Monitoring Program Improves Mesothelioma Diagnosis

A Polish program designed to identify mesothelioma earlier in former asbestos plant workers could have implications for malignant mesothelioma patients around the world.

Mesothelioma is the most deadly of a range of diseases associated with exposure to asbestos. Other illnesses linked to asbestos exposure include lung cancer, asbestosis and pleural plaques.

A new report published by Poland’s Nofer Institute of Occupational Health, says a 16-year-old mesothelioma monitoring program has led to better understanding of malignant mesothelioma, improved the ability to diagnose it, and identified more cases that might have otherwise gone undetected.

Mesothelioma in Asbestos Workers

Although asbestos was banned in Poland in 1997, because the disease has such a long latency period, many people are still being diagnosed with mesothelioma.

Under the Amiantus program which started in 2000, people who worked around deadly asbestos dust in any of 28 Polish asbestos plants are entitled to free comprehensive medical examinations and medications to treat asbestos-related diseases like mesothelioma.

Thirteen regional occupational medicine centers administer the program, which includes yearly physicals, X-rays, CT scans, spirometry and other tests for early signs of mesothelioma.

Between 2001 and 2014, about 1,700 former asbestos workers took part in the Amiantus program  and 289 cases of mesothelioma were diagnosed. Unfortunately, that number represents only about 20 percent of the eligible asbestos workers who are at risk for mesothelioma.

Improved Understanding of Mesothelioma

Worldwide, mesothelioma is an extremely rare cancer. Because most doctors rarely see it, and because the symptoms of mesothelioma are similar to other diseases, it is often misdiagnosed or not diagnosed until in an advanced stage.

The authors of the Amiantus report say, even though many asbestos workers did not participate and others, including asbestos cement workers, were left out, the program has improved mesothelioma diagnoses in Poland. It has also provided critical data for government monitoring of mesothelioma rates.

According to the report in the Bulletin of the World Health Organization, “When comparing data from the register for the period 2001 to 2010 with data from before the Amiantus programme (1991–2000), the number of recorded asbestos-related diseases increased almost twofold and in the case of mesothelioma, almost threefold during the implementation of the programme (Table 1).”

The authors speculate that the increase is largely due to more aggressive monitoring.

Advice for Mesothelioma Monitoring Programs

The report concludes with recommendations for other groups that want to establish medical monitoring programs for pleural and peritoneal mesothelioma.

Among the recommendations are public mesothelioma awareness campaigns, education for eligible asbestos workers and medical practitioners, creation of a national compensation fund for mesothelioma (such as the UK established), establishment of a national asbestos-related diseases register, and research studies on asbestos-exposed workers.

The World Health Organization estimated that 125 million people are exposed to asbestos in their workplaces each year and more than 107,000 deaths are attributable to occupational asbestos exposure.

Source:

Swiatkowska, B, et al, “Medical monitoring of asbestos-exposed workers: experience from Poland”, August 2016, Bulletin of the World Health Organization, pp. 599-604, http://www.who.int/bulletin/volumes/94/8/15-159426/en/