Human diseases associated with exposure to asbestos fibers include pleural fibrosis and plaques, pulmonary fibrosis (asbestosis), lung cancer, and diffuse malignant mesothelioma. The critical determinants of fiber bioactivity and toxicity include not only fiber dimensions, but also shape, surface reactivity, crystallinity, chemical composition, and presence of transition metals. Depending on their size and dimensions, inhaled fibers can penetrate the respiratory tract to the distal airways and into the alveolar spaces. Fibers can be cleared by several mechanisms, including the mucociliary escalator, engulfment, and removal by macrophages, or through splitting and chemical modification. Biopersistence of long asbestos fibers can lead to inflammation, granuloma formation, fibrosis, and cancer. Exposure to synthetic carbon nanomaterials, including carbon nanofibers and carbon nanotubes (CNTs), is considered a potential health hazard because of their physical similarities with asbestos fibers. Respiratory exposure to CNTs can produce an inflammatory response, diffuse interstitial fibrosis, and formation of fibrotic granulomas similar to that observed in asbestos-exposed animals and humans. Given the known cytotoxic and carcinogenic properties of asbestos fibers, toxicity of fibrous nanomaterials is a topic of intense study. The mechanisms of nanomaterial toxicity remain to be fully elucidated, but recent evidence suggests points of similarity with asbestos fibers, including a role for generation of reactive oxygen species, oxidative stress, and genotoxicity. Considering the rapid increase in production and use of fibrous nanomaterials, it is imperative to gain a thorough understanding of their biologic activity to avoid the human health catastrophe that has resulted from widespread use of asbestos fibers.The manufacturing of engineered nanomaterials for both consumer and industrial applications is undergoing exponential growth. Among the many nanomaterials produced since the discovery of fullerenes in 1985, 1 carbon nanofibers (CNFs) and carbon nanotubes (CNTs) are exceptionally attractive, because of their high strength-to-weight ratio, high surface area, thermal stability, and resistance to chemicals. 2 Their unique physicochemical characteristics are expected to be useful in a wide range of applications, including reinforcement of biomaterials, optical devices, drug delivery, biosensors, as well as conducting and reinforcing fillers in polymer composites.Inhalation exposure in occupational environments can occur during the synthesis, collection, purification, handling, and packing of nanomaterials. Because of their shape and dimensions, in particular their high aspect ratio, graphenic CNTs may have similar pathogenic potential as naturally occurring asbestiform fibers. Their structural resemblance to asbestos fibers 3 and potential biopersistence make fibrous carbon nanomaterials a potential human health hazard. *Correspondence to: agnes kane@brown.edu.
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