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Diffuse peritoneal mesothelioma: A case series of 62 patients including paraoccupational exposures to chrysotile
Richard L Kradin1,2, George Eng2, David C Christiani3
1Departments of Medicine (Pulmonary/Critical Care), Massachusetts General Hospital, Boston, Massachusetts.
Background:
Diffuse peritoneal malignant mesothelioma (DPM) is caused by exposure to asbestos. The medical literature has linked DPM primarily to high levels of asbestos exposure, in particular amosite. Controversy persists as to whether chrysotile is capable of causing DPM, especially when exposures are paraoccupational.
Methods:
Sixty-two subjects (51 men, 11 women) with DPM were reviewed in medical-legal consultation with deposition and product identification evidence.
Results:
All had pathologically confirmed DPM. Most were exposed to both amphibole and chrysotile, but chrysotile alone was documented in 14/62 (26%) cases. A total of 7/14 (50%) cases of the paraoccupational exposures were to chrysotile alone. Women were younger than men as were those with paraoccupational versus those with occupational exposure. The mean duration of exposure for all cases was 17.9 ± 10 years and latency from time of first exposure was 45.9 + 11.6 years.
Conclusions:
DPM occurs with both occupational and paraoccupational exposures to asbestos and may be seen in paraoccupational exposures to chrysotile asbestos.
Insights
Diffuse peritoneal malignant mesothelioma (DPM) can result from paraoccupational asbestos exposure, even with chrysotile alone. This study confirms DPM is linked to both occupational and paraoccupational asbestos exposures.
Area of Science:
- Environmental Health
- Occupational Medicine
- Pathology
Background:
- Diffuse peritoneal malignant mesothelioma (DPM) is primarily linked to high asbestos exposure, particularly amosite.
- The role of chrysotile asbestos in causing DPM, especially in paraoccupational settings, remains debated.
Purpose of the Study:
- To investigate the association between asbestos exposure types (occupational vs. paraoccupational) and DPM.
- To examine the specific contribution of chrysotile asbestos to DPM development.
Main Methods:
- Retrospective review of 62 patients with pathologically confirmed DPM.
- Analysis of medical-legal consultation data, including deposition and product identification evidence.
Main Results:
- Chrysotile asbestos alone was documented as the cause in 26% of DPM cases (14/62).
- Among paraoccupational exposures, 50% (7/14) involved chrysotile asbestos exclusively.
- Paraoccupational exposures and female patients were associated with younger age at diagnosis.
Conclusions:
- DPM can arise from both occupational and paraoccupational asbestos exposures.
- Paraoccupational exposure to chrysotile asbestos alone is sufficient to cause DPM.
