Attributable Risk and Exposure to Asbestos

Attributable Risk and Exposure to Asbestos

Asbestos is deadly when it is broken into small pieces and inhaled.  One interesting study is called, “Asbestos and lung cancer in Glasgow and the west of Scotland.” By H De Vos Irvine, D W Lamont, D J Hole, C R Gillis – BMJ 1993; 306 : 1503 doi:  (Published 5 June 1993) – Here is an excerpt: “Abstract – OBJECTIVE–To quantify the relation between lung cancer and exposure to asbestos in men in west Scotland and to estimate the proportion of lung cancer which may be attributed to exposure to asbestos. DESIGN-An ecological correlation study of the incidence of lung cancer in men and past asbestos exposure. The unit of analysis was the postcode sector. Correction was made for past cigarette smoking, air pollution, and deprivation. SETTING–The region covered by the west of Scotland cancer registry, containing 2.72 million people and including Glasgow and the lower reaches of the River Clyde, where shipbuilding was once a major industry. SUBJECTS–All men diagnosed with lung cancer between 1975 and 1984 whose residence at the time of registration was within the west of Scotland. MAIN OUTCOME MEASURE–The population attributable risk for asbestos related lung cancer. RESULTS–An estimated 5.7% (95% confidence interval 2.3 to 9.1%) of all lung cancers in men registered in the west of Scotland during the period 1975-84 were asbestos related, amounting to 1081 cases. CONCLUSIONS–A considerable proportion of cases of lung cancer in men in Glasgow and the west of Scotland from 1975 to 1984 were asbestos related. Most of these may not have been considered for compensation by the Department of Social Security. Given the very small annual number of recorded cases of asbestosis this condition is probably not a prerequisite for the development of asbestos related lung cancer. A heightened awareness of the increasing incidence of asbestos related neoplasms and their more thorough investigation are recommended.”

Another interesting study is called, “Environmental asbestos exposure and malignant pleural Mesothelioma” by M. Metintas, N. Özdemir, G. Hillerdal, I. Uçgun, S. Metintas, C. Baykul, O. Elbek, S. Mutlu, M. Kolsuz – Volume 93, Issue 5, Pages 349-355 (May 1999).  Here is an excerpt: “Abstract – Asbestos-related benign and malignant pleural diseases are endemic in some rural parts of central Turkey because of environmental exposure to asbestos fibres. We report here epidemiological data on 113 patients with diffuse malignant pleural mesothelioma (DMPM) diagnosed in our clinic in Eskişehir, located in central Turkey.

Of the 113 patients, 59 were men and 54 women (male:female ratio=1). Ninety-seven patients (86%) had non-occupational asbestos exposure; all were living in villages. Their mean age was 56 years. As the patients had been exposed to asbestos from birth, the latency period was equivalent to the age of the patients. Twenty-eight patients (29%) had lived in villages their entire lives. The other 69 (71%) had been born in a village but migrated to the city or had given up white-soil usage for various reasons. The mean exposure time was 55 years for those with a long exposure period and 25 years for those with a short exposure period, but there was no significant difference between the age of the disease appearance for both groups (55 and 56 years, respectively). Thus, the latency time of mesothelioma due to environmental exposure to asbestos was longer than that due to occupational exposure, but independent of the length of exposure. Soil samples from 67 villages were analysed, comprising a population of 10 120 villagers. Tremolite and some other types of asbestos were found.

In conclusion, DMPM in our region is due to mainly to environmental exposure to asbestos. The risk is substantial as a large proportion of the villagers are exposed. After smoking, asbestos exposure is one of the most serious health hazards in our rural population.”

Another interesting study is called, “Asbestos in Extrapulmonary Sites Omentum and Mesentery” by Ronald F. Dodson, PhD, FCCP, Michael F. O’Sullivan, BS, Ju Huang, MS, David B. Holiday, PhD and Samuel P. Hammar, MD, FCCP – CHEST February 2000 vol. 117 no. 2 486-493.  Here is an excerpt: “Abstract – Study objectives: Asbestos fibers have not been reported in tissues from the peritoneal cavity. Therefore, omentum, mesentery, and lung tissues from 20 individuals in whom mesothelioma was diagnosed were analyzed for asbestos bodies and asbestos fibers. Design: Tissue was digested and prepared filters were analyzed by light microscopy and analytical transmission electron microscopy. Results: Asbestos bodies were found in the lungs of 18 individuals, mesentery samples from 5, and omentum samples from 2. Uncoated asbestos fibers were found in lungs of 19 patients, 17 of whom had fibers in at least one extrapulmonary site. The most common asbestos in the omentum and mesentery was amosite. Several features of asbestos found in lung influenced the likelihood of amphibole fibers being found in the omentum or mesentery. Lung features included total amphibole fiber burden, length, aspect ratio, and ferruginous body burden. An increased total ferruginous body burden was strongly associated with increased likelihood of detecting amphiboles in the omentum (p < 0.05).  Conclusion: Asbestos fibers reach areas in the peritoneal cavity where some mesotheliomas develop. This study suggests their presence can be predicted based on concentrations and characteristics of fiber burdens in lung tissue.”

We all owe a debt of gratitude to these fine researchers for their hard work and dedication.  If you found any of these excerpts interesting, please read the studies in their entirety.

Monty Wrobleski is the author of this article, for more information please visit the following links

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