Archive for Dezembro 2016

Measuring Mesothelioma Treatment Response with Biomarkers

2516827_blood testMalignant pleural mesothelioma is notoriously difficult to treat and doctors often have to try different treatment combinations to produce a response. But how can they know if a particular treatment strategy is working?
A team of researchers in Pisa, Italy suggest that three key biomarkers may be the answer. Soluble mesothelin-related peptides (SMRP), plasma osteopontin (pOPM) and vimentin have all been studied as potential diagnostic tools.
But University of Pisa scientists say these three key markers may also offer an efficient method for clinicians to track how well a mesothelioma tumor is responding to treatment. This could potentially improve mesothelioma outcomes by enabling doctors to change course if they are not seeing the hoped-for results.

Understanding Mesothelioma Biomarkers

Mesothelioma biomarkers are substances found in unusually high quantities in the blood, serum or lung fluid of mesothelioma patients. Because they are either not present in healthy people, or present at much lower levels, they can be valuable for making a mesothelioma diagnosis or for distinguishing pleural mesothelioma from other lung diseases.
The presence of SMRP in the blood indicates damage to mesothelial cells which line the membranes around the lungs. The test for SMRP called Mesomark has become a staple of mesothelioma management in recent years.
Plasma osteopontin is a protein that plays a role in inflammation, including the kind of inflammation caused by exposure to asbestos. Vimentin is another protein. It is expressed in the mesenchymal cells which give rise to all of the body’s connective tissues.

Biomarkers as Mesothelioma Treatment Monitors

To test the value of these three biomarkers as tools for measuring mesothelioma treatmentresponse, the researchers used 219 serum samples from 56 pleural mesothelioma patients.
By calculating the changes in levels of these biomarkers over time and comparing it to each patient’s clinical course, the doctors demonstrated how their levels fluctuated with mesothelioma treatment response.
“SMRP, pOPN, and vimentin showed statistically significant differences between the disease categories stable disease, partial response, and disease progression,” writes mesothelioma researcher Dr. Alessandra Bonotti.  
The analysis showed that these three markers were especially helpful in mesothelioma cases where there was either a partial response to treatment or where the tumor had progressed. “Their possible use in stable disease should be better investigated,” concludes Dr. Bonotti.
Bonotti, A, et al, “Serum mesothelin, osteopontin, and vimentin: useful markers for clinical monitoring of malignant pleural mesothelioma”, September 14, 2016, International Journal of Biological Markers, Epub ahead of print

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Mesothelioma Risk Among Seaman and Sailors Still Hard to Quantify

310188_Navy Ship smallThousands of people who worked aboard commercial ships may be at higher risk for developing malignant mesothelioma.
Unfortunately, although the mesothelioma risk for merchant seamen has been acknowledged since the 1970s, there is still little information on how high the risk may be.
That news comes from a new report on commercial seamen and mesothelioma published in the journal Inhalation Toxicology.

Mesothelioma Risk and Commercial Seamen

Seamen are thought to be more prone to pleural mesothelioma because of exposure toasbestos, a common but toxic mineral used primarily as an insulator in many ships built in the early part of the 20th century.
By the mid-1900s, cases of malignant mesothelioma had begun to arise in workers in asbestos product manufacturing and asbestos mining and milling industries.
But, according to David Dodge and Barbara Beck of the environmental and risk sciences consulting firm, Gradient, the danger of asbestos exposure on commercial ships was largely ignored for several more decades.
“We found that attention to the potential health risk of asbestos to merchant seamen began in the mid- to late- 1970s and early 1980s,” write Dodge and Beck.

Asbestos and Mesothelioma: Making the Connection

Although tests found the level of asbestos exposure during routine repairs aboard commercial ships was likely to be low, it was enough to send up red flags for people who worked on these ships.
“Responses to this evolving information served to warn seamen and the merchant shipping industry and led to increased precautions regarding asbestos exposure,” conclude Dodge and Beck.
As rates of lung cancer and pleural mesothelioma among merchant seamen began to climb in the 1990s, some researchers finally began to make a connection between shipboard asbestos exposure and cancer.

Asbestos Use in Ships

Asbestos, which was used throughout both commercial and naval vessels, is a naturally-occurring fibrous mineral. When it becomes airborne, the fibers can lodge in body tissues, causing irritation and inflammation that can eventually cause mesothelioma.
Toxicology experts now know that there is no safe level of exposure to asbestos. People who built both commercial and naval ships, sailed on them, repaired them, or decommissioned them, all face a potentially higher lifetime risk of pleural mesothelioma.
It can take decades for mesothelioma to develop but, once it does, it is extremely difficult to treat and there is no cure. An italian study published earlier this year found that the risk of malignant mesothelioma among shipyard workers remains high even thirty years after their jobs ended.
Even if they are unaware of specific instances of asbestos exposure, people who have worked aboard older commercial or military ships should be aware of the symptoms of mesotheliomaand should have regular medical exams.
Doge, DG and Beck, BD, Historical state of knowledge of the health risks of asbestos posed to seamen on merchant ships, November 10, 2016, Inhalation Toxicology, Epub ahead of print

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Multi-Modal Mesothelioma Treatment Leads to Three-Year Survival

There has been some encouraging news this month for patients suffering from an aggressive form of lung cancer called malignant pleural mesothelioma. New research suggests that, even in patients with advanced mesothelioma, long-term survival is possible with a strategic multi-modal approach.

The Research

The new mesothelioma study, conducted at several US medical centers and published in the Annals of Thoracic Surgery, analyzed the survival rates of 73 patients diagnosed with the epithelioid form of pleural mesotheliomabetween 2005 and 2013. All of the patients had been treated with a combination ofpleurectomy/decortication (PD) surgery and intraoperative photodynamic therapy (PDT).
PD surgery for malignant mesothelioma treatment involves removal of the diseased pleural membrane, portions of the diaphragm, and other at risk tissues. In contrast to the more radical EPP surgery, PD surgery leaves the lungs in place.
Photodynamic therapy requires that mesothelioma tumor cells be pre-treated with aphotosensitizing drug and then exposed to a light source on the end of an endoscope. The goal is to kill any residual mesothelioma cells that the surgeon may have missed.
Most of the mesothelioma patients (92%) analyzed for this study also underwent chemotherapy with pemetrexed (Alimta) after their surgery.

The Results

Although pleural mesothelioma typically carries a life expectancy of just 12 to 18 months, the median overall survival for patients receiving this PD/PDT therapy combination was more than twice that at nearly three years.
The news was even better for the 19 mesothelioma patients whose cancer had not spread to their lymph nodes; These patients had an overall median mesothelioma survival rate of 7.3 years.
“The role for lung-sparing surgery is unclear but this series demonstrates that it is an option, even for advanced cases,” writes study author Joseph S. Friedberg, MD, mesothelioma researcher at the University of Maryland Medical Center in Baltimore. “The overall survival of 7.3 years for the node negative subset of patients, still of advanced stage, is encouraging.”  
These node-negative patients experienced longer survival even though their mesothelioma tumors began growing again a median of 2.4 years after surgery. Dr. Friedberg says thisdisparity between tumor growth and survival may be related to the impact of the PDT, which is currently being studied as part of a randomized mesothelioma clinical trial.
Friedberg, JS, et al, “Extended Plearectomy-Decortication-based Treatment for Advanced Stage Epithelial Mesothelioma Yielding a Median Survival of Nearly Three Years”, November 4, 2016, The Annals of Thoracic Surgery, Epub ahead of print

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Study Finds Chemotherapy Maximizes Odds of Mesothelioma Survival

919316_chemo drugA large US study of mesothelioma patients confirms what other studies have suggested: Mesothelioma patients who havechemotherapy live longer than those who don’t, and multimodal therapy is the best way to improve overall mesothelioma survival.
The study utilized data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database and included 1,625 Medicare patients with a diagnosis or eitherperitoneal or pleural mesothelioma.

Mesothelioma Treatment Patterns

Led by researchers at Wayne State University in Detroit, the study tracked mesothelioma treatment and survival data between January 2005 and December 2009 with follow-up through 2010.
The study included analysis of both the patient characteristics (like age, gender, and asbestos exposure) and the unique characteristics of their mesothelioma tumor (size, shape, subtype).
Changes were tracked over the course of various types of mesothelioma treatments in an effort to determine which characteristics, treatment patterns and chemotherapy regimens yielded the best mesothelioma survival.

Tracking Treatment Results

Of the 1,625 mesothelioma patients who were eligible for inclusion in the study, the median age at diagnosis was 78. Thirty percent of patients had mesothelioma surgery as part of their treatment strategy and 45 percent had chemotherapy.
The chemotherapy regimen prescribed most often nationwide for mesothelioma treatment was a combination of pemetrexed (Alimta) and cisplatin or carboplatin. Sixty-seven percent of the mesothelioma patients who received chemotherapy had this combination. The same combination or a drug call gemcitabine was most often used for second-line chemotherapy treatment.
Overall mesothelioma survival among the study subjects was a median of 7 months for those who received chemotherapy with those who received second-line chemotherapy living for amedian of a year.

Chemotherapy Impacts Survival More Than Surgery

While the survival odds for mesothelioma remain grim, the research team concluded that chemotherapy still offered the best chance at a longer life. Their data suggests that it matters even more than surgery.
“Irrespective of surgical resection, mesothelioma patients receiving some form ofchemotherapy survived longer than patients who did not, with an additional survival benefitamong those patients receiving multimodal treatment,” writes Jennifer Lynn Beebe-Dimmer of Wayne State University Medical School.
The study was presented at the annual meeting of the American Society of Clinical Oncology last year and appears in a recent issue of Clinical Epidemiology.
Beebe-DImmer, JL, et al, “Mesothelioma in the United States: a Surveillance, Epidemiology, and End Results (SEER)-Medicare Investigation of treatment patterns and overall survival”, October 26, 2016, Clinical Epidemiology, eCollection

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Platelet Count May be an Effective Tool for Mesothelioma Prognosis

2105823_blood test5high platelet count may not bode well for people battlingmalignant pleural mesothelioma.
New evidence suggests that people who have a high concentration of platelets in their blood prior to the start of mesothelioma treatment have shorter overall survival than those with normal platelet counts.
The news comes from a Chinese meta-analysis including more than 3,600 mesothelioma patients.

Platelets and Health

Smaller than either red or white blood cells, platelets are the components in blood that facilitateclotting. The normal range for platelet counts is 150,000 to 400,000 platelets per microliter (mcL).
When an unusually high concentration of platelets is caused by a secondary problem (such as cancer-related inflammation), it is known as thrombocytosis. By itself, thrombocytosis usually does not cause symptoms and requires a blood test to diagnose.

Platelet Count for Mesothelioma Prognosis

Researchers with First Affiliated Hospital of Fujian Medical University in Fujian, China analyzed 18 different published studies on the relationship between thrombocytosis and mesothelioma survival. The analysis included mesothelioma studies conducted through April 2016 and published in one of four large online databases.
Although there was significant variability between the studies, a clear correlation was found between platelet counts before the start of treatment and mesothelioma treatment  response.
“In conclusion, high pretreatment platelet count resulted in poor overall survival in malignant mesothelioma. Therefore, platelet count could be an adequate and useful factor of prognosis for malignant mesothelioma,” writes Dr. Y. Zhuo of the Thoracic Surgery Department.

A Simple Prognostic Tool

Mesothelioma is rare and difficult to treat. Only about 2,500 people are diagnosed with mesothelioma in the US each year, but the majority of those face a life expectancy of a year or less.
But certain factors can impact outcomes and are valuable for treatment planning, which typically involves a combination of multiple therapies. Because it is fast and easy to measure with a blood draw, platelet count may offer a simple prognostic tool to assist in the mesotheliomatreatment planning process.

Another New Tool for Mesothelioma Prognosis

Platelet count is just one possibility for helping doctors predict mesothelioma prognosis. Earlier this year, an international team of scientists conducted a study suggesting that the protein complex Activin A may be another prognostic indicator in malignant mesothelioma. 
That study included an analysis of plasma samples from 129 mesothelioma patients at four different European institutions. The results showws that the mesothelioma patients had significantly higher levels of Activin A in their bodies than did the healthy controls.
The mesothelioma patients with the lowest Activin A levels had the highest survival levels. Like platelet count, Activin A can be measured with a blood draw.
Zhuo, Y, et al, “Pretreatment thrombocytosis as a significant prognostic factor in malignant mesothelioma: a meta-analysis”, November 16, 2016, Platelets, Epub ahead of print

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Psychological Needs of Mesothelioma Patients Differ from Lung Cancer

24133524_stressNew research suggests that, even though pleural mesothelioma is considered a type of lung cancer, people with the asbestos cancer are likely to face some different stresses and concerns from lung cancer patients.
Pleural mesothelioma grows on the pleural membrane that surrounds the lungs. It is almost always caused by past exposure to asbestos dust, often in an industrial setting.
A new analysis of the psychological needs and concerns of people with malignant mesothelioma or lung cancer found that, although the two groups share many concerns, there are also some notable differences.

Evaluating the Psychological Care Needs in Mesothelioma

To conduct their comparison, a team of researchers in the UK searched the medical literature for published studies on the psychological impact of receiving a lung cancer or mesothelioma diagnosis and going through treatment.
The team identified 17 studies that met their criteria. After examining these studies, the team found ten common areas of concern that came up repeatedly among people going through treatment for mesothelioma or lung cancer.
These were uncertainty, normality, hope/hopelessness, stigma/blame/guilt, family/carer concern, physical symptoms, experience of diagnosis, iatrogenic distress, financial/legal and death and dying,” writes lead study author Hannah Ball, an Advanced Nurse Practitioner and researcher with Oxford University Hospitals.

Different Concerns for Mesothelioma Patients

While many of the lung cancer and mesothelioma patients had similar psychological experiences, people with mesothelioma did have some additional worries.
The researchers found that mesothelioma patients differed from lung cancer patients in the areas of blame, financial/legal concerns and feelings of hopelessness.
Mesothelioma is often caused by workplace asbestos exposure. The idea that a trusted employer could have allowed an employee to be exposed to the toxin that caused their cancer, and that that employer may be liable for doing so, can add an extra layer of complexity and stress for mesothelioma patients and their families.
In addition, there is no cure for mesothelioma and the prognosis for most patients is grim. Based on these key differences between the emotional experience of mesothelioma and lung cancer, the study authors say mesothelioma patients may need more specialized support.
“These findings warrant further research to explore further and, if proven, the need for the provision of specialist mesothelioma care services is affirmed,” concludes Ms. Ball.
Surviving Mesothelioma is committed to helping mesothelioma patients be proactive and feel more hopeful by sharing the stories of mesothelioma survivors, exploring alternative therapies, and publishing news of encouraging new research findings. If you or a loved one suffers from mesothelioma, check this site often for the most up-to-date mesothelioma news and information available online.
Ball, H, et al, “A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer”, December 2016, European Journal of Oncology Nursing, pp. 62-67

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New Mesothelioma Immunotherapies Target Key Protein

10191835_aaThe cell-surface glycoprotein mesothelin is poised to be a key part of several new immunotherapy approaches for the treatment of malignant pleural mesothelioma, a treatment-resistant cancer caused by asbestos.
A team of top mesothelioma researchers with the National Cancer Institute’s Center for Cancer Research recently published their analysis of several ongoing studies of therapies that target mesothelin in mesothelioma treatment.

Mesothelin’s Relationship to Mesothelioma

Mesothelin is a protein that is highly expressed in several malignancies, including ovarian cancer, pancreatic cancer, malignant mesothelioma and some lung cancers.
Mesothelin is especially valuable as a target for mesothelioma treatment because it is primarily expressed by mesothelial cells which make up the membranes where mesothelioma tumorsstart. These cells, as the authors of the new study point out, are “expendable”, meaning that their destruction with targeted drugs would not threaten vital organs.
Mesothelin is also considered the gold standard biomarker for diagnosing malignant mesothelioma.

Mesothelin as a Target for Immunotherapy

In a new report in the Journal of Clinical Oncology, mesothelioma researcher Raffit Hassan, MD, and colleagues offer an overview of mesothelin-focused therapies currently in development for the treatment of mesothelioma.
One category of mesothelin-based therapies mentioned is immunotoxins that target cells expressing mesothelin. These include experimental drugs such as SS1P, and RG7787/LMB-100. Preliminary studies of SS1P produced “significant antitumor activity” in pleural mesothelioma, according to Dr. Hassan. 
Another category is antibodies like the monoclonal anti-mesothelin antibody amatuximab(MORAb-009). The international ARTEMIS trial of amatuximab has indicated that it may boost the effectiveness of standard chemotherapy. Amatuximab is currently being tested as a potential first-line mesothelioma therapy. A similar agent, anetumab ravtansine, is the focus of a multi-center trial as a second-line therapy.
Other mesothelin-focused therapies mentioned in the report include a drug made from a live bacteria and vaccines that can induce T-cell immune response to mesothelin.
The bacteria-based drug, called CRS-207, unmasks mesothelioma cells to make them vulnerable to immune system attack. A recent human trial of CRS-207 along with standard mesothelioma chemotherapy produced an unprecedented 90 percent disease control rate and prompted researchers to refer to it as “an exciting agent for patients with mesothelioma.”
“There has been substantial progress in the development of different approaches to target mesothelin for cancer therapy,” concludes Dr. Hassan.“These ongoing studies will define the utility of mesothelin immunotherapy for treating cancer.” 
Hassan, R, et al, “Mesothelin Immunotherapy for Cancer: Ready for Prime Time?”, December 2016, Journal of Clinical Oncology

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New Clinical Trial Aims to Create Bioresource for Improved Mesothelioma Diagnosis

New Clinical Trial Aims to Create Bioresource for Improved Mesothelioma Diagnosis

385110_labMalignant mesothelioma is not only one of the rarest and most difficult-to-treat cancers. It is also among the hardest to diagnose.
The challenge of diagnosing the asbestos cancer can lead to delayed referral and late treatment and can limit mesothelioma patients’ access to clinical trials that might help them.
In an effort to improve the diagnostic process for malignant mesothelioma, a group of researchers in Scotland has launched the Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma (DIAPHRAGM) trial. The multi-center clinical trial will compare biomarkers in the blood of mesothelioma patients to see which markers are the most clinically useful.


In an explanation of the new trial in the British Medical Journal’s open access online-only journal BMJ Open, the research team detail their plans to recruit up to 120 malignant pleural mesothelioma patients, at least 480 patients with other types of pleural diseases, and 109 people who have been exposed to asbestos but do not have mesothelioma.
Twenty-two recruiting centers across Scotland will perform identical sampling and storage of blood serum and plasma samples from each of the study participants.
These samples will be tested using the SOMAscan proteomic assay, a test that measures a panel of protein biomarkers that can indicate the presence of pleural mesothelioma. The serum samples will also be subjected to an ELISA test for a protein called fibulin-3.

Correlating Markers with Mesothelioma Clinical Characteristics

Once they have each patient’s biomarker levels in hand, the researchers can compare them with their clinical characteristics.
“Blood levels will be compared with paired pleural fluid levels and malignant pleural mesothelioma tumor volume (using MRI) in a nested substudy,” explains researcher Selina Tsim of the Department of Respiratory Medicine at Queen Elizabeth University Hospital in Glasgow.
The goal of the study is to create what the team calls a large “bioresource” of mesothelioma markers which can be used to guide clinicians around the world in their efforts to diagnose and treat mesothelioma.
Right now, a protein called mesothelin remains the primary biomarker for the diagnosis of mesothelioma. But mesothelin is not 100 percent accurate as a mesothelioma biomarker and can also be elevated for reasons other than mesothelioma.
Thoracoscopy, a procedure that uses a thin, flexible viewing tube to obtain a mesothelioma tissue sample, is also valuable for diagnosing mesothelioma but is not available everywhere, which is another reason why reliable biomarkers are critical.
Tsim, S, et al, “Diagnostic and Prognostic Biomarkers in the Rational Assessment of Mesothelioma (DIAPHRAGM) study: protocol of a prospective, multicentre, observational study”, November 24, 2016, BMJ Open,

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Asbestos-Related T-Cell Changes Help Explain Mesothelioma Developmen

1721597_asianResearchers in Japan have taken another step toward understanding how asbestos causes malignant mesothelioma.
Exposure to airborne asbestos fibers is the leading cause of malignant mesothelioma worldwide, but scientists are still unclear on exactly what makes healthy mesothelial cells in the membranes around organs give rise to mesothelioma tumors.
Now, scientists at Kawasaki Medical School and Okayama Universityin Okayama say continuous exposure to asbestos appears to have an impact on the life cycle of regulatory T-cells, the cells that help to fight off tumors before they start.

Testing the Role of T-cells in Malignant Mesothelioma

To test their T-cell theory, researchers took blood samples from healthy people as well as from those with asbestos-related conditions such as pleural plaques and pleural mesothelioma.
From these blood samples, the team extracted immune cells and tested how healthy they were. They found a decrease in the activity of “natural killer cells”, reduced production of new T-cells,  and other changes that could support mesothelioma development.

Asbestos Disrupts Cell Cycle

When the researchers took the experiment a step further and exposed isolated MT-2 human polyclonal T-cells to asbestos fibers directly, they showed a “remarkable” reduction in FoxO1, a transcription factor which plays a role in regulating the life cycles of cells, including immune system cells.
In addition, the cells exposed continuously to asbestos overexpressed cyclin D1, a cell cycle regulator that has been linked to the development and progression of cancers such as malignant mesothelioma. These cells also showed an increase in the DNA-replicating part of their life cycle (S phase).
“The overall findings indicate that antitumor immunity in asbestos-exposed individuals may be reduced…through changes in the function and volume of regulatory T-cells,” writes study author Dr. Suni Lee in a report summary in the International Journal of Oncology.

Multiple Causes of Mesothelioma

As with most cancers, the mechanisms that give rise to mesothelioma are varied and complex.
In addition to asbestos-related changes in immunity, mesothelioma has also been linked to asbestos-related inflammation at the cellular level and to certain genes which appear to predispose people to the disease. In particular, people with changes to their BAP1 gene, are more likely to develop mesothelioma if exposed to asbestos.
Mesothelioma is one of the world’s rarest cancers, affecting fewer than 3,000 people in the US each year. The workplace is the most common site for asbestos exposure.
Lee, S, et al, “accelerated cell cycle progression of human regulatory T cell-like cell line caused by continuous exposure to asbestos fibers”, November 2016, International Journal of Oncology, Epub ahead of print

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Swedish Mesothelioma Rates Unaffected By Asbestos Ban

1885229_asbestos-signThe asbestos ban instituted in Sweden more than 30 years ago had still not had any measurable impact on the incidence ofmalignant mesothelioma in the country as of 2009.
That is the conclusion reached by researchers at Sweden’s Institute of Environmental Medicine at the Karolinska Institutein Stockholm who just completed a major study of asbestos exposure and mesothelioma in Sweden. The group also found that plumbers were at especially high risk for mesothelioma.

Designing a Mesothelioma Research Study

Mesothelioma incidence data was gathered from the Swedish component of the 2009 Nordic Occupational Cancer Study, which included 6.78 million people, as well as the Swedish Cancer Registry and the Swedish Total Population Registry.
The population data was divided into three periods between 1961 and 2009 and then linked to a matrix of likely exposures to carcinogens on the job.
Asbestos, a naturally-occurring mineral which was used for decades as an insulator and building product additive, is the primary carcinogen linked to mesothelioma diagnosis.

Mesothelioma Incidence in Sweden

The team identified 3,716 cases of malignant mesothelioma in Sweden during the study period. Eighty-nine percent of the cases occurred in men. Of the 280 occupations analyzed, 24 of them were red-flagged as potentially increasing the risk for mesothelioma.
“Among men, increased risks of mesothelioma of the pleura were observed in male-dominated occupations, with the greatest elevation of risk among plumbers,” writes Nils Plato, a Chemical Engineer with the Institute of Environmental Medicine.
In women, occupations with increased mesothelioma risk included sewing, canning, packing, cleaning and postal work. (Among the canners and cleaners, the risk existed, even though there was no evidence of asbestos exposure, suggesting that these women may have been exposed elsewhere.)

The Asbestos Ban and Mesothelioma Cases

But perhaps the most sobering news to come out of the Swedish study was the fact that, even though asbestos was banned in Sweden in 1982, the numbers of people being diagnosed with mesothelioma has not decreased.
“The asbestos ban of 1982 has yet to show any clear effect on the occurrence of mesothelioma in this cohort,” concludes the report in Epidemiology and Health.
The problem is mesothelioma’s long latency period, or the length of time between exposure to a carcinogen and disease development. Mesothelioma has one of the longest latency periods of any cancer, taking as long as 50 years after asbestos exposure for symptoms to occur.
The result is that many of today’s Swedish mesothelioma patients were exposed to asbestosdecades before the country put the ban into place.
Sweden is one of 58 countries that have banned asbestos. Although the US places strict regulations on the handling and disposal of asbestos, the toxin has not been banned.
Plato, N, et al, “Occupations and mesothelioma in Sweden: updated incidence in men and women in the 27 years after the asbestos ban”, September 20, 2016, Epidemiology and Health, eCollection 2016

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