Asbestos

When repairs were needed on an old nuclear power plant in Surry, VA, contract workers were called in to do the work. Hundreds of workers were hired including electricians, pipe fitters, general laborers and other contractors from eight different companies. When a dozen workers were caught in a cloud of asbestos after cutting some old pipe, the workers reported the incident. The exposed workers report that they were told all asbestos-containing pipes would be clearly labeled, but they were not labeled at all.

A state investigation ensued and six of the eight companies involved in the plant restoration work were cleared of blame. The company that was in charge of labeling the asbestos-containing pipes and products and that was tasked with safely removing asbestos from the building was Hopewell-based Quality Specialties Inc. and they were fined $4,900 for not labeling the pipes. The state has targeted one other company – Dominion Power, the electricity supplier for VA and NC and the owner of the power plant — to take partial blame for the incident but have not released details of their investigation.

Asbestos was used when the plant was first built to insulate pipes and other parts of the plant from excessive heat. Asbestos has been widely used for such purposes for the past century, but less so in the past 30 years or so since asbestos exposure was definitively tied tomesothelioma and other types of cancer. Asbestos is only carcinogenic when it is airborne and can be breathed into the lungs. Although any amount of asbestos exposure carries risk, mesothelioma victims are usually people who were once exposed to asbestos at a high concentration for an extended period of time.

A spokesperson for the power plant, Richard Zuercher, attempted to assuage the concern of the exposed workers and their families by asserting there was no danger to them. “Most of the asbestos has been removed and replaced with asbestos-free material, including the area where the workers were,” says Zuercher. “There is some equipment with asbestos at the plant, but it has all been abated.”

Zuercher’s statement was proved false, however, after the State Department of Labor and Industry tested the environment and found asbestos fibers on the clothes of the 12 exposed workers as well as in three of the worker trailers.

Exactly how much asbestos the workers were exposed to is indeterminable because the plant’s owner, Dominion Power, did not have air sampling equipment on site at the time of the incident.

It’s long been suspected that a person’s genetics play a role in determining susceptibility to the development of mesothelioma following exposure to asbestos fibers. The suspicion caused the U.S. Department of Health and Human Services National Institutes of Health (NIH) to fund research that would discover this genetic link. As of August, 2011, the specific gene mutation was not only found, but identified to also trigger other types of cancer.

The culprit is the gene, BAP1. Not a very creative name, is it? Why not name genes after Greek gods and goddesses rather than assigning them boring codes made up of capital letters and numbers? The former would better match the mystical powers genes have to determine so much about a person from appearance to temperament to health and beyond. Anyway, the research showed that people with a mutation on the BAP1 gene are more susceptible to developing both mesothelioma cancer as well as melanoma cancer of the eye.

The upshot is that people who are exposed to asbestos are far more likely to develop mesothelioma if they have this mutation to BAP1. The research was funded by the National Cancer Institute (NCI), part of the National Institutes of Health, and led by scientists at the University of Hawaii Cancer Center in Honolulu, and Fox Chase Cancer Center in Philadelphia. The study results were published in Nature Genetics and reported the outcome of tests within two U.S. families with a high incidence of mesothelioma and other cancers linked with BAP1 mutations.

The study’s co-leader,Dr. Joseph Testa, notes that “it appears likely that other genes, in addition to BAP1, will be found to be associated with elevated risk of mesothelioma.” In the study, every person in the two families who developed mesothelioma or melanoma of the eye did have mutations of the BAP1 gene. The research team went on to look at 26 additional people diagnosed with mesothelioma but with no family history of the disease and found that 25 percent of them also had the BAP1 mutations.

Dr. Michele Carbone, study co-leader and director of the University of Hawaii Cancer Center, says of the results: “Identifying people at greatest risk for developing mesothelioma, especially those exposed to dangerous levels of asbestos worldwide, is a task made easier by virtue of this discovery.”

This concludes our series on the newest science concerning mesothelioma. These findings are exciting and inspiring of hope that future diagnostic and treatment practices will help people with mesothelioma live longer, healthier lives. Hope is the message we choose to focus on this week following National Mesothelioma Awareness Week.

In honor of National Mesothelioma Awareness Day, we’re launching a three-part blog series highlighting the newest scientific research regarding mesothelioma. New science has emerged in the last two years that may have significant implications for the future treatment of malignant mesothelioma. In this series, we will look at three important scientific breakthroughs that have the largest potential to affect the future of mesothelioma treatment.

In early 2010, results of a study were published in the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine that proved the safety of a possible vaccine for mesothelioma.

In late 2010, Dr. Rachel Ostroff, the clinical research director of Somalogic Inc., presented results of an ongoing study at the Fourth AACR International Conference on Molecular Diagnostics in Cancer Therapeutic Development about new biomarkers she discovered for mesothelioma that would impact early diagnosis and provide insight into new therapies for the disease.

Just last month, NIH-funded research discovered a genetic link to mesothelioma.

History of Mesothelioma and Asbestos Exposure

As far back as the early 1900’s, cases of mesothelioma and lung cancerhave been linked to asbestos exposure. It wasn’t until 1970 with the United States Clean Air Act that the Environmental Protection Agency (EPA) was permitted to start regulating asbestos as a hazardous pollutant. With asbestos being more and more regulated in the United States over the past forty years, the rate of new mesothelioma diagnosesin the U.S. each year has risen steadily in men and sporadically in woman.

Currently in the United States, there are an estimated 2000 to 3000 new cases of mesothelioma diagnosed each year. The increase in incidence may be the result of lag time between asbestos exposure and diagnosis, which can be up to 50 years. For this reason, the number of new mesothelioma diagnoses is expected to continue to rise through the year 2020.

New Science – Mesothelioma Vaccine

The continued increase in the rate of mesothelioma diagnosis and the current lack of treatment options is what inspired researchers at the Erasmus Medical Center in the Netherlands to study new therapies. Immunotherapy, which stimulates the immune system to target and destroy cancer cells, had previously shown promise. Based on this previous research, Dr. Joachim G Aerts, a pulmonary physician at Erasmus Medical Center, set out to create a vaccine for mesothelioma. The vaccine, which uses a patient’s own dendritic cells (DC) with antigen from the patient’s tumor, was able to induce a T-cell response against mesothelioma tumors.

In other words, three out of ten patients with malignant pleural mesothelioma of the epithelial subtype showed signs of tumor regression and four others showed evidence of cytotoxicity against their own tumors after vaccination. There is much more work to be done before results can be irrefutably attributed to the vaccine and side effects can be minimized, but the study showed real promise.

Dr. Aerts says of the study: “We hope that by further development of our method it will be possible to increase survival in patients with mesothelioma and eventually vaccinate persons who have been in contact with asbestos to prevent them from getting asbestos related diseases.”

In the next post of this series, we’ll look at mesothelioma biomarkers and the implications they have for possible future treatments