Search Results (82)

Background: The heritage of occupational and environmental asbestos exposure in Piedmont, Italy, has resulted in an enduring diffuse pleural mesothelioma (DPM) epidemic. Our study aimed to investigate the accuracy of Pleural biopsy (PB) via thoracoscopy (or video-assisted thoracic surgery—VATS) and analyze the diagnostic path of patients who experienced an initial DPM misdiagnosis. Methods: Patients who underwent PB by VATS for suspected DPM from 2004 to 2013 were analyzed. The Registry of Malignant Mesothelioma (RMM) records were examined to cross-check incident cases and identify misdiagnosed DPM. The sensitivity and specificity of the initial PB assessment versus the final classification of cases by RMM were evaluated. Results: Data from 552 patients were analyzed, and DPM was diagnosed in 178 cases (32%). Sensitivity and specificity were 93% and 100%, respectively. The number of false-negative PBs was 14 (2%). Of those, 10 (71%) had an initial diagnosis of chronic pleuritis, 3 (28.5%) were initially classified as mesothelial proliferation, and 1 had reactive mesothelial proliferation. All of them reported a history of asbestos exposure, and the correct diagnosis was reached after a median of 160 days. One- and four-year survival rates were 52% and 10% in DPM PB-positive cases and 50% and 19% in false-negative cases. Conclusions: When a strong clinical suspicion after a negative PB remains, iterative biopsy attempts should be considered, especially if a history of asbestos exposure is reported. In high-volume centers, the DPM misdiagnosis rate remains low, and future advancements in diagnostic technologies could further increase the accuracy and efficacy of histologic diagnosis. Full article

The Danish asbestos executive order defines a range of situations and work processes that require no protective measures, due to an assumption of low dust generation and therefore negligible exposure to asbestos fibers. The purpose of the study was to investigate the exposure of workers performing tasks where low dust generation is assumed, as well as those in direct proximity. Five roof renovation projects, one facade removal project, and one removal project of whole pipes with intact asbestos insulation were included in the study. A total of 52 personal samples and 33 stationary samples were collected. The asbestos fiber concentrations measured in personal samples ranged from below the detection limit to 0.13 f/cm³ (fibers/cm³). Despite the large spread between projects, the measured concentrations of asbestos fibers in 45 of the 52 personal samples were above the Danish occupational exposure limit value (OEL) of 0.003 f/cm³. The concentration of asbestos fibers in 20 of 33 stationary samples was also above the Danish OEL. The results of personal and stationary measurements suggest that any work with asbestos-containing materials may be associated with a significant risk of exposure above the OEL and, thus, should not be considered a low-dust-generating process without measurements. Full article

Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy associated with occupational or environmental exposure to asbestos. Effective management of MPM remains challenging due to its prolonged latency period and the typically late onset of clinical symptoms. Accordingly, there is an increasing demand for the implementation of reliable, non-invasive, and data-driven diagnostic strategies within large-scale screening programs. In this context, the chemical profiling of volatile organic compounds (VOCs) in exhaled breath has recently gained recognition as a promising and non-invasive approach for the early detection of cancer, including MPM. Therefore, in this cross-sectional observational study, an overall number of 125 individuals, including 64 MPM patients and 61 healthy controls (HC), were enrolled. End-tidal breath fraction (EXP) was collected directly onto two-bed adsorbent cartridges by an automated sampling system and analyzed by thermal desorption–gas chromatography–mass spectrometry (TD-GC/MS). A machine learning approach based on a random forest (RF) algorithm and trained using a 10-fold cross-validation framework was applied to experimental data, yielding remarkable results (AUC = 86%). Fifteen VOCs reflecting key metabolic alterations characteristic of MPM pathophysiology were found to be able to discriminate between MPM and HC. Moreover, twenty breath samples from asymptomatic former asbestos-exposed (AEx) and eight MPM patients during follow-up (FUMPM) were exploratively analyzed, processed, and tested as blinded samples by the validated statistical method. Good agreement was found between model output and clinical information obtained by CT. These findings underscore the potential of breath VOC analysis as a non-invasive diagnostic approach for MPM and support its feasibility for longitudinal patient and at-risk subjects monitoring. 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

(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

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

Objective: This study aims to assess the impact of prolonged occupational exposure to chrysotile asbestos on the epithelial cells of the upper respiratory tract and the levels of surfactant protein D (SP-D) in female workers. Methods: Buccal epithelial cell samples were collected from 40 workers at JSC “Kostanay Minerals”, fixed using the May–Grünwald method, and stained with the Romanowsky–Giemsa technique. SP-D levels were measured using an enzyme-linked immunosorbent assay (ELISA). Results: Workers exposed to asbestos dust exhibited a significant increase in cytological abnormalities and higher SP-D levels compared to the control group. Conclusion: Prolonged exposure to chrysotile-containing dust leads to degenerative changes in upper respiratory tract epithelial cells, characterized by cytological and cytogenetic abnormalities, alongside elevated SP-D levels, highlighting the need for preventive health measures. Full article

This study evaluates the impact of building orientation, typology, and envelope characteristics on energy efficiency and CO₂ emissions in urban dwellings in subtropical climate, with a focus on Cartagena, Colombia. North-facing dwellings consistently demonstrate superior energy performance, achieving an average efficiency increase of 4.27 ± 1.77% compared to south-facing counterparts. This trend is less pronounced near the equator due to the sun’s high zenith angle. Semi-detached homes exhibit 23.17 ± 9.83% greater energy efficiency than corner houses, attributed to reduced exterior wall exposure, which lowers energy demand and CO₂ emissions by 2.16 ± 0.74 kg CO₂/m² annually. Significant disparities in emissions are observed across socioeconomic strata; homes in strata 3 and 4 show the lowest emissions (6.69 ± 1.42 kg CO₂/m² per year), while strata 5 and 6 have the highest (10.48 ± 1.42 kg CO₂/m² per year), due to differences in construction quality and glazing ratios. Roofing materials also play a key role, with thermoacoustic (TAC) roofs reducing emissions by up to 5.80% in lower strata compared to asbestos–cement roofs. Furthermore, sandwich panels demonstrate substantial potential, achieving CO₂ emissions reductions of up to 51.6% in strata 1 and 2 south-facing median homes and a minimum saving of 9.4% in strata 5 and 6. These findings underscore the importance of integrating energy performance criteria into public housing policies, promoting construction practices that enhance sustainability and reduce greenhouse gas emissions while improving occupant comfort and property value. 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

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

Malignant mesothelioma and asbestos-related lung cancer are typically associated with a poor prognosis. However, it has been observed that some patients with these cancers survive significantly longer than the average survival period. While many preliminary studies have investigated factors influencing patient survival, the specific impact of asbestos exposure has not been thoroughly explored. We followed up with 546 patients with malignant mesothelioma and 902 patients with asbestos-related lung cancer, all identified as asbestos victims between 2009 and 2021. In both malignant mesothelioma and asbestos-related lung cancer, patients with occupational asbestos exposure exhibited not only shorter median survival times but also lower 3- and 5-year survival rates compared to those with environmental exposure. Additionally, a longer duration of occupational exposure and closer proximity to the source of asbestos were linked to shorter survival times and lower survival rates. Among the patients with occupational asbestos exposure, the highest hazard ratios (HRs) were observed in those who worked in the production of asbestos-containing products across both cancer types. In contrast, significant HRs were only noted in mesothelioma patients who lived near asbestos industries, slate houses, and redevelopment areas, within the environmentally exposed group. Full article

Background: Asbestos is considered one of the major global work-related carcinogens. Some studies suggest a potential causal relationship between asbestos exposure and colorectal cancer (CRC). However, the role of asbestos in CRC carcinogenesis is still controversial. Methods: 35 claims of occupational CRC among asbestos-exposed workers were reviewed. All claims were rejected by the Italian National Institute for Insurance against Accidents (INAIL) due to the “lack of scientific evidence in the causality” between asbestos exposure and CRC; causality was finally assessed in civil trials. All cases were categorized by age, gender, industry type, task, exposure and latency periods, anatomical location, and histopathological characteristics of CRC and concomitant respiratory diseases. Results: Most workers were males aged 60 years or more and employed in occupational activities with extensive use of asbestos for over 20 years. In 31 out of 35 cases, CRC was diagnosed over 39 years after employment. Right-sided colic adenocarcinoma was diagnosed in nine cases; rectum was involved in eight cases. Respiratory comorbidities were observed in 22 workers. Conclusions: Our study provides some interesting points in the assessment of the causal relationship between asbestos exposure and CRC. Full article

As part of a surveillance plan active since the early 1990s, this study evaluates malignant mesothelioma (MM) mortality for the time-window 2010–2019 in Italy, a country that banned asbestos in 1992. National and regional mortality rates for MM, and municipal standardized mortality ratios (all mesotheliomas, pleural (MPM) and peritoneal (MPeM)), by gender and age group were calculated. A municipal clustering analysis was also performed. There were 15,446 deaths from MM (11,161 males, 3.8 × 100,000; 4285 females, 1.1 × 100,000), of which 12,496 were MPM and 661 were MPeM. In the study period, 266 people ≤50 years died from MM. A slightly decreasing rate among males since 2014 was observed. The areas at major risk hosted asbestos-cement plants, asbestos mines (chrysotile in Balangero), shipyards, petrochemical and chemical plants, and refineries. Female mortality excesses particularly were found in municipalities with a fluoro-edenite-contaminated mine (Biancavilla) and textile facilities. Excesses were also found in a region with the presence of natural asbestos fibres and in males living in two small islands. The Italian National Prevention Plan stated recommendations to eliminate asbestos exposures and to implement health surveillance and healthcare for people exposed to asbestos. Full article