Mesothelioma with Short Latency Periods.

Recently we had the opportunity to study 2 cases of mesothelioma in young workers. A 40-year-old secretary, whose office was close to foundry furnaces and a 35-year-old worker, at another foundry. Both patients presented a pleural mesothelioma with peritoneal extension. It is known the use of asbestos in foundry companies, both in thermal protection equipment, and for being present in their facilities (doors and walls of furnaces). Both patients developed the tumor in periods of latency close to 10 years.

The period of latency is defined as the time interval between the first exposure to asbestos and the appearance of mesothelioma. In most of the published series, this latency period ranges between 20 and 40 years (1), although the variability is very high, with cases described with latency periods of less than 10 years and others over 60 years. It is admitted that mesothelioma is the malignant tumor with longer latency periods and this knowledge has overshadowed the fact that it can also arise a few years after exposure. Numerous publications report specific cases with latency periods of less than 10 years. In a series of 16 pleural mesothelioma in the resident population near a fiber cement factory in Poland, 4 cases presented a latency period of 3.5 to 5 years and another 2 cases of periods of 11 and 12 years respectively (2).

 

An Israeli woman exposed to asbestos released during the demolition and reconstruction of the airport office where she worked at the age of 20, developed a mesothelioma 7 years later (3). The worker of an auxiliary company of the wine industry, exposed to an environmental concentration of 1-2 f / ml in the air breathed in his workplace for 3 - 4 months a year, developed a mesothelioma at 7.5 years of age. work in the company, in which white asbestos was used for filters (4). Some authors have postulated that intense exposures to asbestos at young ages would be behind cases with a shorter latency period (3), but there is controversy (5). 

The collapse of the Twin Towers in New York, after the attack of September 11, 2001, recovered the interest for mesothelioma originated after short periods of latency, it is estimated that at least 400 tons of asbestos had been used in the construction of the World Trade Center. To this end, a working group was created to study the impact on health of volunteers, firefighters and other professionals who suffered environmental exposure in ground zero. It was estimated that the greatest risk of future mesothelioma would be concentrated in the first people who were involved in the cloud of dust formed, as well as in workers responsible for the demolition and removal of the remains of construction materials (6). The press warned of the death by mesothelioma in 2003 of at least 3 people who came to the rescue in ground zero (7).

One of the few publications that investigates in detail the degree of variability of the latency period in the development of mesothelioma, concludes that neither the intensity of the exposure, nor the type of work, significantly influence the duration of the latency period (5) . The study proposes a statistical approach for the detection of factors that may influence the duration of the latency period, in a series of 614 patients died by mesothelioma between 1978 and 2005, from an English register of workers exposed to asbestos. The average period of latency was 22.8 years for the whole series of 614 patients; of 8.2 years for the 132 peritoneal mesothelioma and 2.9 years for the 10 mixed pleural and peritoneal mesothelioma. In other series, a shorter latency period had been detected for peritoneal mesothelioma compared to the pleural, and assuming as true the "intuitive" inverse relationship between intensity and duration of the latency period, it was postulated that peritoneal mesothelioma were markers of intense exposures. to asbestos. But the analysis carried out by Guillian Frost (5), contradicts the so-called "intensity hypothesis" since there are no shorter latency periods among workers with a higher degree of exposure

Frost G. The latency period of mesothelioma among a cohort of British asbestos workers (1978-2005). Br J Cancer. 2013 Oct 1;109(7):1965-73.

REFERENCES

1. Szeszenia-Dabrowska N, Wilczyńska U, Szymczak W, Laskowicz K. Environmental exposure to asbestos in asbestos cement workers: a case of additional exposure from indiscriminate use of industrial wastes. Int J Occup Med Environ Health. 1998; 11 (2): 171-7.

2. Bitchatchi E, Kayser K, Perelman M, Richter ED. Mesothelioma and asbestosis in a young woman following occupational asbestos exposure: Short latency and long survival: Case Report. Diagn Pathol. 2010 Dec 16; 5: 81.

4. Scansetti G, Mollo F, Tiberi G, Andrion A, Piolatto G. Pleural mesothelioma after a short interval from first exposure in the wine filter industry. Am J Ind Med. 1984; 5 (4): 335-9.5.- Frost G. The latency period of mesothelioma among a cohort of British asbestos workers (1978-2005). Br J Cancer. 2013 Oct 1; 109 (7): 1965-73.

5. Landrigan PJ, Lioy PJ, Thurston G, Berkowitz G, Chen LC, Chillrud SN, Gavett SH, Georgopoulos PG, Geyh AS, Levin S, Perera F, Rappaport SM, Small C; NIEHS World Trade Center Working Group. Health and environmental consequences of the world trade center disaster. Environ Health Perspect. 2004 May; 112 (6): 731-9.

6. Arrinda Yeregui JM, Sanz Anquela JM. Natural history of pleural mesothelioma: Asbestos as a necessary causal factor. Hispano-American Pathology Acts, October 2006 (VIII Hispano-American Virtual Congress of Pathological Anatomy).

7.- Gardner A. Toxic After-Effects Still Haunt 9/11 Responders. Cancer links are seen among the many ills that have surfaced since the Twin Towers fell. HealthDay Sep 7, 2011 http://consumer.healthday.com/