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Safety and Health At Work Sep 2022In Brazil, asbestos was intensively used from the 1960s until its ban in 2017. Mesothelioma, asbestosis, and pleural plaques are typical asbestos-related diseases...
BACKGROUND
In Brazil, asbestos was intensively used from the 1960s until its ban in 2017. Mesothelioma, asbestosis, and pleural plaques are typical asbestos-related diseases (ARD-T). To create an ARD-T national database, death records from 1996-2017 were retrieved from several health information systems (HIS).
METHODS
All national HIS containing coded diagnoses (ICD-10) and death information were obtained. Linkage was performed to create a single database of ARD-T death records, either as underlying or contributory causes, in adults aged 30 years and older.
RESULTS
A total of 3,057 ARD-T death records were found, 2,405 (76.4%) of which being malignant mesotheliomas (MM). Pleural MM (n = 1,006; 41.8%) and unspecified MM (n = 792; 32.9%) prevailed. Male to female MM ratio (M:F) was 1.4:1, and higher ratios were found for non-malignant ARD-T: 3.5:1 for asbestosis and 2.4:1 for pleural plaques. Male crude annual mesothelioma mortality (CM x1,000,000) was 0.98 in 1996 and 2.26 in 2017, a 131.1% increment, while for females it was 1.04 and 1.25, a 20.2% increase, correspondingly. The small number of deaths with asbestosis and pleural plaques records precluded conclusive interpretations.
CONCLUSIONS
Even with the linkage of several HIS, ARD-T in death records remained in low numbers. MM mortality in men was higher and showed a rapid increase and, along with non-malignant ARD-T, higher M:F ratios suggested a predominant pattern of work-related exposure. The monitoring of workplace and environmental asbestos exposure needs to be improved, as well as the workers surveillance, following the recent Brazilian ban.
PubMed: 36156859
DOI: 10.1016/j.shaw.2022.04.006 -
JAMA Network Open Sep 2022Comorbidities characterize the underlying health status of individuals. In the context of lung cancer screening (LCS), lung-related comorbidities may influence the...
IMPORTANCE
Comorbidities characterize the underlying health status of individuals. In the context of lung cancer screening (LCS), lung-related comorbidities may influence the observed benefits and harms.
OBJECTIVE
To compare the characteristics of individuals undergoing LCS, the LCS examination result, the cancer detection rate (CDR), and the false-positive rate (FPR) in those with and without lung-related comorbidities.
DESIGN, SETTING, AND PARTICIPANTS
A prospective cohort study was conducted in 5 academic and community screening sites across North Carolina from January 1, 2014, to November 7, 2020. Participants included 611 individuals screened for lung cancer who completed a 1-page health history questionnaire.
EXPOSURES
Presence of at least 1 self-reported lung-related comorbidity, including chronic obstructive pulmonary disease, chronic bronchitis, emphysema, asthma, bronchiectasis, pulmonary fibrosis, silicosis, asbestosis, sarcoidosis, and tuberculosis.
MAIN OUTCOMES AND MEASURES
The LCS examination result was determined from the radiologist's Lung Imaging Reporting and Data System assessment (negative, 1 or 2; positive, 3 or 4). The age-adjusted CDR and FPR were calculated per 100 LCS examinations, using binary logistic regression.
RESULTS
Among the 611 individuals screened for lung cancer (308 men [50.4%]; mean [SD] age, 64 [6.2] years), 335 (54.8%) had at least 1 lung-related comorbidity. Individuals with vs without lung-related comorbidities were more likely to be female than male (180 of 335 [53.7%] vs 123 of 276 [44.6%]; P = .02), White vs non-White race (275 of 326 [84.4%] vs 193 of 272 [71.0%]; P < .001), and have high school or less education vs greater than a high school education (108 of 231 [46.7%] vs 64 of 208 [30.8%]; P = .001). There were no significant differences in the proportion of positive LCS examinations in those with vs without a lung-related comorbidity at baseline (37 [16.0%] vs 22 [11.1%]; P = .14) or subsequent (40 [12.3%] vs 23 [10.6%]; P = .54) LCS examination. Comparing individuals with vs without lung-related comorbidities, there was no statistically significant difference in the CDR (1.6 vs 1.9 per 100; P = .73) or FPR (13.0 vs 9.3 per 100; P = .16). Of the 17 individuals with lung cancer, 13 patients (76.5%) were diagnosed with stage I lung cancer.
CONCLUSIONS AND RELEVANCE
The findings of this study suggest that individuals with self-reported lung-related comorbidities undergoing LCS were more likely to be female, of White race, and have less education than those without lung-related comorbidity. Although no statistically significant differences in the proportion of positive examinations, CDR, or FPR by self-reported lung comorbidities were noted, additional studies with larger numbers of individuals undergoing screening are needed to understand LCS outcomes in those with lung-related comorbidities.
Topics: Comorbidity; Early Detection of Cancer; Female; Humans; Lung; Lung Neoplasms; Male; Middle Aged; Prospective Studies
PubMed: 36066893
DOI: 10.1001/jamanetworkopen.2022.30146 -
Journal of Experimental & Clinical... Aug 2022Malignant pleural mesothelioma is a highly aggressive tumor associated with asbestos exposure. There are few effective treatment options for mesothelioma, and patients...
BACKGROUND
Malignant pleural mesothelioma is a highly aggressive tumor associated with asbestos exposure. There are few effective treatment options for mesothelioma, and patients have a very poor prognosis. Mesothelioma has the potential to represent an appropriate disease to prevent because of its strong association with asbestos exposure and the long latency from exposure to the disease on-set.
METHODS
In the present study, we tested biological activity and toxicity of an artichoke freeze-dried extract (AWPC) as potential complementary preventive/early stage treatment agent for mesothelioma. This phase II clinical study then was conducted in 18 male-patients with evidence of radiographic characteristics related to asbestos exposure such as asbestosis or benign pleural disease as surrogate disease for mesothelioma clinical model.
RESULTS
We investigate AWPC biological activity assessing its effect on mesothelin serum level, a glycoprotein with low expression in normal mesothelial cells and high expression in mesothelioma and asbestos related diseases. We also assess the AWPC effect on circulating miRNAs, as novel biomarkers of both cancer risk and response to therapeutic targets. While we found a small and not significant effect of AWPC on mesothelin serum levels, we observed that AWPC intake modulated 11 serum miRNAs related to gene-pathways connected to mesothelioma etiology and development. In terms of toxicity, we also did not observe any severe adverse effects associated to AWPC treatment, only gastro-intestinal symptoms were reported by five study participants.
CONCLUSIONS
We observed an interesting AWPC effect on miRNAs which targets modulate mesothelioma development. New and much larger clinical studies based on follow-up of workers exposed to asbestos are needed to corroborate the role of AWPC in prevention and early treatment of mesothelioma.
TRIAL REGISTRATION
ClinicalTrials.gov, NCT02076672 . Registered 03/03/2014.
Topics: Asbestos; Biomarkers, Tumor; Cynara scolymus; GPI-Linked Proteins; Humans; Lung Neoplasms; Male; Mesothelin; Mesothelioma; Mesothelioma, Malignant; MicroRNAs; Pleural Neoplasms
PubMed: 35987988
DOI: 10.1186/s13046-022-02455-6 -
Central European Journal of Public... Jun 2022In the Czech Republic, asbestos has been classified as a known human carcinogen since 1984. The use of asbestos-containing products was limited to scenarios where the...
OBJECTIVES
In the Czech Republic, asbestos has been classified as a known human carcinogen since 1984. The use of asbestos-containing products was limited to scenarios where the use of other materials was not possible. Since 1997, the manufacture of asbestos materials has been forbidden, and in 1999, the import, manufacture and distribution of all types of asbestos fibres was legally banned by Act No. 157/1998 Coll. Although the use of asbestos is forbidden, the risk of exposure still exists given the ongoing demolition and reconstruction of buildings in which asbestos has been used. In addition, a novel risk has arisen through the quarrying of asbestos-containing aggregates and their subsequent use. The aim of this paper was to describe and evaluate asbestos in terms of history, legislation, current risk of occupational exposure and its health consequences in the Czech Republic over the last three decades.
METHODS
This retrospective descriptive study used the collected data on occupational exposure and occupational diseases. The counts of workers occupationally exposed to asbestos were obtained from the Registry of Work Categorization; the numbers and structure of occupational diseases caused by asbestos were taken from the Czech National Registry of Occupational Diseases. Data on the total number of mesothelioma cases recorded in the Czech National Cancer Registry was provided by the Institute of Health Information and Statistics of the Czech Republic.
RESULTS
A total of 13,112 subjects were registered as occupationally exposed to asbestos during the period 2001-2020. A total of 687 cases of asbestos-related occupational diseases were reported in the period 1991-2020 in the Czech Republic, comprising 178 cases of asbestosis, 250 cases of pleural hyalinosis, 168 cases of pleural or peritoneal mesothelioma, 90 cases of lung cancer, and one case of laryngeal cancer. The data from the Czech National Cancer Registry, available for a shorter period (1991-2018), reveal 1,389 cases of mesothelioma, of which only ~11% were recognised as occupational, despite the fact that the occupational causality of mesotheliomas is estimated to be up to 90% of mesotheliomas. Moreover, the latency of mesotheliomas since the last occupational exposure reached up to 50 years and this trend is still slightly increasing, unlike asbestosis, where a high cumulative dose of inhaled asbestos is needed. The real proportion of occupational lung cancers may obviously be even higher, especially in smokers, where occupational causes including asbestos are not suspected by most physicians.
CONCLUSION
Czech data on asbestos-related occupational diseases, especially cancers, are grossly underestimated, which is most apparent through the low proportion of mesotheliomas diagnosed as occupational. Asbestos materials in older buildings remained in situ and may represent a danger during reconstruction works. The current source of exposure appears to be quarrying of asbestos-containing aggregate and its subsequent use. Awareness of the professional community is therefore crucial, not only for the possibility of compensating those affected, but also for the early detection of the diseases through the dispensary of exposed persons.
Topics: Asbestos; Asbestosis; Czech Republic; Humans; Lung Neoplasms; Mesothelioma; Occupational Diseases; Occupational Exposure; Retrospective Studies
PubMed: 35876593
DOI: 10.21101/cejph.a7094 -
American Journal of Respiratory and... Nov 2022A common gene polymorphism, rs35705950-T, is associated with idiopathic pulmonary fibrosis (IPF), but its role in severe acute respiratory syndrome coronavirus 2... (Meta-Analysis)
Meta-Analysis
A common gene polymorphism, rs35705950-T, is associated with idiopathic pulmonary fibrosis (IPF), but its role in severe acute respiratory syndrome coronavirus 2 infection and disease severity is unclear. To assess whether rs35705950-T confers differential risk for clinical outcomes associated with coronavirus disease (COVID-19) infection among participants in the Million Veteran Program (MVP). The rs35705950-T allele was directly genotyped among MVP participants; clinical events and comorbidities were extracted from the electronic health records. Associations between the incidence or severity of COVID-19 and rs35705950-T were analyzed within each ancestry group in the MVP followed by transancestry meta-analysis. Replication and joint meta-analysis were conducted using summary statistics from the COVID-19 Host Genetics Initiative (HGI). Sensitivity analyses with adjustment for additional covariates (body mass index, Charlson comorbidity index, smoking, asbestosis, rheumatoid arthritis with interstitial lung disease, and IPF) and associations with post-COVID-19 pneumonia were performed in MVP subjects. The rs35705950-T allele was associated with fewer COVID-19 hospitalizations in transancestry meta-analyses within the MVP (N = 4,325; N = 507,640; OR = 0.89 [0.82-0.97]; = 6.86 × 10) and joint meta-analyses with the HGI (N = 13,320; N = 1,508,841; OR, 0.90 [0.86-0.95]; = 8.99 × 10). The rs35705950-T allele was not associated with reduced COVID-19 positivity in transancestry meta-analysis within the MVP (N = 19,168/N = 492,854; OR, 0.98 [0.95-1.01]; = 0.06) but was nominally significant ( < 0.05) in the joint meta-analysis with the HGI (N = 44,820; N = 1,775,827; OR, 0.97 [0.95-1.00]; = 0.03). Associations were not observed with severe outcomes or mortality. Among individuals of European ancestry in the MVP, rs35705950-T was associated with fewer post-COVID-19 pneumonia events (OR, 0.82 [0.72-0.93]; = 0.001). The variant rs35705950-T may confer protection in COVID-19 hospitalizations.
Topics: Humans; COVID-19; Mucin-5B; Polymorphism, Genetic; Idiopathic Pulmonary Fibrosis; Genotype; Hospitalization; Genetic Predisposition to Disease
PubMed: 35771531
DOI: 10.1164/rccm.202109-2166OC -
Toxics May 2022Although being banned or restricted in many countries since the early 1990s, large quantities of asbestos are still used or present in building materials all over the...
Although being banned or restricted in many countries since the early 1990s, large quantities of asbestos are still used or present in building materials all over the world and its removal or handling requires specific systems that limit exposure to airborne fibers The exposure to asbestos causes chronic diseases such as asbestosis and lung cancer with an incubation period of 20 to 50 years. Among the operators most exposed to contamination are those who handle and analyze the materials in laboratories. For this reason, our work focused on an innovative method for removing a filter unit from a laboratory extraction hood, in order to improve the safety conditions for the operators and the surrounding environment. The hood has a particular construction technology with a mechanism that allows the spraying of a special encapsulating liquid on the ULPA filters below the work-bench, which is capable of forming a film and blocking the fibers on the surface of the same filter. The fibers are irreversibly bounded and can no longer be released into the surrounding environment. The monitoring of activity highlighted the absence of asbestos fibers in the air after installation of the filter and workers feel safer performing their activities. The introduction of an innovative filtering system enhanced the safety of work activities involving asbestos exposure, moreover, the time spent on the hood's maintenance and the risk perception of workers were improved.
PubMed: 35736889
DOI: 10.3390/toxics10060281 -
BMC Pulmonary Medicine Jun 2022Even almost 30 years after the ban on the use of asbestos in Germany, the effects of asbestos are still highly relevant in everyday clinical practice in occupational...
BACKGROUND
Even almost 30 years after the ban on the use of asbestos in Germany, the effects of asbestos are still highly relevant in everyday clinical practice in occupational medicine. The aim of this study was to further investigate the significance of essential parameters of both pulmonary function diagnostics and imaging techniques (low-dose HR-TCT) for the prevention and early detection of asbestos-related morphological and functional lung changes.
METHODS
Data from spirometry, body plethysmography and diffusion capacity, as well as CT images of the thorax, were retrospectively studied from 72 patients examined between 2017 and 2019 at the Institute for Occupational and Maritime Medicine (ZfAM), Hamburg, Germany. The subjects were divided into four subgroups according to the presence of comorbidities (concomitant cardiac diseases, obstructive ventilatory disorder, pulmonary function pattern consistent with emphysema, and no other pulmonary or cardiac diseases). These subgroups were analysed in addition to the overall collective. The CT images were evaluated according to the International Classification of Occupational and Environmental Respiratory Diseases (ICOERD) with radiological expertise. In addition, some asbestos-related parameters were newly quantified, and corresponding scores were defined based on ICOERD. Statistical analysis included the use of correlations and fourfold tables with calculation of Spearman's rho (ρ), Cohen's κ, and accuracy.
RESULTS
Vital capacity (VC) is slightly reduced in the total collective compared to the normal population (mean 92% of predicted value), while diffusion capacity for CO (D) shows predominantly pathological values, mean 70% of the respective predicted value. The CO transfer coefficient (D/VA), which refers to alveolar volume (VA), also shows slightly decreased values (mean 87% pred.). Seventy-nine percent of patients (n = 57) had signs of pulmonary fibrosis on CT scans, and pleural plaques appeared in 58 of 72 patients (81%). Of the newly quantified additional parameters, particularly frequently described findings are subpleural curvilinear lines (SC, n = 39) and parenchymal bands (PB, n = 29). VC correlates well with the expression of pleural plaques (ρ = - 0.273, P < 0.05), and D measures show a better correlation with fibrosis score (ρ = - 0.315, P < 0.01). A third, newly developed score, which includes the extent of pleural plaques and additional subpleural parameters instead of fibrosis parameters, shows significant correlations for both VC and D (ρ = - 0.283, - 0.274, resp.; both P < 0.05).
DISCUSSION
The importance of spirometry (VC) and diffusion capacity measurement (D) as essential diagnostic procedures for the early detection of asbestos-related changes ‒ also including patients with relevant concomitant cardiac or pulmonary diseases ‒ was confirmed. Significant and better correlations between lung function changes (VC and D) and abnormal CT findings are seen when parenchymal bands (PB), subpleural curvilinear lines (SC), and rounded atelectasis (RA) are quantitatively included into the evaluation, in addition to assessing the extent of pleural plaques alone. Therefore, when assessing CT images according to ICOERD, these parameters should also be quantified.
Topics: Asbestos; Asbestosis; Heart Diseases; Humans; Lung; Pleural Diseases; Pulmonary Fibrosis; Retrospective Studies; Tomography, X-Ray Computed; Vital Capacity
PubMed: 35725440
DOI: 10.1186/s12890-022-02022-x -
International Journal of Occupational... Oct 2022The aim of the study was to investigate and assess the incidence of silicosis cases acknowledged as occupational diseases in Poland in 2000-2019.
OBJECTIVES
The aim of the study was to investigate and assess the incidence of silicosis cases acknowledged as occupational diseases in Poland in 2000-2019.
MATERIAL AND METHODS
The cases of all medically recognized pneumoconioses, including silicoses, certified as occupational diseases were studied. The records were extracted from the Central Register of Occupational Diseases, the only official Polish central electronic data base of occupational diseases.
RESULTS
During the period 2000-2019, 2066 confirmed cases of silicoses and 10 665 cases of other pneumoconioses including asbestosis and coal workers' pneumoconiosis were reported to the Central Register of Occupational Diseases. Silicoses accounted for 12.8-21.2% of all pneumoconioses. The number of confirmed silicoses cases was growing along with the length of latency period and was the highest for the period of ≥40 years (513 cases). Over 70% of silicoses cases occurred after occupational exposure >20 years. The most workers who evolved silicosis were employed in manufacturing, predominantly casting of iron, mining and quarrying and construction.
CONCLUSIONS
The number of confirmed cases of silicosis in Poland decreased in 2000-2019 but the disease still remains an important health problem. Prevention is crucial to reduce further disease incidence. The medical monitoring standards of exposed workers should be improved. Developing new diagnosing guidelines with the use of other imaging examinations, like high-resolution computed tomography, has to be considered. The analysis should contribute into the implementation of silicosis preventative programmes, both at the enterprise and national level. Int J Occup Med Environ Health. 2022;35(5):561-70.
Topics: Coal; Humans; Iron; Occupational Diseases; Occupational Exposure; Pneumoconiosis; Poland; Silicosis
PubMed: 35678162
DOI: 10.13075/ijomeh.1896.01950 -
BMC Public Health Jun 2022Pneumoconiosis refers to a class of serious diseases threatening the health of workers exposed to coal or silicosis dust. However, the burden of pneumoconiosis is...
BACKGROUND
Pneumoconiosis refers to a class of serious diseases threatening the health of workers exposed to coal or silicosis dust. However, the burden of pneumoconiosis is unavailable in China.
METHODS
Incident cases, deaths, and disability-adjusted life years (DALYs) from pneumoconiosis and its subtypes in China were estimated from the Global Burden of Disease Study 2019 using a Bayesian meta-regression method. The trend of the burden from pneumoconiosis was analyzed using percentage change and annualized rate of change (ARC) during the period 1990-2019. The relationship between subnational socio-demographic index (SDI) and the ARC of age-standardised death rate was measured using Spearman's Rank-Order Correlation.
RESULTS
In 2019, there were 136.8 (95% uncertainty interval [UI] 113.7-162.5) thousand new cases, 10.2 (8.1-13.6) thousand deaths, and 608.7 (473.6-779.4) thousand DALYs from pneumoconiosis in China. Of the global burdens from pneumoconiosis, more than 60% were in China. Both the total number of new cases and DALYs from pneumoconiosis was keeping increasing from 1990 to 2019. In contrast, the age-standardised incidence, death, and DALY rates from pneumoconiosis and its subtypes, except for the age-standardised incidence rate of silicosis, and age-standardised death rate of asbestosis, experienced a significant decline during the same period. The subnational age-standardised death rates were higher in western China than in eastern China. Meanwhile, the subnational ARC of age-standardised death rates due to pneumoconiosis and its subtypes were significantly negatively correlated with SDI in 2019.
CONCLUSION
China suffers the largest health loss from pneumoconiosis in the world. Reducing the burden of pneumoconiosis is still an urgent task in China.
Topics: Bayes Theorem; Global Burden of Disease; Global Health; Humans; Incidence; Pneumoconiosis; Quality-Adjusted Life Years; Risk Factors; Silicosis
PubMed: 35659279
DOI: 10.1186/s12889-022-13541-x