Endemic pleural disease associated with exposure to mixed fibrous dust in Turkey

Our plain-English summary of Endemic pleural disease associated with exposure to mixed fibrous dust in Turkey, by A.N. Rohl, A.M. Langer, G. Moncure, et al (Science, 1982).

The study

• Authors: A.N. Rohl, A.M. Langer, G. Moncure, I.J. Selikoff, A. Fischbein
• Journal: Science
• Published: 1982;216(4545):518-20
• Cited by: 74 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001802).

Abstract

Pleural mesothelioma, lung cancer, pleural calcification and fibrosis, and interstitial parenchymal fibrosis have been observed among inhabitants of several villages in south-central Turkey. Earlier reports have stated that environmental and lung tissue samples from this area contained the fibrous zeolite mineral erionite, and this mineral has generally been assumed to be the agent responsible for these endemic pathological conditions in the absence of asbestos outcroppings and usage. Several different kinds of asbestos minerals in addition to erionite have now been found in environmental samples taken from the villages where these diseases occur. The lung tissues of mesothelioma patients from these villages contain both fibrous zeolites and asbestos minerals.

In plain English

In 1979, two of the authors collected 123 geological, environmental and tissue samples in villages of Cappadocia, Turkey, for mineral analysis. Some villages had known mesothelioma and some did not. Environmental samples contained both asbestos minerals and fibrous erionite, a zeolite mineral. In one Karain rock specimen, up to 30 percent by weight was tremolite and chrysotile. In lung tissue from Karain mesothelioma patients, about 90 percent of fibrous particles had a composition consistent with erionite, and about 1 to 5 percent by volume was tremolite. Small amounts of chrysotile were also found. Tremolite was found in Tuzkoy whitewash material and settled dust. Sarihidir street dust contained as much as 5 percent chrysotile and tremolite by weight. No asbestos was found in samples from two nearby villages where no mesothelioma had been reported. The authors concluded that their findings were consistent with the known relationship between asbestos exposure and pleural disease. They also noted that animal experiments had shown erionite alone can produce tumors, and that whether combined exposure to asbestos and erionite increases the effect was unknown.

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: Mineralogical analysis of environmental and lung tissue samples from villages with and without reported mesothelioma
• Who was studied: 123 geological, environmental and tissue samples collected in 1979 in Cappadocian villages, some with known mesothelioma (Karain, Tuzkoy, Sarihidir) and some without (Karlik, Yeziloz). Lung tissue came from mesothelioma patients.
• Exposure: Lifelong environmental exposure to inorganic dust from local rocks and soils. The minerals examined included fibrous erionite (a zeolite), chrysotile and tremolite.
• Main results:
  • Environmental samples contained several kinds of fibrous minerals, including both asbestos minerals and fibrous erionite.
  • Up to 30 percent by weight of one specimen (altered tuff from a shear zone in Karain) was tremolite and chrysotile.
  • Other Karain environmental samples showed small amounts of chrysotile and tremolite.
  • In lung tissue from Karain mesothelioma patients, about 90 percent of fibrous particles had a composition consistent with erionite.
  • In Karain patients' lung tissue, about 1 to 5 percent by volume of fibrous mineral was tremolite.
  • Chrysotile was also found in small amounts in the lung tissue.
  • One whitewash ore sample from Tuzkoy was essentially a tremolitic talc.
  • Tremolite fibers were also seen in settled dust samples from Tuzkoy.
  • In lung tissue from Tuzkoy patients with pleural disease, fibrous zeolite predominated, but tremolite fibers were also found.
  • Street dust from Sarihidir contained as much as 5 percent chrysotile and tremolite by weight.
  • No asbestos was found in specimens from Karlik and Yeziloz, nearby villages with no reported mesothelioma.
• The authors' conclusion: The authors concluded that their findings were consistent with the relationship between asbestos exposure and pleural disease established elsewhere. They noted that animal experiments have shown erionite alone can produce tumors.
• Limitations the authors state:
  • The authors stated it was unknown whether combined exposure to asbestos and erionite, or possibly other durable fibers, has an enhanced tumor-causing effect.

Topics

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

Medical terms in this study, explained in our Lexicon: Endemic, Pleural Mesothelioma, Lung Cancer, Pleural Calcification, Fibrosis, Interstitial, Parenchymal Fibrosis, Zeolite.

Related studies

• Lung diseases due to environmental exposures to erionite and asbestos in Turkey — S. Emri, A. Demir, et al. (2002)
• Case report: Lung disease in World Trade Center responders exposed to dust and smoke: carbon nanotubes found in the lungs of World Trade Center patients and dust samples — M. Wu, R.E. Gordon, et al. (2010)
• Increased mineral dust-induced production of reactive oxygen species by blood monocytes from patients with malignant diseases — P.W. Nyberg, S.A. Nordman, et al. (1994)
• Lung cell toxicity experimentally induced by a mixed dust from Mexicali, Baja California, Mexico — A.R. Osornio-Vargas, N.A. Hernández-Rodríguez, et al. (1991)
• Widening perspectives of occupational lung disease — I.J. Selikoff (1973)
• Pulmonary asbestos and dust content in East Anglia — P.G. Stovin, P. Partridge (1982)

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