asbestos related diseases

Selected publications related to asbestos related diseases by Prof. Dr. med. Xaver Baur:

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Ongoing downplaying of the carcinogenicity of chrysotile
The persisting strong influence of vested asbestos-related interests in workers and public health issues including regulations and compensation necessitate ongoing alertness, corrections and appropriate reactions in scientific as well as public media and policy advisory bodies. Industries that mine, manufacture and sell asbestos or asbestos-containing products have a long tradition of promoting the use of asbestos, while placing the burden of economic and health costs on workers and society. This has been successfully done in recent years and decades in spite of the overwhelming evidence that all asbestos types are carcinogenic and cause asbestosis. They continue to be extremely active by using slogans such as chrysotile can be used safely. Another approach of the asbestos industry and of some of its insurance agencies is to broadly defeat liability claims of asbestos victims. In doing so they systematically use inappropriate science produced by their own and/or by industry-affiliated researchers. Some of the latter were also engaged in producing defense material for other industries including the tobacco industry. Frequent examples of distributing such disinformation include questioning or denying established scientific knowledge about adverse health effects of asbestos. False evidence continues to be published in scientific journals and books.

Malignant mesothelioma: Controversies about its etiology in females 
Malignant mesothelioma (MM) is one of the most aggressive cancers with the poorest of outcomes. There is no doubt that mesothelioma in males is related to asbestos exposure, but some authors suggest that most of the cases diagnosed in females are "idiopathic." In this assessment of the science, it is demonstrated that the "low risk" of mesothelioma in females is because of the nonsystematic recording of exposure histories among females. Detailed analysis of the literature shows the risk of MM among females to be close to that in males. The absence of detailed exposure histories should be rectified in future studies involving women. As a matter of social justice, the ongoing failure to recognize asbestos as the cause of a majority of cases of MM in females does them, and their kin, a profound disservice.

Oliver, Baur-letter-to-Feder et al  In a recent publication Feder, Theile and Tannapfel claim an ongoing debate about the hazardous nature of chrysotile. Publications cited by Feder et al (Quinn, LaDou, IARC, WHO), and other professional bodies and government agencies contradict this claim, concluding that chrysotile asbestos exposure increases risk for asbestosis, mesothelioma, lung and other cancers. There is grave risk that the publication by Feder et al. will unfairly and unjustly influence outcomes in the adjudication of asbestos-related disease in the legal system and that, as a result, the injured worker will suffer. This risk would apply to those with a history of occupational exposure to chrysotile asbestos and in whom few or no asbestos fibres are found in the lung years later. The claim by Feder et al. that chrysotile fibres are biopersistent in the lung could be used in courts of law to deny justice to asbestos-harmed victims.

see also letter of the Collegium Ramazzini

Misleading fiber analysis in chrysotile workers The silicate mineral asbestos is categorized into two main groups based on fiber structure: serpentine asbestos (chrysotile) and amphibole asbestos (crocidolite, amosite, anthophyllite, tremolite, and actinolite). All forms of asbestos are capable of inducing mesothelioma, lung cancer, asbestosis, and other diseases. However, unlike other forms of asbestos, chrysotile asbestos, the predominant form of asbestos in world markets today and in the past is well documented to have only a short residence time in lung tissue.

See also full text by Woitowitz and Baur re the "New Insights"

Response to letter of Merget, Tannapfel  In their letter Merget, Feder and Tannapfel ignore the cited publication of leading pneumoconiosis pathologists, namely Hammar and Abraham, who convincingly reject the “modification” of the asbestosis definition from CAP-NIOSH by a group of pathologists headed by V. Roggli. Another concern refers to their differential diagnosis of asbestosis and idiopathic pulmonary fibrosis. According to the annual report of the Deutsche  Mesotheliomregister in 2014, the authors diagnosed in only 11% of the subjects (suspected to suffer from asbestosis and/or asbestos-related plaques/fibrosis asbestosis) grade 1 and in only c. 6% of the  cases asbestosis of higher grades. No details are presented for the overwhelming majority of the patients which were obviously not diagnosed as asbestosis or an asbestos-related non-malignant pleural disorder. The diagnosis of asbestosis is of highly significant relevance in compensation issues because of the German medical legal definition of asbestos-related lung cancer,  asbestosis is requires as a precondition for acceptance of the disorder as an occupational disease in the absence of the 25 fibre years or of asbestos-related non-malignant pleural disorders. Contrary to what the authors of the letter assert, it is obvious from the figures mentioned that non-acceptance of lung cancer as an occupational disease is frequently due to application of this restrictive and unsound definition of asbestosis.

  Asbestos diseases in Germany     This article belongs to the special issue theme “Global Panorama of National Experiences in Public Health Actions to Ban Asbestos”. It was published in the International Journal of Environmental Research and Public Health (IJERPH) with Ken Takahashi, Jukka Takala and Annette David  as guest editors.  The major topic is the German experience in hazardous exposures during industrial application of asbestos, the war in initiating respective health regulations, an asbestos ban, and compensation of victims. In addition to the tragedy of thousands of former workers annually affected by asbestos-related diseases the related economic burden on the society including forthcoming clean-up of contaminated sites is also shortly covered.

 The asbestos cancer epidemic by J. LaDou

Sociallegal aspects

Occupational Cancer (German)

Antigorite is an asbestiform material occuring in tunnelling. Obviously, it comprises the same adverse helath effects as asbestos. Respective precousious measures and regulations are needed:

Asbestiform antigorite: adverse health effects

Mixed-dust pneumoconiosis   Environmental aerosolized particulates pose a potential risk to human health worldwide. Among others, high amounts of contaminants are generated especially in newly industrializing countries in the vicinity of industrial manufacturing, mining operations, but also during agricultural and natural processes. As an example of the needed multi-disciplinary diagnostic and differential diagnostic approach, we report a case of a 59-year old industrial worker who has suffered from chronic bronchitis and progressive dyspnea on exertion for 8 years.

Further publications and commtents:

Asbestos secretariat global-asbestos-mortality

Editorial oemed-2017 Mesothelioma mortality

Odgerel et al. Mesothelioma oemed-2017-104688

Mesothelioma from Asbestos Exposure in Brake Mechanics: Epidemiology in Context by Marty S. Kanarek and Henry A. Anderson Epidemiology has been applied to the study of automobile repair workers who have been exposed to asbestos from the replacement and installation of brakes containing asbestos. In spite of the limits of epidemiology methods there is an abundance of evidence that performing brake installation or repair releases substantial amounts of asbestos into workers’ breathing zones. The documentation of such exposures supports the weight of evidence epidemiologic conclusion that asbestos from brakes can and does cause mesothelioma in workers handling asbestos containing brake materials  Mesothelioma due to chrysotile in brake mechanics