Primary pericardial mesothelioma and asbestos exposure: a rare fatal disease

A 73-year-old woman without a history of cardiovascular disease was admitted to the hospital with progressive dyspnoea on exertion during the past several weeks, bilateral lower extremity oedema, orthopnoea and paroxistic nocturnal dyspnoea. She lived a few metres away from a badly preserved building containing asbestos for 50 years. Estimated jugular venous pressure was 6+5 cm H2O, a pericardial friction rub was heard, bilateral basal lung crackles were present and symmetrical below-knee pitting oedema was seen. Probrain natriuretic peptide was 2304?pg/mL, and chest radiograph showed a globular cardiac silhouette and blunting of the costophrenic angles due to a small transudative pleural effusion containing benign mesothelial cells on cytological analysis. Transthoracic echocardiogram showed a large pericardial effusion with diastolic collapse of the right ventricle and a hypotransparent mass (4×1.6?cm) attached to the visceral pericardium in the right apex (video 1). Therapeutic pericardiocentesis was performed and cytological analysis of pericardial fluid demonstrated malignant cells of inconclusive origin. CT scan of the chest, abdomen and pelvis, mammography and upper and lower gastrointestinal endoscopies showed no evidence of extracardiac disease. A primary cardiac tumour was assumed and positron emission tomography-CT was done, as a part of the staging workup, demonstrating isolated hyperfixation in the apex and right atrium.

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Source: Primary pericardial mesothelioma and asbestos exposure: a rare fatal disease


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Asbestos, spying and the Canadian connection

This week in Geneva, delegates to a conference of the parties to the Rotterdam Convention are again discussing whether chrysotile asbestos should be put on the list of hazardous substances.

One hot topic is sure to be Canada, which until 2012 was a major exporter of chrysotile — the most common form of asbestos — and opposed its inclusion on the hazardous list.However, Ottawa has recently and dramatically changed its tune.

“When it comes to asbestos, the scientific evidence is clear,” Science Minister Kirsty Duncan said in an April 21 statement, just days before the conference got underway.

“Irrefutable evidence has led us to take concrete action to swiftly ban asbestos and to support the listing of chrysotile asbestos to the Rotterdam Convention.

”The listing of asbestos would mean countries that export it would have to get prior informed consent from importing countries, which could block or set conditions on such imports.

But perhaps an even hotter topic at the conference is the case of Robert Moore, who is being sued in Britain on allegations he spied on members of the anti-asbestos movement for four years.

Source: Asbestos, spying and the Canadian connection


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Midkine is a potential novel marker for malignant mesothelioma with different prognostic and diagnostic values from mesothelin

Background  We evaluated possible diagnostic and prognostic values of serum midkine in malignant pleural mesothelioma in comparison with those of serum mesothelin, a well-established diagnostic biomarker.

Methods  Serum mesothelin and midkine levels were determined with an enzyme-linked immunosorbent assay. We examined specimens from 95 Turkish cases with malignant pleural mesothelioma, 56 metastatic cancers to pleura, 27 other types of benign pleural diseases and 20 benign asbestos pleurisy….

Conclusions  Serum mesothelin showed moderate sensitivity and high specificity to differentiate malignant pleural mesothelioma from metastatic malignancy to pleura and from benign pleural diseases. In contrast, midkine was a useful marker for predicting prognosis of mesothelioma patients.

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Source: Midkine is a potential novel marker for malignant mesothelioma with different prognostic and diagnostic values from mesothelin


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Asbestos expert warns ageing population will drive surge in mesothelioma deaths

AN ASBESTOS expert has warned that the number of men dying from a lethal lung disease caused by exposure to the mineral is likely to triple over the next 30 years.

Robin Howie said official predictions had “vastly underestimated” the death toll from mesothelioma, an incurable cancer, because they fail to take account of future improvements in life expectancy.

Mr Howie, an Edinburgh-based occupational hygienist who advises on health and safety, said that the expected surge in people living into the 80s and older meant that increasing numbers of men would survive long enough to develop mesothelioma, whereas past generations tended to die earlier from other illnesses. The condition takes 42 years on average to develop after initial exposure.

Source: Asbestos expert warns ageing population will drive surge in mesothelioma deaths


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Asbestos Deaths Remain A Public Health Problem

People are still dying of cancer linked to asbestos, the U.S. Centers for Disease Control says, despite decades of regulations meant to limit dangerous exposure.

Starting in 1971, the Occupational Safety and Health Administration has regulated how much asbestos workers can be exposed to, because it contains tiny fibers that can cause lung disease or cancer if they are swallowed or inhaled.

The Environmental Protection Agency regulates asbestos too, setting requirements for inspecting, demolishing and renovating buildings that contain materials made with asbestos, like insulation, vinyl tiles, roofing, shingles and paint.

But, a recent CDC analysis found that thousands of people are still dying each year from a type of cancer called malignant mesothelioma that is associated with inhaling asbestos fibers, even briefly or in small amounts. Even after decades of regulation, between 1999 and 2015 there were 45,221 mesothelioma deaths in the U.S. The majority of those who died were men.

The greatest increase is among people over 85 years old, who were likely exposed to asbestos many years ago. It can take anywhere from two to seven decades for mesothelioma to develop after a person inhales asbestos fibers. And early deaths among people 35 to 65 are down overall.

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Source: Asbestos Deaths Remain A Public Health Problem


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EPA Asbestos Review May Trigger Probe of Chlorine Industry

Chlorine manufacturers, which currently are the largest U.S. importers of asbestos, could have their use of the mineral reviewed soon if the Environmental Protection Agency selects asbestos as one of the first 10 substances it will analyze under the amended chemicals law.

Chlorine and caustic soda are manufactured by the chlor-alkali industry, which uses asbestos for one of three processes that companies can use to produce both chemicals. The U.S. Geological Survey has listed the chlor-alkali industry as the primary importer of asbestos in each annual mineral commodity summary the service has published since 2013. The industry’s use accounted for 90 percent of the 358 tons of asbestos imported into the country in 2015, the geologic survey said in its 2016 summary.

The chlor-alkali industry’s use of asbestos should be evaluated by the EPA as part of an assessment of the risks posed by the mineral, Linda Reinstein, president of the nonprofit advocacy group Asbestos Disease Awareness Organization (ADAO), told Bloomberg BNA Sept. 9 [2016].

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Source: EPA Asbestos Review May Trigger Probe of Chlorine Industry


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Asbestos exposure is still making people sick

Researchers at the US Centers for Disease Control and Prevention are struggling to understand why younger populations continue to suffer asbestos-related medical issues despite efforts to reduce exposure from the toxic mineral.

According to a report released by the CDC on Thursday, numbers of deaths related to malignant mesothelioma increased from 2,479 in 1999 to 2,597 in 2015.

The largest increase was seen in those over 85 years old, but younger populations continue to be affected.

In those 16 years, 16,914 of the deaths were among people 75 to 84 years old. In the same period, 682 people between the ages of 25 and 44 died of mesothelioma-related problems.

“Although deaths among persons aged less than 35 years are of concern, we do not have information to understand potential causes,” said Dr. Jacek Mazurek, lead author of the CDC report.

Source: Asbestos exposure is still making people sick


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Mesothelioma deaths alert US to continuing asbestos exposure

A paper from the National Institute for Occupational Safety and Health (Niosh) reveals that the latest data for deaths linked to mesothelioma show increases between 1999 and 2009. The trend was for both sexes and all ethnic groups, and the authors remark that the “continuing deaths of those aged less than 55 suggests continuing exposure to asbestos fibres”.

Continuing deaths from malignant mesothelioma, the lung disease associated with asbestos fibres, have alerted the US health authorities of the need for continuing efforts to prevent exposure…..

The US Geological Survey produced a commodity summary in January 2016, which says that the chloralkali industry accounted for 90% of US consumption of 360 tons in 2015. Its use by the industry is for diaphragms which separate anode and cathode products in chloralkali electrolytic cells. The remainder is used in coatings and compounds, plastics and roofing products.
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Source: Mesothelioma deaths alert US to continuing asbestos exposure


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Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma (DIAPHRAGM) study: protocol of a prospective, multicentre, observational study

Malignant pleural mesothelioma (MPM) is an asbestos-related cancer, which is difficult to diagnose. Thoracoscopy is frequently required but is not widely available. An accurate, non-invasive diagnostic biomarker would allow early specialist referral, limit diagnostic delays and maximise clinical trial access. Current markers offer insufficient sensitivity and are not routinely used. The SOMAmer proteomic classifier and fibulin-3 have recently demonstrated sensitivity and specificity exceeding 90% in retrospective studies. DIAPHRAGM (Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma) is a suitably powered, multicentre, prospective observational study designed to determine whether these markers provide clinically useful diagnostic and prognostic information.

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Source: Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma (DIAPHRAGM) study: protocol of a prospective, multicentre, observational study


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Asbestos-related cancer won’t be overcome anytime soon, doctors say

New methods are giving doctors a better handle on diagnosing and treating asbestos-related cancers, but no cures are on the horizon.

“I think it would be overly optimistic to say it’s going to be cured. I mean we can always dream,” said oncologist Dr. Christopher Lee, an expert on mesothelioma.

Paul Demers, a senior scientist in prevention at the Occupational Cancer Research Centre in Toronto, said one of the difficulties in diagnosing mesothelioma is the long latency period — the period between exposure and the development of symptoms — which can sometimes be up to 40 years.

When asbestos fibres are inhaled or ingested, they become trapped in the pleural lining of the lungs. Over time, thousands of tiny fibres cause scarring in the tissue.

New equipment like the CyTOF instrument allows doctors to detect asbestos earlier and with more precision, which could facilitate more effective treatments for asbestos victims.

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Source: Asbestos-related cancer won’t be overcome anytime soon, doctors say


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