TABLE 5.1 Pulmonary Diseases Associated with Exposure to Asbestos Fibers

Disease

Humans

Animal Models

Asbestosis (diffuse interstitial fibrosis)

+

+

Carcinoma of the lung

+

+

Nonneoplastic pleural disease:

 

 

Pleural effusion

+

+

Visceral pleural fibrosis

+

+

Parietal pleural plaques

+

+

Malignant mesothelioma of the pleura and peritoneum

+

+

SOURCE: Adapted from Bernstein et al. (2005).

fuse interstitial fibrosis) of the lungs and visceral pleural fibrosis and parietal pleural plaques of the pleural linings (Table 5.1). In the pleura, bilateral and symmetric fibrotic plaques usually reflect environmental or occupational exposure to asbestos fibers, and consequently pleural plaques are considered to be markers of asbestos exposure (Travis et al. 2002). These fibrous scars are not precursors of malignant mesothelioma or lung cancer.

Risk Factors for Lung Cancer and Malignant Mesothelioma

Tobacco-smoking is a major causal risk factor for lung cancer (Table 5.2) and risk of developing lung cancer in current or former smokers is greatly increased by exposure to asbestos fibers. Development of malignant mesothelioma of the pleura or peritoneum has not been found to be associated with tobacco-smoking (Battifora and McCaughey 1995). Exposure to

TABLE 5.2 Risk Factors for Development of Lung Cancer

Certainty

Agent

Established

Cigarette, pipe, or cigar-smoking

 

Exposure to environmental tobacco smoke

 

Exposure to asbestos fibers

 

Exposure to radon

 

Occupational exposures (metals and chemicals)

Hypothesized

Air pollution

 

Outdoor

 

Indoor (cooking fumes)

 

HPV (human papilloma virus)



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