Asbestos Related Pleural Abnormalities And Mesotheloma Disease

One interesting study is called, Survival of asbestos insulation workers with mesothelioma. By J Ribak, I J Selikoff - Br J Ind Med 1992;49:732-735. Here is an excerpt: Abstract - Malignant mesothelioma is a lethal disease. It is rare in the general population; however, workers exposed to asbestos suffer significant burdens of the neoplasm. The survival time of 457 consecutive fatal cases of pleural and peritoneal mesothelioma that occurred among 17,800 asbestos insulation workers observed prospectively from 1 January 1967 to 1 January 1987 was studied. Mean survival time from initial presentation of the disease to death was 11.4 months for the pleural mesothelioma patients compared with 7.4 months for the peritoneal group. This difference was statistically significant. Mean survival time from diagnosis to death was shorter for both groups of patients: 8.4 months for pleural mesothelioma v 5.8 months for the peritoneal cases. In conclusion, survival time in mesothelioma patients is short; most die within a year from the onset of the initial symptoms. No effective therapy is yet available.

Another study is called, Computed tomography of asbestos-related pleural abnormalities by M. Tiitola, L. Kivisaari, A. Zitting, M. Huuskonen, S. Kaleva, A. Tossavainen and T. Vehmas - International Archives of Occupational and Environmental Health Volume 75, Number 4, 224-228. Here is an excerpt: Abstract - Objectives: To study the observer agreement in several asbestos-related pleural abnormalities and to define criteria to discriminate between pleural changes in workers with occupational disease, and those in controls. Methods: Pleural abnormalities in spiral computed tomography of 602 construction workers with asbestosis or bilateral pleural plaques and 49 controls were reviewed by three radiologists using structured forms. Results: Intra- and inter-observer agreement (weighted kappa) was 0.4 or better with regard to the calcification, extent and thickness of pleural disease. These factors all correlated positively with the duration of asbestos exposure. There were significant differences in these pleural changes between the workers (mean extent per side 83 cm2) and controls (mean extent per side 40 cm2). Of the controls, 84% showed pleural lesions with an estimated extent of 10 cm2 or more, bilateral in 64%. The extent of 45 cm2 in pleural disease was the best value for discriminating between the controls and diseased workers, with a sensitivity of 82% and a specificity of 66%. The degree of pleural calcification, however, was the best discriminator between these groups, but quantitative methods are necessary for its use in the diagnostics of individuals. Conclusions: The extent, calcification and thickness were well-repeatable indicators of benign pleural pathology and thus their use in future classification systems in computed tomography is recommended. In our material, the extent of 45 cm2 and the degree of calcification were helpful in discriminating between pleural changes in workers with occupational disease, and those in controls who also presented marked pleural pathology.

Another interesting study is called, A Statistical Evaluation of Asbestos Air Concentrations Indoor and Built Environment September 1999 vol. 8 no. 5 293-303 by John H. Lange - Envirosafe Training and Consultants, Pittsburgh, Pa., USA Here is an excerpt: Abstract - Both area and personal air samples collected during an asbestos abatement project were matched and statisti cally analysed. Among the many parameters studied were fibre concentrations and their variability. Mean values for area and personal samples were 0.005 and 0.024 f.cm -3 of air, respectively. Summary values for area and personal samples suggest that exposures are low with no single exposure value exceeding the current OSHA TWA value of 0.1 f.cm-3 of air. Within- and between-worker analysis suggests that these data are homogeneous. Comparison of within- and between- worker values suggests that the exposure source and variability for abatement are more related to the process than individual practices. This supports the importance of control measures for abatement. Study results also suggest that area and personal samples are not statisti cally related, that is, there is no association observed for these two sampling methods when data are analysed by correlation or regression analysis. Personal samples were statistically higher in concentration than area sam ples. Area sampling cannot be used as a surrogate expo sure index for asbestos abatement workers.

If you found any of these excerpts interesting, please read the studies in their entirety. We all owe a debt of gratitude to these fine researchers.

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