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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 January 2022) | Viewed by 63189

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Special Issue Editors

Dr. Lucia Fazzo

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Guest Editor

Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy
Interests: epidemiology; environmental and occupational epidemiology; exposure assessment; health impact; epidemiological surveillance; contaminated sites; waste, asbestos

Dr. Carolina Mensi

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Guest Editor

Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Interests: epidemiology; occupational epidemiology; cancer registry; health surveillance; mesothelioma; asbestos

Special Issue Information

Dear Colleagues,

Asbestos is one of the most widespread occupational carcinogens. The WHO has estimated that around 12 milion people worldwide are currently exposed to asbestos at their workplace (https://www.who.int/ipcs/assessment/public_health/asbestos/en/). There is sufficient evidence that all asbestos fibers cause malignant mesothelioma, lung, larynx, and ovary cancers, and limited evidence for pharingeal, stomach, and colonrectum cancers has been defined (IARC, 2012). In 2017, the IARC defined also the fluoro-edenite, an asbestos-like fibrous mineral, as carcinogenic to humans, on the basis of the ascertained causal link with mesothelioma (IARC, 2017). Non-communicable diseases, such as pleural fibrosis and asbestosis, are caused by asbestos exposure also (Wolff et al, 2015).

The recent Global Burden Diseases study estimated about 63% of occupational cancers attrbutable to asbestos in 2017 at the global level, including 27,000 cases of mesothelioma, 191,000 lung cancers, 6000 ovary and 4000 laynx cancers, and 3000 cases of asbestosis (GBD 2017 Risk Factors Collaborators, 2018). The risk of pleural mesothelioma caused by environmental exposure to asbestos, i.e., the residence near asbestos fiber sources (quarries, asbestos-cement plants), is also recognized, even if estimating the health impact of environmental exposure to asbestos is particularly difficult (Goldberg and Luce, 2009).

The improvement of early diagnosis and the establishment of registries of the people exposed to asbestos is recommended by the WHO ((https://www.who.int/ipcs/assessment/public_health/asbestos/en/). According to WHO recommendations, several investigations are currently in progress aimed at the identification of early markers of mesothelioma and screening protocols for the early diagnosis of lung cancer in subjects exposed to asbestos. The epidemiological surveillance of mesothelioma at national level, based on mortality database and/or cases registry, has been operating in some countries for many years, in the form of tracking of past and ongoing asbestos exposure contexts; initiatives to implement national plans in this sense are ongoing in middle- and low-income countries.

The WHO European Region countries committed to developing national programs to eliminate asbestos-related diseases recommend stopping the use and production of all forms of asbestos, in agreement with the WHO and the International Labor Organization (ILO) (https://www.euro.who.int/__data/assets/pdf_file/0013/341131/Fact-Sheet-4-Elimination-of-Asbestos-Related-Diseases.pdf).

This Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) focuses on the current state of knowledge on the relationship functions between asbestos exposure and the occurrence of asbestos-related diseases and on the estimates of the health impact of asbestos at global and local level. In addition, papers on protocols for early diagnosis and health surveillance will be appreciated.

New research papers, reviews, and case reports on the health impact of occupational and environmental asbestos exposure, including asbestos-like fibers, i.e., erionite and fluoro-edenite, are welcome to this issue.

We will accept manuscripts from different disciplines, including exposure and health impact assessment science, epidemiology, intervention studies, risk management, health surveillance, and public health programs.

Dr. Carolina Mensi
Dr. Lucia Fazzo
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

asbestos
health impact
asbestos-related diseases
mesothelioma
epidemiology
health surveillance
occupational diseases
environmental exposure
exposure assessment

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Published Papers (14 papers)

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Research

Jump to: Review, Other

15 pages, 734 KiB

Open AccessArticle

Frequency of Asbestos Exposure and Histological Subtype of Ovarian Carcinoma

by Pauline Vidican, Olivia Perol, Joëlle Fevotte, Emmanuel Fort, Isabelle Treilleux, Elodie Belladame, Jiri Zavadil, Béatrice Fervers and Barbara Charbotel

Int. J. Environ. Res. Public Health 2022, 19(9), 5383; https://doi.org/10.3390/ijerph19095383 - 28 Apr 2022

Cited by 2 | Viewed by 2269

Abstract

The International Agency for Research on Cancer established a causal link between asbestos exposure and ovarian cancer. However, the exposure frequency and histological characteristics of asbestos-associated ovarian cancers remain to be investigated in detail. This multicenter case–case study assessed the asbestos exposure in ovarian carcinoma (OC) patients, alongside its association with histological subtype. Women were recruited in four hospitals in Lyon, France. Histological reports were reviewed by a pathologist. Patient and family members’ data were collected by phone-based questionnaires. Asbestos exposure was defined as direct (occupational and environmental) and indirect (via parents, partners, and children). An industrial hygienist assessed the probability and level of exposure. The 254 enrolled patients (mean age 60 years) reported having an average of 2.3 different jobs (mean working duration 29 years). The prevalence of direct and indirect asbestos exposure was 13% (mean exposure duration 11 years) and 46%, respectively. High-grade serous carcinoma accounted for 73% of all OCs and 82% of histological subtypes in women with direct exposure. After adjustment on a familial history of OC, no significant associations between asbestos exposure (direct and/or indirect) and high-grade serous carcinoma were found. Women with OC had a high prevalence of asbestos exposure. Establishing risk profiles, as reported here, is important in facilitating compensation for asbestos-related OCs and for the surveillance of women at risk. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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12 pages, 1314 KiB

Open AccessArticle

Sex-Specific Mortality from Asbestos-Related Diseases, Lung and Ovarian Cancer in Municipalities with High Asbestos Consumption, Brazil, 2000–2017

by Cézar Akiyoshi Saito, Marco Antonio Bussacos, Leonardo Salvi, Carolina Mensi, Dario Consonni, Fernando Timoteo Fernandes, Felipe Campos, Franciana Cavalcante and Eduardo Algranti

Int. J. Environ. Res. Public Health 2022, 19(6), 3656; https://doi.org/10.3390/ijerph19063656 - 19 Mar 2022

Cited by 10 | Viewed by 2872 | Correction

Abstract

The aim of this study is to compare the mortality rates for typical asbestos-related diseases (ARD-T: mesothelioma, asbestosis, and pleural plaques) and for lung and ovarian cancer in Brazilian municipalities where asbestos mines and asbestos-cement plants had been operating (areas with high asbestos consumption, H-ASB) compared with in other municipalities. The death records for adults aged 30+ years were retrieved from multiple health information systems. In the 2000–2017 time period, age-standardized mortality rates (standard: Brazil 2010) and standardized rate ratios (SRR; H-ASB vs. others) were estimated. The SRRs for ARD-T were 2.56 for men (257 deaths in H-ASB municipalities) and 1.19 for women (136 deaths). For lung cancer, the SRRs were 1.33 for men (32,604 deaths) and 1.19 for women (20,735 deaths). The SRR for ovarian cancer was 1.34 (8446 deaths). Except for ARD-T and lung cancer in women, the SRRs were higher in municipalities that began using asbestos before 1970 than in municipalities that began utilizing asbestos from 1970 onwards. In conclusion, the mortality rates for ARD-T, and lung and ovarian cancer in municipalities with a history of asbestos mining and asbestos-cement production exceed those of the whole country. Caution is needed when interpreting the results of this ecological study. Analytical studies are necessary to document the impact of asbestos exposure on health, particularly in the future given the long latency of asbestos-related cancers. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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15 pages, 20510 KiB

Open AccessArticle

Spatial Analysis of Shared Risk Factors between Pleural and Ovarian Cancer Mortality in Lombardy (Italy)

by Giorgia Stoppa, Carolina Mensi, Lucia Fazzo, Giada Minelli, Valerio Manno, Dario Consonni, Annibale Biggeri and Dolores Catelan

Int. J. Environ. Res. Public Health 2022, 19(6), 3467; https://doi.org/10.3390/ijerph19063467 - 15 Mar 2022

Cited by 6 | Viewed by 2198

Abstract

Background: Asbestos exposure is a recognized risk factor for ovarian cancer and malignant mesothelioma. There are reports in the literature of geographical ecological associations between the occurrence of these two diseases. Our aim was to further explore this association by applying advanced Bayesian techniques to a large population (10 million people). Methods: We specified a series of Bayesian hierarchical shared models to the bivariate spatial distribution of ovarian and pleural cancer mortality by municipality in the Lombardy Region (Italy) in 2000–2018. Results: Pleural cancer showed a strongly clustered spatial distribution, while ovarian cancer showed a less structured spatial pattern. The most supported Bayesian models by predictive accuracy (widely applicable or Watanabe–Akaike information criterion, WAIC) provided evidence of a shared component between the two diseases. Among five municipalities with significant high standardized mortality ratios of ovarian cancer, three also had high pleural cancer rates. Wide uncertainty was present when addressing the risk of ovarian cancer associated with pleural cancer in areas at low background risk of ovarian cancer. Conclusions: We found evidence of a shared risk factor between ovarian and pleural cancer at the small geographical level. The impact of the shared risk factor can be relevant and can go unnoticed when the prevalence of other risk factors for ovarian cancer is low. Bayesian modelling provides useful information to tailor epidemiological surveillance. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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11 pages, 538 KiB

Open AccessArticle

Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy

by Andrea Spinazzè, Dario Consonni, Francesca Borghi, Sabrina Rovelli, Andrea Cattaneo, Carolina Zellino, Barbara Dallari, Angela Cecilia Pesatori, Hans Kromhout, Susan Peters, Luciano Riboldi, Domenico Maria Cavallo and Carolina Mensi

Int. J. Environ. Res. Public Health 2022, 19(6), 3390; https://doi.org/10.3390/ijerph19063390 - 13 Mar 2022

Cited by 3 | Viewed by 3144

Abstract

The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen’s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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11 pages, 456 KiB

Open AccessArticle

A Cohort Study on Cancer Incidence among Women Exposed to Environmental Asbestos in Childhood with a Focus on Female Cancers, including Breast Cancer

by Sofie Bünemann Dalsgaard, Else Toft Würtz, Johnni Hansen, Oluf Dimitri Røe and Øyvind Omland

Int. J. Environ. Res. Public Health 2022, 19(4), 2086; https://doi.org/10.3390/ijerph19042086 - 13 Feb 2022

Cited by 7 | Viewed by 6027

Abstract

Objectives: To examine the risk of cancer in former school children exposed to environmental asbestos in childhood with a focus on female cancers, including breast cancer. Methods: We retrieved a cohort of females (n = 6024) attending four schools located in the neighborhood of a large asbestos cement plant in Denmark. A reference cohort was frequency-matched 1:9 (n = 54,200) in sex and five-year age intervals. Using Danish registries, we linked information on historical employments, relatives’ employments, cancer, and vital status. We calculated standardized incidence rates (SIRs) for all and specific cancers, comparing these rates with the reference cohort. Hazard ratios were calculated for selected cancers adjusted for occupational and familial asbestos exposure. Results: For cancer of the corpus uteri (SIR 1.29, 95% CI 1.01–1.66) and malignant mesothelioma (SIR 7.26, 95% CI 3.26–16.15), we observed significantly increased incidences. Occupationally, asbestos exposure had a significantly increased hazard ratio for cancer in the cervix, however, a significantly lower risk of ovarian cancer. The overall cancer incidence was similar to that of the reference cohort (SIR 1.02, 95% CI 0.96–1.07). The risk of cancer of the lung was increased for those exposed to occupational asbestos, those with family members occupationally exposed to asbestos and for tobacco smokers. Conclusions: In our study, environmental asbestos exposure in childhood is associated with an increased risk of cancer of the corpus uteri and malignant mesothelioma in women. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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11 pages, 339 KiB

Open AccessArticle

Cancer Incidence and Risk of Multiple Cancers after Environmental Asbestos Exposure in Childhood—A Long-Term Register-Based Cohort Study

by Sofie Bünemann Dalsgaard, Else Toft Würtz, Johnni Hansen, Oluf Dimitri Røe and Øyvind Omland

Int. J. Environ. Res. Public Health 2022, 19(1), 268; https://doi.org/10.3390/ijerph19010268 - 27 Dec 2021

Cited by 8 | Viewed by 3985

Abstract

Objectives: To examine the asbestos-associated cancer incidence and the risk of multiple cancers in former school children exposed to environmental asbestos in childhood. Methods: A cohort of 12,111 former school children, born 1940–1970, was established using 7th grade school records from four schools located at a distance of 100–750 m in the prevailing wind direction from a large asbestos-cement plant that operated from 1928 to 1984 in Aalborg, Denmark. Using the unique Danish personal identification number, we linked information on employments, relatives’ employments, date of cancer diagnosis, and type of cancer and vital status to data on cohortees extracted from the Supplementary Pension Fund Register (employment history), the Danish Cancer Registry, and the Danish Civil Registration System. We calculated standardized incidence rates (SIRs) for asbestos-associated cancers, all cancers, and multiple cancers using rates for a gender and five-year frequency-matched reference cohort. Results: The overall incidence of cancer was modestly increased for the school cohort (SIR 1.07, 95% confidence interval (CI) 1.02–1.12) compared with the reference cohort. This excess was driven primarily by a significantly increased SIR for malignant mesothelioma (SIR 8.77, 95% CI 6.38–12.05). Former school children who had combined childhood environmental and subsequent occupational exposure to asbestos had a significantly increased risk of lung cancer. Within this group, those with additional household exposure by a relative had a significantly increased SIR for cancer of the pharynx (SIR 4.24, 95% CI 1.59–11.29). We found no significant difference in the number of subjects diagnosed with multiple cancers between the two cohorts. Conclusions: Our study confirms the strong association between environmental asbestos exposure and malignant mesothelioma and suggests that environmental asbestos exposure in childhood may increase the overall cancer risk later in life. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

12 pages, 1424 KiB

Open AccessArticle

Asbestos Exposure and Malignant Mesothelioma in Construction Workers—Epidemiological Remarks by the Italian National Mesothelioma Registry (ReNaM)

by Alessandra Binazzi, Davide Di Marzio, Marina Verardo, Enrica Migliore, Lucia Benfatto, Davide Malacarne, Carolina Mensi, Dario Consonni, Silvia Eccher, Guido Mazzoleni, Vera Comiati, Corrado Negro, Antonio Romanelli, Elisabetta Chellini, Alessia Angelini, Iolanda Grappasonni, Gabriella Madeo, Elisa Romeo, Annamaria Di Giammarco, Francesco Carrozza, Italo F. Angelillo, Domenica Cavone, Luigi Vimercati, Michele Labianca, Federico Tallarigo, Rosario Tumino, Massimo Melis, Michela Bonafede, Alberto Scarselli, Alessandro Marinaccio and on behalf of the ReNaM Working Group Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2022, 19(1), 235; https://doi.org/10.3390/ijerph19010235 - 26 Dec 2021

Cited by 18 | Viewed by 5175

Abstract

Notwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993–98 period to 23.9% in 2014–2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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17 pages, 1392 KiB

Open AccessArticle

Using GIS to Estimate Population at Risk Because of Residence Proximity to Asbestos Processing Facilities in Colombia

by Benjamin Lysaniuk, María Fernanda Cely-García, Margarita Giraldo, Joan M. Larrahondo, Laura Marcela Serrano-Calderón, Juan Carlos Guerrero-Bernal, Leonardo Briceno-Ayala, Esteban Cruz Rodriguez and Juan Pablo Ramos-Bonilla

Int. J. Environ. Res. Public Health 2021, 18(24), 13297; https://doi.org/10.3390/ijerph182413297 - 17 Dec 2021

Cited by 4 | Viewed by 3101

Abstract

The recent enactment of the law banning asbestos in Colombia raises a significant number of challenges. The largest factories that have historically processed asbestos include five asbestos-cement facilities located in the cities of Sibaté (Cundinamarca), Cali (Valle del Cauca), and Barranquilla (Atlántico), and Manizales (Caldas), which has two, as well as a friction products facility in Bogotá D.C. An asbestos chrysotile mine has also operated in Colombia since 1980 in Campamento (Antioquia). In the framework of developing the National Asbestos Profile for Colombia, in this study, we estimated the population residing in the vicinity of asbestos processing plants or the mine and, therefore, potentially at risk of disease. Using a geographic information system, demographic data obtained from the last two general population censuses were processed to determine the number of people living within the concentric circles surrounding the asbestos facilities and the mine. In previous studies conducted in different countries of the world, an increased risk of asbestos-related diseases has been reported for people living at different distance bands from asbestos processing facilities. Based on these studies, circles of 500, 1000, 2000, 5000, and 10,000 m radii, centered on the asbestos processing facilities and the mine that operated in Colombia, were combined with the census data to estimate the number of people living within these radii. Large numbers of people were identified. It is estimated that in 2005, at the country level, 10,489 people lived within 500 m of an asbestos processing facility or mine. In 2018, and within a distance of 10,000 m, the number of people was 6,724,677. This information can aid public health surveillance strategies. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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14 pages, 541 KiB

Open AccessArticle

Burden of Mortality from Asbestos-Related Diseases in Italy

by Lucia Fazzo, Alessandra Binazzi, Daniela Ferrante, Giada Minelli, Dario Consonni, Lisa Bauleo, Caterina Bruno, Marcella Bugani, Marco De Santis, Ivano Iavarone, Corrado Magnani, Elisa Romeo, Amerigo Zona, Mariano Alessi, Pietro Comba and Alessandro Marinaccio

Int. J. Environ. Res. Public Health 2021, 18(19), 10012; https://doi.org/10.3390/ijerph181910012 - 23 Sep 2021

Cited by 18 | Viewed by 3441

Abstract

Asbestos is one of the major worldwide occupational carcinogens. The global burden of asbestos-related diseases (ARDs) was estimated around 231,000 cases/year. Italy was one of the main European asbestos producers until the 1992 ban. The WHO recommended national programs, including epidemiological surveillance, to eliminate ARDs. The present paper shows the estimate of the burden of mortality from ARDs in Italy, established for the first time. National standardized rates of mortality from mesothelioma and asbestosis and their temporal trends, based on the National Institute of Statistics database, were computed. Deaths from lung cancer attributable to asbestos exposure were estimated using population-based case-control studies. Asbestos-related lung and ovarian cancer deaths attributable to occupational exposure were estimated, considering the Italian occupational cohort studies. In the 2010–2016 period, 4400 deaths/year attributable to asbestos were estimated: 1515 from mesothelioma, 58 from asbestosis, 2830 from lung and 16 from ovarian cancers. The estimates based on occupational cohorts showed that each year 271 deaths from mesothelioma, 302 from lung cancer and 16 from ovarian cancer were attributable to occupational asbestos exposure in industrial sectors with high asbestos levels. The important health impact of asbestos in Italy, 10–25 years after the ban, was highlighted. These results suggest the need for appropriate interventions in terms of prevention, health care and social security at the local level and could contribute to the global estimate of ARDs. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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16 pages, 1329 KiB

Open AccessArticle

Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples

by Silvia Damiana Visonà, Silvana Capella, Sofia Bodini, Paola Borrelli, Simona Villani, Eleonora Crespi, Andrea Frontini, Claudio Colosio and Elena Belluso

Int. J. Environ. Res. Public Health 2021, 18(4), 2053; https://doi.org/10.3390/ijerph18042053 - 19 Feb 2021

Cited by 12 | Viewed by 3888

Abstract

Increased mortality due to malignant mesothelioma has been demonstrated by several epidemiologic studies in the area around Broni (a small town in Lombardy, northern Italy), where a factory producing asbestos cement was active between 1932 and 1993. Until now, the inorganic fiber burden in lungs has not been investigated in this population. The aim of this study is to assess the lung fiber burden in 72 individuals with previous occupational and/or anthropogenic environmental exposure to asbestos during the activity of an important asbestos cement factory. Inorganic fiber lung burden was assessed in autoptic samples taken from individuals deceased from asbestos-related diseases using a scanning electron microscope equipped with an energy-dispersive spectrometer. Significant differences in the detected amount of asbestos were pointed out among the three types of exposure. In most lung samples taken from patients who died of mesothelioma, very little asbestos (or, in some cases, no fibers) was found. Such subjects showed a significantly lower median amount of asbestos as compared to asbestosis. Almost no chrysotile was detected in the examined samples. Overall, crocidolite was the most represented asbestos, followed by amosite, tremolite/actinolite asbestos, and anthophyllite asbestos. There were significant differences in the amount of crocidolite and amosite fibers according to the kind of exposure. Overall, these findings provide novel insights into the link between asbestos exposure and mesothelioma, as well as the different impacts of the various types of asbestos on human health in relation to their different biopersistences in the lung microenvironment. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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20 pages, 674 KiB

Open AccessArticle

Development of the “National Asbestos Profile” to Eliminate Asbestos-Related Diseases in 195 Countries

by Diana Arachi, Sugio Furuya, Annette David, Alexander Mangwiro, Odgerel Chimed-Ochir, Kenneth Lee, Peter Tighe, Jukka Takala, Tim Driscoll and Ken Takahashi

Int. J. Environ. Res. Public Health 2021, 18(4), 1804; https://doi.org/10.3390/ijerph18041804 - 12 Feb 2021

Cited by 13 | Viewed by 7640

Abstract

Worldwide, 230,000+ people die annually from asbestos-related diseases (ARDs). The World Health Organization (WHO) recommends that countries develop a National Asbestos Profile (NAP) to eliminate ARDs. For 195 countries, we assessed the global status of NAPs (A: bona fide NAP, B: proxy NAP, C: relevant published information, D: no relevant information) by national income (HI: high, UMI: upper-middle, LMI: lower-middle, LI: low), asbestos bans (banned, no-ban) and public data availability. Fourteen (7% of 195) countries were category A (having a bona fide NAP), while 98, 51 and 32 countries were categories B, C and D, respectively. Of the 14 category-A countries, 8, 3 and 3 were LMI, UMI and HI, respectively. Development of a bona fide NAP showed no gradient by national income. The proportions of countries having a bona fide NAP were similar between asbestos-banned and no-ban countries. Public databases useful for developing NAPs contained data for most countries. Irrespective of the status of national income or asbestos ban, most countries have not developed a NAP despite having the potential. The global status of NAP is suboptimal. Country-level data on asbestos and ARDs in public databases can be better utilized to develop NAPs for globally eliminating ARDs. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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Review

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15 pages, 368 KiB

Open AccessReview

Lung Cancer Screening in Asbestos-Exposed Populations

by Steven B. Markowitz

Int. J. Environ. Res. Public Health 2022, 19(5), 2688; https://doi.org/10.3390/ijerph19052688 - 25 Feb 2022

Cited by 15 | Viewed by 4489

Abstract

Asbestos exposure is the most important cause of occupational lung cancer mortality. Two large randomized clinical trials in the U.S. and Europe conclusively demonstrate that annual low-dose chest CT (LDCT) scan screening reduces lung cancer mortality. Age and smoking are the chief risk factors tested in LDCT studies, but numerous risk prediction models that incorporate additional lung cancer risk factors have shown excellent performance. The studies of LDCT in asbestos-exposed populations shows favorable results but are variable in design and limited in size and generalizability. Outstanding questions include how to: (1) identify workers appropriate for screening, (2) organize screening programs, (3) inform and motivate people to screen, and (4) incorporate asbestos exposure into LDCT decision-making in clinical practice. Conclusion: Screening workers aged ≥50 years with a history of ≥5 years asbestos exposure (or fewer years given intense exposure) in combination with either (a) a history of smoking at least 10 pack-years with no limit on time since quitting, or (b) a history of asbestos-related fibrosis, chronic lung disease, family history of lung cancer, personal history of cancer, or exposure to multiple workplace lung carcinogens is a reasonable approach to LDCT eligibility, given current knowledge. The promotion of LDCT-based screening among asbestos-exposed workers is an urgent priority. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

14 pages, 765 KiB

Open AccessReview

Sailors and the Risk of Asbestos-Related Cancer

by Richard A. Lemen and Philip J. Landrigan

Int. J. Environ. Res. Public Health 2021, 18(16), 8417; https://doi.org/10.3390/ijerph18168417 - 9 Aug 2021

Cited by 16 | Viewed by 10873 | Correction

Abstract

Sailors have long been known to experience high rates of injury, disease, and premature death. Many studies have shown asbestos-related diseases among shipyard workers, but few have examined the epidemiology of asbestos-related disease and death among asbestos-exposed sailors serving on ships at sea. Chrysotile and amphibole asbestos were used extensively in ship construction for insulation, joiner bulkhead systems, pipe coverings, boilers, machinery parts, bulkhead panels, and many other uses, and asbestos-containing ships are still in service. Sailors are at high risk of exposure to shipboard asbestos, because unlike shipyard workers and other occupationally exposed groups, sailors both work and live at their worksite, making asbestos standards and permissible exposure limits (PELs). based on an 8-h workday inadequate to protect their health elevated risks of mesothelioma and other asbestos-related cancers have been observed among sailors through epidemiologic studies. We review these studies here. Full article

(This article belongs to the Special Issue Asbestos Exposure and Health Impact)

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