Decreasing Prevalence of Pleural Calcifications Among Metsovites With Nonoccupational Asbestos Exposure

Manda-Stachouli, Carmen; Dalavanga, Yotanna; Daskalopoulos, George; Leontaridi, C.; Vassiliou, M; Constantopoulos, Stavros H.

doi:10.1378/chest.126.2.617

Cited by 13 publications

(9 citation statements)

References 12 publications

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“…We thus grouped the available radiographic evidence in time windows depending on the dynamics of the exposure. As previously reported [27], the prevalence of pleural calcifications is further decreased, while the age where pleural calcifications in CXRs were first encountered shifted from the 30s in 1980 and 40s in 2000 to the late 50s in 2010 (Fig. 4), thus con- firming that significant exposure to asbestos diminished over time and was present in older Metsovites only.…”

Section: Evolution Over Time Of the Radiographic Evidence Of Asbestossupporting

confidence: 81%

“…Tremolite-containing whitewash had been used in Metsovo by all households until 1940-1950. Its use declined gradually and was completely abandoned between 1980 and 1985 [14,27]. We chose to focus on the clinical investigation part of this exposure and recruited young Metsovites, in order to evaluate the presence of two signs of asbestos exposure, i.e., asbestos bodies in BAL and pleural calcifications in chest CT, signs very frequently present among exposed Metsovites in our previous studies, but also in exposed populations studied by other investigators [20][21][22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

“…In sharp contrast, evaluation of the 521 CXRs of Metsovites over 30, recruited in our previous studies, born when "luto" was still widely used 10 and 30 years ago [27], showed that pleural calcifications were very frequent even in those aged 30-49 years in the first study (1978)(1979)(1980)(1981)(1982) and 40-49 years in the second study (1998)(1999)(2000)(2001)(2002) (Fig. 4).…”

Section: Asbestos Exposure Indicated By Pleural Calcifications In Cxrmentioning

confidence: 98%

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Evidence Suggesting the End of Universal Domestic Asbestos Exposure in Metsovo, NW Greece

Gogali

Ntzani²,

Manda-Stachouli³

et al. 2017

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Background: Inhabitants of Metsovo, NW Greece, had been domestically exposed to asbestos from a gradually abandoned whitewash (“luto”) that resulted in a declining epidemic of malignant mesothelioma. Objectives: We aimed to evaluate whether other sources of asbestos exposure exist following “luto” abandonment. Methods: Chest computed tomography (CT) and bronchoalveolar lavage (BAL) were used to evaluate residual asbestos exposure in younger Metsovites through the identification of pleural calcifications and asbestos bodies, respectively. In order to provide a historical universally exposed group for comparison, we used the accumulated chest CTs and chest roentgenograms of our previous studies, performed in Metsovites with confirmed exposure but negative chest roentgenogram. As an additional external comparison group, we also assessed CT scans and chest roentgenograms of Metsovites being older than our target group obtained from the records of the Radiology Department between 2009 and 2011. In order to be able to compare our BAL findings, we sought historical controls among BAL studies performed in Metsovites with known exposure to “luto,” in the 1980s-1990s, mainly to evaluate alveolitis. Those belonging to individuals of the same age range were used for further comparison. Results: Twenty-two Metsovites born between 1960 and 1980 consented to undergo a chest CT scan, while another 14 CTs were retrieved from the records of the Radiology Department (among 86 of all ages), thus increasing the number of individuals studied to 36. Five of the 36 Metsovites studied were former “luto” users for a short period of time. Minimal pleural calcifications were present in 2 of them, while all chest CTs of nonusers were negative. All 8 BAL studies were negative for asbestos bodies. Conclusion: “Luto” use seems to have been the only source of considerable asbestos exposure in Metsovo.

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Section: Evolution Over Time Of the Radiographic Evidence Of Asbestossupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Asbestos Exposure Indicated By Pleural Calcifications In Cxrmentioning

confidence: 98%

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Evidence Suggesting the End of Universal Domestic Asbestos Exposure in Metsovo, NW Greece

Gogali

Ntzani²,

Manda-Stachouli³

et al. 2017

Respiration

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“…A relationship between environmental exposure to NOA and MM has been detected in Greece [7], New Caledonia [8], China [9], and Italy [10], but no research has studied the association between residential distance from environmental (non-occupational) asbestos and mesothelioma risk [11].…”

Section: Introductionmentioning

confidence: 99%

High-risk mesothelioma relation to meteorological and geological condition and distance from naturally occurring asbestos

Abakay

Tanrıkulu

Ayhan

et al. 2015

Environ Health Prev Med

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Objectives Very few studies have investigated the incidence and risk of malignant mesothelioma (MM) associated with distinct sources of asbestos exposure, especially exposure to naturally occurring asbestos (NOA). Methods Subjects were MM, lung, and breast cancer patients who were diagnosed and followed in Diyarbakir Province between 2008 and 2013. The birthplaces of patients were displayed on a geologic map. Geological and meteorological effects on MM were analyzed by logistic regression. Results A total of 180 MM, 368 breast, and 406 lung cancer patients were included. The median distance from birthplace to ophiolites was 6.26 km for MM, 31.06 km for lung, and 34.31 km for breast cancer (p \ 0.001). The majority of MM cases were seen within 20 km from NOA areas. The MM incidence inside of NOA was 1059/100.000, and out of NOA was 397/100.000; this difference was significant (p = 0.014). The largest concentration of MM residential areas was within ±30°(34 residential areas 36.6 %) of the dominant wind direction. Most MM patients were found in or near the dominant wind direction, especially in the acute angle defined by the dominant wind direction. MM incidence was directly proportional to {[area of NOA (km 2 )] * [cosine a of wind direction angle]} and was inversely proportional to the square of the distance (R = 0.291, p = 0.023).Conclusions MM was higher near NOA and in the downwind direction. MM incidence and risk were affected by geological and meteorological factors.

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“…This decrease was attributed to the abandonment of the use of luto whitewash by the beginning of the 1980s (92% of the population used it in 1950 and only 18% in 1980) and considered that, because of the latency period, the mesothelioma epidemic should end somewhere around 2020-2030. This conclusion was strengthened by a study conducted from 1998 to 2002, showing that the withdrawal of the use of the whitewash containing tremolite resulted in a null prevalence of pleural calcifications among young Metsovites (below 40 years of age), and in a decreasing prevalence of calcifications among persons below 60 years of age (Manda-Stachouli et al, 2004).…”

Section: Greecementioning

confidence: 99%

The health impact of nonoccupational exposure to asbestos: what do we know?

Goldberg¹,

Luce²

2009

European Journal of Cancer Prevention

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Decreasing Prevalence of Pleural Calcifications Among Metsovites With Nonoccupational Asbestos Exposure

Cited by 13 publications

References 12 publications

Evidence Suggesting the End of Universal Domestic Asbestos Exposure in Metsovo, NW Greece

Evidence Suggesting the End of Universal Domestic Asbestos Exposure in Metsovo, NW Greece

High-risk mesothelioma relation to meteorological and geological condition and distance from naturally occurring asbestos

The health impact of nonoccupational exposure to asbestos: what do we know?

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