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Asbestos and Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Environmental Health".

Deadline for manuscript submissions: closed (30 November 2020) | Viewed by 17023

Special Issue Editor

Prof. Dr. Arthur W. (Bill) Musk
*
E-Mail Website
Guest Editor
1. School of Population and Global Health, University of Western Australia, Crawley, WA 6009, Australia
2. Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, WA 6009, Australia
Interests: clinical and epidemiological aspects of respiratory diseases and cancer particularly occupational diseases and especially asbestos related diseases
* Passed away on 3 November 2021

Special Issue Information

Dear Colleagues,

"Asbestos" is a term applied to a group of minerals that have been widely used in construction and industry over the past century because of their physical properties: strong and indestructible fibers that are valuable for creating heat-resistant and resilient building sheets, and heat insulation for boilers and furnaces and other machinery. Exposure to airborne asbestos fibers occurs in its mining and transport, and during its use in industry and construction, most recently during the renovation or removal of existing asbestos structures, and environmentally from the deterioration of asbestos in situ. 

The fibrous shape of air-borne asbestos particles determines their passage through the airways when they are inhaled and their resistance to clearance from the lungs when they have been deposited in the conducting airways or the gas-exchanging lung parenchyma as far as the pleura. They also disseminate in the body through lymphatic and circulatory pathways, where they persist. As a result of this they cause inflammatory and neoplastic responses in the airways and lung parenchyma and pleura: asbestosis, respiratory cancer of all varieties (especially in tobacco smokers), malignant mesothelioma (pleural and peritoneal), benign pleural effusions, and diffuse pleural thickening.  Asbestos fibers are persistent in the tissues of the body, and the diseases that result from their inhalation often do not occur until years or decades have passed. Thus, the attribution of disease to asbestos exposure was slow to evolve and epidemiological studies have been critical to their understanding, and laboratory studies of asbestos exposure have contributed to understanding the process of carcinogenesis at a cellular level.

There has been an epidemic of litigation for asbestos-related disease compensation with legal implications, and the input of physicians and epidemiologists have been critical to the successful outcome of these legal cases.

Advances in chemotherapy and immunotherapy have recently been important in the treatment of asbestos-related malignancies and the extension of patient survival.

Prof. Arthur W. (Bill) Musk
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Asbestos
  • Asbestosis
  • Mesothelioma
  • Lung cancer
  • Pleural effusion
  • Pleural fibrosis/thickening
  • Immunotherapy
  • Chemotherapy
  • Epidemiology
  • Litigation/compensation

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Published Papers (4 papers)

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Research

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20 pages, 3131 KiB  
Article
Ascertainment Bias in a Historic Cohort Study of Residents in an Asbestos Manufacturing Community
by Jeremy D. Wortzel, Douglas J. Wiebe, Shabnam Elahi, Atu Agawu, Frances K. Barg and Edward A. Emmett
Int. J. Environ. Res. Public Health 2021, 18(5), 2211; https://doi.org/10.3390/ijerph18052211 - 24 Feb 2021
Cited by 7 | Viewed by 2617
Abstract
This paper describes follow-up for a cohort of 4530 residents living in the asbestos manufacturing community of Ambler, PA, U.S. in 1930. Using re-identified census data, cause and date of death data obtained from the genealogic website Ancestry.com, along with geospatial analysis, we [...] Read more.
This paper describes follow-up for a cohort of 4530 residents living in the asbestos manufacturing community of Ambler, PA, U.S. in 1930. Using re-identified census data, cause and date of death data obtained from the genealogic website Ancestry.com, along with geospatial analysis, we explored relationships among demographic characteristics, occupational, paraoccupational and environmental asbestos exposures. We identified death data for 2430/4530 individuals. Exposure differed significantly according to race, gender, age, and recency of immigration to the U.S. Notably, there was a significant difference in the availability of year of death information for non-white vs. white individuals (odds ratio (OR) = 0.62 p-value < 0.001), females (OR = 0.53, p-value < 0.001), first-generation immigrants (OR = 0.67, p-value = 0.001), second-generation immigrants (OR = 0.31, p-value < 0.001) vs. non-immigrants, individuals aged less than 20 (OR = 0.31 p-value < 0.001) and individuals aged 20 to 59 (OR = 0.63, p-value < 0.001) vs. older individuals. Similarly, the cause of death was less often available for non-white individuals (OR = 0.42, p-value <0.001), first-generation immigrants and (OR = 0.71, p-value = 0.009), second-generation immigrants (OR = 0.49, p-value < 0.001), individuals aged less than 20 (OR = 0.028 p-value < 0.001), and individuals aged 20 to 59 (OR = 0.26, p-value < 0.001). These results identified ascertainment bias that is important to consider in analyses that investigate occupational, para-occupational and environmental asbestos exposure as risk factors for mortality in this historic cohort. While this study attempts to describe methods for assessing itemized asbestos exposure profiles for a community in 1930 using Ancestry.com and other publicly accessible databases, it also highlights how historic cohort studies likely underestimate the impact of asbestos exposure on vulnerable populations. Future work will aim to assess mortality patterns in this cohort. Full article
(This article belongs to the Special Issue Asbestos and Health)
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10 pages, 342 KiB  
Article
Validation of an Asbestos Exposure Questionnaire (QEAS-7) for Clinical Practice
by Jaume Ferrer, Galo Granados, Santos Hernández, María-Jesús Cruz, Júlia Sampol, Daniel Álvarez Simón and José-María Ramada
Int. J. Environ. Res. Public Health 2020, 17(24), 9167; https://doi.org/10.3390/ijerph17249167 - 8 Dec 2020
Cited by 3 | Viewed by 2504
Abstract
Introduction: The seven-item QEAS-7 questionnaire (exposure to asbestos questionnaire) has been designed as a useful and simple tool to establish the probability of exposure to asbestos. The objective of the present study is to validate the QEAS-7 following the recommended methodology. Methods: The [...] Read more.
Introduction: The seven-item QEAS-7 questionnaire (exposure to asbestos questionnaire) has been designed as a useful and simple tool to establish the probability of exposure to asbestos. The objective of the present study is to validate the QEAS-7 following the recommended methodology. Methods: The QEAS-7 was prospectively administered to 90 subjects with and without asbestos-related disease (ARD), on two consecutive occasions by two independent researchers. Logical and content validity was evaluated by a committee of experts and construct validity through hypothesis testing. Intra- and interobserver reliability was assessed by calculating Cohen’s Kappa index (κ), which was estimated as weak if below 0.40, moderate if between 0.41 and 0.60 and good/very good if above 0.60. The comparison between proportions was examined using Pearson’s Chi-square test. Results: The majority of participants (88.9%) were male. Mean age was 70.8 years (SD = 8.4) and most of the sample had completed primary education but had not progressed further (62.2%). Forty-three had ARD. The logical, content and construct validity of the QEAS-7 was considered adequate both by a committee of experts and by the users interviewed. The mean administration time was 9 min and 25 s (SD = 3 min and 49 s). The verification of the five hypotheses confirmed the construct validity and the intra- and interobserver reliability to be κ = 0.93 and κ = 0.50 respectively. The concordance in the estimation of asbestos exposure was κ = 0.65. Conclusions: The QEAS-7 is a simple, valid and reliable tool for estimating the probability of exposure to asbestos. Its application in clinical practice appears justified. What is already known about this subject? No studies have been published to date on the validation of specific questionnaires designed to determine asbestos exposure for routine use by healthcare staff in the clinical setting. What are the new findings? This questionnaire can be considered a comprehensible, viable, valid and reliable instrument for identifying exposure to asbestos. Its brevity and simplicity of administration make it ideally suited for use in daily clinical practice. How might this impact on policy or clinical practice in the foreseeable future? This questionnaire can be of help for physicians attending to patients with suspected asbestos-related diseases both in the hospital and in the primary care setting. Full article
(This article belongs to the Special Issue Asbestos and Health)
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13 pages, 1595 KiB  
Article
Burden of Mesothelioma Deaths by National Income Category: Current Status and Future Implications
by Odgerel Chimed-Ochir, Diana Arachi, Tim Driscoll, Ro-Ting Lin, Jukka Takala and Ken Takahashi
Int. J. Environ. Res. Public Health 2020, 17(18), 6900; https://doi.org/10.3390/ijerph17186900 - 21 Sep 2020
Cited by 22 | Viewed by 3345
Abstract
Background: This study compares estimates of the global-level mesothelioma burden with a focus on how existing national mortality data were utilized and further assesses the interrelationship of country-level mesothelioma burden and asbestos use with national income status. Methods: Country-level mesothelioma deaths in the [...] Read more.
Background: This study compares estimates of the global-level mesothelioma burden with a focus on how existing national mortality data were utilized and further assesses the interrelationship of country-level mesothelioma burden and asbestos use with national income status. Methods: Country-level mesothelioma deaths in the WHO Mortality Database as of December 2019 were analyzed by national income category of countries in terms of data availability and reliability. Numbers of mesothelioma deaths from the study of Odgerel et al. were reanalyzed to assess country-level mesothelioma death burdens by national income status. Results: Among 80 high-income countries, 54 (68%) reported mesothelioma to the WHO and 26 (32%) did not, and among 60 upper middle-income countries, the respective numbers (proportions) were 39 (65%) countries and 21 (35%) countries, respectively. In contrast, among 78 low- and lower middle-income countries, only 11 (14%) reported mesothelioma deaths while 67 (86%) did not. Of the mesothelioma deaths, 29,854 (78%) were attributed to high- and upper middle-income countries, and 8534 (22%) were attributed to low- and lower middle- income countries. Conclusions: The global mesothelioma burden, based on reported numbers, is currently shouldered predominantly by high-income countries; however, mesothelioma burdens will likely manifest soon in upper middle-income and eventually in low and lower middle-income countries. Full article
(This article belongs to the Special Issue Asbestos and Health)
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Review

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14 pages, 359 KiB  
Review
Asbestos in High-Risk Communities: Public Health Implications
by Edward A. Emmett
Int. J. Environ. Res. Public Health 2021, 18(4), 1579; https://doi.org/10.3390/ijerph18041579 - 7 Feb 2021
Cited by 14 | Viewed by 7761
Abstract
Asbestos-related diseases (ARDs)—mesothelioma, lung cancer, and asbestosis—are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, [...] Read more.
Asbestos-related diseases (ARDs)—mesothelioma, lung cancer, and asbestosis—are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended. Full article
(This article belongs to the Special Issue Asbestos and Health)
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