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A risk factor is anything that affects your chance of getting
a disease such as cancer. Different cancers have different risk
factors. For example, exposing skin to strong sunlight is a risk factor
for skin cancer. Smoking is a risk factor for cancers of the lung,
mouth, larynx (voice box), bladder, kidney, and several other organs.
But risk factors don't tell us everything. Having a known risk
factor, or even several risk factors, does not mean that you will get
the disease. And some people who get the disease may not have had any
known risk factors.
Researchers have found some factors that increase a person's
risk of mesothelioma.
Asbestos
The main risk factor for developing mesothelioma is exposure
to asbestos. In fact, most cases of mesothelioma have been linked to
asbestos exposure in the workplace.
Asbestos refers to a family of fibrous minerals made of
silicate. It is a naturally occurring mineral that can be found in dust
and rocks in certain parts of the United States and other parts of the
world.
There are 2 main forms of asbestos:
Serpentine
(curly) fibers include chrysotile, the most widely used
form of asbestos.
Amphiboles
are thin, rod-like fibers. There are 5 main types -- crocidolite,
amosite, anthrophylite, tremolite, and actinolyte.
Amphiboles (particularly crocidolite) are considered to be
more likely to cause cancer. However, even the more commonly used
chrysotile fibers are linked with mesotheliomas.
When chrysotile fibers in the air are inhaled, they tend to
stick to mucus in the throat, trachea (windpipe), or bronchi (large
breathing tubes of the lungs) and are then cleared by being coughed up
or swallowed. But the long, thin amphibole fibers are less readily
cleared, and they may reach the ends of the small airways and penetrate
into the pleural lining of the lung and chest wall. These fibers may
then injure mesothelial cells of the pleura, and eventually cause
mesothelioma.
Asbestos fibers can also damage cells of the lung and result
in asbestosis (formation of scar tissue in the lung) and/or lung
cancer. Indeed, asbestosis, mesothelioma, and lung cancer are the 3
most frequent causes of death and disease among people with heavy
asbestos exposure.
Peritoneal mesothelioma, which forms in the abdomen, may
result from coughing up and swallowing inhaled asbestos fibers.
Because of its heat and fire resistant properties, asbestos
was once used in many products such as insulation, floor tiles, door
gaskets, soundproofing, roofing, patching compounds, fireproof gloves,
ironing board covers, and brake pads. The link between asbestos and
mesothelioma has become well known, so its use in the United States has
decreased dramatically. Most use stopped after 1989, but it is still
used in some products.
Still, millions of Americans may already have been exposed to
asbestos. People at risk for workplace asbestos exposure include some
miners, factory workers, insulation manufacturers and installers,
railroad and automotive workers, ship builders, gas mask manufacturers,
and construction workers. Family members of people exposed to asbestos
at work also have an increased risk of developing mesothelioma because
asbestos fibers can be carried home on the clothes of the workers. The
incidence rate for mesothelioma in men appears to be dropping, probably
because there is now much less direct exposure to asbestos in
industrial workplaces.
Asbestos was also used in the insulation of many older homes,
as well as commercial and public buildings around the country,
including some schools. Because these particles are contained within
the building materials, they are not likely to be found in the air in
large numbers. The risk of exposure is thought to be much less
hazardous unless the particles are somehow escaping into the air, such
as when building materials begin to decompose over time, or during
remodeling or removal.
The risk of developing mesothelioma is related to how much
asbestos a person was exposed to and how long this exposure lasted.
People exposed at an early age, for a long period of time, and at
higher levels are more likely to develop this cancer. Mesotheliomas
take a long time to develop. The time between first exposure to
asbestos and diagnosis of mesothelioma is usually between 20 and 50
years. Unfortunately, the risk of mesothelioma does not drop with time
after exposure to asbestos. The risk appears to be lifelong and
undiminished.
For more detailed information on asbestos, see our document,
Asbestos.
Zeolites
Zeolites are silicate minerals that are chemically related to
asbestos. An example is erionite, which is common in the soil in parts
of Turkey. High mesothelioma rates in these areas are believed to be
due to exposure to this mineral.
Radiation
There have been a few published reports of mesotheliomas that
developed following exposure to high doses of radiation to the chest or
abdomen or after injections of thorium dioxide (Thorotrast). This
material was used by doctors for certain x-ray tests until the 1950s.
Thorotrast was found to cause cancers, so it has not been used for many
years.
SV40 virus
Some studies have raised the possibility that infection with
simian virus 40 (SV40) might increase the risk of developing
mesothelioma. Some injectable polio vaccines given between 1955 and
1963 were contaminated with SV40. As many as 30 million people in the
United States may have been exposed to the virus.
Some lab studies have suggested that SV40 infection may cause
mesothelioma. For example, intentional infection with SV40 of some lab
animals, such as hamsters, causes mesotheliomas to develop. Researchers
also have noticed that SV40 can cause mouse cells grown in dishes to
become cancerous, and that asbestos increases the cancer-causing effect
of SV40 on these cells. Other researchers have found SV40 DNA in some
biopsy specimens of human mesotheliomas. But fragments of SV40 DNA can
also be found in some non-cancerous human tissues.
So far, the largest studies addressing this issue in humans
have not found an increased risk for mesothelioma or other cancers
among people who received the contaminated vaccines as children. But
the peak age range for diagnosis of mesothelioma is 50 to 70 years.
Some researchers have pointed out that this issue may remain unresolved
until more of the people accidentally exposed to SV40 between 1955 and
1963 reach that age range.
Most experts have concluded that at this time we still don't
know whether SV40 is responsible for some mesotheliomas. Research into
this important topic is still under way.
Last Medical Review: 03/17/2009 Last Revised: 03/17/2009
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