[Pleural mesothelioma: etiology and practical consequences]

In the course of the past few decades there has been a heavy world-wide increase in the incidence of mesotheliomas among the industrialised nations. A characteristic feature of this is an extremely great difference in respect of the expected incidence of the tumour between persons who had been in contact--even though a long time back--with asbestos fibre dust, or who worked or resided near sources of asbestos emission, or who had contact with asbestos fibres in their household, on the one hand, and with the rest of the population on the other. Hence, pleuromesothelioma is not only a tumour signalling the risk brought about by the presence of asbestos or of zeolites in the environment, it is also so to say the environmental tumour par excellence. Among the members of those artisan professions where products containing asbestos are being employed, pleuromesotheliomas have been a far more frequent source of professionally conditioned cancer than among the workers of the asbestos industry proper. Since the latency period is as a rule 30 years, the physician must go back scrupulously 20 to 60 years in the patient's previous history to find out whether there had been an exposure to asbestos at any time that would induce tumour formation, the more so since a mere couple of weeks' exposure can be enough to induce a tumour so many years later. On account of the pleurotropy of inhaled asbestos fibres, pointers to an asbestosis of the lungs and/or pleura should be followed up on-target. Further practical consequences are discussed.