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FILE NAME Household Contact HC DATE 1978 Aug DOC HC016 DOCUMENT DESCRIPTION Journal Article - Familial Mesothelioma After Intense Asbestos Exposure at Home |. Familial Mesothelioma After Intense Exposure Asbestos at Home ee $ Lokioh Frederick P. Li MD Jacob Lokioh MD Janet Lapey MD 7 Wilford B. Neptune MD Earle W. Wiki Jr MD summarized 83 published cases of mesothelioma after domestic exposure to asbestos none of the persons had contact with the fiber at work The data on these 37 patients were fragmentary and showed that 27 82 of 83 were women and that primarily examined MESOTHELIOMA is an family were after the diagnosis mesothelioma was diagnosed in 11 50 of 22 before 50 years of age occupational disease of asbestos of mesothelioma in their sister Patient 4 meg workers but the neoplasm may also a year housewife showed slightly The preponderance of women and develop after intense exposure to prominent lung markings in the chest young patients can be explained by e asbestos outside the workplace This roentgenogram but pleural or pulmonary asbestos exposure during laundering report of pleural mesotheliomas in disease could not be diagnosed Patient 5 of dusty work clothes in ten patients the wife and a daughter of an asbestos handler suggests that gross ' asbestos contamination of the home can be a serious health hazard Report of Cases Patient 1 Figure the father worked as a pipe insulator at a shipyard for approxi- metely 25 years 1940 to 1965 Pulmonary asbestosis was diagnosed at age 60 years in 1966. He also smoked one to two packs of cigarettes daily for several decades In 1977 metastatic adenocarcinoma in the left upper lobe of the lung developed and the patient died Findings from an autopsy demonstrated severa pulmonary asbestosis and lung cancer Patient 2 the mother was in good ealth until a right pleural effusion devel- 1 jed in 1967 at age 50 years A right thoracotomy and a pleural biopsy speciman showed a mesothelloma She was not aged 28 years had normal clinical and roentgenographie findings The father had installed asbestos insulation on ships and his exposure to dusts was reported to be particularly intense during World War II and several years thereafter Family membera stated that when he returned home his work clothes were often covered with whitish powdery layer of dust The mother shook the soiled clothes on the porch laundered them in the kitchen and dried them on a line her children played nearby Family members denied other sources of intense exposure to asbestos There was no history of consanguinity or cancer among other close relatives The family lived for many years in a clean residential middle neighborhood located approximately 6 km from the shipyard Revieowf the histopathologic characteristics confirms the diagnosis of mesothe- lioma in the mother and daughter The and during childhood in 11 It is possible that asbestos did not cause the mesotheliomas in patients 2 and 8 since exposure to the agent cannot be identified in the histories of all mesothelioma patients On the other hand the dosage of asbestos to induce mesothelioma in susceptible parsons may be low and hardly noticed Several studies have implicated pollution from asbestos mines and factories in the development of mesothelioma among residents in the neighborhood In the present family three cancers can be attributed to asbestos from the shipyard The father had lung cancer which develops with particularly high frequency among asbestos workers who are also cigarette smokers In addition he had carried asbestos on his work a cigarette smoker and had not experi- daughter's tumor had a biphasic or mixed clothes into his home Mesotheliomas ars enced occupational exposures to asbestos pattern of epithelial cells with papil- subsequently developed in both his She failed to respond to radiotherapy to lary formations gland spaces and wife who laundered the clothing and the right thorax and died in August 1968 An autopsy was not performed spindle cell metaplasia Mitoses were numerous mucicarmine stains were nega- his daughter who was exposed during childhood No other of intense Patient 3 a daughter was born in 1943 tive The mother's tumor had a similar source A right pleural effusion developed at 84 appearance though fibrosis was more asbestos exposure was identified el years of age in 1977. Thoracentesis and a extensive Contributing factors may include ge- pleural biopsy specimen revealed a meso- netic susceptibility to cancer among . Sete thelioma The patient had lived through- Comment family members and exposure at an et out childhood in her parents home and Mesotheliomas usually develop in early age in patient 3. The younger later worked in clerical and secretarial older men with a history of occupa- daughters in the family had shorter we jobs without exposure to asbestos or chem- tional exposure to asbestos several and perhaps intense exposure to ical agents She had been in good health except for a suspected pulmonary embo- decades before diagnosis However Anderson et asbestos They are presently free of cancer but the latent period of asbes lism in 1974 which was attributed to oral al recently reported contraceptive ingestion She had intermit- mesotheliomas in four persons who associated mesothelioma is often tently smoked several cigarettes a day for resided with asbestos workers and more than three decades Thus long- ' approximately 15 years term surveillance for cancer in these The two younger daughters in the From the Clinical Studies Section Clinical D9, patients is needed References Epidemiology Branch National Cancer Inalifute Dr Li the Department of Medicine Sidney Father Cancer Institute Dr Laklah the Depart- ment of Pathology New England Deaconess Hospital Dr Lapey the Department of Surgery Massachusetts General Hospital Harvard Medical School Or Wilkins and the Overholt Thoracic Clinic Dr Neptune Boston Raprint requests to Clinical Bludien Section C nial Epidemiology Branch National Cancer C Wuta C 36 Binney St Boston MA 02116 Dr 0. O, d, | a] Man with asbestosla and lung cancer Woman with mesothelioma Pedigree of family 1. Greenberg M Davies TAL Mesothelioma J register 1967-68 Br Ind Med 91-104 1974 2. Anderson HA Lilla R Daum SM et al E. , Household asbestos neoplastic risk Ann NY Acad Sci 311-823 1976 8. Haramond Selikoff IJ Relation of cigarette smoking to risk of death of asbestos- atshseocUiniatteded disease among insulation States in Bogovaki P workers in Gilson JC Agency Timbrell V et al eds Biological Effects of Asbestos Lyona France International for Research on Cancer 1978 pp 812-317 JAMA Aug 4 1978 240 No. 6 uO ) ~ Familial Mesothelioma et al 487