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1.
Eur Respir Rev ; 33(171)2024 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-38355151

RESUMO

BACKGROUND: Molecular pathways found to be important in pulmonary fibrosis are also involved in cancer pathogenesis, suggesting common pathways in the development of pulmonary fibrosis and lung cancer. RESEARCH QUESTION: Is pulmonary fibrosis from exposure to occupational carcinogens an independent risk factor for lung cancer? STUDY DESIGN AND METHODS: A comprehensive search of PubMed, Embase, Web of Science and Cochrane databases with over 100 search terms regarding occupational hazards causing pulmonary fibrosis was conducted. After screening and extraction, quality of evidence and eligibility criteria for meta-analysis were assessed. Meta-analysis was performed using a random-effects model. RESULTS: 52 studies were identified for systematic review. Meta-analysis of subgroups identified silicosis as a risk factor for lung cancer when investigating odds ratios for silicosis in autopsy studies (OR 1.47, 95% CI 1.13-1.90) and for lung cancer mortality in patients with silicosis (OR 3.21, 95% CI 2.67-3.87). Only considering studies with an adjustment for smoking as a confounder identified a significant increase in lung cancer risk (OR 1.58, 95% CI 1.34-1.87). However, due to a lack of studies including cumulative exposure, no adjustments could be included. In a qualitative review, no definitive conclusion could be reached for asbestosis and silicosis as independent risk factors for lung cancer, partly because the studies did not take cumulative exposure into account. INTERPRETATION: This systematic review confirms the current knowledge regarding asbestosis and silicosis, indicating a higher risk of lung cancer in exposed individuals compared to exposed workers without fibrosis. These individuals should be monitored for lung cancer, especially when asbestosis or silicosis is present.


Assuntos
Asbestose , Neoplasias Pulmonares , Exposição Ocupacional , Fibrose Pulmonar , Silicose , Humanos , Dióxido de Silício/efeitos adversos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Fibrose Pulmonar/diagnóstico , Fibrose Pulmonar/epidemiologia , Fibrose Pulmonar/etiologia , Asbestose/complicações , Silicose/diagnóstico , Silicose/epidemiologia , Silicose/complicações , Exposição Ocupacional/efeitos adversos
2.
Scand J Work Environ Health ; 50(2): 53-60, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38323897

RESUMO

OBJECTIVE: This paper discusses the failure and success of society to decrease the adverse health effects of asbestos exposure on workers' health in relation to scientific knowledge. METHODS: The findings are based on a narrative literature review. RESULTS: Early warnings of the adverse health effects of workplace exposure to asbestos were published already in the 1930s. Serious health effects, such as malignancies and fibrosis due to occupational asbestos exposure, were highlighted in major medical journals and textbooks in late 1960s. New technologies could detect also asbestos fibers in the lung of non-occupational exposed persons in the 1970s. The first bans for using asbestos came in the early 1970s, and more general bans by authorities came in the 1980s and continue until today. CONCLUSIONS: The rather late recognition of adverse effects of asbestos exposure in the general population and measures to decrease the exposure through more general bans came rather late. However, the very strong measures such as general bans in many countries have been a success. A Swedish study showed that the general ban and other measures have decreased the risk of malignancies due to occupational exposure. The effect of the bans on adverse effects in the general population has yet to be studied. Analysis of fibers in the lungs of persons born after the bans could be an efficient method.


Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Mesotelioma , Neoplasias , Exposição Ocupacional , Saúde Ocupacional , Humanos , Saúde Pública , Amianto/efeitos adversos , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Mesotelioma/epidemiologia , Neoplasias Pulmonares/epidemiologia , Asbestose/epidemiologia
3.
Ultrastruct Pathol ; 48(2): 137-148, 2024 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-38192052

RESUMO

Asbestosis, defined as diffuse pulmonary fibrosis caused by inhalation of asbestos fibers, occurs after heavy exposures to asbestos dust over several decades. Because workplace exposures have been significantly curtailed since the banning of asbestos in insulation products, we were interested in examining the clinicopathological characteristics of cases diagnosed in the 21st century. The consultation files of one of the authors (VLR) were reviewed for cases of asbestosis diagnosed since 1/1/2001. 102 cases were identified, with a median age of 75 years (range: 45-89). There were 100 men and 2 women. The women were from Turkey and Brazil (none from the United States). Malignancies were present in 78 cases, including 38 lung cancers, 29 pleural mesotheliomas, and 8 peritoneal mesotheliomas. The grade of asbestosis was available in 88 cases (median severity of 2; scale: 1-4). Pleural plaque was present in 94% of cases. The most common exposure categories were insulators (39), shipyard workers (16), asbestos manufacturing (9), boiler workers (8) and pipefitter/welders (6). The median duration of exposure was 33 years (range: 2-49 years). Lung fiber burden analysis was performed in 34 cases, with amosite being the predominant fiber type. Results were compared with similar information for 475 cases diagnosed prior to 1/1/2001.


Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Exposição Ocupacional , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Asbestose/patologia , Pulmão/patologia , Mesotelioma/complicações , Mesotelioma/patologia , Amianto Amosita , Neoplasias Pulmonares/patologia
4.
Am J Ind Med ; 67(1): 73-80, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38030592

RESUMO

Pleural thickening (PT) is a major consequence of exposure to all fiber types of asbestos. In recent decades, it is more prevalent than parenchymal asbestosis. Its manifestations occupy a full clinical and radiographic spectrum. Six major manifestations can be identified: (a) acute pleuritis generally with effusion; (b) diffuse PT or fibrous pleuritis; (c) rounded atelectasis; (d) circumscribed PT or plaques; (e) chronic pleuritic pain; and (f) mesothelioma. Review of the experience of workers and community members in Libby, MT to asbestiform fibers in vermiculite has confirmed the appearance of these previously known benign and malignant asbestos-related diseases as well as a unique pleuropulmonary disease characterized as lamellar PT and associated with progressive decline in pulmonary function and pleuritic pain. Despite previous literature asserting that PT represents a marker for asbestos exposure without significant effect on pulmonary function and physiology, the experience of Libby amphibole (LA) disease, along with other studies, indicates that PT plays a role in declining vital capacity in those with prolonged or unusual exposures such as those arising from LA.


Assuntos
Amianto , Asbestose , Doenças Pleurais , Pleurisia , Humanos , Amianto/toxicidade , Amiantos Anfibólicos/toxicidade , Asbestose/diagnóstico por imagem , Asbestose/patologia , Fibrose , Dor , Pleura/diagnóstico por imagem , Pleura/patologia , Doenças Pleurais/diagnóstico por imagem , Doenças Pleurais/etiologia , Pleurisia/patologia
5.
Radiol Oncol ; 57(4): 473-486, 2023 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-38038422

RESUMO

BACKGROUND: Asbestos exposure is associated with different asbestos-related diseases, including malignant mesothelioma (MM). MM diagnosis is confirmed with immunohistochemical analysis of several markers, including calretinin. Increased circulating calretinin was also observed in MM. The aim of the study was to determine if CALB2 polymorphisms or polymorphisms in genes that can regulate calretinin expression are associated with serum calretinin levels or MM susceptibility. SUBJECTS AND METHODS: The study included 288 MM patients and 616 occupationally asbestos-exposed subjects without MM (153 with asbestosis, 380 with pleural plaques and 83 without asbestos-related disease). Subjects were genotyped for seven polymorphisms in CALB2, E2F2, MIR335, NRF1 and SEPTIN7 genes using competitive allele-specific polymerase chain reaction (PCR). Serum calretinin was determined with ELISA in 545 subjects. Nonparametric tests, logistic regression and receiver operating characteristic (ROC) curve analysis were used for statistical analysis. RESULTS: Carriers of at least one polymorphic CALB2 rs889704 allele had lower calretinin levels (P = 0.036). Carriers of two polymorphic MIR335 rs3807348 alleles had higher calretinin (P = 0.027), while carriers of at least one polymorphic NRF1 rs13241028 allele had lower calretinin levels (P = 0.034) in subjects without MM. Carriers of two polymorphic E2F2 rs2075995 alleles were less likely to develop MM (odds ratio [OR] = 0.64, 95% confidence interval [CI] = 0.43-0.96, P = 0.032), but the association was no longer significant after adjustment for age (P = 0.093). Optimal serum calretinin cut-off values differentiating MM patients from other subjects differed according to CALB2, NRF1, E2F2, and MIR335 genotypes. CONCLUSIONS: The results of presented study suggest that genetic variability could influence serum calretinin levels. These findings could contribute to a better understanding of calretinin regulation and potentially to earlier MM diagnosis.


Assuntos
Amianto , Asbestose , Calbindina 2 , Mesotelioma Maligno , Humanos , Amianto/efeitos adversos , Asbestose/genética , Calbindina 2/sangue , Mesotelioma Maligno/genética
6.
Sci Rep ; 13(1): 18842, 2023 11 14.
Artigo em Inglês | MEDLINE | ID: mdl-37963950

RESUMO

Asbestos-containing materials (ACM) were present in British and Australian naval vessels throughout the twentieth century. The aim of this study was to identify and quantify the incidence of cancer in naval personnel from onboard asbestos exposure. Subjects were four cohorts of subjects who had served in the armed forces of the United Kingdom and Australia in the 1950s and 1960s. All cohorts had previously been studied, three of them in relation to radiation exposures from British nuclear testing. Comparisons of SIRs between services were made to identify cancers attributable to asbestos exposure. Excess mesotheliomas were found in naval personnel in all cohorts. In all but one cohort the lung cancer incidence was highest in navy personnel. Comparison of other smoking-related conditions indicated that the excess in navy personnel was not smoking-related. The relatively high SIRs for mesothelioma and the occurrence of deaths from asbestosis were indicative of high levels of asbestos exposure, with an expectation of cases of asbestos-related lung cancer. The findings are consistent with the occurrence of significant excesses of mesotheliomas. In addition, notwithstanding some inconsistencies in the results between the cohorts, we estimated that approximately 27% of lung cancers in Australian seamen and 12% in British seamen were related to onboard asbestos exposure.


Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Mesotelioma , Doenças Profissionais , Exposição Ocupacional , Humanos , Austrália/epidemiologia , Amianto/toxicidade , Mesotelioma/epidemiologia , Mesotelioma/etiologia , Asbestose/complicações , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Exposição Ocupacional/efeitos adversos , Doenças Profissionais/epidemiologia
7.
Arch Environ Occup Health ; 78(6): 369-378, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37800384

RESUMO

Asbestos is a mineral with unique physical and chemical properties that make it highly resistant to heat, fire, and corrosion. Nevertheless, exposure to asbestos fibers has been linked to serious health problems, including lung cancer, mesothelioma, and asbestosis. Despite the ban on asbestos usage, asbestos-related diseases are still a major cause of morbidity and mortality worldwide. Analyzing the mineralogical features and fiber analysis of asbestos in biological materials is critical for scenarios where an asbestos exposure history cannot be obtained, a clinical diagnosis cannot be made, or legal aspects necessitate further investigation. This review outlines the mineralogical features and fiber analysis techniques of asbestos in biological materials.


Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Mesotelioma Maligno , Mesotelioma , Humanos , Mesotelioma/induzido quimicamente , Asbestose/etiologia , Neoplasias Pulmonares/induzido quimicamente , Mesotelioma Maligno/complicações
8.
Ann Ist Super Sanita ; 59(3): 187-193, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37712235

RESUMO

BACKGROUND: A mesothelioma cluster in Biancavilla (Sicily, Italy), drew attention to fluoro-edenite, a fibre classified by International Agency for Research on Cancer as carcinogenic to humans. Significant excesses in mortality and morbidity were observed for respiratory diseases and a significant excess of pneumoconiosis hospitalizations was reported. OBJECTIVE: Aim of this study is to assess the characters of the lung damage in Biancavilla residents hospitalized with pneumoconiosis or asbestosis diagnoses. METHODOLOGY: Medical records, available radiographs and computed tomography scans were collected. The obtained imaging was reviewed by a panel of three specialists and focused on pleural and parenchymal abnormalities. Cases with an ILO-BIT or ICOERD score equal or greater than 2 were considered positive for a pneumoconiosis-like damage, cases with a score lower than 2 or insufficient quality of imaging were considered inconclusive. If no pneumoconiotic aspects were present the cases were classified as negative. RESULTS: Out of 38 cases, diagnostic imaging for 25 cases were found. Ten cases out of 25 showed asbestosis-like features, nine subjects were considered negative. In six patients' results were inconclusive. CONCLUSIONS: Asbestosis-like features were substantiated in Biancavilla residents without known occupational exposure to asbestos. Further studies to estimate population respiratory health are required. Experimental studies on the fibrogenic potential of fluoro-edenite are needed.


Assuntos
Asbestose , Mesotelioma , Pneumoconiose , Humanos , Sicília/epidemiologia , Asbestose/diagnóstico por imagem , Asbestose/epidemiologia , Amiantos Anfibólicos/toxicidade , Itália/epidemiologia , Pneumoconiose/diagnóstico por imagem , Pneumoconiose/epidemiologia , Mesotelioma/diagnóstico por imagem , Mesotelioma/epidemiologia
9.
Ann Glob Health ; 89(1): 54, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37637467

RESUMO

Background: Asbestosis is a prevalent worldwide problem, but scarce data sourced from developing countries are available. We describe the sociodemographic characteristics and patterns in the occurrence of care provided for asbestosis in Colombia during the periods 2010-2014 and 2015-2019 to establish the behavior, trends, and variables associated with concentrations among people attended by asbestosis. Methods: A retrospective descriptive study was carried out with data from the Integrated Social Protection Information System (SISPRO) for two 5-year periods. People attended by asbestosis (ICD-10: J61) were identified; the frequency of patient visits, sociodemographic characteristics, case distribution patterns, and trends in both five-year periods were described, as was the crude frequency (cFr, 95% CI) of asbestosis (1,000,000 people/year) in both five-year periods (cFr ratio, 95% CI). Results: During the period 2010-2019, 765 people attended by asbestosis were identified; there were 308 people attended by asbestosis between 2010-2014 (cFr: 2.20, 1.96-2.47), and ther were 457 people attended by asbestos between 2015-2019 (cFr: 3.14, 2.92-3.50). In both periods, the estimated cFr in men was nine times the estimated cFr in women. The cFr increased in the 2015-2019 period (cFr_ratio: 1.23, 1.06-1.43). Compared with the 2010-2014 period, the cFr of asbestosis increased in women (cFr_ratio: 1.44, 1.03-2.01), in the Andean (cFr_ratio: 1.61, 1.35-1.95) and Caribbean regions (cFr_ratio: 1. 66, 1.21-2.30), in the urban area (cFr_ratio: 1.24, 1.05-1.48), and in the age groups 45-59 years (cFr_ratio: 1.34, 1.001-1.79) and ≥60 years (cFr_ratio: 1.43, 1.13-1.83). Discussion: During two five-year periods, the cFr of asbestosis was higher in men; between the first and second five-year periods, it increased significantly, especially in urbanized geographic areas and in populations aged ≥45 years. The estimates possibly reflect the effect of disease latency or the expected impact of public health policies to monitor asbestos exposure and complications.


Assuntos
Asbestose , Masculino , Feminino , Humanos , Asbestose/epidemiologia , Colômbia/epidemiologia , Estudos Retrospectivos , Região do Caribe , Política Pública
10.
BMC Pulm Med ; 23(1): 307, 2023 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-37605147

RESUMO

BACKGROUND: Development of pleural effusion (PE) following CABG is common. Post-CABG PE are divided into early- (within 30 days of surgery) and delayed-onset (30 days-1 year) which are likely due to distinct pathological processes. Some experts suggest asbestos exposure may confer an independent risk for late-onset post-CABG PE, however no large studies have explored this potential association. RESEARCH QUESTION: To explore possible association between asbestos exposure and post-CABG PE using routine data. METHODS: All patients who underwent CABG 01/04/2013-31/03/2018 were identified from the Hospital Episode Statistics (HES) Database. This England-wide population was evaluated for evidence of asbestos exposure, pleural plaques or asbestosis and a diagnosis of PE or PE-related procedure from 30 days to 1 year post-CABG. Patients with evidence of PE three months prior to CABG were excluded, as were patients with a new mesothelioma diagnosis. RESULTS: 68,150 patients were identified, of whom 1,003 (1%) were asbestos exposed and 2,377 (3%) developed late-onset PE. After adjusting for demographic data, Index of Multiple Deprivation and Charlson Co-morbidity Index, asbestos exposed patients had increased odds of PE diagnosis or related procedure such as thoracentesis or drainage (OR 1.35, 95% CI 1.03-1.76, p = 0.04). In those with evidence of PE requiring procedure alone, the adjusted OR was 1.66 (95% CI 1.14-2.40, p = 0.01). Additional subgroup analysis of the 518 patients coded for pleural plaques and asbestosis alone revealed an adjusted OR of post-CABG PE requiring a procedure of 2.16 (95% CI 1.38-3.37, p = 0.002). INTERPRETATION: This large-scale study demonstrates prior asbestos exposure is associated with modestly increased risk of post-CABG PE development. The risk association appears higher in patients with assigned clinical codes indicative of radiological evidence of asbestos exposure (pleural plaques or asbestosis). This association may fit with a possible inflammatory co-pathogenesis, with asbestos exposure 'priming' the pleura resulting in greater propensity for PE evolution following the physiological insult of CABG surgery. Further work, including prospective studies and clinicopathological correlation are suggested to explore this further.


Assuntos
Amianto , Asbestose , Doenças Pleurais , Derrame Pleural , Humanos , Asbestose/epidemiologia , Estudos Prospectivos , Derrame Pleural/epidemiologia , Derrame Pleural/etiologia , Amianto/efeitos adversos , Doenças Pleurais/epidemiologia , Doenças Pleurais/etiologia , Ponte de Artéria Coronária/efeitos adversos
11.
Sci Total Environ ; 904: 166346, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37591378

RESUMO

BACKGROUND: Asbestosis is a common pneumoconiosis caused by long-term asbestos exposure. Analysis of the burden of asbestosis would help in creating informed public health strategies. METHODS: Data on asbestosis were analyzed using the Global Burden of Disease study 2019. The estimated annual percentage change (EAPC) was calculated to demonstrate temporal trends in the age-standardized rate (ASR) of asbestosis from 1990 to 2019. RESULTS: Globally, 36,339 incident cases of asbestosis, led to 3572 deaths and 71,225 disability adjusted life years (DALYs) in 2019. During 1990-2019, the overall ASRs of incidence and DALYs declined by an annual average of 0.29 % and 0.27 %, with the respective EAPCs being -0.29 (95 % confidence interval [CI]: -0.43, -0.14) and -0.27 (95%CI: -0.53, -0.01). The ASRs of mortality increased with EAPC of 0.65 (95%CI: 0.34, 0.96). Trends in incidence and prevalence rose in females, but declined in males. The asbestosis burden was heterogeneous across regions and countries. The heaviest burden of asbestosis was observed in the United States, India, and China. Trends in ASRs of asbestosis varied across countries/territories. Pronounced increasing trends in incidence and prevalence occurred in Georgia, Iran, and Croatia. CONCLUSIONS: Decreasing incident trend of asbestosis was observed globally over the past three decades. However, the ongoing asbestosis burden highlighted that asbestosis remained a challenge to public health, and cost-effective measures were required to reduce the asbestosis burden.


Assuntos
Asbestose , Feminino , Masculino , Humanos , Asbestose/epidemiologia , China , Análise por Conglomerados , Croácia , Georgia , Anos de Vida Ajustados por Qualidade de Vida , Incidência
12.
Am J Ind Med ; 66(10): 831-841, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37482966

RESUMO

BACKGROUND: Pneumoconiosis is a group of occupational lung diseases caused by dust and fiber exposure. This study analyzes Medicare claims to estimate the burden of pneumoconiosis among fee-for-service (FFS; Medicare Parts A and B) Medicare beneficiaries during 1999-2019 in the United States. METHODS: Claim and enrollment information from 81 million continuously enrolled FFS Medicare beneficiaries were analyzed. Beneficiaries with any pneumoconiosis and cause-specific pneumoconiosis (e.g., asbestosis, silicosis) were identified using three case definitions (broad, intermediate, and narrow) with varying diagnostic criteria based on claim International Classification of Diseases, Clinical Modification (ICD-CM) diagnosis codes and Healthcare Common Procedure Coding System codes. Results are presented as ranges of values for the three case definitions. RESULTS: The 21-year prevalence range for any pneumoconiosis was 345,383-677,361 (412-833 per 100,000 beneficiaries) using the three case definitions. The highest prevalence was among those ≥75 years of age, males, Whites, and North American Natives. Most claims (70.0%-72.5%) included an ICD-CM diagnosis code for asbestosis. The broad pneumoconiosis prevalence rate increased significantly (p < 0.001) during 2002-2009 by 3%-10% annually and declined significantly by 3%-5% annually starting in 2009. The average annual broad incidence rate declined significantly by 7% annually during 2009-2019. CONCLUSIONS: Despite the decline in rate for any pneumoconiosis among Medicare beneficiaries, which is primarily attributed to a decline in asbestosis, pneumoconiosis is prevalent among FFS Medicare beneficiaries.


Assuntos
Asbestose , Pneumoconiose , Masculino , Humanos , Idoso , Estados Unidos/epidemiologia , Incidência , Medicare , Prevalência , Pneumoconiose/epidemiologia
13.
Artigo em Chinês | MEDLINE | ID: mdl-37400401

RESUMO

Objective: To analyze the disease burden of pneumoconiosis globally and in China from 1990 to 2019 using Global Burden of Disease (GBD) 2019 data, and to provide a theoretical basis for prevention and control of pneumoconiosis. Methods: In September 2022, the data of incidence, prevalence, morality and disability-adjusted life years (DALY) of pneumoconiosis and its subtypes globally and in China from 1990 to 2019 were collected from GBD 2019, including absolute number and age-standardized rate (ASR). Joinpoint linear regression model was used to calculate average annual percent change (AAPC) and analyze the change trends of incidence, prevalence, mortality and DALY of pneumoconiosis and its subtypes. Results: From 1990 to 2019, the incident cases, prevalent cases and DALY value of pneumoconiosis showed upward trends, while the number of death cases showed downward trends. And the ASR of incidence (ASIR), the ASR of prevalence (ASPR), the ASR of mortality (ASMR) and the ASR of DALY (ASDR) showed downward trends globally and in China. China accounted for a large proportion of the global disease burden of penumoconiosis, accounting for more than 67% of the incident cases, more than 80% of the prevalent cases, more than 43% of the deaths cases and more than 60% of the absolute number of DALY in the world every year. Male were the main population of pneumoconiosis disease burden globally and in China, and the age of onset was earlier than that of female. The peak age periods of incidence, prevalence, mortality and DALY of pneumoconiosis globally and in China from 1990 to 2019 have increased. Silicosis was still the type with the highest disease burden of pneumoconiosis globally and in China. The disease burden of coal workers' pneumoconiosis had an overall improvement trend, but asbestosis had an increasing disease burden worldwide. Conclusion: The disease burden of pneumoconiosis is heavy globally and in China, which is necessary to strengthen the supervision and prevention measures according to gender, age and etiological types.


Assuntos
Antracose , Asbestose , Pneumoconiose , Masculino , Humanos , Feminino , Anos de Vida Ajustados por Qualidade de Vida , Pneumoconiose/epidemiologia , Efeitos Psicossociais da Doença , Asbestose/epidemiologia , China/epidemiologia , Incidência
14.
Am J Ind Med ; 66(8): 670-678, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37302125

RESUMO

BACKGROUND: Silicosis is a fibrotic lung disease caused by exposure to respirable crystalline silica. Historically, silicosis was common among miners and other professions in the 20th century, and in recent decades has re-emerged in coal mining and appeared in new workplaces, including the manufacture of distressed jeans and artificial stone countertops. METHODS: Physician billing data for the province of Ontario between 1992 and 2019 were analyzed across six time-periods (1993-1995, 1996-2000, 2001-2005, 2006-2010, 2011-2015, and 2016-2019). The case definition was two or more billing records within 24 months with a silicosis diagnosis code (ICD-9 502, ICD-10 J62). Cases from 1993 to 1995 were excluded as prevalent cases. Crude incidence rates per 100,000 persons were calculated by time-period, age, sex, and region. Analyses were repeated in parallel for pulmonary fibrosis (PF) (ICD-9 515, ICD-10 J84) and asbestosis (ICD-9 501; ICD-10 J61). RESULTS: From 1996 to 2019, 444 cases of silicosis, 2719 cases of asbestosis and 59,228 cases of PF were identified. Silicosis rates decreased from 0.42 cases per 100,000 in 1996-2000 to 0.06 per 100,000 people in 2016-2019. A similar trend was observed for asbestosis (1.66 to 0.51 per 100,000 persons) but the incidence rate of PF increased from 11.6 to 33.9 per 100,000 persons. Incidence rates for all outcomes were higher among men and older adults. CONCLUSIONS: A decreasing incidence of silicosis was observed in this analysis. However, the incidence of PF increased, consistent with findings from other jurisdictions. While cases of silicosis have been recorded among artificial stone workers in Ontario these cases do not seem to have impacted the population rates thus far. Ongoing, periodic surveillance of occupational diseases is helpful for tracking population-level trends over time.


Assuntos
Asbestose , Exposição Ocupacional , Fibrose Pulmonar , Silicose , Masculino , Humanos , Idoso , Asbestose/epidemiologia , Asbestose/complicações , Ontário/epidemiologia , Silicose/etiologia , Dióxido de Silício/análise , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise
15.
Eur J Med Res ; 28(1): 175, 2023 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-37189132

RESUMO

BACKGROUND: Although asbestos use is banned in many countries, long latency of asbestos-related diseases like pleural plaques or asbestosis mean it is still a public health issue. People suffering from these diseases have a higher risk of developing mesothelioma or lung cancer, which can progress quickly and aggressively. MicroRNAs were suggested as potential biomarkers in several diseases. However, in asbestosis, blood microRNAs are less explored. Since miR-32-5p, miR-143-3p, miR-145-5p, miR-146b-5p, miR-204-5p and miR-451a are involved in fibrotic processes and in cancer, expression of these microRNAs was analyzed in leukocytes and serum of asbestosis patients. METHODS: MicroRNA expression was analyzed in leukocytes and serum of 36 patients (26 affected by pleural plaques and 10 by asbestosis) and 15 healthy controls by real-time RT-PCR. Additionally, data analyses were performed regarding disease severity based on ILO classification. RESULTS: MicroRNA miR-146b-5p was significantly down-regulated in leukocytes of patients suffering from pleural plaques with a large effect indicated by η2p = 0.150 and Cohen's f = 0.42, a value of difference of 0.725 and a 95% confidence interval of 0.070-1.381. In patients suffering from asbestosis miR-146b-5p was not significantly regulated. However, data analyses considering disease severity only, revealed that miR-146b-5p was significantly down-regulated in leukocytes of mildly diseased patients compared to controls with a large effect indicated by η2p = 0.178 and Cohen's f = 0.465, a value of difference of 0.848 and a 95% confidence interval of 0.097-1.599. Receiver operating characteristic (ROC) curve and an area under the ROC curve value of 0.757 for miR-146b-5p indicated acceptable discrimination ability between patients suffering from pleural plaques and healthy controls. Less microRNAs were detectable in serum than in leukocytes, showing no significant expression differences in all participants of this study. Moreover, miR-145-5p was regulated significantly differently in leukocytes and serum. An R2 value of 0.004 for miR-145-5p indicated no correlation in microRNA expression between leukocytes and serum. CONCLUSION: Leukocytes seem more suitable than serum for microRNA analyses regarding disease and potentially cancer risk assessment of patients suffering from asbestos-related pleural plaques or asbestosis. Long-term studies may reveal whether down-regulation of miR-146b-5p in leukocytes might be an early indicator for an increased cancer risk.


Assuntos
Amianto , Asbestose , MicroRNAs , Humanos , Asbestose/genética , Biomarcadores , Leucócitos/metabolismo
16.
BMJ Open ; 13(4): e068628, 2023 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-37012009

RESUMO

OBJECTIVE: To describe the prevalence, clinical features and potential risk factors of pneumoconiosis in combination with connective tissue disease (CTD) or positive autoantibodies. DESIGN: Cross-sectional study. SETTING: A retrospective study of adults recruited in China between December 2016 and November 2021. PARTICIPANTS: A total of 931 patients with pneumoconiosis at Beijing Chao-Yang Hospital were enrolled in this study; of these, 580 patients were included in the final analysis. MAIN OUTCOME MEASURES: Pneumoconiosis combined with CTD or positive autoantibodies was a major adverse outcome. RESULTS: In total, 13.8% (80/580) of the patients had combined pneumoconiosis with CTD, among whom the prevalence of CTD was 18.3% (46/251) in asbestosis and 11.4% (34/298) in silicosis/coal mine workers' pneumoconiosis. In comparison to the general Chinese adult population, the relative risk of various CTD in pneumoconiosis, including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, primary Sjögren's syndrome, idiopathic inflammatory myopathy and antineutrophil cytoplasmic antibodies-associated vasculitis, were 11.85, 12.12, 127.40, 4.23, 9.94 and 644.66, respectively. Multivariate analysis revealed that female sex (OR 2.55, 95% CI 1.56 to 4.17) and a later stage of pneumoconiosis (OR 2.04, 95% CI 1.24 to 3.34) were the independent risk factors for CTD in patients with pneumoconiosis (all p<0.050). CONCLUSION: CTD is highly prevalent in patients with pneumoconiosis, especially in patients of asbestosis, and silicosis/coal mine workers' pneumoconiosis. Female sex and later stages of pneumoconiosis are associated with an increased risk of combined with CTD.


Assuntos
Asbestose , Doenças do Tecido Conjuntivo , Pneumoconiose , Silicose , Adulto , Humanos , Feminino , Estudos Transversais , Asbestose/etiologia , Estudos Retrospectivos , Pneumoconiose/complicações , Pneumoconiose/epidemiologia , Doenças do Tecido Conjuntivo/complicações , Doenças do Tecido Conjuntivo/epidemiologia , Silicose/complicações , Silicose/epidemiologia , Autoanticorpos , Carvão Mineral , China/epidemiologia
17.
Environ Geochem Health ; 45(7): 5039-5051, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37058192

RESUMO

Asbestos bodies (AB) form in the lungs as a result of a biomineralization process initiated by the alveolar macrophages in the attempt to remove asbestos. During this process, organic and inorganic material deposit on the foreign fibers forming a Fe-rich coating. The AB start to form in months, thus quickly becoming the actual interface between asbestos and the lung tissue. Therefore, revealing their composition, and, in particular, the chemical form of Fe, which is the major component of the AB, is essential to assess their possible role in the pathogenesis of asbestos-related diseases. In this work we report the result of the first x-ray diffraction measurements performed on single AB embedded in the lung tissue samples of former asbestos plant workers. The combination with x-ray absorption spectroscopy data allowed to unambiguously reveal that Fe is present in the AB in the form of two Fe-oxy(hydroxides): ferrihydrite and goethite. The presence of goethite, which can be explained in terms of the transformation of ferrihydrite (a metastable phase) due to the acidic conditions induced by the alveolar macrophages in their attempt to phagocytose the fibers, has toxicological implications that are discussed in the paper.


Assuntos
Amianto , Asbestose , Humanos , Asbestose/etiologia , Asbestose/patologia , Amianto/toxicidade , Amianto/análise , Pulmão/química
18.
Environ Res ; 230: 114530, 2023 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-36965800

RESUMO

Malignant mesothelioma is a relatively rare malignancy with a strong association with prior asbestos exposure. A percentage of cases is not related to asbestos, and fiber analysis of lung tissue is a useful methodology for identifying idiopathic or spontaneous cases. We have performed fiber analyses in more than 600 cases of mesothelioma over the past four decades and were interested in looking for trends in terms of fiber types and concentrations as well as percentages of cases not related to asbestos. Demographic information was also considered including patient age, gender, and tumor location (pleural vs. peritoneal). The histologic pattern of the tumor and the presence or absence of pleural plaques or asbestosis were noted. Fiber analysis was performed in 619 cases, using the sodium hypochlorite technique for digestion of lung tissue samples. Asbestos bodies were counted by light microscopy (LM) and coated and uncoated fibers by scanning electron microscopy (EM). The results were stratified over four decades. Trends that were observed included increasing patient age, increasing percentage of women, increasing percentage of peritoneal cases, and increasing percentage of epithelial histological type. There was a decreasing trend in the percentage of patients with concomitant asbestosis (p < 0.001). The percentage of cases with an elevated lung asbestos content decreased from 90.5% in the 1980s to 54.1% in the 2010s (p < 0.001). This trend also held when the analysis was limited to 490 cases of pleural mesothelioma in men (91.8% in the 1980s vs. 65.1% in the 2010s). There was a decrease in the median asbestos body count by LM from 1390 asbestos bodies per gram of wet lung in the 1980s to 38 AB/gm in the 2010s. Similar trends were observed for each of the asbestos fiber types as detected by EM. We conclude that there has been a progressive decrease in lung fiber content of mesothelioma patients during the past four decades, with an increasing percentage of cases not related to asbestos and an increase in median patient age.


Assuntos
Neoplasias Pulmonares , Mesotelioma , Exposição Ocupacional , Feminino , Humanos , Masculino , Amianto/toxicidade , Asbestose/etiologia , Asbestose/complicações , Pulmão/patologia , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/epidemiologia , Mesotelioma/induzido quimicamente , Mesotelioma/epidemiologia , Mesotelioma Maligno/complicações , Mesotelioma Maligno/patologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-36901302

RESUMO

The lack of safe levels of asbestos exposure and the long latency of asbestos-related disease (ARD) makes workers' health surveillance challenging, especially in lower-income countries. This paper aims to present the recently developed Brazilian system for monitoring workers and general population exposed to asbestos (Datamianto), and to discuss the main challenges and opportunities for workers' health surveillance. METHODS: a descriptive study of the Datamianto development process, examining all the stages of system planning, development, improvement, validation, availability, and training of health services for its use, in addition to presenting the main challenges and opportunities for its implementation. RESULTS: The system was developed by a group of software developers, workers' health specialists, and practitioners, and it was recently incorporated by the Ministry of Health to be used for workers' health surveillance. It can facilitate the monitoring of exposed individuals, epidemiological data analysis, promote cooperation between health services, and ensure periodical medical screening guaranteed to workers by labor legislation. Moreover, the system has a Business Intelligence (BI) platform to analyze epidemiologic data and produce near real-time reports. CONCLUSIONS: Datamianto can support and qualify the healthcare and surveillance of asbestos-exposed workers and ARD, promoting a better quality of life for workers and improving companies' compliance with legislation. Even so, the system's significance, applicability, and longevity will depend on the efforts aimed at its implementation and improvement.


Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Mesotelioma , Exposição Ocupacional , Humanos , Asbestose/epidemiologia , Brasil , Qualidade de Vida , Vigilância da População , Mesotelioma/epidemiologia , Neoplasias Pulmonares/epidemiologia
20.
J Occup Environ Med ; 65(4): 349-353, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36728947

RESUMO

OBJECTIVE: Comorbidities are common and affect the prognosis of patients with interstitial lung diseases, but few previous studies have investigated patients with asbestosis. METHODS: We collected comorbidities and death causes of 116 patients with asbestosis treated in Oulu University Hospital. Causes of death were confirmed by autopsy in 68% of the cases. RESULTS: The most common comorbidities of asbestosis patients were pleural plaques (96%) and coronary artery disease (CAD; 67%). The prevalence of rheumatoid arthritis was 8.6%. The most common underlying causes of death were asbestosis (36%), CAD (24%), and lung cancer (LC) (10%). CAD and LC were associated with shorter survival in adjusted analyses. CONCLUSIONS: Patients with asbestosis have multiple comorbidities. Prevention and treatment of CAD and LC may influence the prognosis of asbestosis patients.


Assuntos
Amianto , Asbestose , Neoplasias Pulmonares , Doenças Pleurais , Humanos , Asbestose/epidemiologia , Causas de Morte , Doenças Pleurais/etiologia , Comorbidade , Amianto/efeitos adversos
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