Environmental airborne tremolite asbestos pollution and pleural plaques in Afghanistan

Our plain-English summary of Environmental airborne tremolite asbestos pollution and pleural plaques in Afghanistan, by C. Voisin, I. Marin, P. Brochard, et al (Chest, 1994).

The study

• Authors: C. Voisin, I. Marin, P. Brochard, J.C. Pairon
• Journal: Chest
• Published: 1994;106(3):974-6
• Type of article: Case report, Review
• Cited by: 14 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A 51-year-old man underwent pleuroscopy for radiologic pleural abnormalities. Pathologic examination of pleural and lung biopsy specimens concluded on hyalinized pleural plaques associated with mild asbestosis. Transmission electron microscopy analysis showed significant retention of tremolite asbestos fibers. The absence of any occupational exposure to asbestos and the existence of geologic deposits of tremolite in the Kabul area of Afghanistan suggest an environmental exposure during the patient's childhood spent in this region.

In plain English

This is a case report about one man. A 51-year-old smoker in France had pleural abnormalities found on a routine chest X-ray. Pleuroscopy, done to rule out pleural mesothelioma, showed circumscribed pleural thickening; biopsies revealed hyaline pleural plaques. Lung tissue changes were described as consistent with an early stage of asbestosis. His lung tissue held 7,500 asbestos bodies per gram of dry tissue. Electron microscopy identified only tremolite fibers, 44 percent of them longer than 5 micrometers. He had lived in Kabul, Afghanistan, as a student from birth to age 22. He moved to France in 1964 and worked as a white collar worker, without occupational or domestic asbestos exposure. Kabul is close to the Loghar region, which has natural tremolite deposits. Chest X-rays of four siblings were considered normal. The authors concluded that environmental tremolite exposure may lead to significant lung retention of fibers and that this hazard may be encountered in Afghanistan. They could not obtain detailed information on how common pleural plaques on chest X-rays are in the general population of the Kabul area and Loghar region.

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 (one patient)
• Who was studied: One 51-year-old man seen in France, a smoker (35 pack-years), who lived in Kabul, Afghanistan, from birth to age 22 and moved to France in 1964
• Exposure: Presumed environmental (non-occupational) exposure to tremolite asbestos during childhood and teenage years in Kabul, which is near natural tremolite deposits in the Loghar region. The man reported no occupational or domestic asbestos exposure in France.
• Main results:
  • Pleuroscopy in this patient showed circumscribed parietal and diaphragmatic pleural thickening
  • Pleural biopsies from this patient showed hyaline pleural plaques
  • The lung tissue changes in this patient were described as consistent with an early stage of asbestosis
  • The patient's lung tissue contained 7,500 asbestos bodies per gram of dry tissue, described as significant lung retention
  • Transmission electron microscopy of the patient's lung tissue identified only tremolite fibers
  • The uncoated tremolite fiber count in the patient's lung was printed in the scanned text as 'l.6X107' fibers per gram of dry lung tissue, most likely 1.6 x 10 to the 7th (the superscript appears lost in scanning). The authors described this as a high retention level.
  • Of the patient's tremolite fibers, 44 percent were longer than 5 micrometers, with a median diameter of 0.4 micrometers
  • Lung function tests in the patient showed a tendency to a restrictive pattern (TLC 82 percent, FVC 88 percent)
  • Standard chest X-rays of the patient's four siblings were considered normal
• The authors' conclusion: The authors concluded that environmental tremolite asbestos exposure may lead to significant lung retention of fibers, and that this hazard may be encountered in Afghanistan.
• Limitations the authors state:
  • The authors could not obtain detailed information on how common pleural plaques on chest X-ray are in the general population of the Kabul area and Loghar region
  • The authors noted that the normal X-rays in the siblings do not exclude environmental asbestos-related disease, since similar exposure does not cause the same disease in everyone

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening, Tremolite.

Medical terms in this study, explained in our Lexicon: Tremolite, Pleural Plaques, Biopsy, Transmission Electron Microscopy (TEM), Occupational Exposure, Environmental Exposure.

Related studies

• Diachronic study of pleural plaques in rural population with environmental exposure to asbestos — L. Sichletidis, D. Chloros, et al. (2006)
• Environmental mesothelioma associated with tremolite asbestos: lessons from the experiences of Turkey, Greece, Corsica, New Caledonia and Cyprus — S.H. Constantopoulos (2008)
• Environmental pleural plaques in residents of a Quebec chrysotile mining town — A. Churg, L. DePaoli (1988)
• Environmental exposure to tremolite and respiratory cancer in New Caledonia: a case-control study — D. Luce, I. Bugel, et al. (2000)
• Assessment of environmental and domestic exposure to tremolite in New Caledonia — D. Luce, M.A. Billon-Galland, et al. (2004)
• Radiological survey of past and present vermiculite miners exposed to tremolite — J.C. McDonald, P. Sebastien, et al. (1986)

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