Asbestblootstelling en Retroperitoneale Fibrose (RPF)


Dit artikel in de Lancet beschrijft de hypothese dat asbestblootstelling een oorzaak is van bindweefseltoename rond organen achter het buikvlies. De onderzoekers concluderen dat dat beroepsmatige asbestblootstelling een belangrijke oorzaak van deze aandoening is. RPF zou daarom als een beroepsziekte moeten worden gezien.

Bron: the Lancet, mei 2004.
Asbestos exposure as a risk factor for retroperitoneal fibrosis


Background Retroperitoneal fibrosis (RPF) is an uncommon disease with unknown causation in most cases. The pathognomonic finding is a fibrous mass covering the abdominal aorta and the ureters. Our aim was to clarify the possible role of asbestos exposure in the development of RPF. The hypothesis was based on the ability of asbestos to cause fibrosis in pulmonary and pleural tissue. Methods We undertook a case-control study of 43 patients with the disease (86% of eligible cases) treated in three university hospital districts of Finland in 1990-2001. For every patient, five population-based controls were selected, matched by age, sex, and central hospital district. We assessed asbestos exposure and medical history using a postal questionnaire and a personal interview. Of the 215 eligible controls, 179 (83%) participated in the study. Findings The age-standardised incidence of RPF was 0-10 (95% CI 0-07-0-14) per 100 000 person-years. The disease was strongly associated with asbestos exposure. The odds ratio (OR) was 5-54 (1-64-18-65) for less than 10 fibre-years of asbestos exposure and 8-84 (2-03-38-50) for 10 or more fibre-years, the attributable fraction being 82% and 89%, respectively. Other risk factors were previous use of ergot derivates (OR 9-92 [1-63-60-26]), abdominal aortic aneurysm (OR 6-73 [0-81-56-08]), and smoking for more than 20 pack-years (OR 4-73 [1-28-17-41]). Interpretation Our results show that occupational asbestos exposure is an important causal factor for RPF. For patients with work-related asbestos exposure, RPF should be considered an occupational disease.

Toomas Uibu, Panu Oksa, Anssi Auvinen, Eero Honkanen, Kaj Metsärinne, Heikki Saha, Jukka Uitti, Pekka Roto. Lancet 2004. 363: 1422-26.

Buikvlieskanker door het eten van met asbest besmet voedsel


Dit onderzoek beschrijft het geval van een 76 jarige vrouw met buikvlieskanker door het eten van met asbest besmet voedsel. Zij vertelde dat ze gewend was groenten te koken in regenwater dat verzameld werd uit een dakgoot van asbestgolfplaat.

Bron: Van Kesteren et al. (2004). International Journal of Gynecological Cancer.
Malignant peritoneal mesothelioma in a 76-year-old woman with a history of asbestos fiber ingestion

Author(s): P. Van Kesteren . J. Bulten . C. Schijf . H. Boonstra . L. Massuger

Source: International Journal of Gynecological Cancer Volume: 14 Number: 1 Page: 162 — 165

DOI: 10.1111/j.1048-891x.2004.14149.x

Publisher: Blackwell Publishing

Abstract: Abstract. van Kesteren P, Bulten J, Schijf C, Boonstra H, Massuger L. Malignant peritoneal mesothelioma in a 76-year-old woman with a history of asbestos fiber ingestion.

We report on a woman with malignant mesothelioma of the peritoneum. This is the first report of a subject with this disease who revealed a history of asbestos ingestion by asbestos-contaminated food. She presented with episodes of sweating and fever, ascites, and weight loss. At laparotomy, small tumor deposits were noted on the peritoneum. The omental cake was removed, together with the uterus, ovaries, and tubes which were all macroscopically normal. The diagnosis was established by immunohistochemistry and electron microscopy. Postoperatively, her complaints of fever and sweating disappeared. She refused further chemotherapy. After questioning her for asbestos exposure, she told us that, years ago, she used to prepare vegetables for cooking in rain water collected from a roof made of asbestos.