Asbestos Case Study

Asbestos is a naturally occurring fibrous mineral. It has been used in building materials and thermal insulation, but use has been limited since the 1970s after numerous organizations such as the International Agency for Research on Cancer have classified asbestos as a human carcinogen (Scarlett, 2012). Exposure to inhaled asbestos fibers can cause one of three clinical entities: 1. Asbestosis, 2. Pleural disease, or 3. Mesothelioma (King, 2016). Asbestosis is a progressive fibrotic lung disease. Pleural disease may manifest as benign asbestos pleural effusions (BAPE), or benign pleural plaques. Pleural thickening is regarded as a unique hallmark of asbestos exposure. Mesothelioma, most often manifesting as malignant pleural mesothelioma is

Samples were collected and tested in 87% of the hospitals, of which 61.5% (16) had confirmed ACBM. Most of the ACBM was used as thermal insulation for boilers and steam pipes. The authors report the Occupational Safety and Health Administration (OSHA) established asbestos exposure limit of 0.1 fibers/cc air. Given these recommendations, the authors argue for the immediate removal of the ACBM found in the Jamaican hospitals to reduce occupational exposure and the risk of development of pleural disease, asbestosis, or mesothelioma. The Mesothelioma Cancer Alliance is a community agency aimed at providing high-quality resources for patients and families who are affected by mesothelioma. Although there is no cure for mesothelioma and the median survival for stage I, II, III, and IV disease is only 20, 19, 16, and 11 months respectively (Sterman, 2017), there is a patient population who may benefit from surgical resection from surgeons such as Dr. Alexander

Alexander Patterson he discussed the various surgical options available to mesothelioma patients. Broadly these options fall into potentially curative interventions and palliative interventions. Potentially curative surgical options include pleurectomy and pneumonectomy, while palliative interventions include pleurocentesis and pleurodesis. There are emerging therapies for mesothelioma as well, including immunotherapy and photodynamic therapy. He discussed how the majority of cases he sees are males older than 60 with confirmed occupational exposure when they were younger. Interestingly I found out that mesothelioma is a relatively rare manifestation of asbestos exposure, which is a good given its extremely lethal course. He discussed an advanced surgical option for certain patients that involves cytoreductive surgery combined with heated intraperitoneal chemotherapy (HIPEC). Finally, he discussed how systemic chemotherapy may be beneficial in addition to surgery for certain patients with widespread disease. Asbestos is a real public health concern given its natural prevalence and through the former widespread use in building and heating materials. Asbestos exposure can manifest in a number of ways, from benign pleural plaques to a chronic fibrotic disease to malignant mesothelioma. Given that the relative risk of lung cancer is increased by 59-fold among those exposed to asbestos who smoke cigarettes (King et al. 2016), one priority for community health