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Mesothelioma asbestos exposure evidences |
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Mesothelioma: experimental evidence for the role of asbestos Animal experiments have confirmed the oncogenicity of asbestos. A single intrapleural or intraperitoneal injection of various asbestos fibers ( crysotile or amphiboles) produce mesothelioma in rats, hamsters and mice, often after a relatively long delay of seven month or more. Intratracheal instillation or inhalation are less often successful. Physical characteristics rather than chemical properties are incriminated, since many durable fibers of similar size and shape but of different nature ( glass, aluminum-oxide, talc ) can also produce mesothelioma in animals. The most oncogenic fibers are the long, thin ones with a length > 8 µm (micrometers) and a diameter < 0,25 µm the so called “Stanton hypothesis” whereas shorter fibers may be inactivated by phagocytosis. This long thin fibers may deposit deeply in the lung parenchyma, eventually reaching the subpleural and pleural structures, and penetrating into cells without killing them, there by thereby implementing a complex oncogenic process. The effect of gravity on inhaled fibers may explain the predominance of pleural mesothelioma in the lower thorax and on the right side. The possibility that asbestos exposure increases the risk of other cancers besides mesothelioma and lung cancers has been recently reviewed. The evidence is strong for laryngeal cancer ( relative risk = 1,4 ), suggestive but not conclusive for esophageal cancer, possible for renal cancer, and inconclusive for gastrointestinal, pancreatic and ovarian cancers (where misdiagnosis of mesothelioma is difficult to exclude ). There appears also to be no overal association with lymphomas, except possibly with large cell lymphomas of the oral cavity and gastrointestinal tract.
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