Mortality in chrysotile asbestos workers in China
JC School of Public Health and Primary Care, the Chinese University of Hong Kong, Hong Kong, China. Current opinion in pulmonary medicine
(Impact Factor: 2.76).
03/2013; 19(2):169-73. DOI: 10.1097/MCP.0b013e32835d6f56
China has been the world's top chrysotile asbestos consumer and producer. However, the national mortality rate for asbestos-related diseases, particularly from malignancies, is unknown. This review elaborates recent studies on cancer mortality and nonmalignant respiratory diseases in Chinese chrysotile asbestos workers.
Studies conducted in asbestos products factory workers and miners have demonstrated strong associations between exposure to chrysotile and mortality rates for lung cancer and nonmalignant respiratory diseases. Mortality rates for lung cancer and nonmalignant respiratory diseases in both asbestos workers and miners are four and three times higher, respectively, than expected, which are greater than those seen in studies from western countries, likely a reflection of heavier exposures and less effective protection for workers. An increased risk of gastrointestinal cancer was also detected in chrysotile miners. There have been surprisingly few reported cases of mesothelioma, however, which could, at least partially, indicate a problem in diagnosis.
Given the substantially increased death risks for lung cancer and nonmalignant respiratory diseases, urgent efforts must be made to implement occupational health and safety regulations and decrease workers' exposures to prevent a future heavier disease burden. Meanwhile, improvements in diagnostics and systematic recording of the incidence and mortality of asbestos-related diseases are needed.
Available from: Jinhui Li
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ABSTRACT: With of the rapid economic development of the Asian-Pacific region during the past several decades, asbestos products have been used, and asbestos waste generated, in large quantities, while issues of occupational hazards and environmental risks have not been given adequate attention. In order to better understand the asbestos management situation in this area, this study selected 13 countries that consumed more than half of the global quantity of asbestos in 2011; researched information on asbestos production, consumption and import; compared data from developed and developing countries in the region; and predicted the amount of asbestos waste that would be generated in the Asian-Pacific from 2013 to 2022. Then, related aspects such as regulations and authorities, occupational exposure and follow-up medical care, asbestos waste treatment, awareness-raising activities and possible substitutes for asbestos, were discussed and analyzed. Asbestos waste, at an estimated generation of 48.8 million tons, should be efficiently disposed of or recycled with new technologies and treatment facilities in the region. What't more, the governments of these countries should take action to regulate the mining and processing of asbestos or asbestos-containing products, set up and equip medical facilities for asbestos-affected communities, search for asbestos substitutes, raise public awareness, and seek international cooperation for asbestos waste management. The article is specifically intended to be used as a basis for the development of new strategies and policies for asbestos waste management, and for investments in new waste treatment facilities, for decision makers at all levels of government and in private industries in the region.
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ABSTRACT: Vascular hyporeactivity plays an important role in severe trauma and shock. We investigated the beneficial effect of cyclosporine A (CsA) on traumatic shock and its relationship to vascular reactivity improvement and mitochondrial permeability transition pore (MPTP).
Sodium pentobarbital-anesthetized rats were used to induce traumatic hemorrhagic shock by left femur fracture and hemorrhage, the beneficial effects of CsA (1, 5, and 10 mg/kg, intravenously) on animal survival, cardiovascular function, tissue blood perfusion, and mitochondrial function of vital organs were observed. In addition, hypoxia-treated vascular smooth muscle cells from normal rats were used to investigate the relationship of this beneficial effect of CsA to Rho-associated serine/threonine kinase (ROCK) and protein kinase C.
CsA prolonged the survival time and increased the 24-h survival rate of traumatic hemorrhagic shock (31%, 56%, and 56% in 1, 5, and 10 mg/kg CsA group versus 25% in lactated Ringer solution group). Five milligrams per kilogram of CsA had the best effect, which stabilized and improved the hemodynamics, increased the tissue blood flow, and improved the liver and kidney function including its mitochondrial function in shock rats. CsA had no significant influences on the production of inflammatory mediators and cardiac output after traumatic hemorrhagic shock. Further results indicated that CsA significantly improved the vascular constriction and dilation reactivity of superior mesenteric artery to norepinephrine and acetylcholine, which was antagonized by ROCK inhibitor, Y27632, but not by protein kinase C inhibitor, staurosporine. Further studies showed that CsA restored hypoxia-induced decrease of ROCK activity and inhibited the opening of MPTP in hypoxia-treated vascular smooth muscle cells.
CsA is beneficial for the treatment of traumatic hemorrhagic shock. The mechanism is mainly through improving the vascular reactivity, stabilizing the hemodynamics, and increasing tissue perfusion. This beneficial effect of CsA is related to the inhibitory effect of CsA on MPTP opening. ROCK is an important regulator molecule in this process.
Copyright © 2015 Elsevier Inc. All rights reserved.
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ABSTRACT: Recent epidemiologic investigations suggest that occupational and environmental exposures contribute to the overall burden of idiopathic pulmonary fibrosis (IPF). This article explores the epidemiologic and clinical challenges to establishing exposure associations, the current literature regarding exposure disease relationships and the diagnostic work-up of IPF and asbestosis patients.
IPF patients demonstrate a histopathologic pattern of usual interstitial pneumonia. In the absence of a known cause or association, a usual interstitial pneumonia pattern leads to an IPF diagnosis, which is a progressive and often terminal fibrotic lung disease. It has long been recognized that asbestos exposure can cause pathologic and radiographic changes indistinguishable from IPF. Several epidemiologic studies, primarily case control in design, have found that a number of other exposures that can increase risk of developing IPF include cigarette smoke, wood dust, metal dust, sand/silica and agricultural exposures. Lung mineralogic analyses have provided additional support to causal associations. Genetic variation may explain differences in disease susceptibility among the population.
An accumulating body of literature suggests that occupational and environmental exposure can contribute to the development of IPF. The impact of exposure on the pathogenesis and clinical course of disease requires further study.
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