Asbestos Fibers and Other Elongate Mineral Particles: State of the ...

More documents

Recommendations

Info

Figure 4. Number of deaths due to malignant mesothelioma, U.S. residents aged ≥15 years, 1999– 2005. Source of data: NIOSH [2007b]. [Järvholm et al. 1999]. One analysis of malignant mesothelioma incidence based on the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program data found that an earlier steep increase in incidence had moderated and that mesothelioma incidence may have actually peaked sometime in the 1990s in SEER-covered areas [Weill et al. 2004]. In contrast to NORMS data, which represents a census of all deaths in the entire United States, the analyzed SEER data were from areas in which a total of only about 15% of the U.S. population resides. 2.5 Workers’ Home Contamination In addition to workers’ exposures, their families also have the potential for exposure to asbestos 14 [NIOSH 1995]. Families have been exposed to asbestos when workers were engaged in mining, shipbuilding, insulating, maintenance and repair of boilers and vehicles, and asbestos removal operations. Occupants of homes where asbestos workers live may be exposed while house cleaning and laundering; these activities can result in hazardous exposure for the person performing the tasks, as well as for others in the household. As the understanding of the effects of secondhand exposure to asbestos has increased, health effects among families of asbestos- exposed workers have been identified. Most documented cases of asbestos-related disease among workers’ family members have occurred in households where women were exposed during home laundering of contaminated work clothing. In addition, children have been exposed NIOSH CIB 62 • Asbestos
at home by playing in areas where asbestos- contaminated shoes and work clothes were located, or where asbestos-containing materials were stored [NIOSH 1995]. As a result of these exposures, family members have been found to be at increased risk of malignant mesothelioma, lung cancer, cancer of the gastrointestinal tract, asbestosis, and nonmalignant pleural abnormalities [NIOSH 1995]. Because of the long latency periods between exposure and manifestation of asbestos-related disease, identification and intervention are difficult. Home contamination may pose a serious public health problem; however, the extent to which these health effects occur is not fully known because there are no information systems to track them [NIOSH 1995]. 2.6 Clinical Issues A thorough review of how asbestos-related diseases are diagnosed is beyond the scope of this document, and authoritative guidance on the diagnosis and attribution of asbestos-caused diseases has been published elsewhere [Anonymous 1997; British Thoracic Society Standards of Care Committee 2001; Henderson et al. 2004; ATS 2004]. The diagnosis of asbestos-caused malignancies (e.g., lung cancer and malignant mesothelioma) is almost always based on characteristic histology (or abnormal cytology in some cases). Despite research on other possible etiologies, genetic susceptibilities, and hypothesized cofactors such as simian virus 40, it is generally accepted that most cases of malignant mesothelioma are caused by exposure to asbestos or other mineral (e.g., erionite) fibers [Robinson and Lake 2005; Carbone and Bedrossian 2006]. Of particular concern to patients diagnosed with malignant mesothelioma, as well as to individuals NIOSH CIB 62 • Asbestos who remain at risk due to past exposures, the disease currently is essentially incurable [British Thoracic Society Standards of Care Committee 2001]. Diagnosis may be relatively straightforward but can be difficult because of a challenging differential diagnosis [Lee et al. 2002]. Advances have been made to improve diagnostic testing for malignant mesothelioma with use of immunochemical markers and other more sophisticated histopathological analyses, and additional research is aimed at improving treatment of the disease [Robinson and Lake 2005]. Notable recent research efforts have been directed toward the development of biomarkers for mesothelioma that can be assessed by noninvasive means. A long-term goal of the biomarker research is to enable screening of high-risk individuals with sufficiently sensitive and specific noninvasive biomarkers to identify disease at an early stage, when therapeutic intervention might have a greater potential to slow the progression of the disease or be curative. Other goals are to use noninvasive biomarkers for monitoring the disease in patients treated for mesothelioma and for diagnosing the disease. Noninvasive biomarkers, including osteopontin and soluble mesothelin-related peptide, have been and continue to be evaluated, but none are considered ready for routine clinical application [Cullen 2005; Scherpereel and Lee 2007]. Nonmalignant asbestos-related diseases are diagnosed by considering three major necessary criteria: (1) evidence of structural change consistent with asbestos-caused effect (e.g., abnormality on chest image and/or tissue histology); (2) evidence of exposure to asbestos (e.g., history of occupational or environmental exposure with appropriate latency, and/ or higher than normal numbers of asbestos bodies identified in lung tissue, sputum, or bronchoalveolar lavage; and/or other concurrent marker of asbestos exposure, such as 15
Page 1 and 2: CURRENT INTELLIGENCE BULLETIN 62 As
Page 3 and 4: CURRENT INTELLIGENCE BULLETIN 62 As
Page 5 and 6: Foreword Asbestos has been a highly
Page 7 and 8: Executive Summary In the 1970s, NIO
Page 9 and 10: NIOSH recognizes that its 1990 desc
Page 11: of exposure to various types of EMP
Page 14 and 15: xii 2.9.3 Biopersistence and other
Page 16 and 17: xiv List of Figures Figure 1. U.S.
Page 18 and 19: xvi MAPK mitogen-activated protein
Page 20 and 21: xviii Brooke Mossman, PhD Universit
Page 22 and 23: controlled, even when exhaustive lo
Page 25 and 26: 2 Overview of Current Issues 2.1 Ba
Page 27 and 28: juxtaposition or matrixed together,
Page 29 and 30: A further source of confusion comes
Page 31 and 32: Figure 2. Asbestos: Annual geometri
Page 33: Figure 3. Number of asbestosis deat
Page 37 and 38: physician from an occupational and
Page 39 and 40: of airborne asbestos fibers was fir
Page 41 and 42: which the deposits have been report
Page 43 and 44: with the most pronounced excess of
Page 45 and 46: A limitation of the epidemiological
Page 47 and 48: CI = 1.8-6.7) was noted in the earl
Page 49 and 50: exposure to commercial asbestos, an
Page 51 and 52: of these populations should be purs
Page 53 and 54: affect only a small number of obser
Page 55 and 56: exposed to fibers considerably long
Page 57 and 58: the extent to which the material ha
Page 59 and 60: or statistical power to permit a co
Page 61 and 62: capillaries, whereas insoluble part
Page 63 and 64: mechanisms and increase the rate of
Page 65 and 66: can penetrate their interior to pro
Page 67 and 68: A review for the EPA by an internat
Page 69 and 70: 2.9.4.3.1 Reactive Oxygen Species A
Page 71 and 72: of different types of mineral parti
Page 73 and 74: secreted by mesothelial cells after
Page 75 and 76: direct oxidant production, exposure
Page 77 and 78: widths are greater for the prismati
Page 79 and 80: concluded that asbestos fibers
Page 81 and 82: crystal structure, and surface comp
Page 83 and 84: is calibrated appropriately for NIO
Page 85 and 86:
is made of an area larger than a si
Page 87:
data are needed to more fully asses
Page 90 and 91:
70 III. Develop improved sampling a
Page 92 and 93:
the current paradigm because their
Page 94 and 95:
on the development of disease endpo
Page 96 and 97:
esponse, and time-course data would
Page 98 and 99:
In the second phase of cellular res
Page 100 and 101:
80 • Investigate mechanisms of EM
Page 102 and 103:
Research is needed to produce infor
Page 104 and 105:
periods that characterize manifesta
Page 106 and 107:
children in tow, placing both sexes
Page 108 and 109:
88 • Develop, validate, and promo
Page 110 and 111:
elevant, then an exposure assessmen
Page 112 and 113:
ased on counts made by the current
Page 114 and 115:
established precedence in applying
Page 116 and 117:
the mechanisms by which asbestos fi
Page 119 and 120:
4 The Path Forward Developing an in
Page 121 and 122:
surveillance investigations. By hav
Page 123 and 124:
5 References Aadchi S, Yoshida S, K
Page 125 and 126:
Berman DW, Crump KS [2008b]. A meta
Page 127 and 128:
mineral fiber number and epidemiolo
Page 129 and 130:
the United States, 1968-81. J Natl
Page 131 and 132:
Greim HA [2004]. Research needs to
Page 133 and 134:
France: International Agency for Re
Page 135 and 136:
millers in New York State. Arch Env
Page 137 and 138:
Mandel J (mand0125@umn.edu) [2008].
Page 139 and 140:
gpo.gov/2008/pdf/E8-3828.pdf]. Date
Page 141 and 142:
Pneumoconioses to Digital Chest Rad
Page 143 and 144:
Potter RM [2000]. Method for determ
Page 145 and 146:
glass: pleural response in the rat
Page 147 and 148:
Vianna NJ, Maslowsky J, Robert S, S
Page 149:
Yano E, Wang Z, Wang X [2001]. Canc
Page 152 and 153:
efficiency, regardless of sampler o
Page 154 and 155:
Table 1. Definitions of general min
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 164 and 165:
Page 166 and 167:
Table 2. Definitions of specific mi
Page 168 and 169:
Page 170 and 171:
Page 172 and 173:
Page 174:
safer • healthier • people tm D
show all

Asbestos Fibers and Other Elongate Mineral Particles: State of the ...

Create successful ePaper yourself

Delete template?

Save as template?