in RUSSIA - Chrysotile
in RUSSIA - Chrysotile
in RUSSIA - Chrysotile
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MESOTELIOMA and CHRYSOTILE<strong>in</strong> <strong>RUSSIA</strong>Kashansky S.V., Gr<strong>in</strong>berg L.M., Kuzm<strong>in</strong> S.V.,Berdnikov R.B., Berz<strong>in</strong> S.A.Ekater<strong>in</strong>burg Medical Research Center for Prophylaxis and HealthProtection <strong>in</strong> Industrial WorkersUral State Medical AcademySverdlovsk Regional Pulmonological CenterUral Scientific-Research Institute of PhthisiopulmonologyEkater<strong>in</strong>burgRussiaInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Mesothelioma <strong>in</strong>cidence <strong>in</strong> 1990s(casesper million a year) [Bianchi C., 2004; Indulski J. et al,1997; Takahashi K. et al, 1999; Tossava<strong>in</strong>en A., 2004]Ukra<strong>in</strong>eTunisiaMoroccoSloveniaIsraelLithuaniaLatviaEstoniaSlovakiaPolandJapanRomaniaHungaryGreeceCroatiaDenmarkUSANorwaySwedenGermanyFranceF<strong>in</strong>landNewZealanItalyBelgiumNetherlandsGreatAustralian0,20,60,72,633,23,23,43,7455,97,79,610131414151517181819293033350 5 10 15 20 25 30 35International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
MESOTHELIOMA <strong>in</strong> <strong>RUSSIA</strong>True <strong>in</strong>cidence rates of mesothelioma <strong>in</strong>Russia are UNKNOWN [BianchiC. et al, , 2000].International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
MESOTHELIOMA <strong>in</strong> <strong>RUSSIA</strong>An extensive use of asbestos <strong>in</strong> Russiapresupposes high mesothelioma<strong>in</strong>cidence and mortality rates [LaDouThe author believes that low ratesof mesothelioma <strong>in</strong>cidence andprevalence <strong>in</strong> Russia and many othercountries of the world can be expla<strong>in</strong>edonly by concealment of factual data.LaDou J., 2004].International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
MESOTHELIOMA <strong>in</strong> <strong>RUSSIA</strong>?. Tossava<strong>in</strong>en (F<strong>in</strong>land) expla<strong>in</strong>s this bysay<strong>in</strong>g that “… only chrysotile asbestoshas been used <strong>in</strong> Russia, and the lifeexpectancy of the population is not longenough for mesothelioma to develop…”[Tossava<strong>in</strong>en? ., 2005].International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
RESEARCHTEAMKashansky S.V., ., Kuzm<strong>in</strong> S.V.Ekater<strong>in</strong>burg Medical Research Center for Prophylaxis and HealthProtection <strong>in</strong> Industrial WorkersGr<strong>in</strong>berg L.M.Ural State Medical Academy, Sverdlovsk Regional Pulmonological CenterBerz<strong>in</strong> S.A.Ural State Medical AcademyBerdnikov R.B.Ural Scientific-Research Institute of PhthisiopulmonologyInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
MAIN DIRECTIOMSof RESEARCHüStudy<strong>in</strong>gstate-ofof-the-artissue of“Mesothelioma <strong>in</strong> Russia”;üDeterm<strong>in</strong><strong>in</strong>gcl<strong>in</strong>ical and epidemiologiccharacteristics of mesothelioma <strong>in</strong> theSverdlovsk Region.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
STUDYING“MESOTHELIOMA <strong>in</strong> <strong>RUSSIA</strong>”Primary data:üInRussian statistical formsmesothelioma of the pleura and othersites are NOT ALLOCATED to a separategroup.üThereis NOT A SINGLE officialmesothelioma register <strong>in</strong> Russia.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
STUDYING“MESOTHELIOMA <strong>in</strong> <strong>RUSSIA</strong>”By 2005 Russian-speak<strong>in</strong>gspeak<strong>in</strong>g scientistshave published 806 works conta<strong>in</strong><strong>in</strong>g<strong>in</strong>formation about 3,259 mesotheliomacases diagnosed <strong>in</strong> Russia for the periodof 133 years (1871-2004).International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
TOTAL NUMBERof MESOTHELIOMA CASES <strong>in</strong>RussiaSexPleuraPeritoneumPericardiumTestisOtherN.A.TotalM1,03311775123-1,240F79818460-1-1,043N.A.Total8972,7285735821156-12-4119763,259N.A. - data not availableInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Mesotheliomas <strong>in</strong> different areas of theRussian Empire, , USSR and RussiaInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Ukra<strong>in</strong>e0,2Byelorussia0,6Kuybishev Region1,8Perm Region1,9Lithuania3,2Latvia3,2Estonia3,4Republic of Karelia3,80 0,5 1 1,5 2 2,5 3 3,5 4Mesotheliomaepidemiology <strong>in</strong> regions ofthe USSR and Russia (casesper million a year)International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
100001401000100101Asbestos prodused, thousand tonsAsbestos prodused, thousand tonsAbsolute number of casesAbsolute number of cases12010080600,1400,01200,0010Year 1880 1890 1900 19101920 1930 1940 1950 1960 1970 1980 1990 2000Asbestos produced and number ofmesotheliomas <strong>in</strong> the Russia (1871-2005)International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
LOCAL <strong>in</strong> TOWNSüAsbestüEkater<strong>in</strong>burgAsbest [Kogan F.M. et al, 1986],Ekater<strong>in</strong>burg [Kashansky S.V. et al, 2003].REGIONALüRepublicof KareliaüSverdlovskRegion (pilot1996].Karelia[RomanchukI.Yu., 1999],pilot) [FedosenkoN.E.,International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Sverdlovsk Region on the map of RussiaInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Ma<strong>in</strong> asbestos deposits and asbestosenterprises <strong>in</strong> the Sverdlovsk RegionInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
CONVENTIONAL SINGNSInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Ma<strong>in</strong> asbestos deposits and asbestosenterprises <strong>in</strong> the Sverdlovsk RegionInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
URALASBESTEnterpriseOpenedClosedProductivity,thousand tonsM<strong>in</strong>e1885operat<strong>in</strong>g34,000, of oreOktyabrskayamill1896195620Mill # 11924195570Mill # 219301980260Mill # 319361977320Mill # 41956operat<strong>in</strong>g260Mill # 519551994325Mill # 61969operat<strong>in</strong>g550International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
REASONS for EXCLUDING from theANALYSIS PATIENTS with the INITIALDIAGNOSIS of MESOTHELIOMAReasons for exclusionCancer of other sitesNonneoplastic pleurisyTuberculous pleurisyChronic pancreatitisNeither life-timenor postmortem morphologicverification has been doneMedical records and <strong>in</strong>itial morphologic assays havebeen lostResidents of other regionsTotalAbs.43111114283101International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
TUMORS – REASONS for EXCLUDINGfrom the ANALYSIS PATIENTS with theINITIAL DIAGNOSIS of MESOTHELIOMAReasonsLung cancer(ofdifferent sites, , histologic types, <strong>in</strong>vasionand metastasis <strong>in</strong> the pleura)Metastasis of uterus cancerMetastasis of bra<strong>in</strong> cancerMetastasis of liver cancerMetastasis of ovarian carc<strong>in</strong>omaMetastasis of prostate adenomaPleural angiofibromaMetastasis of unspecified primary sourceTotalAbs.24641111543%55.814.09.32.32.32.32.311.7100International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
AGE and SEX DISTRIBUTIONof MESOTHELIOMA CASES2019,216MenWomen1615,21210,410,4 10,487,243,23,23,21,600< 29 30-39 40-49 50-59 60-69 > 70International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
SOME GENERAL MESOTHELIOMAINCIDENCE RATES <strong>in</strong> theSVERDLOVSK REGIONIndices1986-901981-851991-951996-002001-04TotalAbsolute2039252120125Incidence rate per million ayear0.881.671.040.971.111.11Percent of mesothelioma cases<strong>in</strong> the general structure ofcancer <strong>in</strong>cidence, , %0.0360.0630.0390.0320.0360.041Percent of pleuralmesothelioma cases <strong>in</strong> thestructure of regional <strong>in</strong>cidenceof respiratory cancer, , %0.190.310.210.190.250.23International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Mesothelioma <strong>in</strong>cidence <strong>in</strong> the SverdlovskRegion, cases per million a yearInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
DYNAMICS of MESOTHELIOMAINCIDENCE <strong>in</strong> the SVERDLOVSKREGION1,81,51,20,90,61981-85 1986-90 1991-95 1996-00 2001-04International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
WORKPLACES of PATIENTSwith OCCUPATIONAL ASBESTOSEXPOSUREEnterprises“Uralasbest” JSC, , <strong>in</strong>clud<strong>in</strong>g:üm<strong>in</strong>ersümillers“UralATI” JSCAnatolyevsky m<strong>in</strong>e and millMotor transportShabrovsky talc plantTotalAbs.734133115%46.620.026.66.720.020.06.7100.0International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Indices for occupationally exposedmalignant mesothelioma cases byasbestos type, mean (range)Index, yearsMean age, diagnosisMean age, first contactMean length of serviceLatency periodTotal dust load, gram<strong>Chrysotile</strong>63.0±2.5(55-75)22.3±1.4(18-27)25.8±4.5(10.5-45)36.6±5.2(13-57)609.0±114.2(292.7-1062.6)Amphibole48.3±3.73.7(41-53)19.3±0.3(19-20)10.2±4.0(5-18)26.7±4.2(22-35)205.4±87.1(72.6-369.4)Statisticallysignificantdifferences?
Asbestos enterprises and mesothelioma<strong>in</strong>cidence <strong>in</strong> the Sverdlovsk RegionInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Asbestos enterprises and mesothelioma<strong>in</strong>cidence <strong>in</strong> the Sverdlovsk RegionInternational Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
10000890008000700060005000400030002000Production of chrysotile asbestos,thousand tons2032,54359,76937,57891,79376,1 7,18286,75,9*6921,85,1 6776,13388,8Morbidity of malignantpleural mesothelioma765433329,11,7 1,722144,1100001951-55Production of chrysotile asbestosMorbidity of malignant pleural mesothelioma1956-601961-651966-701971-751976-801981-851986-901991-951996-00Production of chrysotile and the <strong>in</strong>cidenceof malignant pleural mesothelioma <strong>in</strong>Asbest (* - accord<strong>in</strong>g to F.M. Kogan, 1986)International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada02001-0410
180160140120100806040200164,1Dust level, mg/m31951-5525,81956-60Dust level, mg/m315,21961-659,81966-705,95,1 4,6 3,5 4 5,3 4,2 401971-751976-80Dust level at “Uralasbest” and <strong>in</strong>cidencerates of malignant pleural mesothelioma <strong>in</strong>Asbest (* - accord<strong>in</strong>g to F.M. Kogan, 1986)International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada7,1Morbidity of malignant pleural mesothelioma*1981-855,11986-901,7 1,71991-951996-00Morbidity of malignantpleural mesothelioma2001-04876543210
Results of assess<strong>in</strong>g riskof environmental exposureto asbestosAreasAddedpersonal riskRelativepersonal riskAddedpopulation riskAdded share ofpopulation riskAsbest (except(<strong>in</strong>dustrialworkers)0.331.300.370.33Nevyansk0.331.300.370.33Alapayevsk2.092.322.322.09Asbest(general)3.203.883.553.20Sysertskydistrict5.986.396.645.98International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
CONCLUSIONSüDur<strong>in</strong>g24 years of conduct<strong>in</strong>g the firstRussian systematic study ofmesothelioma epidemiology <strong>in</strong> thelargest <strong>in</strong>dustrial region of the countrywe revealed 125 cases ofmorphologically verified mesotheliomas.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
CONCLUSIONSüTheaverage long-termmesothelioma<strong>in</strong>cidence rate <strong>in</strong> regional towns variedfrom 0.2 to 27.1 cases per million a yeardur<strong>in</strong>g the study period, the mean be<strong>in</strong>g1.1.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
CONCLUSIONSüIn50% of regional towns and theregional average <strong>in</strong>cidence rate wascomparable to background rates <strong>in</strong> othercountries of the world - 1-2 cases permillion a year.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
CONCLUSIONSüA statistically significant associationbetween asbestos exposure andmesothelioma was established <strong>in</strong> 12.0%of cases. All of them had experiencedoccupational exposure to high asbestosconcentrations <strong>in</strong> 1950-60s.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
CONCLUSIONSüAssess<strong>in</strong>g risk of environmentalexposure to chrysotile asbestos weresimilar to regional averages whenexclud<strong>in</strong>g cases of occupational disease.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
CONCLUSIONSüTherole of chrysotile asbestos <strong>in</strong>etiology of mesothelioma rema<strong>in</strong>sdisputed. It is obvious that chrysotile isnot an obligatory and, moreover, theonly mesothelioma-<strong>in</strong>duc<strong>in</strong>g<strong>in</strong>duc<strong>in</strong>g factor.International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
Thank you for your attention!International Conference “<strong>Chrysotile</strong> at a Turn<strong>in</strong>g Po<strong>in</strong>t: Results and Scientific Perspectives”, May 23 – 24, 2006, Montreal, Quebec, Canada
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