Mesothelioma is a type of cancer that
develops from the thin layer of tissue that covers many of the internal organs
known as the mesothelium). The most common area affected is the lining
of the lungs and chest wall.Less commonly the lining of the abdomen and
rarely the sac surrounding the heart,or the sac surrounding the
testis may be affected.Signs and symptoms of mesothelioma may
include shortness of breath due to fluid around the lung, a
swollen abdomen, chest wall pain, cough, feeling tired, and weight loss.These
symptoms typically come on slowly.
Greater than 80% of mesothelioma is
caused by exposure to asbestos. The greater the exposure the greater the
risk.As of 2013 about 125 million people have been exposed to asbestos at
work. High rates of disease occur in people who mine asbestos, produce
products from asbestos, work with asbestos products, live with asbestos
workers, or work in buildings containing asbestos. Often it takes around 40
years for the disease to begin.Washing the clothing of someone who worked with
asbestos also increases the risk.Other risk factors
include genetics and infection with the simian virus
40. The diagnosis may be suspected based on chest
X-ray and CT scan findings, and is confirmed by
either examining fluid produced by the cancer or by a tissue
biopsy of the cancer.
Prevention centers around reducing
exposure to asbestos. Treatment often includes surgery, radiation
therapy, and chemotherapy. A procedure known aspleurodesis, which involves
using substances such as talc to scar together the pleura, may
be used to prevent more fluid from building up around the lungs.Chemotherapy
often includes the
medications cisplatin and pemetrexed. The percentage of
people that survive five years following diagnosis is on average 8%
in the United States.
In 2013 about 50,000 people had mesothelioma
and 34,000 died from the disease. Rates of mesothelioma vary in different
areas of the world. Rates are higher in Australia and Great Britain and lower
in Japan. It occurs in about 3,000 people per year in the United
States It occurs more often in males than females. Rates of disease have
increased since the 1950s. Diagnosis typically occurs after the age of 65 and
most deaths occur around 70 years old. The disease was rare before the
commercial use of asbestos.


Cause
Working with asbestos is the
most common risk factor for mesothelioma. In the United States, asbestos
is considered the major cause of malignant mesothelioma and has been
considered "indisputably" associated with the development of
mesothelioma. Indeed, the relationship between asbestos and mesothelioma is so
strong that many consider mesothelioma a “signal” or “sentinel” tumor. A
history of asbestos exposure exists in most cases. However, mesothelioma has
been reported in some individuals without any known exposure to asbestos. In
rare cases, mesothelioma has also been associated with irradiation of the chest
or abdomen, intrapleural thorium dioxide (thorotrast) as a contrast medium, and
inhalation of other fibrous silicates, such as erionite or talc. Some
studies suggest that simian virus 40 (SV40) may act as
a cofactor in the development of mesothelioma.This has been confirmed
in animal studies,but studies in humans are inconclusive.Pericardial
mesothelioma may not be associated with asbestos exposure.
Asbestos was known in antiquity, but it
was not mined and widely used commercially until the late 19th century. Its use
greatly increased during World
War II. Since the early 1940s, millions of American workers have been
exposed to asbestos dust. Initially, the risks associated with asbestos
exposure were not publicly known. However, an increased risk of developing
mesothelioma was later found among naval personnel (e.g., Navy, Marine Corps
and Coast Guard), shipyard workers, people who work in asbestos mines and
mills, producers of asbestos products, workers in the heating and construction
industries, and other tradespeople. Today, the official position of the
U.S. Occupational Safety and
Health Administration(OSHA) and the U.S. EPA is that protections and
"permissible exposure limits" required by U.S. regulations, while
adequate to prevent most asbestos-related non-malignant disease, are not adequate
to prevent or protect against asbestos-related cancers such as mesothelioma.Likewise,
the British Government's Health and Safety Executive (HSE)
states formally that any threshold for exposure to asbestos must be at a very
low level and it is widely agreed that if any such threshold does exist at all,
then it cannot currently be quantified. For practical purposes, therefore, HSE
assumes that no such "safe" threshold exists. Others have noted as
well that there is no evidence of a threshold level below which there is no
risk of mesothelioma.There appears to be a linear, dose-response relationship,
with increasing dose producing increasing disease.Nevertheless, mesothelioma
may be related to brief, low level or indirect exposures to asbestos.The dose
necessary for effect appears to be lower for asbestos-induced mesothelioma than
for pulmonary asbestosis or lung cancer. Again, there is no known safe
level of exposure to asbestos as it relates to increased risk of mesothelioma.
The duration of exposure to asbestos
causing mesothelioma can be short. For example, cases of mesothelioma have been
documented with only 1–3 months of exposure. People who work with asbestos
wear personal protective equipment to lower their risk of exposure.
Latency, the time from first exposure to
manifestation of disease, is prolonged in the case of mesothelioma. It is
virtually never less than fifteen years and peaks at 30–40 years.In a review of
occupationally related mesothelioma cases, the median latency was 32 years.Based
upon the data from Peto et al., the risk of mesothelioma appears to
increase to the third or fourth power from first exposure.
Environmental exposures
Incidence of mesothelioma has been found
to be higher in populations living near naturally occurring asbestos. People
can be exposed to naturally occurring asbestos in areas where mining or road
construction is occurring, or when asbestos-containing rock is naturally
weathered. Another common route of exposure is through asbestos-containing
soil, which is used to whitewash, plaster, and roof houses in Greece.In
central Cappadocia, Turkey, mesothelioma was causing 50% of all
deaths in three small villages—Tuzköy, Karain and Sarıhıdır. Initially, this
was attributed to erionite. Environmental exposure to asbestos has caused
mesothelioma in places other than Turkey, including Corsica, Greece, Cyprus,
China, and California.In Metsovo, this exposure had resulted in mesothelioma
incidence around 300 times more than expected in asbestos free populations and
was associated with very frequent pleural calcification known as "Metsovo
Lung".
The documented presence of asbestos
fibers in water supplies and food products has fostered concerns about the
possible impact of long-term and, as yet, unknown exposure of the general
population to these fibers.
Exposure to talc is also a risk factor
for mesothelioma; exposure can affect those who live near talc mines, work in
talc mines, or work in talc mills.
Occupational
Exposure to asbestos fibers has been
recognized as an occupational health hazard since the early 20th century.
Numerous epidemiological studies have associated occupational exposure to
asbestos with the development of pleural plaques, diffuse pleural thickening,
asbestosis, carcinoma of the lung and larynx, gastrointestinal tumors, and
diffuse malignant mesothelioma of the pleura and peritoneum. Asbestos has been
widely used in many industrial products, including cement, brake linings,
gaskets, roof shingles, flooring products, textiles, and insulation.
Commercial asbestos mining at Wittenoom,
Western Australia, took place from 1937 to 1966. The first case of mesothelioma
in the town occurred in 1960. The second case was in 1969, and new cases began
to appear more frequently thereafter. The lag time between initial exposure to
asbestos and the development of mesothelioma varied from 12 years 9 months up
to 58 years. A cohort study of miners employed at the mine
reported that 85 deaths attributable to mesothelioma had occurred by 1985. By
1994, 539 reported deaths due to mesothelioma had been reported in Western
Australia.
Occupational exposure to asbestos in the
United States mainly occurs when people are maintaining buildings that already
have asbestos. Approximately 1.3 million US workers are exposed to asbestos
annually; in 2002, an estimated 44,000 miners were potentially exposed to
asbestos.
Paraoccupational secondary exposure
Family members and others living with
asbestos workers have an increased risk of developing mesothelioma, and
possibly other asbestos related diseases.This risk may be the result of
exposure to asbestos dust brought home on the clothing and hair of asbestos
workers via washing a worker's clothes or coming into contact with
asbestos-contaminated work clothing.To reduce the chance of exposing family
members to asbestos fibres, asbestos workers are usually required to shower and
change their clothing before leaving the workplace.
Asbestos in buildings
Many building materials used in both
public and domestic premises prior to the banning of asbestos may contain
asbestos. Those performing renovation works or DIY activities
may expose themselves to asbestos dust. In the UK use of Chrysotile asbestos
was banned at the end of 1999. Brown and blue asbestos was
banned in the UK around 1985. Buildings built or renovated prior to these dates
may contain asbestos materials.
Genetic disposition
In a recent research carried on white
American population in 2012, it was found that people with a germline mutation
on theirBAP1 gene
are at higher risk of developing mesothelioma and uveal melanoma.
Erionite
Main article: Erionite
Erionite is a zeolite mineral with similar properties to asbestos and
is known to cause mesothelioma.Detailed epidemiological investigation has shown
that erionite causes mesothelioma mostly in families with a genetic
predisposition.Erionite is found in deposits in the Western United States,
where it is used in gravel for road
surfacing, and in Turkey, where it is used to construct homes. In Turkey,
the United States, and Mexico, erionite has been associated with mesothelioma
and has thus been designated a "known human carcinogen" by the
US National Toxicology Program
Asbestos is a set of six naturally occurring silicate
minerals,which all have in common theireponymous asbestiform habit:
long (roughly 1:20 aspect ratio), thin fibrouscrystals, with
each visible fiber composed of millions of microscopic "fibrils" that
can be released by abrasion and other processes.They are
commonly known by their colors, as blue asbestos, brown
asbestos, white asbestos, andgreen asbestos.
Asbestos mining existed more than 4,000
years ago, but large-scale mining began at the end of the 19th century, when
manufacturers and builders began using asbestos because of its desirable
physical properties:sound absorption, average tensile
strength, its resistance to fire, heat, electrical and chemical
damage, and affordability. It was used in such applications aselectrical insulation for hotplate
wiring and in building insulation. When asbestos is used for
its resistance to fire or heat, the fibers are often mixed with cement or woven
into fabric or mats. These desirable properties made asbestos a very widely
used material, and its use continued to grow throughout most of the 20th century
until the knowledge of carcinogenic effects of asbestos dust caused its
effective demise as a mainstream construction and fireproofing material
in most countries.
It is now known that prolonged inhalation of
asbestos fibers can cause serious and fatal illnesses including lung
cancer, mesothelioma, and asbestosis (a
type of pneumoconiosis).Health issues related to asbestos
exposure can be found in records dating back to Roman
times. By the beginning of the 20th century concerns were beginning to be
raised, which escalated in severity during the 1920s and 1930s. By the 1980s
and 1990s asbestos trade and use started to become banned outright, phased out,
or heavily restricted in an increasing number of countries.
The severity of asbestos-related
diseases, the material's extremely widespread use in many areas of life, its
continuing long-term use after harmful health effects were known or suspected,
and fact that asbestos-related diseases can emerge decades after exposure
ceases, have resulted in asbestos litigationbecoming the longest, most
expensive mass tort in U.S. history and a much lesser
legal issue in most other countries involved.Asbestos-related liabilityalso
remains an ongoing concern for many manufacturers, insurers and reinsurers.
Mesothelioma attorneys understand asbestos legal issues and the unique challenges asbestos victims face. We offer information on what to expect when working with a mesothelioma lawyer, as well as help finding a qualified mesothelioma attorney for your case.
Successful asbestos ligation requires an attorney who understands the many facets of the case, from how people get exposed to asbestos to the state-by-state regulations about filing lawsuits, to the fragile nature of many clients. Often, people who inquire about an asbestos-related claim are people who are also coping with mesothelioma cancer and all the health issues that go along with treatment.
Choosing a lawyer to represent you in depositions and in legal filings can be as important to your family's future as selecting the right doctor. If were you exposed to asbestos and you got sick as a result, you have a right to stake a claim for compensation.
The dangers and toxicity of asbestos were well-known in the 1930s, yet corporations continued using it extensively through much of the 20th century. They willingly put profits ahead of the health and well-being of employees and the public. An experienced asbestos lawyer will know how to hold those corporations responsible.
Tips When Looking For an Asbestos Litigation Specialist
You should consider several things when you start to evaluate the hiring of an attorney. You want to find someone with whom you feel comfortable talking because you will be discussing intimate details about your health and about where you used to work. Although your lawyer likely will know all the right questions to ask you, good communication is essential.
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