Chest
Volume 122, Issue 6, December 2002, Pages 2224-2229
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Occupational and Environmental Lung Disease
Malignant Mesothelioma due to Environmental Exposure to Asbestos: Follow-Up of a Turkish Cohort Living in a Rural Area

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Study objectives

This study examines the incidence of malignant pleural mesothelioma (MPM) in a rural population of Turkey with environmental exposure to asbestos-contaminated soil mixtures (white soil).

Design

A field-based epidemiologic study.

Setting and subjects

A cohort of villagers (the “Eskisehir” cohort) from 11 villages around Eskisehir in central Anatolia, who had been environmentally exposed to asbestos due to the use of white soil.

Measurements

The mineral content and asbestos contamination of the white soil used in these villages was determined, as well as airborne fiber concentrations. Cohort members’ details of age, sex, ambient exposure data, duration of residence in the villages, and hospital records, including pathologic diagnosis, were recorded.

Results

The Eskisehir cohort consisted of 1,886 villagers. During the observation time, 377 deaths occurred and 24 MPM cases were diagnosed. Average annual mesothelioma incidence rates were 114.8/100,000 for men and 159.8/100,000 for women.

Conclusions

These data indicate that the risk of mesothelioma is 88.3 times greater in men and 799 times greater in women, respectively, in comparison to world background incidence rates.

Section snippets

Eskisehir Cohort

The Eshisehir cohort was formed as follows: of the 403 villages of Eskisehir, we were able to acquire data, via a questionnaire, from 196 villages. We learned that white soil had been used in 140 villages and was still being used in 126 villages. We randomly chose 67 villages from these 126 villages. We were receiving patients from some of these villages already, and we collected white soil samples from them. We found tremolite or other types of asbestos fiber contamination in a total of 41

Results

The white soil samples from 11 villages all contained asbestos fibers, a high rate of tremolite or tremolite-plus-actinolite-plus-chrysotile mixtures, as well as a lower rate of anthophyllite-plus-chrysotile mixtures. Indoor and outdoor air fiber concentrations were low. Indoor fiber concentrations were from 0.009 to 0.28 fibers per milliliter (f/mL) [mean, 0.089 f/mL]; and outdoor fiber concentrations were 0.009 to 0.04 f/mL (mean, 0.012 f/mL).

Age and sex characteristics of the cohort are on

Discussion

Environmental exposure to asbestos as a cause of mesothelioma has been well documented in many studies.1,3,7,8,9,16,17,18 However, the AMIR values of 114.8/100,000 for men and 159.8/100,000 for women that we established in a cohort of villagers who had been environmentally exposed to asbestos from birth through the use of white soil are the first values presented in the literature for such a cohort. Mesothelioma case series and incidence data from other similar types of exposure19,20 in Turkey

ACKNOWLEDGMENT

The authors thank Tayyibe Kavak, Pinar Atabek, and Kezban Akyuz Simsek from National Institute of Workers Health and Security for their careful fiber analysis, and our teacher, Prof. Dr. Izzettin Baris, for support of our scientific studies.

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    This study was partly supported by TÜBİTAK and the Research Fund of Osmangazi University.

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