develop a malignant diagnosis. 12 sites across nine countries contributed anonymised data on 187 patients. 175 records were suitable for analysis. The commonest aetiology for NSP was recorded as idiopathic (80 out of 175, 44%). This was followed by pleural infection (15%), benign asbestos disease (12%), malignancy (6%) and cardiac failure (6%). The malignant diagnoses were predominantly mesothelioma (six out of 175, 3.4%) and lung adenocarcinoma (four out of 175, 2.3%). The median time to malignant diagnosis was 12.2 months (range 0.8-32 months). There was a signal towards greater asbestos exposure in the malignant NSP group compared to the benign group (0.63 versus 0.27, p=0.07). Neither recurrence of effusion requiring further therapeutic intervention nor initial biopsy approach were associated with a false-negative biopsy. A computed tomography finding of a mass lesion was the only imaging feature to demonstrate a significant association (0.18 versus 0.01, p=0.02), although sonographic pleural thickening also suggested an association (0.27 versus 0.09, p=0.09). This is the first multicentre study of NSP and its associated outcomes. While some of our findings are reflected by the established body of literature, other findings have highlighted important areas for future research, not previously studied in NSP.

Occupational asbestos exposure and urinary bladder cancer: a systematic review and meta-analysis

PurposeThere is conflicting evidence on the association between asbestos exposure and bladder cancer. We performed a systematic review and meta-analysis to provide evidence on occupational asbestos exposure and the risk of mortality and incidence of bladder cancer.MethodsWe searched three relevant electronic databases (Pubmed, Scopus, and Embase) from inception to October 2021. The methodological quality of included articles was evaluated using the US National Institutes of Health tool. Standardized incidence ratios (SIRs) and standardized mortality ratios (SMRs) for bladder cancer, as well as respective 95% confidence intervals (CIs), were extracted or calculated for each included cohort. Main and subgroup meta-analyses according to first year of employment, industry, sex, asbestos type, and geographic region were performed.ResultsFifty-nine publications comprising 60 cohorts were included. Bladder cancer incidence and mortality were not significantly associated with occupational asbestos exposure (pooled SIR: 1.04, 95% CI: 0.95–1.13, P = 0.000; pooled SMR: 1.06, 95% CI: 0.96–1.17, P = 0.031). Bladder cancer incidence was higher among workers employed between 1908 and 1940 (SIR: 1.15, 95% CI: 1.01–1.31). Mortality was elevated in asbestos workers cohorts (SMR: 1.12, 95% CI: 1.06–1.30) and in the subgroup analysis for women (SMR: 1.83, 95% CI: 1.22–2.75). No association was found between asbestos types and bladder cancer incidence or mortality. We observed no difference in the subgroup analysis for countries and no direct publication bias evidence.ConclusionThere is evidence that workers with occupational asbestos exposure have a bladder cancer incidence and mortality similar to the general population.

The Evolving Role of Immune-Checkpoint Inhibitors in Malignant Pleural Mesothelioma.

Malignant pleural mesothelioma (MPM) is a rare cancer usually caused by asbestos exposure and associated with a very poor prognosis. After more than a decade without new therapeutic options, immune checkpoint inhibitors (ICIs) demonstrated superiority over standard chemotherapy, with improved overall survival in the first and later-line settings. However, a significant proportion of patients still do not derive benefit from ICIs, highlighting the need for new treatment strategies and predictive biomarkers of response. Combinations with chemo-immunotherapy or ICIs and anti-VEGF are currently being evaluated in clinical trials and might change the standard of care in the near future. Alternatively, some non-ICI immunotherapeutic approaches, such as mesothelin targeted CAR-T cells or denditric-cells vaccines, have shown promising results in early phases of trials and are still in development. Finally, immunotherapy with ICIs is also being evaluated in the peri-operative setting, in the minority of patients presenting with resectable disease. The goal of this review is to discuss the current role of immunotherapy in the management of malignant pleural mesothelioma, as well as promising future therapeutic directions.

Molecular Characterization of Testicular Mesothelioma and the Role of Asbestos as a Causative Factor.

Mesothelioma of the tunica vaginalis testis (TVT) is an extremely rare form of mesothelioma. To compare the clinical and molecular characteristics of mesothelioma of the TVT with those of mesothelioma at other more common sites, including the relationship with exposure to asbestos. We present clinical and pathological data for 9 cases of primary TVT mesothelioma. We performed whole-genome sequencing on 3 cases for the first time. The majority (7 of 9 cases) of TVT mesotheliomas were epithelioid, with the remaining 2 cases showing biphasic morphology. Morphology and immunohistochemical profiles were indistinguishable from mesothelioma elsewhere. Asbestos exposure was documented for 7 of the 9 cases, with no information for 2 cases. The 3 TVT mesothelioma cases that underwent whole-genome sequencing displayed a mutational profile similar to that of mesothelioma at other sites, including NF2 and TP53 mutations. The clinical and molecular profile of TVT mesothelioma is similar to that of mesothelioma elsewhere.

Asbestos exposure as an additional risk factor for small duct intrahepatic cholangiocarcinoma: a pilot study

Intrahepatic cholangiocarcinoma (iCCA) is a rare malignancy, recently classified in small duct and large duct morphological subtypes. Growing evidence suggests asbestos as a putative risk factor for iCCA, albeit no correlation between asbestos and iCCA morphology has been investigated so far. The aim of the present study was to assess the relationship between asbestos exposure and iCCA morphological subtype. Forty patients with surgically removed iCCA were prospectively enrolled: asbestos exposure was assessed according to the Italian National Mesothelioma Register questionnaire. From the surgical iCCA specimens the main histopathological variables were collected, including the small duct (sd-iCCA, 32 patients) and large duct subtypes (ld-iCCA, 8 patients). Five sd-iCCA cases had a definite/probable occupational exposure to asbestos, while no cases of ld-iCCA were classified as being occupationally exposed (definite/probable). Other kind of asbestos exposure (i.e. possible occupational, familial, environmental) were recorded in 16 sd-iCCA and 3 ld-iCCA. Cases with unlikely exposure to asbestos were 11 sd-iCCA (35.5%) and 5 ld-iCCA (62.5%). In conclusion, these findings seem to indicate that sd-iCCA might be more frequently associated to asbestos exposure rather than ld-iCCA, suggesting that asbestos fibres might represent a parenchymal, rather than a ductal risk factor for iCCA. This pilot study must be confirmed by further case–control studies or large independent cohorts.

Asbestos Consumption and Malignant Mesothelioma Mortality Trends in the Major User Countries.

The causal association between mesothelioma and asbestos exposure is conclusive, and many studies have proved that the trend in asbestos use is a strong predictor of the pattern in mesothelioma cases with an adequate latency time (generally around 30-40 years or more). Recently, a novel approach for predicting malignant pleural mesothelioma, based on asbestos consumption trend and using distributed non-linear models, has been applied. The purpose of this study is to analyse trends in asbestos consumption and malignant mesothelioma mortality in the major asbestos-user countries. Furthermore, we applied distributed non-linear models to estimate and compare epidemiological relationships between asbestos consumption and mesothelioma mortality across these countries. The study involves major asbestos-user countries in which historical asbestos consumption and mesothelioma mortality data are available. Data on asbestos consumption were derived from worldwide asbestos supply and mesothelioma mortality data from World Health Organization (WHO) mortality archives. A quasi-Poisson generalized linear model was used to model past asbestos exposure and male mesothelioma mortality rates in each country. Exposure-response associations have been modelled using distributed lag non-linear models. According to the criteria defined above, we selected 18 countries with raw asbestos cumulative consumptions higher than two million tons in the period 1933-2012. Overall, a clear linear relationship can be observed between total consumption and total deaths for mesothelioma. Country-specific exposure, lag and age-response relationships were identified and common functions extracted by a meta-analysis procedure. Non-linear models appear suitable and flexible tools for investigating the association between mesothelioma mortality and asbestos consumption. There is a need to improve the global epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, and the absence of reliable data for some major asbestos-user countries is a real concern. A reliable assessment of mesothelioma mortality is a fundamental step towards increasing the awareness of related risks and the need of an international ban on asbestos.

Global Incidence, Risk Factors, and Temporal Trends of Mesothelioma: A Population-Based Study

IntroductionMesothelioma is an uncommon type of cancer which has received little attention. This study aims to evaluate the global disease burden; trends of mesothelioma by age, sex, and geographic locations; and its risk factors on the population level. MethodsThe Global Cancer Observatory, Cancer Incidence in Five Continents Plus, and Global Burden of Disease were accessed for mesothelioma incidence and its risk factors worldwide. The associations between mesothelioma incidence and asbestos were evaluated for each country by multivariable linear regression analysis by sex and age. Average annual percentage change (AAPC) was calculated using Joinpoint regression to evaluate the epidemiologic trends of mesothelioma. ResultsThe age-standardized rate of mesothelioma was 0.30 per 100,000 persons with Northern Europe reporting the highest incidence rates. The incidence rate of the male population was much higher than that of the females. Countries with higher human development index (β = 0.119, confidence interval [CI]: 0.073–0.166, p < 0.001), gross domestic product per capita (β = 0.133, CI: 0.106–0.161, p < 0.001), and asbestos exposure (β = 0.087, CI: 0.073–0.102, p < 0.001) had higher mesothelioma. The overall trend of mesothelioma incidence was decreasing, although an increase was observed in Bulgaria (AAPC: 5.56, 95% CI: 2.94–8.24, p = 0.001) and Korea (AAPC: 3.24, 95% CI: 0.08–6.49, p = 0.045). ConclusionsThere was a substantial declining incidence trend of mesothelioma in the past decade possibly related to the restriction of the use of asbestos in some countries. Meanwhile, the increasing trend in mesothelioma incidence observed in females might be indicative of an increase in environmental exposure to mineral fibers.

MEK1 drives oncogenic signaling and interacts with PARP1 for genomic and metabolic homeostasis in malignant pleural mesothelioma

Malignant pleural mesothelioma (MPM) is a lethal malignancy etiologically caused by asbestos exposure, for which there are few effective treatment options. Although asbestos carcinogenesis is associated with reactive oxygen species (ROS), the bona fide oncogenic signaling pathways that regulate ROS homeostasis and bypass ROS-evoked apoptosis in MPM are poorly understood. In this study, we demonstrate that the mitogen-activated protein kinase (MAPK) pathway RAS-RAF-MEK-ERK is hyperactive and a molecular driver of MPM, independent of histological subtypes and genetic heterogeneity. Suppression of MAPK signaling by clinically approved MEK inhibitors (MEKi) elicits PARP1 to protect MPM cells from the cytotoxic effects of MAPK pathway blockage. Mechanistically, MEKi induces impairment of homologous recombination (HR) repair proficiency and mitochondrial metabolic activity, which is counterbalanced by pleiotropic PARP1. Consequently, the combination of MEK with PARP inhibitors enhances apoptotic cell death in vitro and in vivo that occurs through coordinated upregulation of cytotoxic ROS in MPM cells, suggesting a mechanism-based, readily translatable strategy to treat this daunting disease. Collectively, our studies uncover a previously unrecognized scenario that hyperactivation of the MAPK pathway is an essential feature of MPM and provide unprecedented evidence that MAPK signaling cooperates with PARP1 to homeostatically maintain ROS levels and escape ROS-mediated apoptosis.

Pleural Plaques and the Role of Exposure to Mineral Particles in the Asbestos Post-exposure Survey

Previous studies have inconsistently reported associations between refractory ceramic fibers (RCFs) or mineral wool fibers (MWFs) and the presence of pleural plaques. All these studies were based on chest radiographs, known to be associated with a poor sensitivity for the diagnosis of pleural plaques. Does the risk of pleural plaques increase with cumulative exposure to RCFs, MWFs, and silica? If the risk does increase, do these dose-response relationships depend on the co-exposure to asbestos or, conversely, are the dose-response relationships for asbestos modified by co-exposure to RCFs, MWFs, and silica? Volunteer workers were invited to participate in a CT scan screening program for asbestos-related diseases in France. Asbestos exposure was assessed by industrial hygienists, and exposure to RCFs, MWFs, and silica was determined by using job-exposure matrices. A cumulative exposure index (CEI) was then calculated for each subject and separately for each of the four mineral particle exposures. All available CT scans were submitted to randomized double reading by a panel of radiologists. In this cohort of 5,457 subjects, significant dose-response relationships were determined after adjustment for asbestos exposure between CEI to RCF or MWF and the risk of PPs (ORs of 1.29 [95%CI, 1.00-1.67] and 1.84 [95%CI, 1.49-2.27] for the highest CEI quartile, respectively). Significant interactions were found between asbestos on one hand and MWF or RCF on the other. This study suggests the existence of a significant association between exposure to RCFs and MWFs and the presence of pleural plaques in a large population previously exposed to asbestos and screened by using CT scans.

Incidence and mortality from malignant mesothelioma 1982–2020 and relationship with asbestos exposure: the Australian Mesothelioma Registry

ObjectivesMalignant mesothelioma is an uncommon cancer associated with asbestos exposure, predominantly occupational. Asbestos has been banned in Australia since 2003 but mesothelioma has a long latency and incident cases continue...

A Call for Reform: The Need for An Effective Response to Asbestos in Australian Workplaces and Residential Settings

This article argues for greater regulatory efforts to prevent unnecessary deaths from asbestos exposure in Australia. Despite asbestos-related diseases being responsible for a large number of deaths in Australia every year, the danger from exposure to asbestos is not well understood in the community and the regulatory response has been inadequate. A survey of 43,000 Australians between April 2020 and May 2021 found that only 28 percent of respondents knew that asbestos is dangerous to health and only 5 percent were aware that once diagnosed, most cases of asbestos-related disease are fatal within relatively short timeframes. Despite the significant risk to Australian lives posed by in situ asbestos, governments have failed to ensure that Australians are accurately informed about that risk, and responsible corporations have not been fully held to account.