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New Assessment Identifies People at High Risk for Malignant Mesothelioma

Black American PatientScottish researchers say they have come up with a better way to decide which asbestos-exposed people might benefit from mesothelioma screening or even mesothelioma prevention measures.

They have developed an assessment tool to gather detailed information from workers about the time, duration, and nature of their asbestos exposure in order to better quantify their mesothelioma risk.

“The assessment is based on the tasks carried out and includes parameters for substance emission potential, activity emission potential, the effectiveness of any local control measures, passive emission, the fractional time the asbestos source is active, and the efficiency of any respiratory protection worn,” writes lead author John W, Cherrie with the Institute of Occupational Medicine in Edinburgh.

Measuring Asbestos Exposure

Asbestos is the number one cause of malignant mesothelioma worldwide. It  was once commonly used in thousands of different building products and the vast majority of mesothelioma patients are people who were exposed to the toxin in their work environment.

Although asbestos exposure assessment tools already exist, the newly-developed Scottish tool demonstrated an especially good association between the estimated asbestos exposure level (based on the subject’s answers) and the measured asbestos exposure level.

“Ninety-five percent of the estimated individual values were within about a factor of ten of the associated measured value,” says Cherrie.

Why Does an Assessment Tool Matter?

Like many cancers, malignant mesothelioma is most responsive to treatment if it is found early. Unfortunately, most mesothelioma patients do not even develop symptoms until the the disease is in its advanced stages.

A tool that could provide a more detailed analysis of mesothelioma risk based on exposure pattern could be valuable for funneling high risk individuals into appropriate interventions.

“The method described would be suitable for pre-selecting individuals at high risk of malignant pleural mesothelioma for screening using appropriate tools and/or enrollment in clinical trials of chemo-prophylaxis,” states the report in the International Journal of Hygiene and Environmental Health.

Although there is no definitive diagnostic screening test for mesothelioma, some studies have suggested that using CT to scan high-risk individuals might be a valuable way to spot the cancer earlier. However, because CT is expensive and repeated screening carries a radiation risk, it is not routinely used to screen asbestos-exposed people.


Cherrie, JW, et al, “Estimating past inhalation exposure to asbestos: A tool for risk attribution and disease screening”, International Journal of Hygiene and Environmental Health, October 7, 2017, Epub ahead of print

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