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Mesothelioma in Patients with Nonoccupational Asbestos Exposure: An Evidence-Based Approach to Causation Assessment



Details

  • Personal Author:
  • Description:
    The specific parameters of nonoccupational asbestos exposures (NOAE) that can distinguish an idiopathic from an asbestos-caused malignant mesothelioma (MM) are controversial. A systematic literature review yielded 1028 cases with this putative association. Only 287 of those reports had a defined single exposure to a household, building occupant, or neighborhood/community asbestos source. The available "evidence" was used to develop semiarbitrary evidence-based causation guideline rules for the assessment of putative associations between MM and NOAE. The rules are classified into class A (tissue burden analysis shows asbestos body counts or fiber counts in lung tissues comparable to MM caused by occupational exposure to asbestos) and classes B to D based on whether certain combinations of NOAE features and MM (evidence) have been described in over 15% (class B), 5% to 15% (class C), and less than 5% (class D) of the patients reviewed. The proposed 4 classes of evidence-based causation guidelines provide a semiarbitrary framework to evaluate the causation of individual MM patients by NOAE based on decreasing levels of currently available evidence. The neoplasms in classes A to C patients are probably caused by NOAE, with decreasing weight of evidence in the 3 groups. There is minimal evidence to support the causation of MM by NOAE in class D patients. There is no evidence or only anecdotal evidence to support a causal association between MM and NOAE in individuals who cannot be classified into any of the 4 classes. Future studies are needed to provide more comprehensive data regarding the association between MM and NOAE. [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISSN:
    1092-9134
  • Document Type:
    Text
  • Funding:
    Grant
  • Genre:
    Journal Article
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Pages in Document:
    241-250
  • Volume:
    10
  • Issue:
    4
  • NIOSHTIC Number:
    nn:20058525
  • Citation:
    Ann Diagn Pathol 2006 Aug; 10(4):241-250
  • Contact Point Address:
    Alberto M. Marchevsky MD, Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
  • Email:
    marchevsky@cshs.org
  • CAS Registry Number:
    Asbestos (CAS RN 1332-21-4)
  • Federal Fiscal Year:
    2006
  • Performing Organization:
    University of California Los Angeles
  • Peer Reviewed:
    True
  • Start Date:
    20050701
  • Source Full Name:
    Annals of Diagnostic Pathology
  • End Date:
    20270630
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:0699dda65a677e82c06887de8c03f526a376f3384118d010a3534ace3eaf607b8e763beef9a7e3efa8e51716a39685696cffcc13910370d1f9b6f56c6c5be578
  • Download URL:
  • File Type:
    Filetype[PDF - 188.37 KB ]
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