Pleural mesothelioma and lung cancer risks in relation to occupational history and asbestos lung burden

Abstract

BackgroundWe have conducted a population-based study of pleural mesothelioma patients with occupational histories and measured asbestos lung burdens in occupationally exposed workers and in the general population. The relationship between lung burden and risk, particularly at environmental exposure levels, will enable future mesothelioma rates in people born after 1965 who never installed asbestos to be predicted from their asbestos lung burdens.MethodsFollowing personal interview asbestos fibres longer than 5 µm were counted by transmission electron microscopy in lung samples obtained from 133 patients with mesothelioma and 262 patients with lung cancer. ORs for mesothelioma were converted to lifetime risks.ResultsLifetime mesothelioma risk is approximately 0.02% per 1000 amphibole fibres per gram of dry lung tissue over a more than 100-fold range, from 1 to 4 in the most heavily exposed building workers to less than 1 in 500 in most of the population. The asbestos fibres counted were amosite (75%), crocidolite (18%), other amphiboles (5%) and chrysotile (2%).ConclusionsThe approximate linearity of the dose–response together with lung burden measurements in younger people will provide reasonably reliable predictions of future mesothelioma rates in those born since 1965 whose risks cannot yet be seen in national rates. Burdens in those born more recently will indicate the continuing occupational and environmental hazards under current asbestos control regulations. Our results confirm the major contribution of amosite to UK mesothelioma incidence and the substantial contribution of non-occupational exposure, particularly in women.

Asbestos bodies in bronchoalveolar lavage in the 21st century: a time-trend analysis in a clinical population

“…Indeed, AB are mainly formed on amphibole fibres and much less on the more widely used chrysotile fibres,17 which are also less persistent in the lung due to their composition and structure. Owing to the short clearance half-time of chrysotile,18 19 there is no time to form AB in the lung. This will possibly lead to false-negative results for AB in BAL .…”

The role of thoracic surgery in the management of mesothelioma: an expert opinion on the limited evidence

“…It arises from the mesothelial cells of the parietal pleura[1], whose incidence varies according to a geographical pattern from 40 cases per million people in Australia to 18 cases per million in Europe (with a different incidence among different countries, with the highest rate in UK, 33 per million); asbestos exposure is the most important risk factor and its relation with MPM has been fully proved and clarified [2]. In Europe mesothelioma is expected to peak in the next decade [3][4][5].…”

Malignant mesothelioma in Lynch syndrome: A report of two cases and a review of the literature

“…While it is well established that occupational exposures to asbestos are a cause of malignant mesothelioma, the precise amounts of asbestos exposure necessary for malignancy to develop are not well established. However, lower levels of asbestos associated with paraoccupational exposure have been linked to the development of malignancy . In a recent case series of 62 diffuse peritoneal mesotheliomas, 14 cases were attributed to paraoccupational domicile exposure .…”