Skip to main content
NCBI home page
Revista Brasileira de Medicina do Trabalho logoLink to Revista Brasileira de Medicina do Trabalho
. 2023 Feb 13;20(4):650–658. doi: 10.47626/1679-4435-2022-733

Occupational characterization of workers exposed to asbestos: an integrative review

Caracterização ocupacional dos trabalhadores expostos ao asbesto: uma revisão integrativa

Kauane Vicari 1,✉, Inaye Mayr Ribeiro 1, Bianca Fontana Aguiar 1, Christiane Brey 1, Shirley Boller 1, Fernanda Moura D’Almeida Miranda 1
PMCID: PMC10124803  PMID: 37101434

Abstract

Asbestos is a mineral fiber abundant in nature and classified as a carcinogen since 1987. The present study aimed to identify, in the scientific literature, what are the occupation and activities developed by sick workers and which categories would be affected with asbestos-related diseases. Through a literature review performed in the following databases: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and Regional Portal of the Virtual Health Library, 23 studies published from 2015 to 2020 were selected and evaluated. The occupations that showed greater illness due to exposure to asbestos were general asbestos workers (40%), miners (22%), and textile workers (9%), followed by naval, automotive, carpentry, doll-making, construction, and upholstery workers, as well as workers involved in the rescue, recovery, cleaning, and restoration of the World Trade Center (4%). Of the disease associated with exposure to asbestos, the most described is malignant mesothelioma (43%). Evidence found corroborate pre-existing information in the literature showing that exposure to asbestos may be harmful to health. Moreover, the importance of using personal protective equipment was emphasized, in order to prevent the development of asbestos-related diseases.

Keywords: asbestos, occupations, occupational exposure, occupational health

INTRODUCTION

Asbestos is a collective term used for commercial identification of a heterogeneous group of minerals whose crystals form bundles of easily separable fibers. These minerals derive from eruptive metamorphic rocks that, due to a natural process of recrystallization, undergo changes, forming a fibrous material. They belong to two different groups: a) amphiboles, which includes amosite (brown asbestos), crocidolite (blue asbestos), anthophyllite, actinolite, and tremolite; and b) serpentines, represented by chrysotile (white asbestos).1,2

The applicability of this mineral goes beyond the construction industry. There are reports of more than 3 thousand products made of asbestos, such as water tanks, asbestos-cement tiles, canvas and brake pads for cars and trucks, fabrics, fireproof blankets, thermal insulation fabrics, vinyl flooring, hydraulic cardboards, automotive gaskets, inks, asphalt, and reinforced plastics.1,3

Surely, exposure to asbestos contributes to the development of asbestos-related disease (ARD), resulting from biopersistence of fibers in the lung.4,5 Furthermore, the José de Alencar Gomes da Silva National Cancer Institute (Instituto Nacional de Câncer José de Alencar Gomes da Silva, INCA) and the International Agency for Research on Cancer (IARC) state that the aforementioned fibers are potentially carcinogenic agents.6

With regard to ARDs, it is worth highlighting malignant mesothelioma (MM), lung neoplasms, and non-malignant conditions, such as asbestosis and development of pleural plaques.7 Occupational exposure is one of the main factors for the onset of ARDs and other diseases as well, since some workers are routinely exposed to different substances harmful to health.8,9

Due to the applicability of asbestos in several products, its use was widespread in some countries such as Russia, China, Brazil, Thailand, Kazakhstan, India, and Ukraine.10 Brazil also stood out as producer and exporter, a fact that deserves attention and monitoring by health services due to the possible occurrence of ARDs.11,12

Total ban of asbestos is already a reality in at least 66 countries,13,14 and, in Brazil, only in 2017 the Federal Supreme Court (Supremo Tribunal Federal, (STF) established the prohibition of extraction, manufacturing, and sale of chrysotile asbestos in the entire national territory.15

ARDs are often identified lately, due to their long period of latency, which lasts from exposure to the first clinical symptoms, thus contributing to disease underregistration.16,17 In light of the foregoing, knowledge of the possible at-risk groups and of the prevalent diseases resulting from occupational exposure has become indispensable. Based on these considerations, the aim of this study was to identify, in the scientific literature, what are the occupations and activities developed by sick workers and what categories are most affected with ARDs.

METHODS

This was an integrative literature review, a method that allows for gathering and synthesizing evidence available in articles produced about a topic.18

This research was developed based on Whittemore & Knaff19, who proposed the following steps: 1) formulation of the research question; 2) data collection; 3) data assessment according to inclusion and exclusion criteria; 4) data analysis; and 5) presentation of results and knowledge synthesis.

The guiding research question was structured using the non-clinical research strategy characterized by the acronym formed by the words population/patient/problem, interest, and context (PIC), being P: workers; I: disease caused by asbestos; and C: exposure to asbestos. Therefore, the resulting question was “what characterizes workers with diseases resulting from exposure to asbestos?”.

Inclusion criteria consisted of studies published from January 2015 to January 2020 and written in English, Italian, Portuguese, or Spanish. Exclusion criteria consisted of duplicate articles and those not fully available online, as well as theses, dissertations, letters, and editorials from scientific journals. The search for studies was performed from February to March 2020, in the following databases: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Web of Science, and the Regional Portal of the Virtual Health Library (VHL), which gathered findings from the MEDLINE and IBECS databases. The following Health Science Descriptors (Descritores de Ciências da Saúde, DeCS) were used: “Workers”, “Asbestos”, “Amianto”, “Occupational exposure,” and “Inhalation exposure”.

This search identified 320 studies, 175 in BVS, 22 in CINAHL, 82 in PubMed, and 41 in Web of Science, and, after application of exclusion criteria, 237 publications remained in the analysis. These publications were then analyzed after reading of abstracts, and, finally, 23 articles were considered eligible, which constituted the sample of this review. The study selection process was based on the recommendations of Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA),20 as shown in Figure 1.

Figure 1.

Figure 1

Open in a new tab

Study selection flowchart, adapted from the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) model, Brazil, 2020.

CINAHL = Cumulative Index to Nursing and Allied Health Literature; VHL = Virtual Health Library.

RESULTS

The final sample consisted of 23 articles that addressed the occupational relationships of workers with diseases resulting from exposure to asbestos. Of these articles, 17 (74%) were cohort studies, 5 (22%) were case studies, and 1 (4%) was a pilot study. With regard to year of publication, four of them were published in 2015, three in 2016, nine in 2017, five in 2018, and two in 2019.

Concerning the country where the study was conducted, Italy was the leading country, with seven (30%) articles, followed by the United States (USA), with five (22%); South Korea, China, and France, with two (9%) articles each; and then Germany, Belgium, Great Britain, Japan, and Spain, with one (4%) article each.

As for workers’ occupations reported in the studies, nine (40%) articles included general asbestos workers; five (22%), miners; two (9%), textile workers, followed by workers in the naval, automotive, carpentry, doll making, construction, upholstery industries, and workers who participated in the rescue, recovery, cleaning, and restoration of the World Trade Center, with one (4%) publication each.

Corning the study population, it was observed that, in 16 (70%) articles, sick workers were men; whereas four (17%) studies involved both men and women and three (13%) studies included only female participants.

Among the ARDs that affected workers, articles reported cases of MM in ten (43%) publications; lung cancer and other neoplasms, such as those affecting mouth, pharynx, esophagus, liver, bile duct, ovary, and colon, were found in eight (35%) publications; and respiratory diseases, asbestoses and the development of pleural plaques were observed in five (22%) studies.

Chart 1 presents the main characteristics of the articles selected for this review.

Chart 1.

Characterization of the selected articles, Curitiba, Paraná, Brazil, 2020

Title Authors Language Country Productive industry Research design Journal and year of publication
1. “Cancer attributable to asbestos exposure in shipbreaking workers: a matched-cohort study” Wu et al.21 English China Naval industry Retrospective cohort PLoS ONE, 2015
2. “Enduring health effects of asbestos use in Belgian industries: a record-linked cohort study of cause-specific mortality (2001-2009)” Borre & Deboosere22 English Belgium General asbestos Retrospective cohort BMJ Open, 2015
3. “Malignant mesotheliomas in textile rag sorters” Chelini et al.23 English Italy Textile industry Retrospective cohort Annals of Occupational Hygiene, 2015
4. “CT characteristics of pleural plaques related to occupational or environmental asbestos exposure from South Korean asbestos mines” Kim et al.24 English South Korea Mining Retrospective cohort Korean Journal of Radiology, 2015
5. “Malignant mesothelioma in a motor vehicle mechanic: case report and review of the literature” Meisenkothen25 English United States Automotive industry Case study NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy, 2016
6. “Pleural plaques and lung function in the Marysville worker cohort: a re-analysis” Zu et al.26 English United States Mining Retrospective cohort Inhalation Toxicology, 2016
7. “Pleural mesothelioma: case-report of uncommon occupational asbestos exposure in a small furniture industry” Oddone & Imbriani27 English Italy Carpentry Case study International Journal of Occupational Medicine and Environmental Health, 2016
8. “Asbestos-related lung cancers: a retrospective clinical and pathological study” Ugues et al.28 English France General asbestos Retrospective cohort Molecular and Clinical Oncology, 2017
9. “Mortality of talc miners and millers from Val Chisone, Northern Italy: an updated cohort study” Pira et al.29 English Italy Mining Retrospective cohort Journal of Occupational and Environmental Medicine, 2017
10. “Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos Related Diseases Cohort (ARDCo-Nut)” Paris et al.30 English France General asbestos Retrospective cohort Environmental Health Perspectives, 2017
11. “Asbestos-related disease in upholsterers” Cruz et al.31 English Spain Upholstery Case study Archives of Environmental & Occupational Health, 2017
12. “Mesoteliomi pleurici in addette alla fabbricazione di bambole: esposizione ad amianto?” Barbieri et al.32 Italian Italy Doll making Case study La Medicina del Lavoro, 2017
13. “Mortality from asbestos-associated disease in Libby, Montana 1979-2011” Naik et al.33 English United States Mining Retrospective cohort Journal of Exposure Science and Environmental Epidemiology, 2017
14. “Chest physician-reported, work-related, long-latency respiratory disease in Great Britain” Carder et al.34 English Great Britain General asbestos Retrospective cohort European Respiratory Journal, 2017
15. “The effects of pleural plaques on longitudinal lung function in vermiculite miners of Libby, Montana” Clark et al.35 English United States Mining Retrospective cohort The American Journal of the Medical Sciences, 2017
16. “Pleural and peritoneal mesotheliomas in the Friuli Venezia Giulia register: data analysis from 1995 to 2015 in Northeastern Italy” D’Agostin et al.36 English Italy General asbestos Retrospective cohort Journal of Thoracic Disease, 2017
17. “Clustering of malignant pleural mesothelioma in asbestos factories: a subgroup analysis in a 29-year follow-up study to identify high-risk industries in Taiwan” Lee et al.37 English China General asbestos Retrospective cohort BMJ Open, 2018
18. “Chest CT scan findings in World Trade Center workers” Hoz et al.38 English United States Workers involved in the rescue, recovery, cleaning, and restoration of the World Trade Center Retrospective cohort Archives of Environmental & Occupational Health, 2018
19. “Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance” Barbiero et al.39 English Italy General asbestos Retrospective cohort International Archives of Occupational and Environmental Health, 2018
20. “Potential asbestos exposure among patients with primary lung cancer in Japan” Tamura et al.40 English Japan General asbestos Retrospective cohort Journal of Occupational Health, 2018
21. “Ovarian cancer in a former asbestos textile factory worker: a case report” Park et al.41 English South Korea Textile industry Case study Annals of Occupational and Environmental Medicine, 2018
22. “Investigating the association between occupational exposure to asbestos and ovarian carcinoma: results from a pilot study in Germany” Rajput et al.42 English Germany General asbestos Pilot study BMC Public Health, 2019
23. “Malignant mesothelioma in construction workers: the Apulia regional mesothelioma register, Southern Italy” Vimercati et al.43 English Italy Construction industry Retrospective cohort BMC Research Notes, 2019
Open in a new tab

DISCUSSION

The selected studies revealed the hazards of asbestos and characterized workers with diseases resulting from exposure to this substance. Measures to restrict its use have already been implemented by several countries; however, its deleterious effects will last for decades in the health of many workers.44,45

ARDs are increasingly more common and are especially observed in regions where this mineral was widely employed, being also considered an occupational disease.43,44,46

Of the ARDs that affect the workers included in this research, it is worth noting the prevalence of MM, a rapidly evolving disease whose period of latency depends on time of exposure and may reach up to 50 years.21,27,47,48 A study conducted in Belgium in 2015 showed that mortality for MM was higher among blue-collar asbestos workers.22

It bears highlighting that, in other studies, workers of the following industries also presented with diagnosis of MM: naval, textile, automotive, chemical, metal, construction, and furniture.21-23,25 Furthermore, MM occurred among employees of a doll-making factory, whose exposure to asbestos has not been known so far.32

The incidence rates of MM were higher in the male population.23,29,37 The prevalence in men is justified by the occupations they perform, which often involve a direct handling of asbestos.34,36

Women diagnosed with MM were exposed to asbestos in the workplace, especially in the textile industry, or had a history of paraoccupacional exposure, probably derived from the household environment or from contact with a family member who worked directly with the mineral.34,36,49

Lung cancer was also identified, with incidence for workers of the naval industry21,28,39 and for those who handle asbestos directly.22 Trachea and bronchus cancer was also observed in this population.21

A relevant issue for the development of these diseases is the possible association between smoking and exposure to asbestos: the frequency of self-acknowledged smokers in a study was 79.5%,31 corroborating another research that found 74.4% of smokers with lung cancer.41 Therefore, smoking cessation is also necessary in the population exposed to asbestos.31,50 The synergy between smoking and exposure to asbestos potentiates the toxic effects of fibers and increase the risk for lung cancer.

Other neoplasms attributable to exposure to asbestos are those affecting mouth, pharynx, esophagus, liver, and bile duct, and mortality for these causes was found in blue-collar asbestos workers, followed by automotive, naval, and construction workers.21,22 This circumstance confirms the carcinogenic potential of the fibers.51,52

Contrary to the already reported types of cancer and in line with a study conducted in Italy, the occurrence of ovary cancer stands out in the female population, especially among women working in the textile industry.41,42,53 For the male population, in turn, findings point out to development of colorectal cancer.30,54

With regard to non-cancerous asbestos-related diseases, they include asbestosis and pleural plaques.24,28 Asbestosis is caused by the deposition of asbestos fibers in the lungs, leading to fibrosing interstitial pneumonitis.55,56 Pleural plaques represent a predisposing factor of ARDs.38,40,55

Miners are found to be the workers with the most extensive pleural plaques and asbestosis.24 In others studies, there are reports of the prevalence of these conditions in construction workers, followed by metal, mining, and furniture workers.33,31,40 This differs from findings reported in studies conducted in Marysville (United States) and in Libby (United States), which did not evidence an association between single pleural plaques and reduced lung function.26,35 However, the identification of these data, which are related to risk factors, help predict malignant comorbidities.38,40

Studies emphasize that workers exposed, directly or not, to asbestos should be informed about the hazards it causes, so as to provide better work conditions, as well as better health surveillance, for this population.25,39,57

It is important to reinforce the importance of characterizing workers, in order to promote health care measures aimed at those whose occupation is directly related to ARDs.

CONCLUSIONS

Evidence found in this study makes it possible to characterize workers with diseases resulting from exposure to asbestos. Findings reveal that workers exposed, directly or not, to asbestos, are prone to the development of any type of ARD.

The main occupations of these workers consists of general asbestos workers, miners, carpenters, as well as those working in the textile, naval, and automotive industry. Associated diseases were MM, lung, ovary and colorectal neoplasms, and non-neoplastic conditions such as asbestosis and pleural plaques. In most studies, workers with diseases resulting from any type of ARD were men.

These data corroborate information showing that exposure to asbestos may be detrimental to health. The hazards of occupation exposure are highlighted; however, the risk is still imminent, since restriction of asbestos is not still a reality in many countries. Therefore, it is proposed to develop scientific productions and to implement effective health surveillance measures aimed at the most vulnerable population.

One limitation of this study was the non-inclusion of grey literature. However, the articles selected for this integrative review contributed to the outcome of the research, since they were recent articles published in international journal and addressing a relevant topic.

Acknowledgments

Fundação Araucária - public notice PIBIC 2019/2020.

Footnotes

Conflicts of interest: None

Funding: None

References

  • 1.Castro H, Giannasi F, Novello C. A luta pelo banimento do amianto nas Américas: uma questão de saúde pública. Cien Saude Colet. 2003;8(4):903–911. [Google Scholar]
  • 2.Brum SC, Almeida B, Pelosi ES, Pacheco J, Guimarães MGA. Amianto: a bioética entre o custo e a toxicidade. Rev Eletronica Teccen. 2016;9(1):52–56. [Google Scholar]
  • 3.Alleman JE, Mossman BT. Asbestos revisited. Sci American. 1997;277(1):70–75. [Google Scholar]
  • 4.Santos FRF, Souza Neto JA. Identificação e quantificação de amianto em solo no entorno de fábrica de materiais de construção a base de fibrocimento, no bairro da Várzea, Recife (PE) Estud Geol. 2014;24(2):127–147. [Google Scholar]
  • 5.Associação Brasileira dos Expostos ao Amianto . Página inicial [Internet] São Paulo: ABREA; 2020. [citado em 21 jul. 2020]. Disponível em: https://www.abrea.org.br/ [Google Scholar]
  • 6.Instituto Nacional de Câncer . Amianto [Internet] Rio de Janeiro: INCA; 2020. [citado em 21 jul. 2020]. Disponível em: https://www.inca.gov.br/assuntos/amianto . [Google Scholar]
  • 7.Kratzke P, Kratzke RA. Asbestos-related disease. J Radiol Nurs. 2018;37(1):21–26. [Google Scholar]
  • 8.Instituto Nacional do Câncer . Exposição no trabalho e no ambiente - amianto [Internet] Rio de Janeiro: INCA; 2018. [citado em 21 jul. 2020]. Disponível em: https://www.inca.gov.br/exposicao-no-trabalho-e-no-ambiente/amianto . [Google Scholar]
  • 9.Brey C, Gouveia FT, Silva BS, Sarquis LMM, Miranda FMA, Consonni D. Câncer de pulmão relacionado à exposição ocupacional: revisão integrativa. Rev Gaucha Enferm. 2020;41:e20190378. doi: 10.1590/1983-1447.2020.20190378. [DOI] [PubMed] [Google Scholar]
  • 10.Marsili D, Terracini B, Santana VS, Ramos-Bonilla JP, Pasetto R, Mazzeo A, et al. Prevention of Asbestos-Related Disease in Countries Currently Using Asbestos. Int J Environ Res Public Health. 2016;13(5):494. doi: 10.3390/ijerph13050494. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Terracini B, Pedra F, Otero U. Asbestos-related cancers in Brazil. Cad Saude Publica. 2015;31(5):903–905. doi: 10.1590/0102-311XPE010515. [DOI] [PubMed] [Google Scholar]
  • 12.Martin-Chenut K, Saldanha J. O caso do amianto: os limites das soluções locais para um problema de saúde global. Lua Nova. 2016;98:141–170. [Google Scholar]
  • 13.Santos SA. Amianto: do uso em larga escala ao banimento. BEPA. 2016;13(153-154):53–61. [Google Scholar]
  • 14.Nolasco LG, Matoso FP, Matos WR. Princípio da precaução para gestão de riscos do amianto. Rev Dir Pub. 2019;14(2):28–54. [Google Scholar]
  • 15.Brasil. Supremo Tribunal Federal . Emenda da Lei Federal 9.055/1995: dispõe sobre a proibição da extração, comercialização e exportação do amianto em território brasileiro. Brasília: STF; 2017. [Google Scholar]
  • 16.Porto FA, López-Arranz MA, Fachal FM. In: Anuario da Facultade de Ciencias do Traballo da Universidade da Coruña. Ramos SP, editor. Coruña: Facultade de Ciencias do Traballo, Servizo de Publicacións; 2017. Enfermidades profesionais relacionadas coa exposición ao amianto; pp. 33–53. [Google Scholar]
  • 17.Arantes MD, Cruz NR, Sousa GF, Varoto ACV, Almeida PV. Análise epidemiológica do mesotelioma pleural maligno no estado de São Paulo, de 2000 a 2015. Braz J Hea Rev. 2019;2(3):1930–1940. [Google Scholar]
  • 18.Salge AKM, Castral TC, Sousa MC, Souza RRG, Minamisava R, Souza SMB. Infecção pelo vírus Zika na gestação e microcefalia em recém-nascidos: revisão integrativa de literatura. Rev Eletr Enferm. 2016;18:e1137. [Google Scholar]
  • 19.Whittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs. 2005;52(5):546–553. doi: 10.1111/j.1365-2648.2005.03621.x. [DOI] [PubMed] [Google Scholar]
  • 20.Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi: 10.1371/journal.pmed.1000097. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 21.Wu WT, Lin YJ, Li CY, Tsai PJ, Yang CY, Liou SH, et al. Cancer attributable to asbestos exposure in shipbreaking workers: a matched-cohort study. PLoS ONE. 2015;10(7):e0133128. doi: 10.1371/journal.pone.0133128. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 22.Van den Borre L, Deboosere P. Enduring health effects of asbestos use in Belgian industries: a record-linked cohort study of cause-specific mortality (2001-2009) BMJ Open. 2015;5(6):e007384. doi: 10.1136/bmjopen-2014-007384. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Chellini E, Martino G, Grillo A, Fedi A, Martini A, Indiani L, et al. Malignant mesotheliomas in textile rag sorters. Ann Occup Hyg. 2015;59(5):547–553. doi: 10.1093/annhyg/meu114. [DOI] [PubMed] [Google Scholar]
  • 24.Kim Y, Myong JP, Lee JK, Kim JS, Kim YK, Jung SH. CT characteristics of pleural plaques related to occupational or environmental asbestos exposure from South Korean asbestos mines. Korean J Radiol. 2015;16(5):1142–1152. doi: 10.3348/kjr.2015.16.5.1142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Meisenkothen C. Malignant mesothelioma in a motor vehicle mechanic: case report and review of the literature. New Solut. 2017;26(4):524–542. doi: 10.1177/1048291116655526. [DOI] [PubMed] [Google Scholar]
  • 26.Zu K, Tao G, Goodman JE. Pleural plaques and lung function in the Marysville worker cohort: a re-analysis. Inhal Toxicol. 2016;28(11):514–519. doi: 10.1080/08958378.2016.1210704. [DOI] [PubMed] [Google Scholar]
  • 27.Oddone E, Imbriani M. Pleural mesothelioma: case-report of uncommon occupational asbestos exposure in a small furniture industry. Int J Occup Med Environ Health. 2016;29(3):523–526. doi: 10.13075/ijomeh.1896.00597. [DOI] [PubMed] [Google Scholar]
  • 28.Uguen M, Dewitte JD, Marcorelles P, Loddé B, Pougnet R, Saliou P, et al. Asbestos-related lung cancers: a retrospective clinical and pathological study. Mol Clin Oncol. 2017;7(1):135–139. doi: 10.3892/mco.2017.1277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 29.Pira E, Coggiola M, Ciocan C, Romano C, La Vecchia C, Pelucchi C, et al. Mortality of talc miners and millers from Val Chisone, Northern Italy: an updated cohort study. J Occup Environ Med. 2017;59(7):659–664. doi: 10.1097/JOM.0000000000000992. [DOI] [PubMed] [Google Scholar]
  • 30.Paris C, Thaon I, Hérin F, Clin B, Lacourt A, Luc A, et al. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the Asbestos-Related Diseases Cohort (ARDCo-Nut) Environ Health Perspect. 2017;125(3):409–415. doi: 10.1289/EHP153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Cruz MJ, Sampol J, Pallero M, Rodríguez E, Ferrer J. Asbestos-related disease in upholsterers. Arch Environ Occup Health. 2018;73(3):186–188. doi: 10.1080/19338244.2017.1350133. [DOI] [PubMed] [Google Scholar]
  • 32.Barbieri PG, Somigliana A, Lombardi S, Festa R, Girelli R, Sarnico M. Mesoteliomi pleurici in addette alla fabbricazione di bambole: esposizione ad amianto? Med Lav. 2017;108(2):111–117. doi: 10.23749/mdl.v108i2.6115. [DOI] [PubMed] [Google Scholar]
  • 33.Naik SL, Lewin M, Young R, Dearwent SM, Lee R. Mortality from asbestos-associated disease in Libby, Montana 1979-2011. J Expo Sci Environ Epidemiol. 2017;27(2):207–213. doi: 10.1038/jes.2016.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 34.Carder M, Darnton A, Gittins M, Stocks SJ, Ross D, Barber CM, et al. Chest physician-reported, work-related, long-latency respiratory disease in Great Britain. Eur Respir J. 2017;50(6):1700961. doi: 10.1183/13993003.00961-2017. [DOI] [PubMed] [Google Scholar]
  • 35.Clark KA, Flynn JJ 3rd, Karmaus WJJ, Mohr LC. The effects of pleural plaques on longitudinal lung function in vermiculite miners of Libby, Montana. Am J Med Sci. 2017;353(6):533–542. doi: 10.1016/j.amjms.2017.03.033. [DOI] [PubMed] [Google Scholar]
  • 36.D’Agostin F, De Michieli P, Chermaz C, Negro C. Pleural and peritoneal mesotheliomas in the Friuli Venezia Giulia register: data analysis from 1995 to 2015 in Northeastern Italy. J Thorac Dis. 2017;9(4):1032–1045. doi: 10.21037/jtd.2017.03.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 37.Lee LJH, Lin CK, Pan CH, Cheng Y, Chang YY, Liou SH, et al. Clustering of malignant pleural mesothelioma in asbestos factories: a subgroup analysis in a 29-year follow-up study to identify high-risk industries in Taiwan. BMJ Open. 2018;8(12):e021063. doi: 10.1136/bmjopen-2017-021063. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.de la Hoz RE, Weber J, Xu D, Doucette JT, Liu X, Carson DA, et al. Chest CT scan findings in World Trade Center workers. Arch Environ Occup Health. 2019;74(5):263–270. doi: 10.1080/19338244.2018.1452712. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 39.Barbiero F, Zanin T, Pisa FE, Casetta A, Rosolen V, Giangreco M, et al. Cancer incidence in a cohort of asbestos-exposed workers undergoing health surveillance. Int Arch Occup Environ Health. 2018;91(7):831–841. doi: 10.1007/s00420-018-1326-3. [DOI] [PubMed] [Google Scholar]
  • 40.Tamura A, Funakoshi M, Awn JPN, Hasegawa K, Ishimine A, Koike A, et al. Potential asbestos exposure among patients with primary lung cancer in Japan. J Occup Health. 2018;60(3):236–245. doi: 10.1539/joh.2017-0199-OA. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41.Park S, Park J, Lee E, Eom H, Shin MY, Kim J, et al. Ovarian cancer in a former asbestos textile factory worker: a case report. Ann Occup Environ Med. 2018;30:65. doi: 10.1186/s40557-018-0277-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Rajput Z, Hering KG, Kraus T, Tannapfel A, Sonnenschein G, Centmayer A, et al. Investigating the association between occupational exposure to asbestos and ovarian carcinoma: results from a pilot study in Germany. BMC Public Health. 2019;19(1):1341. doi: 10.1186/s12889-019-7590-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Vimercati L, Cavone D, Caputi A, Delfino MC, De Maria L, Ferri GM, et al. Malignant mesothelioma in construction workers: the Apulia regional mesothelioma register, Southern Italy. BMC Res Notes. 2019;12(1):636. doi: 10.1186/s13104-019-4675-4. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 44.Takahashi K, Landrigan PJ, Collegium Ramazzini The global health dimensions of asbestos and asbestos-related diseases. Ann Glob Health. 2016;82(1):209–213. doi: 10.1016/j.aogh.2016.01.019. [DOI] [PubMed] [Google Scholar]
  • 45.Rong Y, Luo X, Zhang Z, Cui X, Liu Y, Chen W. Occupational exposure to asbestos and cardiovascular related diseases: a meta-analysis. Prev Med Rep. 2015;2:920–926. doi: 10.1016/j.pmedr.2015.10.005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 46.Kang DM, Kim JE, Kim YK, Lee HH, Kim SY. Occupational burden of asbestos-related diseases in Korea, 1998-2013: asbestosis, mesothelioma, lung cancer, laryngeal cancer, and ovarian cancer. J Korean Med Sci. 2018;33(35):e226. doi: 10.3346/jkms.2018.33.e226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Gogou E, Hatzoglou C, Zarogiannis SG, Malli F, Jagirdar RM, Gourgoulianis KI. Mesothelioma mortality rates in Greece for the period 2005-2015 is increased compared to previous decades. Medicina (Kaunas) 2019;55(8):419. doi: 10.3390/medicina55080419. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 48.Dragani TA, Colombo F, Pavlisko EN, Roggli VL. Malignant mesothelioma diagnosed at a younger age is associated with heavier asbestos exposure. Carcinogenesis. 2018;39(9):1151–1156. doi: 10.1093/carcin/bgy089. [DOI] [PubMed] [Google Scholar]
  • 49.Noonan CW. Environmental asbestos exposure and risk of mesothelioma. Ann Transl Med. 2017;5(11):234. doi: 10.21037/atm.2017.03.74. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 50.Ngamwong Y, Tangamornsuksan W, Lohitnavy O, Chaiyakunapruk N, Scholfield CN, Reisfeld B, et al. Additive synergism between asbestos and smoking in lung cancer risk: a systematic review and meta-analysis. PLoS One. 2015;10(8):e0135798. doi: 10.1371/journal.pone.0135798. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 51.Merlo DF, Bruzzone M, Bruzzi P, Garrone E, Puntoni R, Maiorana L, et al. Mortality among workers exposed to asbestos at the shipyard of Genoa, Italy: a 55 years follow-up. Environ Health. 2018;17(1):94. doi: 10.1186/s12940-018-0439-1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 52.Latifovic L, Villeneuve PJ, Parent MÉ, Kachuri L, Canadian Cancer Registries Epidemiology Group. Harris SA. Silica and asbestos exposure at work and the risk of bladder cancer in Canadian men: a population-based case-control study. BMC Cancer. 2020;20(1):171. doi: 10.1186/s12885-020-6644-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 53.Luberto F, Ferrante D, Silvestri S, Angelini A, Cuccaro F, Nannavecchia AM, et al. Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy. Environ Health. 2019;18(1):71. doi: 10.1186/s12940-019-0510-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 54.Korda RJ, Clements MS, Armstrong BK, Law HD, Guiver T, Anderson PR, et al. Risk of cancer associated with residential exposure to asbestos insulation: a whole-population cohort study. Lancet Public Health. 2017;2(11):e522–e528. doi: 10.1016/S2468-2667(17)30192-5. [DOI] [PubMed] [Google Scholar]
  • 55.Marchiori E, Hochhegger B, Zanetti G. Calcificações pleurais. J Bras Pneumol. 2018;44(6):447. doi: 10.1590/S1806-37562018000000344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 56.Tonet C, Chultz RM, Zimmer MF, Silva NO. Relação entre pneumoconioses e o câncer de pulmão. Rev Uninga. 2019;56(4):177–186. [Google Scholar]
  • 57.Silva CCS, Rodrigues LMC, Silva VKBA, Silva ACO, Silva VLA, Martins MO. Percepção da enfermagem sobre condições de trabalho em unidades de saúde da família na Paraíba - Brasil. Rev Eletr Enferm. 2013;15(1):205–214. [Google Scholar]

Articles from Revista Brasileira de Medicina do Trabalho are provided here courtesy of Associação Nacional de Medicina do Trabalho

RESOURCES