Use of agent-based modeling to analyze potential non-occupational exposures to asbestos of the general population of Sibaté (Colombia).

Previous studies conducted in the municipality of Sibaté (Colombia) have revealed alarming findings regarding asbestos exposure in the region, as it is the site of the country's first mesothelioma cluster. Non-occupational asbestos exposure events were identified in this population, and the young age of the mesothelioma cases at the time of diagnosis suggests that asbestos exposure occurred during their childhood. The creation of landfilled zones in the 1980s and 1990s, utilizing friable asbestos among other disposed materials, may have been a significant asbestos exposure event contributing to the elevated number of mesothelioma cases. The objective of this study was to model various historical exposure scenarios related to the creation and interaction of the population with asbestos-contaminated landfilled zones, in light of the absence of asbestos monitoring in the region. The models utilized a multi-agent simulation process, focusing on a 10-year period (1986-1995). Various relevant variables were incorporated into the modeling process, including, for example, the number of children playing in the landfilled zones and the percentage of children carrying asbestos fibers on their clothes to their homes. A range of values for input data for the models were utilized, spanning from very conservative numbers to exposure-promoting values. The average number of exposed individuals estimated over 750 simulation runs, considering all scenarios, was 571, with a range between 31 and 3800 exposed individuals. The use of multi-agent simulation models can assist the understanding of past asbestos exposure events, especially when there is a lack of environmental surveillance data.

Mapping roof coverings of asbestos-cement, the first step to control the technical condition/threat and establish priorities for replacement in developing countries.

This paper presents a systematic and data-driven approach to prioritize interventions in urban areas with asbestos cement (AC) roofs, addressing the urgent need to mitigate asbestos-related risks. The objective is to propose a comprehensive methodology that considers multiple criteria at the neighborhood level, allowing for a nuanced assessment of intervention priorities. The methodology involves the normalization of various parameters, including population density, facility density, and the area covered by asbestos-cement roofs. In addition, an innovative aspect is introduced by incorporating weathering status identification data, represented as an index, validated in previous research, further enriching the evaluation process. The integration of these diverse factors allows for a holistic understanding of the risk landscape associated with AC roofs in urban settings. The cornerstone of the proposed approach is the development of a Priority Intervention Index (PII) at the neighborhood level. This index serves to standardize the assessment of intervention priorities, enabling a fair and transparent comparison across different regions. To enhance practical application, the PII is discretized into three categories, low, mid and high intervention priority. The results obtained are robust, replicable in other scenarios, and practical for decision-makers. The new methodology provides a structured and quantifiable approach to identify and prioritize areas for asbestos-related interventions based on well-defined criteria at the neighborhood level. The resulting prioritization strategy offers urban planners and local officials a clear and evidence-based tool to allocate resources efficiently and effectively manage the inherent risks associated with AC roofs in urban environments. The paper will describe how the prioritization can be applied "at the neighborhood level" by urban planners and local officials.

Assessment of asbestos-cement roof distribution and prioritized intervention approaches through hyperspectral imaging.

The discernment of asbestos-cement (AC) roofs within urban areas stands as a pivotal concern pertinent to communal well-being and ecological oversight, particularly in emerging nations where asbestos continues to be extensively employed. Conventional methodologies entailing the recognition of asbestos-cement roofs and the characterization of their degradation status, such as tangible examinations and laboratory assays, prove to be temporally protracted, financially demanding, and arduous to extrapolate comprehensively across expansive urban domains. In this paper, it is presented a novel approach for identifying asbestos-cement roofs in urban areas using hyperspectral airborne acquisition and carry out a diagnosis that allows to identify the state of asbestos-cement roofs and thus provide a tool for the competent authorities to develop and prioritize intervention strategies to mitigate the problem. Four different methodologies were implemented and compared, three of which are new in the literature, to identify the deterioration of asbestos-cement (AC) roof state in large urban areas. This, in turn, furnishes a tool for competent authorities to identify the state of AC roofs, develop and prioritize intervention strategies to mitigate the problem. The control points in field allowed validating the classification and the proposed methodology for the prioritization of intervention in AC roofs. Some neighborhoods in the city showed peaks in the area of asbestos-cement roofs of 47% of the total area of the neighborhood, representing practically all of the roofs present in the neighborhood. On average around 20% of the total area of a neighborhood in Cartagena is covered by AC. Furthermore, it was found a total area of AC roofs throughout the city of more than 9 km2 (9 million square meters). On the other hand, two of the 4 methods used showed encouraging results that demonstrate their ability to identify covers in poor and good condition at a large scale from hyperspectral images. This academic novelty suggests that there is a possibility of practical application of these methods in other urban contexts with high concentrations of AC roofs, helping in the planning and optimization of intervention strategies to mitigate the risk in public and environmental health due to the presence of asbestos.

Placas pleurales por probable asbestosis no ocupacional / Pleural Plaques Caused by Possible Non-Occupational Asbestosis

RESUMEN Paciente masculino, sin antecedentes conocidos, nunca tabaquista, que en el contexto de un cuadro de hiperreactividad bronquial aislado, se evidencian imágenes pleurales bilaterales compatibles con exposición crónica a asbesto.

ABSTRACT In the context of an isolated bronchial hyperreactivity condition, the patient presents bilateral pleural images consistent with chronic asbestos exposure.

[Malignant mesothelioma in Colombia: burden of disease, overview, and subnational sociodemographic index, 2015-2020Mesotelioma maligno na Colômbia: carga de morbidade, visão geral e índice sociodemográfico subnacional, entre 2015 e 2020]. / Mesotelioma maligno en Colombia: carga de enfermedad, panorama general e índice sociodemográfico subnacional, 2015-2020.

Objective: Establish the disease burden of malignant mesothelioma (MM) in Colombia between 2015 and 2020, and its association with the subnational sociodemographic development index (SDI) and with asbestos sites. Methods: Mixed ecological study of the Colombian population diagnosed with MM (according to ICD-10) from 2015 to 2020. The global burden of disease (GBD) was estimated using the methodology proposed by Murray and Lopez, based on prevalence and mortality data obtained from official sources. The subnational (departmental level) SDI was estimated as a measure of socioeconomic development. Linear regressions were established with the GBD, SDI, and documented asbestos sites. Results: The estimated GBD of MM in Colombia during 2015-2020 was 51.71 disability-adjusted life years (DALYs) per 1 000 000 inhabitants (15 375.79 total DALYs), with predominance in people over 50 years of age (91.1%) and males (66.4%).Bogotá and Valle del Cauca were the departments with the highest number of adjusted DALYs. Bogotá had the highest SDI and Guainía and Cesar had the lowest. There was evidence of an association between DALYs and SDI, explaining 22.8% of DALYs. Conclusion: Malignant mesothelioma is the cause of a large number of DALYs, predominantly in the departments with greater socioeconomic development and with companies that used to use asbestos. However, possible underdiagnosis of MM limits analysis of the information.

Objetivo: Estabelecer o ônus da doença por mesotelioma maligno (MM) na Colômbia entre 2015 e 2020 e sua associação ao índice sociodemográfico subnacional (ISS) e locais de amianto. Métodos: Estudo ecológico misto na população colombiana diagnosticada com MM, de acordo com a CID-10 durante 2015 a 2020. A carga global da doença (CGD) foi estimada usando a metodologia proposta por Murray e López com base na prevalência e na mortalidade obtidas de fontes oficiais. O SDI subnacional (nível departamental) foi estimado como uma medida de desenvolvimento socioeconômico e foram estabelecidas regressões lineares com CGD, SDI e localizações documentadas de amianto. Resultados: A estimativa de CGD por MM na Colômbia entre 2015-2020 foi de 51,71 anos de vida ajustados por incapacidade (AVAI) por 1 000 000 de habitantes (15 375,79 AVAI totais), com predominância em pessoas com mais de 50 anos (91,1%) e do sexo masculino (66,4%).Com relação aos departamentos, Bogotá e Valle del Cauca tiveram o maior número de AVAI ajustados, enquanto Bogotá teve o maior SDI, e Guainía e Cesar, o menor. Houve uma associação entre os AVAI e o SDI, sendo que o SDI foi responsável por 22,8% dos AVAI. Conclusões: O MM é a causa de um grande número de AVAI, predominantemente em departamentos com maior desenvolvimento socioeconômico e com a presença de empresas que usavam amianto; no entanto, o possível subdiagnóstico do MM limita a análise das informações.

The Current Treatment Landscape of Malignant Pleural Mesothelioma and Future Directions.

The incidence of malignant pleural mesothelioma is expected to increase globally. New treatment options for this malignancy are eagerly awaited to improve the survival and quality of life of patients. The present article highlights the results of recent advances in this field, analyzing data from several relevant trials. The heterogeneous tumor microenvironment and biology, together with the low mutational burden, pose a challenge for treating such tumors. So far, no single biomarker has been soundly correlated with targeted therapy development; thus, combination strategies are often required to improve outcomes. Locally applied vaccines, the expansion of genetically engineered immune cell populations such as T cells, the blockage of immune checkpoints that inhibit anti-tumorigenic responses and chemoimmunotherapy are among the most promising options expected to change the mesothelioma treatment landscape.

An Approach to Overcome the Limitations of Surveillance of Asbestos Related Diseases in Low- and Middle-Income Countries: What We Learned from the Sibaté Study in Colombia.

Introduction: The asbestos industry began its operations in Colombia in 1942 with the establishment of an asbestos-cement facility in Sibaté, located in the Department of Cundinamarca. Despite extensive asbestos use and production in Colombia, the country lacks a reliable epidemiological surveillance system to monitor the health effects of asbestos exposure. The Colombian health information system, known as SISPRO, did not report mesothelioma cases diagnosed in the municipality, posing a significant challenge in understanding the health impacts of asbestos exposure on the population of Sibaté. Methods: To address this issue, an active surveillance strategy was implemented in Sibaté. This strategy involved conducting door-to-door health and socioeconomic structured interviews to identify Asbestos-Related Diseases (ARDs). Validation strategies included a thorough review of medical records by a panel of physicians, and the findings were communicated to local, regional, and national authorities, as well as the general population. Results: The active surveillance strategy successfully identified a mesothelioma cluster in Sibaté, revealing the inadequacy of the existing health information system in monitoring asbestos-related diseases. The discovery of this cluster underscores the critical importance of implementing active surveillance strategies in Colombia, where governmental institutions and resources are often limited. Conclusion: The findings of this study emphasize the urgent need for Colombia to establish a reliable epidemiological surveillance system for asbestos-related diseases (ARDs). Active surveillance strategies can play a crucial role in identifying mesothelioma clusters and enhancing our understanding of the health effects of asbestos exposure in low- and middle-income countries.

A critical review of asbestos concentrations in water and air, according to exposure sources.

Asbestos, a group of minerals with unique physical and chemical properties, has been widely used in various industries. However, extensive exposure to asbestos fibers, present in the environment, has been linked to several types of cancer, mesothelioma, and asbestosis. Despite worldwide regulations prohibiting or regulating the use of this material, the uncertainty surrounding the concentrations of asbestos fibers in the environment (air and water) from different sources of exposure persists. The objective of this review paper is to identify the levels of asbestos in air and water reported in the literature based on the source of exposure in diverse contexts to assess conformity with the reference limits for this mineral. Initially, the review delineates various forms of exposure and the origin of fiber generation in the environment, whether direct or indirect. Regarding the presence of asbestos in the environment, high concentrations were identified in natural water bodies known as Naturally Occurring Asbestos (NOA), and there is a risk in the process of distributing drinking water due to the presence of asbestos-cement pipes. In the air, studies to determine asbestos concentrations vary based on the sources of exposure in each region or city studied. The presence of asbestos mines around the city and the intensity of vehicular traffic are some of the most relevant sources found to be related to high concentrations of asbestos fibers in the air. The present review paper features a critical review section in each chapter to highlight critical points found in the literature and suggest new methodologies/ideas to standardize future research. It emphasizes the necessity to standardize methods for measuring asbestos concentrations in air and water arising from diverse sources of exposure to enable comparisons between different regions and countries.

The Brazilian System for Monitoring Workers and General Population Exposed to Asbestos: Development, Challenges, and Opportunities for Workers' Health Surveillance.

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.

Environmental management criteria, aimed at public policymaking, for the removal and disposal of asbestos-containing building materials in Colombia.

Asbestos is a carcinogenic mineral banned in Colombia since 1 January 2021; however, there is a considerable amount of asbestos-containing building materials (ACBM) installed across the country in products such as roof tiles, tanks, pipes, and downspouts. Installed ACBM represent an exposure risk when the mineral fibers are released into the air through deterioration, damage, or disturbance of the cement matrix within which the asbestos is contained. Due to potential detrimental impacts on human health, safe management and correct handling of ACBM is a matter of vital importance. This article proposes evidence-based environmental management guidelines, aimed at public policymaking, for the removal and final disposal of installed ACBM in Colombia. A descriptive study was carried out, with a qualitative approach, based on an integrative literature review of international practices applied in the removal and disposal of installed ACBM. Forty scientific publications were reviewed, as well as the regulations for removal, transport, and final disposal of installed asbestos-cement from Australia, the USA, Italy, Chile, the UK, and Canada. Guidelines for the removal and final disposal of installed ACBM are proposed, suggesting the following stages: (a) diagnosis and management plan of installed ACBM, (b) removal of installed ACBM, (c) transport of ACBM waste, and (d) final disposal of ACBM waste. Expert opinion was collected to assess the local feasibility of the proposed guidelines. These guidelines may help direct national and regional agencies to establish comprehensive strategies with clear, measurable, and achievable goals for future replacement of installed ACBM. Integr Environ Assess Manag 2023;19:1079-1088. © 2023 SETAC.

Mesotelioma maligno en Colombia: carga de enfermedad, panorama general e índice sociodemográfico subnacional, 2015-2020 / Malignant mesothelioma in Colombia: burden of disease, overview, and subnational sociodemographic index, 2015-2020 / Mesotelioma maligno na Colômbia: carga de morbidade, visão geral e índice sociodemográfico subnacional, entre 2015 e 2020

RESUMEN Objetivo. Establecer la carga de enfermedad por mesotelioma maligno (MM) en Colombia entre 2015 y 2020 y su asociación con el índice sociodemográfico (SDI) subnacional y las localizaciones de asbesto. Métodos. Estudio ecológico mixto en la población colombiana con diagnóstico de MM según la CIE-10 durante 2015 a 2020. La carga global de enfermedad (GBD, por su sigla en inglés) se estimó por medio de la metodología propuesta de Murray y López a partir de la prevalencia y mortalidad obtenida de fuentes oficiales. Se estimó el SDI (por su sigla en inglés) subnacional (nivel departamental) como medida de desarrollo socioeconómico y se establecieron regresiones lineales con la GBD, el SDI y las localizaciones documentadas de asbesto. Resultados. La GBD estimada por MM en Colombia durante 2015-2020 fue de 51,71 años de vida ajustados por discapacidad (AVAD) por cada 1 000 000 de habitantes (15 375,79 AVAD totales), con predominio en personas mayores de 50 años (91,1%) y de sexo masculino (66,4%). A nivel departamental, Bogotá y Valle del Cauca presentaron la mayor cantidad de AVAD ajustados; mientras que Bogotá tuvo el SDI más alto, y Guainía y Cesar el más bajo. Se evidenció una asociación entre los AVAD y el SDI, donde este último explicó 22,8% de los casos de AVAD. Conclusión. El MM es causa de una gran cantidad de AVAD, con predominio en los departamentos con mayor desarrollo socioeconómico, y con presencia de empresas que solían utilizar asbesto; no obstante, el posible subdiagnóstico de MM limita el análisis de la información.

ABSTRACT Objective. Establish the disease burden of malignant mesothelioma (MM) in Colombia between 2015 and 2020, and its association with the subnational sociodemographic development index (SDI) and with asbestos sites. Methods. Mixed ecological study of the Colombian population diagnosed with MM (according to ICD-10) from 2015 to 2020. The global burden of disease (GBD) was estimated using the methodology proposed by Murray and Lopez, based on prevalence and mortality data obtained from official sources. The subnational (departmental level) SDI was estimated as a measure of socioeconomic development. Linear regressions were established with the GBD, SDI, and documented asbestos sites. Results. The estimated GBD of MM in Colombia during 2015-2020 was 51.71 disability-adjusted life years (DALYs) per 1 000 000 inhabitants (15 375.79 total DALYs), with predominance in people over 50 years of age (91.1%) and males (66.4%). Bogotá and Valle del Cauca were the departments with the highest number of adjusted DALYs. Bogotá had the highest SDI and Guainía and Cesar had the lowest. There was evidence of an association between DALYs and SDI, explaining 22.8% of DALYs. Conclusion. Malignant mesothelioma is the cause of a large number of DALYs, predominantly in the departments with greater socioeconomic development and with companies that used to use asbestos. However, possible underdiagnosis of MM limits analysis of the information.

RESUMO Objetivo. Estabelecer o ônus da doença por mesotelioma maligno (MM) na Colômbia entre 2015 e 2020 e sua associação ao índice sociodemográfico subnacional (ISS) e locais de amianto. Métodos. Estudo ecológico misto na população colombiana diagnosticada com MM, de acordo com a CID-10 durante 2015 a 2020. A carga global da doença (CGD) foi estimada usando a metodologia proposta por Murray e López com base na prevalência e na mortalidade obtidas de fontes oficiais. O SDI subnacional (nível departamental) foi estimado como uma medida de desenvolvimento socioeconômico e foram estabelecidas regressões lineares com CGD, SDI e localizações documentadas de amianto. Resultados. A estimativa de CGD por MM na Colômbia entre 2015-2020 foi de 51,71 anos de vida ajustados por incapacidade (AVAI) por 1 000 000 de habitantes (15 375,79 AVAI totais), com predominância em pessoas com mais de 50 anos (91,1%) e do sexo masculino (66,4%). Com relação aos departamentos, Bogotá e Valle del Cauca tiveram o maior número de AVAI ajustados, enquanto Bogotá teve o maior SDI, e Guainía e Cesar, o menor. Houve uma associação entre os AVAI e o SDI, sendo que o SDI foi responsável por 22,8% dos AVAI. Conclusões. O MM é a causa de um grande número de AVAI, predominantemente em departamentos com maior desenvolvimento socioeconômico e com a presença de empresas que usavam amianto; no entanto, o possível subdiagnóstico do MM limita a análise das informações.

A comparative study of the disease burden attributable to asbestos in Brazil, China, Kazakhstan, and Russia between 1990 and 2019.

BACKGROUND: Brazil, China, Kazakhstan, and Russia are the main asbestos-producing countries, and all forms of asbestos are carcinogenic to humans. The objective of this study was to estimate the disease burden attributable to asbestos between 1990 and 2019 in major producing countries, including Brazil, China, Kazakhstan, and Russia. METHODS: Age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life year (DALY) rates (ASDR) of disease burden attributable to asbestos by country, age, and sex were extracted from the Global Burden of Disease 2019. Percentage change and estimated annual percentage change (EAPC) were used to assess the trends of ASDR and ASMR of disease burden attributable to asbestos between 1990 and 2019. RESULTS: Asbestos-related diseases were highly heterogeneous across Global, Brazil, China, Kazakhstan, and Russia. There was a downward trend in ASMR and ASDR of diseases burden related to asbestos globally. The age-specific mortality rate of disease attributable to asbestos increased in men and women, although it decreased in women aged 85-89, the highest age-specific mortality rate were observed in age 95 + group in men [162.14 (95% UI: 103.76-215.45)] and women [30.58 (95% UI: 14.83-44.33)] per 100 000 population, respectively. Tracheal, bronchus, and lung (TBL) cancer was the leading cause of death and DALYS attributable to asbestos between 1990 and 2019 globally and in Brazil, China, Kazakhstan, and Russia. China had the highest percentage change (73.31%) and EAPC [3.41 (95% CI: 2.75-4.08)] in ASMR related to exposure to asbestos in men, with the highest percentage change (73.31%) and EAPC [3.41 (95% CI: 2.75-4.08)] in ASDR in men. CONCLUSIONS: The ASMR and ASDR of disease burden attributable to asbestos decreased between 1990 and 2019 globally. TBL cancer was the leading cause of death and DALYs attributable to asbestos between 1990 and 2019. There has been an increasing trend in mortality and DALYs globally, especially in older men. The burden of disease attributable to asbestos is increasing in China, especially in men.

Asbestos awareness among the residents of St. Kitts and Nevis: a cross-sectional study.

BACKGROUND: High levels of public awareness regarding the hazards of asbestos, rights to health, and benefits of an asbestos-free country can increase advocacy and political commitment to a total ban on asbestos. We aimed to investigate asbestos awareness and associated sociodemographic characteristics among the adult population of St. Kitts and Nevis. METHODS: In this cross-sectional study, 1009 participants completed an online questionnaire with questions about sociodemographic data and asbestos awareness. We applied multiple regression models to estimate associations between sociodemographic factors, levels of asbestos knowledge, and attitudes toward asbestos management. RESULTS: We found that 70% of residents of St. Kitts and Nevis considered asbestos exposure to be a general public concern and believed the government should prevent it. Of all participants, 54% were in favor of completely banning the use and importation of all asbestos products and materials; those with higher levels of asbestos knowledge were more likely to favor a total ban. Higher proportions and odds of favoring a total asbestos ban were also observed in participants aged ≥ 30 years, women, those with higher education, and those living in St. Kitts (vs. Nevis). CONCLUSIONS: These findings support implementing policies to regulate and outright ban the use of asbestos products and materials in St. Kitts and Nevis. This data can be used to develop tailored campaigns to improve asbestos knowledge among sociodemographic groups with lower asbestos awareness, such as in the wider Caribbean and other under-resourced countries.

Analysis of Mortality from Asbestos-Related Diseases in Brazil Using Multiple Health Information Systems, 1996-2017.

Background: In Brazil, asbestos was intensively used from the 1960s until its ban in 2017. Mesothelioma, asbestosis, and pleural plaques are typical asbestos-related diseases (ARD-T). To create an ARD-T national database, death records from 1996-2017 were retrieved from several health information systems (HIS). Methods: All national HIS containing coded diagnoses (ICD-10) and death information were obtained. Linkage was performed to create a single database of ARD-T death records, either as underlying or contributory causes, in adults aged 30 years and older. Results: A total of 3,057 ARD-T death records were found, 2,405 (76.4%) of which being malignant mesotheliomas (MM). Pleural MM (n = 1,006; 41.8%) and unspecified MM (n = 792; 32.9%) prevailed. Male to female MM ratio (M:F) was 1.4:1, and higher ratios were found for non-malignant ARD-T: 3.5:1 for asbestosis and 2.4:1 for pleural plaques. Male crude annual mesothelioma mortality (CMmm x1,000,000) was 0.98 in 1996 and 2.26 in 2017, a 131.1% increment, while for females it was 1.04 and 1.25, a 20.2% increase, correspondingly. The small number of deaths with asbestosis and pleural plaques records precluded conclusive interpretations. Conclusions: Even with the linkage of several HIS, ARD-T in death records remained in low numbers. MM mortality in men was higher and showed a rapid increase and, along with non-malignant ARD-T, higher M:F ratios suggested a predominant pattern of work-related exposure. The monitoring of workplace and environmental asbestos exposure needs to be improved, as well as the workers surveillance, following the recent Brazilian ban.

Is asbestos still a problem in the world? A current review.

Asbestos has been used by automobile, construction, manufacturing, power, and chemical industries for many years due to its particular properties, i.e. high tensile strength, non-flammable, thermal and electrical resistance and stability, and chemical resistance. However, such a mineral causes harmful effects to human health, including different types of cancer (e.g., mesothelioma). As a result, the use of asbestos has been banned since the 1980s in many countries. Nonetheless, asbestos is still part of the daily life of the population as asbestos-containing materials (ACMs) are still present in many buildings constructed and renovated before the 1990s. This work aims to present a current literature review about asbestos. The literature review was composed mainly of research articles published in international journals from the medical and engineering disciplines to provide an overview of asbestos use effects reported in interdisciplinary areas. The literature review comprised asbestos characteristics and its relationship to the risks of human exposure, countries where asbestos use is permitted or banned, reducing asbestos in the built environment, and environmental impact due to use and disposal of asbestos. The main findings were that ACMs are still responsible for severe human diseases, particularly in areas where there is a lack of coordinated asbestos management plans, reduced awareness about asbestos health risks, or even a delay in the implementation of asbestos-ban. Such issues may be more prevailing in developing countries. The current research in many countries contemplates several methodologies and techniques to process ACMs into inert and recyclable materials. The identification and coordinated management of ACM hazardous waste is a significant challenge to be faced by countries, and its inadequate disposal causes severe risk of exposure to asbestos fibres. Based on this work, it was concluded that banning asbestos is indicated in all countries in the world.

Mesothelioma in situ with regressive malignant pleural effusion and an unexpected evolution: A case report.

Malignant pleural mesothelioma (MPM) is an aggressive neoplasm that originates from hyperplasia and metaplasia of the mesothelial cells that cover the pleural cavity. Previous exposure to asbestos is the main risk factor. Since MPM is often diagnosed at an advanced stage with rapid evolution and resistance to treatment, it is associated with an unfavorable outcome. Mesothelioma in situ (MIS) has been postulated as a preinvasive phase of MPM; however, its diagnostic criteria have been defined only recently. Diagnosis of MIS may represent an opportunity for early therapies with better results, but the optimal approach has not been defined thus far. Here, we report on a case of a 74-year-old man with right-sided pleural effusion and a previous history of occupational exposure to asbestos for 9 years who was diagnosed with MIS after a latency of 36 years. During follow-up, spontaneous disease regression was observed 5 months after the initial diagnosis; however, it recurred in the form of invasive epithelioid MPM. There is a paucity of literature on MIS and its evolution; however, our case provides relevant knowledge of this unusual behavior, which is important to define follow-up and therapeutic strategies for future cases.

Sex-Specific Mortality from Asbestos-Related Diseases, Lung and Ovarian Cancer in Municipalities with High Asbestos Consumption, Brazil, 2000-2017.

The aim of this study is to compare the mortality rates for typical asbestos-related diseases (ARD-T: mesothelioma, asbestosis, and pleural plaques) and for lung and ovarian cancer in Brazilian municipalities where asbestos mines and asbestos-cement plants had been operating (areas with high asbestos consumption, H-ASB) compared with in other municipalities. The death records for adults aged 30+ years were retrieved from multiple health information systems. In the 2000-2017 time period, age-standardized mortality rates (standard: Brazil 2010) and standardized rate ratios (SRR; H-ASB vs. others) were estimated. The SRRs for ARD-T were 2.56 for men (257 deaths in H-ASB municipalities) and 1.19 for women (136 deaths). For lung cancer, the SRRs were 1.33 for men (32,604 deaths) and 1.19 for women (20,735 deaths). The SRR for ovarian cancer was 1.34 (8446 deaths). Except for ARD-T and lung cancer in women, the SRRs were higher in municipalities that began using asbestos before 1970 than in municipalities that began utilizing asbestos from 1970 onwards. In conclusion, the mortality rates for ARD-T, and lung and ovarian cancer in municipalities with a history of asbestos mining and asbestos-cement production exceed those of the whole country. Caution is needed when interpreting the results of this ecological study. Analytical studies are necessary to document the impact of asbestos exposure on health, particularly in the future given the long latency of asbestos-related cancers.

Asbestos cement waste treatment through mechanochemical process with KH2PO4 for its utilization in soil pH correction and nutrient delivery.

The manufacture of asbestos materials has been banished worldwide due to their toxicity, but discarding the existing wastes remains a challenge. We investigated an alternative mechanochemical method to treat asbestos-cement materials by loading them with potassium and phosphorus from KH2PO4 during the milling process to obtain a product used as liming and soil conditioner. The results showed total asbestos fibrous elimination after 7 to 8 h of milling. The materials showed a slow-release fertilizer profile. The liming property is maintained when the asbestos-cement weight proportion used is equal to or higher than KH2PO4. A comparative soil experiment with limestone also indicates that lower doses of the K- and P-enriched detoxified asbestos cement were required to reach similar liming effects. Maize cultivation (greenhouse) was used to evaluate its performance showing higher biomass production for the sample loaded with potassium and phosphorous.

Occupational characterization of workers exposed to asbestos: an integrative review.

Asbestos is a mineral fiber abundant in nature and classified as a carcinogen since 1987. The present study aimed to identify, in the scientific literature, what are the occupation and activities developed by sick workers and which categories would be affected with asbestos-related diseases. Through a literature review performed in the following databases: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and Regional Portal of the Virtual Health Library, 23 studies published from 2015 to 2020 were selected and evaluated. The occupations that showed greater illness due to exposure to asbestos were general asbestos workers (40%), miners (22%), and textile workers (9%), followed by naval, automotive, carpentry, doll-making, construction, and upholstery workers, as well as workers involved in the rescue, recovery, cleaning, and restoration of the World Trade Center (4%). Of the disease associated with exposure to asbestos, the most described is malignant mesothelioma (43%). Evidence found corroborate pre-existing information in the literature showing that exposure to asbestos may be harmful to health. Moreover, the importance of using personal protective equipment was emphasized, in order to prevent the development of asbestos-related diseases.

O asbesto é uma fibra mineral abundante na natureza, classificado como substância cancerígena desde 1987. Objetivou-se identificar, na literatura científica, quais são as ocupações e atividades desenvolvidas por trabalhadores adoecidos e quais categorias seriam afetadas com doenças relacionadas ao asbesto. O presente estudo trata-se de uma revisão de literatura realizada mediante a busca nas bases de dados PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science e Portal Regional da Biblioteca Virtual em Saúde, sendo selecionados e avaliados 23 estudos publicados entre 2015 e 2020. As ocupações que demonstraram maior adoecimento pela exposição ao asbesto foram trabalhadores gerais de indústrias de asbesto (40%), mineradores (22%) e do setor têxtil (9%), seguidos por trabalhadores da indústria naval, do setor automotivo, carpinteiros, do setor de fabricação de bonecas, da construção civil, estofadores e trabalhadores que participaram do resgate, recuperação, limpeza e restauração do local do World Trade Center (4%). Entre as patologias associadas à exposição ao asbesto, a principal descrita é o mesotelioma maligno (43%). As evidências encontradas corroboram as informações preexistentes na literatura de que a exposição ao asbesto pode ser prejudicial à saúde. Ainda, ressalta-se a importância da utilização de equipamentos de proteção individual, a fim de evitar o desenvolvimento de doenças relacionadas ao asbesto.

Using GIS to Estimate Population at Risk Because of Residence Proximity to Asbestos Processing Facilities in Colombia.

The recent enactment of the law banning asbestos in Colombia raises a significant number of challenges. The largest factories that have historically processed asbestos include five asbestos-cement facilities located in the cities of Sibaté (Cundinamarca), Cali (Valle del Cauca), and Barranquilla (Atlántico), and Manizales (Caldas), which has two, as well as a friction products facility in Bogotá D.C. An asbestos chrysotile mine has also operated in Colombia since 1980 in Campamento (Antioquia). In the framework of developing the National Asbestos Profile for Colombia, in this study, we estimated the population residing in the vicinity of asbestos processing plants or the mine and, therefore, potentially at risk of disease. Using a geographic information system, demographic data obtained from the last two general population censuses were processed to determine the number of people living within the concentric circles surrounding the asbestos facilities and the mine. In previous studies conducted in different countries of the world, an increased risk of asbestos-related diseases has been reported for people living at different distance bands from asbestos processing facilities. Based on these studies, circles of 500, 1000, 2000, 5000, and 10,000 m radii, centered on the asbestos processing facilities and the mine that operated in Colombia, were combined with the census data to estimate the number of people living within these radii. Large numbers of people were identified. It is estimated that in 2005, at the country level, 10,489 people lived within 500 m of an asbestos processing facility or mine. In 2018, and within a distance of 10,000 m, the number of people was 6,724,677. This information can aid public health surveillance strategies.