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Asbestos, asbestosis, and cancer, the Helsinki criteria for diagnosis and attribution 2014: recommendations

Published on Jan 1, 2015in Scandinavian Journal of Work, Environment & Health 3.49
· DOI :10.5271/sjweh.3462
Henrik Wolff29
Estimated H-index: 29
,
Tapio Vehmas29
Estimated H-index: 29
+ 2 AuthorsHarri Vainio60
Estimated H-index: 60
Cite
Abstract
IntroductionAlthough the use of asbestos has been banned in several industrialized countries, many workers continue to be exposed in asbestos repair and removal work, and asbestos is still widely used in various newly industrialized, rapidly developing countries. According to the most recent World Health Organization (WHO) estimates, more than 107 000 people die each year from asbestos-related lung cancer, mesothelioma, and asbestosis resulting from exposure at work (1). The asbestos epidemic is far from over.The expert meeting on "asbestos, asbestosis, and cancer" was convened in Helsinki in 1997 (2) and consisted of 19 participants from eight countries. This meeting had the goal to "discuss disorders in association with asbestos and agree upon state of the art criteria for diagnosis and attribution with respect to asbestos". In addition, questions concerning the surveillance of asbestos-exposed workers were discussed. The resulting consensus report was titled "Asbestos, asbestosis, and cancer: the Helsinki criteria for diagnosis and attribution" (in the current report a shorter name "Helsinki criteria" or just "criteria" will be used). A follow-up expert meeting on new advances in radiology and screening of asbestos-related diseases was organized in 2000 in Helsinki (3).This report summarizes the results of a project, organized by the Finnish Institute of Occupational Health (FIOH), to update the 1997 and 2000 Helsinki criteria documents in view of the new advances in research. It presents the conclusions of a meeting on 10-13 February 2014 in Espoo, Finland, among an international group of experts working to update the criteria.Recommendations from the Helsinki criteria of 1997In the following, recommendations from the Helsinki criteria document of 1997 (and for radiology 2000) are quoted together with commentary by the authors.General considerations"In general, reliable work histories provide the most practical and useful measure of occupational asbestos exposure". "Using structured questionnaires and checklists, trained interviewers can identify persons who have a work history compatible with significant asbestos exposure." "A cumulative fibre dose expressed as fibreyears per cubic centimetre, is an important parametre of asbestos exposure.""Analysis of lung tissue for asbestos fibres and asbestos bodies can provide data to supplement the occupational history.""For clinical purposes, the following guidelines are recommended to identify persons with a high probability of exposure to asbestos dust:* over 0.1 million amphibole fibres (>5 μm) per gram of dry lung tissue or* over 1 million amphibole fibres (>1 μm) per gram of dry tissue as measured by electron microscopy in a qualified laboratory or* over 1000 asbestos bodies per gram of dry tissue (100 asbestos bodies per gram of wet tissue) or* over 1 asbestos body per millilitre of bronchoalveolar lavage fluid as measured by light microscopy in a qualified laboratory.Each laboratory should establish its own reference values."Asbestosis"Asbestosis is defined as diffuse interstitial fibrosis of the lung as a consequence of exposure to asbestos dust." It is noted that neither clinical nor histological features of asbestosis differ sufficiently from those of other causes of interstitial fibrosis to allow confident diagnosis without a history of asbestos exposure or the detection of increased levels of asbestos bodies or asbestos fibres in lung tissue."Asbestosis is generally associated with relatively high exposure levels." It is however noted that mild fibrosis may occur at lower exposure levels and that histologically detectable fibrosis can occur in situations when radiological criteria are not fulfilled."A histological diagnosis of asbestosis requires the identification of diffuse interstitial fibrosis" in technically sound lung samples "plus the presence of either 2 or more asbestos bodies in tissue with a section area of 1 cm2 or a count of uncoated asbestos fibres that falls in the range recorded for asbestosis by the same laboratory. …
  • References (14)
  • Citations (71)
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References14
Newest
Published on Mar 4, 2014in Annals of Internal Medicine 19.32
Virginia A. Moyer56
Estimated H-index: 56
DESCRIPTION: Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for lung cancer. METHODS: The USPSTF reviewed the evidence on the efficacy of low-dose computed tomography, chest radiography, and sputum cytologic evaluation for lung cancer screening in asymptomatic persons who are at average or high risk for lung cancer (current or former smokers) and the benefits and harms of these screening tests and of surgical resection of early-stage non-small cell lu...
Published on May 1, 2013in Chest 9.66
Frank C. Detterbeck47
Estimated H-index: 47
(Yale University),
Peter J. Mazzone32
Estimated H-index: 32
(Cleveland Clinic)
+ 1 AuthorsPeter B. Bach53
Estimated H-index: 53
(MSK: Memorial Sloan Kettering Cancer Center)
Background Lung cancer is by far the major cause of cancer deaths largely because in the majority of patients it is at an advanced stage at the time it is discovered, when curative treatment is no longer feasible. This article examines the data regarding the ability of screening to decrease the number of lung cancer deaths. Methods A systematic review was conducted of controlled studies that address the effectiveness of methods of screening for lung cancer. Results Several large randomized contr...
Published on Mar 1, 2013in CA: A Cancer Journal for Clinicians 223.68
Richard C. Wender29
Estimated H-index: 29
(Thomas Jefferson University),
Elizabeth T. H. Fontham48
Estimated H-index: 48
(LSU: Louisiana State University)
+ 17 AuthorsDouglas Kelsey25
Estimated H-index: 25
(Eli Lilly and Company)
Findings from the National Cancer Institute’s National Lung Screening Trial established that lung cancer mortality in specific high-risk groups can be reduced by annual screening with low-dose computed tomography. These findings indicate that the adoption of lung cancer screening could save many lives. Based on the results of the National Lung Screening Trial, the American Cancer Society is issuing an initial guideline for lung cancer screening. This guideline recommends that clinicians with acc...
Published on Feb 1, 2013in Molecular Oncology 5.96
Penny Nymark13
Estimated H-index: 13
(HYKS: Helsinki University Central Hospital),
Mervi Aavikko4
Estimated H-index: 4
(Finnish Institute of Occupational Health)
+ 10 AuthorsEsa Vanhala21
Estimated H-index: 21
(Finnish Institute of Occupational Health)
Abstract We have previously demonstrated an association between genomic alterations in 19p13, 2p16, and 9q33.1 and asbestos exposure in patients' lung tumours. This study detected allelic imbalance (AI) in these regions in asbestos-exposed lung cancer (LC) patients' histologically normal pulmonary epithelium. We extended the analyses of tumour tissue to cover a large LC patient cohort and studied DNA copy number alteration (CNA) and AI in 19p13, 2p16, and 9q33.1 for the first time in combination...
Published on Dec 1, 2012in Journal of Cardiothoracic Surgery 1.47
Jingquan Han4
Estimated H-index: 4
(HMU: Harbin Medical University),
Shouqiang Cao6
Estimated H-index: 6
(HMU: Harbin Medical University)
+ 5 AuthorsJian Cui7
Estimated H-index: 7
(HMU: Harbin Medical University)
Background The identification of malignant cells in effusions by conventional cytology is hampered by its limited sensitivity and specificity. The aim of this study was to investigate the value of fluorescence in situ hybridization (FISH) as adjuncts to conventional cytologic examination in patients with malignant pleural effusions.
Michael T. Jaklitsch45
Estimated H-index: 45
(Brigham and Women's Hospital),
Francine L. Jacobson26
Estimated H-index: 26
(Brigham and Women's Hospital)
+ 11 AuthorsRavi Salgia81
Estimated H-index: 81
(U of C: University of Chicago)
Results: The American Association for Thoracic Surgery guidelines call for annual lung cancer screening with low-dose computed tomography screening for North Americans from age 55 to 79 years with a 30 pack-year history of smoking. Long-term lung cancer survivors should have annual low-dose computed tomography to detect second primary lung cancer until the age of 79 years. Annual low-dose computed tomography lung cancer screening should be offered starting at age 50 years with a 20 pack-year his...
Published on May 1, 2012in Journal of Thoracic Oncology 12.46
Christophe Blanquart18
Estimated H-index: 18
(University of Nantes),
Fabien Gueugnon9
Estimated H-index: 9
(University of Nantes)
+ 6 AuthorsMarc Grégoire27
Estimated H-index: 27
(University of Nantes)
Introduction: Malignant pleural mesothelioma (MPM) is a highly aggressive tumor with poor prognosis. one major challenge for this disease is the development of new, early, and highly reliable diag nostic markers. The aim of this study was to compare the diagnostic value of the chemokine chemokine (C-C motif) ligand 2 (CCL2), galectin-3, and the secretory leukocyte peptidase inhibitor (SLPI) with soluble mesothelin-related peptides (SMRP), and to evaluate the diagnostic performance of marker comb...
Published on Aug 4, 2011in The New England Journal of Medicine 70.67
Denise R. Aberle51
Estimated H-index: 51
,
Amanda M. Adams7
Estimated H-index: 7
+ 7 AuthorsJoRean D. Sicks7
Estimated H-index: 7
Published on Jul 1, 2010in Chest 9.66
Spasenija Savic22
Estimated H-index: 22
,
Noreli Franco4
Estimated H-index: 4
+ 10 AuthorsInti Zlobec49
Estimated H-index: 49
Background Distinction of malignant mesothelioma (MM) from reactive mesothelial cells (RM) in effusions is notoriously difficult. The aim of our study was to test chromosomal aberrations detected by fluorescence in situ hybridization (FISH) in the diagnosis of MM in effusion cytology and to explore the potential role of p16, p14, and p15 gene methylation as an alternative mechanism of tumor suppressor gene inactivation. Methods Fifty-two effusions of biopsy-proven MM and 28 benign effusions were...
Published on Mar 1, 2010in Archives of Pathology & Laboratory Medicine 4.15
Victor L. Roggli48
Estimated H-index: 48
(Duke University),
Allen R. Gibbs22
Estimated H-index: 22
+ 10 AuthorsJeffrey R. Galvin26
Estimated H-index: 26
(AFIP: Armed Forces Institute of Pathology)
Abstract Asbestosis is defined as diffuse pulmonary fibrosis caused by the inhalation of excessive amounts of asbestos fibers. Pathologically, both pulmonary fibrosis of a particular pattern and evidence of excess asbestos in the lungs must be present. Clinically, the disease usually progresses slowly, with a typical latent period of more than 20 years from first exposure to onset of symptoms. Differential Diagnosis: Idiopathic Pulmonary Fibrosis The pulmonary fibrosis of asbestosis is interstit...
Cited By71
Newest
Published on Dec 1, 2019in BMC Cancer 2.93
Eeva Kettunen15
Estimated H-index: 15
(Finnish Institute of Occupational Health),
Sauli Savukoski1
Estimated H-index: 1
(Finnish Institute of Occupational Health)
+ 5 AuthorsHenrik Wolff29
Estimated H-index: 29
(Finnish Institute of Occupational Health)
Deletion of the CDKN2A locus is centrally involved in the development of several malignancies. In malignant pleural mesothelioma (MPM), it is one of the most frequently reported genomic alteration. MPM is strongly associated with a patients’ asbestos exposure. However, the status of CDKN2A and the expression of the corresponding protein, p16, in relation to MPM patient’s asbestos exposure is poorly known. Copy number alterations in 2p16, 9q33.1 and 19p13 have earlier been shown to accumulate in ...
Published on Apr 6, 2018in Tumori 1.23
Pietro Gino Barbieri5
Estimated H-index: 5
,
Dario Mirabelli27
Estimated H-index: 27
(UNITO: University of Turin)
+ 1 AuthorsAlessandro Brollo11
Estimated H-index: 11
Background:Malignant pleural mesothelioma (MPM) diagnosis is known to be difficult. We report on the diagnostic elements available in life in an MPM necropsy case series and describe the frequency of non-neoplastic asbestos-related diseases as biological exposure indices.Methods:We reviewed pathologic and clinical records of an unselected series of autopsies (1977–2016) in patients with MPM employed in the Monfalcone shipyards or living with shipyard workers. We assessed the consistency with aut...
Published in Lung Cancer 4.60
Patrick Maisonneuve Eng93
Estimated H-index: 93
(IEO: European Institute of Oncology),
Sergio Iavicoli2
Estimated H-index: 2
(National Insurance Institute),
Giulia Veronesi20
Estimated H-index: 20
Published in Human Pathology 2.74
Kelly J. Butnor (University of Vermont Medical Center), Elizabeth N. Pavlisko10
Estimated H-index: 10
(Duke University)
+ -3 AuthorsVictor L. Roggli48
Estimated H-index: 48
(Duke University)
Summary Malignant mesothelioma arising from the serosal membranes of the tunica vaginalis testis (TVT) is rare. Most examples in the published medical literature are individual case reports. This study presents the clinicopathologic findings of mesothelioma of the TVT in one of the largest series to date. Design Individuals with mesothelioma of the TVT were identified from a database of more than 4000 mesothelioma cases and their clinicopathologic features were recorded. Eighteen men with malign...
Published on Jun 1, 2019in Occupational and Environmental Medicine 3.56
Sergio Iavicoli23
Estimated H-index: 23
,
Tim Driscoll49
Estimated H-index: 49
+ 4 AuthorsJukka Takala13
Estimated H-index: 13
Recent estimates demonstrated that occupational cancer accounted for 27% of the 2.4 million deaths due to work-related diseases.1–3 In numerical terms, this estimate means that the number of deaths attributable to occupational cancer annually increased from 666 000 deaths in 2011 to 742 000 deaths in 2015.2 3 This increase could be explained by different variables such as the evidence on new carcinogens, the methods of estimation, changes in the industry distribution of workers and the growing a...
Published on May 1, 2019in Lung Cancer 4.60
Patrick Maisonneuve Eng93
Estimated H-index: 93
(IEO: European Institute of Oncology),
Cristiano Rampinelli18
Estimated H-index: 18
(IEO: European Institute of Oncology)
+ 13 AuthorsPierluigi Novellis6
Estimated H-index: 6
Abstract Objectives Smoking is the main risk factor for lung cancer, but environmental and occupational exposure to carcinogens also increase lung cancer risk. We assessed whether extending low-dose computed tomography (LDCT) screening to persons with occupational exposure to asbestos may be an effective way reducing lung cancer mortality. Materials and methods We conducted a nested case-control study within the COSMOS screening program, assessing past asbestos exposure with a questionnaire. LDC...
Published on Mar 29, 2019in Annals of global health 2.04
Eduardo Algranti6
Estimated H-index: 6
,
Juan Pablo Ramos-Bonilla8
Estimated H-index: 8
(University of Los Andes)
+ 7 AuthorsDaniela Marsili5
Estimated H-index: 5
(ISS: Istituto Superiore di Sanità)
Background: Asbestos consumption in Latin America (LA) amounts to 10% of yearly global production. Little is known about the impact of asbestos exposure in the region. Objective: To discuss scientific and socio-economic issues and conflicts of interest and to summarize epidemiological data of asbestos health effects in LA. Discussion: Recent data on chrysotile strengthened the evidence of its carcinogenicity and showed an excessive risk of lung cancer at cumulative exposure levels as low as 1.5 ...
Published on Mar 4, 2019in Expert Review of Respiratory Medicine 2.62
E. Harris1
Estimated H-index: 1
(Curtin University),
A. William Musk56
Estimated H-index: 56
(UWA: University of Western Australia)
+ 3 AuthorsFraser Brims9
Estimated H-index: 9
(Curtin University)
ABSTRACTIntroduction: The diagnosis of lung disease in asbestos-exposed individuals is a process that not only requires a detailed occupational and tobacco smoking history, but the correlation with physical signs, appropriate imaging, detailed lung function assessment and histology/cytology when required.Worldwide, the total quantity of asbestos mined is static, having decreased dramatically in developed countries but increased in countries where there is no restriction on mining: for example, R...
Published on Mar 1, 2019in Journal of Thoracic Oncology 12.46
Simonetta Guarrera32
Estimated H-index: 32
(UNITO: University of Turin),
Clara Viberti5
Estimated H-index: 5
(UNITO: University of Turin)
+ 13 AuthorsCaterina Casadio35
Estimated H-index: 35
Abstract Introduction Malignant pleural mesothelioma (MPM) is an aggressive tumor strongly associated with asbestos exposure. Patients are usually diagnosed when current treatments have limited benefits, highlighting the need for noninvasive early diagnostic tests to monitor asbestos-exposed people. Methods We used a genome-wide methylation array to identify, in asbestos-exposed subjects, novel blood DNA methylation markers of MPM in 163 MPM cases and 137 cancer-free controls (82 MPM cases and 6...
Gert van der Laan7
Estimated H-index: 7
,
Gert van der Laan , Lex Burdorf5
Estimated H-index: 5
Voor de periode 2019-2035 worden nog ongeveer 8000 sterfgevallen door mesothelioom bij mannen verwacht en ten minste hetzelfde aantal door asbestgerelateerde longkanker. Stumphius voorzag een groot volksgezondheidsprobleem door asbest, maar dat de gezondheids-schade door asbest zo’n grote omvang zou krijgen werd 50 jaar geleden niet verwacht. In dit artikel presenteren we een overzicht van asbestgerelateerde aandoeningen met cijfermateriaal en trends.