Evaluation the enviromental and occupational asbetos exposures in the development of asbestos related diseas

Aim: While there are many studies related to environmental asbestos exposure in our country, there is no information about occupational exposure. In this study we aimed to determine the environmental and occupational exposures and occupations with high risk in disease development in patients with asbestos related diseases. Materials and Method: 139 patients older than 18 years of age who had thorax computerized tomography and diagnosed for asbestos related diseases (pleural plaque, pleural calcification, mesothelioma etc.) in the registry of radiology or pathology departments between 01.01.2006-01.07.2016 at Bezmialem Vakıf University Medical Faculty Hospital were included to the study. All subjects were questioned for age, gender, birth place, living environment and period, occupations and periods. Occupations were classified according to Work-Related Lung Disease Surveillance Report 2002 as high, intermediate and low risk. Birth places of the subjects were marked at the geological maps showing ophiolitic units and the distance were measured as kilometers. Results: The distribution of the subjects according to the occupation was 31(22.3%), 29 (20.9%), and 79 (56.8%) in the high, intermediate and low risk groups, respectively. Although all female subjects were in the low risk group; 31%, 29% and 41% of the male subjects were in high, intermediate and low risk groups, respectively. While 90 subjects (71.2%) were close (<10 km) to ophiolites, 40 subjects (28.8%) were far (>10 km) from ophiolites. Mean age of the male subjects was 65.05±11.9 and female subjects was 63.03±13.1. Age distribution and distance to environmental asbestos exposure were significantly different in the high risk group than the rest of the subjects. However, there was no significant difference between low and intermediate risk groups. Optimal safety distance for environmental asbestos exposure was identified as 13-14,5 km. We have identified risky occupations and generated a map of Turkey for risk groups. Also, we have determined 10, 9, 6, 1 and 1 cases from Kastamonu-Taşköprü, Adıyaman-Gerger, Erzurum-Oltu, Niğde-Ulukışla and Sinop-Boyabat, respectively which were never reported at the literature. Conclusion: In our study, we determined that at least 20% of the asbestos related disease were related to occupational exposures. Also, we have identified new areas for environmental exposure. During the evaluation of the asbestos related diseases, occupational exposure should be questioned in accordance environmental exposures assessment.