Cleaning Company’s Asbestos Mistake Costly

A commercial cleaning company made a costly mistake of using a high pressure washer to clean the roof of an empty home – a roof that contained the deadly substance asbestos.  Adjacent homes and properties next to the empty house located in Moffat Beach, a suburb of the Sunshine Coast in Queensland, Australia, were sprayed with asbestos containing dust and debris.

Asbestos was commonly used in roofing tiles and products as it is highly fire, heat and erosion resistant.  Asbestos also causes cancer, the most fatal type being mesothelioma, and asbestosis, an irreversible scarring of the lungs.  Although repeated exposure increases risk, even a singly incident can lead to illness.

Asbestos related diseases can take anywhere from ten to up to fifty years before symptoms begin to develop.  Therefore, the two neighbors most affected by the improper roof cleaning will really not know the extent of the damage for decades to come.

In the meantime, the clean up is difficult and time-consuming.  Comprehensive efforts must be made to make sure not even a single microscopic asbestos fiber is left behind.  Because of the method of cleaning the roof – high pressure hose- the spread was far and wide.  Not only will all hard, impermeable surfaces need to be cleaned, but all fabric and permeable items including garden soil, pavers, etc, will need to be replaced.

The owner of the cleaning company is taking full responsibility for his employee’s action, and offering to pay for the asbestos specialists who have been brought in to do the clean up.  In addition to the fact that the cost of the clean up may be so great as to cause his business to cease, he also feels badly about knowing his employee’s actions may one day cause others to become gravely ill.

This is a good reminder to all to take precautions when repairing, cleaning, removing or disposing of any asbestos containing materials.  It’s best to hire specialists who have been trained and spare the risk of potentially causing unwanted exposure and death.

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What is Asbestos Cancer Mesothelioma?

Asbestos is a prominent mineral that is vastly used in many modern manufacturing undertakings. It is agreed that the mineral is used for construction and various other projects. The mineral is also known to be a health hazard. It causes asbestos cancer or cancer of the mesothelioma. This is a delicate situation and many industries are not recognizing the harmful effects of asbestos. When employees develop the asbestos cancer, they file for lawsuits. These lawsuits run into millions and in order to avoid unlikely situations, the companies must invest on appropriate protective gear for their employees working with asbestos.



Every inch of the human body is composed of cells. These cells are known to replicate at regular intervals. This cell replication procedure happens for the major share of one's life. As long as the cell replication process is under control, the body and the included organs will function normally. When the cell replication becomes unusual, then it leads to the condition termed as cancer. Since the mesothelioma is also composed of cells, irregular growth of the cells in the region causes asbestos cancer mesothelioma. The factor that triggers this abnormal growth of the mesothelioma cells is still mysterious.



There are certain differences between the other normal forms of cancer and the mesothelioma cancer. Since the mesothelioma can be found covering almost all the major organs such as the lungs and the heart, the cancer can originate anywhere on the body. Secondly, it is hard to diagnose this type of cancer. Employees complain of body aches and pains, but the family members ignore it as work related fatigue and tiredness. It is during the final stages that the patient realizes that he has got cancer of the mesothelioma. You might already know this fact - there is a threshold period within which the patient must be subjected to treatment procedures.



Once the period is long gone, the patient's cancer might not respond to the treatment. It is said that fine powder of asbestos, when inhaled, will lead to cancer of the mesothelioma. The importance of the mesothelioma layer must never be underestimated. This protective layer is known to lubricate the organs at regular intervals and protect it from shocks and sudden impacts. Treatment for this form of cancer is widely available, but only small ratios of the people who are subjected to the treatment are known to successfully respond to the treatment.



Insist on effective protective measures when one is working with asbestos. The cancer of the mesothelioma might affect one, and he might be unaware of it. Educating the employees about the disease and providing them with ample information is the first step that must be taken by the companies in order to eliminate the condition. It is disheartening to find that even though many employers are aware of the situation, the cancer of the mesothelioma is progressing at a fast pace in our country. Many human lives are at stake because of this condition and employers seem to ignore the situation.

Mesothelioma and the Asbestos Time Bomb

The one-time friend turned killer that was once such an indispensible, yet unnoticed, part of our daily lives for so many centuries, is now a feared enemy. It is Asbestos (from the Greek for 'inextinguishable') and is the reason for thousands of global compensation claims by mesothelioma lawyers against employers, manufacturers and processors of asbestos-related products. Many asbestos workers, and those unwitingly exposed to asbestos, have been given a mesothelioma diagnosis for which there is no cure, maybe just a little temporary relief, until the inevitable distressing death a few months or years after diagnosis.



Mesothelioma is a time bomb because it can be that less than a day's exposure to asbestos dust is enough to produce mesothelioma, some 30-40 years later, when mesothelioma symptoms are first noticed. Though most mesothelioma victims are men, because mainly they worked in those industries, sometimes their wives and family too are innocent sufferers from this disease, inhaling the asbestos dust shaken from their husband's/fathers' clothing, or hair, at the end of the working day.



Whether the fault lies with manufacturers & employers (assuming they knew of the dangers) or the employees (did everyone diligently use respirator equipment and protective clothing, if it was supplied?), is something for the mesothelioma lawyers, insurance companies and courts to thrash out.



Meanwhile, asbestosis & mesothelioma victims are dying a painful and inexorable death, before their cases can even come to court or a settlement is reached. As there is no cure for mesothelioma or asbestosis, all that can be done is to make the sufferer's plight as comfortable as possible, before death finally brings mercyful relief. Although various governments have introduced, albeit belatedly, anti-asbestos legislation, sufferers find that in some cases the time limit for claiming compensation is unrealistically short, given

the long time (30-40 years) before mesothelioma symptoms are first noticed. Many victims are dying before they get a court verdict, or even before they get to court. Unlike its Greek derivation, Mesothelioma and asbestosis victims are not inextinguishable.



What is Mesothelioma



Mesothelioma is a form of cancer in the fluid-filled sac between the Mesothelium lining the lungs, or abdominal cavity or heart, and the body. In a healthy person, the mesothelium secretes a fluid which lubricates these organs, allowing them to expand, contract and easily slide over neighbouring tissues. Fluid in excess of that required for lubrication is removed through the blood & lymph system. In a person with Mesothelioma, the asbestos fibres penetrate the organ, into the fluid sac, producing cancerous cells which attack other cells, thickening the fluid, causing pain, and difficulty with breathing. Peritoneal Mesothelioma and, less commonly, Pericardial Mesothelioma, are not as common as the pleural type, but just as deadly.



The Causes of Pleural Mesothelioma



Pleural Mesothelioma, the most common form of mesiothelioma, is caused, according to all known evidence, exclusively by inhalation of asbestos fibres. These fibres are very thin & sharp enough to penetrate the lining of the lung, entering the plural sac, thereby damaging the mesothelium cells. Often, cancerous growth results, as described above. Other factors also come into play, including the changes induced in macrophages by their ingestion of asbestos particles. The asbestos seems to stimulate the macrophage to produce free radicals, which then affect DNA to induce cancerous cell behaviour. The chances of a person in an asbestos-related environment developing lung cancer, are said to be about 50 times increased if that person smokes, though there is no evidence to show that smoking itself causes mesothelioma. Ironically, one brand of cigarettes in the 1950's used asbestos in the filter tips.



There are other factors too that can play a part, such as heredity, general health and diet. Although not too much has been clincially proven about these factors, as with all diseases, the better the person's health the better their chances of not catching a disease.



The History of Asbestos.

It is probably not generally known that asbestos has been around since 4000 BC, when it was used in lamp wicks and candles. Interestingly, it was also used in the cloth wrapping of Egyptian mummies. Maybe this is the real origin of 'The Curse of The Mummy' stories; grave robbers, and maybe Egyptologists, could expect to get their just desserts! Clothing made from asbestos was highly prized in ancient times to wrap the bodies of Kings, so that their ashes would not mix with the earth or other contaminants during cremation, and it is said the Romans simply threw their asbestos napkins into a fire to cleanse and purify them.



Asbestos, a type of silica, is mined from three main types of metamorphic rock:- Chrysotile (white asbestos), Amosite (brown asbestos) and Crocodilite (blue asbestos). Other asbestos bearing rocks such as Tremolite, Anthophyllite and Actinolite are not in such common use but could still be found in some construction work, talcum powders and vermiculite. During the Middle Ages there does not appear to be much evidence of asbestos use; they probably had other problems, like recurring plagues and crusades, to contend with.



The fact that asbestos workers developed respiratory illnesses, and died young, was known as far back as Roman times when Pliny the Elder commented that asbestos workers seemed to have many health problems, advising against buying asbestos-workings slaves as they "died young". Obviously, there were no mesothelioma lawyers around then! The deleterious effects of asbestos, in modern industrial times, have been recorded as far back as the start of the 18th Century but little notice was paid by factory owners & Governments to the plight of asbestos workers - labour was cheap and life even cheaper; nothing should stand in the way of the sacred cows of Industrial Progress and the profits of industrialists and politicians.



That it took until the 1970s before more stricter legislation to restrict its use and safeguarded workers was drawn up, is scandalous. A charitable reason for this inertia may be that asbestos had become so widely used in almost every aspect of our everyday lives, delivering such tremendous benefits, that there was such a reluctance to finally admit that something so useful could also be so deadly. People who have expounded the virtues, and made a lot of money out of, asbestos are hardly likely to suddenly throw up their hands and admit to being wrong. The alternative, less charitable, explanation can only be that greed and profit were more important than employees' health.

Lawsuit Involving Mesothelioma

Receiving a diagnosis of malignant mesothelioma can be quite devastating, since there is essentially no cure for this disease. While treatment of the disease in its earlier stages can help prolong life for more than five years, the prognosis tends to be much shorter. Since the costs of treatment can be quite high, it is a good idea to explore any legal options one might have to help offset medical expenses and lost income.
Mesothelioma is typically caused by a long term exposure to asbestos, and this usually occurs in the work place. Since 1977, it has been public record that some corporations have known of the hazards of asbestos, but suppressed the information. In other cases, the corporation simply did not know of a hazard, but should have.



The first lawsuit involving the effects of asbestos exposure occurred in 1929. While there are no extensive records involving this case, it was the first to put a focus on the dangers of asbestos. In 1970, the Clean Air Act was introduced and the Environmental Protection Agency declared for the first time that asbestos was a pollutant, yet did not enforce a ban. In 1982, facing 16,000 lawsuits, the Johns Manville Corporation filed for bankruptcy. Documents in court indicated that company officers at Manville had knowledge of the hazards associated with asbestos exposure, but suppressed this information from their employees. At the time, this was the largest corporate bankruptcy in U.S. history. Following Manville's bankruptcy, many other manufacturers soon followed suit due to the growing number of lawsuits.
As recently as 2010, a Los Angeles woman collected a settlement over $200 million due to negligence regarding asbestos. Several other high profile cases have resulted in significant awards in the last several years.
If you have been diagnosed with mesothelioma, then it is a good idea to hire an attorney who has experience in dealing with mesothelioma lawsuits. In many cases, legal precedent and case law will favor the plaintiff. However, it is often that these cases may be drawn it over a period of years. The purpose of these lawsuits is to improve the financial condition of the patient and his/her family, particularly if they are the primary breadwinner of the household.
Malignant mesothelioma cases tend to have a higher success rate than non-malignant conditions such as asbestosis. While this is a positive, it is still necessary that the litigant have all documents in order prior to filing the lawsuit.
The first step is to be sure that all medical records are in order. The defense will go out of its way to show that your illness was not caused by any actions of their client. They will scour your medical records and insurance claims to cast any doubt that asbestos exposure caused your illness by suggesting it may have been your own actions in some way. The reason they do this is because mesothelioma is caused almost exclusively by asbestos exposure, and many plaintiffs walk away from the lawsuit with a favorable ruling and compensation.
With this in mind, it is imperative that your diagnosis of mesothelioma was from a qualified physician such as an oncologist or cancer specialist. The diagnosis should include chest X-rays, CT scan and a biopsy. The medical records should show beyond a reasonable doubt that your diagnosis is mesothelioma, and you had no prior knowledge of the condition prior to the diagnosis.
Since time is of the essence due to the poor prognosis of many patients diagnosed with mesothelioma, the next step is to immediately hire a qualified attorney. Once you have found such an attorney, they will need all your medical documentation to file a formal complaint with the court. This complaint will then be delivered to each defendant named in the complaint.
Typically, the attorney for the defendant will file an immediate motion to have the complaint dismissed. However, an attorney experienced in such cases will leave little room in the complaint to allow the court to dismiss the case. To help be sure that this is the case with your complaint, your attorney may ask you for specific information regarding your job, your job title, the specific asbestos product that may have been handled in your work place, contact information for co-workers, and signed releases that will allow your attorney to review your medical records.
After the defendants receive the complaint, the will respond, or otherwise risk a default judgment. Once they respond, the discovery phase of the lawsuit begins, and both sides will gather, organize and analyze evidence by reviewing records, interviewing witnesses, etc. Knowledgeable experts may be hired to offer testimony and sworn depositions may be conducted. All evidence and witnesses are then available to the plaintiff and defendant. At some point, you, the patient, may be interrogated by the defense attorneys. This may come during the discovery phase, and again during the trial.
No matter the outcome, and no matter the potential for a favorable judgment, anyone diagnosed with this awful disease should seek legal counsel. As mentioned, the treatment costs are high, and if the prognosis is unfavorable, it may help the family deal with the fateful outcome in a better light. Mesothelioma is a dreadful disease where the primary cause has been asbestos exposure in the work place. Therefore, any patient diagnosed with this disease should seek compensation for themselves to help offset the high costs of treatment and loss of income.

Scott Connolly provides information regarding the causes, symptoms and treatment of the disease as well as information regarding the legal issues surrounding asbestos. For more information, visit here

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Lung Cancer and Lymphoma - DNA Analysis and Molecular Genetics

DNA analysis (i.e., molecular genetics) can be used in evaluating lung cancer, and can reliably separate lung tumors into their morphologic categories of squamous, large cell, small cell, and adenocarcinoma. Gene expression profiling (GEP) may have even more utility in the assessment of patients with non-small cell lung cancers (NSCLCs) and similar histology.

Several investigators have attempted to subclassify these tumors by correlating GEP patterns with clinicopathologic variables.
A series that included 41 lung adenocarcinomas identified three prognostically separate subgroups. The genes involved in this classification included thyroid transcription factor, hepsin, cathepsin L, vascular endothelial growth factor C (VEGF-C), and the intercellular adhesion molecule-1 (ICAM-1).
In another report of 139 lung adenocarcinomas defined four distinct subclasses. Tumors expressing neuroendocrine-type genes had a significantly less favorable survival than those lacking such characteristics. The genes that defined the neuroendocrine cluster adenocarcinomas included dopa decarboxylase, achaete-scute homolog 1, and the serine protease kallikrein 11.
Others used GEP to predict outcome from surgery in 67 patients with resected stage I adenocarcinoma. A specific group of genes distinguished high-risk from lower risk groups, with significantly different survival. Among the 50 genes comprising the risk index were erbB2, VEGF, S100P, cytokeratin 7 and 18, and fas-associated death domain protein.
In another series of 125 patients from Taiwan with surgically resected NSCLC, 16 genes were identified that correlated with increased or decreased survival. Further RT-PCR validation assay confirmed the microarray findings and showed that survival was significantly associated with five of the 16 genes (DUSP6, MMD, STAT1, ERBB3, and LCK). The five-gene signature was further validated in microarray data from patients of Western population and was an independent predictor of recurrence and overall survival for patients with surgical resection of NSCLC without any adjuvant therapy. This GEP profile is being used to select high risk patients for adjuvant chemotherapy in prospective clinical trials.
Lymphoma - Gene expression profiling (GEP) by means of DNA microarrays is an evolving approach to classification, diagnosis, and prognostication of Non-Hodgkin's Lymphoma (NHL).
As an example, diffuse large B-cell lymphoma (DLBCL) is a clinically heterogeneous disease in which approximately 40 percent of patients with advanced stage disease respond well to combination chemotherapy and are long-term survivors. Using GEP, DLBCL has been subclassified into three distinct molecular subgroups, germinal center B-cell-like (GCB), activated B-cell-like (ABC), and other (type 3), that appear to be derived from different stages of B-cell differentiation, utilize different oncogenic mechanisms, and differ clinically in their ability to be cured by multiagent chemotherapy.
Patients whose tumors express genes characteristic of germinal center B cells (GCB) have a significantly better outcome from chemotherapy than those whose gene expression is more typical of activated B cells (ABC). In one series for example, a clustering algorithm applied to 58 patients with DLBCL receiving cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) chemotherapy separated patients into two groups with very different five-year overall survival rates (70 versus 12 percent).
Although most of the early studies used fresh frozen tissue sections, similar results have been reported with GEP performed on formalin-fixed, paraffin-embedded material. No formal head-to-head comparisons of GEP from fresh versus archived materials have yet been performed.
GEP has also been used to develop a more precise molecular diagnosis of primary mediastinal B-cell lymphoma, a clinically unfavorable entity that cannot be reliably distinguished from other types of diffuse large B-cell lymphoma. These tumors do poorly with CHOP chemotherapy alone and may need more aggressive therapy than used for standard DLBCL.

Finally, GEP has the potential to reveal new therapeutic molecular targets. As an example, the ABC subtype of DLBCL is characterized by constitutive activation of the nuclear factor kappaB (NF-kappaB) signaling pathway; interference with this pathway selectively kills these lymphoma cells. The ubiquitin-proteasomal pathway and the NF-kappaB axis are intimately involved in the control of apoptosis. Inhibitors of this pathway (eg, proteasome inhibitors) can induce apoptosis in human leukemia cells that ectopically express the antiapoptotic protein Bcl-2. One such agent, the synthetic dipeptide boronic acid bortezomib, is a potent promoter of apoptosis in several human tumor cell types.
Summary - The rapidly evolving field of DNA microarray analysis and gene expression profiling has wide-ranging implications for the molecular classification of tumors, refinement of prognostic estimates, and prediction of response to therapy. Despite its exciting potential and significant recent advances, this field remains relatively new, and it is premature to conclude that microarray data can be used as a sole means of classifying cancers or predicting outcomes of treatment.
Among the specific challenges that must be met are the need for larger studies with appropriate validation, standardization of methods and establishment of guidelines for the conduct and reporting of studies, and the formation of repositories and registries where research institutions may deposit data for comparison with independent works involving the same malignant disorder. Finally, DNA microarray-based tests must demonstrate utility in prospectively designed clinical trials before this technology is considered a routine part of clinical evaluation. These studies may eventually establish a new treatment paradigm in personalized cancer therapy in the future.

Dr. Richard Graydon, http://www.medauthor.com, trained as an Oncologist, holding both M.D. and PhD degrees, andspecializes in molecular genetics and cancer research. His education and experience have provided him analytical and clinical skills for keen insight into diagnosis, treatment, and care of cancer patients. See http://www.medauthor.com for further information

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Attorneys For Asbestos Related Cases

Asbestos is not to be taken lightly. It is a very serious matter and lots of people have suffered greatly from it. There are attorneys that are specifically trained in dealing with asbestos cases. Asbestos is a fiber that is used in old buildings as an insulator. The tiny fibers look like little spikes and get down into your lungs and can suffocate a person and cause severe problems and sometimes even death. Medical bills can be rather unbelievable and there is no reason that someone should be stuck with them because a job failed to tell you the health risks and details of the job.
Lawyers that are specifically experienced in asbestos cases see the effects of exposure to it. The suffering that it causes and the lives that have been destroyed is something that touches these people and inspires them to help. Mesothelioma is the disease that is caused by asbestos. So many innocent people are suffering from this as a result of working hard at their jobs. They deserve compensation for their suffering and these lawyers will work hard to make sure they get everything they can for having gone through this.
There are three main types of Mesothelioma; Pleural, peritoneal and pericardial. These are all tumors that start to grow in the lungs. Attorneys are so serious about bringing you justice they can tell you every little tiny detail of asbestos and all of the diseases that come with it. If you are beginning to see symptoms you might want to take precautions or see a doctor and an attorney before it is too late.
It takes 20-45 years for symptoms to start showing, but some of the typical symptoms include shortness of breath, coughing chest pain or pain in the back and other areas, weight loss and fever. There are different symptoms for the different types of Mesothelioma as well. Your attorney can explain everything to you in great detail. There are other diseases that are related to asbestos exposure as well. Attorneys will represent you if you have any sort of related illnesses.
Health hazards of asbestos were recognized in the early 1900s. In the '30s it was already beginning to show up in medical journals that asbestos could cause cancer after a latency period of 15 years or more. Also it was written that it was a progressive disease and yes, fatal. Many asbestos companies kept notes on the danger of the exposure. Even though they knew how fatal it was they continued to keep this information from workers and let them continue to be exposed to it.

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The Stigma of Lung Cancer Why Are Lung Cancer Patients Treated Differently Than Other Cancer Patients?

Being diagnosed with lung cancer carries a certain stigma.

”How long did you smoke?” “I didn’t know you were a closet smoker.” “Too bad he didn’t quit smoking sooner.” Unlike the unconditional support given to those with other forms of cancer, people with lung cancer often feel singled out, like somehow they “deserve” to have cancer. Where does this stigma come from?

Public Perception of a Diagnosis of Lung Cancer

There is a feeling among the general public, that lung cancer is a self-inflicted disease. Smoking is responsible for 80 to 90% of lung cancers, but let’s put this in perspective: Twice as many women die from lung cancer in the United States each year as die from breast cancer, and 20% of these women have never touched a cigarette. Even for those who smoke and develop lung cancer, why do we attach such a stigma to them? Many cancers, and other chronic diseases, are related to lifestyle choices. We don’t seem to judge as harshly those who overeat, are sedentary or sunbathe extensively.

Physicians’ Attitude Regarding Lung Cancer

Physicians are people too, and the bias we see among the public is present in the doctor's office as well. Joan Schiller, MD, the President and Founder of National Lung Cancer Partnership, and a physician who has done a lot of research on the stigma of lung cancer, surveyed primary care physicians in Wisconsin with some saddening results. Though the physicians stated that the type of cancer was not a factor in their referral decisions, results showed that:

• When hypothetical patients were presented as having advanced cancer, physicians were less likely to refer lung cancer patients to an oncologist than they were to refer breast cancer patients.
• More physicians were aware that chemotherapy improves survival in advanced breast cancer than with advanced lung cancer.
• Breast cancer patients were more likely to be referred for further therapy, whereas lung cancer patients were often referred only for symptom control.

Lung Cancer Patient’s Perceived Stigma

Those who are diagnosed with lung cancer experience more embarrassment than those with prostate or breast cancer, and individuals tend to feel stigmatized whether they smoked or not. Some people have even concealed their diagnosis leading to negative financial consequences and lack of social support.

Funding for Lung Cancer Research vs Other Cancers

Sadly, even though lung cancer kills more people than breast cancer, prostate cancer and colon cancer combined, federal funding lags behind. Funding from the private sector also pales in comparison to fund-raising efforts for some other cancers.

Clearly, lung cancer carries a stigma that extends from the government down to the individual. That said, we won’t move forward by pointing the finger and blaming ourselves, physicians, the public and the government. Each of us can make a difference by supporting those with lung cancer as we would support someone with any other form of cancer. Whether you are a lung cancer survivor, the loved one of someone living with lung cancer or a professional working with those with lung cancer, we need to raise awareness. Those living with lung cancer need and deserve our care and support, not an evaluation of the possible causes.

_Sources:

_{Chapple A, Zieband S, McPherson A. Stigma, shame, and blame experienced by patients with lung cancer: qualitative study. British Medical Journal. 2004. 328(7454).}

_{LeConte NK, Else-Quest NM, Eickhoff J, Hyde J, Shiller JH. Assessment of guilt and shame in patients with non-small-cell lung cancer compared with patients with breast and prostate cancer. Clinical Lung Cancer. 2008. 9(3):171-8.}

_{Wassenarr TR, Eickhoff JC, Jarzemsky DR, Smith SS, Larson ML, Shiller JH. Differences in primary care clinicians’ approach to non-small cell lung cancer patients compared with breast cancer. Journal of Thoracic Oncology. 2007. 2(8):722-8.}

Identification of Asbestos

Over the years much data have been accumulated about asbestos, which suggests that amphibole asbestos and its nonasbestos analogues possess very different biologic potential. Davis et al demonstrated that although asbestiform tremolite was extremely carcinogenic when
injected into peritoneal cavities of rats, nonasbestiform tremolite samples had little or no carcinogenic potential. Therefore, it is important to distinguish between asbestiform and nonasbestiform amphiboles and types of fibers in bulk, air, and tissue samples. There are some
problems related to the mineralogic techniques necessary to prepare and characterize samples. The designation of the shape and size of fibrous materials can be relatively easily revealed by optical examination. Optics became the technique of choice to investigate the occurrence of inorganic fibrous airborne particulates at occupational sites, in schools, or any buildings, and even outdoors where filters could be set up to obtain a representative aliquot of the air. However, the light (optical) microscope does not have enough spatial resolution and so is not sufficient on its own for positive identification of minerals. It is difficult to identify some fibers such as chrysotile in the tissue samples under the optical microscope because of the small fiber sizes. Since the small fiber size of chrysotile in the tissue samples preclude the use of optical microscopes, morphologic, chemical, and structural identifications are done by combinations of methods in order to makeunambiguous mineral identifications. The crystal chemical range of potentially hazardous inorganic and mineral species should be accurately identified. Morphologic identifications can be performed by using transmission electron microscopy (TEM) and scanning electron microscopy (SEM). Chemical information is most commonly obtained by energy dispersive spectroscopy (EDS) or wavelength dispersive spectroscopy (WDS), which is an integral part of SEM or TEM. A relative error percentage for EDS is about 10% and for WDS is about 1%. Therefore, EDS provides only semiquantitative information, but WDS provides more quantitative information on chemical composition of the
sample. Crystal structures can be determined by electron diffraction (ED) on samples. Powder x-ray diffraction (XRD) is a powerful technique providing that enough material is available, but not for a mineral present at low percentage in tissue and air samples. Certain regulations may require specific species of amphiboles; thus, quantitative chemical data may be necessary. For example, substitution solid solution series of amphiboles, such as a tremolite and an actinolite, must be identified. The SEM studies combined with EDS may not be conclusive because of the lack of information on the mineral structure. It is also very difficult to observe chrysotile through the electron microscope because of its beam sensitivity. Analysts tend to measure fibers that are more stable under beam conditions. Lung burden studies indicate that chrysotile is often inhaled as a shorter fiber than amphiboles. Therefore, in a tissue with both amphibole and chrysotile, it is possible to make a misjudgment unless the fibers are identified individually. 

The levels of sensitivity using the high-resolution techniques now available mandate that we follow up the reactions delineated as interference of inorganic materials in the biologic environment. The information on the inorganic fibrous particulates can be matched with the equally high-resolution techniques applied to analyses of tissues, with data gathered at the cellular and molecular levels. The advances in techniques increase the possibilities that we can test hypotheses and, it is hoped, gain greater understanding from the anatomic to the genetic
of the reactions that lead to induction of disease. Coordinating ultramicroscopic levels with the health and mineralogic investigations for a particular geographic area should enable us to refine the possibilities. The exchange of information among the several disciplines is needed to advance our knowledge.

Asbestos Mineralogy and Health Effects

Fibers and fibrous minerals, for example, the asbestos minerals, erionite (one of the many natural and synthetic zeolite species), fiberglass, or other silica forms (diatoms) have been shown to be extremely hazardous. Their airborne character is paramount, and the specific gravity of the species, the size, and an appropriate morphology that permits suspension are of primary consideration. Asbestos as a ubiquitous natural resource refers to several types of fibrous minerals formed by earth processes and made up of microscopic bundles of fibers. The dangers associated with inhalation of asbestos fibers haveeen known for more than 30 years. Asbestos is known as a group A human carcinogen. The potential hazards of exposure to asbestos materials are of concern worldwide. There are several modes of exposure to airborne fibers including occupational exposure and the erosion of natural deposits in asbestos-bearing rocks. Asbestos may also be dispersed in water from a number of sources, including erosion of natural deposits, corrosion, and disintegration of asbestos materials. Governments and industries have introduced regulatory measures requiring safety controls throughout the product life cycle to limit asbestos exposure to the general public and workers. Although asbestos materials have been well documented as to their physical and chemical characteristics, they remain under investigation both by mineralogists studying geologic aspects and by pathologists/epidemiologists studying medical aspects. The term asbestos may be well known,
but the precise definition, safe level of exposure, duration of exposure, and asbestos types of these fibrous materials still raise questions and often lead to differences of opinions and arguments as well as legal disputes.

Mesothelioma and Asbestos Exposure

It was the Conference on the Biological Effects of Asbestos at the New York Academy of Sciences, organized by Irving Selikoff in November 1964 , that put both mesothelioma and asbestos on the map. Before that meeting, few people in the scientific or general community had much knowledge of either subject. There they learned the nature and numerous essential industrial uses of a group of naturally occurring mineral fibers, collectively known as asbestos, although in fact comprising at least five distinct materials, chemically, physically, and geologically. Of these, chrysotile, a serpentine mineral mined mainly in Quebec and the Ural mountains of Russia, made up over 90%. Of the remainder the two most important were crocidolite and amosite, produced mainly in South Africa and Australia, both amphibole minerals with distinctive qualities valuable for heat insulation, naval marine use, and the production of large-bore cement pipes. Two other amphibole mineral fibers were anthophyllite, of limited production in Finland, and tremolite, little used, though by far the most widespread
geologically. Presenters at the conference stated that within some 20 years of the first industrial exploitation of asbestos in the 1880s, workers heavily exposed to airborne fiber and dust developed a distinctive, seriously disabling and sometimes fatal diffuse pulmonary fibrosis, later termed asbestosis. Little was done to limit exposure until the late 1930s, when after a well-conducted survey of four asbestos textile plants in North Carolina, Dreessen et al (2) and others of the U.S. Public Health Service recommended in 1938 that a workplace dust concentration of 5 million particles per cubic foot (about 15 fibers/mL) should not be exceeded. Mainly because of the Second World War, this recommendation was not implemented; and probably for the same reason it went unnoticed that there were case reports by some German
pathologists of malignant tumors of the pleura and peritoneum in men with asbestosis. Thus it was only in the 1950s that the causal association of asbestos exposure with lung cancer in the United Kingdom, and later with mesothelioma in South Africa , was recognized.

Until that time even the very existence of primary malignancies of the mesotheleum was questioned by reputable pathologists. Looking back, however, a review by Saccone and Coblenz in 1943 had included the identification of over 40 cases in autopsies published since 1870, and referred to two cases of “endothelioma” reported in 1767 by Lieutaud in France among 3000 autopsies. That mesothelial cancers in low frequency probably occurred well before the industrial use of asbestos is discussed more fully later. Indeed, a low background incidence of unknown etiology has almost certainly continued, affecting both children and adults.

Definition of Asbestos

Asbestosis is defined as diffuse interstitial fibrosis of the lung that has been caused by inhalation of asbestos fibers. Clinically evident and radiologic changes of asbestosis are usually associated with prolonged heavy exposures to asbestos, which are far higher than necessary 
to produce mesothelioma. Changes of asbestosis are frequently absent in cases of mesothelioma. If they are present, then there is usually a strong and convincing history of asbestos exposure.
The main histopathologic evidence for asbestos exposure is dependent on the finding of asbestos bodies in light microscopic sections of lung tissue either by conventional or iron stains. Asbestos bodies are golden, brown, club-shaped, often beaded structures that contain a clear pale transparent straight needle-like core. They are formed by the coating of the asbestos fiber with ferritin and protein and take months or years to develop after deposition of the fiber in the lung. If the morphologic criteria are carefully adhered to the majority (greater then 95%) of the
asbestos bodies are found on examination by electron microscopy with energy dispersive x-ray spectrometry to contain commercial amphibole (crocidolite or amosite) cores. In some areas of the world with environmental exposures to asbestos they contain tremolite or anthophyllite. Asbestos bodies formed from chrysotile are rare. The finding of one convincing asbestos body by light microscopy in a standard histologic section nearly always signifies an above-background exposure. However, ferruginous bodies that are not formed on asbestos fibers can
occur, for example, on talc, mica, kaolin, coal, carbon, rutile, and iron. These are distinguished by having cores that are yellow or black or platy rather than fibrous. Particular care has to be exercised by the histopathologist when evaluating cases with mixed dust exposures where substantial amounts of sheet silicates (talc, mica, kaolin, etc.) are present; these silicates can be coated to form ferruginous bodies and although these are platy, they can be cut at such an angle as to appear to be fibrous and can be incorrectly identified as asbestos. If the histopathologist finds clusters of asbestos bodies, this usually signifies very high levels of commercial asbestos fibers.