Exposure to asbestos and lung cancer: a case report

Abstract

SummaryIn 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 (chrysotile) favoured its spreading and use on a large scale. Asbestos has been a well known confirmed human carcinogen since 1992, but before that date it was widely and regularly used for its insulating properties and its resistance. Exposure to asbestos appears associated to several diseases, such as pulmonary fibrosis, asbestosis (characterized by typical lung lesions), and neoplasms such as pleural and peritoneal mesothelioma and pulmonary adenocarcinoma. To put the blame of a disease on exposure to asbestos, however, diagnostic criteria are needed, ranging from the discovery of asbestos fibers in lung parenchyma to an array of radio-immuno-histo-chemical findings, to the duration and extent of exposure, etc. Here is a case report of lung cancer attributed to exposure to asbestos, which reconstructs the history of the patient in a critical analysis of the diagnostic criteria. Data have been discussed in the light of the current knowledge, with the support of a scrupulous literary review, which lead us step by step along the evolution of our achievement about the carcinogenicity of asbestos. Mr. P (1932-2002) worked for a transport tramway company at the routine maintenance and repairs and died for lung adenocarcinoma. Scientific information worldwide produced about asbestos and its effects on human health are abundant, but it can't be assumed that what is now universally recognized and taken for granted was recognized and taken for granted and with the same diffusion in past years and in the years during which Mr. P worked (1955 1992). Hence, there is no certainty of the diagnosis of the lung primitive adenocarcinoma attributed to Mr. P because the diagnostic criteria suggested by the international literature have not been strictly applied. There are no clinical or instrumental or laboratory signs that can be considered as indicators of the effect of exposure to asbestos: pulmonary fibrosis, asbestosis, pleural plaques, asbestos fibers, asbestos corpuscles, and the hypotesis of a possible cause and effect relationship is not supported by valid data. KEY WORDS: asbestos, adenocarcinoma, cancerogenesis, TLV-TWA. BackgroundIn 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 Case report