Exposure to Nickel Oxide Nanoparticles Induces Acute and Chronic Inflammatory Responses in Rat Lungs and Perturbs the Lung Microbiome.

Nickel oxide nanoparticles (NiO NPs) are highly redox active nanoparticles. They can cause acute and chronic inflammation in rat lungs. Unlike the gut microbiome, the association between the lung microbiome's role and pulmonary inflammatory response to inhaled nanoparticles remains largely unexplored. We aimed to explore the interaction between the lung microbiome and inflammatory responses in rats exposed to NiO NPs. Thirty female Wistar rats were randomly categorized into control and low- (50 cm2/rat), and high- (150 cm2/rat) dose NiO NPs exposure groups. NiO NPs were intratracheally instilled, and cytological, biochemical, proinflammatory cytokine, and lung microbiome analyses of bronchoalveolar lavage fluid were performed at 1 day and 4 weeks after instillation. NiO NPs caused a neutrophilic and lymphocytic inflammatory response in rat lung. We demonstrated that exposure to NiO NPs can alter the lung microbial composition in rats. In particular, we found that more Burkholderiales are present in the NiO NPs exposure groups than in the control group at 1 day after instillation. Dysbiosis in the lung microbiome is thought to be associated with acute lung inflammation. We also suggested that Burkholderiales may be a key biomarker associated with lung neutrophilic inflammation after NiO NPs exposure.

Erratum: Asbestos exposure and autoantibody titers.

[This corrects the article e32 in vol. 32, PMID: 33072343.].

Asbestos Exposure Level and the Carcinogenic Risk Due to Corrugated Asbestos-Cement Slate Roofs in Korea.

Asbestos-cement slate roofs are one of the most common environmental causes of asbestos exposure. However, few studies have examined residential asbestos-cement slate-related exposure and its effects on human health. This study was performed to evaluate cumulative asbestos exposure levels and to calculate the Excess Lifetime Cancer Risk (ELCR) of residents of asbestos-cement slate-roofed houses. We reviewed previous Korean literature to estimate the concentration of airborne asbestos from asbestos-cement slate roofed buildings. Finally, eight studies were selected, and a pooled analysis was performed. The results derived from the pooled analysis were combined with the data from a health impact survey conducted from 2009 to 2016 at the Environmental Health Center for Asbestos (EHCA) of the Yangsan Pusan National University Hospital, and a carcinogenic risk assessment was performed. As a result, the representative value of the indoor exposure concentration related to asbestos-cement slate was found to be 0.0032 f/cc on average, and the representative value of the exposure related to occupational asbestos-cement slate dismantling and demolition was found to be 0.0034 f/cc. In addition, the ELCR of asbestos-cement slate related indoor exposure and occupational dismantling and demolition was found to be of medium risk, and the ELCR of residential dismantling and demolition of asbestos-cement slate was less than 10-6, indicating that the risk was low. Since there is no threshold for carcinogenicity related to asbestos, this should not be ignored even if the risk appears low, and it would be reasonable to calculate the carcinogenic risk based on total lifetime exposure. More studies on asbestos exposure scenarios and the scope of similar exposure groups through additional data collection and further analysis of risk are needed.

Activity-Based Exposure Levels and Cancer Risk Assessment Due to Naturally Occurring Asbestos for the Residents Near Abandoned Asbestos Mines in South Korea.

This study aims to evaluate the overall asbestos exposure intensity and assess the health risk to residents due to naturally occurring asbestos (NOA) near abandoned asbestos mines in South Korea. Of 38 mines, we found 19 with measured concentrations of NOA. We evaluated the average of airborne NOA concentrations according to the environmental exposure category. When evaluated regionally by dividing into two clusters, the mean concentrations in activity-based sampling (ABS) scenarios exceeded the Korean exposure limit (0.01 f/cc) in both clusters. Moreover, airborne NOA concentrations in agricultural activity (5.49 × 10-2 f/cc) and daily activity (6.95 × 10-2 f/cc) had the highest values for clusters A and B, respectively. The excess lifetime cancer risk of one region (cluster A) by the ABS scenarios did not exceed the Korean Ministry of the Environment's criteria for soil purification (1 × 10-4). However, one of the ABS scenarios-the daily life activity of clusters centered on Chungcheongbuk-do (cluster B)-showed an exposure of 1.08 × 10-4, greater than the limit (1 × 10-4). This indicates non negligible health damage to residents living near the abandoned asbestos mines, and it is necessary to continuously monitor and clean up the asbestos contamination.

Development of Nationwide Excess Lifetime Cancer Risk Evaluation Methods with Comprehensive Past Asbestos Exposure Reconstruction.

Although exposure to asbestos via various routes has been acknowledged, comprehensive exposure and risk assessment methods have not been developed at the national level. We conducted a study to reconstruct comprehensive past asbestos exposure estimations and to suggest a method to calculate the Excess Lifetime Cancer Risk (ELCR) of Koreans. The past occupational exposure reconstruction was conducted by rebuilding the previous general population job-exposure matrix (JEM). The para-occupational and household exposure estimation was based on the pooled analysis of data from other countries as well as Korea. The neighborhood exposure from occupational sources by distance was estimated by the exponential decay model. As a result, 141 JEM exposure groups across four periods including ~79, the 80s, 90s, 2000s with a ratio of 2.0:1.0:0.5:0.05 were reconstructed. The para-occupational and household exposures were 11% and 1% of the JEM respectively. The environmental exposure source concentration from outside occupational exposure was 2.5% of the inside concentration. The ratio of the concentration of environmental exposure source (C0) to distance d (Cd) was exp-kd  with a decay constant k of 6.834. The mean concentrations (f/cc) were 2.28 × 10-3 for outdoor, 4.65 × 10-5 for indoor, 1.95 × 10-2 for transportation activity, 4.44 × 10-2 for agricultural activity, and 4.68 × 10-2 for daily life activity in naturally occurring asbestos areas. Indoor and outdoor asbestos concentrations from living in a slate roof house were 1.73 × 10-6 and 2.70 × 10-8, respectively. For improved generalizability, validity, and applicability of the proposed method, further studies on each route with real assessments and experiments are required.

Holographic metasurface gas sensors for instantaneous visual alarms.

The rapid detection of biological and chemical substances in real time is particularly important for public health and environmental monitoring and in the military sector. If the process of substance detection to visual reporting can be implemented into a single miniaturized sensor, there could be a profound impact on practical applications. Here, we propose a compact sensor platform that integrates liquid crystals (LCs) and holographic metasurfaces to autonomously sense the existence of a volatile gas and provide an immediate visual holographic alarm. By combining the advantage of the rapid responses to gases realized by LCs with the compactness of holographic metasurfaces, we develop ultracompact gas sensors without additional complex instruments or machinery to report the visual information of gas detection. To prove the applicability of the compact sensors, we demonstrate a metasurface-integrated gas sensor on safety goggles via a one-step nanocasting process that is attachable to flat, curved, and flexible surfaces.

Reconstruction of the Korean Asbestos Job Exposure Matrix.

BACKGROUND: A job-exposure matrix (JEM) is an important surrogate indicator to evaluate past exposure levels. Although a Korean asbestos JEM has been constructed previously, this JEM includes only a few industrial and occupational groups. This study aimed to reconstruct the JEM by integrating the latest organized data to improve its utility. METHODS: We used recent Korean standard industry and occupation codes and extracted 36 articles from a systematic literature review to initiate the reconstruction of the previous Korean asbestos JEM. The resulting data consisted of 141 combinations of industrial and occupational groups. Data from the Netherlands's JEM were also reviewed and categorized into 70 industrial and 117 occupational groups by matching with the Korean data. We also utilized Germany's data, which consisted of 10 industrial and 14 occupational groups. RESULTS: The reconstructed Korean asbestos JEM had 141 combinations of industries and occupations. The time periods are from the 1980s to the 2000s in 10-year intervals. Most of the data were distributed between the 1990s and the 2000s. Occupations with high exposure to asbestos included knitting and weaving machine operators, automobile mechanics or assemblers, ship mechanics or assemblers, mineral ore and stone products processing mechanics, and metal casting machine operators or mold makers. CONCLUSIONS: The reconstructed Korean asbestos JEM has expanded the type and duration of the occupational groups of the previous JEM and can serve as an important reference tool for evaluating asbestos exposure and designing compensation and prevention policies in Korea.

Diagnostic Utility of Galactose-Deficient Immunoglobulin A1 Immunostaining in the Differentiation of Lupus Nephritis and Immunoglobulin A Nephropathy.

Background: Renal biopsy plays an important role in the establishment of the diagnosis and the management of patients with lupus nephritis. Immunoglobulin A (IgA) nephropathy rarely has been reported in kidney biopsy of lupus patients. Lupus nephritis and IgA nephropathy can be readily diagnosed on renal biopsy when the classic patterns are present. However, atypical patterns can become a diagnostic challenge. Galactose-deficient IgA1 (Gd-IgA1) is a key element in the pathogenesis of primary IgA nephropathy. Glomerular Gd-IgA1 deposits, detected by immunofluorescent staining of KM-55 (a Gd-IgA1-specific monoclonal antibody), are consistently identified in the mesangium of IgA nephropathy but are significantly less or absent in lupus nephritis accompanied by significant IgA deposition. Case Presentation: Here we report the case of an 11-year-old girl who was recently diagnosed with systemic lupus erythematosus (SLE) and was found to have hematuria and proteinuria. Renal biopsy showed focal mesangial hypercellularity with IgA dominant, "full house" like pattern of mesangial deposition. The biopsy findings present a diagnostic dilemma with the differential diagnosis of IgA nephropathy versus lupus nephritis with atypical immunofluorescence, and IgA nephropathy is favored, in the absence of strong straining of C1q or C3, extraglomerular deposits, tissue antinuclear antibodies, and endothelial tubuloreticular inclusions. However, no detectable glomerular KM-55 staining was seen in the kidney biopsy. Conclusions: We demonstrate the unique diagnostic utility of immunostaining for KM-55 in a challenging kidney biopsy of an SLE patient with features suggestive of IgA nephropathy. The absence of KM-55 staining excludes IgA nephropathy, supporting a diagnosis of lupus nephritis with atypical immunofluorescence in this patient with SLE.

Asbestos exposure and autoantibody titers.

BACKGROUND: Asbestos is a well-known hazardous substance that causes occupational and environmental diseases including asbestosis (lung fibrosis). Silica exposure which causes silicosis (another type of lung fibrosis) has long been linked to the development of autoimmune diseases; however, there are few studies on the relationship between asbestos exposure and autoimmune diseases. METHODS: A total of 54 individuals who had worked in a former asbestos textile factory underwent autoantibody-related blood tests, chest X-ray imaging, and pulmonary function tests. Based on the job exposure matrix (JEM), the estimated asbestos exposure concentrations were determined, and the presence of asbestosis was determined by chest radiography. RESULTS: Scleroderma (Scl-70) and ribonucleoprotein (RNP) antibodies were significantly lowered in the pleural plaque present group than in the absent group. Additionally, Scl-70, RNP, and Sjögren's syndrome type B (SS-B) antibodies were significantly lowered in the asbestosis present group. When stratifying variables with or without asbestosis, Scl-70, Smith, SS-B, and RNP antibodies decreased in female, crocidolite handling group, and higher estimated asbestos exposure level group. CONCLUSIONS: Contrary to our expectations that autoantibody titers would be higher in groups with high asbestos exposure or in the asbestosis group, those with asbestosis showed lower titers. But as our research has some methodological limitations, the lowered titer of autoimmune antibody in our asbestos exposed subjects could not be simply interpreted as a lowered risk of autoimmune diseases. So careful interpreting should be taken when examine autoantibodies to screening or diagnose autoimmune diseases in people with asbestos exposure. In addition, it is necessary to establish relevance of asbestosis and autoantibodies through further studies of larger scale and higher confidence levels.

Galactose-Deficient IgA1 Deposits in Clear Cell Renal Cell Carcinoma-Related Henoch-Schönlein Purpura Nephritis.

Recent studies suggest that galactose-deficient IgA1 (Gd-IgA1) plays a role in the pathogenesis of primary IgA nephropathy (IgAN) and Henoch-Schönlein purpura nephritis (HSPN). Furthermore, immunostaining of KM55, an antibody that identifies Gd-IgA1, may be helpful to differentiate primary IgAN and HSPN from secondary causes of glomerular IgA deposition. We report sequential kidney biopsies of a malignancy-associated HSPN, showing intense glomerular mesangial IgA deposition at the initial kidney biopsy and dramatic decrease in disappearance of glomerular deposits after tumor removal. We demonstrate that the glomerular IgA deposition contains Gd-IgA1, detected by immunostaining of KM55, with similar distribution and intensity to IgA. This suggests that renal Gd-IgA1 deposition may play a role in the pathogenesis of malignancy-associated HSPN.

Distribution of age, gender, and occupation among individuals with carpal tunnel syndrome based on the National Health Insurance data and National Employment Insurance data.

BACKGROUND: The present study aimed to investigate the basic characteristics of carpal tunnel syndrome (CTS) and its differences between occupations using Korea's National Health Insurance (NHI) and National Employment Insurance (NEI). METHODS: The study participants were obtained from the NEI and NHI data from 2008 to 2015, with a diagnosis code of G560 (CTS) as the main or sub-diagnosis. Data about gender, age, diabetes mellitus, smoking, drinking, and length of employment, information about type of occupation, and number of employees according to age and occupation were obtained from NHI and NEI data. In total, 240 occupations were classified into blue-collar (BC) and white-collar (WC) work. In addition, each occupation was classified as high-risk and low-risk groups depending on the degree of wrist usage. RESULTS: The number of patients with CTS per 100,000 individuals increased with advancing age, and it was higher in women (4,572.2) than in men (1,798.5). Furthermore, the number was higher in BC workers (3,247.5) than in WC workers (1,824.1) as well as in the high-risk group than in the low-risk group in both BC workers (3,527.8 vs. 1,908.2) and WC workers (1,829.9 vs. 1,754.4). The number of patients with CTS was higher in the high-risk group than in the low-risk group among male and female BC workers and female WC workers. However, the number was higher in the low-risk group among male WC workers. In the BC category, the number of patients with CTS was highest among food processing-related workers (19,984.5). In the WC category, the number of patients with CTS was highest among social workers and counselors (7,444.1). CONCLUSIONS: The results of this study are expected to help identify occupational differences in patterns of CTS. High number of patients with CTS was seen in new jobs, as well as in previous studies.

Public Facility Utility and Third-Hand Smoking Exposure without First and Second-Hand Smoking According to Urinary Cotinine Level.

Third-hand smoke (THS) causes pathological changes in the liver, lungs, and skin. THS exposure can be ubiquitous, chronic, and unconscious. However, little is known about THS exposure in public facilities and its susceptible population. This paper aimed to identify which public facilities and socio-demographic groups were especially vulnerable to THS. Data from 1360 adults obtained from Korean National Environmental Health Survey I (2009⁻2011) were analyzed. To study the sole effect of THS, we restricted the study population to those participants who had never smoked and who had no exposure to second-hand smoke. The assessed variables included the type and frequency of public transportation, frequency of use of 12 different public facilities, and 8 socio-demographic factors. Urinary cotinine was used as a biomarker. T-tests and analysis of variance were used for univariate analyses, while generalized linear regression was used for multivariate analysis. Frequent use of public transportation, bars, internet cafés, and participants with low levels of education, divorced or bereaved, living in multi-unit houses, and with smokers within the family were associated with significantly high urinary cotinine levels. These findings indicate that the frequent use of public transportation, certain public facilities and certain socio-demographic factors can result in high THS exposure.

Thermally reconfigurable Janus droplets with nematic liquid crystalline and isotropic perfluorocarbon oil compartments.

We report that mixtures of perfluorocarbon oils and hydrocarbon mesogens can be used to prepare multi-compartment (Janus) emulsion drops comprising coexisting nematic liquid crystalline (LC) and isotropic oil phases. The droplets exhibit stable spherical shapes with internal Janus-type morphologies that can be tuned widely through changes in temperature or adsorbates. In particular, we observe evidence of preferential adsorption of hydrocarbon or fluorocarbon surfactants on the interfaces of nematic versus isotropic domains, respectively, providing added control over the droplet structure. Comparisons of experiments and numerical simulations using a Landau-de Gennes continuum model provide insight into the relative importance of the LC elasticity and orientational-dependent interfacial energies on droplet morphologies and properties. We show that the hierarchical organization of the LC compartments generates optical properties and responsiveness not found in emulsions of isotropic oils.

Differences in the Incidence of Symptomatic Cervical and Lumbar Disc Herniation According to Age, Sex and National Health Insurance Eligibility: A Pilot Study on the Disease's Association with Work.

The aim of this research was to identify the differences in the incidence of symptomatic cervical and lumbar disc herniation according to age, sex, and national health insurance eligibility. We evaluated the hospital documents of patients who received medical treatment for symptomatic cervical and lumbar disc herniation between 2004 and 2010 and excluded those who claimed to have expenses at oriental medical clinics or pharmacies. Furthermore, any duplicate documents from the labor force population aged 20⁻69 years were excluded from the analysis. The results showed that the number of individuals diagnosed with symptomatic cervical and lumbar disc herniation increased with age, and the incidence of these diseases was higher in women than in men. Additionally, the incidence differed depending on the subject's qualification for health insurance. The incidence of lumbar disc herniation showed differences depending on the degree of the lumbar burden. The present study findings may help determine whether lumbar disc herniation is associated with tasks performed at the patient's workplace. Further research is needed to classify the risk of lumbar disk herniation in the workplace into detailed categories such as types of business, types of occupation, and lumbar compression force.

Occupational Burden of Asbestos-Related Diseases in Korea, 1998-2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer.

BACKGROUND: Asbestos exposure causes asbestos-related diseases (ARDs) including asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer. Although Korea used substantial amounts of asbestos in the past, no study has focused on its occupational burden of disease (OBD). Therefore, this study aimed to determine the OBDs of ARDs in Korea. METHODS: The CARcinogen Exposure (CAREX) database was used to determine the proportion of exposed population. Relative risks for lung cancer, laryngeal cancer, and ovarian cancer were used to determine the population-attributable fraction. Data for deaths caused by ARDs during 1998-2013 were obtained from the World Health Organization mortality database. The potential years of life lost (PYLL) and annual average PYLL (APYLL) indicated OBDs. RESULTS: In Korea, the number of ARD-attributable deaths and PYLL due to all ARDs during 1998-2013 were 4,492 and 71,763.7, respectively. The number of attributable deaths and PYLL due to asbestosis, malignant mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer were 37 and 554.2, 808 and 15,877.0, 3,256 and 47,375.9, 120 and 1,605.5, and 271 and 6,331.1, respectively; additionally, the APYLL were 15.0, 19.7, 14.6, 13.4, and 23.4, respectively, and the average age at death was 70.4, 62.6, 69.1, 69.9, and 61.8, respectively. Our study showed that although the use of asbestos has ceased in Korea, the incidence of ARDs tends to increase. CONCLUSION: Therefore, efforts to reduce future OBDs of ARDs, including early detection and proper management of ARDs, are needed in Korea.

Relationships of Lower Lung Fibrosis, Pleural Disease, and Lung Mass with Occupational, Household, Neighborhood, and Slate Roof-Dense Area Residential Asbestos Exposure.

This study aimed to evaluate the relationship between various asbestos exposure routes and asbestos-related disorders (ARDs). The study population comprised 11,186 residents of a metropolitan city who lived near asbestos factories, shipyards, or in slate roof-dense areas. ARDs were determined from chest X-rays indicating lower lung fibrosis (LFF), pleural disease (PD), and lung masses (LMs). Of the subjects, 11.2%, 10.4%, 67.2% and 8.3% were exposed to asbestos via occupational, household, neighborhood, and slate roof routes, respectively. The odds ratio (OR) of PD from household exposure (i.e., living with asbestos-producing workers) was 1.9 (95% confidence interval: 0.9⁻4.2), and those of LLF and PD from neighborhood exposure, or residing near asbestos factories) for <19 or >20 years, or near a mine, were 4.1 (2.8⁻5.8) and 4.8 (3.4⁻6.7), 8.3 (5.5⁻12.3) and 8.0 (5.5⁻11.6), and 4.8 (2.7⁻8.5) and 9.0 (5.6⁻14.4), respectively. The ORs of LLF, PD, and LM among those residing in slate-dense areas were 5.5 (3.3⁻9.0), 8.8 (5.6⁻13.8), and 20.5 (10.4⁻40.4), respectively. Substantial proportions of citizens residing in industrialized cities have potentially been exposed to asbestos, and various exposure routes are associated with the development of ARDs. Given the limitations of this study, including potential confounders such as socioeconomic status, further research is needed.

Monitoring and Simulating Environmental Asbestos Dispersion from a Textile Factory.

Although workplace asbestos concentrations (AC) have been reported several times, the past environmental AC are relatively poorly studied. Due to the harmful effects of the asbestos industry, production has moved from early industrialized countries (Japan), to late industrialized countries (Korea), and finally to industrializing countries (Indonesia). The purpose of this study was to determine current occupational exposure levels and evaluate neighborhood environmental exposure levels in an Indonesian asbestos textile factory through collaboration among three generation of industrialized countries. Asbestos concentrations were measured inside and outside of the factory and compared with simulated data. ACs in the factory were similar to those of 1980s and 1990s levels in the Korean factory that transferred the machines. Environmental ACs were dispersed according to wind direction. There were no significant differences between monitored and simulated data, and correlation coefficients between downwind, upwind, and middle wind directions were high, with some statistical significance. This study can be used to estimate past environmental ACs to understand the causality of asbestos related diseases. Because of the small sample size and specific weather conditions, a large-scale study of various asbestos exposure sources, including asbestos cement factories, shipyards, and mines, and various atmospheric conditions is required.

Environmental asbestos exposure sources in Korea.

BACKGROUND: Because of the long asbestos-related disease latencies (10-50 years), detection, diagnosis, and epidemiologic studies require asbestos exposure history. However, environmental asbestos exposure source (EAES) data are lacking. OBJECTIVES: To survey the available data for past EAES and supplement these data with interviews. METHODS: We constructed an EAES database using a literature review and interviews of experts, former traders, and workers. Exposure sources by time period and type were visualized using a geographic information system (ArcGIS), web-based mapping (Google Maps), and OpenWeatherMap. The data were mounted in the GIS to show the exposure source location and trend. RESULTS: The majority of asbestos mines, factories, and consumption was located in Chungnam; Gyeonggi, Busan, and Gyeongnam; and Gyeonggi, Daejeon, and Busan, respectively. Shipbuilding and repair companies were mostly located in Busan and Gyeongnam. CONCLUSIONS: These tools might help evaluate past exposure from EAES and estimate the future asbestos burden in Korea.

Parenchymal infiltration and lymphoma-associated membranoproliferative pattern of glomerular injury: an unusual presentation of mantle cell lymphoma.

Lymphomatous processes have been shown to involve the kidney by direct and paraneoplastic mechanisms. Direct injury can manifest by effacement of typical parenchymal architecture by the lymphomatous infiltrate, and indirect, paraneoplastic mechanisms have been associated with a variety of glomerular lesions. Mantle cell lymphoma (MCL) has rarely been reported to be associated with both direct infiltration and/ or paraneoplastic glomerular lesions. We describe a patient with rapidly progressive glomerulonephritis whose renal biopsy showed effacement of the renal parenchyma by MCL and a membranoproliferative pattern of glomerular injury. The patient's bone marrow was also involved by MCL, and serology revealed small M-spikes and a positive rheumatoid factor. The clinicopathologic findings were consistent with a membranoproliferative pattern of glomerular injury secondary to MCL with infiltrative destruction of renal parenchyma. This case is unusual in that MCL was diagnosed on renal biopsy, that there was a two-pronged mechanism of renal injury, and that there were two separate monoclonal immunoglobulins elaborated by the lymphoma that could be associated with the glomerular injury. Although it is uncommon to make an initial diagnosis of lymphoma from a renal biopsy, it should be recognized that patients with lymphoma might develop clinically significant renal sequelae secondary to both direct and indirect mechanisms of lymphoma-mediated nephropathy.

Risk assessment of gastric cancer associated with asbestosis: a case report.

BACKGROUND: The International Agency for Research on Cancer classifies asbestos as belonging to Carcinogen Group 2A for gastric cancer. We herein report a case of gastric cancer associated with asbestosis and describe the work-related and risk assessments of asbestos exposure for gastric cancer. CASE PRESENTATION: The 66-year-old male patient in our case worked in asbestos spinning factories. His level of cumulated asbestos fiber exposure was estimated to be 38.0-71.0 f-yr/cc. Thus, the Excess Life Cancer Risk for lung cancer associated with asbestos exposure was 9,648×10(-5), almost 9,600 times the value recommended by the United States of America Environmental Protection Agency (1 × 10(-5)). The relative risk of developing lung cancer for this patient was more than 25 f-yr/cc, a well-known criterion for doubling the risk of lung cancer. CONCLUSION: The patient's exposure to high-dose asbestos was sufficient to increase his risk of gastric cancer because as the risk of lung cancer increased, the risk of gastric cancer was due to increase as well. Therefore, occupational asbestos fiber exposure might be associated with gastric cancer in this case.