Asbestos-related diseases of the lungs and pleura: uses, trends and management over the last century.
Saturday, March 31st, 2007.
The International Journal of Tuberculosis and Lung Disease. Volume 11, Number 4, April 2007 , pp. 356-369(14) [Link]
Becklake MR, Bagatin E, Neder JA.
Respiratory Epidemiology and Clinical Research Unit, Department of Epidemiology, Biostatistics and Occupational Health, Montreal Chest Institute, McGill University, 3650 Saint-Urbain Street, Montréal, Québec, Canada. margaret.becklake@mcgill.ca
Abstract
Asbestos is a descriptive term for a group of naturally occurring minerals known to mankind since ancient times. The main types of asbestos (chrysotile, and the amphiboles crocidolite and amosite) differ in chemical structure, biopersistence in human tissue and toxicity. Commercial exploitation, with little thought for environmental controls, increased over the twentieth century, particularly after World War II, to accommodate globalisation and the demands of the world’s burgeoning cities. As its ill-health effects, both non-malignant (fibrosis of the lungs or asbestosis; pleural effusion, plaques and thickening) and malignant (mesothelioma, lung and other cancers), became evident, public pressure rose to control its use. The last decades of the last century saw decreases in exposure and rates of asbestosis in industrialised and in some less-industrialised countries, where pleural plaques and malignant mesothelioma are currently the most frequent manifestations of asbestos exposure. Longer follow-up of asbestos-exposed cohorts in mining and manufacturing has also strengthened the evidence of a fibre gradient in toxicity, with chrysotile exhibiting lower toxicity than the amphiboles, and amosite lower toxicity than crocidolite. The last decades of the twentieth century saw stabilisation and/or declines in mesothelioma rates in several industrialised countries. In less-industrialised countries, data on disease are sparse, exposure generally high and rates may peak in the future. Management of asbestos-related disease in the workplace requires collaboration between workers and unions (responsible for monitoring workplace dust levels, to which they must have access) and companies (responsible for engineering controls), reinforced by appropriate government regulations and by community support.
Keywords: asbestos; diseases of the lung and pleura; trends in disease; industrialised and less-industrialised countries
Glossary
- pleura
- (pler-uh) the membrane around the lungs and lining of the chest cavity. (Pleural mesothelioma.)
- fibrosis
- formation of scar-like (fibrous) tissue. This can occur anywhere in the body.
- epidemiology
- (ep-uh-deem-ee-AHL-uh-gee) the study of diseases in populations by collecting and analyzing statistical data. In the field of cancer, epidemiologists look at how many people have cancer; who gets specific types of cancer; and what factors (such as environment, job hazards, family patterns, and personal habits, such as smoking and diet) play a part in the development of cancer.
- tissue
- a collection of cells, united to perform a particular function.
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
- pleural effusion
- an abnormal accumulation of fluid, usually caused by trauma or disease, in the pleural space.
