CURRENT CONCEPTS IN ASBESTOS RELATED LUNG DISEASE Fourth Annual Course (original) (raw)

Asbestos-related lung diseases: A brief update

Journal of Inflammatory Diseases, 2023

Health risks from asbestos exposures have been evaluated, considering past professional histories when exposures at workplaces were higher than today. A linear no-threshold (LNT) model has been applied, although its relevance is unproven. Fibers are often found in the lungs and pleura of deceased people. Fiber findings do not prove that a disease is caused by asbestos. It is reasonable to assume that a targeted search for mesothelioma and other asbestos-related conditions in asbestos workers resulted in an increased detection rate. Histological and immunohistochemical characteristics of malignant mesothelioma partly overlap with other cancers, which may contribute to the overdiagnosis in exposed populations. The etiology and differential diagnosis of malignant pleural mesothelioma as well as differences in carcinogenicity between different asbestos types are briefly discussed here. In the author’s opinion, current regulations applied in some countries are excessive and should be reconsidered based on independent research. The most promising way to obtain reliable information would be through lifelong bioassays. It can be reasonably assumed that the non-use of asbestos-containing brakes, fireproofing, insulation, etc. increases the harm caused by fires, traffic accidents, and armed conflicts.

Diagnosis and Initial Management of Nonmalignant Diseases Related to Asbestos

American Journal of Respiratory and Critical Care Medicine, 2005

The Ad Hoc Statement Committee submits that the American Thoracic Society currently recognizes no confounding by cigarette smoking in the radiographic presentation of asbestosis (1). This challenges the current state of science in this field. Small, irregular opacities are recognized to be present on the posteroanterior chest X-ray in a significant number of individuals ‫ف(‬ 5%) without any prior history of exposure to either particles or fibers. There is voluminous investigation defining the capacity of cigarette smoking to result in such a profusion of irregular opacities (summarized in Reference 2). This association between cigarette smoking and chest X-ray findings of an interstitial lung injury is also supported by computed tomography that similarly demonstrates these opacities (3). Furthermore, there are pathologic data delineating the relationship between collagen deposition and fibrosis in the human lung and cigarette smoking (4). This manifests as microscopic foci of fibrosis in areas of emphysematous destruction, peribronchiolar fibrosis as an aspect of small airway disease, or the more generalized fibrosis observed with respiratory bronchiolitis-associated interstitial lung disease. Finally, there is postulated to be a shared mechanism of injury between cigarette smoking and fiber inhalation. Exposures to all particles and fibers can present as an oxidative stress in the lung and effect a fibrotic injury to the respiratory tract. Those particles associated with cigarette smoking are comparable to other particles and fibers in that oxidant generation follows in vitro and in vivo exposures (summarized in Reference 5). Such free radical production has been proposed as the common avenue for fibrosis in a tissue exposed to either cigarette smoke or asbestos. Decades of investigation have provided the insight that cigarette smoking can confound the diagnosis of asbestosis. To disregard this evidence discredits the American Thoracic Society as a scientific body and contradicts the Society's recognition of interstitial lung disease associated with cigarette smoking (6).

Diagnosis of Asbestos-Related Diseases

American Journal of Forensic Medicine and Pathology, 2016

Because asbestos diseases represent a complex pattern of legal, social and political issue, the involvement of the mineralogist and pathologist for a multidisciplinary assess of its diagnosis helps to investigate the relationship between mesothelioma or lung cancer and occupational or environmental asbestos exposure. In the present study we consider the concentrations of asbestos bodies (ABs) detected by Optical Microscopy (OM) and Scanning Electron Microscopy (SEM), and the burden of different kinds of mineral fibres (among which asbestos) identified by SEM combined with an Energy Dispersive Spectrometer (EDS), in 10 lung tissue samples of subjects with occupational and non-occupational exposure to asbestos. In all subjects with occupational exposure to asbestos more than 1,000 ABs per gdw (gram of dry weight) were detected both with OM and SEM: this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos. In nine lung samples of the ten investigated by EDS-SEM, different inorganic fibres were found. Asbestos fibres have been identified too, and more than 100,000 ff per gdw were detected in subjects with occupational exposure: this concentration is internationally accepted as suggesting high probability of past occupational exposure to asbestos. Instead, when the ABs burden is low or moderate (such as in subjects with absent or probable asbestos exposure), the correlation between ABs concentration determined by MO and those determined by SEM is lost. Therefore, when the ABs value in OM is borderline the SEM investigation became essential. Furthermorethe mineralogical analysis by SEM-EDS (identification and quantification of inorganic fibres in general, and asbestos in particular) of the fibres detected in the lung tissues is very useful, if not necessary, to complete the pathological diagnosis of asbestos-related malignancies in medico-legal field.

Nonpulmonary Outcomes of Asbestos Exposure

Journal of Toxicology and Environmental Health, Part B, 2011

The adverse pulmonary effects of asbestos are well accepted in scientific circles. However, the extrapulmonary consequences of asbestos exposure are not as clearly defined. In this review the potential for asbestos to produce diseases of the peritoneum, immune, gastrointestinal (GIT), and reproductive systems are explored as evidenced in published, peer-reviewed literature. Several hundred epidemiological, in vivo, and in vitro publications analyzing the extrapulmonary effects of asbestos were used as sources to arrive at the conclusions and to establish areas needing further study. In order to be considered, each study had to monitor extrapulmonary outcomes following exposure to asbestos. The literature supports a strong association between asbestos exposure and peritoneal neoplasms. Correlations between asbestos exposure and immune-related disease are less conclusive; nevertheless, it was concluded from the combined autoimmune studies that there is a possibility for a higher-than-expected risk of systemic autoimmune disease among asbestos-exposed populations. In general, the GIT effects of asbestos exposure appear to be minimal, with the most likely outcome being development of stomach cancer. However, IARC recently concluded the evidence to support asbestos-induced stomach cancer to be "limited." The strongest evidence for reproductive disease due to asbestos is in regard to ovarian cancer. Unfortunately, effects on fertility and the developing fetus are under-studied. The possibility of other asbestos-induced health effects does exist. These include brain-related tumors, blood disorders due to the mutagenic and hemolytic properties of asbestos, and peritoneal fibrosis. It is clear from the literature that the adverse properties of asbestos are not confined to the pulmonary system. # This author has disclosed a potential conflict of interest as described by one or more of the following: He/She may have also received (and may also apply in future for) competitive-funding research grants from U.S. publicly financed, peer-reviewed grant approval process agencies concerning asbestos exposure and disease, including topics covered in all aspects of the workshop, including but not limited to research support from NIEHS.

Epidemiology of Asbestos-Related Diseases

Environmental Health Perspectives, 1980

This paper is intended to give the reader an overview ofthe epidemiology of asbestos-related diseases and is rsticted to primarily occupational exposure studies. However, some mention of nonoccupational exposur are made because of their direct relationship to a worker or to a secondary occupational source. Over 100 epidemiological studies are reviewed, dating back to the first case of asbestos-associated disease reported by Montague Murray in 1906. The studies are divided by specific fiber type and by specific disease outcomes and the interaction of asbestos and cigarette smoking is discussed in great detail.

Exposure to asbestos and lung cancer: a case report

Prevention & Research, 2013

In Greek ¢μίaντοj (amiantos) means immaculate and incorruptible and ¥σβηστοj (asbestos) perpetual and inextinguishable. The knowledge of its particular characteristics and its applications dates back to ancient times; for example, Egyptians already used it for embalming. Industrial use of asbestos dates back to the late nineteenth century, following the discovery of large Canadian deposits in Quebec (1877). The later discovery of important deposits in South Africa (crocidolite, chrysotile, amosite), Russia (chrysotile), United States (chrysotile), Australia (crocidolite) and Finland (anthophyllite), Italy © C I C E d i z i o n i I n t e r n a z i o n a l i

Environmental asbestosis complicated by lung cancer

CHEST Journal, 1994

Environmental asbestosis complicated by lung http://chestjournal.chestpubs.org/content/105/5/1593 can be found online on the World Wide Web at: The online version of this article, along with updated information and services ) ISSN:0012-3692 http://chestjournal.chestpubs.org/site/misc/reprints.xhtml