Regional findings in Metsovo lung

Our plain-English summary of Regional findings in Metsovo lung, by S.H. Constantopoulos, A.M. Langer, N. Saratzis, et al (Lancet, 1987).

The study

• Authors: S.H. Constantopoulos, A.M. Langer, N. Saratzis, R.P. Nolan
• Journal: Lancet
• Published: 1987;2(8556):452-3
• Type of article: Letter
• Cited by: 8 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. 000954).

Summary of the article

In this letter, the authors reported further findings on 'Metsovo lung', the pleural calcification seen among inhabitants of Metsovo and three adjacent villages in northwest Greece. They had previously linked it to inhaling asbestiform tremolite fibre from a soil widely used before 1950 for interior whitewashing, and had found a high incidence of malignant pleural mesothelioma in the same area. Chest X-rays of more than 800 people from Metsovo showed evidence of pleural disease on 46% of films. No sex or occupational factor was found, and prevalence increased with age: 81% of adults over 70 had calcified pleural plaques. Because chest X-ray is insensitive to early disease, computerised tomography was performed on 16 X-ray-negative subjects born in Metsovo before 1940, and all scans showed pleural calcification. Of some 500 Metsovites who had emigrated since 1970 to Trikala, in Thessaly, where the geology precludes environmental exposure to asbestiform fibre, 71 had chest X-rays and 50 (70%) showed pleural calcification. Its age distribution and prevalence were identical to those in Metsovo. The authors compared this with mesothelioma among Turkish emigrants in Sweden exposed early in life to erionite in Karain. They had found four more affected areas in northwest Greece, where investigations were under way. They expected clusters across Balkan states and concluded that Metsovo lung appeared more widespread than previously thought.

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 letter to The Lancet, from researchers in Ioannina, Greece, and New York, concerned "Metsovo lung", pleural calcification among people of Metsovo and three nearby villages in northwest Greece. The authors stated that their earlier work linked it to inhaled asbestiform tremolite fibre from a soil used before 1950 for interior whitewashing. They reported that chest X-rays of more than 800 people from Metsovo showed pleural disease on 46% of films, with no sex or occupational factor. Among adults over 70, 81% had calcified pleural plaques on X-ray. CT scans of 16 people born in Metsovo before 1940 whose X-rays were negative all showed pleural calcification. Of 71 Metsovites who had moved to Trikala, on the plains of Thessaly, 50 (70%) had pleural calcification. The authors said this supported exposure early in life in Metsovo, since the geology of Thessaly precludes environmental exposure to asbestiform fibre. They reported four more affected areas in northwest Greece. They anticipated pleural calcification and malignant pleural mesothelioma in Balkan areas whose geology allows asbestiform tremolite to form, if environmental conditions there were similar to those in Metsovo.

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: Letter to the editor (correspondence) reporting chest X-ray and CT findings in an environmentally exposed population and in emigrants from it
• Who was studied: More than 800 people from Metsovo, northwest Greece, who had chest X-rays; 16 X-ray-negative people born in Metsovo before 1940 who had CT scans; and 71 of about 500 Metsovites who had emigrated since 1970 to Trikala, Thessaly
• Exposure: Environmental exposure to asbestiform tremolite fibre from a soil used before 1950 for interior whitewashing (source identified in the authors' earlier work)
• Main results:
  • Of more than 800 chest X-rays from Metsovo, 46% showed evidence of pleural disease; there was no sex or occupational factor, and pleural calcification increased with age
  • 81% of adults over age 70 in Metsovo showed X-ray evidence of calcified pleural plaques
  • CT scans of 16 X-ray-negative subjects born in Metsovo before 1940 all showed pleural calcification
  • Among 71 Metsovites living in Trikala who had chest X-rays, 50 (70%) had pleural calcification, with age distribution and prevalence character identical to Metsovo
  • The authors found four more areas in northwest Greece where pleural calcification occurs in the population
• The authors' conclusion: The authors concluded that the findings reinforced their impression that the cause was asbestiform mineral fibre with exposure early in life in Metsovo, and that Metsovo lung appears more widespread than previously thought; they anticipated pleural calcification and malignant pleural mesothelioma in other Balkan areas if environmental conditions there are similar to those in Metsovo
• Limitations the authors state:
  • The authors noted that chest X-ray is an insensitive technique for early disease, which they used to explain the lack of pleural calcification on X-ray in some exposed elderly people

Topics

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

Medical terms in this study, explained in our Lexicon: Metsovo Lung, Pleural Calcification, Asbestiform Tremolite, Pleural Mesothelioma, Chest X-Ray, Pleural Plaques, Environmental Exposure, Asbestiform.

Related studies

• Association of Metsovo lung and pleural mesothelioma with exposure to tremolite-containing whitewash — A.M. Langer, R.P. Nolan, et al. (1987)
• Metsovo lung outside Metsovo. Endemic pleural calcifications in the ophiolite belts of Greece — S.H. Constantopoulos, P. Theodoracopoulos, et al. (1991)
• Metsovo-tremolite asbestos fibres: in vitro effects on mutation, chromosome aberration, cell transformation and intercellular communication — K. Athanasiou, S.H. Constantopoulos, et al. (1992)
• Malignant pleural mesothelioma from nonoccupational asbestos exposure in Metsovo (north-west Greece): slow end of an epidemic? — K. Sakellariou, V. Malamou-Mitsi, et al. (1996)
• Metsovo lung: pleural calcification and restrictive lung function in northwestern Greece. Environmental exposure to mineral fiber as etiology — S.H. Constantopoulos, J.A. Goudevenos, et al. (1985)
• 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)

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