From the Guidelines
Mesothelioma is primarily caused by exposure to asbestos fibers, with approximately 85% of all mesotheliomas in males being attributable to occupational asbestos exposures 1. The main cause of mesothelioma is breathing in asbestos dust, and the latency period between first exposure and development of the disease is very long, typically 30–40 years 1. Some key points to consider include:
- Occupational exposure is the most common risk factor, particularly among workers in construction, shipbuilding, mining, and manufacturing industries where asbestos was commonly used 1.
- Family members of these workers may also develop mesothelioma through secondary exposure from asbestos fibers brought home on clothing 1.
- The latency period between asbestos exposure and disease development is typically 20-50 years, which explains why many cases are diagnosed in older adults despite asbestos use being heavily restricted in recent decades 1.
- While asbestos exposure accounts for approximately 80% of mesothelioma cases, other less common risk factors include radiation exposure, certain genetic factors, and exposure to zeolites (minerals similar to asbestos) 1.
- There is no safe level of asbestos exposure, and even brief or minimal contact with asbestos fibers can potentially lead to mesothelioma decades later 1. It's worth noting that the most recent and highest quality study on this topic is from 2020, which provides a comprehensive overview of the management of malignant pleural mesothelioma, including diagnosis, treatment, and palliative care 1. However, the study from 2018 provides the most relevant information on the causes of mesothelioma, and is therefore the most relevant to this question 1.
From the Research
Causes of Mesothelioma
- Malignant mesothelioma is an incurable cancer caused by exposure to asbestos 2
- Asbestos exposure is the primary cause of malignant pleural mesothelioma, a rare pleural cancer 3, 4, 5, 6
- The mechanisms of asbestos carcinogenesis include chronic inflammation and autophagy-mediated cell survival, leading to the development of mesothelioma 5
Asbestos Exposure and Mesothelioma
- Millions of individuals have been exposed to asbestos or other carcinogenic mineral fibers occupationally or environmentally, resulting in an increased risk of developing mesothelioma 5
- Individuals carrying inactivating germline mutations in the BRCA-associated protein 1 (BAP1) gene and other genes are predisposed to developing cancers, prevalently mesothelioma, and their risk further increases upon exposure to asbestos 5
- Asbestos exposure can lead to the release of high mobility group box 1 (HMGB1) from mesothelial cells, initiating an inflammatory response and promoting mesothelioma development 5
Controversies and Guidelines
- There are current controversies regarding the role of asbestos exposure in the causation of malignant mesothelioma, including the carcinogenicity of chrysotile and the assignment of causation in individuals exposed to multiple industrial products containing variable concentrations of various asbestos fibers 6
- There is a need for evidence-based guidelines to develop medicolegal guidelines for the causation of malignant mesothelioma 6