Environmental asbestosis complicated by lung cancer

Our plain-English summary of Environmental asbestosis complicated by lung cancer, by P. De Vuyst, P. Dumortier, D. Jacobovitz, et al (Chest, 1994).

The study

• Authors: P. De Vuyst, P. Dumortier, D. Jacobovitz, S. Emri, L. Cöplü, Y.I. Baris
• Journal: Chest
• Published: 1994;105(5):1593-5
• Type of article: Case report
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Diagnosis of asbestosis and bronchiolo-alveolar carcinoma was made in a 55-year-old Turkish woman who was a nonsmoker. She originated from and was living in an area with a high prevalence of environmental diseases attributed to tremolite asbestos. Mineralogic analysis of lung tissue revealed very high concentrations of asbestos bodies (1.64 x 10(6)/g of dry tissue) and tremolite fibers (173.7 x 10(6) of dry tissue). This case illustrates the following points: (1) In some areas, environmental exposure can lead to cumulated fiber retention comparable to occupational exposure and thus can represent a risk for lung fibrosis (asbestosis). (2) Lung cancer as a complication of environmental asbestosis also should be considered as a potential environmental disease.

In plain English

This is a case report of one person: a 55-year-old Turkish woman, a nonsmoker, evaluated at Hacettepe Hospital in Ankara for coughing up blood and left chest pain. She came from and lived in Cezin, a village in southeastern Turkey, and had done whitewashing, as most women in rural Turkey do. Her asbestos exposure was environmental only. Her chest X-ray showed changes compatible with asbestosis and asbestos-related pleural plaques. Lung biopsies showed fibrosis with numerous asbestos bodies, next to a bronchiolo-alveolar carcinoma, a type of lung cancer. Lung tissue contained 1.64 million asbestos bodies and 173.7 million tremolite fibers per gram of dry lung. The authors placed these levels in the range usually associated with asbestosis. They cautioned that absolute fiber counts by electron microscopy must be interpreted with caution. The authors concluded that asbestosis can be associated with environmental exposure to tremolite. They also concluded that lung cancer as a complication of environmental asbestosis should be considered a potential environmental disease.

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 55-year-old woman, a nonsmoker and housewife with no past respiratory disease. She came from and lived in Cezin, a village next to Maden/Elazig in southeastern Turkey, and was evaluated at Hacettepe Hospital, Ankara, Turkey. No date of evaluation is given.
• Exposure: Environmental (non-occupational) exposure to asbestos, mainly tremolite, in an area of rural Turkey. The patient had done whitewashing of houses. The authors state that asbestos material is used there as a whitewash product and that exposure in the area starts at birth.
• Main results:
  • The chest X-ray showed a large opacity in the left lower lobe. It also showed bilateral diffuse irregular opacities and diaphragmatic calcifications, which the authors described as compatible with asbestosis and asbestos-related pleural plaques.
  • Lung biopsy tissue showed interstitial and peribronchiolar fibrosis with numerous asbestos bodies. Next to these changes was a bronchiolo-alveolar carcinoma.
  • Light microscopy counted 1.64 x 10^6 asbestos bodies per gram of dry lung in the patient's tissue.
  • Electron microscopy of the patient's lung tissue found 173.7 x 10^6 tremolite fibers, 1.9 x 10^6 anthophyllite fibers and 25.1 x 10^6 non-asbestos fibers per gram of dry lung. Erionite fibers were not detected.
  • The tremolite fibers had a mean geometric length of 4.3 micrometres, a mean geometric diameter of 0.26 micrometres and a mean geometric aspect ratio of 17.
  • The authors stated that the fiber values in this case were greater by about 1,000 times than the amount of tremolite usually found in a general population.
• The authors' conclusion: The authors concluded that this case demonstrates that asbestosis can be associated with environmental exposure to tremolite. They also concluded that bronchial carcinoma as a complication of environmental asbestosis should be considered a potential environmental disease.
• Limitations the authors state:
  • The authors note that absolute numbers of fibers counted by electron microscopy must be interpreted with caution.
  • The authors acknowledge that the coexistence of asbestosis and lung cancer may only reflect two diseases with a similar dose-effect relationship, rather than one causing the other.

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Carcinoma, Tremolite, Asbestos Bodies, Environmental Exposure, Occupational Exposure, Fibrosis.

Related studies

• Malignant pleural mesothelioma caused by environmental exposure to asbestos or erionite in rural Turkey: CT findings in 84 patients — A.A. Sahin, L. Cöplü, et al. (1993)
• The role of environmental and occupational exposures in Turkish immigrants with fibre-related disease — P. Dumortier, A. Göcmen, et al. (2001)
• Persistent effects of Libby amphibole and amosite asbestos following subchronic inhalation in rats — S.H. Gavett, C.U. Parkinson, et al. (2016)
• Assessment of environmental asbestos exposure in Turkey by bronchoalveolar lavage — P. Dumortier, L. Coplü, et al. (1998)
• Environmental exposure to tremolite and respiratory cancer in New Caledonia: a case-control study — D. Luce, I. Bugel, et al. (2000)
• Environmental airborne tremolite asbestos pollution and pleural plaques in Afghanistan — C. Voisin, I. Marin, et al. (1994)

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