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Tremolite and mesothelioma
Victor L Roggli1, Robin T Vollmer, Kelly J Butnor
1Department of Pathology, Duke University and Durham VA Medical Centers, NC 27710, USA. roggli.v@durham.va.gov
Background:
Exposure to chrysotile dust has been associated with the development of mesothelioma and recent studies have implicated contaminating tremolite fibers as the likely etiological factor. Tremolite also contaminates talc, the most common non-asbestos mineral fiber in our control cases.
Methods:
We examined 312 cases of mesothelioma for which fiber burden analyses of lung parenchyma had been performed by means of scanning electron microscopy to determine the content of tremolite, non-commercial amphiboles, talc and chrysotile. The vast majority of these patients were exposed to dust from products containing asbestos.
Results:
Tremolite was identified in 166 of 312 cases (53%) and was increased above background levels in 81 cases (26%). Fibrous talc was identified in 193 cases (62%) and correlated strongly with the tremolite content (P < 0.0001). Chrysotile was identified in only 32 cases (10%), but still correlated strongly with the tremolite content (P < 0.0001). Talc levels explained less of the tremolite deviance for cases with an increased tremolite level than for cases with a normal range tremolite level (22 versus 42%). In 14 cases (4.5%) non-commercial amphibole fibers (tremolite, actinolite and/or anthophyllite) were the only fiber types found above background.
Conclusions:
We conclude that tremolite in lung tissue samples from mesothelioma victims derives from both talc and chrysotile and that tremolite accounts for a considerable fraction of the excess fiber burden in end-users of asbestos products.
Insights
Tremolite asbestos contamination in talc and chrysotile products is linked to mesothelioma. This study quantifies tremolite fiber burden in mesothelioma patients, highlighting its significant role in asbestos-related diseases.
Area of Science:
- Environmental Health
- Occupational Medicine
- Mineralogy
Background:
- Chrysotile asbestos exposure is linked to mesothelioma.
- Contaminating tremolite fibers are implicated as the etiological factor in mesothelioma.
- Tremolite also contaminates talc, a common mineral fiber in control cases.
Purpose of the Study:
- To determine the content of tremolite, non-commercial amphiboles, talc, and chrysotile in lung tissue samples from mesothelioma cases.
- To investigate the association between tremolite, talc, and chrysotile fiber burdens.
Main Methods:
- Analysis of lung parenchyma fiber burden in 312 mesothelioma cases using scanning electron microscopy.
- Quantification of tremolite, non-commercial amphiboles, talc, and chrysotile content.
Main Results:
- Tremolite was identified in 53% of cases, with elevated levels in 26%.
- Fibrous talc was found in 62% of cases and strongly correlated with tremolite content (P < 0.0001).
- Chrysotile was identified in 10% of cases, also correlating strongly with tremolite (P < 0.0001).
Conclusions:
- Tremolite in mesothelioma victims' lungs originates from both talc and chrysotile sources.
- Tremolite constitutes a significant portion of the excess fiber burden in asbestos product users.