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
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