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Environmental Asbestos Exposure in Denizli and its Respiratory Effects *

Environmental Asbestos Exposure in Denizli and its Respiratory Effects *. Dr.Fatma Evyapan 1 ,,Dr. Erhan Uğurlu 1 , Dr. Yahya Özpınar 2 , Dr. Mustafa Eğri 2,D Dr. Ahmet Ergin 3 , Dr. Nevzat Karabulut 3 1 PAU Medical Faculty Department of Chest Diseases

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Environmental Asbestos Exposure in Denizli and its Respiratory Effects *

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  1. EnvironmentalAsbestosExposure in Denizli anditsRespiratoryEffects* Dr.Fatma Evyapan1,,Dr. Erhan Uğurlu1, Dr. Yahya Özpınar2 , Dr. Mustafa Eğri2,D Dr. Ahmet Ergin 3, Dr. Nevzat Karabulut3 1 PAU Medical Faculty Department of Chest Diseases 2PAU Geological Engineering Faculty 3PAU Medical Faculty Public Health Department 4PAU Medical Faculty Radiology Department *This research is founded by Turkish Scientific and Technical Research Institute project No:107S270

  2. INTRODUCTION • Asbestos (gr) asbestinon heat resistant • Amiantos (Lt) spotless • Due to its physicochemical properties it has been widely used since XIXth century • Asbestos exposure may be: • Occupational • Paraoccupational • Environmental

  3. Environmental Asbetos Exposure • Since birth • Low level • Continous • With high cumulative exposure

  4. EnvironmentalAsbestosExposure in Turkey • Central Anatolian Region,Southeastern Region, Western Region • Denizli is situated in the inner part of the Agean region • The presence of asbestos mines has been shown in Çal and Tavas counties Asbestos and Erionite Related Chest Diseases, Semih Ofset, Ankara (1987) ATS Am J Respir Crit Care Med 170, 691-715 (2004) Artvinli, Arch Environ Health May-Jun 37 (3): 177-81(1982) Dumorlier Am J Respir Crit Care Med 1998. Şenyiğit Respiration, 67: 610-14 (2000)

  5. RespiratoryDisordersAssociatedwithAsbestosExposure

  6. Material and Methods I • A 55 yearswoman has presentedbilateralcalcificplaquesconsistentwithenvironmentalasbestosexposure. • She has beenliving in Çal during her 45 years of her life. Shewasusingasbestoscontainingsoil as a whitestucco al leastonce a month. • Weconducted a studywithgeologicalengineeringdepartment of ouruniversity. Thespecimens of asbestoscontainingsoilhavebeentakenandanalyzedby SEM and X ray diffractionanayzis • Theanalyzeshaveconfirmedthe presence of tremolite asbestos • A mapshowingasbestoscontainingparts of theregion has beendevelopped

  7. Material and Methods II • Study population has been assessed by stratified, simple randomized methods: • 999 adults with environmental asbestos exposure (Süller,Ekizbaba Köyü, Poyrazlı ve Gömce köyleri); • 506 controls without environmental asbestos exposure (Bekilli Yenimahalle, Bahçeli ve Üçkuyu).

  8. Poyrazlı Ekizbaba Closed asbestos mine near Poyrazlı Asbest containing soil in front of mine

  9. Material and Methods III • A questionnaire ATS-DLD-78-A has been completed face to face by interviewers • Pulmonary function tests have been performed by MIR spirobank ile uygulandı • Standard35 X35 mm PA chest X rays have been taken by Siemens Plyphos 200-E in a mobile vehicle

  10. Evaluations of Standard Chest X Rays • Chest X rayshavebeenevaluatediaccordingto ILO classificationsystmeforasbestosrelatedpleuralabnormalities. • By an A readerchestphysician • Andby a radiologistseparately • Incase of discordanceforthe presence of anyabnormalitiestwophysiciansreevaluatedchest X ray togethertotake a commonand final decision

  11. AsbestosFibersMeasurmentsandExposureAssessment • Measurements of asbestos fibers have been performed by regional ISGÜM laboratory. Indoor and outdoor measurements have been performed. • CASELLA LONDON AFC® 123 dust sampler has been used. • During dust measurement daily dusty activities have been been performed • Air samples have been taken to 25mm diameter cellulose nitrate filters with 1,2 mikron diameters • Samples have also been analyzed by SEM and X ray diffraction

  12. Demographic data

  13. RESULTS : RESPIRATORY SYMPTOMS

  14. Pulmonary Function Tests

  15. PulmonaryFunctionTests in ExposedMaleandFemales

  16. RadiologicalFindings(N= 1406) • Pleuropulmonary abnormalities rates: • Exposed population: %15,2 • Unexposed population : %3,6 • OR (%95 GA): 4,17 (2,4-7,1) • Male %14,1; Female %5,1 OR:2,7 (1,14-2,9) • Mean determinants of the presence of radiological abnormalities • Time elapsed since the first exposure • Cumulative exposure (27,09 fiber years/15,5 fiber years)

  17. Distribution of Radiological Abnormalities according to age groups and sex *P<0,01

  18. Radiological Abnormalities and Pulmonary Function Tests

  19. Conclusions • Indexcasesarecriticalforinvestigatingthesources of environmentalrespiratoryhazards • Radiologicalabnormalitiesduetoenvironmentalasbestosexposurearemainlyseen in male • But respiratoryfunctiontestsaremainlyaffectedbywomen • Accordingtopreviousresultscumulativeexposureand time elapsed since firstexposurearemaindeterminants of radiologicalabnormalities. • Presence of radiologicalabnormalitiesmaydeterioratepulmonaryfunctiontests

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