Feasibility of a screening programme for lung cancer in former asbestos workers

Mastrangelo, Giuseppe; Ballarin, Maria Nicoletta; Bellini, E.; Bizzotto, Rosanna; Zannol, F; Gioffrè, Francesco; Gobbi, Mario; Tessadri, Gianna; Marchiori, Luciano; Marangi, G; Bozzolan, Saverio; Lange, John H.; Valentini, F; Spolaore, Paolo

doi:10.1093/occmed/kqn018

Cited by 35 publications

(25 citation statements)

References 18 publications

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“…Asbestos health monitoring guidelines were published by the Spanish Health Minister in 2003 (24) and by French Haute Autoritè de Santè in 2010 (25). In Italy a consensus document developed by experts was developed in 2012 (13) after several experiences carried out in the previous two decades (5,7,(26)(27)(28)(29)(30)(31)(32)(33). Anyhow, official specific recommendations of the Italian Health Minister are not available yet.…”

Section: Discussionmentioning

confidence: 99%

Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region

Chellini¹,

Battisti²,

Cristaudo³

et al. 2018

J. Thorac. Dis.

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Asbestos-related diseases usually have a long latency since first exposure and this legitimates a health surveillance programme addressed to asbestos workers after the cessation of their occupational exposure. After a brief history of health surveillance initiatives performed in Italy as well as in other countries, we describe a regional programme for former asbestos-exposed workers, focusing on organizational features.A regional group of experts defined its operational and economical aspects. The Regional Council supported the whole programme, making it free of charge for all subjects who fulfil the predefined enrolment criteria (being resident in the region, being younger than 80 years old with cessation of occupational asbestos exposure within the last 30 years). The programme activities are classified in two levels: a first level for a basic health evaluation and a second level for in-depth analyses. In order to guarantee an homogeneous delivery in the whole region, the programme has to be performed by public health services with a quality control of activities. The involvement of specific public health services and the cooperation of social stakeholders are expected to play a major role in overcoming still open critical issues, such as the lack of programme existence awareness and adhesion, the correct stratification of subjects for the follow-up, and the real homogeneous delivery of the health surveillance in whole region.

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Section: Discussionmentioning

confidence: 99%

Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region

Chellini¹,

Battisti²,

Cristaudo³

et al. 2018

J. Thorac. Dis.

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“…The authors concluded that lung screening with LDCT is useful in asbestos-exposed subjects at least as in strong smokers. On the contrary, Mastrangelo et al (32), in an observational study performed in Padova, evaluated over 1,119 exposed subjects (mean age, 57 years; mean exposure, 123 fibers/mL × year; 65% smokers) and identified 5 lung cancers (detection rate 0.4%), 1 at stage 1; no mesothelioma was found. In this paper lung cancer screening with LDCT was not considered cost-effective.…”

Section: Ldct Lung Cancer Screening In Asbestos-exposed Workersmentioning

confidence: 98%

“…From 2002 to 2009, the results of some lung cancer screening trials with LDCT on asbestos-exposed workers were published (29)(30)(31)(32)(33)(34). Unfortunately, in these studies CT image acquisition and reconstruction algorithms are different as well as technical parameters (mA, slice thickness, reconstruction interval, additional HRCT slices, etc.…”

Section: Ldct Lung Cancer Screening In Asbestos-exposed Workersmentioning

confidence: 99%

“…); furthermore, the criteria to determine a positive test are not homogeneous. Most of all use ELCAP, I-ELCAP criteria (22,23) or a modification of these (29,31,32,35) to determine a positive test for non-calcific nodule; in other trials the presence of pleural abnormalities is a criterion considered for a positive test (29)(30)(31)(32), but the definitions of pleural involvement and subsequent work-up are various and not always included in the protocol study.…”

Section: Ldct Lung Cancer Screening In Asbestos-exposed Workersmentioning

confidence: 99%

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Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?—a systematic review about the use of screening programs in a population of asbestos exposed workers

Falaschi¹,

Romei²,

Fiorini

et al. 2018

J. Thorac. Dis.

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Malignant pleural mesothelioma (MPM) in an uncommon neoplasia with high mortality rate, mostly related to professional asbestos exposure. Clinical manifestations are not specific so that diagnosis is performed at advanced stage and screening protocols are not feasible now. On the other hand, asbestosexposed workers have a high incidence of developing lung cancer. Low-dose computed tomography (LDCT) is a volumetric acquisition technique with high spatial resolution and a low dose exposure; it is used in many trials to detect lung tumours at an early stage in screening protocols, reducing mortality rate in smoker subjects. In recent papers, the possibly role of lung cancer screening was evaluated and recommended also in subjects exposed to asbestos. This article summarizes previous and present clinical trials validated for lung cancer screening, to discuss the possibility of early diagnosis or screening programs in a population of asbestos exposed workers by LDCT.

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“…If a subject changed job or factory the cumulative exposure was the sum of products (Σ (i × f × l)). The interviewers were trained in the use of the questionnaire in order to minimize the information bias [8]. Length of exposure (years), time elapsed since first and last exposure (years), peak asbestos level (highest asbestos exposure for any job held, fibers/ml) and cumulative asbestos exposure (fibers×years/ml) have been considered in the present study.…”

Section: Assessment Of Occupational and Environmental Exposurementioning

confidence: 99%

Urinary asbestos fibers and inorganic particles in past asbestos workers

Zaina

Mastrangelo

Ballarin

et al. 2014

Archives of Environmental & Occupational Health

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To assess the validity of the procedure as test of exposure to asbestos, we compared urinary asbestos fibers with occupational and environmental exposure data in a random sample of 48 patients. Occupational and environmental asbestos exposure were estimated on questionnaire, pleural plaques were diagnosed with computed tomography, inorganic fibers and particles were identified by scanning electron microscope with an energy dispersive spectrometry. Few urinary asbestos fibers (in 15% of workers and in 17% of cases with pleural plaques) and high amount of urinary silicate (particularly nonfibrous particles) were detected. Asbestos undergoes dissolution in lung tissues but the secondary minerals are largely unknown. These materials, possibly nonfibrous silicates or metals, could be excreted with urine. Therefore, another study including a control group is warranted to discriminate the occupational origin of minerals in the urine.

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Feasibility of a screening programme for lung cancer in former asbestos workers

Cited by 35 publications

References 18 publications

Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region

Health surveillance for former asbestos exposed worker: a specific programme developed in an Italian region

Imaging of malignant pleural mesothelioma: it is possible a screening or early diagnosis program?—a systematic review about the use of screening programs in a population of asbestos exposed workers

Urinary asbestos fibers and inorganic particles in past asbestos workers

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