Old Habits Die Hard - Asbestos Exposure

Our plain-English summary of Old Habits Die Hard - Asbestos Exposure, by B. Çil, M.R. Polat, M. Kabak (Turkish Thoracic Journal, 2021).

The study

• Authors: B. Çil, M.R. Polat, M. Kabak
• Journal: Turkish Thoracic Journal
• Published: 2021;22(5):381-385
• Read it: PubMed · Publisher · Free full text

Abstract

Objective: Although the damages to health that are caused by asbestos exposure are known, the mineral continues to be in use. Our main purpose in the study was to determine the relationship between awareness and asbestos use.

Material And Methods: A total of 100 residents from the Armutova village of Ergani District in the Diyarbakir province of Turkey, with previous asbestos exposure were studied between January 2010 and December 2010. Exposure to asbestos was questioned in all participants. Asbestos doses were measured in the setting where they lived. The pulmonary function tests (PFTs) including forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were performed, and chest radiography was taken.

Results: The duration of asbestos exposure was found to be associated with reduced PFTs and the pathological lung findings on radiology. Although 97% of the participants were aware of asbestos and its health risks, the rates of its use were significantly higher, and associated with excessive exposure levels. Longer duration of asbestos exposure was significantly associated with reduced FVC. There were more prominent reductions in FEV1 with longer durations of asbestos exposure.

Conclusion: The high rates of asbestos use indicate that changing habits, particularly among individuals residing in rural areas, is difficult. In our country, the main route of asbestos exposure is through the environment, which is at least as hazardous as occupational exposure.

In plain English

This study screened 100 adults living in Armutova village, Ergani district, Diyarbakir province, Turkey, during 2010. Asbestos had been mined, processed and sold there, and was used to coat cowsheds. The article does not name the fiber type. The mean duration of asbestos exposure was 36.85 years. Participants answered questionnaires and had chest X-rays and breathing tests (spirometry). Air was sampled in one randomly selected house: 1.108 fibers/cm3 inside and 0.07 fibers/cm3 outside. All but 3 participants were aware of asbestos. Participants generally reported no asbestos use in the previous 1 to 2 years, but the authors took the indoor level as evidence that use continued. Chest X-rays were normal in 64 people; 27 showed pleural plaques and 5 asbestosis. Longer exposure was associated with lower breathing-test values (FVC and FEV1). Pathological X-ray findings were seen in 20 of 34 people exposed more than 40 years, against 16 of 66 exposed less than 40 years. The authors concluded that changing habits in rural areas is difficult. They noted that only one house was sampled.

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: Cross-sectional screening study (questionnaire, physical examination, chest X-ray, spirometry, and indoor and outdoor dust measurement)
• Who was studied: 100 adult residents (60 women, 40 men; mean age 44.67 years, range 18 to 89) of Armutova village, Ergani district, Diyarbakir province, Turkey, studied January to December 2010
• Exposure: Environmental asbestos in the village, where it was mined, processed, used and sold, and used in the inner and outer coatings of cowsheds. Fiber type is not named.
• Main results:
  • Mean duration of asbestos exposure among participants was 36.85 plus or minus 17.70 years
  • In one randomly selected house, asbestos concentration was 1.108 fibers/cm3 inside and 0.07 fibers/cm3 outside
  • All but 3 of the 100 participants were aware of asbestos and its presence in their surroundings
  • Participants generally reported no asbestos use in the past 1 to 2 years. The authors inferred continued use from the measured indoor concentration.
  • On chest X-ray, 34 individuals (34%) had asbestos-related lesions, mostly pleural plaques (27%). Table 2 lists 64 normal, 27 pleural plaques, 5 asbestosis, 2 pleural fluid, 1 calcific lymphadenopathy, 1 solitary pulmonary nodule.
  • Breathing tests were normal in 57 participants, obstructive in 12 and restrictive in 31
  • Longer asbestos exposure was significantly associated with reduced FVC (r = -0.400)
  • Longer asbestos exposure was associated with decline in FEV1 (r = -0.429)
  • Pathological chest X-ray findings in 20 of 34 (58.8%) participants exposed more than 40 years, against 16 of 66 (24.2%) exposed fewer than 40 years (P = .001)
  • Presence or absence of pathological chest X-ray findings was significantly correlated with shortness of breath (dyspnea), which 77 participants reported
  • No correlation was found between breathing-test results and the presence or absence of asbestos-related X-ray findings
• The authors' conclusion: The authors concluded that the high rates of asbestos use show that changing habits is difficult, particularly in rural areas. They called for steps to remove existing asbestos products.
• Limitations the authors state:
  • Asbestos was measured in only one randomly selected house, so levels in other houses are unknown
  • Further lung function tests, such as the carbon monoxide diffusion test, were not performed

Topics

Medical terms in this study, explained in our Lexicon: Habit, Asbestos Exposure, Damages, Pulmonary Function Test (PFT), FEV1, Occupational Exposure.

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• Mortality patterns among hard rock gold miners exposed to an asbestiform mineral — J.D. Gillam, J.M. Dement, et al. (1976)
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• Discussion paper: asbestos fiber exposures in a hard rock gold mine — J.M. Dement, R.D. Zumwalde, et al. (1976)
• Sectioning and imaging hard mineral fibres in biological tissues — N.F. Johnson, K. Ibe (1981)
• Asbestos exposure, smoking habits, and cancer incidence among production and maintenance workers in an electrochemical plant — B. Hilt, S. Langård, et al. (1985)
• Pulmonary function, smoking habits, and high resolution computed tomography (HRCT) early abnormalities of lung and pleural fibrosis in shipyard workers exposed to asbestos — S. Neri, P. Boraschi, et al. (1996)

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