Environmental diseases due to asbestos exposure in two different regions in the rural area of Sivas [Sivas ki{dotless}rsali{dotless}ndaki i?ki ayri{dotless} bölgede asbeste maruz kalma sonucunda gelişen çevresel hastali{dotless}klar]

Abstract

Objective: Sivas is the leading region with regard to the intensity of environmental asbestos exposure in our country. Clinical observations suggest pulmonary and/or pleural involvements to various degrees, due to this exposure. However, although most common asbestosis formations were found in the southern and south-eastern parts of Sivas, the incidence of mesothelioma is lower in this region compared to northern and north-western parts. The objectives of this study were to examine the cause of this situation by means of mineralogical, clinical and radiological data and to investigate both the prevalence of asbestosis-related diseases and the frequency of malignancy based on verbal autopsy findings in residents of these two regions. Material and Methods: The individuals born in two villages situated each in two different study regions and lived at least 20 years in those villages, who were accessible and aged 20 years or older and who agreed to participate in the study were enrolled. The mineralogical compositions of inorganic samples taken from habitats in the towns were determined by the X-ray diffraction (XRD) method. Physical examination and posteroanterior chest X-ray were done following thorough medical history including age, gender, occupation, asbestos exposure, family history, and respiratory symptoms. The X-rays were evaluated according to the 2000 Classification of the International Labor Organization. Results: Mineralogical examinations showed that tremolite asbestos was not detected in our region and the samples contained chrysotile asbestos at similar intensity. The study included 96 participants. Verbal autopsy investigation revealed cancer in the family history of 49 (50.5%) subjects. Dyspnea was the most common symptom, being present in 32 (33%) patients. Twenty-nine (30%) cases had at least one physical examination finding. In terms of parenchymal, pleural and additional pathologies, there was no significant difference between chest radiographs of patients who lived in two villages. Small parenchymal opacities consistent with asbestosis and pleural pathology were found in 25 (25.8%) and 24 (24.7%) cases, respectively. Of the 96 subjects with chest x-rays, 37 (38.1%) had parenchymal 1/0 and above densities compatible with pneumoconiosis. Pleural pathology was detected in 24.7% and additional pathologies were detected in 69.1% of the cases. Conclusion: This study revealed that there was chrysotile (serpentine) asbestos exposure instead of tremolite in our region and in the vast majority of the population over 20 years of age, there was significant clinical and radiological influences. © 2013 by Türkiye Klinikleri.