Thursday, January 3, 2008

Mesothelioma: A 21st Century Pandemic?

Mesothelioma, a rare and invariably fatal form of cancer that is caused by prolonged exposure to asbestos fibers might become more common by the middle of the 21st Century courtesy of the September 11,2001 attacks.

By: Ringo Bones and Vanessa Uy

The valiant men and women who helped the victims of the terrorist attack on the World Trade Center that fateful morning of September 11, 2001 may be in for an unpleasant surprise by the middle of the 21st Century. Everyone at “Ground Zero”, victims and rescuers alike might invariably come down with mesothelioma. The “twin towers” of the World Trade Center were built before the comprehensive ban on the use of asbestos fibers for building construction was ratified thus both rescue workers and victims were exposed to large amounts of asbestos fibers. The following months after the September 11, 2001 attacks- New Yorkers were continuously exposed to asbestos fibers wafting around as the clean up at “Ground Zero” went on. The big question is, should everyone be concerned?

A research was conducted at Mount Sinai Medical Center in New York 60 years before. The researchers spent 20 years studying 933 workers who produced asbestos insulation at a manufacturing plant in Paterson, New Jersey from 1941 to 1954. The researchers discovered that 186 of the workers had developed a then unique form of lung cancer. In 1973, the researchers began X-ray examinations of some of the worker’s families. The researchers found out that nearly 40 per cent of the 210 families tested had lung abnormalities common to asbestos workers. Four people who had come into contact with asbestos workers when they were children developed mesothelioma, a rare and invariably fatal form of cancer that is caused by exposure to asbestos fibers. Using this “occupational health study” data, the Mount Sinai Medical Center researchers feared that a plague of mesothelioma might break out around the year 2000. The World Trade Center / 9-11 incident could change mesothelioma forecasts for the 21st Century for the worse.

The pathologic description of malignant mesotheliona –according to Robbins’ “Pathologic Basis of Disease”- refers to an uncommon tumor of mesothelial cells. This tumor occurs most often on the pleura and rarely in the peritoneum or other organs. It is associated with exposure to asbestos in 90% of cases, but only 20% of patients have actual pulmonary asbestosis. The lifetime risk in heavily exposed individuals is 7 to 10%, and the latent period between exposure and the development of mesothelioma is 25 to 45 years. Nevertheless, bronchogenic carcinoma remains the most common lung tumor found in asbestos workers. The clinical features of mesothelioma are patients present with chest pain, dyspnea, and recurrent pleural effusions.

Since the recent scandal of soldiers wounded in action in Iraq receiving substandard treatment became headline news during the first few months of 2007. Many are concerned weather firefighters and law enforcement personnel who responded to the World Trade Center attacks will have adequate medical coverage if they develop mesothelioma in the future. Even Michael Moore is rumored to be already planning a sequel to his latest documentary “Sicko” devoted solely to the NYFD and NYPD personnel who will be diagnosed with mesothelioma in the future and how the US Government treats them. I hope that the next administration will take the ramifications of this issue very seriously.

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