A mesothelioma epidemic in Cappadocia: Scientific developments and unexpected social outcomes

Department of Geophysical Sciences, University of Chicago, Chicago, Illinois, United States
Nature reviews. Cancer (Impact Factor: 37.4). 03/2007; 7(2):147-54. DOI: 10.1038/nrc2068
Source: PubMed


In Cappadocia, Turkey, an unprecedented mesothelioma epidemic causes 50% of all deaths in three small villages. Initially linked solely to the exposure to a fibrous mineral, erionite, recent studies by scientists from Turkey and the United States have shown that erionite causes mesothelioma mostly in families that are genetically predisposed to mineral fibre carcinogenesis. This manuscript reports, through the eyes of one of the researchers, the resulting scientific advances that have come from these studies and the social improvements that were brought about by both the scientists and members of the Turkish Government.

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Available from: A. Umran Dogan, Oct 14, 2015
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    • "The distinctive fibrous-asbestiform crystal habit and surface activity, responsible for the outstanding technological properties of asbestos minerals, seem to be also the cause of their potential toxicity. Erionite has a very limited use and is known to induce mesothelioma [35]. Crocidolite is now banned worldwide whereas 72% of the countries worldwide admit the safe use of chrysotile. "
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    ABSTRACT: This work presents a comparative FEG–SEM study of the morphological and chemical characteristics of both asbestos bodies and fibres found in the tissues of Sprague–Dawley rats subjected to intraperitoneal or intrapleural injection of UICC chrysotile, UICC crocidolite and erionite from Jersey, Nevada (USA), with monitoring up to 3 years after exposure. Due to unequal dosing based on number of fibres per mass for chrysotile with respect to crocidolite and erionite, excessive fibre burden and fibre aggregation during injection that especially for chrysotile would likely not represent what humans would be exposed to, caution must be taken in extrapolating our results based on instillation in experimental animals to human inhalation. Notwithstanding, the results of this study may help to better understand the mechanism of formation of asbestos bodies. For chrysotile and crocidolite, asbestos bodies are systematically formed on long asbestos fibres. The number of coated fibres is only 3.3% in chrysotile inoculated tissues. In UICC crocidolite, Mg, Si, and Fe are associated with the fibres whereas Fe, P and Ca are associated with the coating. Even for crocidolite, most of the observed fibres are uncoated as coated fibres are about 5.7%. Asbestos bodies do not form on erionite fibres. The crystal habit, crystallinity and chemistry of all fibre species do not change with contact time, with the exception of chrysotile which shows signs of leaching of Mg. A model for the formation of asbestos bodies from mineral fibres is postulated. Because the three fibre species show limited signs of dissolution in the tissue, they cannot act as source of elements (primarily Fe, P and Ca) promoting nucleation and growth of asbestos bodies. Hence, the limited number of coated fibres should be due to the lack of nutrients or organic nature.
    Full-text · Article · Dec 2015 · Journal of hazardous materials
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    • "A naturally occurring zeolite mineral also exists in a fi brous form. It has been implicated as a potent cause of mesothelioma in humans and animals (Wagner et al. 1985, Baris et al. 1981, 1987, Baris and Grandjean 2006, Carbone et al. 2007, Ryan et al. 2011). "
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    ABSTRACT: Airborne fibers, when sufficiently biopersistent, can cause chronic pleural diseases, as well as excess pulmonary fibrosis and lung cancers. Mesothelioma and pleural plaques are caused by biopersistent fibers thinner than ∼0.1 μm and longer than ∼5 μm. Excess lung cancer and pulmonary fibrosis are caused by biopersistent fibers that are longer than ∼20 μm. While biopersistence varies with fiber type, all amphibole and erionite fibers are sufficiently biopersistent to cause pathogenic effects, while the greater in vivo solubility of chrysotile fibers makes them somewhat less causal for the lung diseases, and much less causal for the pleural diseases. Most synthetic vitreous fibers are more soluble in vivo than chrysotile, and pose little, if any, health pulmonary or pleural health risk, but some specialty SVFs were sufficiently biopersistent to cause pathogenic effects in animal studies. My conclusions are based on the following: 1) epidemiologic studies that specified the origin of the fibers by type, and especially those that identified their fiber length and diameter distributions; 2) laboratory-based toxicologic studies involving fiber size characterization and/or dissolution rates and long-term observation of biological responses; and 3) the largely coherent findings of the epidemiology and the toxicology. The strong dependence of effects on fiber diameter, length, and biopersistence makes reliable routine quantitative exposure and risk assessment impractical in some cases, since it would require transmission electronic microscopic examination, of representative membrane filter samples, for determining statistically sufficient numbers of fibers longer than 5 and 20 μm, and those thinner than 0.1 μm, based on the fiber types.
    Full-text · Article · Aug 2014 · Critical Reviews in Toxicology
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    • "Genetic factors can play a role in the development and progression of MM as depicted in a study on the population in parts of Cappadocia, Turkey exposed to erionite (a fiber found in the volcanic rock of this area that shares many similar properties with crocidolite asbestos). Erionite related MM reached epidemic proportions, but only in families that passed on a predisposition to MM by erionite exposure in an autosomal‐dominant manner [Carbone et al., 2007] "
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    ABSTRACT: Malignant mesothelioma (MM) is an aggressive cancer of the mesothelium caused by asbestos. Asbestos use has been reduced but not completely stopped. In addition, natural or man-made disasters will continue to dislodge asbestos from old buildings into the atmosphere and as long as respirable asbestos is available, MM will continue to be a threat. Due to the long latency period of MM development, it would still take decades to eradicate this disease if asbestos was completely removed from our lives today. Therefore, there is a need for researchers and clinicians to work together to understand this deadly disease and find a solution for early diagnosis and treatment. This article focuses on developmental mechanisms as well as current therapies available for MM. J. Cell. Biochem. © 2013 Wiley Periodicals, Inc.
    Full-text · Article · Jan 2014 · Journal of Cellular Biochemistry
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