Estimating past inhalation exposure to asbestos: A tool for risk attribution and disease screening

Abstract

This method is of potential clinical value in developing novel treatment approaches for mesothelioma. Pilot studies to test this approach are urgently needed.

Progress and challenges in Mesothelioma: From bench to bedside

“…MRI may also prove to be a better screening tool than CT, since it does not involve exposure to ionising radiation and offers superior precision [16] and complementary (but as yet unproven) diagnostic functional end-points [17]. In addition, recent data suggests that reconstruction of cumulative life-time asbestos exposure and accurate modelling of lifetime MPM risk is possible [109], and may better select individuals most likely to benefit. This selection may be further improved by use of novel biomarkers such as ENOX2 protein transcript variants, which can be detected in the serum of patients destined to develop MPM up to 10 years prior to diagnosis [110].…”

“…Chemoprophylaxis involves use of preventative therapies with minimal or no side effects to modify the biology associated with carcinogenesis, thereby reducing cancer incidence. Unlike screening, chemoprophylaxis does not require development of expensive diagnostic tools but could utilise similar lifetime MPM risk models [109] to identify those most likely to benefit. MPM is typically preceded by decades of chronic asbestos-related inflammation and the production of ROS [87], which in turn has recently been associated with the common genetic lesions found in MPM tumours [22].…”

Retrospective Exposure Assessment Methods Used in Occupational Human Health Risk Assessment: A Systematic Review

“…Since asbestos have been widely used in different industrial scenarios, the cluster of activities interested by an REA of asbestos fibers is broad and various. In this review different industrial scenarios were considered, such as the power industry [ 26 ], iron foundries [ 12 ] and others [ 16 , 19 , 20 , 29 ]. As is well known, the target organs for asbestos are the lungs and the lung mucous membranes.…”

“…Besides job titles, length of the exposure and specific occupational tasks [ 26 ] and a priori exposure rating for each held job (non/low/high exposed) [ 44 ] should be preferably included in the assessment, in order to analyze the scenario with greater detail. Moreover, data regarding the substance emission potential, the activity emission potential and effectiveness of any local control, as well as the passive and/or fugitive emissions and the efficiency of any respiratory protection (RPE) [ 19 ] are relevant in the assessment procedure. Finally, personal conditions (i.e., depression, anxiety), can also affect the ability of a subject to evaluate his working conditions while undertaking a job-specific-questionnaire or habits (i.e., smoking habits) and, for this reason, these personal conditions can interfere with the assessment procedure [ 46 ].…”

“…SYNJEM [ 44 ], result to be a valid instrument for the assessment of occupational exposures in a quantitatively-way. Regarding the evaluation of the models, Cherrie and collaborators [ 19 ] evaluated in their study the efficiency of a model to estimate past exposure to asbestos, finding out that despite an overestimation at lower levels and an under-estimation at higher levels, results obtained with the model were comparable with measured exposure levels.…”