Researchers at the US Centers for Disease Control and Prevention are struggling to understand why younger populations continue to suffer asbestos-related medical issues despite efforts to reduce exposure from the toxic mineral.
According to a report released by the CDC on Thursday, numbers of deaths related to malignant mesothelioma increased from 2,479 in 1999 to 2,597 in 2015.
The largest increase was seen in those over 85 years old, but younger populations continue to be affected.
In those 16 years, 16,914 of the deaths were among people 75 to 84 years old. In the same period, 682 people between the ages of 25 and 44 died of mesothelioma-related problems.
“Although deaths among persons aged less than 35 years are of concern, we do not have information to understand potential causes,” said Dr. Jacek Mazurek, lead author of the CDC report.
Asbestos refers to six naturally occurring minerals. Because of their flexibility, resistance to heat and low cost, these mineral fibers became popular in manufacturing during the 20th century.
Before the 1980s, they were used in home insulation and vehicle brakes. Commercial products such as hair dryers and cigarette filters also utilized asbestos.
When handled or damaged, the fibers that form asbestos easily separate. Particles too small to see with the naked eye can be inhaled into the lungs.
According to the National Cancer Institute, studies have also suggested an association between asbestos exposure and gastrointestinal and colorectal cancers, as well as an elevated risk for cancers of the throat, kidney, esophagus and gallbladder.
The use of asbestos was widely reduced when it was discovered that these microscopic fibers could embed in lung tissue, causing lung diseases and respiratory problems. Built-up fibers can cause mesothelioma, a rare form of cancer in the lining of the lungs, chest, abdomen and heart.
Since the 1970s, the Environmental Protection Agency has banned most asbestos-related products and materials in the United States, dramatically reducing the amount of asbestos used nationwide.
However, almost 40 years later, people born after the mineral was banned continue to fall victim to asbestos-related mesothelioma.
“The problem with asbestos exposure is, there are really so many places where one can be exposed,” said Dr. Hedy Kindler, professor of medicine at the University of Chicago and director of its mesothelioma program.
Kindler says exposure can occur in many places, with occupational exposure being one of the most common. “This disease remains relevant,” she said, “and it remains a killer of people who, of no fault of their own other than doing their job, ere exposed to something that was preventable.”
When working in areas where exposure to asbestos is possible, protective equipment is a must. The US Department of Labor requires employers to provide special equipment and additional training for jobs that have an increased risk of exposure, as well as medical monitoring.
When it comes to asbestos and mesothelioma today, cases in people under 50 are declining but not as rapidly as some would like. One possible reason: Symptoms can take a long time to manifest.
“It can take anywhere from 20 to 50 years from exposure to the development of mesothelioma,” Kindler said, adding that varying amounts of asbestos exposure over periods of time can also make it tricky to predict. “You can be exposed at small levels for a long period or high levels for a brief period.” Both circumstances could lead to a diagnosis of mesothelioma or another lung disorder.
Additionally, genetics can affect the likelihood of developing respiratory issues. “This is what we call a gene-environment interaction,” she said. “You still need the asbestos exposure, but the genetic predisposition can make you more likely to develop mesothelioma with a lower level of asbestos exposure.”
Screening for rare diseases such as mesothelioma is typically not included in a routine physical examination. However, Kindler points out that some groups should consider getting screened.
“People who have had a family member who had that disease should think about getting screened,” Kindler said.
But even early detection does not offer much help. “Unfortunately, proven approaches do not currently exist to improve outcomes through early detection of malignant mesothelioma,” Mazurek said.
Kindler also emphasizes precautions: “We have to make sure that people who could have been exposed have adequate protection and are aware of it.”