Mesothelioma From Household Asbestos Exposure

ABSTRACT Non-occupational exposure to asbestos is a hazard that may contribute to the burden of mesothelioma over the next decades. Such exposure may result from cohabitation with an asbestos worker and the handling of his/her work clothes. This paper reviews the features of mesothelioma from domestic exposure reported by the literature. Household-exposure mesothelioma cases are more likely to be 1) female (primarily wife), 2) diagnosed with pleural mesothelioma 3) exposed and, in some cases, 4) diagnosed at a younger age, and to have a 5) longer latency and 6) similar lung asbestos concentrations compared to occupational cases. Non-occupational subjects are more likely to be under-recognized than those with occupational exposure. This underlines the ongoing importance of exposure history in enhancing early diagnosis and the need of a framework for insurance and welfare protection for mesothelioma cases induced by non-occupational exposure to asbestos. Introduction Malignant mesothelioma (MM) is a rare tumor arising most frequently from the mesothelial lining of the pleura and the peritoneum. Patients commonly show unspecific symptoms (i.e., dyspnoea, chest wall pain, pleural effusion, increased abdominal girth and weight loss). Diagnosis usually occurs at a late stage and in untreated patients, median survival is less than one year1 . MM is causally related to asbestos exposure with an aetiological fraction above 80%2 . The International Agency for Research on Cancer recently confirmed that all types of asbestos cause cancer in humans3 . Many western countries are currently going through an MM epidemic, considering the extensive use of asbestos from 1950 to 1985 in a large number of industries (e.g., construction and shipbuilding) and the long latency period (around 40 years) since the beginning of exposure. Asbestos is still used in many countries of Asia, South America, Africa and former Soviet Union4 . The incidence rates of pleural MM in a large proportion of Europe are in the range of 10-20 cases per million. The highest incidence rates of disease, about 30 cases per million, are reported from Australia and the United Kingdom5 . In Italy, the standardized incidence rate for pleural MM in 2008 was 3.84 (cases per 100,000 inhabitants) for men and 1.45 for women4 . The incidence rates of peritoneal MM in industrialized countries range from 0.5 to about 3 cases per million population in men and between 0.2-2 cases per million in women6