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Published in Ken Addley, MCQs, MEQs and OSPEs in Occupational Medicine, 2023
Asbestos exposure can produce pleural plaques, which are a painless and benign marker. Asbestosis is the pulmonary fibrosis associated with relatively high levels of asbestos exposure. Mesothelioma can develop following any (even trivial) asbestos exposure. It typically presents with pain (which can proceed any radiological evidence of pleural effusions or pleural thickening), breathlessness and weight loss. Any pleural effusion in those with evidence of pleural plaques should be considered at high risk of mesothelioma. Asbestos also increases the risk of primary lung cancer, which can present with similar symptoms.
The respiratory system
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Asbestosis is a form of interstitial pulmonary fibrosis that occurs after prolonged, substantial exposure (the latency from first exposure to development of symptoms is in excess of 20 years). Asbestosis prevalence is associated with age, fibre type, smoking, and cumulative exposure. Clinically asbestosis is associated with a non-productive cough, basal crackles, dyspnoea, and, in advanced stages, finger clubbing and cor pulmonale.
Evaluating Toxic Tort Cases
Published in Julie Dickinson, Anne Meyer, Karen J. Huff, Deborah A. Wipf, Elizabeth K. Zorn, Kathy G. Ferrell, Lisa Mancuso, Marjorie Berg Pugatch, Joanne Walker, Karen Wilkinson, Legal Nurse Consulting Principles and Practices, 2019
William P. Gavin, Mark A. Love, Wendie A. Howland
Inhaled asbestos fibers can cause pulmonary fibrosis. At a sufficient lifetime dose level, asbestosis irreversibly restricts alveolar gas exchange and can also cause pleural cancer, called mesothelioma (Fritz, 2018). Mesothelioma occurs at lower doses than asbestosis and is almost always fatal. Additionally, asbestos exposure can cause lung cancer and has been linked in some studies with potentially increasing the risk of other cancers, including colon cancer and laryngeal cancer.
Palliative care roles and responsibilities of mesothelioma clinical nurse specialists in the UK
Published in Progress in Palliative Care, 2023
Clare Gardiner, Madeleine Harrison, Sarah Hargreaves, Beth Taylor
Mesothelioma is a rare, incurable cancer caused by exposure to asbestos. In the majority of cases mesothelioma will present in the pleura, but it can also occur in the peritoneum and in rare cases in the pericardium or tunica vaginalis testis1,2. Prognosis is poor with one and three-year survival rates 40% and 10%, respectively3. Few treatments are available; in the UK only around half of all patients will receive active anti-cancer treatment. Symptom burden is high and patients with mesothelioma have significant palliative care needs including fatigue, dyspnoea, pain, weight loss, anxiety, and low mood4. A 2020 literature review of palliative care needs in mesothelioma identified requirements for good palliative care including a coordinated team-based approach to palliative care, open and frank communication around the progression of the disease and the opportunity for patients and carers to discuss fears and anxieties around end of life issues5. In addition, mesothelioma is an industrial disease and as a consequence patients often face legal and compensation challenges unique to the condition.
Discrepancies of asbestos body and fiber content between formalin-fixed and corresponding paraffin embedded lung tissue
Published in Inhalation Toxicology, 2021
Barbara K. Kuhn, Fabio Barresi, Holger Dressel, Bart Vrugt
Although the use of asbestos has been banned in large parts of the western industrialized world, it remains a major global health problem due to its biopersistence and wide use in developing countries (Collegium Ramazzini 2016a). Asbestos exposure is a considerable risk factor for developing diseases including asbestosis, pleural disease, mesothelioma, and lung cancer. In many countries, including Switzerland, patients are eligible to receive compensation for asbestos related diseases if a causal relation between occupational asbestos exposure and the condition can be established. Mineralogical analysis of lung dust is an important adjunct to the occupational history in certain cases, especially lung cancer (Churg 1982; De Vuyst et al. 1998; Dodson and Atkinson 2006; Roggli et al. 2010). Except for asbestosis, histology of peripheral lung tissue is not indicative of the degree of exposure to asbestos. The widely used ‘Helsinki criteria’ (Henderson et al. 1997; Wolff et al. 2015) recommended that detection of more than 1 million amphibole fibers (>1 µm) and over 1000 asbestos bodies (AB) per gram dry lung tissue is helpful to identify those subjects with a high probability of exposure to asbestos dust. In addition, detection of a burden of more than 5000 AB is regarded to be associated with a twofold risk of developing lung carcinoma (Henderson et al. 1997; Wolff et al. 2015).
Quantitative measurement of carbon nanotubes in rat lung
Published in Nanotoxicology, 2020
Jérôme Devoy, Hervé Nunge, Elodie Bonfanti, Carole Seidel, Laurent Gaté, Frédéric Cosnier
The main risks associated with CNT exposure, especially following inhalation by workers, are pulmonary adverse effects. Several studies in the literature have been conducted on laboratory animals and those have shown that pulmonary exposure by different methods (i.e. inhalation, intratracheal instillation and pharyngeal aspiration) leads to, among other effects, lung inflammation, fibrosis and tumor development, as assessed with different types of CNT, including single-walled (SWCNT) and multi-walled (MWCNT) (Shvedova et al. 2008, Ryman-Rasmussen et al. 2009, Porter et al. 2010, Kasai et al. 2016). The high aspect ratio (L/d) of MWCNT, a characteristic shared with asbestos fibers, has led to concern that exposure to MWCNT (especially Carbon NanoFibers ‘CNF’) might cause asbestos-like lung diseases in the animal, such as lung fibrosis, lung cancer, pleural plaque and malignant mesothelioma (Donaldson et al. 2010, Pacurari, Castranova, and Vallyathan 2010). The incidence of such asbestos-like lung diseases has been reported for both inhalation (Li et al. 2007, Mitchell et al. 2007, Shvedova et al. 2008) and intratracheal exposure (Warheit et al. 2004, Muller et al. 2005). However, further research is still needed due to difficulties in linking the physico-chemical properties of CNT with their toxicological potential.