Search Results (86)

(1) Background: Occupational exposure to asbestos remains a significant public health concern due to its association with pleural cancer and other cancers. This cohort study examines the incidence of asbestos-related diseases among railway carriage maintenance workers exposed to asbestos between 1960 and 1979 in Bologna, Italy. (2) Methods: A cohort of 2197 male workers was followed from 1960 onwards, with data collected on asbestos exposure, smoking habits, and mortality outcomes. The association of asbestos exposure and smoking with the risk of pleural cancer and lung cancer was assessed using Cox proportional hazards regression models. (3) Results: This study identified a substantial burden of asbestos-related pleural cancer, with an exponential increase in risk over time since the beginning of exposure. Our results suggest the lack of a multiplicative effect of asbestos exposure and smoking on lung cancer risk. The Cox models showed a significant association between smoking and lung cancer risk, with a hazard ratio of 3.26 (95% CI: 1.10–9.64, p = 0.03), less significant for asbestos exposure, with a hazard ratio of 1.42 (95% CI: 0.66–3.06). (4) Conclusions: This study provides valuable insights into the long-term health effects of occupational asbestos exposure and underscores the complex interaction between asbestos exposure and smoking in the development of lung cancer. Full article

We report the first case of pleural mesothelioma (PM) occurring in a child affected by NF2-related schwannomatosis (NF2-SWN) and without any history of environmental exposure to asbestos. Mesothelioma is a rare secondary tumor in brain cancer patients and the association with NF2-SWN has been described only in a few anecdotal cases and never in the pediatric field. NF2-SWN is an autosomal dominant disease caused by inactivating germline mutations of the NF2 tumor suppressor gene, one of the most common mutations associated with human primary mesothelioma too. By MLPA assay, array-CGH analysis, and NGS on blood and tumor DNA, we determined the mutation profile of this rare NF2-driven PM and we identified several atypical chromosomal aberrations in tumor cells, suggesting a different genomic signature between pediatric and adult mesothelioma. Full article

Background/Objectives: Artificial intelligence (AI) has evolved from early diagnostic expert systems to advanced generative models, such as GPT-4, which are increasingly being used in healthcare. Concerns persist regarding inaccuracies and input dependency. This study aimed to deliver initial insights into whether gender influences the interaction of medical professionals with generative AI. Methods: This analysis investigated gender differences in medical students’ and physicians’ interactions with ChatGPT-4 while researching occupational medicine cases in a randomized controlled study. Participants assessed cases involving asbestos-related disease, metal sulfate allergy, and berylliosis using ChatGPT. Inputs and outputs were evaluated for accuracy, confabulations, communication styles, and user satisfaction. Demographic data and self-assessments of occupational medicine knowledge before and after the tasks were also collected. Results: Among 27 participants (63% women, 37% men), women showed greater knowledge improvement after using ChatGPT, particularly in asbestos-related cancer identification. No significant gender differences emerged in diagnostic accuracy, reporting procedures, or satisfaction with ChatGPT. Women exhibited significantly higher self-rated competence after using the ChatGPT application, while men only showed minimal change. Input from the female participants led to more confabulations, although response accuracy remained comparable. Conclusions: This study offers the first real-world insights into the use of generative AI in occupational medicine, highlighting the importance of understanding user-dependent variability in AI-supported clinical practice and decision-making. These findings underscore the need for gender-sensitive AI literacy training in medical education, accommodating diverse interaction styles and strategies to mitigate AI-generated misinformation. Future research with larger and more diverse cohorts could provide deeper insights into the influence of gender, age, and experience on AI utilization in healthcare. Integrating gender-based interaction differences into AI training and applications may improve clinical performance and promote more equitable healthcare practices. Full article

Background: Mesothelioma is a rare and aggressive cancer primarily caused by asbestos exposure. In Colombia, asbestos use began in 1942, but mortality surveillance remains limited. Long latency periods and poor documentation hinder public health action. Materials and Methods: A retrospective descriptive study was conducted using mortality data from 1997 to 2022 obtained from the National Administrative Department of Statistics (DANE), including all mesothelioma cases recorded under the five ICD-10 diagnostic categories (C45.0 to C45.9), covering all anatomical sites of first occurrence. Variables analyzed included sex, age, occupation, and place of residence. Mortality rates and trends were estimated using R, Excel, JoinPoint, and Minitab. Results: A total of 1539 mesothelioma deaths were recorded. Most occurred in men (65.1%) and in individuals over 60 years old (62.6%). Urban areas accounted for 92% of deaths. The most frequent diagnosis was unspecified mesothelioma (61.3%). Cities with the highest adjusted mortality rates per 100,000 inhabitants were Sibaté (38.36), Soacha (8.41), and Bogotá (1.89), aligning with historical exposure zones. Conclusions: Mesothelioma is still a preventable public health issue in Colombia, with sustained mortality affecting even working-age populations. The high rate of unspecified diagnoses and weak linkage between morbidity and mortality data underscore the need to strengthen diagnostic capacity, improve surveillance, and implement a national asbestos-related disease elimination strategy. Full article

Safety in workplaces is a requirement for work sustainability. Construction workers are frequently exposed to dangerous airborne substances. While previous studies examined chemical risks in other sectors, there is limited research on occupational chemical risk perception (OCRP) among construction workers. This study focuses on evaluating OCRP in construction workers and identifying its association with socio-demographic, occupational, and training variables. In L’Aquila, Italy, a sample of male construction workers involved in post-earthquake reconstruction were enrolled in this cross-sectional study. Chemical hazard perception, occupational exposure, personal protective equipment (PPE) use, and training were all covered by our questionnaire. Although the involved 117 workers appear to be aware of dust-related risks and asbestos-related diseases, 53% think that there is no asbestos at their worksite. Respiratory protection equipment was used by 36% of the respondents. OCRP was associated with refresher training (OR = 2.56; p = 0.025); perception of noise (OR = 10.03; p = 0.027); and solar radiation (OR = 26.07; p = 0.001). Although we observed an appropriate awareness of some occupational hazards, gaps between awareness, hazard perception, and protective behavior were evident. Comprehensive site inspections and improved risk communication are necessary to assess chemical hazards and enhance work sustainability. Full article

Mesothelioma is a highly malignant condition arising from the pleura and peritoneum that is closely related to asbestos exposure. The prognosis for this condition has traditionally been poor due to the difficulty physicians have faced in diagnosing and treating this disease, even in its early phase. Fortunately, recent advances in both the molecular understanding of the development of this disease and innovative and novel treatment modalities have accelerated the discovery of new ways to treat mesothelioma. In this review, we first summarize the mechanism of mesothelioma pathophysiology and then relate it to emerging treatment modalities. These include immunotherapy or immune checkpoint inhibitors (ICIs), molecular targeted therapies, and cell-based therapies (such as CAR-T cells or dendritic cells). The scientific basis for the utilization of these treatment modalities, alongside the current clinical evidence for each option, will be explored in detail later on. The hope is that this review can elucidate how these emerging therapeutic options work clinically to help accelerate further developments in novel mesothelioma treatment modalities. Full article

Background: Nitric oxide (NO) has been linked to the pathogenesis of asbestos-related pleural diseases, including an extremely aggressive cancer called malignant pleural mesothelioma (MPM). Given that MPM cells are characterized by a higher expression of NO synthases and elevated NO production relative to normal cells, the use of NO-donor compounds could potentially saturate the cancerous cells with NO, triggering their death. Methods: We developed a novel class of NO prodrugs by merging two NO-releasing components, 1,2,5-oxadiazole 2-oxides (furoxans) and 1,2,4-oxadiazoles, and studied their NO-releasing characteristics in a time-dependent manner using the Griess assay. The cytotoxicity against two human MPM cell lines and non-cancerous lung fibroblasts was evaluated using a colorimetric MTT assay. Results: All compounds exhibited excellent NO-donating properties, surpassing the capacity of two reference NO donor compounds, 3-carbamoyl-4-(hydroxymethyl)furoxan (CAS-1609) and 4-ethoxy-3-phenylsulphonylfuroxan (CHF-2363), by at least 1.5–3 times. All oxadiazole hybrids demonstrated high cytotoxicity against MPM cell lines in a low micromolar range, comparable or higher than the cytotoxicity of the standard-of-care drug cisplatin. Conclusions: Notably, the novel compounds displayed a markedly greater selectivity towards cancerous cells than cisplatin when compared with non-cancerous lung fibroblasts, aligning with the intended design. Full article

Asbestos is a fibrous variety of certain minerals, some of which occur naturally as an accessory to a wide variety of mineral resources. Although asbestos itself has been historically mined for various useful properties, the negative health effects of asbestos dust have greatly diminished it as a useful earth material, as many countries have banned the use of these fibrous minerals based on those health concerns. Resulting regulations of asbestos have focused primarily on intentionally mined material used in product manufacturing, such as building materials made with beneficiated asbestos and their derivative exposures, e.g., airborne asbestos in schools with asbestos-containing materials. The hazards of asbestos as unintended byproducts have not been as extensively considered, although this “contamination” has been repeatedly observed in common earth materials including talc, vermiculite, sand, and gravel. This study reveals such contamination of ornamental and dimension stone commonly referred to as “marble”. Asbestos types that can be associated with certain Indian marble reserves include asbestiform tremolite, actinolite, anthophyllite, and chrysotile asbestos. This case reveals such contamination in a marble reserve in Rajsamand, Rajasthan. At this location, marble dust in slurry is disposed at waste collection points, unfortunately including a location now open to the public that has become a tourist destination. Using Transmission Electron Microscopy (TEM) in this study, dust from this location revealed abundant tremolite asbestos fibres in the disaggregated dust. This poses potential health risks to the workers, bystanders, and tourists that may be exposed to this recognized carcinogen, a known cause of mesothelioma, lung cancer, and other asbestos-related diseases. Full article

Objectives: Occupational respiratory diseases represent a major public health concern worldwide. This study analyses the hospitalization costs and characteristics of four major occupational respiratory diseases: malignant mesothelioma (MM), sinonasal cancer (SNC), pneumoconiosis (PN), and hypersensitivity pneumonitis (HP). The findings are situated within the context of Italy’s population trends and healthcare system, offering insights into the economic and clinical burden of these diseases. Study Design: This retrospective, population-based study examines Italian hospitalizations for MM, SNC, PN, and HP during the period 2010–2021. The primary outcomes were the number of hospitalizations, length of stay, and associated cost. Costs were derived from charges linked to diagnosis-related groups (version 24) and major diagnostic category coding systems. Results: Though the Italian population is rapidly aging, the annual number and rate of hospitalizations declined by 35% over the study period. SNC hospitalizations aligned with the overall trend, PN and MM experienced faster declines, whereas HP admissions remained steady. MM emerged as the most resource-intensive (EUR 25 million yearly, with 86% attributable to occupation), followed by PN (EUR 10 million, entirely occupational), SNC (EUR 5 million, with EUR 650,000 occupational), and HP (EUR 2 million, with EUR 370,000 occupational). All studied diseases had an average length of stay exceeding the national one. The SNC admissions were the shortest (6.5 days) and least expensive (EUR 3647). In contrast, MM, PN, and HP had a mean length of stay exceeding 10 days, with admission costs averaging EUR 4700 for MM and EUR 4000 for PN and HP. The median age was the highest for PN (78 years) and MM (71 years), while SNC and HP patients had a median age of approximately 65 years. Conclusions: Consistent with their anticipated benefits, Italian workplace health regulations over the last three decades, including the 1992 asbestos ban and D.lgs. 81/2008, are associated with significant reductions in the hospitalization burden and an increased median age at discharge for MM and PN. In contrast, fewer conclusions can be drawn for SNC and HP due to their lower occupational fractions (10–20%). This finding suggests adding an occupational exposure flag in hospital records for acknowledged occupational diseases to enhance surveillance. Finally, this study provides the first estimate of the occupational fraction of hospitalization costs for the studied diseases in Italy. Full article

The use of asbestos, once celebrated for its versatility and fire-resistant properties, has left a lasting legacy of environmental degradation and public health risks. This paper provides a comprehensive assessment of the environmental impacts and health risks associated with asbestos, highlighting its widespread use, environmental persistence, and adverse effects on human health. Through a literature review, this study examines the historical context of asbestos use, its adverse environmental effects and the mechanisms by which exposure to asbestos poses significant health risks, including the development of asbestos-related diseases such as mesothelioma, lung cancer, asbestosis, etc. It also assesses the current regulatory framework and provides a methodological analysis of the strategy for recycling end-of-life materials containing asbestos fibers, proposing the inclusion of asbestos-containing materials (ACMs) in the rock wool industry to reduce Greenhouse Gasses (GHG) emissions. Drawing on interdisciplinary insights from environmental science, public health, and regulatory analysis, this paper concludes with recommendations for improving asbestos management strategies, promoting safer alternatives and mitigating the long-term environmental and human health impacts of asbestos. Full article

Asbestos is a naturally occurring mineral renowned for its exceptional tensile strength, chemical resistance, and low thermal and electrical conductivity. Due to these properties, it has been widely used in various industries. However, asbestos exposure is strongly linked to severe health conditions, including lung cancer, mesothelioma, and asbestosis. Although over 70 countries have banned asbestos-containing materials, significant health risks persist due to ongoing use and poor management practices in many regions. To mitigate these risks, robust occupational health measures are essential. These include safe removal protocols, comprehensive worker training, proper use of personal protective equipment (PPE), regular exposure monitoring, rigorous compliance checks, and severe penalties for non-compliance. Moreover, effective asbestos waste management and the development of advanced disposal technologies are essential to reducing risks. Public awareness campaigns, regulatory enforcement, and a global ban on asbestos production, use, and export are also necessary, particularly in countries where asbestos is still in use. Lessons from asbestos management in Australia and New Zealand provide valuable insights for nations currently dealing with asbestos issues. This paper reviews current practices in asbestos surveying, removal, and disposal, comparing them to the stringent regulatory frameworks in Australia and New Zealand. It highlights strategies that can be adopted globally to ensure safer management and complete elimination of asbestos. Full article

Background: Colorectal cancer (CRC) is considered a “man’s disease”. However, emerging data show that females may have a higher prevalence of certain risk factors. A potential causal role of asbestos in CRC carcinogenesis has been suggested. This relationship is controversial, and only a few studies have focused on exposed female populations. The aim of this study was to review the scientific literature related to asbestos-related CRC incidence and mortality rates in female populations to address gender bias in the existing research. Methods: A systematic review was performed following PRISMA statement. Results: Fourteen studies reporting 92 cases in total were included. Most women were aged 50 years or older and were employed in occupational activities with high asbestos exposure (steel, textile, and asbestos-cement industry) for at least 10 years. In one single case, household asbestos exposure was reported. The colon was the primary location of the tumor in 47 out of 92 cases. Three women were also affected by synchronous or metachronous peritoneal mesotheliomas. Conclusions: This study revealed a general methodological “gender bias” in scientific research. A significantly higher representation of women in clinical studies is needed to clarify the link between asbestos exposure and the development of colorectal cancer. Full article

Background: The incidence and mortality of pleural mesothelioma (PM) reflect the production and consumption of asbestos over time. However, despite the current global concern, these data remain to be known. Objective: Our aim was to carry out a descriptive analysis of PM cases and mortality from some Portuguese databases between 2014 and 2020. Methods: A retrospective observational study was carried out between 2014 and 2020. Data on the number of PM cases were provided by the Portuguese Cancer Registry, and data on mortality were from the Portuguese Death Certificate Information System. Results: Between 2014 and 2020, 315 cases of PM were reported, with 222 (70.5%) men. The average age of patients was 72.1, with the highest number of cases in patients aged >70 years (n = 198; 62.9%). The highest number of cases was reported in 2018 (n = 62; 19.7%). Regarding mortality, 169 deaths were reported, with 126 (74.6%) men and mostly in individuals aged >70 years (n = 109; 64.5%). It is estimated that around 520 years of potential life were lost. The highest number of deaths occurred in 2015 (n = 33; 19.5%). Conclusion: It is mandatory to reinforce the need for surveillance programs that allow us to gather real and reliable data and eliminate asbestos-related diseases. Full article

Asbestos is a term that includes six fibrous mineral phases related to different lung diseases, including asbestosis, lung cancer, and Malignant Pleural Mesothelioma (MPM). Since the last century, these minerals have been widely studied under their mineralogical/chemical and physical aspects with in vivo and in vitro studies to understand the mechanisms of their carcinogenicity. There are several techniques described in the literature, as optical and electron microscopies, for the identification of coated (asbestos bodies, ABs) and uncoated fibers, but only micro-Raman spectroscopy permits a sure characterization of these minerals—and of the related phases—directly in the histological sections of pulmonary parenchyma without any manipulation. In this case, the risk of the loss of associated inorganic phases from asbestos bodies (ABs) and fibers (e.g.: iron or carbonaceous micro-particles) is avoided. Asbestos bodies are produced by the activity of alveolar macrophages with degradation/inactivation of asbestos fibers. Inside the alveolar macrophages, organic and inorganic material settles on the foreign fibers forming an iron-rich proteic and carbonaceous coating. In this study, Variable Pressure Scanning Electron Microscopy with annexed Electron Dispersive Spectroscopy (VP-SEM/EDS) and micro-Raman spectroscopy were applied to the characterization of the phases in the ABs. Characterization of carbonaceous materials (CMs), observed in pristine asbestos phases in previous works, was therefore performed, addressing the micro-Raman laser beam on different points of the asbestos bodies, and Raman mappings on ABs were carried out for the first time. Coupling the data obtained by VP-SEM/EDS and micro-Raman spectroscopy, it was possible to collect information about the iron and carbonaceous phases adhered to the fibers, probably lost during the classical tissue digestion procedures. Information about both mineral and carbonaceous components might be useful to understand the whole structure of “asbestos bodies” and the inflammogenic and carcinogenic effects of the asbestos phases coupled to CMs, that might derive from cigarette smoke or from environmental pollution; this study might be useful to deepen also the possible detrimental role of ABs in the tissues. Full article

Amphibole asbestos is related to multiple diseases, mainly those targeting the lungs. Asbestos-related malignancies can also be caused by non-regulated asbestiform minerals and some elongated mineral particles (EMPs). In particular, the role of nano- and micro-sized EMPs internalized by lung epithelial cells must be clarified. This is of major importance when considering that EMPs to which humans are exposed are likely a highly heterogeneous mix of different mineral types, shapes, and sizes. Here, we document that particles smaller than 4.54 µm in length and smaller than 0.89 µm in width (e.g., particles that do not fit the regulatory categories to be identified as asbestos) are easily internalized because of their specific dimensions, surface charge, and shape (mostly dictated by the aspect ratio L/w). Once internalized, these particles can be found in proximity to the cell nucleus, in vesicles, and in the cytoplasm. Examining the localization of particles in cells provides important information, which helps in determining the physicochemical environment found inside the biological compartment, thus allowing for a better comprehension of the mineralogical transformation that might happen after internalization by cells. Full article