Document QXx647602BdNeLe2bywOMjrmE

(Page 1 of 2) (Page 2 of 2) years since the first exposure to amphibole asbestos, suggesting that with lower exposures latency time increases.16 These data are still consistent with the hypothesis of Peto,17 relating risk to a linear effect of fiber type and dose to the risk of mesothelioma multiplied by time of first exposure to the exponent 3-4. This lias obvious public health consequences, since it suggests that people who are now healthier than their predecessors and will live longer are at risk for MPM due to low-dose amphibole asbestos expo sure. These mesotheliomas would not have been seen in this older population if they had a shorter life span. How much of the increased incidence of mesothelioma in Europe18 is due to the improved health of the general population and consequently a longer life expectancy is unclear. Certain viral infec tions, such as SV40, may play an important role in the pathogenesis of mesotheliomias in the certain Western countries but not in Turkey.19 The role of genetic factors in susceptibility to mesotheliomia is an area of active research but is still unclear.20 Dorsett D. Smith, MD, FCCP Everett, WA Dr. Smith is Clinical Professor of Medicine, Division of Pulmo nary Disease and Critical Care, Department of Medicine, Uni versity of Washington. Correspondence to: Dorsett D. Smith, MD, FCCP, 4310 Colby Arc, Everett, WA 98203; e-mail: chestdis@ix.netcum.com 1 Metinas M, Hillerdal G, Metinas S. Malignant mesothelioma due to environmental exposure to erionite: follow-up of a Turkish emigrant cohort. Eur Respir J 1999; 13:523-526 2 Riback J, Lilis R, Suzuki Y, et al. Malignant mesothelioma in a cohort of asbestos insulation workers: clinical presentation, diagnosis, and causes of death. Br J Ind Med 1988; 45:182 187 3 Hansen J, De Klerk NH, Musk AW, et al. Environmental exposure to Crocidolite and mesothelioma, exposure response relationships. Am J Respir Crit Care Med 1998: 157:69-75 4 Albin M, Magnani C, Krestev S, et al. Asbestos and cancer, an overview of current trends in Europe. Environ Health Per- spect 1999; 107:289-298 5 Becklake MR. Asbestos-related diseases of the lung and other organs: their epidemiology and implications for clinical prac tice. Am Rev Respir Dis 1976; 114:187-227 6 Becklake MR, Toyota B, Stewart M, et al. Lung structure as a risk factor in adverse pulmonary responses to asbestos exposure. Am Rev Respir Dis 1983; 128:385-388 7 Cocco P, Dosemeci M. Peritoneal cancer and occupational exposure to asbestos: results from applications of a job- exposure matrix. Am J Ind Med 1999; 35:9-14 8 Heller DS, Gordon RE, Clement PB, et al. Presence of asbestos in peritoneal malignant mesotheliomas in women. Int J Gynecol Cancer 1999; 9:452-455 9 Bollinger DJ, Wick MR, Dehner LP, et al. Peritoneal malig nant mesothelioma vs serous papillary adenocarcinoma. Am J Surg Pathol 1989; 13:659-670 10 Cramer D, Welch W, Scully RE. Ovarian cancer and talc: a case control study. Cancer 1982; 50:372-376 11 Kerrigan S, Clement P, Tumnir R, et al. Diffuse malignant mesothelioma of the peritoneum in women. Cancer 2002; 94:378-385 12 Spiratas R, Heineman EF, Bernstein L, et al. Malignant mesothelioma: attributable risk of asbestos exposure. Occup Environ Med 1994; 51:804 - 811 13 Dawson A, Gibbs AR, Poole)' FD, et al. Malignant mesothe lioma in women. Thorax 1993; 48:269-274 14 Mowe G, Gylseth B, Hartveit F, et al. Occupational asbestos exposure, lung-fiber concentration and latency time in malig nant mesothelioma. Scand J Work Environ Health 1984; 10:293-298 15 de Klerk Nil, Armstrong BK. The epidemiology of asbestos and mesothelioma In; Henderson DW, Shilkin KB, Langlois SL, et al, eds. Malignant mesothelioma. New York, NY: Hemisphere Publishing Corporation, 1992; 223-250 .16 Bianelii C, Brollo A, Ramani L, et al. Asbestos exposure in malignant mesothelioma of the pleura: a survey of 557 cases. Ind Health 2001; 39:161-167 ' 17 Peto J. Problems in dose response and risk assessment: the example asbestos. Banbury Rep 1985; 19:89-97 18 Peto J, Decarli A, La Vecchia C, et al. The European mesothelioma epidemic. Br J Cancer 1999; 79:666-672 19 De Rienzo A, Tor M, Sterman D, et al. Detection of SV40 DNA sequences in malignant mesotheliomia from the United States but not from Turkey. J Cell Biochem 2002; 84:455-459 20 Carbone M, Kratzke R, Testa J. The pathogenesis of me sotheliomia. Semin Oncol 2002; 29:2-17