Malignant Mesothelioma in a Motor Vehicle Mechanic

Case reports remain an important source of data in the debate over the carcinogenic effect of asbestos-containing automotive friction products. This report documents a case of pleural mesothelioma accompanied by asbestos bodies in the lung tissue of a career auto mechanic with no other known sources of exposure. Previously unreported historical and contemporary exposure data are also discussed in the context of providing additional support for the proposition that work with asbestos-containing automotive products presents a risk of significant exposure. While there remains a body of negative epidemiology that fails to find an increased risk of disease among auto workers, those data must be approached with caution. Many of those studies have drawn technical criticisms, which are beyond the scope of this report, but they remain a key part of the legal defense mounted by defendant-companies who are involved in asbestos-related litigation. This ongoing debate provides the context for the continued relevance of case reports such as this one, as well as the presentation of new and previously unpublished exposure data.

Source: Malignant Mesothelioma in a Motor Vehicle Mechanic


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Deadly Remnants of Asbestos in Italy (photos slideshow)

Although Italy joined asbestos-producing nations in banning the carcinogenic material at the end of the 20th century, thousands of people working in factories and living in public housing had already been exposed. In other words, as the Italian photographer Cinzia Canneri explained, the damage had been done by the 1980s.

Ms. Canneri said it could take up to 30 years after exposure for diseases like asbestosis or mesothelioma to develop. As a result, large numbers of people in the last decade have begun to suffer in Italy and more are expected to — with few legal or medical protections.

“They have not been recognized as victims,” Ms. Canneri said through an interpreter. “They want to speak and be heard.

”To help them, Ms. Canneri spent the last two years closely following asbestos victims, documenting their daily lives and struggles as they deal with new diseases, mourn deceased family members, visit doctors and contemplate whether or not time is running out on their health.

[Article continues at original source]

Source: Deadly Remnants of Asbestos in Italy (photos slideshow)


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Boeing Can Take Asbestos Case to Federal Court Under Contractor Defense

The Boeing Co. is entitled to the military contractor defense from liability in a suit claiming it failed to warn of the dangers of asbestos, the U.S. Court of Appeals for the Third Circuit ruled on Tuesday.

The appeals panel reversed the decision of a U.S. district court judge in New Jersey who granted the plaintiff’s motion to send the case back to state court after Boeing removed it to federal court under the federal officer removal statute. Boeing is entitled to remove the case to federal court because it made the requisite showing that it engaged in the allegedly culpable behavior at the direction of a federal officer or agency, Third Circuit Judges Kent Jordan, Thomas Vanaskie and Cheryl Ann Krause ruled in Papp v. Fore-Kast Sales.

U.S. District Judge Peter Sheridan of the District of New Jersey granted the plaintiff’s motion to send the case back to state court upon finding that, as a contractor, it had a “special burden” to demonstrate that it was acting under federal government control. Sheridan said Boeing could only show it was acting under a federal officer by showing that was directly instructed by federal authority to keep mum about the dangers of asbestos.

Source: Boeing Can Take Asbestos Case to Federal Court Under Contractor Defense


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Is Asbestos Trial Consolidation Ending in Philadelphia

Defense attorneys have long said the practice of consolidating asbestos trials in Philadelphia gives the plaintiffs’ bar an unfair advantage, but some are now looking to a recent state Supreme Court decision as an indication that the consolidation of asbestos trials might be on its way out.

The practice of consolidating trials began more than 25 years ago in an effort to get control of a spiraling backlog of asbestos cases. Consolidation was credited with quickly wiping out the backlog and became the standard for how asbestos cases would be tried in Philadelphia.

Nearly five years ago, however, the court eliminated mandatory consolidation and placed a limit on the number of cases that could be consolidated into a single trial. Since then, the number of asbestos cases being tried to verdict has been decreasing, which attorneys attributed to growing success with mediation. Of the cases that go to trial, thought, many are still consolidated.

However, according to defense attorneys, the Supreme Court’s recent decision in Rost v. Ford Motor might help the defense bar in its efforts to challenge consolidation.

Source: Is Asbestos Trial Consolidation Ending in Philadelphia


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Asbestos ban to be announced by federal government next week

The federal government plans to announce a comprehensive ban on asbestos in Canada next week, CBC News has learned.

The country currently allows imports of construction products and automotive parts that contain the toxic fibre, even though Canada no longer exports the material.

Asbestos is known to cause deadly cancers and lung diseases, and has already been banned in Europe, Australia and Japan. The World Health Organization recommends replacing asbestos with safer substitutes.

Canadian labour and public health groups have been calling for a comprehensive ban for years.

About 2,000 Canadians die of asbestos-related diseases every year — many of those deaths have been linked to asbestos exposure in the workplace.

[Article continues at original source]

Source: Asbestos ban to be announced by federal government next week


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Canada should stop importing deadly asbestos, labour group says

The Canadian Labour Congress is calling for a ban on asbestos.

Exposure to asbestos — a fibrous mineral used in building and construction — is the leading cause of workplace-related death in Canada.

Canada stopped exporting asbestos in 2011, and its last asbestos mine closed in 2012. But Canada still imports asbestos for use in construction products and automotive parts.

According to the Canadian Labour Congress, the value of the imports has increased from $4.7 million in 2011 to $8.2 million in 2015.

Hassan Yussuff, president of the Canadian Labour Congress, told CBC’s The Early Edition the government needs to step up and ban the import of asbestos.

“We only stopped exporting it because the mine went bankrupt, not because this is good public policy.  We knew the evidence long before that asbestos is a carcinogen.”

[Article continues at original source]

Source: Canada should stop importing deadly asbestos, labour group says


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Treatments to prolong life for mesothelioma patients closer

Researchers have uncovered a strange way that asbestos-related tumours grow, which could pave the way towards better treatments.

The scientists at Adelaide’s Flinders University have found that malignant mesothelioma tumours are able to transform into blood vessels, promoting their own growth.

Associate Professor Sonja Klebe said the behaviour was unusual.

“Instead of waiting for the outside of the tissue to grow blood vessels in, the tumour cells themselves branch out, growing blood vessels that reach out into surrounding tissues, tapping into the native vasculature,” she said.

Existing tumour treatments target blood vessels that grow into the cancer, and not the other way around.

“So I think a future approach would involve treating both of these types of vessels to more or less starve the tumour of blood supply,” Associate Professor Klebe said.

[Article continues at original source]

Source: Treatments to prolong life for mesothelioma patients closer


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New Paradigms in the Treatment of Mesothelioma and NSCLC: An Overview by Fred Hirsch

Dr. Haffizulla: Welcome to PracticeUpdate. I’m Dr. Farzanna Haffizulla. Joining me today is Dr. Fred Hirsch, CEO of the International Association for the Study of Lung Cancer, and Professor of Medicine at the University of Colorado in Denver. Dr. Hirsch, thank you, so much, for joining me.

Dr. Hirsch: Thank you, so much, for the invitation.

Dr. Haffizulla: You’re very welcome. Well, I want to first start off with talking about mesothelioma. Any latest advances or current treatments that have come to the forefront that have precipitated based on clinical trials recently?

Dr. Hirsch: Mesothelioma is an interesting disease where we unfortunately haven’t seen much progress, either, over a long time. Pemetrexed-platinum is a standard of care for mesothelioma, but what we have seen most recently is the introduction of immunotherapy also in this disease, and with very encouraging data. It is still very preliminary data, and certainly we need much more matured clinical trials, but already by now we can see a very clear encouraging signal with the PD-L1, PD-1 antibodies.

Dr. Haffizulla: Okay. Absolutely. Well, switching gears a little bit. I want to talk a little bit further on immunologic biomarkers, talking about neoantigen signatures and mutational load of tumors. Other than assessing or using this information to assess the severity of the disease, perhaps, or the risk of relapse and choice of agents that you would like to use in this particular patient, anything else you’d like to share on that home front?

Dr. Hirsch: Yeah, so that will probably be most related to non-small cell lung cancer. We have recently seen data in mesothelioma for follow-up on the mesothelioma stuff that mesothelioma has much less mutation burden than we see in small cell and non-small cell lung cancer, and that might be important when we are talking immunotherapy and promises, but we don’t know. We see encouraging results currently in mesothelioma with the new immune checkpoints. In non-small cell lung cancer there seems to be a relation between mutation burden and sensitivity to some of the checkpoint inhibitors, and that is interesting. On a personal level, I think we need to learn more about it because I don’t think all mutations are equal, and all mutations are not equally immunogenic, so we need to learn more about the mutation load, mutation types. Are we talking tumor heterogeneity? Are we talking trunk mutations? Are we talking branch mutations, so mutation load might be too broad in term in the future, but currently we actually see an association between mutation load and sensitivity to some of those immune checkpoints.

Source: New Paradigms in the Treatment of Mesothelioma and NSCLC: An Overview by Fred Hirsch


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Myxoid variant epithelioid pleural mesothelioma defines a favourable prognosis group: an analysis of 191 patients with pleural malignant mesothelioma

Malignant pleural mesothelioma shows marked cytoarchitectural diversity. The aim of the study was to evaluate how morphological phenotype impacted upon overall survival. 191 cases of malignant pleural mesothelioma with available follow-up were identified, examined and classified according to histological types. The epithelioid mesotheliomas were further subdivided according to morphological subtypes: myxoid, microcystic, tubulopapillary, solid epithelioid, micropapillary and pleomorphic; biphasic mesotheliomas were divided into epithelioid component dominant and sarcomatoid component dominant; pure sarcomatoid mesotheliomas were divided into not otherwise specified, leiomyoid, desmoplastic and heterologous. All cases were confirmed by two experienced observers. Myxoid variant malignant pleural epithelioid mesothelioma was observed to have a favourable overall survival compared with pleomorphic form (p=0.00008). Pleomorphic phenotype had the worst overall survival. Morphological phenotype is an important histological factor that should be included in pathology reports to convey potential favourable prognostic subgroups of patients with mesothelioma.

Source: Myxoid variant epithelioid pleural mesothelioma defines a favourable prognosis group: an analysis of 191 patients with pleural malignant mesothelioma


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Residual fibre lung burden among patients with pleural mesothelioma who have been occupationally exposed to asbestos

Objectives  To evaluate the lungs asbestos fibres concentration in participants with malignant pleural mesothelioma (MPM) who have been occupationally exposed.

Methods  The lung samples were obtained from pleuropneumonectomies or autopsies of 271 male MPMs. The lung samples were examined through scanning electron microscopy. Retrospective assessment was used to assess for asbestos exposure. This study includes 248 MPMs with an occupational exposure defined as either ‘definite’ or ‘probable’ or ‘possible’.

Results  The participants had finished working in asbestos exposure conditions more than 20?years ago (on average 26.1±11.0?years). The fibre burden resulted with a geometric mean equal to 2.0 (95% CI 1.6 to 2.4) million fibres per gram of dry lung tissue. The burden was higher among participants employed in asbestos textiles industry and in shipyards with insulation material, if compared with construction workers or non-asbestos textile workers or participants working in chemicals or as auto mechanics. 91.3% of MPMs had a detectable amount of amphibole fibres. A strong lung clearance capability was evident among workers exposed to chrysotile fibres. Owing to that, the 1997 Helsinki Criteria for occupational exposure were reached in <35% of cases among participant working in construction, in metallurgical industry, in chemical or textile industry and among those performing brake repair activities.

Conclusions  The MPM cases are now occurring in Italy in participants who ceased occupational asbestos exposure decades before the analysis. A large majority still shows a residual content of amphibole fibres, but given the lung clearance capability, attribution to occupational exposure cannot rely only on fibres detection.

Source: Residual fibre lung burden among patients with pleural mesothelioma who have been occupationally exposed to asbestos


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