Category: Asbestos Exposure
Genetic Predisposition to Mesothelioma Observed by Cancer Researchers
By Wade Rawlins
People who carry a mutation in a certain gene are susceptible to developing mesothelioma and exposure to asbestos may significantly increase the risk of developing the life-threatening respiratory cancer, according to new research funded by the National Cancer Institute.
The study published in Nature Genetics reports on two American families with a high incidence of mesothelioma as well as other cancers associated with mutations of the BAP1 gene. It is the first study to demonstrate that family genetic makeup can influence susceptibility to mesothelioma, a cancer of the lining of the lung and abdomen. The discovery may lead to early detection and benefit people who have been exposed to asbestos in the workplace, people with a family history of mesothelioma and individuals who have previously been diagnosed with a rare tumor of the eye known as uveal melanoma.
Mesothelioma takes the lives of about 3,000 people a year in the U.S. The incidence of mesothelioma has risen steadily in the last decade in some parts of the world, including Europe and China. Yet, only a small portion of people exposed to asbestos or eronite, another mineral fiber similar to asbestos, develop symptoms of mesothelioma.
Scientists at the University of Hawaii Cancer Center in Honolulu and Fox Chase Cancer Center in Philadelphia followed two extended families with unusually high rates of mesothelioma for 14 years. The researchers suspected that mutations of the BAP1 gene, which is involved in tumor suppression, might underlie mesothelioma in people with a strong family history of the disease after noticing genetic changes in or near stretches of DNA where the BAP1 gene is located.
When the scientists looked more closely, they saw that every person who had provided a DNA sample and had developed mesothelioma or melanoma of the eye also carried mutations in the BAP1 gene.
The researchers then studied the genetic makeup of 26 patients diagnosed with mesothelioma who did not have a known family history of asbestos-related disease. They observed that tumors in about a fourth of the patients contained mutations in the BAP1 gene. In two cases, the mutations were inherited. Both of the individuals with inherited mutations had previously developed melanoma of the eye.
“The discovery is the first step in understanding the role of the BAP1 gene and its potential utility when screening for mutations in those at high risk,” said Michele Carbone, M.D., director of the University of Hawaii Cancer Center in a prepared statement. “Identifying people at greatest risk for developing mesothelioma, especially those exposed to dangerous levels of asbestos and eronite worldwide, is a task made easier by virtue of this discovery.”
People in jobs in which asbestos is an occupational hazard such as mining, shipbuilding, maintenance, plumbing and electrical work have a higher incidence of asbestos-related disease.
The study found evidence that some individuals with the BAP1 gene mutations also developed breast, ovarian, pancreatic and renal cancers, suggesting the gene mutation may be involved in multiple cancer types, also known as a cancer syndrome. About 10 percent of women with an inherited risk of breast or ovarian cancer carry mutations in the genes BRCA1 or BRCA2, which are associated with those diseases. Some inherited risk of breast or ovarian cancer may be associated with mutations in the BAP1 gene.
Just as breast cancer is linked to more than one gene mutation, Fox Chase scientists Joseph R. Testa, who led the study with Carbone, said that it appears likely that other genes in addition to BAP1 will be found to be linked with elevated risk of mesothelioma.
Asbestos Ban Would Prevent Millions of Cancer Deaths
A University of Wisconsin epidemiologist says that the use of asbestos-containing building materials in developing countries will lead to millions of avoidable cases of cancer and an epidemic of asbestos-disease.
In an article in the September issue of the Annals of Epidemiology, Marty S. Kanarek, a University of Wisconsin School of Medicine and Public Health professor, said his review of health studies around the world suggests that an epidemic of mesothelioma, a cancer caused by asbestos exposure, is forthcoming in developing nations.
Mesothelioma is a cancer of the lining of the lung or abdomen caused by inhaling asbestos fibers. Most individuals who develop mesothelioma worked around asbestos and typically develop symptoms of asbestos disease 20 years to 50 years after exposure. In the United States, mesothelioma is blamed for 131,200 cancer deaths between 1985 and 2009 and 10 million worldwide. About 3,000 new cases of mesothelioma are diagnosed each year in the United States.
Kanarek, who has been studying the health effects of asbestos for 40 years, said his conclusion and that of many environmental health scientists is that all asbestos should be banned worldwide. “We could prevent a million or more cases of cancer,” Kanarek said in a press release issued by the University of Wisconsin School of Medicine and Public Health. “The evidence is very clear.”
Kanarek says the association between asbestos and serious respiratory health projects has been known for a century. But he contends that the asbestos industry has clouded the issue by attributing the health problems to a rarely used form of asbestos and not to chrysotile asbestos, which accounts for more then 95 percent of commercially used asbestos.
Kanarek reviewed dozens of studies of mesothelioma cases involving brake workers in the United States, miners in Africa, cement pipe factory workers in Egypt and concluded that chrysotile asbestos poses an occupational hazard of developing mesothelioma around the world.
“Because asbestos has not yet been banned in many countries, there are projections of an increasing epidemic worldwide,” Kanarek said. “Today, there are many safer, cheaper substitutes materials available, so the time is long past for a worldwide asbestos ban.”
Eleven Indicted in NY Asbestos Removal Project at Buffalo Housing Project
Three New York inspectors are among nine people and two companies indicted on criminal charges involving illegal asbestos removal at a Buffalo, N.Y. housing complex. Breathing asbestos causes life threatening diseases including mesothelioma and lung cancer so New York and federal laws strictly regulate the handling of asbestos-containing materials.
The 62-page federal indictment, handed down Aug. 4, focuses on work done by two companies that were hired to remove asbestos from the Kensington Heights housing project before its demolition. Johnson Contracting of WNY, Inc., was contracted to remove and dispose of an estimated 63,000 square feet of hazardous asbestos from each of six housing towers in the 17-acre complex. JMD Environmental Inc. was hired as a sub-contractor to monitor the asbestos removal work and do air sampling.
According to the U.S. Department of Justice release, from June 2009 to January 2010, workers for Johnson Contracting overseen by company president Ernest Johnson and supervisor Rai Johnson allegedly illegally stripped asbestos-containing materials at the Kensington Towers in violation of the Clean Air Act. The indictment accuses the company officials of instructing workers to dump asbestos-containing debris down holes cut in the floor and directing workers to leave asbestos in the towers knowing that the buildings were going to be demolished.
During the same time period, the JMD Environmental was supposed to monitor the asbestos removal work and perform air sampling, according to the Justice Department. The indictment alleges that JMD and its employees including supervisor Evan Harnden and three project monitors failed to conduct proper air sampling and created false visual inspection reports by certifying that all asbestos had been removed from the buildings.
Two city of Buffalo building inspectors also were charged with falsely certifying that all asbestos had been removed from the six buildings, when they knew the asbestos had not been removed. Also indicted was an inspector with the New York State Department of Labor Asbestos Control Bureau for allegedly concealing the illegal asbestos removal activities occurring at Kensington Heights.
Each of the 23 charges carries a maximum penalty of five years in prison, a fine of $250,000 or both.
Each year, an estimated 3,000 Americans are diagnosed with mesothelioma, a cancer of the lining of the lung that is a signature disease of asbestos exposure. Many older houses and buildings contain insulation, shingles and other building materials containing asbestos. Asbestos exposure is an occupational hazard for construction and demolition workers and a primary way people are exposed to asbestos today.
Hawaii Researchers’ Efforts to Crack Mesothelioma Code Aided by $3.5m Gift
Michele Carbone, director of the University of Hawaii Cancer Center and his colleagues, have made a series of recent scientific breakthroughs in understanding the mechanism by which asbestos triggers mesothelioma, an aggressive cancer of the lining of the lung and abdomen.
In recognition of that groundbreaking research, an anonymous donor has given the University of Hawaii Cancer Center a $3.58 million gift to support mesothelioma research, the university announced this month. The gift is the second largest in UH Cancer Center history.
“Mesothelioma is a serious public health problem,” said Virginia Hinshaw, chancellor of the University of Hawaii Manoa. “We’re proud that Dr. Carbone’s team is leading the world in this area of discovery. This gift validates their efforts and will help them remain at the forefront of thoracic oncology research.”
Closely associated with inhaling airborne asbestos fibers, mesothelioma produces an aggressive type of tumor. The current median survival from diagnosis is just 12 months, creating a need for more effective therapies to extend mesothelioma patients’ lives. Approximately 2,500 to 3,000 people in the U.S. are diagnosed with mesothelioma each year. Most were exposed to asbestos decades before cancer symptoms appeared.
Dr. Carbone and colleagues including Assistant Professor Haining Yang and Adjunct Professor Giovanni Gaudino have studied asbestos-related disease for more than a decade, analyzing how genetics, environmental carcinogens and viral infection interact to cause malignant mesothelioma.
In an article in the Proceedings of the National Academy of Sciences, Carbone and colleagues described how asbestos killed cells through a process called programmed cell necrosis that leads to the release of a protein molecule HMGB1. People exposed to asbestos have elevated levels of the protein in their blood. The protein begins an inflammatory chain reaction in tissue that causes the release of mutagens that promote tumor growth. Cancer often occurs in the presence of chronic inflammation. By interfering with the inflammatory reaction, it may be possible to decrease the occurrence of mesothelioma.
Many of the UH researchers’ findings have been based on work conducted in the villages of Capadoccia, a region of Turkey that has an extraordinarily high rate of mesothelioma deaths. Nearly 50 percent of the region’s residents develop and die of mesothelioma from exposure to eronite, a naturally occurring mineral fiber found in rock formations that is even more toxic than asbestos. Eronite has been used in the U.S. in road paving.
Drs. Carbone and Yang plan to conduct a clinical trial co-sponosored by the U.S. National Cancer Institute in Cappadocia to validate the serum biomarkers they discovered for the early detection of mesothelioma.
Their findings may have applications far beyond the villages of Turkey and lead to new ways to prevent and treat the disease. In the future, treatment approaches aimed at identifying people who are likely to develop mesothelioma based on elevated biomarkers and blocking chronic inflammation could reduce the risk of mesothelioma among workers exposed to asbestos.
“This generous gift is critical to support our efforts to generate discoveries that will aid in the prevention of mesothelioma and the development of new therapies,” Dr. Carbone said in a statement.
NY Medical Center Cited For Asbestos Workplace Safety Violations
One of the primary ways that workers today are exposed to cancer-causing asbestos is during demolition and remodeling activities. A workplace safety investigation at a Brooklyn medical center serves as a cautionary tale of the need to train workers to prevent asbestos exposure.
Many older buildings and houses, constructed before 1980, have asbestos-containing ceiling tiles, floor tiles, insulation, or plumbing. Demolition and remodeling activity can raise clouds of asbestos dust, jeopardizing the health of workers who breathe the microscopic mineral fibers floating in the air. Inhaling asbestos is associated with mesothelioma, an incurable cancer of the lining of the lungs, as well as lung cancer and asbestosis, a chronic scarring of the lung that causes shortness of breath and breathing problems.
Last week, inspectors with the federal Occupational Safety and Health Administration cited the Interfaith Medical Center in Brooklyn, New York with 14 violations of workplace safety and health standards and proposed $48,000 in fines.
Kay Gee, OSHA’s NY area director for Brooklyn, Manhattan and Queens, said that federal work safety standards require that employees whose jobs bring them into contact with asbestos or potential asbestos-containing materials should be trained about the hazards of asbestos and the required safety precautions to protect their health.
According to a U.S. Department of Labor news release, an OSHA inspection found that the medical center failed to provide adequate asbestos training for environmental staff and employees in the engineering department who perform demolition and renovation. Asbestos exposure is an occupational hazard for demolition and renovation workers. In addition, the hospital failed to label properly asbestos-containing insulation and floor tile and allowed the disposal of asbestos-containing materials in the hospital dumpster. The hospital also failed to train trade workers about the hazards or inform outside contractors of the presence of potentially asbestos-containing materials, the inspectors said.
The OSHA inspectors issued citations for 10 serious asbestos violations and proposed a total of $48,000 in fines. A serious violation is defined as one where there is a substantial probability that serious physical harm or death could result from a hazard that an employer knew about or should have known about.
Interfaith Medical Center has 15 business days to comply or contest the findings before the independent OSHA review commission.
Robert Kulick, OSHA’s regional administrator in New York, said creating and maintaining an illness and injury prevention program to identify and eliminate hazards is a means of addressing such workplace hazards.
Approximately 3,000 people in the U.S. are diagnosed with mesothelioma each year. Many are workers and veterans exposed to asbestos in the 1960s, 1970s and 1980s. The symptoms of mesothelioma typically take 20 to 50 years to appear after the initial exposure.
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