Journal of Thoracic Oncology 2017 April [Epub ahead of print] [Link]
Bian L, van Gerwen M, Bonassi S, Taioli E; IASLC Mesothelioma Taskforce
While the association between exposure to asbestos and malignant mesothelioma (MM), particularly malignant pleural mesothelioma (MPM) has been well established, the health impact of environmental exposure (EE) to asbestos is less studied. This review summarizes the most recent studies on the association between MM and EE to asbestos, in order to identify features associated with EE, and quantify the association with MPM. There were 44 studies from eighteen countries that met our selection criteria, with considerable amount of heterogeneity in study design, the measures for exposure, and health outcomes. The male to female ratio (M:F) was close to or less than 1, and generally lower than the ratio reported when both occupational and environmental exposure types were considered. While recent studies continue to improve our understanding of the types of EE to asbestos still present, challenges remain. We highlighted a few new research directions, such as a need for reliable matrixes to identify common and less recognized environmental exposure types, asbestos biomarker studies specifically focusing on environmental exposures, and research focused on populations and geographic areas that have not been previously studied.