Fiber burden and asbestos-related diseases: an umbrella review.

Autor:	Ramada Rodilla JM; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Servei de Salut Laboral, Parc de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Center for Research in Occupational Health (CISAL-UPF), Barcelona, Spain. Electronic address: jramada@parcdesalutmar.cat., Calvo Cerrada B; Servei de Salut Laboral, Parc de Salut Mar, Barcelona, Spain., Serra Pujadas C; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Servei de Salut Laboral, Parc de Salut Mar, Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Center for Research in Occupational Health (CISAL-UPF), Barcelona, Spain., Delclos GL; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Center for Research in Occupational Health (CISAL-UPF), Barcelona, Spain; Southwest Center for Occupational and Environmental Health, The University of Texas Health Science at Houston School of Public Health, Houston, Texas, USA., Benavides FG; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Spain; Center for Research in Occupational Health (CISAL-UPF), Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Gaceta sanitaria [Gac Sanit] 2022 Mar-Apr; Vol. 36 (2), pp. 173-183. Date of Electronic Publication: 2021 Jun 11.
DOI:	10.1016/j.gaceta.2021.04.001
Abstrakt:	Objective: What are the levels of asbestos exposure that cause each type of health effect? The objective of this study was to review the available scientific evidence on exposure levels for asbestos and their relationship to health effects. Method: An umbrella review of English-language reviews and meta-analyses, from 1980 to March 2021 was conducted. We included reviews involving quantified asbestos exposures and health outcomes. The review has been adapted to the indications of the PRISMA declaration. Methodological quality of the selected studies was assessed using the AMSTAR instrument. Results: We retrieved 196 references. After applying the search strategy and quality analysis, 10 reviews were selected for in-depth analysis. For lung cancer, the highest risk was observed with exposure to amphiboles. Longer, thinner fibers had the greatest capacity to cause lung cancer, especially those > 10 μm in length. For mesothelioma, longer and thinner fibers were also more pathogenic; amphiboles ≥ 5 μm are especially associated with increased mesothelioma risk. No studies observed an increased risk for lung cancer or mesothelioma at asbestos exposure levels <0.1 f/ml. No reviews provided information on exposure concentrations for pulmonary fibrosis. Currently, there is limited evidence in humans to establish the causal relationship between gastrointestinal cancer and asbestos exposure. Conclusions: Banning all asbestos exposure remains the best measure to preventing its negative health effects. The highest quality reviews and meta-analyses support that there is little risk of lung cancer or mesothelioma at daily exposure levels below 0.1 f/ml. (Copyright © 2021 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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