The epidemiology of mesothelioma in historical context

Abstract

T Th he e e ep pi id de em mi io ol lo og gy y o of f m me es so ot th he el li io om ma a i in n h hi is st to or ri ic ca al l c co on nt te ex xt tThe epidemiology of mesothelioma in historical context. J.C. McDonald, A.D. McDonald. ©ERS Journals Ltd 1996. ABSTRACT: Primary malignant mesothelial tumours were recognized by pathologists before asbestiform minerals (chrysotile, crocidolite and amosite) were mined commercially. The discovery, 40 yrs ago, of a causal link with crocidolite and the wide-ranging epidemiological studies which followed are the subject of this review.Early case-control and descriptive surveys, supplemented by cohort studies in insulation workers and chrysotile miners, quickly demonstrated major occupational and geographical differences, with high risk in naval dockyard areas and in the heating trades. In the 1980s, reliable cohort surveys showed that in mining and in the manufacture of asbestos products the mesothelioma risk was much higher when exposure included crocidolite or amosite than chrysotile alone. However, qualitative and quantitative information on exposure was too often inadequate for this evidence to be conclusive. Well-controlled lung fibre analyses have reduced these deficiencies and demonstrated the probable implications of the greater biopersistence of amphibole fibres. Chrysotile for industrial use often contains low concentrations of fibrous tremolite, which may well explain the few cases of mesothelioma associated with this type of asbestos.Progress in this field has been much retarded by controversy, for which the 20 year gap between the availability of reliable estimates of risk for the mining of chrysotile and that for crocidolite or amosite may have been largely responsible.

Evolution of pleural cancers and malignant pleural mesothelioma incidence in France between 1980 and 2005

“…20 Another likely explanation for the decreasing trend in men since the 2000s in France is the implementation of the first regulations regarding asbestos exposure at work in 1977 (introduction of threshold limit value in occupational settings), which would be consistent with a latency period of about 30 years between exposure to asbestos and the onset of mesothelioma, and the fact that the vast majority of mesotheliomas in men are induced by occupational exposure to asbestos. 29 The same regulations regarding asbestos exposure at work were implemented in 1972 in US and later in 1987 in UK.…”

“…In occupational cohorts, the exposure specific risk of mesothelioma was in the ratio 1:100:500 for chrysotile, amosite and crocidolite, respectively. [27][28][29] The US imported mainly chrysotile and amosite, whereas the United Kingdom (UK) imported more crocidolite asbestos. In France, the main imports were chrysotile asbestos.…”

Presence and role of Simian Virus 40 (SV40) in malignant pleural mesothelioma

“…14,16 The data of patients with mesothelioma who had not been exposed to asbestos has varied. 15,19 However, since only a small fraction of subjects exposed to asbestos fibres develop MPM, it has been suggested that additional factors may be involved in mesothelial malignant transformations. Other causes, in addition to asbestos, including nonasbestos fibres (erionite, in Cappadocia, Turkey), therapeutic radiation and intense pleural scarring (caused by prior plombage therapy for tuberculosis) have been reported to cause mesothelioma in rare cases.…”

Mesotelioma maligno: descripción clínica y radiológica de 45 casos con y sin exposición a asbestos

“…Además, la asociación de ésta con la exposición a asbestos presenta un efecto sinergista para el desarrollo del mesotelioma. 11 Es importante notar que ninguno de los pacientes de la presente serie mostró alguno de estos antecedentes.…”

“…* Gavira y colaboradores, en su trabajo El asbesto y la salud en la ciudad de México, detectaron 52 casos de MM registrados en los archivos de los servicios de Anatomía Patológica de los distintos institutos nacionales de salud, así como del Instituto Mexicano del Seguro Social (IMSS) y el Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE) en el periodo 1980-1985. 9 En la etiología del MM, 70% de los casos se puede establecer con una historia o antecedente de exposición directa o indirecta a asbestos; [10][11][12] sin embargo, no se ha podido correlacionar de manera directa la intensidad y duración de la exposición con la aparición de enfermedad pleural. La exposición a asbestos se asocia también con la aparición de bronquitis crónica, fibrosis pulmonar y cáncer broncogénico.…”