Malignant mesothelioma in a cohort of asbestos insulation workers: clinical presentation, diagnosis, and causes of death.

نویسندگان

  • J Ribak
  • R Lilis
  • Y Suzuki
  • L Penner
  • I J Selikoff
چکیده

Malignant mesothelioma has been rare in the general population. In recent decades its incidence has risen dramatically, parallel to the increasing use of asbestos in industry since 1930. Altogether 17,800 asbestos insulation workers, members of the International Association of Heat and Frost Insulators and Asbestos Workers (AFL-CIO-CLC) in the United States and Canada, were enrolled for prospective study on 1 January 1967 and followed up to the present. Every death that occurs is investigated by our laboratory. One hundred and seventy five deaths from mesothelioma occurred among the 2221 men who died in 1967-76 and 181 more such deaths in the next eight years. Altogether, 356 workers had died of malignant mesothelioma (pleural or peritoneal) by 1984. Diagnosis of mesothelioma was accepted only after all available clinical, radiological, and pathological material was reviewed by our laboratory and histopathological confirmation by the pathology unit made in each case. One hundred and thirty four workers died of pleural and 222 of peritoneal mesothelioma. Age at onset of exposure, age at onset of the disease, and age at death were similar in both groups of patients. Significant difference was noted only in the time elapsed from onset of exposure to the development of first symptoms, which was longer in the group with peritoneal mesothelioma. Shortness of breath, either new or recently increased, and chest pain were the most frequent presenting symptoms in the group with pleural mesothelioma; abdominal pain and distension were frequent in the patients with peritoneal mesothelioma. Pleural effusion or ascites were found in most patients. The most effective approach to the diagnosis of malignant pleural mesothelioma in these cases was by open lung biopsy; exploratory laparotomy was best for diagnosing peritoneal mesothelioma. Patients with pleural mesothelioma died principally from pulmonary insufficiency whereas those with peritoneal mesothelioma succumbed after a period of pronounced wasting.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Asbestos-related Lung Diseases: A Brief Update

Health risks from asbestos exposures have been evaluated, considering past professional histories when exposures at workplaces were higher than today. A linear no-threshold (LNT) model has been applied, although its relevance is unproven. Fibers are often found in the lungs and pleura of deceased people. Fiber findings do not prove that a disease is caused by asbestos. It is reasonable to assum...

متن کامل

Lung cancer and mesothelioma in the pleura and peritoneum among Swedish insulation workers.

OBJECTIVES To estimate the risk of cancer and death in Swedish insulation workers some years after their exposure to asbestos had stopped. One hypothesis was that the risk of lung cancer would tend to decrease some years after the exposure had ended. METHODS In a cohort study the cancer morbidity and cause of death was investigated in 248 insulation workers and compared with the corresponding...

متن کامل

مولفه های شغلی و محیطی در موارد مزوتلیومای بدخیم پلور و تعیین نسبت شانس بروز مزوتلیوما در مواجهه با آزبست

Background and aimsThe relationship between pleural malignant mesothelioma and exposure to asbestos is well-known, but there is no accurate information regarding high risk occupations and types of exposure in Iran. In this study we specified high risk jobs for asbestos exposure.MethodsIn this case-control study, 64 cases with diagnosis of pleural malignant mesothelioma who were admitted in Masi...

متن کامل

گزارش یک مورد مزوتلیوم بدخیم تونیکا واژینالیس بیضه

Malignant mesothelioma of the tunica vaginalis constitutes a very rare but often fatal malignancy of the male genitalia. This diagnosis should be suspected in patients exposed to asbestos and those presenting with clinical symptoms of either hydrocele or inguinal hernia. We report here a case of malignant mesothelioma of the tunica vaginalis. A 69-year-old man with a left hydrocele and inguina...

متن کامل

Non-malignant chest x ray changes in patients with mesothelioma in a large cohort of asbestos insulation workers.

To assess the prevalence of non-malignant chest x ray abnormalities in cases of mesothelioma 184 cases of mesothelioma (72 pleural and 112 peritoneal) which had occurred in a cohort of asbestos insulation workers followed up since 1967 were studied. Chest x ray films of satisfactory quality, on which the presence or absence of non-malignant radiological changes indicating interstitial pulmonary...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • British journal of industrial medicine

دوره 45 3  شماره 

صفحات  -

تاریخ انتشار 1988