Search Results (88)

Asbestos exposure remains an important cause of lung cancer and mesothelioma worldwide, and the long latency of asbestos-related diseases means that health and economic consequences persist even after asbestos bans. In Colombia, the economic burden attributable to historical asbestos exposure has not been comprehensively quantified. This study estimated the economic burden attributable to asbestos exposure in Colombia in 2022 using a prevalence-based cost-of-illness framework from a societal perspective. Direct medical costs were derived from a national lung cancer cost study and updated to 2022 values. Epidemiological inputs were obtained from the Global Burden of Disease (GBD) database. Mesothelioma was considered predominantly attributable to asbestos exposure, while lung cancer was adjusted using population-attributable fractions and an alternative 1:3 mesothelioma-to-lung-cancer ratio scenario. Indirect costs were estimated using the human capital approach, and disability-adjusted life year (DALY) losses were monetized using alternative willingness-to-pay thresholds. Colombia was estimated to have 150 prevalent mesothelioma cases and between 389 and 450 asbestos-attributable lung cancer cases in 2022. Direct costs ranged from USD 6.5 to 10.7 million annually, increasing to USD 16.7–23.1 million when productivity losses were included. Expanded societal valuation scenarios ranged from USD 71 million to more than USD 180 million annually. Asbestos-related malignancies continue to impose a substantial economic burden in Colombia and support the need for strengthened surveillance, long-term management of installed asbestos, and policies aimed at reducing future asbestos-related disease burden. Full article

Background/Objective: This study aimed to develop and validate an automated framework for detecting pleural plaques (PPs) at the patient level using a single chest CT scan. Methods: A database of chest CT scans with corresponding individual binary annotations for PP presence was first established through expert visual assessment, based on consensus among a board of specialized radiologists. This dataset served to train and validate a patient-level classification framework for automated PP presence detection. This framework leverages a pre-trained PP segmentation network, thus obviating the need for retraining large-scale deep learning models. This segmentation backbone is supplemented by a lightweight classification module that integrates the network’s outputs to infer the presence or absence of PPs at patient level. Furthermore, a patch-wise processing strategy was employed to optimize computational efficiency and training time while retaining critical local contextual information. Results: The framework was evaluated on a cohort of 1241 retired workers with documented occupational asbestos exposure, using 10-fold cross-validation (30% training, 10% validation, 60% testing). It achieved a balanced accuracy of 97.0%, sensitivity of 96.6%, and specificity of 97.4%, demonstrating performance slightly superior to that of two expert radiologists (balanced accuracy: 90.9%/91.4%, sensitivity: 88.0%/88.8%, specificity: 93.9%/94.1% for Expert1/Expert2) and substantially superior to that of a radiologist without specialized expertise in asbestos-related manifestations (balanced accuracy: 80.0%, sensitivity: 75.1%, specificity: 84.8%). Conclusion: The proposed framework demonstrates strong potential for automated patient-level identification of pleural plaques from a single CT scan. Our approach could be particularly useful in screening settings that involve compensation claims related to occupational diseases. Full article

Asbestos, a group 1 carcinogen, has generated a serious health and environmental liability in Pedro Leopoldo/MG, Brazil, even after its national ban in 2017. This study aims to analyze the silent epidemic of asbestos-related diseases (ARDs) through the lens of social injustice. We used a qualitative, socio-historical, and clinical approach within the framework of an Expanded Research Community (ERC), based on ergology, with content analysis of interviews with workers and institutional documents. The evidence reveals a pattern of institutional silencing and omission, marked by corporate fraud, denial of risk, and medical underreporting, perpetuating occupational, domestic, and environmental exposure. In response, the Brazilian Association of Asbestos-Exposed Individuals of Minas Gerais (ABREA/MG) emerged as a central actor in the struggle for recognition and justice. It is concluded that overcoming this injustice requires structured public policies of recognition, integrated surveillance, historical reparation, and strengthening of the SUS (Unified Health System), with collective resistance being fundamental to transforming suffering into memory and social demands. Full article

Background and Objectives: Lung cancer in never-smokers (LCINS) has become a major global health concern, ranking as the fifth leading cause of cancer-related mortality. Unlike smoking-related lung cancer, LCINS arises from complex interactions between environmental carcinogens and distinct genomic alterations. This review summarizes current evidence on environmental risks, molecular features, and therapeutic progress shaping lung cancer management. Methods: A narrative review was conducted to examine risk factors for lung cancer in non-smokers. Studies reporting driver mutations in never-smokers and smokers were identified across major lung cancer histological subtypes, including small-cell lung cancer (SCLC), lung adenocarcinoma (LUAD), squamous cell carcinoma (SCC), and large-cell carcinoma (LCC). In addition, PubMed was searched for phase III trials and studies on targeted therapies related to driver mutations published between 2016 and 2025. Results: Environmental factors such as cooking oil fumes, radon, asbestos, arsenic, and fine particulate matter (PM_2.5) are strongly associated with LCINS through oxidative stress, DNA damage, and chronic inflammation. EGFR, PIK3CA, OS9, MET, and STK11 mutations are characteristic of never-smokers, in contrast to TP53 mutations, which are more common in smokers. Recent advances in targeted therapy and immunotherapy have improved survival and quality of life, emphasizing the importance of molecular profiling for treatment selection. Conclusions: LCINS represents a distinct clinical and molecular entity shaped by complex interactions between environmental exposures and genetic susceptibility. Genetic alterations promote tumor immune evasion, facilitating cancer development and progression. Continued advances in air quality control, molecular diagnostics, and precision therapies are essential for prevention, early detection, and reduction of the global disease burden. Full article

Asbestos, consisting of six natural mineral fibrous silicate phases, was widely utilized in industrial development during the 20th century and has left a global legacy of health, environmental, and regulatory challenges. Its remarkable properties (e.g., heat resistance, sound absorption, and tensile strength) made it a useful material in numerous applications. However, scientific research revealed its serious health risks in the early 1900s, with growing evidence during the 1960s, and nowadays its role in the development of different diseases (e.g., respiratory diseases, such as lung cancer, mesothelioma, and asbestosis) is well defined. Mapping this complex history requires integrating heterogeneous and often inconsistent information from nearly 200 countries. In this study, we tested the use of generative artificial intelligence (AI) tools as exploratory and comparative instruments to support the collection of asbestos-related data worldwide. Using Google Gemini (version 2.5 flash) and OpenAI ChatGPT (GPT-4-turbo variant), we gathered historical, medical, and regulatory information and then systematically verified and contextualized it with expert analysis. This dual approach allowed us to assess both the global asbestos situation and the reliability, advantages, and limitations of AI-assisted research. Our results highlight how AI can accelerate data collection and provide useful first drafts while underscoring the necessity of human expertise for validation, interpretation, and critical integration. This study, therefore, contributes a dual perspective: a comprehensive overview of the asbestos legacy across countries and a methodological reflection on the opportunities and pitfalls of employing AI in geoscientific and environmental research. Full article

Although asbestos use has been banned in many countries, including South Korea, the long latency period of asbestos-related diseases remains a serious public health concern. We conducted a nationwide, registry-based retrospective study to estimate the latency period of asbestosis and identify its determinants. We analyzed exposure history and demographics for 1110 asbestosis cases collected by the Ministry of Environment and the Environmental Health Center for Asbestos in Korea between 2009 and 2021. Mean latency was 45.3 years for asbestosis Grade 1 and 46.3 years for Grade 2. Patients with occupational exposure had shorter latency than those with environmental exposure: 44.4 vs. 46.0 years in Grade 1 (p = 0.010) and 45.0 vs. 47.0 years in Grade 2 (p < 0.001). Within occupations, production-type work showed the shortest latency; within environmental exposure, residence near asbestos-related industries showed the shortest latency, whereas residence near asbestos mines showed the longest. Longer exposure duration (occupational) was associated with shorter latency, and greater residential distance from the source (environmental) with longer latency. Priorities for further investigation include differences by asbestos fiber type and exposure intensity/modality, to inform strengthened occupational health monitoring and targeted surveillance for residents near industrial sources and legacy mines. Full article

Asbestos-related diseases (ARDs), including malignant mesothelioma, asbestos-related lung cancer, and asbestosis, are known for their long latency periods and poor prognoses. Although the physical effects of ARDs have been widely studied, limited research has examined the psychological burden faced by affected individuals. This study investigated depressive and anxiety symptoms among 275 patients officially recognized as asbestos victims in Korea. Mental health was assessed using the Korean version of the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Hospital Anxiety and Depression Scale (HADS). The analysis revealed that the mean ± standard deviation of depression and anxiety levels among patients with asbestos-related diseases were 8.06 ± 6.27 for PHQ-9, 6.02 ± 5.64 for GAD-7, 7.09 ± 5.44 for HADS-A, and 8.41 ± 5.47 for HADS-D. Patients with asbestosis had higher levels of depressive and anxiety symptoms than those with malignant mesothelioma or lung cancer, with symptom severity increasing alongside asbestosis grade. When compared with national data from the 2020–2021 Korea National Health and Nutrition Examination Survey (KNHANES), PHQ-9 and GAD-7 scores among ARD patients, particularly those with Grade 1 asbestosis, were higher than the scores reported for all major cancer types. These findings highlight the substantial psychological distress experienced by individuals with ARDs and emphasize the urgent need for targeted mental health interventions in this population. Full article

(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