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Int. J. Environ. Res. Public Health 2017, 14(11), 1293; https://doi.org/10.3390/ijerph14111293

Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program

1
Medical Faculty Department of Public Health, Eskisehir Osmangazi University, Eskisehir 26040, Turkey
2
Lung and Pleural Cancers Research and Clinical Center, Eskisehir Osmangazi University, Eskisehir 26040, Turkey
3
Medical Faculty Department of Chest Surgery, Marmara University, İstanbul 34722, Turkey
4
Medical Faculty Department of Chest Diseases, Koç University, İstanbul 34450, Turkey
5
Medical Faculty Department of Chest Diseases, Health Science University, Ankara 06430, Turkey
6
Medical Faculty Department of Chest Diseases, Uludağ University, Bursa 16059, Turkey
On behalf of the Turkish Mesothelioma Working Group.
*
Author to whom correspondence should be addressed.
Received: 24 August 2017 / Revised: 12 October 2017 / Accepted: 22 October 2017 / Published: 25 October 2017
(This article belongs to the Section Environmental Health)
Full-Text   |   PDF [1855 KB, uploaded 26 October 2017]   |  

Abstract

Malignant mesothelioma (MM) is an important health problem due to ongoing asbestos exposure. Environmental asbestos exposure leads to a high risk of MM in Turkey. The Turkish Mesothelioma Working Group and the Turkish Public Health Institute designed and performed the Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program (TUNMES-EAECP). The aim of this study was to analyze the results of the TUNMES-EAECP. Patients diagnosed with MM (code C45.0–C45.9) between 2008 and 2012 were identified. The “from case to the field” method was used to determine the villages with current or previous asbestos exposure. Special public health teams took soil samples from these villages, which were then examined using an X-ray diffractometer. Direct Standardized Average Annual Mesothelioma Incidence Rate (AMIR) and relative risk (RR) of MM were calculated. Finally, a projection on the incidence of MM between 2013 and 2033 was made. The number of confirmed MM cases was 5617 with a male to female ratio of 1.36. Mean age was 61.7 ± 13.4 (20–96) years. The median survival was eight (95% CI 7.6–8.4) months. Asbestos exposure continues in 379 villages, with 158,068 people still living in high risk areas. The standardized AMIR was 2.33/100,000 per year. The risk of MM was higher in males, in both sexes over the age of 40, in asbestos-containing provinces, and in those where the TUNMES was organized. Among the population with continuing asbestos exposure in rural areas, the number of MM cases between 2013 and 2033 was estimated as 2511. As such, the incidence of MM in Turkey is as high as in industrialized countries. Asbestos exposure in rural areas continues to be a serious problem in Turkey, which obviates the necessity for effective preventive measures. View Full-Text
Keywords: mesothelioma; environmental asbestos exposure; epidemiology; asbestos mesothelioma; environmental asbestos exposure; epidemiology; asbestos
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Metintaş, S.; Batırel, H.F.; Bayram, H.; Yılmaz, Ü.; Karadağ, M.; Ak, G.; Metintaş, M. Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program. Int. J. Environ. Res. Public Health 2017, 14, 1293.

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