Lung cancer and mesothelioma in towns with environmental exposure to asbestos in Eastern Anatolia

Our plain-English summary of Lung cancer and mesothelioma in towns with environmental exposure to asbestos in Eastern Anatolia, by H.C. Hasanoglu, Z. Yildirim, H. Ermis, et al (International Archives of Occupational and Environmental Health, 2006).

The study

• Authors: H.C. Hasanoglu, Z. Yildirim, H. Ermis, T. Kilic, N. Koksal
• Journal: International Archives of Occupational and Environmental Health
• Published: 2006;79(1):89-91
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: Our previous study demonstrated the presence of environmental tremolite and chrysotile asbestos fiber exposure in Hekimhan town in Malatya located in eastern Turkey. The aim of this study was to investigate whether environmental asbestos exposure increases the incidence of lung cancer and mesothelioma.

Method: One hundred and forty-nine patients with mesothelioma and lung cancer living in the center or in the towns of Malatya were retrospectively analyzed. The Incidences of lung cancer and mesothelioma were calculated.

Results: The incidences of lung cancer and mesothelioma were 3.39/100,000 and 0.21/100,000, respectively, for the whole population of Malatya; while they were 8.23/100,000 and 1.45/100,000 in Hekimhan. The incidences were strikingly high (22.39/100,000 for lung cancer and 7.46/100,000 for mesothelioma) in Arguvan, another town in Malatya where an analysis for asbestos could not be performed. The overall incidence in Turkey was reported as 5.9/100,000 by the Health Ministry in 1994. The incidences of lung cancer were nearly 1.3-fold higher in Hekimhan and fourfold higher in Arguvan then in the general population of Turkey.

Conclusion: The incidences of mesothelioma and lung carcinoma in Hekimhan were higher than those of the general population in Turkey, suggesting a role of environmental asbestos exposure in lung cancer and mesothelioma.

In plain English

This short communication reviewed the hospital charts of 200 patients with lung cancer or mesothelioma admitted to a university hospital in Malatya, eastern Turkey, between 1997 and 2001. Of these, 149 lived in Malatya province. None had occupational asbestos exposure. The authors' earlier study had found environmental tremolite and chrysotile exposure in the town of Hekimhan. Across the province, the yearly incidence per 100,000 people was 3.39 for lung cancer and 0.21 for mesothelioma. In Hekimhan it was 8.23 and 1.45. In neighbouring Arguvan, where no mineralogical study had been done, it was 22.39 and 7.46. The authors compared the lung cancer figures with the 5.9 per 100,000 reported for Turkey by the Health Ministry in 1994. They described Arguvan's rate as about fourfold higher and Hekimhan's as 1.3-fold higher. Smoking was common in both groups: 28 of 36 patients from Arguvan and Hekimhan smoked, and 93 of 113 from elsewhere. The authors concluded that asbestos-contaminated soil may be related to high incidences of these cancers. They noted that some patients may have gone to other hospitals.

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: Retrospective review of hospital charts, with incidence rates calculated per town (short communication)
• Who was studied: Charts of 200 patients with lung cancer or mesothelioma admitted to the Inonu University hospital in Malatya, Turkey, between 1997 and 2001. 149 of them (126 male, 23 female) lived in Malatya province, whose towns had a total population of 823,521. The other 51 came from outside the province.
• Exposure: Environmental (non-occupational) asbestos exposure. The authors' previous study found tremolite and chrysotile in Hekimhan. Villagers use asbestos-containing white soil or stucco to whitewash house walls. Arguvan inhabitants reported the same practice, but no mineralogical study had been done there. None of the patients had occupational asbestos exposure.
• Main results:
  • For the whole Malatya province, the annual incidence was 3.39 per 100,000 for lung cancer and 0.21 per 100,000 for mesothelioma.
  • In Hekimhan (population 41,288), the annual incidence was 8.23 per 100,000 for lung cancer (17 cases) and 1.45 per 100,000 for mesothelioma (3 cases) over 5 years.
  • In Arguvan (population 10,716), the annual incidence was 22.39 per 100,000 for lung cancer (12 cases) and 7.46 per 100,000 for mesothelioma (4 cases). No asbestos analysis had been done in this town.
  • The authors compared these lung cancer rates with the overall annual lung cancer incidence in Turkey of 5.9 per 100,000 reported by the Health Ministry in 1994. They described the rates as approximately fourfold higher in Arguvan and 1.3-fold higher in Hekimhan.
  • Among the 771,517 people in Malatya province not living in Arguvan or Hekimhan, there were two mesothelioma cases in 5 years.
  • Smoking was common in both groups: 28 of the 36 patients from Arguvan and Hekimhan were smokers, as were 93 of the 113 patients from other places.
  • Lung cancer was mostly in men (124 men, 16 women) and mesothelioma mostly in women (2 men, 7 women).
  • No pleural plaques or other asbestos-associated lesions were seen in the lung cancer patients. Extensive pleural plaques were seen in one patient with mesothelioma.
• The authors' conclusion: The authors concluded that soil contaminated with asbestos may be related to high incidences of lung cancer and mesothelioma in some rural areas of Malatya province.
• Limitations the authors state:
  • Some patients with lung cancer or mesothelioma may have been referred to hospitals in western cities and not counted, so the authors regarded the incidences as minimum figures.
  • Asbestos exposure in Arguvan was not confirmed by any mineral analysis.

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: Lung Cancer, Mesothelioma, Environmental Exposure, Tremolite, Chrysotile, Asbestos Exposure, Carcinoma.

Related studies

• Unusually high incidence of malignant pleural mesothelioma in a town of eastern Sicily: an epidemiological and environmental study — L. Paoletti, D. Batisti, et al. (2000)
• Environmental exposure to asbestos in eastern Turkey — H.C. Hasanoğlu, M. Gokirmak, et al. (2003)
• Environmental malignant mesothelioma in southern Anatolia: a study of fifty cases — E.H. Zeren, D. Gümürdülü, et al. (2000)
• Survey of environmental exposure to asbestos in the town of Buyuktatlar, Turkey — N. Köksal, M. Çelik, et al. (2012)
• Asbestos knowledge and awareness level in central part of Anatolia — S. Metintas, G. Ak, et al. (2017)
• Turkey National Mesothelioma Surveillance and Environmental Asbestos Exposure Control Program — S. Metintaş, H.F. Batırel, et al. (2017)

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