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Moshammer en Neuberger concluderen dat de verslechtering van de conditie van de longen een betere voorspeller is van de levensverwachting is dan de kennis over de hoeveelheid asbest waaraan iemand is blootgesteld. Volgens Christensen et al. is er een relatie tussen het aantal asbestvezels dat in de longen aangetroffen wordt en de levensverwachting van een mesothelioompatiënt.
Bron: Moshammer, H. & Neuberger, M. (2008). Lung function predicts survival in a cohort of asbestos cement workers. Int Arch Occup Environ Health. 2008 Apr 12. ABSTRACT

PURPOSE: To study the predictive power of respiratory screening examinations a cohort of asbestos workers was followed from active work in an asbestos cement plant until death.

METHODS: From a cohort with data on individual exposure since first employment 309 workers who had a preventive medical examination in 1989/1990 were observed until death or the end of 2006. The impact of asbestos exposure (fibre years) and of smoking history on lung function was examined by linear regression, on specific causes of death and total mortality by Cox regression. The prognostic value of lung function, chest X-ray, and various clinical findings regarding total mortality was also examined by Cox regression.

RESULTS: Lung function proved to be the best predictor of survival apart from current smoking. Depending on the lung function variable an impairment by the interquartile range resulted in a hazard ratio of 1.5-1.6 while for current smokers it was 2.3. An increase of 70 fibre years (interquartile range) led to a hazard ratio of only 1.1. Lung function was influenced by asbestos exposure, current (but not former) smoking, and by pathological X-ray findings. The risk for pleural mesothelioma was dominated by time since first exposure to crocydolite in the pipe factory while the risk for bronchial cancer increased with smoking and total fibre years. An unexpected finding was an increase of gastric cancer in asbestos cement workers.

CONCLUSION: Lung function decrease predicts risk of premature death better than exposure history and regular spirometry should therefore be offered as primary screening to all former asbestos workers. In workers with a history of high cumulative exposure or rapid lung function decrease or radiological signs (diffuse pleural thickening or small irregular opacities) more sensitive techniques (high resolution computer tomography) need to be applied. All smokers with a history of asbestos exposure should be given free smoking cessation therapy to prevent premature death and lung cancer in particular.

Bron: Christensen, B.C. et. al. (2008). Asbestos burden predicts survival in pleural mesothelioma. Environmental  Health Perspectives, Jun;116(6):723-6.

Abstract

Background: Malignant pleural mesothelioma (MPM) is a rapidly fatal asbestos-associated malignancy with a median survival time of <1 year following diagnosis. Treatment strategy is determined in part using known prognostic factors. OBJECTIVE: The aim of this study was to examine the relationship between asbestos exposure and survival outcome in MPM in an effort to advance the understanding of the contribution of asbestos exposure to MPM prognosis. Methods: We studied incident cases of MPM patients enrolled through the International Mesothelioma Program at Brigham and Women's Hospital in Boston, Massachusetts, using survival follow-up, self-reported asbestos exposure (n=128), and a subset of cases (n=80) with quantitative asbestos fiber burden measures. Results: Consistent with the established literature, we found independent, significant associations between male sex and reduced survival (p<0.04), as well as between nonepithelioid tumor histology and reduced survival (p<0.02). Although self-reported exposure to asbestos was not predictive of survival among our cases, stratifying quantitative asbestos fiber burden [number of asbestos bodies per gram of lung (wet weight)] into groups of low (0-99 asbestos bodies), moderate (100-1,099), and high fiber burden (>1,099), suggested a survival duration association among these groups (p=0.06). After adjusting for covariates in a Cox model, we found that patients with a low asbestos burden had a 3-fold elevated risk of death compared to patients with a moderate fiber burden [95% confidence interval (CI), 0.95-9.5; p=0.06], and patients with a high asbestos burden had a 4.8-fold elevated risk of death (95% CI, 1.5-15.0; p<0.01) versus those with moderate exposure. Conclusion: Our data suggest that patient survival is associated with asbestos fiber burden in MPM and is perhaps modified by susceptibility.

De Nederlandse staat krijgt de meer dan 5 miljoen kosten voor de sanering van het asbestschip de Otapan mogelijk niet volledig terug. Een schikking met de voormalige Mexicaanse eigenaar van het schip ,,behoort tot de mogelijkheden”, zei milieuminister Jacqueline Cramer op 23 september j.l. in de Tweede Kamer.

Philips reserveert in het derde kwartaal 2008 241 mln euro om te kunnen schikken in een slepende asbestaffaire in de VS.

Het Spaanse hooggerechtshof heeft kanker aan het strottenhoofd (larynxkanker) als beroepsziekte erkend bij een arbeider die als stuwadoor in de haven van Barcelona geregeld asbest had ingeademd.
In 2006 oordeelde het Amerikaanse ‘Institute of Medicine’ dat er voldoende bewijs is om aan te nemen dat er een causaal verband is tussen asbestblootstelling en larynx kanker. Bron: El Pais, 17 september 2008, Europees Vakbondsinstituut Hesa, 8 juni 2006.

Het Gerechtshof Den Bosch oordeelt een aannemer aansprakelijk voor de angstklachten bij een werknemer ten gevolge van blootstelling aan asbest bij het bedrijf.
Volgens het hof staat vast dat ‘de werknemer onbeschermd met asbest in aanraking is gekomen. In het midden kan blijven hoe lang deze blootstelling heeft geduurd. Het was de verantwoordelijkheid van het aannemersbedrijf om erop toe te zien dat de werknemer niet onbeschermd met asbest in aanraking zou komen. Door deze verantwoordelijkheid niet te nemen, is het aannemersbedrijf tekort geschoten in zijn zorgplicht ex art. 7:658 lid 4 BW’. Op grond van een deskundigenrapport acht het hof voldoende aangetoond dat er causaal verband bestaat tussen de klachten van de werknemer en de blootstelling aan asbest. Bron: Gerechtshof ’s Hertogenbosch, 6 mei 2008: HD 103.003.179, LJN BD5666

Mensen die in de omgeving van een Japanse asbestfabriek hebben gewoond hebben een hoger risico op de ziekte mesothelioom. Datzelfde geldt voor vrouwen die in de omgeving woonden van de blauwe asbestmijn in het Australische Wittenoom.

Kurumatani N, Kumagai S. (2008). Mapping the risk of mesothelioma due to neighborhood asbestos exposure. Am J Respir Crit Care Med. 2008 Sep 15;178(6):624-9.
ABSTRACT
RATIONALE: Little is known about neighborhood exposure to asbestos and mesothelioma risk among residents around an industrial source of asbestos. OBJECTIVES: To investigate the magnitude of the risk among residents by asbestos exposure levels and to determine the range of the area affected by asbestos. METHODS: We calculated standardized mortality ratios of mesothelioma from 1995 to 2006 among the estimated population at risk that lived around a former large asbestos cement pipe plant in Amagasaki City, Japan, between 1957 and 1975, the time when the plant had used crocidolite and chrysotile. The distance between the plant and homes and relative asbestos concentrations obtained by diffusion equations involving meteorological conditions were used to determine asbestos exposure levels among residents. MEASUREMENTS AND MAIN RESULTS: We identified 73 mesothelioma deaths of 35 men and 38 women who had no occupational exposure to asbestos. Among persons who had lived within a 300-m radius of the plant, the standardized mortality ratio of mesothelioma was 13.9 (95% confidence interval, 5.6-28.7) for men and 41.1 (95% confidence interval, 15.2-90.1) for women. When the study area was divided into five regions by relative asbestos concentration, standardized mortality ratios of mesothelioma declined, for both sexes, in a linear dose-dependent manner with concentration. The regions with a significantly elevated standardized mortality ratio reached 2,200 m from the plant in the same direction in which the wind predominantly blew. CONCLUSIONS: Neighborhood exposure to asbestos can pose a serious risk to residents across a wide area.

Bron: Reid, A. et al. (2008). Cancer incidence among women and girls environmentally and occupationally exposed to blue asbestos at Wittenoom, Western Australia. Int J Cancer. 2008 May 15;122(10):2337-44.
ABSTRACT
The impact of crocidolite exposure on the health of former Wittenoom miners and millers (largely male) has been well documented. Less is known about the health outcomes of the 2,968 women and girls who lived (N = 2,552) and worked (N = 416) in the blue asbestos milling and mining town of Wittenoom between 1943 and 1992. Quantitative exposure measurements were derived from dust studies undertaken over the lifetime of the mine and mill and the township. Incident cancers were obtained from the Western Australian (WA) Cancer Registry and the National Cancer Clearing House. Standardized incidence ratios (SIRS) compared Wittenoom females with the WA female population. Exposure-response relationships were examined using a matched case-control study design. There were (47) mesothelioma and (55) lung cancer cases among the 437 cancers in the Wittenoom females over the period 1960-2005. When compared to the WA female population, Wittenoom women and girls had higher rates of mesothelioma and possibly lung cancer. Mesothelioma incidence rates are increasing with the incidence rate of 193 per 100,000 in the period 2000-2005 being more than double that for the period 1995-1999 at 84 per 100,000. A significant exposure-response relationship was present for mesothelioma, but not for lung cancer. Forty years after the asbestos mine and mill at Wittenoom were closed, there is a high toll from cancer among the former female residents of the town and company workers.

Een Britse ondernemer heeft 36.000 pond (ca. 46.000 euro) boete gekregen nadat zijn firma zonder vergunning asbest uit een winkel had verwijderd. Bron: safetymedia.co.uk, 30 september 2008.

Alle Britse mesothelioomslachtoffers komen sinds 1 oktober j.l. in aanmerking voor een vergoeding van gemiddeld 10.000 pond (bijna 13.000 euro) via het Mesothelioma Scheme 2008.

Het met asbest vervuilde vermiculiet uit de voormalige mijn in Libby, Montana, heeft tot nu toe 31 gevallen van mesothelioom veroorzaakt. In 11 gevallen betreft het slachtoffers die niet in de mijn hebben gewerkt, o.a. omwonenden en mensen vlak bij de rivier en spoorlijn woonden waarover het materiaal werd vervoerd.

Bron: Whitehouse, A.C., et al., (2008). Environmental exposure to Libby asbestos and mesotheliomas. American Journal of Industrial Medicine, Jul 23.                                        ABSTRACT                                                                         
BACKGROUND: Thirty-one cases of mesothelioma resulting from exposure to Libby Asbestos have been identified from Libby, Montana. Eleven cases not previously reported are the subject of this report. METHODS: These cases are in non-occupationally exposed people, appearing to have resulted from exposure to contamination of the community, the surrounding forested area, and areas in proximity to the Kootenai river and railroad tracks used to haul vermiculite. RESULTS: These exposures are considered to be of a low degree of magnitude, but are similar to those in Western Australia's crocidolite mine at Wittenoom Gorge. An epidemic of mesothelioma can likely be expected from this type of asbestos contamination over the next 20 plus years. Am. J. Ind. Med. (c) 2008 Wiley-Liss, Inc.

Het ‘publiek’ mag tot eind september 2008 commentaar geven op de inhoud van een onderzoeksrapport van het Amerikaanse ‘National Institute for Occupational Safety and Health (NIOSH)’over de schadelijkheid van asbest en onderzoeksvoorstellen die daarvoor gedaan zijn. Bron: NIOSH, juli 2008.