Malignant pleural mesothelioma after household exposure to asbestos

Our plain-English summary of Malignant pleural mesothelioma after household exposure to asbestos, by A.V. Patel, P.N. Bogner, D. Klippenstein, et al (Journal of Clinical Oncology, 2008).

The study

• Authors: A.V. Patel, P.N. Bogner, D. Klippenstein, N. Ramnath
• Journal: Journal of Clinical Oncology
• Published: 2008;26(33):5480-3
• Type of article: Case report
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

The authors described two women who developed malignant mesothelioma without direct asbestos exposure, apparently after household (second-hand) exposure. The first patient, a 70-year-old former smoker (20 pack-years, quit 25 years earlier), presented with cough, pleuritic chest pain, dyspnea on exertion and a 10-pound weight loss. She denied occupational exposure. Her husband of 35 years had sprayed asbestos (crocidolite) as a fire repellant in construction and had died of mesothelioma 12 years earlier. She had shaken out and washed his clothes. CT showed a large right pleural effusion and nodular pleural masses, and pleural biopsy showed sarcomatoid mesothelioma. Her disease progressed on cisplatin-pemetrexed and on gemcitabine. Vinorelbine-cisplatin caused grade 4 neutropenia, and she was receiving single-agent vinorelbine. The second patient, a 77-year-old former grocery store clerk with a 70 pack-year smoking history, had a right upper lobectomy for stage IA adenocarcinoma. A left pleural nodule grew from 1.5 cm × 1 cm to 2.7 cm × 2.3 cm over 4 years, and needle biopsy showed epithelioid mesothelioma. Her husband of 53 years, a pipe fitter, had died of mesothelioma, and she had shaken out and washed his clothes daily. The authors reviewed published reports of household asbestos exposure and mesothelioma. They concluded that physicians should consider mesothelioma in patients with secondary as well as direct asbestos exposure.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short case report described two women who developed mesothelioma and who, according to the authors, never had direct asbestos exposure. The first woman, aged 70, had a 20 pack-year smoking history and denied any occupational exposure. Her husband had died of mesothelioma. He had sprayed asbestos (crocidolite) as a fire repellant in a construction business, and she had shaken out and washed his clothes. A pleural biopsy showed sarcomatoid mesothelioma. Her disease progressed on cisplatin with pemetrexed and then on gemcitabine, and at the time of writing she was on vinorelbine alone. The second woman, aged 77, was a grocery store clerk with a 70 pack-year smoking history. She washed the clothes of her husband daily. He was a pipe fitter who died of mesothelioma, and the article does not name a fiber type for his work. After surgery for stage IA lung adenocarcinoma, a pleural-based nodule in her other lung grew over 4 years. A biopsy showed epithelioid-type mesothelioma. The authors concluded that both women developed mesothelioma from second-hand exposure, perhaps by washing their husbands' clothes.

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 of two patients
• Who was studied: Two women: a 70-year-old with a 20 pack-year smoking history who quit 25 years before diagnosis, and a 77-year-old grocery store clerk with a 70 pack-year smoking history who quit 10 years earlier. Both husbands had died of mesothelioma. The article does not state where or when the patients were seen.
• Exposure: Household (second-hand) exposure from shaking out and washing their husbands' work clothes. The first husband sprayed asbestos (crocidolite) as a fire repellant in construction. The second husband was a pipe fitter, and no fiber type is given for his work.
• Main results:
  • First patient (70 years old): pleural biopsy showed sarcomatoid mesothelioma.
  • First patient: the disease progressed after five cycles of cisplatin and pemetrexed and then on gemcitabine. She developed grade 4 neutropenia on vinorelbine with cisplatin and was then receiving single-agent vinorelbine.
  • Second patient (77 years old): she had a right upper lobectomy for stage IA lung adenocarcinoma.
  • Second patient: a left pleural-based nodule present at the time of lobectomy grew from 1.5 cm by 1 cm to 2.7 cm by 2.3 cm over 4 years.
  • Second patient: needle biopsy findings were consistent with malignant epithelioid-type mesothelioma.
• The authors' conclusion: The authors concluded that the two women developed mesothelioma from second-hand asbestos exposure, perhaps by washing their husbands' clothes. They also concluded that physicians should consider mesothelioma in the setting of secondary asbestos exposure as well as direct exposure.

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Malignant Mesothelioma, Asbestos Exposure, Pleuritic Chest Pain, Dyspnea, Occupational Exposure, Crocidolite, Mesothelioma.

Related studies

• Mesothelioma in household members of asbestos-exposed workers: 32 United States cases since 1990 — A. Miller (2005)
• Pleural mesothelioma and household asbestos exposure — J. Schneider, K. Straif, et al. (1996)
• Mineral fiber content of lung tissue in patients with environmental exposures: household contacts vs. building occupants — V.L. Roggli, W.E. Longo (1991)
• Global magnitude of reported and unreported mesothelioma — E.K. Park, K. Takahashi, et al. (2011)
• Comparison of risks from outdoor and indoor exposure to toxic chemicals — L.A. Wallace (1991)
• Indoor air quality differences between urban and rural preschools in Korea — C. Yoon, K. Lee, et al. (2011)

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