Asbestos Exposure Research Articles

NELL-1 as a Target Antigen in Asbestosis Associated Membranous Nephropathy — A Case Report

An 80-year-old male with a history of prolonged asbestos exposure presented with 24-hour urine protein of 8 gm, and serum albumin of 1.7 gm/dl. Renal biopsy disclosed features of membranous nephropathy. Immunohistochemistry showed positivity for neural epidermal-like growth factor- like 1 (NELL1) (2+/3+). Further assessment uncovered an incidental finding of asbestos-related pleural plaques and left hemithorax volume loss on computed tomography (CT) chest, leading to a diagnosis of asbestosis. This case highlights the rare association between asbestosis and NELL-1 positive membranous nephropathy.

Relationships between asbestos exposure and pleural plaques: dose and time effects using fractional polynomials

ObjectiveThe aim of this study was to confirm the relationship between several parameters of exposure to asbestos and pleural plaques (PP) using data from a large cohort of retired workers...

Trends in malignant pleural mesothelioma prevalence in the United States from 2000 to 2020.

e20094 Background: Malignant pleural mesothelioma (MPM) is a rare cancer that is closely associated with prolonged asbestos exposure. Its incidence has steadily declined over time with decreasing prevalence of asbestos-related lung disease. Our study aims to provide an update on recent MPM trends in the United States from 2000 to 2020. Methods: This is a retrospective cohort study design. The primary endpoints of this study are age-adjusted MPM rates and annual percentage change (APC) in rates from 2000-2020. We queried the Surveillance, Epidemiology, and End Results (SEER) 17 database for information about demographics, cause of death, and survival time for patients diagnosed with MPM from 2000-2020. For rate analysis, we used the SEER 22 database which covers 22 national cancer registries and approximately 41.9% of the US population. Age-adjusted rate analysis was performed using the National Cancer Institute (NCI) joinpoint regression program. Results: We identified 13,018 patients diagnosed with MPM from 2000-2020 who were eligible for analysis in the SEER 17 database. Individuals with MPM were primarily male (78.2%) and belonged to Non-Hispanic White (80.7%) ancestry. The mean age at diagnosis overall was 72.4 (SD +/- 10.6) years. The overall age-adjusted rate of MPM for all groups decreased from 0.97 (cases per 100,000 population) in 2000 to 0.55 in 2020. When stratified by sex, the MPM rate in males decreased from 1.91 to 0.93. The rate decrease in females over the same period was more modest, from 0.33 to 0.27. Overall APC for all groups from 2000-2013 was -1.45 (95% CI -2.01 to -0.40, p<.05), and from 2013-2020 it was -5.22 (95% CI -8.92 to -3.76, p<.05). The APC for males from 2000-2013 was -1.88 (95% CI -2.62 to -0.62, p<.05) and -6.46 (95% CI -10.49 to -4.57, p<.05) from 2013-2020. The rate decrease for females demonstrated a consistent APC of -0.87 (95% CI -1.54 to -0.26, p<.05) from 2000-2020. Conclusions: MPM is a disease that is best managed at large academic cancer centers due to its rarity. Our study demonstrates an accelerated decline in overall MPM rates since 2013, mainly driven by a similar fall in rates in males over the same period. MPM rates are lower in females and continue to decline, albeit slowly. The continued and reassuring decrease in rates of MPM likely reflects the effectiveness of regulations targeting widespread industrial and residential asbestos use that have been in place since the 1990s. [Table: see text]

Evolving burden of lung cancer attributable to occupational carcinogens in 38 OECD countries: Global, national differences, age dynamics and implications for global health.

10576 Background: Lung cancer (LC) remains a predominant cause of global mortality and disability, particularly significant in Organization for Economic Cooperation and Development (OECD) nations. Understanding the evolving burden of LC attributable to occupational carcinogens (OC) is critical due to its prevalence in occupational settings. Methods: Employing a standardized approach from the Global Burden of Disease study, we estimated deaths and disability-adjusted life years (DALYs) caused by lung cancer linked to OC. Our analysis spans age, gender, year, and location across the 38 OECD countries from 1990-2019. Results were presented as absolute counts and age-standardized rates (ASR) per 100,000 person-years, with projections extended to 2040 using regression frameworks. Results: Deaths from LC attributable to OC increased from 120,862 (95%UI: 91,114-148,937) in 1990 to 167,917 (127,888-208,066) in 2019, with DALYs rising from 2.4 million (1.8-3.1) to 2.9 million (2.2-3.6) over the same period. The United States recorded the highest number of deaths (41,075), followed by Japan (20,496) and the United Kingdom (15,223) in 2019. Notably, the Netherlands exhibited the highest age-standardized mortality rate (ASMR) at 12.62 cases per 100,000, with Belgium and the United Kingdom following closely. Asbestos exposure accounted for the highest number of deaths (147,263), followed by silica (15,660), arsenic (3,172), and diesel engine exhaust (2,798). Males bore a significantly higher burden than females over the last three decades, with the 75-79 age group recording the highest number of deaths (32,477) and the 70-74 age group registering the highest DALYs (613,442). Conclusions: The study underscores the escalating burden of LC attributable to occupational carcinogens across OECD countries, highlighting the imperative for robust preventive measures and targeted interventions. Urgent action is warranted to mitigate exposures to known carcinogens in occupational settings, particularly among vulnerable populations, to curb the escalating public health challenge posed by occupational lung cancer.

Global burden of mesothelioma attributable to occupational asbestos exposure in 204 countries and territories: 1990–2019

Malignant mesothelioma, a rare and aggressive cancer primarily caused by occupational asbestos exposure, has a poor prognosis. This study leverages the Global Burden of Disease (GBD) 2019 dataset to analyze the burden of mesothelioma linked to occupational asbestos exposure from 1990 to 2019. The analysis includes the number of mesothelioma deaths and disability-adjusted life years (DALYs) attributable to occupational asbestos exposure, focusing on trends in age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life-year rate (ASDR) by year, age, sex, country, region, and Socio-demographic Index (SDI). In 2019, 91.7% of mesothelioma deaths and 85.2% of DALYs were attributable to occupational asbestos exposure, resulting in 26,820 (95% UI 24,312–28,622) deaths and 569,429 (95% UI 509,956–617,484) DALYs. Despite a decline in ASMR and ASDR from 1990 to 2019, the absolute number of deaths and DALYs almost doubled. The United States reported the highest number of mesothelioma deaths, while China had the highest number of DALYs. Age-specific mortality rates and DALYs decreased in the 25–74 age group but increased in the 75+ age group. In conclusion, occupational asbestos exposure remains the primary cause of mesothelioma worldwide, with an increasing number of deaths and DALYs. The highest incidence rates are observed in high-income areas, and rates are rising in low-income areas. It is crucial to raise awareness about the hazards of asbestos to reduce the global burden of mesothelioma linked to occupational exposure.

Multiple institutions’ research findings using the National Mesothelioma Virtual Bank

Mesothelioma remains an under-researched cancerous disease due to the lack of high-quality patient samples and clinical information especially outcomes and asbestos exposure data. The National Mesothelioma Virtual Bank (NMVB) is a biobank in which mesothelioma annotated biospecimens can be made widely available to the research community. Here, we summarized the significant research findings from 20 publications that utilized the NMVB samples for novel biomarker and therapeutic discoveries. The results showed that the use of the NMVB resource was dispersed among a variety of basic science topics including, but not limited to, biomarkers, abnormal gene expression, and potential therapeutic targets. Positive biomarkers included several miRNAs and antibodies, HMGB1, ATG5, PIAS3, pancytokeratin and GATA3. Genes that had mutations or high/low levels of expression were BAP1, a human control gene of importance in this disease, as well as various cytokines, and checkpoint inhibitors TM4SF1, PKM2, ARHGDIA, COBLL1, WT1, FOXM1, and CD30. Treatments investigated include thiostrepton, interferon-β gene, and Brentuximab. Publications reviewed indicated a significant impact of the NMVB resource utilized in significant studies focusing on biomarker and therapeutic discoveries, which can act as a model for rare diseases, especially in oncology.

Analysis of Treatment Strategies and Outcomes in Malignant Peritoneal Mesothelioma: Insights From a Multi-Center Study

BackgroundThis study aimed to evaluate the demographic,” clinicopathologic, and prognostic characteristics of malignant peritoneal mesothelioma (MPeM), as well as the treatment options for the rare and heterogeneous MPeM population.MethodsA retrospective multi-center observational cohort study was conducted to evaluate patients with MPeM. Due to the heterogeneity of the study population, the study divided them into two main groups in terms of treatments, follow-up periods, and prognostic features. The first group comprised the patients who underwent cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), and the second group included the patients with metastatic disease for whom curative intent surgery was not possible. The patients’ diagnostic procedures and treatments were identified from medical records. Patients older than 18 years old were included in the study regardless of asbestos exposure. Well-differentiated papillary and multicystic mesothelioma histologic types were not included in the study.ResultsThe study evaluated 118 patients from five centers. Survival times, prognosis, and treatment responses were analyzed in both groups. The study showed that CRS-HIPEC was associated with longer overall survival (OS) and progression-free survival (PFS). Perioperative therapy was evaluated in subgroup analyses of this population and shown to provide survival benefits. The patients treated with chemotherapy (metastatic and medically inoperable patients and those for whom complete cytoreduction was not achievable) had a poorer prognosis than the surgery group. The study showed that life expectancy decreased significantly for the patients not suitable to undergo surgery for any reason.ConclusionsAccording to data from experienced centers, CRS-HIPEC is a treatment option recognized as effective, cost-effective, and safe, with better OS and PFS , as well as low morbidity and mortality rates similar to those in the literature. In addition, the platinum-pemetrexed combination continues to be an effective and acceptable treatment option for metastatic patients, those who are medically inoperable, and those for whom complete or near-complete cytoreduction is not achievable.

Asbestos exposure determined 357 days after death through autopsy: a report of a multidisciplinary approach.

Asbestosis is an interstitial lung disease caused by the inhalation of asbestos fibers and poses a significant risk to individuals working in construction, shipping, mining, and related industries. In a forensic context, postmortem investigations are crucial for accurate diagnosis, for which the gold standard is the histopathological examination. This case report describes the autopsy and related investigations conducted on an 84-year-old man, nearly one year (357 days) after his death. After a post-mortem CT scan, an autoptic investigation was performed, followed by histopathological, immunohistochemical, and scanning electron microscopy examinations. The integration of the evidence from these examinations with previously available personal and clinical information conclusively confirmed the diagnosis of asbestosis. We demonstrated the efficacy and reliability of our diagnostic protocol in detecting asbestosis and asbestos fibers and excluding mesothelioma even in decomposed tissues. According to our findings autopsy remains the diagnostic gold standard in cases of suspected asbestosis within a forensic context, even 1 year after death, therefore it is always highly recommended, even in cases where the body has decomposed.

Extended analysis of solid cancer incidence among nuclear industry workers in the UK 1955-2011: comparison of workers first hired in earlier and later periods.

To address points arising from the recent study of nuclear workers in the USA and the International Nuclear Workers Study (INWORKS), concerning the difference in solid cancer risk estimates between those first hired in earlier and later calendar years, subsidiary analyses were conducted on a cohort of 172 452 workers in the National Registry for Radiation Workers (NRRW) from the UK. A total of 18 310 incident first primary solid cancer cases were registered in the period from 1955 until 2011 in the NRRW cohort and workers accrued 5.25 million person-years of follow-up. Incidences rates of all solid cancers combined, lung cancer and solid cancer excluding lung cancer were examined in terms of external radiation doses in the full cohort and in a sub-cohort of workers who had no record of internal exposure monitoring and were defined by the periods of first hire before and after the beginning of the years 1960, 1965 and 1970. All analyses were carried out using Poisson Regression. These analyses demonstrated that only for lung cancer between the pre-1965 and post-1964 periods is there strong evidence for a difference in the risks using the NRRW full cohort. In the other calendar period breakdowns and for the other cancer groups, there is no clear evidence of differences in the risks. The NRRW estimation of risks between recent and early workers is not generally consistent with the US workers cohort or the INWORKS evaluations that later hired workers are at much higher solid cancer risk than earlier hired workers, although INWORKS contains a significant part of the latest updated NRRW cohort as well as the US data. The conclusion that the INWORKS and US study data demonstrate a real difference in excess solid cancer risk from external radiation exposure between earlier and later workers is premature. The results presented here should also be treated with caution because of the limited corroborating evidence from other published studies. Information on internal doses, neutron doses as well as non-radiation factors such as smoking and asbestos exposure would be needed to make definitive inferences.

Potential Advantage of Magnetic Resonance Imaging in Detecting Thoracic Wall Infiltration in Pleural Mesothelioma. A Retrospective Single Center Analysis.

Abstract Background Thoracic wall infiltration in pleural mesothelioma (PM) can be an important prognostic factor when determining the extent of resection. Currently, standardized imaging for restaging after neoadjuvant systemic therapy comprises contrast enhanced Computed Tomography (CT) or Positron Emission Tomography (PET/CT) scan. Aims However, thoracic Magnetic Resonance Imaging (MRI) could be a better discriminator of chest wall infiltration prior to surgery. To increase the preoperative staging accuracy, we introduced a MRI protocol at our center. Methods A retrospective analysis of this prospective new imaging protocol was performed from 07/2018 to 08/2023, including descriptive analysis for patient`s sex, age, nicotine consumption, asbestos exposure, histological subtype, TNM-stage, RECIST criteria and number of neoadjuvant therapy cycles. Preoperative restaging included routine imaging and MRI. After histological diagnosis of PM, neoadjuvant therapy was conducted, followed by partial pleurectomy or extended pleurectomy/decortication, with intraoperative biopsies of suspicious chest wall lesions. The CT/MRI results were compared to the intraoperative biopsies. Sensitivity and specificity of both modalities were analyzed. Results Twenty-five patients (mean age 65.4, 12% female) with possible chest wall infiltration were included out of the 35 patients with PM treated during the observation period. Of the 10 patients with actual chest wall infiltration, 9 (90%) had a T-Stage of 3 or higher, 9 (90%) had PM of epithelioid histologic subtype and 4 (40%) a R2-Resection. The mean overall survival of all patients was 18.88 months (8-58). In our study, thoracic MRI showed a high sensitivity (90%) and specificity (100%) for the detection of chest wall infiltration, especially when compared to the CT scan (sensitivity of 10%). Conclusion With the adjunctive use of thoracic MRI we demonstrated a higher sensitivity for detection of chest wall infiltration compared to conventional imaging prior to surgery. This may facilitate the preoperative assessment of the extent of resection. Nevertheless, larger studies are required to confirm these results.

Quality of life in retired workers with past exposure to asbestos.

Asbestos causes cancer and non-cancerous lung and pleural diseases and can also have a negative psychological impact but little is known about its effect on health-related quality of life. The aim of this study is to describe the health-related quality of life (HRQoL) of retired men with a history of occupational exposure to asbestos and examine factors linked with low HRQoL. Retired male workers of the French Asbestos-Related Disease Cohort (ARDCO) completed self-questionnaires that included SF-36v2 and HAD scales, questions about their perception of asbestos (perceived dangers and level of exposure, expectations to fall ill, or knowing someone who is) and their respiratory symptoms. Asbestos exposure was assessed by industrial hygienists. A perceived risk score was created using factorial analysis. Multivariable regressions were performed for all SF-36 subscales. A total of 1266 of 2075 questionnaires (61%) were returned complete and included in analysis. After adjustment for potential confounders, an increase in perceived risk score resulted in a decrease in physical component summary score (PCS), up to 10.7 points (p = 0.048) and in mental component summary score (MCS) (p = 0.044). Presence of respiratory symptoms was also associated with significantly decreased PCS and MCS (p < 0.001). Poor HRQoL was linked to higher perceived risk score with p ≤ 0.01 for all SF-36 dimensions. Asbestos exposure assessed by an expert was not associated with any outcome. All dimensions of HRQoL appear to be affected by the perceived risk of incurring asbestos-related disease and respiratory symptoms.

The significance of BAP1 and MTAP/CDKN2A expression in well-differentiated papillary mesothelial tumour: a series of 21 cases and a review of the literature

The nomenclature and diagnostic criteria of well-differentiated papillary mesothelial tumour (WDPMT) have been changed in the 2021 World Health Organization (WHO) classification of thoracic tumours, and a new entity, mesothelioma in situ (MIS), introduced. Histologically these two entities may be similar. However, MIS is regarded as a precursor to invasive mesothelioma and requires demonstration of loss of BAP1 and/or MTAP/CDKN2A for diagnosis, whereas performance of these ancillary tests is desirable but not essential for a diagnosis of WDPMT, in which the significance of BAP1 and/or MTAP/CDKN2A loss is not well understood or well defined. Against this backdrop, we undertook an investigation of 21 cases of WDPMT, identified from our case files and diagnosed according to 2021 WHO criteria, to explore the relationship between histology and BAP1 and MTAP/CDKN2A expression with clinical features including asbestos exposure, focality of tumours and clinical outcome. There were 18 women and three men, with ages ranging from 23-77 years (median 62 years), in which six had a history of asbestos exposure, two had no exposure, and in 13 exposure history was unavailable. Of 20 peritoneal tumours and one pleural tumour, 13 were detected incidentally at the time of surgery for unrelated conditions and eight peritoneal tumours were multifocal at the time of diagnosis. BAP1 immunohistochemistry (IHC) was performed in all 21 tumours, with nine tumours showing BAP1 expression loss. MTAP/CDKN2A testing was performed in 14 tumours, comprising MTAP IHC in 12 and CDKN2A fluorescence in situ hybridisation (FISH) in two, with three tumours showing MTAP/CDKN2A expression loss. Two tumours with MTAP/CDKN2A loss also showed BAP1 expression loss. Four patients progressed to invasive mesothelioma, including one male with a pleural tumour and asbestos exposure, and three females with multifocal peritoneal tumours, two with asbestos exposure and one without exposure. BAP1 expression loss was seen in all tumours from the four patients who progressed to invasive mesothelioma, whilst two of these tumours showed retained MTAP IHC and two were not tested. There was one patient with a tumour with MTAP loss and retained BAP1 who died from unrelated causes 5 months after diagnosis. Eight patients received WDPMT-specific treatment in addition to the initial excision. Survival for all patients ranged from 4-218 months, with one patient dying of mesothelioma at 49 months. Based on our results in this series of 21 patients with WDPMT diagnosed according to 2021 WHO criteria, we propose that WDPMT with BAP1 expression loss may best be regarded as papillary MIS and that a history of asbestos exposure and the presence of multifocal tumours in patients diagnosed with WDPMT should prompt ancillary testing with BAP1 IHC. Further we propose that BAP1 IHC should be essential in the diagnosis of WDPMT, with the diagnosis restricted to those tumours which show retained BAP1 expression. However more studies in larger cohorts of patients are needed to explore the relationship between BAP1 expression and MTAP loss in WDPMT, which will help to define this entity and separate it more clearly from MIS and invasive mesothelioma.

Gluteal muscle metastases from malignant pleural mesothelioma: a case report.

Malignant pleural mesothelioma (MPM) is a rare malignancy arising from the mesothelial or subthelial layer of the pleura, and it has increased in recent decades, mainly associated with asbestos exposure. Sarcomatoid mesothelioma is the second-most common subtype of MPM. It is usually difficult to differentiate MPM from benign mesothelial pleural proliferations or other cancers. Because of its nonspecific symptoms, MPM is often diagnosed at a late stage with distal metastases. However, it is extremely rare to see a metastatic lesion within subcutaneous tissue and muscles, which is most likely caused by hematogenous spread. We present a case of sarcomatoid mesothelioma with a metastatic lesion of the right gluteal muscles.

From the Recognition of ‘Psychiatric Disorder Caused by Asbestos Exposure’ to the Mobilisation of Dignity in Labour Law: A Comparison of France and Sweden

Abstract In two rulings on 8 February 2023, the French Court of Cassation invoked the notion of ‘dignity’ in labour law to support claims for ‘damage due to anxiety’ (‘préjudice d’anxiété’). The concept of ‘damage due to anxiety’, which might in English be translated more functionally as ‘psychiatric disorder caused by asbestos exposure’, is based on loss arising from the fear of developing a future disease due to occupational exposure to a toxic and hazardous substance, such as asbestos. Based on a reading of these two cases, the aim of this article is to analyse the approach developed in the French legal system, and to discuss it from the standpoint of Swedish law. The concept of ‘psychiatric disorder caused by asbestos exposure’ is not currently recognised in Swedish law. However, the idea that physical work environment factors can cause psychological injury is not entirely unfamiliar. It touches upon the ideas of a holistic approach to the work environment and a broad and inclusive concept of health and illness, which are important foundations for Swedish work environment law. By studying this specific occupational health and safety issue it is possible to illuminate not only how this topical and important issue is regulated in France and Sweden, but also on a broader level how these two legal systems—the French one based on the individual responsibility of the employer and the Swedish one on collective bargaining—are functioning when it comes to systems of prevention of and compensation for ill health.

Asbestos exposures associated with the use and handling of drilling mud additives.

This paper summarizes historical asbestos exposure data collected during the handling of short-fiber chrysotile asbestos that was used as an additive to drilling fluid in oil and gas exploration. A total of 1171 industrial hygiene (IH) personal and area air samples were collected and analyzed from more than 20 drilling rigs between 1972 and 1985. The dataset consists of 1097 short-term samples (<240min) with more than 80% having sample durations less than 30min. Average airborne fiber concentrations measured during asbestos handling activities ranged from 0.62 f/cc to 3.39 f/cc using phase-contrast microscopy (PCM). An additional 14 samples were considered long-term samples (>240min) and there were 60 samples with no reported sample duration. Eight-hour time-weighted average (8-h TWA) results, calculated using short-term samples, along with long-term samples greater than 240min, did not exceed contemporaneous Occupational Safety and Health Administration (OSHA) permissible exposure limits (PELs). This analysis fills a data gap in the evaluation of asbestos exposures from the use of drilling mud additives (DMAs) that contained chrysotile asbestos.

Personal protective equipment for preventing asbestos exposure in workers.

Personal protective equipment for preventing asbestos exposure in workers.

Who is at risk of lung nodules on low-dose CT in a Western country? A population-based approach.

This population-based study aimed to identify the risk factors for lung nodules in a Western European general population. We quantified the presence or absence of lung nodules among 12 055 participants of the Dutch population-based ImaLife (Imaging in Lifelines) study (≥45 years) who underwent low-dose chest computed tomography. Outcomes included the presence of 1) at least one solid lung nodule (volume≥30 mm3) and 2) a clinically relevant lung nodule (volume≥100 mm3). Fully adjusted multivariable logistic regression models were applied overall and stratified by smoking status to identify independent risk factors for nodules presence. Among the 12 055 participants (44.1% men; median age 60 years; 39.9% never smokers; 98.7% Caucasian), we found lung nodules in 41.8% (5045 out of 12 055) and clinically relevant nodules in 11.4% (1377 out of 12 055); the corresponding figures among never smokers were 38.8% and 9.5%. Factors independently associated with increased odds of having any lung nodule included male-sex, older-age, low-educational level, former smoking, asbestos exposure, and chronic obstructive pulmonary disease. Among never smokers, a family history of lung cancer increased the odds of both lung nodules and clinically relevant nodules. Among former and current smokers, low educational level was positively associated with lung nodules, whereas being overweight was negatively associated. Among current smokers, asbestos exposure and low physical activity were associated with clinically relevant nodules. The study provides a large-scale evaluation of lung nodules and associated risk factors in a Western European general population: lung nodules and clinically relevant nodules were prevalent, and never smokers with a family history of lung cancer were a non-negligible group.

Pleural mesothelioma from fluoro-edenite exposure: PACAP and PAC1 receptor. A preliminary report.

Pleural mesothelioma is a devastating malignancy primarily associated with asbestos exposure. However, emerging evidence suggests that exposure to fluoro-edenite fibers, a naturally occurring mineral fiber, can also lead to the development of pleural mesothelioma. In this study, based on the hypothesis that pituitary adenylate cyclase-activating polypeptide (PACAP) and PACAP-preferring receptor (PAC1R) expressions could be dysregulated in pleural mesothelioma samples and that they could potentially act as diagnostic or prognostic biomarkers, we aimed to investigate the immunohistochemical expression of PACAP and PAC1R in pleural biopsies from patients with pleural mesothelioma exposed to fluoro-edenite fibers. A total of 12 patients were included in this study, and their biopsies were processed for immunohistochemical analysis to evaluate the expression of PACAP and its receptor. The study revealed a correlation between the overexpression of PACAP and PAC1R and shorter overall survival in patients with malignant mesothelioma. These findings suggest that PACAP and PAC1R expression levels could serve as potential prognostic biomarkers for malignant mesothelioma. Furthermore, the immunohistochemical analysis of PACAP and PAC1R may provide valuable information for clinicians to guide therapeutic decisions and identify patients with poorer prognosis.

Impact of air quality on the health of present-day workers in an Asbestos roof manufacturing industry, Sri Lanka.

The study's objective was to determine the air quality in an asbestos-related industry and its impact on current workers' respiratory health. Seventy-seven air and 65 dust samples were collected at 5-day intervals in an asbestos roofing sheets production factory in Sri Lanka having two production facilities. Sampling was performed in ten sites: Defective sheets-storage, Production-plant, Pulverizer, Cement-silo, and Loading-area. A detailed questionnaire and medical screening were conducted on 264 workers, including Lung Function Tests (LFT) and chest X-rays. Asbestos fibres were observed in deposited dust samples collected from seven sites. Free chrysotile fibres were absent in the breathing air samples. Scanning Electron Microscopy confirmed the presence of asbestos fibres, and the Energy Dispersive X-ray analysis revealed Mg, O, and Si in depositions. The average concentrations of trace metals were Cd-2.74, Pb-17.18, Ni-46.68, Cr-81.01, As-7.12, Co-6.77, and Cu-43.04mg/kg. The average Zn, Al, Mg, and Fe concentrations were within 0.2-163g/kg. The highest concentrations of PM2.52.5 and PM1010, 258 and 387µg/m3, respectively, were observed in the Pulverizer site. Forty-four workers had respiratory symptoms, 64 presented LFT abnormalities, 5 indicated chest irregularities, 35.98% were smokers, and 37.5% of workers with abnormal LFT results were smokers. The correlation coefficients between LFT results and work duration with respiratory symptoms and work duration and chest X-ray results were 0.022 and 0.011, respectively. In conclusion, most pulmonary disorders observed cannot directly correlate to Asbestos exposure due to negligible fibres in breathing air, but fibres in the depositions and dust can influence the pulmonary health of the employees.

Association Study of Pleural Mesothelioma and Oncogenic Simian Virus 40 in the Crocidolite-Contaminated Area of Dayao County, Yunnan Province, Southwest China.

Background: In Dayao County, Chuxiong Yi Autonomous Prefecture, Yunnan Province, Southwest China, 5% of the surface is scattered with blue asbestos, which has a high incidence of pleural mesothelioma (PMe). Simian virus 40 (SV40) is a small circular double-stranded DNA polyomavirus that can cause malignant transformation of normal cells of various human and animal tissue types and promote tumor growth. In this study, we investigate whether oncogenic SV40 is associated with the occurrence of PMe in the crocidolite-contaminated area of Dayao County, Yunnan Province, Southwest China. Methods: Tumor tissues from 51 patients with PMe (40 of whom had a history of asbestos exposure) and pleural tissues from 12 non-PMe patients (including diseases such as pulmonary maculopathy and pulmonary tuberculosis) were collected. Three pairs of low-contamination risk primers (SVINT, SVfor2, and SVTA1) were used to detect the gene fragment of SV40 large T antigen (T-Ag) by polymerase chain reaction (PCR). The presence of SV40 T-Ag in PMe tumor tissues and PMe cell lines was detected by Western blotting and immunohistochemical staining with SV40-related antibodies (PAb 101 and PAb 416). Results: PCR, Western blotting, and immunohistochemical staining results showed that the Met5A cell line was positive for SV40 and contained the SV40 T-Ag gene and protein. In contrast, the various PMe cell lines NCI-H28, NCI-H2052, and NCI-H2452 were negative for SV40. PCR was negative for all three sets of low-contamination risk primers in 12 non-PMe tissues and 51 PMe tissues. SV40 T-Ag was not detected in 12 non-PMe tissues or 51 PMe tissues by immunohistochemical staining. Conclusion: Our data suggest that the occurrence of PMe in the crocidolite-contaminated area of Yunnan Province may not be related to SV40 infection and that crocidolite exposure may be the main cause of PMe. The Clinical Trial Registration number: 2020-YXLL20.