Environmental Asbestos Exposure Research Articles

Environmental asbestos exposure and risk of mesothelioma.

Mesothelioma is commonly considered an occupational disease occurring as a result of asbestos exposure in the workplace. Several avenues for environmental asbestos exposures have been described and may be associated with asbestos related disease, including mesothelioma. Worker take-home asbestos, or para-occupational exposure, has been well documented and is the most commonly reported pathway for asbestos exposure among mesothelioma cases that do not have history of occupational asbestos exposure. Observational studies have evaluated several communities with elevated mesothelioma incidence and environmental exposures attributed to local asbestos-related industries. Potential, but uncertain, mesothelioma risk also may be associated with general population asbestos exposure through contact with asbestos-containing commercial products, particularly housing materials that can be easily disturbed through normal activity. Finally, studies have described elevated mesothelioma incidence in several areas where populations are exposed to naturally occurring asbestos materials. These various environmental asbestos exposure pathways are poorly understood, and further studies should be pursued to evaluate their respective importance for population mesothelioma risk.

Malignant mesothelioma in 91 danish women: The environmental asbestos exposure.

8560 Background: Malignant Mesothelioma (MM) is an asbestos-related malignancy that presents mainly in the pleura (MPM) and peritoneum (MAM). In a densely populated area of Aalborg city in North Jutland, Denmark, a large Eternit asbestos factory that was active for 60 years until 1986 and two shipyards were situated. The Region of North Jutland, Denmark has a high mm incidence in women of 1.0/100,000. Methods: From 1974-2015, 101 histological and cytological samples of women diagnosed with mm in Aalborg University Hospital were identified re-evaluated by modern immunohistochemistry. Patient information regarding asbestos exposure was retrieved from medical records and selected Danish registries. Asbestos exposure was classified as primary for asbestos workers; domestic, for women living with an asbestos worker; environmental, when living or working within 10.000 meters from an asbestos emitting location; unknown, where no source of asbestos exposure could be identified. Results: Clinical and histopathological mm diagnosis was certain for 91 women. Potential asbestos exposure is summarized in Table 1. The employment of the women and their relatives include work at the asbestos cement factory, shipyard, construction, laboratory, pipe factory, electrician and insulator. The women with domestic and combined domestic and environmental (secondary) exposure to asbestos were most prone to develop MPM rather than MAM while women primary exposed to asbestos developed MAM rather than MPM (p=0.016). Conclusions: This study showed that the vast majority (64%) of the women diagnosed with mm had documented non-occupational asbestos exposure and almost 1/5 had a sole environmental exposure, by living in proximity to asbestos industry. Environmental asbestos exposure is a serious risk factor for mm in women. Primary asbestos exposure, inferring more intense exposure through occupation, may predispose to peritoneal mesothelioma in women. [Table: see text]

Environmental asbestos disease: pleural plaque volume measurement with Chest Tomography is there a correlation between pulmonary function?

Objectives: Chest X-ray is correlated with pulmonary function of asbestos related disease. These correlations limited by low specific and sensitive. Computed tomography (CT) more sensitive. There was no adopted for the measurement of CT. Our aim in this study was to determine correlation between pleural plaque (PP) volume and lung function for use improving classification with CT. Methods: The study included 75 patients with environmental asbestos exposure. PP areas measured in patients were divided by the patient lung area to determine PP ratio with CT. Diffusing capacity and six minute walking distance (6MWD) measured and evaluated quality of life. Results:PP identified in 66 (88%) of the patients with CT. PP most frequently noted in the front right quadrant and had an average plaque volume of 7729,17 mm3. Plaque ratio taken as the percentage of the ratio to the lung volume, mean plaque percentage was 0,37±0,45% (0,003-2,3). In 12(18,1%) of the patients, asbestosis not seen with chest X-ray was detected with CT. Conclusions: PP volume and ratios were not statistically significantly correlated with respiratory functions, exercise capacity, cumulative amount of exposure. Patient of asbestos disease total lung capacity was lower, 6MWD distance was shorter and quality of life was poorer. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 336-342).

Pleural mesothelioma in doll manufacture: possible asbestos exposure.

The occurrence of malignant mesothelioma is almost always causally associated to asbestos exposure but, considering women occurrences, this association is often difficult to demonstrate and consequently the asbestos exposure is defined as 'unknown'. To describe the working activity and to give occupational asbestos exposure probability estimation related to an uncommon and poorly investigated productive sector: doll manufacture. From the Province of Brescia Mesothelioma Registry, established in 1993 on population-based criteria, we have extracted the certified mesothelioma diagnosis cases, related to patients who were employed for some time in doll manufacture. Among the 757 total cases of malignant mesothelioma registered and studied up to 2016, we found 3 cases of pleural epithelial mesothelioma histologically diagnosed in young women who had worked in two doll manufacturing companies and whose asbestos exposure had been initially defined as 'unknown', because an environmental, family or extra-professional asbestos exposure was considered unlikely. However, the judicial autopsy performed on one of the 3 women had allowed examining lung tissue samples with Scanning Electron Microscopy. This technique showed a concentration of amphiboles fibers of about 12,000,000 per gram of dry lung tissue, with a consequent re-classification of asbestos exposure from 'unknown' to 'occupational certified'. Mesotheliomas in women with no apparent occupational asbestos exposure are normally referred to life or family environmental exposure. Moreover, it is known that occupational asbestos exposure in women is difficult to recognize. Previously, only one publication had reported two cases of mesothelioma in cloth doll manufacture. The occurrence of two mesothelioma cases in the same company out of the three here presented was suggesting an occupational exposure. The finding of a high amphibole fibers lung concentration confirmed the previous hypothesis, despite the impossibility to determine the circumstances with good evidence. The three cases of mesothelioma in doll production workers suggest that also in this restricted manufacturing sector had occurred an occupational asbestos exposure, which is up to now unknown and isn't due only to the use of sewing or ironing machines. The lung asbestos fibers burden analysis is confirmed to be a decisive factor in the assessment of mesothelioma cases with 'unknown' exposure.

Validity and Reliability of Asbestos Knowledge and Awareness Questionnaire for Environmental Asbestos Exposure in Rural Areas

Validity and Reliability of Asbestos Knowledge and Awareness Questionnaire for Environmental Asbestos Exposure in Rural Areas

Pleurectomy/decortication for malignant pleural mesothelioma

Malignant pleural mesothelioma (MPM) is a tumour arising from the mesothelial cells lining the pleural cavity. There is an association between environmental asbestos exposure and the development of MPM with an increasing annual incidence in UK of over 2,000 cases per year. The standard treatment is chemotherapy and in some patients additional surgery may have a survival benefit. The role of surgical resection in the management of MPM is still controversial. Recent reports suggest that patients undergoing surgery experienced a longer median survival compared with those without surgery. Two surgical techniques are available, Extended pleurectomy/decortication (EPD) and extrapleural pneumonectomy which is less tolerated. EPD is an operation to achieve macroscopic complete resection of the disease involving resection of the parietal and visceral pleurae, pericardium, and diaphragm without sacrificing the lung. In MPM because of inability to eradicate residual microscopic disease, surgery is cytoreductive rather than radical. Therefore, treatment has focused on surgery in combination with radiation and/or chemotherapy in a multimodality setting. The MARS2 trial was initiated to establish the role of EPD in the setting of multimodal therapy. CT-scan and associated positron emission tomography (PET)-scan are essential for staging the disease and planning surgical strategy. Stage IV patients with diffuse disease or metastatic disease should be excluded from surgery. The EPD is conducted via a single skin incision and single or double thoracotomy. The steps are as follows: (I) dissection and mobilisation of parietal pleura from the chest wall; (II) dissection and mobilisation of mediastinal pleural to separate the tumor from mediastinum; (III) decortication of the lung separating visceral pleura from lung parenchyma; (VI) mediastinal lymph node dissection; (V) anterior, posterior and inferior pericardial resection; (VI) mobilisation and resection of diaphragm; (VII) reconstruction of diaphragm and pericardium; (VIII) closure.

Environmental asbestos exposure sources in Korea.

BackgroundBecause of the long asbestos-related disease latencies (10–50 years), detection, diagnosis, and epidemiologic studies require asbestos exposure history. However, environmental asbestos exposure source (EAES) data are lacking.ObjectivesTo survey the available data for past EAES and supplement these data with interviews.MethodsWe constructed an EAES database using a literature review and interviews of experts, former traders, and workers. Exposure sources by time period and type were visualized using a geographic information system (ArcGIS), web-based mapping (Google Maps), and OpenWeatherMap. The data were mounted in the GIS to show the exposure source location and trend.ResultsThe majority of asbestos mines, factories, and consumption was located in Chungnam; Gyeonggi, Busan, and Gyeongnam; and Gyeonggi, Daejeon, and Busan, respectively. Shipbuilding and repair companies were mostly located in Busan and Gyeongnam.ConclusionsThese tools might help evaluate past exposure from EAES and estimate the future asbestos burden in Korea.

Pleural mesothelioma risk associated with environmental asbestos exposure in Casale Monferrato (Italy) area: a case control study

Introduction. The area of Casale Monferrato (north west Italy) is affected by high levels of environmental asbestos pollution from an Eternit asbestos cement (AC) plant active from 1906 to 1986. We...

Estimation of national and subnational environmental burden of disease, Republic of Korea

Introduction: In Korea, first estimation of environmental burden of disease was first conducted on 2009. This study aimed to estimate the environmental burden of disease in Korea while adopting the updated method of assessment and data sources on both national and local level. Methods: Environmental risk factors responsible for the main health outcomes were selected based on the known public health impacts, exposure prevalence, level of individual risk, and public concern: environmental asbestos exposure, radon, second hand smoking, radiation, environmental chemical exposure, and particulate matter. Burden of disease for specific cancers were estimated based on the global burden of disease 2010 method, using National Health Insurance dataset, national mortality dataset and National Cancer Registry dataset. Depending on the type of exposure-response function available, either relative risk or unit risk was estimated based on the systematic review of literature, both domestic and global. Population attributable fractions of specific environmental factors on health outcome were estimated based on the sources on the national exposure population assessment for each risk factor. Based on the local exposure, demographic, and health data, disability-adjusted life years (DALY) was estimated for local areas whenever possible. Results: DALYs were estimated from years of life lost (YLL) and years with disability (YLD) for ambient and indoor air pollution, water and sanitation, climate disasters, occupation, environmental disasters, second hand smoking, radon, ultraviolet radiation, and metals. Conclusions: This study presents a comprehensive feature of environmental risk of health outcomes both nationwide and at local level. This study provides strong evidence to booster environmental health policies to control and of environmental risk factors as a high priority.

Evaluation of New Biomarkers in the Prediction of Malignant Mesothelioma in Subjects with Environmental Asbestos Exposure.

The purpose of this study was to investigate the potential value of certain biomarkers in predicting the presence of malignant pleural mesothelioma (MPM) in individuals environmentally exposed to asbestos. This prospective study investigated three groups; a control group composed of 41 healthy subjects, an asbestos exposure group consisting of 48 individuals, and a MPM group consisting of 42 patients. Serum levels of soluble mesothelin-related peptide (SMRP), thioredoxin-1 (TRX), epidermal growth factor receptor (EGFR), fibulin-3, syndecan-1 (SDC-1), and mesothelin were determined. Benign pleural plaques were present in 27 (58.3%) of the individuals in the asbestos exposure group. The asbestos exposure group had significantly higher mean TRX, SMRP, and mesothelin levels compared to the control group (p=0.023, p=0.011, and p<0.001, respectively). Compared to the asbestos exposure group, the MPM group had significantly higher mean EGFR, TRX, SMRP, and fibulin-3 levels (p=0.041, p=0.023, p=0.002, and p=0.001, respectively), and significantly lower mean SDC-1 levels (p=0.002). Unlike the other biomarkers, SMRP and TRX levels increased in a graded fashion among the control, asbestos exposure, and MPM groups, respectively. Area under the curve values for SMRP and TRX were 0.86 and 0.72, respectively (95% CI0.79-0.92 and p<0.001 for SMRP, and 95% CI0.62-0.81 and p<0.001 for TRX). The cut-off value for SMRP was 0.62nmol/l (sensitivity: 97.6%, specificity: 68.9%, positive predictive value (PPV): 56.2%, and negative predictive value (NPV): 98.3%) and for TRX was 156.67ng/ml (sensitivity: 92.9%, specificity: 77.6%, PPV: 41.4%, and NPV: 92.1%). The combination of the biomarkers reached a sensitivity of 100%, but had lower specificity (as high as 27.7%). Serum biomarkers may be helpful for early diagnosis of MPM in asbestos-exposed cases. SMRP and TRX increased in a graded fashion from the controls to asbestos exposure and MPM groups. These two seem to be the most valuable biomarkers for the diagnosis of MPM, both individually and in combination.

Malignant Pleural Mesothelioma: New Ideas Needed

10.2217/lmt.15.28 © 2015 Future Medicine Ltd Malignant pleural mesothelioma (MPM) is a rare and aggressive neoplasm that arises from the mesothelial cells of the serous membrane. In more than 80% of cases it affects the pleura whereas peritoneal (roughly 20%), pericardial cavities and the tunica vaginalis are less frequently involved [1,2]. In around 80% of cases MPM is caused by occupational and environmental asbestos exposure or as a result of second hand exposure. It is more common in men over 65 years of age (sex-ratio 4:1) [1]. Exposure to a Simian Virus 40 (SV40), radiation and erionite have also been shown to play a causative role [3]. The annual incidence of MPM is estimated at around 2000–3000 new cases per year in the USA, 1000–1500 per year in Great Britain and 1000 per year in Germany [4], while in Europe a quarter of a million deaths of MPM are expected in the next years only among men with occupational exposure. This is due to the long latency period between asbestos exposure and disease onset (from 20 to 40 years) [5]. Moreover, although in most of the countries the use of asbestos is forbidden, MPM incidence is predicted to increase in many developing countries where asbestos is still currently used. Indeed, many experts have announced that we are on the verge of a worldwide epidemic of subjects affected by this cancer. MPM is characterized by a very poor prognosis with median survival time up to 18 months and the 5-year survival rate is less than 5% [6]. Survival rate is even shorter for patients with sarcomatous subtype [6]. These daunting figures are mostly due to the fact that MPM is still a difficult cancer to treat and very few drugs, for example, platin combined with antifolates or gemcitabine, show some efficacy against this disease however, unfortunately, their effect on the overall survival is negligible [7]. In earlier stages of nonsarcomatous MPM in patients with good performance status, multimodality therapy is proposed including extrapleural pneumonectomy or extended pleurectomy/decortication, followed by chemotherapy and radiotherapy. Nevertheless there are no randomized clinical trials that can provide a conclusive outcome of this approach as a standard treatment for MPM [7]. Eventually, a standard second-line treatment is still to be defined [7]. Chemotherapy has not shown any significant effect in this setting and even new approaches including those ‘biological’ have shown disappointing results so far [8]. Fore ord Special Focus Issue: Novel Insights into the Pathophysiology and Treatment of Malignant Pleural Mesothelioma

Current Research and Opportunities to Address Environmental Asbestos Exposures.

SummaryAsbestos-related diseases continue to result in approximately 120,000 deaths every year in the United States and worldwide. Although extensive research has been conducted on health effects of occupational exposures to asbestos, many issues related to environmental asbestos exposures remain unresolved. For example, environmental asbestos exposures associated with a former mine in Libby, Montana, have resulted in high rates of nonoccupational asbestos-related disease. Additionally, other areas with naturally occurring asbestos deposits near communities in the United States and overseas are undergoing investigations to assess exposures and potential health risks. Some of the latest public health, epidemiological, and basic research findings were presented at a workshop on asbestos at the 2014 annual meeting of the Society of Toxicology in Phoenix, Arizona. The following focus areas were discussed: a) mechanisms resulting in fibrosis and/or tumor development; b) relative toxicity of different forms of asbestos and other hazardous elongated mineral particles (EMPs); c) proper dose metrics (e.g., mass, fiber number, or surface area of fibers) when interpreting asbestos toxicity; d) asbestos exposure to susceptible populations; and e) using toxicological findings for risk assessment and remediation efforts. The workshop also featured asbestos research supported by the National Institute of Environmental Health Sciences, the Agency for Toxic Substances and Disease Registry, and the U.S. Environmental Protection Agency. Better protection of individuals from asbestos-related health effects will require stimulation of new multidisciplinary research to further our understanding of what constitutes hazardous exposures and risk factors associated with toxicity of asbestos and other hazardous EMPs (e.g., nanomaterials).

CT Characteristics of Pleural Plaques Related to Occupational or Environmental Asbestos Exposure from South Korean Asbestos Mines

ObjectiveThis study evaluated the CT characteristics of pleural plaques in asbestos-exposed individuals and compared occupational versus environmental exposure groups.Materials and MethodsThis study enrolled 181 subjects with occupational exposure and 98 with environmental exposure from chrysotile asbestos mines, who had pleural plaques confirmed by a chest CT. The CT scans were analyzed for morphological characteristics, the number and distribution of pleural plaques and combined pulmonary fibrosis. Furthermore, the CT findings were compared between the occupational and environmental exposure groups.ResultsConcerning the 279 subjects, the pleural plaques were single in 2.2% and unilateral in 3.6%, and showed variable widths (range, 1-20 mm; mean, 5.4 ± 2.7 mm) and lengths (5-310 mm; 72.6 ± 54.8 mm). The chest wall was the most commonly involved (98.6%), with an upper predominance on the ventral side (upper, 77.8% vs. lower, 55.9%, p < 0.001) and a lower predominance on the dorsal side (upper, 74.9% vs. lower, 91.8%, p = 0.02). Diaphragmatic involvement (78.1%) showed a right-side predominance (right, 73.8% vs. left, 55.6%, p < 0.001), whereas mediastinal plaques (42.7%) were more frequent on the left (right, 17.6% vs. left, 39.4%, p < 0.001). The extent and maximum length of plaques, and presence and severity of combined asbestosis, were significantly higher in the occupational exposure group (p < 0.05).ConclusionPleural plaques in asbestos-exposed individuals are variable in number and size; and show a predominant distribution in the upper ventral and lower dorsal chest walls, right diaphragm, and left mediastinum. Asbestos mine workers have a higher extent of plaques and pulmonary fibrosis versus environmentally exposed individuals.

S4 Relationship Between Historic Uk Asbestos Imports And Annual Mortality Due To Mesothelioma, Asbestosis And Idiopathic Pulmonary Fibrosis

Background Previous studies from a number of countries have demonstrated that the rising mortality due to mesothelioma and asbestosis can be predicted from their historic asbestos usage. Mortality due to idiopathic pulmonary fibrosis (IPF) is also rising in the UK, without any identified explanation. This analysis compared annual male and female mortality due to IPF, asbestosis and mesothelioma, and examined the relationship between mortality and national asbestos import data. Methods Mortality data for IPF and asbestosis in England and Wales were available from the Office for National Statistics (ONS). Data for mesothelioma deaths in England and Wales and historic UK asbestos import data were available from the Health and Safety Executive (HSE). The numbers of annual deaths due to each condition were plotted separately by gender, against UK asbestos imports 48 years earlier. Pearson correlation co-efficients were then calculated. Results Correlation co-fficients for each condition are shown in Table 1. The annual number of deaths due to mesothelioma and IPF were significantly correlated with historical asbestos imports for both genders. For asbestosis mortality, a similar relationship was found for male but not female deaths. Conclusion The strength of the association between IPF and historical asbestos imports was similar to that seen for mesothelioma mortality. This finding suggests that the role of occupational and environmental asbestos exposure in the aetiology of IPF requires further consideration.

Amphibole Asbestos Exposure Metrics for a Superfund Community

Amphibole Asbestos Exposure Metrics for a Superfund CommunityAbstract Number:2723 Curtis Noonan*, Kathrene Conway, Erin Landguth, Tracy McNew, Laura Linker, Jean Pfau, Brad Black, Jaime Szeinuk, and Raja Flores Curtis Noonan* University of Montana, United States, E-mail Address: [email protected] Search for more papers by this author , Kathrene Conway University of Montana, United States, E-mail Address: [email protected] Search for more papers by this author , Erin Landguth University of Montana, United States, E-mail Address: [email protected] Search for more papers by this author , Tracy McNew Center for Asbestos Related Disease, United States, E-mail Address: [email protected] Search for more papers by this author , Laura Linker Icahn School of Medicine at Mount Sinai, United States, E-mail Address: [email protected] Search for more papers by this author , Jean Pfau Idaho State University, United States, E-mail Address: [email protected] Search for more papers by this author , Brad Black Center for Asbestos Related Disease, United States, E-mail Address: [email protected] Search for more papers by this author , Jaime Szeinuk Icahn School of Medicine at Mount Sinai, United States, E-mail Address: [email protected] Search for more papers by this author , and Raja Flores Icahn School of Medicine at Mount Sinai, United States, E-mail Address: [email protected] Search for more papers by this author AbstractBackground: Libby, Montana, located in the Rocky Mountain region of the United States, was home to workers at a historical vermiculite mining facility. The material was contaminated with amphibole fibers, Libby amphibole, and several pathways of environmental asbestos exposure to the general population have been described. The objective of this study was to develop a comprehensive exposure assessment approach that integrates information on individuals’ contact frequency with multiple exposure pathways.Methods: A local clinic and health screening program collected data from participants on past occupational and environmental exposures to vermiculite and asbestos. For 3,031 participants, we developed formulas to describe cumulative exposure via environmental pathways, occupational history, and residents’ contact with carry-home dust from household workers. Cumulative exposure metrics were evaluated with respect to age and sex by analysis of variance.Results: The mean age (sd) was 58.0 (12.7) years and 46.5% were women. Of the 2,440 participants with some residence time in Libby, the mean (sd) years of residence was 17.8 (11.4) years. Contact with the 11 environmental exposure pathways was common, ranging from 32% to 89% of all respondents. The cumulative mean (sd) metric for environmental exposures was not significantly different by age group (p = 0.24) or by sex (mean (sd) years = 0.87 (2.81) for women and 0.77 (1.96) for men, p = 0.25). Combined cumulative exposures for carry-home pathways were almost two times higher among women compared to men (p < 0.001). Strong sex*age interactions were observed for occupational exposure pathways and carry-home pathways (p < 0.001).Conclusion: The comprehensive exposure assessment strategies will advance health studies and risk assessment approaches in this general population with a complex history of both occupational and environmental asbestos exposure.

Environmental Asbestos Exposure and Pleural Malignant Mesothelioma in Italy

Up to the asbestos ban in 1992 an amount of 3,748,550 tons of raw asbestos has been produced in Italy, with a peak in the period between 1976 and 1980 with a consistent delay in trend with respect to many other industrialized countries. As a consequence, in Italy a surveillance system of mesothelioma incidence is active since 2002 by the National Register of Mesotheliomas (ReNaM) searching cases and defining asbestos exposure modalities. ReNaM collected a caselist of 15,845 MM cases, the standardised incidence rates for pleural mesothelioma in 2008 is 3.84 (per 100,000) for men and 1.45 for women; 0.26 and 0.12 for peritoneal site respectively and less than 1 case for million inhabitants for pericardial and tunica vaginalis testis forms. Among 15,845 MM collected cases, the modalities of exposure to asbestos fibres have been investigated for 12,065 subjects (76.1%) and we found 514 cases (4.3%) with an environmental exposure to asbestos (they lived near sources of asbestos pollution and they have been not occupationally exposed), 530 (4.4%) with a familial exposure (they have lived with a cohabitant occupationally exposed) and 188 (1.6%) have suffered an exposure due to hobby-related or leisure activities. A statistically significant difference in median age at diagnosis, at first exposure and of the latency period has been found (p&lt;0.01). Clusters of MM cases due to environmental exposure are prevalently related to the presence of asbestos-cement industry plants (Casale Monferrato, Broni, Bari), to shipbuilding and repair activities (Monfalcone, Trieste, La Spezia, Genova, Castellamare di Stabia, Livorno, Taranto) and to soil contamination (Biancavilla in Sicily). Asbestos pollution outside the workplaces contributes in a significant magnitude to the burden of asbestos-related diseases; there is a need to discuss how to deal compensation rights for malignant mesothelioma cases induced by a not occupational exposure to asbestos.

Past trends and future prediction of mesothelioma incidence in an industrialized area of Italy, the Veneto Region

Background Malignant Mesothelioma (MM) is so associated with (professional, familial or environmental) asbestos exposure that trends in incidence and mortality parallel, after 30–40 years, the trend in asbestos consumption. In recent decades, the industrialized countries have witnessed a steady growth of pleural MM (MPM), following a stabilization or decline in rates in the countries that first adopted restrictive policies. The aim of this study was to evaluate the temporal variations of pleural MM incidence in the Veneto Region of Italy in the period 1987–2010. Methods We included only MPM with histological or cytological diagnosis. Age-Period-Cohort (APC) models were used to assess the trend in the incidence of MPM in both genders. Future predictions were evaluated by using a Bayesian APC model. Results In the period 1987–2010, 1600 MPMs have occurred. We observe a positive trend in the incidence in the whole period considered. The APC model showed that in both genders the cohort at higher risk is the one born between the years 1940–1945. Future projections indicate that the trend will decrease after the incidence peak of 2010; yet 1234 men are expected to develop a mesothelioma between 2011 and 2026. Among women, the future MPM rates will be stable or slightly decreasing. Conclusions The asbestos ban introduced in Italy in the year 1992 as a prospective result will certainly determine a decreasing incidence. However, the extremely long latency of MPM means that its influence is not yet observable.

Environmental exposure to asbestos

This article aims to review the geological background of environmental asbestos exposure and the distribution of asbestos-related disease (ARD) in association with naturally occurring asbestos (NOA), and discusses the potential health risks associated with exposure to non-occupational asbestos. With the motion of continental and oceanic plates, in some parts of the world serpentinites in the lower layer of the oceanic plate move into the continental plate and form the so-called ophiolites. Ophiolites consist of soil and rocks containing serpentine-type asbestos. There is an increase in ARDs in regions close to ophiolites. Indoor exposure and outdoor exposure to NOA, outdoor exposure to industrial asbestos and mines, urbanization and construction works in NOA regions are the known sources and types of environmental asbestos exposure. Although there is an expectance of decline in ARDs caused by industrial exposure to asbestos, the environmental exposure to asbestos is still a challenge waiting to be overcome.

Multiple pathway asbestos exposure assessment for a Superfund community.

Libby, MT, USA, was the home to workers at a historical vermiculite mining facility and served as the processing and distribution center for this industrial product that was contaminated with amphibole asbestos. Several pathways of environmental asbestos exposure to the general population have been identified. The local clinic and health screening program collects data from participants on past occupational and environmental exposures to vermiculite and asbestos. Health studies among this population have demonstrated associations between amphibole exposure and health outcomes, but critical questions regarding the nature and level of exposure associated with specific outcomes remain unanswered. The objective of this study was to develop a comprehensive exposure assessment approach that integrates information on individuals' contact frequency with multiple exposure pathways. For 3031 participants, we describe cumulative exposure metrics for environmental exposures, occupational exposures, and residents' contact with carry-home asbestos from household workers. As expected, cumulative exposures for all three occupational categories were higher among men compared with women, and cumulative exposures for household contact and environmental pathways were higher among women. The comprehensive exposure assessment strategies will advance health studies and risk assessment approaches in this population with a complex history of both occupational and environmental asbestos exposure.

거미 서폐의 미세구조와 석면노출 환경의 모니터링을 위한 생물지표적 유용성 평가에 관한 연구

거미 서폐의 미세구조와 석면노출 환경의 모니터링을 위한 생물지표적 유용성 평가에 관한 연구