Malignant Mesotheliomas In A Small Village In The Anatolian Region Of Turkey: An Epidemiologic Study

Our plain-English summary of Malignant Mesotheliomas In A Small Village In The Anatolian Region Of Turkey: An Epidemiologic Study, by M. Artvinli, Y.I. Baris (1979).

The study

• Authors: M. Artvinli, Y.I. Baris
• Published: Journal Of The National Cancer Institute 63(1):17-22, July (1979)
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library, J-M no. 002068. The article is still under copyright, so we describe it here rather than post it.

In plain English

This epidemiologic study looked at malignant pleural mesothelioma (MPM) and other chest disease in Tuzkoy, a village in the Anatolian region of Turkey. The neighboring village of Kizilkoy served as a control. A stratified sample of people aged 25 or older was studied: 312 from Tuzkoy (145 men, 167 women) and 95 from Kizilkoy. Participants were examined, given breathing tests and chest X-rays. Soil, building stones, water and lung tissue were analyzed for fibers. Two cases of MPM were found in the Tuzkoy group. From these, the authors estimated an annual incidence of at least 6.5 cases, or 22 per 10,000 people, at least 942 times higher than expected. Among Tuzkoy participants, X-rays showed pleural calcification in 53 (17%) and interstitial pulmonary fibrosis in 38 (12.1%), among other findings. The control group had no malignant disease and no X-ray abnormalities. No asbestos was found. Fibrous zeolite minerals (mordenite, erionite or chabazite) were found in Tuzkoy's soil and building stones and in patients' lung samples, but not in the control village. The authors concluded that the zeolites probably caused the mesotheliomas.

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: Epidemiologic and cause-related (cross-sectional survey) study comparing an affected village with a control village, with mineralogic analysis of environmental and lung samples
• Who was studied: Residents aged 25 years or older, chosen by stratified sampling. 312 people from Tuzkoy (145 males, 167 females; 30.7% of villagers that age) and 95 from the control village of Kizilkoy (45 males, 50 females), Anatolia, Turkey. Tuzkoy population 2,919 in June 1977.
• Exposure: Environmental exposure to fibrous zeolite minerals (mordenite, erionite or chabazite) in the soil, roads, fields and building stones of Tuzkoy. No asbestos was found in the area.
• Main results:
  • 2 cases of MPM were found in the 312 Tuzkoy participants.
  • The authors estimated the annual incidence of MPM in Tuzkoy at at least 6.5 cases, or 22 cases per 10,000 people.
  • This estimated incidence was at least 942 times higher than expected for the village. The authors had calculated that 1 case should occur in 145 years.
  • Among Tuzkoy participants, X-rays showed 53 (17%) cases of pleural calcification and 33 (10.5%) cases of pleural thickening.
  • Among Tuzkoy participants, X-rays showed 47 (15%) cases of obscured costodiaphragmatic angle and 38 (12.1%) cases of interstitial pulmonary fibrosis.
  • No malignant diseases were seen in the control village, and its X-rays showed no pathologic conditions.
  • During the investigation period in Tuzkoy, 1 person with lung cancer and 3 with peritoneal mesothelioma died. Some people listed in the deaths and patients tables were not in the study group.
  • No asbestos was found. Zeolite fibers were found in lung samples from thoracotomy patients.
  • No fibrous zeolites were found in the control village or in the lungs of 2 tortoises from Tuzkoy.
• The authors' conclusion: The authors concluded that the zeolites probably caused the mesotheliomas, and possibly the other cancers and respiratory disorders, in Tuzkoy. They called for an experimental study of zeolites in animals.
• Limitations the authors state:
  • The village-wide figure of 6.5 MPM cases was extrapolated from the 2 cases in the sample, and the authors describe it as theoretical.
  • Because of large out-migration of young people, the authors note the incidence figure could be higher.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pleural Mesothelioma, Chest X-Ray, Pleural Calcification, Interstitial, Pulmonary Fibrosis, Zeolite, erionite.

Browse return to medical research.