Milieublootstelling aan asbest in de regio Goor vastgesteld als oorzaak van maligne pleuramesothelioom bij vrouwen

To determine whether a disease cluster of 22 additional cases of pleural mesothelioma among women could be attributed to environmental asbestos exposure due to asbestos fibers from waste material on roads and property yards. The women studied were observed in an area with substantial environmental exposure to asbestos during the period 1989-2002.

Design

Ecological study.

Method

In the study period of 1989-2002, all cases of mesothelioma among women, based on a strict histopathologic definition, occurring in the region of Twente, the Netherlands (n = 59) were provided by the regional cancer register. Additional information was collected on the occupational histories of the cases and their partners and addresses of residence through medical records, general practitioners, and next-of-kin. Environmental asbestos exposure was assigned to all cases that had had a long-term stay in a house in the area around Goor with demonstrated local environmental asbestos pollution and where any contact with asbestos through occupation or in the household had been excluded.

Results

In the risk area around Goor, out of a total of 28 cases of women with pleural mesothelioma, asbestos in the environment was found to be the only source of asbestos exposure for 10 women. In a further 4 women, environmental asbestos exposure was found to be the most likely cause of pleural mesothelioma. The average cumulative exposure was around 0.11 fiber/ml × exposure years. The observed extra incidence of 22 cases was attributed to the environmental exposure to asbestos in 64 (14/22) of cases.

Conclusion

The environmental pollution to asbestos waste materials in the area around Goor was the main cause of the strongly increased incidence of pleural mesothelioma among women in this area. Taking into account an equal risk among men, the consequences of asbestos exposure in the area around Goor in the next 25 years are likely to result in 2 cases of pleural mesothelioma each year.

Ned Tijdschr Geneeskd. 2007;151:2453-9