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Published in Ken Addley, MCQs, MEQs and OSPEs in Occupational Medicine, 2023
COPD: This worker is a lifelong smoker with a hyperinflated chest X-ray, which would suggest air trapping and therefore an obstructive lung condition. COPD remains common (and underdiagnosed) and should be considered in anyone over 35 years of age with a significant smoking history or with evidence of other health conditions which are smoking related. Pleural plaques are a sign of asbestos exposure but in themselves, plaques do not cause significant respiratory symptoms. Asbestosis is the pulmonary fibrosis associated with significant asbestos exposure and as with other fibrotic conditions (silicosis and IPF) produce fine ‘Velcro’ crackles on examination. Mesothelioma typically presents with pain, breathlessness and evidence of a new pleural effusion or pleural thickening.
Cancer
Published in Sally Robinson, Priorities for Health Promotion and Public Health, 2021
Mesothelioma is a carcinoma which usually starts in the double outer linings of the lungs, the pleura. Typically, it spreads to lung tissue and the diaphragm. Peritoneal mesothelioma is found in the surface linings of other organs in the abdomen. It is quite a rare cancer which is strongly linked to asbestos, an insulation material banned in 1999 in the UK. Table 14.9 compares the psychological impact of mesothelioma with lung cancer.
Sarcomas
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Sarcomas affect all age groups. However, certain histological types are more common in the young while others are common in the older population. They have no sex or race selection. The exact etiological factors are unknown. While the majority of the sarcomas develop de novo, some develop in a benign precursor. Genetic factors may play a role. Almost 10% of neurofibrosarcomas develop in patients with neurofibromatosis of the Von Recklinghausen’s type.1 Similarly, osteogenic sarcoma may develop in older patients with Paget’s disease of the bone. High doses of radiation therapy have been associated with angiosarcoma, lymphangiosar-coma, and osteogenic sarcoma. Chemical carcinogens have also been implicated. These include vinyl chloride, phenoxy acids, chlorophenol, benzpyrene, and methylcholanthrene. Asbestos workers have a high incidence of mesothelioma. Viruses have been suggested as an etiological factor for sarcomas since Rous discovered a sarcoma virus as the cause of a soft tissue sarcoma in chickens. Clinical and laboratory investigations in human sarcomas strongly suggest the presence of virus.2 The higher incidence of Kaposi’s sarcoma in homosexual men may relate to the human immunodeficiency virus. Trauma has never been proven as a causative factor, yet sarcomas have developed in scars and chronic granulation tissues.
Mesothelioma mortality within two radiation monitored occupational cohorts
Published in International Journal of Radiation Biology, 2022
Michael T. Mumma, Jennifer L. Sirko, John D. Boice, William J. Blot
Mesothelioma is a rare and highly lethal cancer originating in the mesothelial cells that line the pleura, peritoneal, heart, and other cavities. Most cases (81%) of mesothelioma arise in the pleural lining of the lung and chest cavity, while 9% arise in the peritoneal lining of the abdominal cavity and a smaller percentage in the pericardium (ACS 2017). Asbestos exposure in the workplace is the major cause of mesothelioma, accounting for up to 80% of cases (Crew et al. 2005; Boffetta and Stayner 2006; International Agency for Research on Cancer (IARC) 2012; Carbone et al. 2012; Carbone and Yang 2017). Asbestos was widely used in heat-resistant materials and insulation from the 1940s through the 1970s in the United States, primarily in the construction, textile, auto, aircraft and shipbuilding industries, and in electric power plants including nuclear power plants (NPP) (Selikoff and Seidman 1991). Incidence rates of mesothelioma in the United States increased until the mid-1990s, remained level for several years, and began to decline in 2005 in men while remaining stable in women (ACS 2017). These trends and sex-specific differences reflect in large part the reduction in workplace exposure to asbestos in jobs that were traditionally male-oriented professions.
Asbestos-related cancers: the ‘Hidden Killer’ remains a global threat
Published in Expert Review of Anticancer Therapy, 2020
Nico van Zandwijk, Glen Reid, Arthur L. Frank
In other countries the ultimate consequences of living in an asbestos- contaminated environment have also been noted. Simply living near the Eternit asbestos factory in Casale Monferrato (Italy) was sufficient to cause mesothelioma in local residents [71]. Similar observations have been made around asbestos industries in another part of Italy [72] and elsewhere in the world (Japan, Finland etc). In the Netherlands roads and garden paths paved with tailings of another (Eternit) asbestos factory in the municipality of Goor also led to multiple mesothelioma cases [73]. The carcinogenic potency of environmental asbestos is highlighted by the results of a long-term (> 60 yr) follow-up of more than 12,000 former school pupils in a register-based cohort study in Denmark [74]. Attending primary school near an asbestos cement plant lead to a highly significant increase in mesothelioma incidence in later life. Moreover, loose-fill asbestos insulation present in a considerable number of houses in and near Canberra (Australia) also turned out to be associated with a significantly increased cancer risk, particularly mesothelioma, later in life [75]. There is no doubt that living in an asbestos-polluted environment greatly increases the risk of developing mesothelioma.
Talc and mesothelioma: mineral fiber analysis of 65 cases with clinicopathological correlation
Published in Ultrastructural Pathology, 2020
Victor L. Roggli, John M. Carney, Thomas A. Sporn, Elizabeth N. Pavlisko
The consultation files of one of the authors (VLR) were reviewed for cases of histologically confirmed mesothelioma for which a fiber burden analysis of lung tissue had been performed. The diagnosis of mesothelioma was based on radiographic findings, observations of the surgeon at the time of biopsy or of the prosector at the time of autopsy, histologic features of the tumor, and immunohistochemical profile as previously described.3,17 The location of the tumor (pleural or peritoneal) and histologic pattern (epithelial, sarcomatoid or biphasic) were noted.18 Demographic information, including gender, age, exposure data, presence or absence of asbestosis, and presence or absence of parietal pleural plaques, was noted. Pleural plaques were determined to be present if reported radiographically or if confirmed pathologically. The criteria for a histologic diagnosis of asbestosis have been previously reported.19,20