Nonpulmonary Outcomes of Asbestos Exposure

Figures & data

TABLE 1. Publications on Asbestos-Induced Peritoneal Disease

Endpoint	Fiber type (if known)	Human (Occupational)	Human (water/ingested)	Animal (inhalation)	Animal (ip)
Peritoneal mesothelioma	Chrysotile or mixed	2(–) ^a			4(+) ^b
	Crocidolite	9(+) ^c			4(+) ^d
	Unknown	2(+) ^e
		1(–) ^f
	Amosite				1(+) ^g
Peritoneal cancer (general)	Chrysotile	1(+) ^h	1(+) ^i	1(–) ^j
	Crocidolite				1(+) ^k
Peritoneal fibrosis	Chrysotile				1(+) ^l
	Crocidolite and amosite				1(+) ^m
Note. The number indicates how many articles were found with a positive (+) or negative (–) association between asbestos and disease. “Unknown” exposures indicate the data came from occupational exposure matrices, including textiles, insulation, or cement workers. Sources: ^a Ulvestad, 2002; Albin, 1990. ^b Adachi, 2001; Davis, 1988; Minardi, 1988; Suzuki, 1984. ^c Armstrong, 1984; de Klerk, 1989b; Reid, 2005; Browne, 1983; McDonald, 2006; Musk, 1989; Sluis-Cremer, 1992; McDonald, 1997; Merler, 2000. ^d Minardi, 1988; Adachi, 1994; Branchaud, 1989; Cullen, 2002. ^e Ribak, 1988; Selikoff, 1984. ^f Lumley, 1976. ^g Suzuki, 1984. ^h Pira, 2009. ^i Kanarek, 1980. ^j Boorman, 1984. ^kKoerten, 1990b. ^l Bateman, 1982. ^m Wirth, 1975.

TABLE 2. Publications on Asbestos-Induced Autoimmune Disease

Endpoint	Primary exposur (if known)	Type of exposure	Human studies	Animal studies	Case study
Rheumatoid athritis	Unknown	Occupational (e.g., cement worker)	1(+) ^a , 1(–) ^b		1(+) ^c
	Amphibole (Libby)	Occup/environ	1(+) ^d
SLE or lupus-like	Tremolite	Pulmonary instillation		1(++) ^e
	Amphibole	Occup/environ	1(+) ^d , 1(–) ^b
Scleroderma	Chrysotile, amphibole	Occupational	2(+) ^f
Autoimmune vasculitis	Unknown	Occupational	2(+) ^g , 1(–) ^h
Interstitial pneumonia (ANCA-associated)	Unknown	Occupational	1(+) ^i		1(+) ^j
Autoantibodies ANA	chrysotile	Occupational	1(+) ^k
	Tremolite	Occupational, intratracheal	1(++) ^l	1(++) ^e
	Various	Occupational	4(+) ^m
Autoantibodies ANCA	Unknown	Occupational	1(+) ^n
	Amphibole	Occup/environ	1(–) ^o
Autoantibodies IgM Rh factor	Chrysotile	Occupational	4(+) ^p
	Unknown	Occupational	2(–) ^q
	Amphibole	Occup/environ	1(–) ^o
Rheumatoid, nonspecific	chrysotile	Occupational	1(+) ^r
Periaortitis or retroperitoneal fibrosis	Mixed (chrysotile and amphiboles)	Occupational	5(+) ^s		1(+) ^t
Note. The number indicates how many articles were found with a positive (+) or negative (–) association between asbestos and disease. “Unknown” or “various” exposures indicate the data came from occupational exposure matrices, including textiles, insulation, or cement workers. Sources: ^a Olsson, 2004. ^b Gold, 2007. ^c Greaves, 1979. ^d Noonan, 2006. ^e Pfau, 2008. ^f Gold, 2007; Noonan, 2006. ^g Rihova, 2005; Inoue, 2004. ^h Stratta, 2001. ^i Rihova, 2005. ^j Inoue, 2004. ^k Turner-Warwick, 1970. ^l Zerva, 1989. ^m Pfau, 2005; Nigam, 1993; Tamura, 1993; Stansfield, 1974. ^n Pelclova, 2003. ^o Pfau, 2005. ^p Pernis, 1965; Turner-Warwick, 1970; Stansfield, 1974; Lange, 1974. ^q Zone, 1985; Zerva, 1989. ^r White, 1974. ^s van Bommel, 2009; Vaglio, 2009; Uibu, 2004; Sauni, 1998; Maguire, 1991. ^t Cottin, 2008.

TABLE 3. Publications on Asbestos-Induced Gastrointestinal Disease

Endpoint	Fiber type (if known)	Occupational exposure	Ingested/water	Animal studies
GI cancer (general)	Chrysotile	6(–) ^a	1(–) ^c	1(+) ^d
		2(+) ^b
	Crocidolite	1(–) ^e
	Unknown	5(+) ^f	3(–) ^h
		2(–) ^g
	Amosite or Tremolite			2(–) ^i
Colon/colorectal cancer	Unknown	3(+) ^j	1(+) ^k
	Chrysotile			3(+) ^l
	Crocidolite			1(+) ^m
Stomach cancer	Unknown	4(+) ^n	2(+) ^o
	Crocidolite	3(+) ^p
		1(–) ^q
	Chrysotile		2(+) ^r
Note. The number indicates how many articles were found with a positive (+) or negative (–) association between asbestos and disease. “Unknown” exposures indicate the data came from occupational exposure matrices, including textiles, insulation, or cement workers. Sources: ^a Berry, 1983; Thomas, 1982; Pira, 2009; Albin, 1990; Gardner, 1986; Finkelstein, 1989. ^b Finkelstein, 1984; Weiss, 1977. ^c Toft, 1983. ^dJacobs, 1978a. ^e Reid, 2004. ^f Kang, 1997; Lumley, 1976; Lacquet, 1980; Newhouse, 1985; Selikoff, 1974. ^g Hodgson, 1986; Tsai, 1996. ^h Browne, 2005; Harrington, 1978; Levy, 1976. ^iMcConnell, 1983a, 1983b. ^j Germani, 1999; Albin, 1990; Szeszenia-Dabrowska, 1998. ^k Kjaerheim, 2005. ^l Corpet, 1993; Amacher, 1974; Donham, 1980. ^m Corpet, 1993. ^n Lumley, 1976; Sun, 2008; Enterline, 1987; Raffn, 1989. ^o Kjaerheim, 2005; Andersen, 1993. ^p Newhouse, 1988; Armstrong, 1988; Botha, 1986. ^qde Klerk, 1989a. ^r Kanarek, 1980; Polissar, 1983.

TABLE 4. Publications on Asbestos-Induced Reproductive Disease/Disorders

Endpoint	Fiber type	Primary route of exposure	Human studies	Animal studies	In vitro
⇑Infant mortality/stillbirths	Chrysotile	Transplacental	4(+) ^a	1(+) ^b
Decreased fertility	Chrysotile	Ingested		1(+) ^c	3(+) ^d
Ovarian cancer	Chrysotile and/or crocidolite	Occupational	9(+) ^e	1(+) ^g
			1(–) ^f
Intratesticular mesothelioma	Unknown, case studies	Occupational	1(+) ^h
Tumors of the testis	Unknown	Drinking water	1(+) ^i
Note. The number indicates how many articles were found with a positive (+) or negative (–) association between asbestos and disease. “Unknown” exposures indicate the data came from occupational exposure matrices, including textiles, insulation, or cement workers. Sources: ^a Haque, 1992; 1996; 1998; Tsurikova, 1992. ^b Haque, 2001. ^c Schneider, 1977. ^d Saat, 1980; Dopp, 1997; Stevens, 1983. ^e Germani, 1999; Langseth, 2004; Magnani, 2008; Pira, 2005; Reid, 2009; Acheson, 1982; Newhouse, 1985; Wignall, 1982; Berry, 2000. ^f Millette, 1983. ^g Graham, 1967. ^h Attanoos, 2000. ^i Polissar, 1982.

TABLE 5. Publications on Asbestos Tissue Burden/Translocation

Tissue	Disease outcome	Fiber type	Exposure	Human	Animal
Lymph nodes, lung draining	Asbestosis or lung cancer	Amphibole Chrysotile	Occupational	3(+) ^a
Lymph nodes, thoracic	Unknown	Short, noncommercial amphiboles	Nonoccupational (environmnt)	1(+) ^b
Lymph nodes, thoracic	Pleural meso	Crocidolite	Cigarette filters	1(+) ^c
Lymph nodes, para-aortic/mesen	Asbestos-related lung disease	Mixed amph/chrys	Low-level occupational	1(+) ^d
Liver	See note e	Mixed	Pulmonary or gavage	3(+) ^f	1(+) ^g
Spleen	See note e	Mixed	Pulmonary or gavage	2(+) ^h	2(+) ^i
Colon	Colon carcinoma	Amosite and chrysotile	Occupational	2(+) ^j
Kidney	Lung cancer or meso	Crocidolite	Occupational or gavage	3(+) ^k	1(+) ^l
Ovary	Risk for ovarian cancer?	Crocidolite and chrysotile	Household contact	3(+) ^m
Transplacental	Stillborn	“short, thin fibers”	Maternal (environmt)	3(+) ^n
Omentum, mesentery	Risk of peritoneal mesothelioma?	Amphiboles and chrysotile	Various	3(+) ^o
Pancreas	Asbestosis	Mixed	Occupational or gavage	1(+) ^p	1(+) ^q
Heart	See note e	Mixed	Occupational or gavage	1(+) ^r	1(+) ^q
Note. The number indicates how many articles were found with a positive (+) or negative (–) association between asbestos and outcomes. Sources: ^a Dodson, 2007; 1990; Tossavainen, 1994. ^b Dodson, 2000. ^c Dodson, 2006. ^d Uibu, 2009. ^eAlthough no disease outcome was noted, fibers were detected in these studies. ^f Watanabe, 1994; Kobayashi, 1987; Huang, 1988. ^g Williams, 2001. ^h Kobayashi, 1987; Watanabe, 1994. ^i Kaczenski, 1984, Williams, 2001. ^j Ehrlich, 1991; Huang, 1988. ^k Watanabe, 1994; Kobayashi, 1987; Tossavainen, 1994. ^l Patel-Mandlik, 1983. ^m Heller, 1996; 1999; Langseth, 2004. ^n Haque, 1996, 1992, 1998. ^o Dodson, 2000; 2001; Heller, 1996. ^p Huang, 1988. ^q Kaczenski, 1984. ^r Kobayashi, 1987.

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