Fibrous Zeolites And Endemic Mesothelioma In Cappadocia, Turkey

Our plain-English summary of Fibrous Zeolites And Endemic Mesothelioma In Cappadocia, Turkey, by R. Lilis (1981).

The study

• Author: R. Lilis
• Published: Journal Of Occupational Medicine 23(8):548-550, August (1981)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 001995. The article is still under copyright, so we describe it here rather than post it.

In plain English

This short article reviewed endemic mesothelioma in Karain and Tuzköy, villages in Cappadocia, central Turkey. It drew mainly on Baris and co-workers' work, plus the author's own patient examinations. In Karain (575 inhabitants), 24 pleural mesothelioma cases occurred from 1970 to 1974. From January 1975 to June 1979, Karain had 28 mesothelioma cases (12 females, 16 males) and 10 chronic fibrosing pleuritis cases. Tuzköy (population 2919) had at least nine cases (six pleural, three peritoneal) in 1977 and 1978. In November 1978 the author and Dr. Baris examined nine confirmed mesothelioma patients. Pleural calcification, pleural fibrosis, benign pleural effusions and interstitial pulmonary fibrosis were also common. Mesothelioma often occurred at young ages and about equally in men and women. Mineral analyses had so far detected no asbestos in local soil, rocks, dust, building stones or whitewash, but found fibrous zeolites, mostly mordenite, erionite or chabazite. Similar fibers were found in patients' lung tissue. The author concluded that the hypothesis that non-asbestos fibrous materials can cause this disease seemed confirmed for fibrous zeolites. Lung cancer information for the area was limited.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Review/commentary summarizing published epidemiologic data from Cappadocia (largely by Baris and co-workers), with the author's own clinical examination of patients
• Who was studied: Inhabitants of the villages of Karain (population 575) and Tuzköy (population 2919, about 50 km from Karain) in Cappadocia, central Turkey, 1970s
• Exposure: Environmental exposure from birth to fibrous zeolite minerals (aluminum silicates), mostly mordenite, erionite or chabazite. The search had so far failed to detect any asbestos in local soil, rocks, dust, building stones and whitewash used in houses.
• Main results:
  • Karain (population 575): 24 cases of pleural mesothelioma occurred from 1970 to 1974
  • Karain, January 1975 to June 1979 (Table 1): 28 mesothelioma cases (12 females, 16 males) and 10 chronic fibrosing pleuritis cases (2 females, 8 males)
  • Tuzköy (population 2919): at least nine mesothelioma cases, six pleural and three peritoneal, occurred in 1977 and 1978
  • In November 1978 the author and Dr. Baris examined nine confirmed mesothelioma patients; another six patients had suspicious pleural findings and were scheduled for work-up
  • Pleural calcifications, pleural fibrosis, benign pleural effusions and interstitial pulmonary fibrosis were also found with high prevalence in Karain and Tuzköy
  • Mesothelioma incidence was described as practically identical in men and women, although women in the area are nonsmokers and most men smoke
  • The search for the causative agent had so far failed to detect any asbestos in soil, rocks, dust, building stones or whitewash; fibers similar to the local zeolite fibers were identified in lung tissue from patients who underwent thoracotomy
• The authors' conclusion: The author concluded that the possibility that fibrous materials other than asbestos may cause the disease spectrum classically associated with asbestos seemed to have been epidemiologically documented, and that Stanton's fiber hypothesis seemed confirmed for fibrous zeolites. The author called for investigation of zeolite exposure elsewhere, including in zeolite mining, milling, processing and use.
• Limitations the authors state:
  • Only limited information was available on lung cancer incidence in the Karain and Tuzköy areas
  • The incidence of peritoneal mesothelioma was probably highly underestimated, because reports came from a thoracic diseases department and the autopsy rate was low
  • Incidence of lung, gastrointestinal and other cancers in this population remained an open question

Topics

Medical terms in this study, explained in our Lexicon: Zeolite, Endemic, Mesothelioma, Cappadocia, Karain, Pleural Mesothelioma, Pleural Calcification, Fibrosis.

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