tremolite and Lung-Neoplasms

Following a previously published (2012) evaluation of the potential health hazards related to the use of asbestos-containing drywall accessory products, additional information regarding asbestos exposures during the use of accessory products, as well as studies of chrysotile asbestos risk as a function of exposure, have been published in the peer-reviewed literature. The purpose of this analysis is to update the original evaluation with this new information. It was previously estimated that a professional drywaller performing joint compound-associated tasks could have a lifetime cumulative chrysotile exposure of 12-26 f/cc-year. Using conservative assumptions regarding airborne asbestos levels during different drywalling tasks, task duration, and job tenure, we found that a range of 4.3-36.3 f/cc-year is a plausible estimate of a career drywaller's cumulative asbestos exposure from historical joint compound use. The estimated range for bystander exposures would be below (sometimes significantly below) this range depending on the frequency and duration of work near drywallers. Further, the estimated drywaller and bystander total fiber exposures were well below a recently published "no-observed adverse effect level, best estimate" for predominately chrysotile exposures of 89-168 f/cc-year for lung cancer and 208-415 f/cc-year for mesothelioma. We also determined that, even if the chrysotile or possibly talc ingredients in the drywall products had contained asbestiform tremolite, the cumulative tremolite exposures would have been well below a recently published tremolite no-effect level of 0.5-2.6 f/cc-year. Based on our calculations, typical drywall work using asbestos-containing drywall accessory products is not expected to increase the risk of asbestos-related lung cancer or mesothelioma. These conclusions are consistent with the lack of epidemiological evidence that drywall work resulted in an increased incidence of asbestos-related disease in the drywall trades.

Topics: Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Construction Materials; Environmental Exposure; Humans; Lung Neoplasms; No-Observed-Adverse-Effect Level; Risk Assessment

The present review summarizes the results of several follow-up studies assessing an asbestos product manufacturing plant in Chongqing, China, and discusses three controversial issues related to the carcinogenicity of asbestos. The first issue is the amphibole hypothesis, which asserts that the carcinogenicity of asbestos is limited to amphiboles, such as crocidolite, but not serpentines, such as chrysotile. However, considering the possible multiple component of asbestos carcinogenicity in the presence of tobacco smoke or other carcinogens, chrysotile cannot be regarded as non-carcinogenic. Additionally, in a practical sense, it is not possible to assume "pure" chrysotile due to its ubiquitous contamination with tremolite, which is a type of amphibole. Thus, as the International Agency for Research on Cancer (IARC) assessed, all forms of asbestos including chrysotile should be regarded carcinogenic to humans (Group 1). The second issue is the chrysotile/tremolite paradox, which is a phenomenon involving predominant levels of tremolite in the lung tissues of individuals who worked in locations with negligible levels of tremolite due to the exclusive use of chrysotile. Four possible mechanisms to explain this paradox have been proposed but this phenomenon does not support the claim that amphibole is inert. The final issue discussed is the textile mystery, i.e., the higher incidence of cancer in asbestos textile plants compared to asbestos mines where the same asbestos was produced and the exposure levels were comparable. This phenomenon was first reported in North America followed by UK and then in the present observations from China. Previously, levels of fiber exposure were calculated using a universal converting coefficient to estimate the mass concentration versus fiber concentration. However, parallel measurements of fiber and mass concentrations in the workplace and exposed air indicated that there are wide variations in the fiber/mass ratio, which unjustifies the universal conversion. It is possible that contamination by airborne non-fibrous particles in mines with mass fiber conversion led to the overestimation of fiber concentrations and resulted in the textile mystery. Although the use and manufacturing of asbestos has been banned in Japan, more than 10 million tons of asbestos had been imported and the majority remains in existing buildings. Thus, efforts to control asbestos exposure should be continued.

Topics: Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Carcinogens; China; Follow-Up Studies; Humans; Lung Neoplasms; Manufacturing and Industrial Facilities; Mining; Occupational Diseases; Occupational Exposure; Textiles; Tobacco Smoking

This review analytically examines the published data for erionite-related malignant pleural mesothelioma (E-MPM) and any data to support a genetically predisposed mechanism to erionite fiber carcinogenesis. Adult patients of age ≥18 years with erionite-related pleural diseases and genetically predisposed mechanisms to erionite carcinogenesis were included, while exclusion criteria included asbestos- or tremolite-related pleural diseases. The search was limited to human studies though not limited to a specific timeframe. A total of 33 studies (31042 patients) including 22 retrospective studies, 6 prospective studies, and 5 case reports were reviewed. E-MPM developed in some subjects with high exposures to erionite, though not all. Chest CT was more reliable in detecting various pleural changes in E-MPM than chest X-ray, and pleural effusion was the most common finding in E-MPM cases, by both tests. Bronchoalveolar lavage remains a reliable and relatively less invasive technique. Chemotherapy with cisplatin and mitomycin can be administered either alone or following surgery. Erionite has been the culprit of numerous malignant mesothelioma cases in Europe and even in North America. Erionite has a higher degree of carcinogenicity with possible genetic transmission of erionite susceptibility in an autosomal dominant fashion. Therapeutic management for E-MPM remains very limited, and cure of the disease is extremely rare.

Topics: Adult; Asbestos; Asbestos, Amphibole; Environmental Exposure; Female; Humans; Lung Neoplasms; Male; Mesothelioma; Mesothelioma, Malignant; Middle Aged; Pleura; Pleural Effusion; Pleural Neoplasms; Prognosis; Prospective Studies; Retrospective Studies; Tomography, X-Ray Computed; Zeolites

Tremolite is a noncommercial form of amphibole mineral that is present in some chrysotile, talc, and vermiculite deposits. Inhalation of asbestiform tremolite is suspected to have caused or contributed to an increased incidence of mesothelioma in certain mining settings; however, very little is known about the magnitude of tremolite exposure that occurred at these locations, and even less is known regarding tremolite exposures that might have occurred during consumer use of chrysotile, talc, and vermiculite containing products. The purpose of this analysis is to evaluate the exposure-response relationship for tremolite asbestos and mesothelioma in high exposure settings (mining) and to develop estimates of tremolite asbestos exposure for various product use scenarios. Our interpretation of the tremolite asbestos exposure metrics reported for the Thetford chrysotile mines and the Libby vermiculite deposits suggests a lowest-observed-adverse-effect level (LOAEL) for mesothelioma of 35-73 f/cc-year. Using measured and estimated airborne tremolite asbestos concentrations for simulated and actual product use, we conservatively estimated the following cumulative tremolite asbestos exposures: career auto mechanic: 0.028 f/cc-year; non-occupational use of joint compound: 0.0006 f/cc-year; non-occupational use of vermiculite-containing gardening products: 0.034 f/cc-year; home-owner removal of Zonolite insulation: 0.0002 f/cc-year. While the estimated consumer tremolite exposures are far below the tremolite LOAELs derived herein, this analysis examines only a few of the hundreds of chrysotile- and talc-containing products.

Topics: Aluminum Silicates; Animals; Asbestos, Amphibole; Asbestos, Serpentine; Humans; Incidence; Lung Neoplasms; Mesothelioma; Occupational Diseases; Occupational Exposure; Risk Assessment; Talc; Toxicity Tests

It has been more than 40 years since occupational crocidolite exposure in South African miners was found to be associated with development of malignant mesothelial tumors 30 to 40 years later. Similar cases were not seen in the amosite and chrysotile miners. Since then, epidemiological and toxicological knowledge have increased enormously, but mortality continues to rise steeply (5% to 10% per year) in most industrialized countries. Even with widespread asbestos abatement efforts, this increase is likely to continue in Western Europe and the United State well into the next century, at least until 2020. Unregulated use of asbestos in less industrialized countries may cause the epidemic to continue throughout the next century in those regions. Asbestos abatement seems to be successful as evidenced by a decline in the proportion of patients with peritoneal tumors, which are the most common malignancies in heavily exposed individuals. Whereas in the 1960s peritoneal tumors comprised up to 30% of the total, in recent years the proportion has fallen to about 10%, This changing ratio could also be due to the steady increase in pleural tumors. The difficulty in formulating the connection as to the etiology of mesothelioma resulted from an unforeseeable difference in the carcinogenicity of various asbestos and mineral fiber types and was compounded by the very long latency of the disease. Unfortunately, the use of a single term, "asbestos," to describe at least five fibrous silicate minerals, each with unique physical, chemical, and biological properties and not infrequently and naturally admixed, severely hampered scientific investigation into the occupational health risks. The field became confused and filled with debate. At the heart of the fiber type controversy lies a fundamentally differing view of the importance of biopersistence of various asbestos fibers in carcinogenesis. This review will deal with the epidemiology of mesothelioma with particular attention to the studies that elucidate the impact of various asbestos fiber types on the etiology of the disease.

Topics: Asbestos; Asbestos, Amphibole; Asbestos, Crocidolite; Case-Control Studies; Cohort Studies; Global Health; Humans; Lung Neoplasms; Mesothelioma; Occupational Diseases; Occupational Exposure; Pleural Neoplasms

Primary malignant mesothelial tumours were recognized by pathologists before asbestiform minerals (chrysotile, crocidolite and amosite) were mined commercially. The discovery, 40 yrs ago, of a causal link with crocidolite and the wide-ranging epidemiological studies which followed are the subject of this review. Early case-control and descriptive surveys, supplemented by cohort studies in insulation workers and chrysotile miners, quickly demonstrated major occupational and geographical differences, with high risk in naval dockyard areas and in the heating trades. In the 1980s, reliable cohort surveys showed that in mining and in the manufacture of asbestos products the mesothelioma risk was much higher when exposure included crocidolite or amosite than chrysotile alone. However, qualitative and quantitative information on exposure was too often inadequate for this evidence to be conclusive. Well-controlled lung fibre analyses have reduced these deficiencies and demonstrated the probable implications of the greater biopersistence of amphibole fibres. Chrysotile for industrial use often contains low concentrations of fibrous tremolite, which may well explain the few cases of mesothelioma associated with this type of asbestos. Progress in this field has been much retarded by controversy, for which the 20 year gap between the availability of reliable estimates of risk for the mining of chrysotile and that for crocidolite or amosite may have been largely responsible.

Topics: Asbestos; Asbestos, Amosite; Asbestos, Amphibole; Asbestos, Crocidolite; Asbestos, Serpentine; Carcinogens; Case-Control Studies; Cohort Studies; Female; History, 20th Century; Humans; Lung Neoplasms; Male; Mesothelioma; Mineral Fibers; Mining; Occupational Diseases; Reproducibility of Results; Risk Factors

Although tremolite asbestos has been well characterized since 1916, appreciation of its role in disease induction is relatively recent. It has always been understood that the morphology of tremolite is complex, and part of the slowness in recognizing it as a hazard has been definitional in nature. Reduced to simple terms the questions are, when is tremolite "asbestos-like," when is it an innocuous amorphous particle, do these forms occur together, with what confidence can they be separated for regulatory purposes, and what is the spectrum of disease potential for varying exposure? A brake on regulation is partially due to a convergence of opinion of unlikely and unintentional allies: industries producing tremolite-containing materials and some epidemiologists resisting attribution of risk to tremolite on the grounds that its known effects--pleural plaques, asbestosis, lung cancer and mesothelioma--are principally due to chrysotile, which is often contaminated with fibrous tremolite. The latter group concentrate their skepticism on internal-dose biomarker studies associating lung tremolite content with mesothelioma (but not so clearly with lung cancer or asbestosis). They ignore the basic carcinogenic quality of fibrous tremolite, shown in both animal and epidemiological studies. Evidence from the Quebec chrysotile/tremolite mining districts suggests that very low concentrations of tremolite in ambient air can be translated into high concentrations in lung, even in those without occupational exposure. Disease incidence, especially for mesothelioma, seems also to be associated with tremolite air and lung content. The risk associated with tremolite has been demonstrated in Corsica, Cyprus, the United States, and Canada. Of particular importance is an apparent increase in the proportion of mesothelioma risk attributable to tremolite, since the fibers heretofore most responsible for that disease--commercial amphiboles--have been or are being severely regulated or completely eliminated in production and use. Further, amosite and crocidolite, while still a concern, form a small fraction of "asbestos-in-place": most of this material is chrysotile and we do not really know to what degree it is contaminated with tremolite. The available evidence suggests that bulk analysis or airborne fiber analysis will not answer this question, and perhaps only animal bioaccumulation assay is sufficient. Until we know more, it seems prudent for public health to avoid dispersing c

Topics: Animals; Asbestos, Amphibole; Carcinogens; Humans; Lung Neoplasms; Mesothelioma; Mining; Occupational Diseases; Particle Size; Silicic Acid

Topics: Aged; Asbestos; Asbestos, Amphibole; Humans; Lung Neoplasms; Mesothelioma; Middle Aged; Occupational Diseases; Silicic Acid; Silicon Dioxide; Talc

The question of whether chrysotile asbestos ever causes mesothelioma in man has become a major public and occupational health issue. Review of the literature suggests that only 53 acceptable cases of chrysotile-induced mesothelioma have ever been reported; of these, 41 cases have occurred in individuals exposed to chrysotile mine dust, all of it naturally contaminated with tremolite. Ten cases have occurred in secondary industry workers, but here the suspicion of amosite or crocidolite contamination is high. Analysis of lung asbestos content indicates that induction of mesothelioma by chrysotile requires, on average, as great a lung fiber burden as induction of asbestosis by chrysotile, whereas amphibole (amosite or crocidolite)-induced mesotheliomas appear at a several hundred-fold smaller lung burden. Tremolite alone has definitely produced mesothelioma in man, particularly when exposure has been to long, high aspect ratio, fibers. Analysis of tremolite:chrysotile fiber ratios in human lung suggests that some, but not all tremolite is removed in milling chrysotile ores. The low incidence of mesothelioma in secondary chrysotile users may reflect the small amount of tremolite left in the product. These observations indicate that although chrysotile asbestos can produce mesothelioma in man, the total number of such cases is small and the required doses extremely large. The data are consistent with the idea that mesotheliomas seen in chrysotile miners and some secondary industry workers are produced by the tremolite contained in the chrysotile ore, but that the short length and low aspect ratio of the tremolite make its carcinogenicity quite low. However, these data are very indirect, and a role for the chrysotile fiber itself is still possible.

Topics: Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Dose-Response Relationship, Drug; Humans; Lung Neoplasms; Mesothelioma; Mining; Occupational Diseases; Particle Size; Risk Factors; Silicic Acid; Silicon Dioxide; Textile Industry

Tissues obtained at autopsy or biopsy from 81 workers and 2 household persons, were chemically digested. The asbestos fibres recovered were characterized by analytical transmission electron microscopy. Among the 83 causes of death were 33 mesotheliomas, 35 lung cancers, 12 asbestosis and 3 from other cancers. Of the three major commercial asbestos fibre types, amosite was found to be the most prevalent fibre, occurring in approximately 76% of the cases, followed by chrysotile in approximately 60% and crocidolite in approximately 24%. Amosite and chrysotile were observed as the single commercial fibre in approximately 22 and approximately 17% of the cases respectively, whereas crocidolite and tremolite were found as the single fibre type in only approximately 2.5% of the cases. Among the fifteen cases where chrysotile and tremolite occurred together, the amount of chrysotile fibre always exceeded tremolite. However, tremolite was also found in ten additional cases where chrysotile was not detected. Amosite was present in four, amosite plus crocidolite in three, and crocidolite alone in one. Amosite was present in all of the insulation workers' lungs studied and was found in the highest concentration in this exposure category. The highest chrysotile concentration was found among workers in general trades. Although most prevalent in shipyard workers lungs, crocidolite concentration is not statistically different among the exposure groups studied. Although crocidolite was found in twenty cases, amosite accompanied it in eighteen of these. Eleven of the 20 cases were from shipyard workers. Of the 8 mesothelioma cases, 7 also contained amosite. Crocidolite alone only occurred in 1 of the 33 mesothelioma cases analysed. We concluded the following: crocidolite exposure occurred among USA insulators and a large percentage of other workers as well; insulation workers are primarily exposed to amosite; mixed fibre exposures are associated with more mesotheliomas than single fibre exposures; chrysotile only exposure is associated with approximately 12% of the mesothelioma cases studied; and if tremolite exposure is associated with chrysotile exposure, the chrysotile amount exceeds that for the associated tremolite.

Topics: Aged; Asbestos; Asbestos, Amosite; Asbestos, Amphibole; Asbestos, Crocidolite; Asbestos, Serpentine; Asbestosis; Autopsy; Biopsy; Female; Humans; Lung; Lung Neoplasms; Male; Microscopy, Electron; Middle Aged; Occupational Exposure; Organ Culture Techniques; United States

Asbestos lung content is regarded as the most reliable tool for causal attribution of malignant mesothelioma (MM) to previous asbestos exposures. However, there is a lack of studies on asbestos burden in lungs of MM patients in comparison with healthy individuals. This study aims to provide such a comparison, investigating, as well, differences in asbestos lung burden with sex and time trends.. Asbestos lung content has been assessed on formalin-fixed lung fragments using scanning electron microscopy coupled with energy dispersion spectroscopy (SEM-EDS) on individuals deceased from MM (cases) and healthy subjects without any lung disease who died from violent causes (controls) between 2005 and 2023.. Asbestos and asbestos bodies (ABs) were found, respectively, in 73.7% and 43.2% of cases and in 28 and 22% of controls; in MM cases the most represented asbestos types were crocidolite and amosite, whereas in controls it was tremolite-actinolite asbestos. The concentration of both asbestos fibers and ABs was statistically significantly higher in MM cases compared to controls. The mean asbestos fibers width was also significantly higher in cases than controls. Males and females with MM showed similar asbestos and ABs concentrations, but females had higher concentrations of chrysotile, and significantly lower fibers width compared to males. Time trends show that MM lung asbestos concentrations decreased starting in 2011.. The results suggest a correlation between asbestos burden in lungs and MM risk. The different concentration of chrysotile, as well as the different width of asbestos fibers in MM males and females might reflect a sex difference in response of the lung microenvironment to inhaled asbestos. Finally, this study provides the first pathological evidence of the effect of the ban of asbestos use, demonstrating a significant decrease of asbestos lung content after 2011.

Topics: Asbestos; Asbestos, Serpentine; Case-Control Studies; Female; Humans; Lung; Lung Neoplasms; Male; Mesothelioma; Mesothelioma, Malignant; Tumor Microenvironment

The onset of malignant mesothelioma (MM) is linked to exposure to asbestos fibers. Asbestos fibers are classified as serpentine (chrysotile) or amphibole, which includes the crocidolite, amosite, anthophyllite, tremolite, and actinolite types. Although few studies have been undertaken, anthophyllite has been shown to be associated with mesothelioma, and tremolite, a contaminant in talc and chrysotile, is a risk factor for carcinogenicity. Here, after characterizing the length and width of these fibers by scanning electron microscopy, we explored the cytotoxicity induced by tremolite and anthophyllite in cells from an immortalized human mesothelial cell line (MeT5A), murine macrophages (RAW264.7), and in a rat model. Tremolite and short anthophyllite fibers were phagocytosed and localized to vacuoles, whereas the long anthophyllite fibers were caught on the pseudopod of the MeT5A and Raw 264.7 cells, according to transmission electron microscopy. The results from a 2-day time-lapse study revealed that tremolite was engulfed and damaged the MeT5A and RAW264.7 cells, but anthophyllite was not cytotoxic to these cells. Intraperitoneal injection of tremolite in rats induced diffuse serosal thickening, whereas anthophyllite formed focal fibrosis and granulomas on peritoneal serosal surfaces. Furthermore, the loss of Cdkn2a/2b, which are the most frequently lost foci in human MM, were observed in 8 cases of rat MM (homozygous deletion [5/8] and loss of heterozygosity [3/8]) by array-based comparative genomic hybridization techniques. These results indicate that tremolite initiates mesothelial injury and persistently frustrates phagocytes, causing subsequent peritoneal fibrosis and MM. The possible mechanisms of carcinogenicity based on fiber diameter/length are discussed.

Topics: Animals; Asbestos; Asbestos, Amphibole; Asbestos, Crocidolite; Asbestos, Serpentine; Comparative Genomic Hybridization; Cyclin-Dependent Kinase Inhibitor p15; Cyclin-Dependent Kinase Inhibitor p16; Homozygote; Humans; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Rats; Risk Factors; Sequence Deletion

Asbestos is the primary known cause of malignant mesothelioma. Some cosmetic talc products have been shown to contain asbestos. Recently, repeated exposures to cosmetic talc have been implicated as a cause of mesothelioma.. Seventy-five individuals (64 females; 11 males) with malignant mesothelioma, whose only known exposure to asbestos was repeated exposures to cosmetic talcum powders, were reviewed in medical-legal consultation. Out of the 75 cases, 11 were examined for asbestiform fibers.. All subjects had pathologically confirmed malignant mesothelioma. The mean age at diagnosis was 61 ± 17 years. The mean latency from exposure to diagnosis was 50 ± 13 years. The mean exposure duration was 33 ± 16 years. Four mesotheliomas (5%) occurred in individuals working as barbers/cosmetologists, or in a family member who swept the barber shop. Twelve (16%) occurred in individuals less than 45 years old (10 females; 2 males). Forty-eight mesotheliomas were pleural (40 females; 8 males), 23 were peritoneal (21 females; 2 males). Two presented with concomitant pleural and peritoneal disease. There was one pericardial, and one testicular mesothelioma. The majority (51) were of the epithelioid histological subtype, followed by 13 biphasic, 8 sarcomatoid, 2 lymphohistiocytoid, and 1 poorly differentiated. Of the 11 individuals whose nontumorous tissues were analyzed for the presence of asbestiform fibers, all showed the presence of anthophyllite and/or tremolite asbestos.. Mesotheliomas can develop following exposures to cosmetic talcum powders. These appear to be attributable to the presence of anthophyllite and tremolite contaminants in cosmetic talcum powder.

Topics: Adult; Air Pollutants, Occupational; Asbestos, Amphibole; Barbering; Beauty Culture; Female; Humans; Lung Neoplasms; Male; Mesothelioma, Malignant; Middle Aged; Occupational Diseases; Occupational Exposure; Pleural Neoplasms; Talc; Time Factors

Worldwide studies have been published on the mortality of workers employed in asbestos-based materials for the production of clutches and brakes. However no one of these studies is related to Italian cases. Furthermore, not even surveys have been conducted in Italy to characterize the correlation between asbestos exposures and the possible occurring of asbestos-related disease. Our objectives are the following: i) to assess and quantify the asbestos exposure cases, ii) to describe the nature and the frequency of asbestos-related diseases among blue collar employees of an important factory producing brakes and clutches with chrysotile asbestos content from 1971 to 1993 and iii) to provide preliminary data on cumulative asbestos exposure estimated using lung fibre burden analysis. Critical appraisal of airborne asbestos fibre measurements and identification of cases of asbestos-related diseases between the blue collar employees, either notified to the local health authority or recovered from the Italian national Mesothelioma registry was investigated. Lung fibre burden analysis using the lung tissue samples from two deceased blue collar employees was also performed. Airborne asbestos fibre measurements (carried out in 1982) suggested asbestos fibres average concentrations of about 0.3 f/ml, while all 1992 measurements showed results below 0.1 f/ml. Furthermore, since 1988, we identified four cases of pleural plaques, three cases of asbestosis and seven cases of lung cancer. No case of malignant mesothelioma was found. In both lung cancer cases, analysed to measure the lung fibre burden, commercial amphiboles were absent or in limited concentration but chrysotile and, especially, tremolite asbestos were present in noticeable amount. In conclusion, since 1971 and up to early 1980s, exposure to chrysotile asbestos and talc, likely contaminated by tremolite, had been significant and comparable to levels causing asbestosis long-term risk. No case of malignant mesothelioma was found, that is consistent with the absence of amphiboles and with the lower risk of mesothelioma associated with the chrysotile asbestos. However a subset of the blue collar employees, the ones employed later on, could still have not reached the full risk condition, and so being still at risk of developing malignant mesothelioma. In the two lung cancer cases studied, the lung fibre burden was essentially made of chrysotile and tremolite. Lastly, lung cancer occurrence in the population of b. Nella letteratura scientifica sono presenti studi epidemiologici di mortalità su coorti di lavoratori addetti alla produzione di materiali di attrito in amianto ma non in Italia, dove neppure sono disponibili indagini conoscitive per caratterizzare l’esposizione ad amianto e la possibile presenza di patologie asbesto-correlate. Per questa ragione si è ricostruita la natura e l’entità dell’esposizione ad amianto, la frequenza e la tipologia delle patologie asbesto-correlate in lavoratori di una importante industria di materiali di attrito in asbesto crisotilo utilizzato dal 1971 al 1993; si sono inoltre forniti iniziali elementi per una stima dell’esposizione cumulativa ad asbesto dei lavoratori attraverso l’analisi del carico polmonare di fibre di amianto. Si è operata una valutazione dei monitoraggi ambientali e una rilevazione dei casi di patologie asbesto-correlate diagnosticati tra lavoratori della fabbrica, oltre all’analisi di campioni di tessuto polmonare di due lavoratori per la determinazione del carico residuo di fibre di amianto. Monitoraggi ambientali eseguiti nel 1982 indicavano concentrazioni medie di 0,3 fibre/cc e nel 1992 inferiori a 0,1 fibre/cc per tutti i campioni. Dal 1988 sono stati osservati 4 casi di placche pleuriche, 3 casi di asbestosi, 7 casi di tumore polmonare, nessun caso di mesotelioma maligno. In ambedue i casi di tumore polmonare con analisi delle fibre di amianto gli anfiboli erano assenti o con valori modesti mentre per il crisotilo e soprattutto per la tremolite le concentrazioni rilevate erano consistenti. In conclusione, dagli anni ’70 ai primi anni ’80 l’esposizione ad amianto crisotilo e a talco, in parte contaminati da tremolite, è risultata consistente e compatibile con casi di asbestosi. Non sono stati osservati casi di mesotelioma maligno. Non essendo stati usati anfiboli questo può essere dovuto al più basso rischio di mesotelioma associato al crisotilo, ma parte dei lavoratori assunti in anni successivi potrebbero non essere ancora a pieno rischio. Il carico polmonare di fibre nei due casi di tumore polmonare è essenzialmente dato dal crisotilo e dalla tremolite. La frequenza di tumori polmonari incidenti in questa coorte è verosimilmente sottostimata; il rischio di questa neoplasia dovrebbe essere valutato attraverso uno studio della mortalità della coorte.

Topics: Aged; Air Pollutants, Occupational; Asbestos, Amphibole; Asbestos, Serpentine; Asbestosis; Automobiles; Female; Friction; Humans; Italy; Lung; Lung Neoplasms; Male; Manufacturing Industry; Mesothelioma; Middle Aged; Mineral Fibers; Occupational Exposure; Preliminary Data; Talc; Time Factors

Human exposures to asbestiform elongate mineral particles (EMP) may lead to diffuse fibrosis, lung cancer, malignant mesothelioma and autoimmune diseases. Cleavage fragments (CF) are chemically identical to asbestiform varieties (or habits) of the parent mineral, but no consensus exists on whether to treat them as asbestos from toxicological and regulatory standpoints. Alveolar macrophages (AM) are the first responders to inhaled particulates, participating in clearance and activating other resident and recruited immunocompetent cells, impacting the long-term outcomes. In this study we address how EMP of asbestiform versus non-asbestiform habit affect AM responses. Max Planck Institute (MPI) cells, a non-transformed mouse line that has an AM phenotype and genotype, were treated with mass-, surface area- (s.a.), and particle number- (p.n.) equivalent concentrations of respirable asbestiform and non-asbestiform riebeckite/tremolite EMP for 24 h. Cytotoxicity, cytokines secretion and transcriptional changes were evaluated. At the equal mass, asbestiform EMP were more cytotoxic, however EMP of both habits induced similar LDH leakage and decrease in viability at s.a. and p.n. equivalent doses. DNA damage assessment and cell cycle analysis revealed differences in the modes of cell death between asbestos and respective CF. There was an increase in chemokines, but not pro-inflammatory cytokines after all EMP treatments. Principal component analysis of the cytokine secretion showed close clustering for the s.a. and p.n. equivalent treatments. There were mineral- and habit-specific patterns of gene expression dysregulation at s.a. equivalent doses. Our study reveals the critical nature of EMP morphometric parameters for exposure assessment and dosing approaches used in toxicity studies.

Topics: Air Pollutants, Occupational; Animals; Asbestos; Asbestos, Amphibole; Autoimmune Diseases; Bodily Secretions; Cells, Cultured; Cytokines; Lung Neoplasms; Macrophages, Alveolar; Mesothelioma, Malignant; Mice; Mice, Inbred C57BL; Mineral Fibers; Minerals; Occupational Exposure; Particle Size; Particulate Matter; Transcription, Genetic

Asbestos is well-recognized as the cause of a variety of disorders of the respiratory tract, including neoplastic as well as non-neoplastic conditions. Fiber dimensions and biopersistence are important determinants of the pathologic response, and analytical electron microscopy is a powerful technique for determining the fiber content of lung tissue samples. For decades our laboratory has examined lung tissue samples counting fibers measuring 5 µm or greater in length. More recent observations have indicated that fibers 10 µm or greater in length are pathogenic, and that a length of 10 µm and diameter less than 1.0 µm are useful features for distinguishing asbestiform fibers from cleavage fragments. We examined more than 570 fibers from more than 90 cases to determine the dimensions of fibers that might be classified as asbestos. The vast majority of fibers classified as amosite or crocidolite met the criteria for length greater than 10 µm and diameter less than 1.0 µm. However, a significant proportion of fibers classified as tremolite, actinolite, or anthophyllite did not meet these criteria. These findings have important implications for the identification and classification of elongated mineral particles, both in terms of pathogenicity as well as classification as asbestiform vs. cleavage fragments.

Topics: Asbestos; Asbestos, Amphibole; Humans; Lung; Lung Neoplasms; Minerals

The length distributions of single fibrils of Coalinga, UICC-B and wet dispersed chrysotile were measured by transmission electron microscopy (TEM). It was found that the distributions significantly diverged above approximately 10 μm (μm) in length, corresponding to differences in published results of animal experiments. This result is in contrast to published data in which counting of an insufficient number of fibers resulted in an erroneous conclusion that the length distribution of Coalinga chrysotile fibrils was indistinguishable from those of other sources of chrysotile. The size distributions of the respirable particle size fractions from acknowledged tremolite asbestos samples were found to be dominated by elongate particles longer than 5 μm that are within the dimensional range of non-asbestiform amphiboles. Prior studies have shown that these elongate particles obscure a correlation between a specific size range of particles and results of animal implantation studies that used tremolite of various morphologies. In the prior studies, a reference protocol was developed from four crushed non-asbestiform amphiboles to differentiate the size range of amphibole particles that correlates with the mesothelioma frequencies observed in the animal studies. In the work reported here, this correlation was tested with TEM analyses of amphiboles from Libby, MT, Sparta, NJ and Homestake mine, Lead, SD, which represent known environmental/occupational situations. Further TEM analyses of the tremolite samples used in the original animal implantation studies have also shown that the numbers of elongate tremolite particles with lengths ≤5 μm implanted into the animals are not correlated with the observed mesothelioma frequencies.

Topics: Animals; Asbestos, Amphibole; Asbestos, Serpentine; Humans; Lung Neoplasms; Mesothelioma; Mesothelioma, Malignant; Microscopy, Electron, Transmission; Mineral Fibers; Minerals; Occupational Exposure; Particle Size; Particulate Matter

The carcinogenicity of short tremolite fibers in human has not been cleared and has been argued hitherto. A lung cancer patient had worked at a gabbro quarry. Particles isolated from the excised lung parenchyma of the patient were measured for asbestos bodies (ABs) and asbestos fibers (AFs). The concentrations of ABs were 3964 AB/g dry lung, and AFs were 5.60 × 106 fibers/g dry lung (>5 um in length) and 22.5 × 106 fibers/g dry lung (>1 um in length). AFs were mostly tremolite fibers and under 7 um in length (mean length 4.0 um, standard deviation 2.8 um). Almost all fibers were <10 um in length and an aspect ratio (AR) of <20:1 and ≥3:1. The patient had never smoked. His wife, who had worked with him in the quarry, had died of pleural mesothelioma. This study strongly indicates that such short tremolite fibers will induce lung cancer and possibly mesothelioma in human.

Topics: Aged, 80 and over; Asbestos, Amphibole; Extraction and Processing Industry; Humans; Lung; Lung Neoplasms; Male; Occupational Diseases; Parenchymal Tissue; Particle Size

The objective of this study is to describe the morphology, molecular structure, and chemistry of amphibole fibers from lung samples from workers in the chrysotile mines at Asbestos and Thetford Mines, Quebec. A fibrous tremolite-actinolite contaminant in an asbestos ore sample from the deposit at Asbestos was used for comparison. Lattice imaging was performed using high-resolution transmission electron microscopy (HRTEM). Silica-rich amorphous coatings (SIRA) that may be related to carcinogenesis are noted on all of the HRTEM photographs of fibers retained in lung, but not on fiber surfaces of the bulk comparison sample. Fibers found in lung samples and in a bulk comparison sample are produced primarily by splitting of thicker crystals and, as such, might not be considered asbestos fibers on the basis of certain mineralogical criteria. Implications of SIRA coatings with respect to carcinogenesis are worthy of further study.

Topics: Air Pollutants, Occupational; Asbestos, Amphibole; Cohort Studies; Lung Neoplasms; Mesothelioma; Microscopy, Electron, Transmission; Miners; Occupational Diseases; Quebec

One of the most significant diseases related to environmental asbestos exposure is malignant mesothelioma (MM). Sivas province is located in the Central Anatolia where asbestos exposure is common. We aimed to study clinical, demographical and epidemiologic features of the patients with MM in Sivas, along with the history of asbestos exposure. In total, 219 patients with MM who were diagnosed in our hospital between 1993 and 2010 were retrospectively analyzed in terms of demographical and clinical features. Rock, soil and house plaster samples were taken from the habitats of those patients and were evaluated with optical microscopy and X-ray diffraction methods. The age of the patients ranged between 18 and 85 years. The male-to-female ratio was 1.4:1. Most of the patients confirmed an asbestos exposure history. The most frequent symptoms of the patients were chest pain (60 %) and dyspnea (50 %). The gap between the start of first symptoms and the diagnosis date was approximately 4 months in average. The plaster materials used in most of the houses were made up of mainly carbonate and silicate minerals and some chrysotile. Ophiolitic units contained fibrous minerals such as serpentine (clino + orthochrysotile) chiefly and pectolite, brucite, hydrotalcite and tremolite/actinolite in smaller amounts. MM is not primarily related to occupational asbestos exposure in our region, and hence, environmental asbestos exposure may be indicted. Yet, single or combined roles and/or interactions of other fibrous and non-fibrous minerals in the etiology of MM are not yet fully understood and remain to be investigated.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asbestos; Asbestos, Amphibole; Environmental Exposure; Female; Geology; Housing; Humans; Lung Neoplasms; Male; Mesothelioma; Mesothelioma, Malignant; Microscopy, Electron, Scanning; Middle Aged; Turkey; X-Ray Diffraction; Young Adult

Asbestos was abundantly used in industry during the last century. Currently, asbestos confers a heavy social burden due to an increasing number of patients with malignant mesothelioma (MM), which develops after a long incubation period. Many studies have been conducted on the effects of the asbestos types that were most commonly used for commercial applications. However, there are few studies describing the effects of the less common types, or minor asbestos. We performed a rat carcinogenesis study using Japanese tremolite and Afghan anthophyllite. Whereas more than 50% of tremolite fibers had a diameter of < 500 nm, only a small fraction of anthophyllite fibers had a diameter of < 500 nm. We intraperitoneally injected 1 or 10 mg of asbestos into F1 Fischer-344/Brown-Norway rats. In half of the animals, repeated intraperitoneal injections of nitrilotriacetate (NTA), an iron chelator to promote Fenton reaction, were performed to evaluate the potential involvement of iron overload. Tremolite induced MM with a high incidence (96% with 10 mg; 52% with 1 mg), and males were more susceptible than females. Histology was confirmed using immunohistochemistry, and most MMs were characterized as the sarcomatoid or biphasic subtype. Unexpectedly NTA showed an inhibitory effect in females. In contrast, anthophyllite induced no MM after an observation period of 550 days. The results suggest that the carcinogenicity of anthophyllite is weaker than formerly reported, whereas that of tremolite is as potent as major asbestos as compared with our previous data.

Topics: Animals; Asbestos, Amphibole; Carcinogenicity Tests; Cell Transformation, Neoplastic; Female; Lung Neoplasms; Male; Mesothelioma; Mesothelioma, Malignant; Nitrilotriacetic Acid; Particle Size; Rats; Rats, Inbred BN; Rats, Inbred F344; Risk Assessment; Risk Factors; Sex Factors; Time Factors

The health risks associated with exposure to non-asbestiform asbestos minerals, including nephrite, are unclear. In 1965 nephrite processing began in the town of Fengtian in Taiwan, and the majority of inhabitants were involved in the industry from 1970 until 1980. The objectives of this study were to examine lung cancer deaths and assess the carcinogenic effects of nephrite carving.. We studied mortality due to lung cancer (ICD-9 code 162 for cancers of the trachea, bronchus and lung) from 1979 to 2011. We calculated the standardised mortality ratio (SMR) for lung cancer using the age- and sex-specific cancer mortality rates in eastern Taiwan as the standard rates. Air samples, bulk samples and a surface sample were analysed.. Nephrite is a non-asbestiform asbestos mineral composed of microcrystalline tremolite. During nephrite processing, in personal air samples the average concentration of elongated mineral particles with the morphological characteristics of asbestos fibres was 1.4 f/cm(3), with rough grinding generating the highest concentrations (4.7 f/cm(3)). Transmission electron microscopy (TEM) confirmed that the air samples contained intact asbestiform tremolite fibres. The ambient air samples and the wipe sample indicated paraoccupational contamination. The crude mortality rates for lung cancer were higher in Fengtian than in Taiwan for all age groups and both genders. The SMR for lung cancer was 1.28 (95% CI 1.12 to 1.45).. Nephrite carving may increase the risk of lung cancer. Appropriate medical monitoring is warranted for workers who are exposed to similar materials.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asbestos, Amphibole; Carcinogens; Child; Female; Follow-Up Studies; Humans; Lung Neoplasms; Male; Middle Aged; Occupational Diseases; Risk Factors; Taiwan; Young Adult

In the 1960s and 1970s, well designed case-referent studies put beyond doubt that exposure to airborne asbestos fibres was a cause of malignant mesothelioma. Some 35 cohort mortality studies in a large variety of industries during the 20-year period, 1974-1994, showed a wide range of outcomes, but in general that the risk was higher in exposures which included amphiboles rather than chrysotile alone. Real progress began, however, with discoveries along several lines: the link between pleural changes and mineralogy, the concept and importance of biopersistence, the developments in counting and typing mineral fibres in lung tissue, and data on amphibole mining in South Africa and Australia for comparison with that on chrysotile in Canada and Italy. This led to the recognition of the potential contamination in North America of chrysotile with tremolite. A survey in Canada in 1980-1988 and other surveys demonstrated that crocidolite, amosite, and tremolite could explain almost all cases of mesothelioma. Effective confirmation of this was finally achieved with data on vermiculite miners in Libby, Montana, in the years 1983-1999, where exposure was to tremolite-actinolite and/or other amphibole fibres alone.

Topics: Air Pollutants, Occupational; Aluminum Silicates; Asbestos; Asbestos, Amphibole; Canada; Carcinogens; Case-Control Studies; Cohort Studies; Humans; Italy; Lung Neoplasms; Mesothelioma; Mineral Fibers; Mining; North America; Occupational Diseases; Occupational Exposure; Risk Factors; South Africa; United Kingdom; United States

Given the role of phosphoinositide-specific phospholipase C (PLC) isozymes in the control of cell growth and differentiation we were prompted to analyze the expression of some of these PLC in human bronchoalveolar carcinoma-derived alveolar epithelial A549 cells. The effects of several fluoro-edenite fibers were compared with those of tremolite, a member of the calcic amphibole group of asbestos that originates from Calabria (Italy), and crocidolite, that, due to its high toxicity, is one of the most studied asbestos amphiboles. Our data show an increased expression of both PLC beta1 and PLC gamma1 in A549 cells treated with asbestos-like fibers, hinting at a role of PLC signalling in those cancerous cells.

Topics: Adenocarcinoma, Bronchiolo-Alveolar; Asbestos, Amphibole; Asbestos, Crocidolite; Cell Line, Tumor; Enzyme Activation; Humans; Lung Neoplasms; Phosphatidylinositols; Phospholipase C beta; Phospholipase C delta; Second Messenger Systems

Topics: Administration, Oral; Animals; Asbestos, Amphibole; Carcinogenicity Tests; Carcinogens, Environmental; Cells, Cultured; Disease Models, Animal; Gastrointestinal Neoplasms; Humans; Inhalation Exposure; Lung Neoplasms; Mesothelioma; Mineral Fibers; Organ Culture Techniques; Risk Assessment

Vermiculite from the mine near Libby, Montana, is contaminated with tremolite asbestos and other amphibole fibers (winchite and richterite). Asbestos-contaminated Libby vermiculite was used in loose-fill attic insulation that remains in millions of homes in the United States, Canada, and other countries.. This report describes asbestos-related occupational respiratory disease mortality among workers who mined, milled, and processed the Libby vermiculite.. This historical cohort mortality study uses life table analysis methods to compare the age-adjusted mortality experience through 2001 of 1,672 Libby workers to that of white men in the U.S. population.. Libby workers were significantly more likely to die from asbestosis [standardized mortality ratio (SMR) = 165.8; 95% confidence interval (CI), 103.9-251.1], lung cancer (SMR = 1.7; 95% CI, 1.4-2.1), cancer of the pleura (SMR = 23.3; 95% CI, 6.3-59.5), and mesothelioma. Mortality from asbestosis and lung cancer increased with increasing duration and cumulative exposure to airborne tremolite asbestos and other amphibole fibers.. The observed dose-related increases in asbestosis and lung cancer mortality highlight the need for better understanding and control of exposures that may occur when homeowners or construction workers (including plumbers, cable installers, electricians, telephone repair personnel, and insulators) disturb loose-fill attic insulation made with asbestos-contaminated vermiculite from Libby, Montana.

Topics: Aged; Aluminum Silicates; Asbestos, Amphibole; Asbestosis; Cohort Studies; Humans; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Mining; Montana; Occupational Exposure; Pleural Neoplasms; Retrospective Studies

Lung tissue from 15 women who died from mesothelioma was evaluated for tissue burden of ferruginous bodies and uncoated asbestos fibers. The group contained individuals who had occupational exposure to asbestos and others had family members whose work history included vocations where contact with asbestos containing materials occurred.. Tissue samples from tumor free lung were digested and filtered and then investigated for ferruginous bodies by light microscopy and asbestos and non-asbestos fibers by analytical transmission electron microscopy (ATEM). Size and type of fibers were also analyzed.. Asbestos bodies were found in 13 of the 15 samples and asbestos fibers were found in all cases. The most commonly found uncoated asbestos fiber in these individuals was amosite whereas tremolite was the second most commonly found form. The asbestos fiber burden in these females was often of mixed types.. The asbestos body and fiber burden in these cases show variation in tissue burden. Some cases in this study had appreciable burden, which was attributed to secondhand exposure from occupationally exposed family members. Mesothelioma can occur also in individuals with comparatively low tissue burdens of asbestos.

Topics: Aged; Aged, 80 and over; Asbestos, Amosite; Asbestos, Amphibole; Asbestos, Crocidolite; Asbestosis; Body Burden; Environmental Exposure; Female; Humans; Lung; Lung Neoplasms; Mesothelioma; Microscopy, Electron; Middle Aged; Mineral Fibers; Occupational Exposure; Reproducibility of Results

To study the associations between occupational exposures and the risk of lung cancer in New Caledonia.. All cases diagnosed between January 1993 and December 1995 (228 lung cancers) and 305 population controls were included. Detailed information on lifetime job history, smoking, and other potential risk factors was collected by interview. Occupational exposures were assessed from the questionnaires by an industrial hygienist, without knowledge of case-control status.. No significant association was found with exposures related to nickel mining and refining, the main industrial activity in the territory. Among men, an excess risk of lung cancer was found for bus and truck drivers. Increased risks were also observed in men with the highest level of cumulative exposure to cleaning products and inorganic fertilisers. Exposure to field dust was associated with lung cancer risk in both sexes, and risk increased with cumulative exposure level. In some areas tremolite asbestos derived from local outcroppings was used as a whitewash. The association between exposure to field dust and lung cancer was limited to men and women exposed to this whitewash-that is, living in areas where the soil may contain tremolite.. This study shows several associations between occupational exposures and lung cancer. The findings suggest that exposure to tremolite fibres from cultivated fields may increase the risk of lung cancer in New Caledonia.

Topics: Adult; Aged; Asbestos, Amphibole; Case-Control Studies; Female; Humans; Lung Neoplasms; Male; Middle Aged; New Caledonia; Occupational Exposure; Odds Ratio; Risk Factors; Sex Factors

Topics: Asbestos, Amphibole; Humans; Lung Neoplasms; Mining; Risk; Time Factors

Mining and processing of amphibolite is associated with workers' exposure to dust containing asbestos minerals (actinolite, tremolite) and with the presence of respirable fibers, i.e. small particles above 5 microns long and below 3 microns in diameter (with length-to-diameter ratio higher than 3:1). Results of epidemiological and laboratory studies show that such dust may be responsible for the development of cancer in dust-exposed people. This work reports the measurement results of concentrations of total dust, respirable fibers and mineral composition of samples collected in plant mining and processing amphibolite rock. Based on the results, cumulated exposure was calculated for the 10-, 20- and 30-year exposure periods. The cumulated exposure was classified into two categories: 0.1-1.0 f/cm3 years and 1.0-10 f/cm3. x years. It has been found that mining and processing of amphibolite is associated with increased risk of death from mesothelioma--11.2 x 10(-5) (crushers--10 years of exposure) to 240.0 x 10(-5) (miners--30 years of exposure). The risk of excessive mortality from lung cancer was not high (below 1. x 10(-4)) for all workplaces and periods of exposure.

Topics: Adult; Asbestos, Amphibole; Carcinogens; Dust; Environmental Monitoring; Humans; Lung Neoplasms; Maximum Allowable Concentration; Mesothelioma; Mining; Occupational Exposure; Poland; Risk Assessment; Time Factors

The health effects of asbestos are intimately related to the fate of inhaled fibers in the lungs. The kinetics of asbestos fibers have been studied primarily in rodents. The objective of this study was to explore the application of these kinetic models to human autopsy data.. We analyzed the asbestos fiber content of the lungs of 72 Quebec chrysotile miners and millers and 49 control subjects using analytical transmission electron microscopy. Statistical methods included standard multivariate linear regression and locally weighted regression methods.. The lung burdens of asbestos bodies and chrysotile and tremolite fibers were correlated, as were the concentrations of short, medium, and long fibers of each asbestos variety. There were significant associations between the duration of occupational exposure and the burdens of chrysotile and tremolite. The concentration of chrysotile decreased with the time since last exposure but the concentration of tremolite did not. The clearance rate varied inversely with the length of chrysotile fibers. For fibers greater than 10 mu in length the clearance half-time was estimated to be 8 years.. The patterns in our data are compatible with both of the hypotheses suggested from rodent experiments; the existence of a long-term sequestration compartment and overload of clearance mechanisms in this compartment.

Topics: Aged; Aged, 80 and over; Asbestos, Amphibole; Asbestos, Serpentine; Asbestosis; Case-Control Studies; Humans; Lung Neoplasms; Male; Mesothelioma; Metabolic Clearance Rate; Microscopy, Electron; Middle Aged; Mineral Fibers; Mining; Multivariate Analysis; Regression Analysis

Recently published analyses have shown that the risks of mesothelioma and lung cancer in Quebec chrysotile miners and millers were related to estimated level of fibrous tremolite in the mines where they had worked. An analysis has therefore been made of radiographic changes in men who in 1965 were employed by companies in Thetford Mines where the same question could be examined for fibrogenicity. Of 294 men who met the necessary requirements, 129 had worked in six centrally located mines, where the tremolite content was thought to be high, 81 in 10 peripheral mines where it was thought to be low and 84 in both. The median prevalence of small parenchymal opacities (> or = 1/0) in chest radiographs read by six readers was higher among men ever than never employed in the central mines (13.6% against 7.4%), despite the fact that the mean cumulative exposure was lower in the former (430 mpcf.y vs 520 mpcf.y). After accounting by logistic regression for cigarette smoking, age, smoking-age interaction and cumulative exposure, the adjusted odds ratio for central mine employment was 2.44 (95% lower bound: 1.06). Together with other surveys of asbestos miners and millers, this study suggests that amphibole fibres, including tremolite, are more fibrogenic than chrysotile, perhaps to the same extent that they are carcinogenic, though the data available were not sufficient to address the latter question.

Topics: Aged; Asbestos, Amphibole; Asbestos, Serpentine; Cohort Studies; Humans; Lung; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Mining; Occupational Exposure; Occupational Health; Odds Ratio; Radiography, Thoracic; Risk Assessment

Using light and electron microscopy analysis, as well as electron diffraction, and energy-dispersive x-ray analysis, an aliquot of UICC chrysotile B was analyzed with special attention given to any tremolite contamination. Polarized light microscopy, with its limit of detection of approximately 1 micron when using dispersion staining, revealed chrysotile as the only fibrous asbestos component. Analytical electron microscopy at 333,000x of more than 20,000 consecutive fibers showed only the tubular morphology characteristic of chrysotile. These findings highlight that when this sample was used for exposure disease induced in animal models correlates with chrysotile-induced pathology, and does not support an explanation based on the "amphibole hypothesis." Thus, chrysotile should be considered as having the biologic ability to produce cancers, including mesotheliomas, based on the extensive use of this material as a standard reference material.

Topics: Asbestos, Amphibole; Asbestos, Serpentine; Carcinogens; Humans; Lung Neoplasms; Mesothelioma; Microscopy, Electron; Reference Values; Sensitivity and Specificity

Topics: Asbestos, Amphibole; Asbestos, Serpentine; Cohort Studies; Humans; Lung Neoplasms; Male; Mesothelioma; Mining; Occupational Diseases; Occupational Exposure; Quebec; Time Factors

Twenty cases of mesothelioma among miners of the township of Asbestos, Quebec, Canada, have been reported. To further explore the mineral characteristics of various fibrous material, we studied the fibrous inorganic content of postmortem lung tissues of 12 of 20 available cases. In each case, we measured concentrations of chrysotile, amosite, crocidolite, tremolite, talc-anthophyllite, and other fibrous minerals. The average diameter, length, and length-to-diameter ratio of each type of fiber were also calculated. For total fibers > 5 microns, we found > 1,000 asbestos fibers per mg tissue (f/mg) in all cases; tremolite was above 1,000 f/mg in 8 cases, chrysotile in 6 cases, crocidolite in 4 cases, and talc anthophyllite in 5 cases. Among cases with asbestos fibers, the tremolite count was highest in 7 cases, chrysotile in 3 cases, and crocidolite in 2 cases. The geometric mean concentrations of fibers > or = 5 microns were in the following decreasing order: tremolite > crocidolite > chrysotile > other fibers > talc-anthophyllite > amosite. For total fibers < 5 microns, we found > 1,000 fibers per mg tissue (f/mg) in all cases; tremolite was above 1,000 f/mg in 12 cases, chrysotile in 8 cases, crocidolite in 7 cases, and talc-anthophyllite in 6 cases. Tremolite was highest in 8 cases, chrysotile in 2 cases, and crocidolite and amosite in 2 cases. The geometric mean concentrations of fibers < 5 microns were in the following decreasing order: tremolite > other fibers > chrysotile > crocidolite > talc-anthophyllite > amosite. We conclude, on the basis of the lung burden analyses of 12 mesothelioma cases from the Asbestos township of Quebec, that the imported amphibole (crocidolite and amosite) were the dominant fibers retained in the lung tissue in 2/12 cases. In 10/12 cases, fibers from the mine site (chrysotile and tremolite) were found at highest counts; tremolite was clearly the highest in 6, chrysotile in 2, and 2 cases had about the same counts for tremolite and chrysotile. If a relation of fiber burden-causality of mesothelioma is accepted, mesothelioma would be likely caused by amphibole contamination of the plant in 2/12 cases and by the mineral fibers (tremolite and chrysotile) from the mine site in the 10 other cases.

Topics: Aged; Asbestos; Asbestos, Amosite; Asbestos, Amphibole; Asbestos, Crocidolite; Asbestos, Serpentine; Culture Techniques; Humans; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Mining; Occupational Diseases; Quebec; Textile Industry

Tremolite is nearly ubiquitous and represents the most common amphibole fiber in the lungs of urbanites. Tremolite asbestos is not mined or used commercially but is a frequent contaminant of chrysotile asbestos, vermiculite, and talc. Therefore, individuals exposed to these materials or to end-products containing these materials may be exposed to tremolite. We have had the opportunity to do asbestos body counts and mineral fiber analysis on pulmonary tissue from five mesothelioma cases and two asbestosis cases with pulmonary tremolite burdens greater than background levels. There were no uncoated amosite or crocidolite fibers detected in any of these cases. Three patients were occupationally exposed to chrysotile asbestos; two patients had environmental exposures (one to vermiculite and one to chrysotile and talc) and one was a household contact of a shipyard worker. The tremolite burdens for the asbestosis cases were one to two orders of magnitude greater than those for the mesothelioma cases. Our study confirms the relationship between tremolite exposure and the development of asbestos-associated diseases. Furthermore, the finding of relatively modest elevations of tremolite content in some of our mesothelioma cases suggests that, at least for some susceptible individuals, moderate exposures to tremolite-contaminated dust can produce malignant pleural mesothelioma.

Topics: Adult; Aged; Asbestos; Asbestos, Amphibole; Asbestosis; Environmental Exposure; Female; Humans; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Occupational Exposure

Chrysotile formation arises through serpentinization of ultramafics and silicified dolomitic limestones. Rock types tend to control the trace metal content and both the nature and amounts of admixed minerals in the ore, such as fibrous brucite (nemalite) and tremolite. Some associated minerals and trace metals are thought to play a role in biological potential. Tremolite, one of the important associated minerals, may occur with different morphological forms, called habits. These habits range from asbestiform (tremolite asbestos) to common blocky or non-fibrous form (tremolite cleavage fragments). The latter is most common in nature. Tremolite in chrysotile ore varies in habit and concentration, both factors determining the degree of risk following inhalation. Tremolite fibre is thought to be important in relation to the occurrence of mesothelioma. Chrysotile fibrils may vary in diameter. Dust clouds generated following manipulation vary in fibre number and surface area. Chrysotile fibres exhibit a range of physical characteristics. The fibre may be non-flexible ('stiff') and low in tensile strength ('brittle'), and may lack an ability to curl. This fibre, referred to as 'harsh', sheds water more quickly than its curly, flexible 'soft' variety. The behaviour of the harsh fibres is more amphibole-like and their splintery nature suggests an enhanced inhalation potential. Slip fibre ore from Canada tends to contain more fibrous brucite (nemalite) than cross-fibre ore in the same mine. Industrial manipulation, which includes chemical treatment, heating and milling, may impart new surface properties to chrysotile dusts. Biological potential may be enhanced (opening of fibre bundles) or reduced (disruption of surface bonds and lessened ability to interact with organic moieties). Leaching of magnesium from chrysotile occurs at a pH less than about 10. Chrysotile has been demonstrated to lose magnesium in vivo and undergo clearance from the lung. The biological potential of magnesium-depleted chrysotile is much reduced, or even eliminated. Reduction of mesothelioma-inducing and cytotoxic potential has been observed and quantified experimentally. Use of chrysotile products in high-temperature environments may heat the mineral to the point where it undergoes alteration of properties, especially by dehydroxylation. Chrysotile ore may vary in properties and associated minerals: it may form aerosols with different size distributions, especially fibre/fibril diameters a

Topics: Asbestos, Amphibole; Asbestos, Serpentine; Asbestosis; Humans; Lung Neoplasms; Mesothelioma; Pleural Neoplasms; Research; Surface Properties; Trace Elements

The linear, no-threshold model is commonly used for estimating lifetime lung cancer risk from asbestos exposures. Studies of chrysotile workers have observed shallow slopes for the exposure-response relationship for miners/millers, friction products manufacturing workers and asbestos-cement (primarily chrysotile) workers but a steeper slope (approximately 16 times higher) for textile workers. For chrysotile exposures in buildings, where short fibres constitute the great majority of the fibres, the shallow slope is judged more appropriate. Using this slope the data regarding exposure levels to building occupants and maintenance workers, the annualized risks of lung cancer would be approximately 0.01 and 0.6 per million for these groups, respectively. Using the higher slope would result in risks 16 times higher, still considerably lower than those commonly accepted. Contrary to the model's assumption of increased risk for any amount of exposure, a number of studies have demonstrated evidence that lung cancer risk is not associated with years exposed to low exposure levels. Moreover, the accumulating evidence that asbestos-induced lung cancer may require lung fibrosis suggests a practical threshold since detectable lung fibrosis will not result from environmental exposure levels. Evidence suggests that the relative risk to non-smokers bay be slightly higher than to smokers (by a factor of 1.8). However, if this is true, this has little effect on risk assessment due to the low absolute risk in non-smokers. Tremolite has been associated with an increased risk of lung cancer in a study of vermiculite miners; the slope of the exposure-response relationship was similar to that for crocidolite miners and much higher than that of chrysotile miners. In spite of a recent report indicating that asbestos-associated lung cancer risk may be limited only to adenocarcinomas, the bulk of the evidence fails to confirm this.

Topics: Adolescent; Adult; Age Factors; Asbestos, Amphibole; Asbestos, Serpentine; Child; Child, Preschool; Environmental Exposure; Humans; Industry; Linear Models; Lung Neoplasms; Mining; Occupational Exposure; Occupations; Risk Factors; Smoking; Textile Industry; Time Factors

Diagnosis of asbestosis and bronchiolo-alveolar carcinoma was made in a 55-year-old Turkish woman who was a nonsmoker. She originated from and was living in an area with a high prevalence of environmental diseases attributed to tremolite asbestos. Mineralogic analysis of lung tissue revealed very high concentrations of asbestos bodies (1.64 x 10(6)/g of dry tissue) and tremolite fibers (173.7 x 10(6) of dry tissue). This case illustrates the following points: (1) In some areas, environmental exposure can lead to cumulated fiber retention comparable to occupational exposure and thus can represent a risk for lung fibrosis (asbestosis). (2) Lung cancer as a complication of environmental asbestosis also should be considered as a potential environmental disease.

Topics: Adenocarcinoma, Bronchiolo-Alveolar; Asbestos, Amphibole; Asbestosis; Environmental Exposure; Female; Humans; Lung Neoplasms; Middle Aged

To examine how fiber type, fiber concentration, and fiber size correlate with the presence of asbestos-related disease in workers with heavy chrysotile exposure, we used analytic electron microscopy to determine the fiber content of the lungs of 94 long-term chrysotile miners and millers from the region of Thetford Mines, Quebec. Mesothelioma, airway fibrosis, and asbestosis were strongly associated with a high tremolite fiber concentration, whereas pleural plaques and carcinoma of the lung showed no relationship to tremolite burden. Similar patterns were seen for chrysotile concentration, but further analysis suggested that the apparent effect of chrysotile probably was due to the high correlation (r = 0.70) between chrysotile and tremolite concentration rather than to an independent effect of chrysotile. Increased tremolite-chrysotile ratio was marginally associated with the presence of pleural plaques but not with any other disease. Very high correlations (r > 0.90) between the concentrations of fibers longer or shorter than 8 microns prevented assessment of the effects of long compared with short fibers. Pleural plaques were very strongly associated with higher mean tremolite fiber aspect ratios, but no differences in mean fiber size (length, width, aspect ratio, surface area, and mass) were seen for any other disease. Total fiber size measures (total fiber length/g and others) showed differences similar to fiber concentration for mesothelioma, airways fibrosis, and asbestosis, but no one measure was clearly better than another or better than fiber concentration. We conclude that, in this population of heavily exposed chrysotile miners and millers, the presence of airways fibrosis and asbestosis and, probably, mesothelioma reflects high tremolite burden.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Asbestosis; Humans; Lung; Lung Neoplasms; Mesothelioma; Microscopy, Electron; Middle Aged; Mining; Particle Size; Pleural Diseases; Pulmonary Fibrosis; Quebec; Regression Analysis; Silicic Acid

Estimation of exposure-response relations from epidemiological data is complicated by the fact that exposures usually vary in intensity over time. Cumulative exposure indices, which do not separate the effects of intensity and duration, are commonly used to circumvent this problem. In this paper the estimation of relative risk for specific ranges of exposure intensity from such data is considered using existing statistical methods for fitting multivariate relative risk models. This has the advantage that it does not assume that exposure intensity and duration have equivalent effects on risk. It also throws light on the possible existence of a threshold. The procedure was applied to data from a cohort of 406 vermiculite miners to examine the lung cancer risk associated with exposure to fibrous tremolite, which contaminated the vermiculite. The pattern of exposure-response differed substantially from that obtained using a cumulative exposure index to assess risk.

Topics: Aluminum Silicates; Asbestos, Amphibole; Case-Control Studies; Humans; Lung Neoplasms; Male; Mining; Occupational Diseases; Occupational Exposure; Regression Analysis; Risk Factors; Silicic Acid; Time Factors

In an attempt to explain the much greater risk of respiratory cancer at the same cumulative exposure in asbestos textile workers in Charleston, South Carolina, than in Quebec miners and millers, both exposed to chrysotile from the same source, 161 lung tissue samples taken at necropsy from dead cohort members were analysed by transmission electron microscopy. Altogether 1828 chrysotile and 3270 tremolite fibres were identified; in both cohorts tremolite predominated and fibre dimensions were closely similar. Lung fibre concentrations were analysed statistically (a) in 32 paired subjects matched for duration of employment and time from last employment to death and (b) in 136 subjects stratified by the same time variables. Both analyses indicated that the Quebec/Charleston ratios for chrysotile fibre concentration in lung tissue were even higher than the corresponding ratios of estimated exposure intensity (mpcf). After allowance for the fact that regression analyses suggested that the proportion of tremolite in dust was probably 2.5 times higher in Thetford Mines, Quebec, than in Charleston, the results from both matched pair and stratification analyses of tremolite fibre concentrations in lung were almost the same as for chrysotile. It is concluded that neither fibre dimensional differences nor errors in estimation of exposure can explain the higher risks of lung cancer observed in asbestos textile workers. The possible co-carcinogenic role of mineral oil used in the past in asbestos textile plants to control dust provides an alternative hypothesis deserving consideration.

Topics: Adult; Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Humans; Lung; Lung Neoplasms; Male; Microscopy, Electron; Mining; Occupational Diseases; Quebec; Silicic Acid; South Carolina; Textile Industry

A small cohort of 194 men with low exposure to fibrous tremolite (mean 0.75 f/ml y) in the mining and milling of vermiculite in South Carolina experienced 51 deaths 15 years or more from first employment. The SMR (all causes) was 1.17 reflecting excess deaths from circulatory disease. There were four deaths from lung cancer and 3.31 expected (SMR 1.21, 95% CI 0.33-3.09). Three of the four deaths were in the lowest exposure category (less than 1 f/ml y); no death was attributed to mesothelioma or pneumoconiosis. These findings contrast with those in Montana where the vermiculite ore was heavily contaminated with fibrous tremolite. A radiographic survey of 86 current and recent South Carolina employees found four with small parenchymal opacities (greater than or equal to 1/0) and seven with pleural thickening. These proportions were not higher than in a non-exposed group and much lower than had been observed in Montana. Examination of sputum from 76 current employees showed that only two specimens contained typical ferruginous bodies, confirming low cumulative fibre exposure. Any possible adverse effects of work with vermiculite, minimally contaminated with fibrous or non-fibrous tremolite, were thus beyond the limits of detection in this workforce.

Topics: Aluminum Silicates; Asbestos, Amphibole; Canada; Cohort Studies; Humans; Lung Neoplasms; Mesothelioma; Mining; Occupational Diseases; Pulmonary Fibrosis; Silicic Acid; Silicon Dioxide

Topics: Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Humans; Lung Neoplasms; Mesothelioma; Occupational Diseases; Silicic Acid

There is a chrysotile mine in the central mountains of Cyprus but no other appreciable source of industrial asbestos. Hence the island was thought to offer ideal conditions to seek pure chrysotile induced mesothelioma. The first reported case was a village woman whose lung tissue contained amphibole asbestos fibres, which were later identified as tremolite. This began a search for the origin of her exposure to asbestos. Our studies have shown that tremolite is widespread, being found, along with chrysotile, in domestic and environmental dust samples. Other cases of mesothelioma have been diagnosed, and the pattern of their distribution suggests that the mine is not the major source of disease. Exposure to tremolite is equally, if not more, important.

Topics: Aged; Asbestos, Amphibole; Cyprus; Dust; Female; Humans; Lung; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Silicic Acid; Silicon Dioxide

The vermiculite ore and concentrate of a mine and mill located near Libby, Montana was found to be contaminated with a fiber of the tremolite/acetinolite series. A study was conducted to estimate the exposure-response relationship for mortality for 575 men who had been hired prior to 1970 and employed at least 1 year at the Montana site. Individual cumulative fiber exposure (fiber-years) was calculated. Results indicated that mortality from nonmalignant respiratory disease (NMRD) and lung cancer was significantly increased compared to the U.S. white male population. For those workers more than 20 years since hire, the standard mortality rate (SMR) for lung cancer (ICDA 162-163) was 84.7, 225.1, 109.3, and 671.3 for less than 50, 50-99, 100-399, and more than 399 fiber-years respectively. Corresponding results for NMRD (ICDA 460-519) were 327.8, 283.5, 0, and 278.4. Based on a linear model for greater than 20 years since hire, the estimated percentage increase in lung cancer mortality risk was 0.6% for each fiber-year of exposure. At 5 fiber-years, the estimated percentage was 2.9% from an unrestricted (nonthreshold) linear model and 0.6% from a survival model.

Topics: Aluminum Silicates; Asbestos, Amphibole; Humans; Lung Neoplasms; Male; Mesothelioma; Minerals; Mining; Montana; Occupational Diseases; Silicon Dioxide; Smoking; Time Factors

Samples of commercially used asbestos, especially chrysotile, are frequently contaminated by small amounts of other fibrous minerals. Among these are tremolite and brucite although pure tremolite is also produced commercially in relatively small quantities. In order to determine how harmful commercially exploited tremolite might be in comparison with other asbestos types and to explore the possibility that small amounts of tremolite and brucite as contaminants could significantly affect the pathogenicity of industrially used chrysotile, long-term animal inhalation and injection studies using rats were undertaken with what were considered to be mineralogically pure samples of these minerals. Rats treated with tremolite developed very high levels of pulmonary fibrosis as well as 16 carcinomas and two mesotheliomas in a group of 39 animals. Tremolite thus proved to be the most dangerous mineral that we have studied. Animals treated with 'brucite' developed moderate levels of pulmonary fibrosis and two carcinomas. Both tremolite and brucite produced mesotheliomas in greater than 90% of animals following i.p. injection. However, it was found that the supposedly pure brucite in fact contained 10% chrysotile, a level of contamination that could well have been responsible for the pathological changes found in both inhalation and intraperitoneal injection studies. The greatest care should be exercised by industry in handling tremolite or materials contaminated with it.

Topics: Air Pollutants, Occupational; Animals; Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Body Burden; Dust; Injections, Intraperitoneal; Lung; Lung Neoplasms; Magnesium; Magnesium Hydroxide; Male; Microscopy, Electron, Scanning; Rats; Rats, Inbred Strains; Silicic Acid; Silicon Dioxide

The role of chrysotile asbestos in the genesis of mesotheliomas in humans is disputed. We analyzed the asbestos content of the lung in 6 long-term chrysotile miners and millers who had pleural mesotheliomas. In five patients, only chrysotile ore components (chrysotile and tremolite/actinolite/anthophyllite types of amphibole asbestos) were found, while the sixth patient presented both chrysotile ore components and amosite, a type of asbestos that is not derived from the mining process. The mean number of fibers/g dry lung for the 5 patients with mesothelioma containing only chrysotile ore components was higher (chrysotile 64 X 10(6) and tremolite group 540 X 10(6] than in a group of long-term chrysotile miner control subjects who had no asbestos-related disease (chrysotile 23 X 10(6), tremolite group 58 X 10(6], but some patients with mesothelioma had fiber burdens near the mean of the control range. Fiber sizes and aspect ratios in the mesothelioma group were approximately the same as those in the control subjects, and analysis of fiber distribution failed to show any preferential localization in the periphery of the lung. However, the concentration ratio of tremolite in the lungs of the mesothelioma cases compared to the control cases was 9.3, while the ratio of chrysotile was only 2.8. Our findings provide strong evidence that chrysotile mine dust (chrysotile and amphibole components) can produce mesotheliomas in humans; the greater relative amounts of tremolite group amphiboles present in the patients with mesothelioma raise the possibility that these fibers may be important in the pathogenesis of the tumors.

Topics: Aged; Asbestos; Asbestos, Amphibole; Asbestos, Serpentine; Humans; Lung; Lung Neoplasms; Male; Mesothelioma; Middle Aged; Minerals; Occupational Diseases

Tremolite is an amphibole which has been implicated in a variety of disease patterns in different parts of the world. It occurs in a number of phases, which are chemically identical but have specific physical characteristics. In an attempt to clarify the epidemiological findings, tremolite fibres of 3 specific forms--A, B and C--were characterized and studied for biological activity by: (i) in vivo intrapleural injection of rats (2 separate experiments--1 with poor survival). (ii) in vitro enzyme release from mouse peritoneal macrophages (iii) in vitro giant-cell formation in A549 cultures (iv) in vitro cytotoxicity for V79-4 cells. Sample C, which contained more long thin fibres than A and B, was alone in producing mesotheliomas. C, but not A or B, induced LDH and B-glucuronidase enzyme release, and induced giant cells. A was not cytotoxic, B moderately cytotoxic and C as highly cytotoxic as UICC crocidolite. The in vivo studies were marred by being split between 2 experiments, of which the second had poor survival. We are aware of the weakness of our in vivo data, but as Tremolite C was being considered for commercial use on the European market we felt it timely to submit our findings for publication.

Topics: Animals; Asbestos, Amphibole; Cell Line; Cricetinae; Cricetulus; Dust; Female; Humans; Lung Neoplasms; Macrophages; Male; Mesothelioma; Mice; Mutagenicity Tests; Neoplasms, Experimental; Particle Size; Rats; Rats, Inbred Strains; Silicic Acid; Silicon Dioxide