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

Abstract

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.

Mesothelioma Mortality Rates in Greece for the Period 2005–2015 Is Increased Compared to Previous Decades

“…Bazas et al, and Konstantopoulos et al, have carried out studies and had proved the health hazards imposed by luto [22,23]. After that a health promotion strategy was implemented and luto has not been used since 1985, leading to the end of the domestic exposure epidemic [24,25]. For the time, the rate in Epirus is remaining the same and a decreased rate is anticipated in the following years.…”

Metsovo Lung: A Story of Episteme, Techne, and Phronesis

“…In this issue of Respiration, Gogali et al [5] aimed to investigate whether the residents in the region of Metsovo were still exposed No pleural calcifications were observed in the active surveillance group with the exception of 2 individuals that reported exposure to luto until adolescence. This is in stark contrast with a previous study in the area of Metsovo where even in the absence of visible calcified pleural plaques on chest X-ray, they were observed in all individuals when they were examined with chest CT [6].…”