A case of malignant mesothelioma in a rice-starch factory

Our plain-English summary of A case of malignant mesothelioma in a rice-starch factory, by R. De Zotti, A. Fiorito (International Archives of Occupational and Environmental Health, 2007).

The study

• Authors: R. De Zotti, A. Fiorito
• Journal: International Archives of Occupational and Environmental Health
• Published: 2007;80(8):743-5
• Type of article: Case report
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Introduction: Recent reports of cases of malignant mesothelioma (MM) in "non-traditional" areas of employment are an indication of the numerous occasions in which exposure to asbestos has occurred in the workplace. We describe an unusual case of occupational exposure to asbestos to stress the importance of careful history taking when assessing a patient's work history, especially in generic occupations in which there is apparently no exposure to asbestos.

Case Report: Malignant mesothelioma was diagnosed in a woman worker employed in a factory making rice starch. She had worked in the storehouse of the factory for approximately 40 years. From circumstantial interviews with relatives and workmates, it emerged that her job involved retrieving, for re-use, the jute sacks in which the rice was transported. More than one source remembered distinctly that some of the sacks had "Asbestos" written on the outside.

Discussion: This case provides further confirmation of the importance of careful history taking among workers with mesothelioma to avoid failing to diagnose occupational disease. It also highlights the risk of asbestos exposure represented by recycling asbestos-contaminated sacks in both occupational and non-occupational settings.

In plain English

This short communication was a case report about one woman who worked in the storehouse of a rice-starch factory in Italy from 1943 to 1982. In 2002 she was diagnosed with epithelial mesothelioma of the pleura, and an HRCT scan showed pleural plaques on both sides. The disease affected her lymph nodes and the skin where her chest had been drained, and she died in 2003 aged 78. The factory had closed in 1986, so the authors relied on interviews with relatives and workmates. These showed that her job was cleaning the jute sacks the rice arrived in so they could be re-used. She put the empty sacks into a machine that shook out the dust, and the sacks were then washed and repaired. Some sacks had "Asbestos" written on them. No exposure outside work was found. The authors concluded it was reasonable to assume her exposure came from handling recycled asbestos sacks. They noted that they did not know how often this exposure occurred, and they stressed the need for careful work-history taking.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (short communication) of a single patient
• Who was studied: One woman who worked in the storehouse of a rice-starch factory from 1943 to 1982. The case came from the Mesothelioma Registry of the Friuli-Venezia Giulia Region of Italy. She was diagnosed in 2002 and died in 2003 aged 78.
• Exposure: Recycling the jute sacks the rice was transported in. Some sacks were marked "Asbestos", and the sacks came from countries including China, Russia and Canada. The fiber type in this case was not identified.
• Main results:
  • The definite diagnosis, made in 2002, was epithelial mesothelioma of the pleura. Calretinin and vimentin were positive and CEA was negative.
  • HRCT showed bilateral pleural plaques.
  • The patient died in 2003, aged 78.
  • Her job was putting empty sacks into a machine that shook out dust and leftover rice. The sacks were then washed and repaired.
  • No asbestos exposure outside her work was identified.
  • The authors judged her job history consistent with occupational asbestos exposure from recycled sacks that had previously contained asbestos.
• The authors' conclusion: The authors concluded it was reasonable to assume the exposure came from handling recycled asbestos sacks. They said the case points to the importance of careful history taking in patients with malignant mesothelioma.
• Limitations the authors state:
  • The factory closed in 1986, so no further information about the workplace was available. The job history rested on interviews with relatives and workmates.
  • The authors did not know how often she was exposed to asbestos-contaminated sacks.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Mesothelioma, Occupational Exposure, Occupational History, Occupational Disease, Asbestos Exposure.

Related studies

• Talc-treated rice and Japanese stomach cancer — R.R. Merliss (1971)
• The tocotrienol-rich fraction from rice bran enhances cisplatin-induced cytotoxicity in human mesothelioma H28 cells — K. Nakashima, N. Virgona, et al. (2010)
• Talc-coated rice as a risk factor for stomach cancer — G.N. Stemmermann, L.N. Kolonel (1978)
• Relationship of mortality to measures of environmental asbestos pollution in an asbestos textile factory — J. Peto, R. Doll, et al. (1985)
• Comparing milled fiber, Quebec ore, and textile factory dust: has another piece of the asbestos puzzle fallen into place? — D.W. Berman (2010)
• Monitoring and Simulating Environmental Asbestos Dispersion from a Textile Factory — D. Kang, Y. Hwang, et al. (2018)

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