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1/8/2009
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| In stating that a threshold of effect has never been found for asbestos, Rall
stands behind the outdated one fiber can kill theory of carcinogenesis.
However, Rall fails to mention data supporting a threshold for chrysotile in
lung cancer (11, asbestosis (12), and mesothelioma (13) as well as a panel
report from the Health Effects Institute-Asbestos Research (HEI-AR) detailing
animal and in vitro dose-response studies exhibiting no-observed adverse effect
levels (NOAELs) for asbestos (14). Our recent work documents a dose-dependent
increase in asbestos-induced proto-oncogene activation in mesothelial cells with
no induction at lowest concentrations of fibers tested and an enhanced potency
of crocidolite asbestos in comparison to chrysotile (15). |
| The Monfalcone area, in northeastern Italy, is a small industrial
territory (population about 60,000), with a large shipyard.
Between October 1979 and April 1992, ninety-two malignant
mesotheliomas were diagnosed at the Monfalcone Hospital. The
series included 84 men and 8 women, aged 42 to 89 years (median age
68 years). There were 89 pleural and 3 peritoneal
tumors. Seventy patients (69 men and 1 woman) had worked in the
shipyards; six were seamen, and four insulators. Five men
had been exposed to asbestos in various industries; six women had
histories of domestic exposure, and one woman had a
history of possible environmental exposure. The latency periods
(intervals between first exposure to asbestos and diagnosis of
the tumor) ranged from 20 to 65 years (median 52 years). Latency
periods among insulators were significantly lower than
among shipyard workers, as well as lower than among the other
categories (. |
| In order to provide estimates of the accuracy of death certification
of malignant pleural mesothelioma in Italy, the causes of
death of a series of ascertained cases were investigated. The study
included 523 cases of pleural mesothelioma diagnosed in
1984-1988 by 88 hospital departments and clinics. Vital status at 7
May 1990 was ascertained for 92.7% of subjects. The
overall concordance between pathological diagnosis and death
certification was about 75%.
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Med Lav 1994 Mar-Apr;85(2):157-60 |
| Latency periods (time intervals elapsing between first exposure to
asbestos and death) were examined in 421 cases of
malignant pleural mesothelioma, diagnosed in the Trieste-Monfalcone
area, Italy. Occupational data were collected from the
patients or from their relatives by personal or telephone interviews.
Routine lung sections were examined for asbestos bodies in
370 cases. Latency periods, calculated in 312 cases, ranged from 14
to 72 years (mean 48.7, median 51). Latency periods
differed significantly from one occupational group to another. Mean
latency periods were 29.6 among insulators, 35.4 among
dock workers, 43.7 in a heterogeneous group defined as various, 46.4
in non-shipbuilding industry workers, 49.4 in shipyard
workers, 51.7 among women with a history of domestic exposure to
asbestos, and 56.2 in people employed in maritime
trades. The ANOVA test indicated a correlation between latency
periods an. |
| All cases of pleural malignant mesothelioma occurring in Tuscany were
collected, backdated to 1980 (to 1970 for the
provinces of Florence and Prato; to 1975 for the provinces of Pisa
and Siena), in order to evaluate the incidence of
occupational exposure to asbestos. The aim was to enhance primary
prevention in those workplaces still at risk nowadays. To
achieve information on the possible occupational, domestic or
environmental exposure, an interview was conducted using a
semi-structured questionnaire. An exposure classification was
produced to focus preventive intervention. This surveillance
system needs to be developed to contribute to epidemiological
research, especially on the effects of low level exposures, and to
primary prevention.
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Med Lav 1997 Jul-Aug;88(4):302-9 |
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