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1.
Pneumologie ; 74(9): 603-610, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32643765

RESUMO

Occupational diseases are certain diseases designated as such by law. Whereas the medical conditions are described in guidelines, their recognition is based on judicial administrative procedures. Establishing causality is based on requirements of social law. The basic socio-legal concepts are mentioned and the principles of causality in asbestos-related occupational diseases are listed. Exemplary social court judgments are cited. Judgements may not infrequently differ from the medical point of view. The aim of this article is to describe the correct use of social medical understanding in order to carry out adequate assessment of occupational diseases, which implements the legal requirements.


Assuntos
Asbestos/efeitos adversos , Asbestose , Dermatologia/legislação & jurisprudência , Doenças Profissionais , Medicina do Trabalho/legislação & jurisprudência , Justiça Social/legislação & jurisprudência , Asbestose/diagnóstico , Asbestose/terapia , Humanos , Doenças Profissionais/diagnóstico , Doenças Profissionais/terapia
2.
Ann Agric Environ Med ; 27(2): 284-289, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32588607

RESUMO

INTRODUCTION AND OBJECTIVE: Occupational asbestos exposure is one of the major public health issues. Although asbestos use in Poland has decreased, asbestosis continues to remain an important health concern in the area of occupational medicine. The aim of the study is to perform a descriptive analysis of hospitalization cases in patients suffering from asbestosis in Poland. MATERIAL AND METHODS: The authors used hospital discharge records to conduct a retrospective, population-based study. To estimate the asbestosis hospitalization rate, data from the Nationwide General Hospital Morbidity Study conducted by the National Institute of Public Health were used. Events were defined as in-patient hospital discharges during 2006-2016. 1,101 hospitalization records of 764 patients were included in the study. RESULTS: In the study group of first-time hospitalized patients, the mean and median ages were 68.1 and 69 years, respectively; CI: 67.3-68.9; SD: 11.1, min-max:16-99 years. In this group, significant gender differences were observed (560 males vs. 204 female; P<0.001). No statistical differences were observed regarding the place of residence. During the observation period, 61 in-hospital deaths were reported (8% of all patients), 40 of whom (5.2 % of all patients) took place during the first-time hospitalizations. Asbestosis hospitalizations were mainly clustered in the south-western region, whereas the highest hospitalization rates were clustered in several areas of Poland. CONCLUSIONS: The authors believe this study to be the first evaluation of asbestosis in Poland made on the basis of the hospital morbidity database. The data presented may be helpful in comparative studies on the epidemiology of asbestosis across European countries.


Assuntos
Asbestose/epidemiologia , Hospitalização/estatística & dados numéricos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Asbestose/etiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Estudos Retrospectivos , Adulto Jovem
3.
Internist (Berl) ; 61(6): 626-633, 2020 Jun.
Artigo em Alemão | MEDLINE | ID: mdl-32328688

RESUMO

Rare work-related illnesses do not usually meet the requirements to be recognised and compensated as a legal occupational disease. However, common diseases (e.g. ovarian carcinoma) are sometimes caused by occupational influences (e.g. asbestos), making the occupational disease ovarian cancer caused by occupational exposure to asbestos a rare disease. Since in our modern working world the occupational influences that are harmful to health are decreasing qualitatively (substitutes) and quantitatively (limit values), the diseases they cause are also becoming increasingly rare.


Assuntos
Asbestos/efeitos adversos , Asbestose , Doenças Profissionais , Exposição Ocupacional , Neoplasias Ovarianas/induzido quimicamente , Feminino , Humanos , Doenças Raras
4.
Am J Physiol Lung Cell Mol Physiol ; 318(5): L1084-L1096, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-32209025

RESUMO

Alveolar epithelial cell (AEC) apoptosis, arising from mitochondrial dysfunction and mitophagy defects, is important in mediating idiopathic pulmonary fibrosis (IPF). Our group established a role for the mitochondrial (mt) DNA base excision repair enzyme, 8-oxoguanine-DNA glycosylase 1 (mtOGG1), in preventing oxidant-induced AEC mtDNA damage and apoptosis and showed that OGG1-deficient mice have increased lung fibrosis. Herein, we determined whether mice overexpressing the mtOGG1 transgene (mtOgg1tg) are protected against lung fibrosis and whether AEC mtOGG1 preservation of mtDNA integrity mitigates phosphatase and tensin homolog-induced putative kinase 1 (PINK1) deficiency and apoptosis. Compared with wild type (WT), mtOgg1tg mice have diminished asbestos- and bleomycin-induced pulmonary fibrosis that was accompanied by reduced lung and AEC mtDNA damage and apoptosis. Asbestos and H2O2 promote the MLE-12 cell PINK1 deficiency, as assessed by reductions in the expression of PINK1 mRNA and mitochondrial protein expression. Compared with WT, Pink1-knockout (Pink1-KO) mice are more susceptible to asbestos-induced lung fibrosis and have increased lung and alveolar type II (AT2) cell mtDNA damage and apoptosis. AT2 cells from Pink1-KO mice and PINK1-silenced (siRNA) MLE-12 cells have increased mtDNA damage that is augmented by oxidative stress. Interestingly, mtOGG1 overexpression attenuates oxidant-induced MLE-12 cell mtDNA damage and apoptosis despite PINK1 silencing. mtDNA damage is increased in the lungs of patients with IPF as compared with controls. Collectively, these findings suggest that mtOGG1 maintenance of AEC mtDNA is crucial for preventing PINK1 deficiency that promotes apoptosis and lung fibrosis. Given the key role of AEC apoptosis in pulmonary fibrosis, strategies aimed at preserving AT2 cell mtDNA integrity may be an innovative target.


Assuntos
Células Epiteliais Alveolares/efeitos dos fármacos , Asbestose/genética , DNA Glicosilases/genética , Pulmão/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Proteínas Quinases/genética , Fibrose Pulmonar/genética , Células Epiteliais Alveolares/metabolismo , Células Epiteliais Alveolares/patologia , Animais , Apoptose/efeitos dos fármacos , Apoptose/genética , Asbestos/administração & dosagem , Asbestose/etiologia , Asbestose/metabolismo , Asbestose/patologia , Bleomicina/administração & dosagem , Dano ao DNA , DNA Glicosilases/deficiência , DNA Mitocondrial/genética , DNA Mitocondrial/metabolismo , Feminino , Regulação da Expressão Gênica , Peróxido de Hidrogênio/farmacologia , Pulmão/metabolismo , Pulmão/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Mitocôndrias/metabolismo , Cultura Primária de Células , Proteínas Quinases/metabolismo , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/metabolismo , Fibrose Pulmonar/patologia , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/metabolismo , Transdução de Sinais , Titânio/administração & dosagem
6.
7.
Occup Environ Med ; 77(6): 407-414, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32188634

RESUMO

OBJECTIVES: Pneumoconiosis remains a major global occupational health hazard and illness. Accurate data on the incidence of pneumoconiosis are critical for health resource planning and development of health policy. METHODS: We collected data for the period between 1990 and 2017 on the annual incident cases and the age-standardised incidence rates (ASIR) of pneumoconiosis aetiology from the Global Burden of Disease Study 2017. We calculated the average annual percentage changes of ASIR by sex, region and aetiology in order to determine the trends of pneumoconiosis. RESULTS: Globally, the number of pneumoconiosis cases increased by a measure of 66.0%, from 36 186 in 1990 to 60 055 in 2017. The overall ASIR decreased by an average of 0.6% per year in the same period. The number of pneumoconiosis cases increased across the five sociodemographic index regions, and there was a decrease in the ASIR from 1990 to 2017. The ASIR of silicosis, coal workers' pneumoconiosis and other pneumoconiosis decreased. In contrast, measures of the ASIR of asbestosis displayed an increasing trend. Patterns of the incidence of pneumoconiosis caused by different aetiologies were found to have been heterogeneous for analyses across regions and among countries. CONCLUSION: Incidence patterns of pneumoconiosis which were caused by different aetiologies varied considerably across regions and countries of the world. The patterns of incidence and temporal trends should facilitate the establishment of more effective and increasingly targeted methods for prevention of pneumoconiosis and reduce associated disease burden.


Assuntos
Exposição Ocupacional/efeitos adversos , Pneumoconiose/epidemiologia , Pneumoconiose/etiologia , Adulto , Asbestose/epidemiologia , Feminino , Carga Global da Doença , Saúde Global , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , Distribuição por Sexo , Silicose/epidemiologia
9.
Pneumologie ; 74(4): 201-209, 2020 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-32053838

RESUMO

BACKGROUND: The aim of this study was to evaluate the effects of an outpatient medical rehabilitation (OMR) mainly composed of exercise therapy and sports for patients with asbestosis and focused on keeping up sustainability effects. METHODS: 157 male patients aged 65.2 ±â€Š5.7 years suffering from asbestosis carried out over a period of three weeks 5 times weekly 6 h at a time phase 1 of the OMR consisting of evidence-based contents of the pulmonary rehabilitation. In the immediately following phase 2, the patients completed once a week for 3 hours over 12 weeks further therapeutic applications with the main focus on exercise therapy and sports and were subsequently transferred to health sports groups near to residence (phase 3). The effects of the OMR were evaluated at the beginning (T1), at the end of phase 1 (T2) and phase 2 (T3) as well as 6 (T4) and 20 months (T5) after T3. 61 patients (73.5 years ±â€Š5.6) were re-examined 6 years after T5 (T6) without any interim care. RESULTS: 72.1 % of the 61 patients (n = 44) carried out health sports twice a week in T5 as well as in T6 eight years after T1 and were able to maintain their physical performance (6-minute walk test, hand force, PWC test) as well as the perceived quality of life (SF-36, baseline/transition dyspnea index) according to age, while the rehab effects of the 17 patients breaking off any sporting activities after T3 fell significantly (p < .01) below the starting condition in T1. CONCLUSIONS: In spite of a restrictive pulmonary disease specific exercise therapy and sports are able to mobilize physical reserves of performance and induce an increasing quality of life as well as a higher resilience in activities of daily living. These positive effects could be stabilized in the long term by a regular training. The results underline the necessity of integrating aftercare strategies into the concept of rehabilitation with special consideration of perceived self-efficacy.


Assuntos
Assistência Ambulatorial/estatística & dados numéricos , Asbestose/reabilitação , Terapia por Exercício/métodos , Atividades Cotidianas , Idoso , Asbestose/diagnóstico , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Qualidade de Vida , Resultado do Tratamento
10.
Am J Respir Crit Care Med ; 201(1): 57-62, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31433952

RESUMO

Rationale: Asbestos exposure is associated with a dose-dependent risk of lung cancer. The association between lung cancer and the presence of pleural plaques remains controversial.Objectives: To define the relationship between pleural plaques and lung cancer risk.Methods: Subjects were from two cohorts: 1) crocidolite mine and mill workers and Wittenoom Township residents and 2) a mixed-asbestos-fiber, mixed-occupation group. All subjects underwent annual review since 1990, chest X-ray or low-dose computed tomography scan, and outcome linkage to national cancer and mortality registry data. Cox regression, with adjustment for age (as the underlying matching time variable), was used to estimate hazard ratios (HRs) for lung cancer incidence by sex, tobacco smoking, asbestos exposure, presence of asbestosis, and pleural plaques.Measurements and Main Results: For all 4,240 subjects, mean age at follow up was 65.4 years, 3,486 (82.0%) were male, 1,315 (31.0%) had pleural plaques, and 1,353 (32.0%) had radiographic asbestosis. Overall, 3,042 (71.7%) were ever-smokers with mean tobacco exposure of 33 pack-years. In total, 200 lung cancers were recorded. Risk of lung cancer increased with cumulative exposure to cigarettes, asbestos, and presence of asbestosis. Pleural plaques did not confer any additional lung cancer risk in either cohort (cohort 1: HR, 1.03; 95% confidence interval, 0.64-1.67; P = 0.89; cohort 2: HR, 0.75; 95% confidence interval, 0.45-1.25; P = 0.28).Conclusions: The presence of pleural plaques on radiologic imaging does not confer additional increase in the risk of lung cancer. This result is consistent across two cohorts with differing asbestos fiber exposures and intensity.


Assuntos
Asbestos/efeitos adversos , Asbestose/fisiopatologia , Neoplasias Pulmonares/fisiopatologia , Exposição Ocupacional/efeitos adversos , Doenças Pleurais/fisiopatologia , Adulto , Asbestose/epidemiologia , Estudos de Coortes , Feminino , Humanos , Incidência , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Doenças Pleurais/epidemiologia , Modelos de Riscos Proporcionais , Fatores de Risco
11.
Sci Total Environ ; 700: 134622, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31693951

RESUMO

Serpentinitic ultramafic geological environments (SUGEs) contain toxic geogenic contaminants (TGCs). Yet comprehensive reviews on the medical geology of SUGEs are still lacking. The current paper posits that TGCs occur widely in SUGEs, and pose human health risks. The objectives of the review are to: (1) highlight the nature, occurrence and behaviour of TGCs associated with SUGEs; (2) discuss the human intake pathways and health risks of TGCs; (4) identify the key risk factors predisposing human health to TGCs particularly in Africa; and (5) highlight key knowledge gaps and future research directions. TGCs of human health concern in SUGEs include chrysotile asbestos, toxic metals (Fe, Cr, Ni, Mn, Zn, Co), and rare earth elements. Human intake of TGCs occur via inhalation, and ingestion of contaminated drinking water, wild foods, medicinal plants, animal foods, and geophagic earths. Occupational exposure may occur in the mining, milling, sculpturing, engraving, and carving industries. African populations are particularly at high risk due to: (1) widespread consumption of wild foods, medicinal plants, untreated drinking water, and geophagic earths; (2) weak and poorly enforced environmental, occupational, and public health regulations; and (3) lack of human health surveillance systems. Human health risks of chrysotile include asbestosis, cancers, and mesothelioma. Toxic metals are redox active, thus generate reactive oxygen species causing oxidative stress. Dietary intake of iron and geophagy may increase the iron overload among native Africans who are genetically predisposed to such health risks. Synergistic interactions among TGCs particularly chrysotile and toxic metals may have adverse human health effects. The occurrence of SUGEs, coupled with the several risk factors in Africa, provides a unique and ideal setting for investigating the relationships between TGCs and human health risks. A conceptual framework for human health risk assessment and mitigation, and future research direction are highlighted.


Assuntos
Monitoramento Ambiental , Substâncias Perigosas/análise , Medição de Risco , África , Animais , Asbestos Serpentinas , Asbestose , Exposição Ambiental , Geologia , Humanos , Ferro , Neoplasias Pulmonares , Mesotelioma , Metais Pesados , Metais Terras Raras , Mineração
12.
BMC Cancer ; 19(1): 1204, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823764

RESUMO

BACKGROUND: Malignant pleural mesothelioma (MPM) is a debilitating disease of the pleural cavity. It is primarily associated with previous inhalation of asbestos fibers. These fibers initiate an oxidant coupled inflammatory response. Repeated exposure to asbestos fibers results in a prolonged inflammatory response and cycles of tissue damage and repair. The inflammation-associated cycles of tissue damage and repair are intimately involved in the development of asbestos-associated cancers. Macrophages are a key component of asbestos-associated inflammation and play essential roles in the etiology of a variety of cancers. Macrophages are also a source of C-C motif chemokine ligand 2 (CCL2), and a variety of tumor-types express CCL2. High levels of CCL2 are present in the pleural effusions of mesothelioma patients, however, CCL2 has not been examined in the serum of mesothelioma patients. METHODS: The present study was carried out with 50 MPM patients and 356 subjects who were possibly exposed to asbestos but did not have disease symptoms and 41 healthy volunteers without a history of exposure to asbestos. The levels of CCL2 in the serum of the study participants was determined using ELISA. RESULTS: Levels of CCL2 were significantly elevated in the serum of patients with advanced MPM. CONCLUSIONS: Our findings are consistent with the premise that the CCL2/CCR2 axis and myeloid-derived cells play an important role in MPM and disease progression. Therapies are being developed that target CCL2/CCR2 and tumor resident myeloid cells, and clinical trials are being pursued that use these therapies as part of the treatment regimen. The results of trials with patients with a similar serum CCL2 pattern as MPM patients will have important implications for the treatment of MPM.


Assuntos
Quimiocina CCL2/sangue , Neoplasias Pulmonares/sangue , Mesotelioma/sangue , Neoplasias Pleurais/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Asbestose/sangue , Biomarcadores Tumorais/sangue , Progressão da Doença , Feminino , Voluntários Saudáveis , Humanos , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/patologia , Pessoa de Meia-Idade , Adulto Jovem
13.
Med Lav ; 110(6): 459-485, 2019 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-31846450

RESUMO

The Position Paper (PP) on asbestos of the Italian Society of Occupational Medicine (SIML) aims at providing a tool to the occupational physician to address current diagnostic criteria and results of epidemiological studies, and their consequences in terms of preventive and evaluation actions for insurance, compensation and litigation. The PP was based on an extensive review of the scientific literature and was compiled by a Working Group comprising researchers who have contributed to the international literature on asbestos-related diseases, as well as occupational physicians with extensive experience in the evaluation of risks and the medical surveillance of workers currently and formerly exposed to asbestos. The PP was drafted and reviewed between 2017 and 2018; its final version was prepared according to the guidelines of AGREE Reporting Checklist. All the members of the Working Group subscribed to the document, which was eventually approved by SIML's Executive Committee. The first section addresses industrial hygiene issues, such as methods for environmental monitoring, advantages and limitations of different microscopy techniques, the potential role of microfibers and approaches for retrospective assessment of exposure, in particular in epidemiological studies. The second section reviews the biological effects of asbestos with particular attention to the diagnostic aspects of asbestosis, pleural changes, mesothelioma and lung cancer. In the following section the criteria of causal attribution are discussed, together with different hypotheses on the form of the risk functions, with a comparison of the opinions prevalent in the literature. In particular, the models of the risk function for mesothelioma were examined, in the light of the hypothesis of an acceleration or anticipation of the events in relation to the dose. The last section discusses topics of immediate relevance for the occupational physician, such as health surveillance of former exposed and of workers currently exposed in remediation activities.


Assuntos
Asbestos , Asbestose , Neoplasias Pulmonares , Mesotelioma , Exposição Ocupacional , Medicina do Trabalho , Neoplasias Pleurais , Humanos , Itália , Estudos Retrospectivos
14.
Artigo em Inglês | MEDLINE | ID: mdl-31861686

RESUMO

Background: In spite of the reduced exposure level, and its ban in numerous countries, compensation claims for asbestos-related diseases are far from decreasing. Methods: We used retrospective exposure assessment techniques to explore respiratory function and a computerized tomography (CT) scan in relation to past asbestos exposure in 115 male workers retired from an acrylic and polyester fiber plant. Based, on detailed information on exposure circumstances, we reconstructed a cumulative exposure estimate for each patient. Results: Time-weighted average exposure in our study population was 0.24 fibers/ml (95% confidence inteval (CI) 0.19-0.29), and the average cumulative exposure was 4.51 fibers/mL-years (95% CI 3.95-5.07). Exposure was elevated among maintenance workers, compared to other jobs (p = 0.00001). Respiratory function parameters did not vary in relation to the exposure estimates, nor to CT scan results. Risk of interstitial fibrosis showed a significant upward trend (Wald test for trend = 2.62, p = 0.009) with cumulative exposure to asbestos; risk associated with 5.26 fibers/mL-years or more, was 8-fold (95% CI 1.18-54.5). Conclusions: Our results suggest that a CT scan can detect pleuro-parenchymal lung alterations at asbestos exposure levels lower than previously thought, in absence of respiratory impairment. Further studies are required to validate our techniques of retrospective assessment of asbestos exposure.


Assuntos
Asbestos/efeitos adversos , Asbestose/diagnóstico por imagem , Asbestose/fisiopatologia , Pulmão/diagnóstico por imagem , Pulmão/fisiopatologia , Exposição Ocupacional/efeitos adversos , Adulto , Asbestose/epidemiologia , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
15.
Med Lav ; 110(5): 353-362, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31659992

RESUMO

BACKGROUND: The relationship between pleural plaques and cumulative asbestos exposure is controversial. OBJECTIVES: To evaluate the relationship between lung asbestos bodies (AB) and fibres (AF) and plaques presence and extension. METHODS: In a necropsy series of shipyard workers with asbestos-related diseases, we measured counts (per g of dry lung tissue) of AB (thousands) and AF>1 µm (millions). Pleural plaques were classified into three extension grades. We fitted univariate and multivariable linear (dependent variables: AB and AF, log10 transformed) and multinomial (dependent variable: plaques grade) regression models. RESULTS: We analysed 124 subjects, 13 without plaques 20 with grade 1, 69 with grade 2, and 22 with grade 3 plaques. Geometric means (GM) of AB were 10.6, 23.3, 126, and 140 in the four groups respectively (P=0.0001). GMs for AF (mostly amphiboles) were 1.2, 1.4, 7.3, and 12.9 (P=0.0001). AB and AF were strongly correlated (r=0.81). The likelihood of no plaques and grade 1 plaques decreased with increasing AB and AF doses, with a corresponding increase of grade 2 and 3 plaques. Plaque presence and extension was also associated with histologically verified asbestosis (P<0.001). CONCLUSIONS: Our study showed a strong positive relationship between pleural plaque presence and extension and both lung asbestos burden and asbestosis.


Assuntos
Asbestos , Asbestose , Exposição Ocupacional , Doenças Pleurais , Asbestos/farmacocinética , Amiantos Anfibólicos , Asbestose/diagnóstico , Biomarcadores , Humanos , Doenças Pleurais/etiologia
16.
Rev Mal Respir ; 36(8): 924-936, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31522950

RESUMO

INTRODUCTION: In France, long-term follow-up after occupational exposure to asbestos is recommended. This study looked at the psychological consequences in the longer term following a CT-scan, in particular the impact of having received compensation for an occupational disease. METHODS: As part of an asbestos post-exposure survey study (APExS), volunteers from Normandy were asked to complete self-assessment questionnaires about their psychological condition at different points during follow-up, including a psychological questionnaire before, then 6 months, and finally 18 to 24 months after their chest CT-scan. Information collected from 622 individuals were analyzed based on information provided as to the result of the screening and whether they had received compensation for having an occupational disease. RESULTS: The identification of an occupational disease eligible for compensation is associated with a long term increase in psychological distress. The impact of psychological state during follow-up is greater in men who reported receiving occupational disease compensation. The discovery of an asbestos-related disease during the screening is associated with a negative perception of general health and an increase in psychological distress. CONCLUSION: The receipt of compensation of an occupational disease does not seem to compensate for the negative psychological impact related to the discovery of a disease during the asbestos post-exposure follow-up.


Assuntos
Asbestos/toxicidade , Asbestose/psicologia , Exposição Ocupacional/efeitos adversos , Estresse Psicológico/etiologia , Indenização aos Trabalhadores , Adulto , Idoso , Idoso de 80 Anos ou mais , Asbestose/diagnóstico , Estudos de Coortes , Feminino , França , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Inquéritos e Questionários
17.
Environ Health ; 18(1): 71, 2019 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391078

RESUMO

BACKGROUND: Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos. METHODS: The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution. RESULTS: Mortality was significantly increased for 'All Causes' and 'All Malignant Neoplasm (MN)', in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%. CONCLUSIONS: Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studies.


Assuntos
Asbestos/efeitos adversos , Asbestose/epidemiologia , Neoplasias/epidemiologia , Exposição Ocupacional/efeitos adversos , Adulto , Asbestose/etiologia , Estudos de Coortes , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/induzido quimicamente , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
18.
Laeknabladid ; 105(7): 327-334, 2019.
Artigo em Islandês | MEDLINE | ID: mdl-31411568

RESUMO

Asbestos are crystallized silicate minerals that form fibers with different structures and characteristics. Asbestos fibers are very durable and can tolerate very high temperatures. Therefore it was common to use asbestos as a fire retardants, heat insulation and where high temperature is used. Asbestos has been banned in Iceland from 1983 but can still be found in large amounts in buildings, ships and hot water pipes. Large amounts of asbestos were imported in the years before the ban but diminished soon to almost nothing today. Needle or filamentous shaped dust is released when working with asbestos. It is this dust that is dangerous for health. The latent time from exposure to disease can be up to forty years. Asbestos reaches the lungs via inhalation and can cause asbestosis that is a form of lung fibrosis with slow progression. Asbestos can also cause benign pleural effusions, pleural plaques and diffuse pleural thickening. Asbestos is a carcinogen. Lung cancer is most common but asbestos is also a risk factor for cancers of other organs. Mesothelioma is most common in the pleura but can be seen in other membranes. The incidence of these tumors is high in Iceland and is still increasing among males. Of all the European countries mortality is highest in Iceland. It is important for physicians to include asbestos exposure in the differential diagnosis of lung diseases and when lung cancer is diagnosed.


Assuntos
Asbestos/efeitos adversos , Asbestose/epidemiologia , Materiais de Construção/efeitos adversos , Exposição Ambiental/efeitos adversos , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Asbestose/diagnóstico por imagem , Asbestose/patologia , Feminino , Humanos , Islândia/epidemiologia , Incidência , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/diagnóstico , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Distribuição por Sexo , Fatores de Tempo
19.
Occup Environ Med ; 76(10): 765-771, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31331950

RESUMO

OBJECTIVES: To determine cell differential counts and the number of asbestos bodies (ABs) in bronchoalveolar lavage (BAL) fluid obtained from patients with asbestosis, and to correlate the results with their survival. METHODS: The BAL cell differential counts and ABs from 91 patients with asbestosis were determined. The BAL cell differential counts were analysed in relation to smoking status. BAL cell differential counts and the number of ABs were correlated with the patients' survivals. RESULTS: A neutrophilic cell pattern was observed independently of smoking habits with both Papanicolau (8.4%) and May-Grunwald-Giemsa (6.5%) staining. Smoking and a high number of ABs (>2 AB/mL) were associated with high total cell counts and high macrophage and low lymphocyte differential counts. The median survival of the patients was 131.8 months. Shortened survival was associated with high numbers of ABs (78 vs 165 months; p=0.042) and low lymphocyte (77 vs 179 months; p=0.005), high neutrophil (102 vs 180 months; p=0.016) and high eosinophil (104 vs170 months; p=0.007) differential counts. CONCLUSION: A neutrophilic cell pattern was evident in BAL from patients with asbestosis. Smoking and ABs both affected the total cell count and the macrophage and lymphocyte differential counts. Several BAL parameters associated with patient survival, suggesting that BAL cell count analyses could be used in the estimation of the prognosis of patients with asbestosis.


Assuntos
Asbestos/análise , Asbestose/patologia , Líquido da Lavagem Broncoalveolar/citologia , Análise de Sobrevida , Idoso , Contagem de Células , Feminino , Finlândia , Humanos , Linfócitos/patologia , Macrófagos/patologia , Masculino , Neutrófilos/patologia , Fumar/efeitos adversos
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