December 19, 2009

How Carbon Nanotubes Can Affect Lining Of The Lungs

ScienceDaily (Oct. 26, 2009) — Carbon nanotubes are being considered for use in everything from sports equipment to medical applications, but a great deal remains unknown about whether these materials cause respiratory or other health problems. Now a collaborative study from North Carolina State University, The Hamner Institutes for Health Sciences, and the National Institute of Environmental Health Sciences shows that inhaling these nanotubes can affect the outer lining of the lung, though the effects of long-term exposure remain unclear.

Using mice in an animal model study, the researchers set out to determine what happens when multi-walled carbon nanotubes are inhaled. Specifically, researchers wanted to determine whether the nanotubes would be able to reach the pleura, which is the tissue that lines the outside of the lungs and is affected by exposure to certain types of asbestos fibers which cause the cancer mesothelioma. The researchers used inhalation exposure and found that inhaled nanotubes do reach the pleura and cause health effects.

Short-term studies described in the paper do not allow conclusions about long-term responses such as cancer. However, the inhaled nanotubes "clearly reach the target tissue for mesothelioma and cause a unique pathologic reaction on the surface of the pleura, and caused fibrosis," says Dr. James Bonner, associate professor of environmental and molecular toxicology at NC State and senior author of the study. The "unique reaction" began within one day of inhalation of the nanotubes, when clusters of immune cells (lymphocytes and monocytes) began collecting on the surface of the pleura. Localized fibrosis, or scarring on parts of the pleural surface that is also found with asbestos exposure, began two weeks after inhalation.

The study showed the immune response and fibrosis disappeared within three months of exposure. However, this study used only a single exposure to the nanotubes. "It remains unclear whether the pleura could recover from chronic, or repeated, exposures," Bonner says. "More work needs to be done in that area and it is completely unknown at this point whether inhaled carbon nanotubes will prove to be carcinogenic in the lungs or in the pleural lining."

The mice received a single inhalation exposure of six hours as part of the study, and the effects on the pleura were only evident at the highest dose used by the researchers -- 30 milligrams per cubic meter (mg/m3). The researchers found no health effects in the mice exposed to the lower dose of one mg/m3.

The study, "Inhaled Carbon Nanotubes Reach the Sub-Pleural Tissue in Mice," was co-authored by Bonner, Dr. Jessica Ryman-Rasmussen, Dr. Arnold Brody, and Dr. Jeanette Shipley-Phillips of NC State, Dr. Jeffrey Everitt who is an adjunct faculty at NC State, Dr. Mark Cesta of the National Institute of Environmental Health Sciences (NIEHS), Earl Tewksbury, Dr. Owen Moss, Dr. Brian Wong, Dr. Darol Dodd and Dr. Melvin Andersen of The Hamner Institutes for Health Sciences. The study is published in the Oct. 25 issue of Nature Nanotechnology and was funded by The Hamner Institutes for Health Sciences, NIEHS and NC State's College of Agriculture and Life Sciences.

Asbestos Contamination: Health Impacts Of One Of The Nation's Largest Environmental Disasters

ScienceDaily (Nov. 2, 2009) — Over nearly a century, thousands of residents and workers in Libby, MT, have been exposed to asbestos-contaminated vermiculite ore, leading to markedly higher rates of lung disease and autoimmune disorders, and causing to Libby in 2002 to be added to the federal Environmental Protection Agency's "National Priorities List."

Researchers at Mount Sinai School of Medicine, leading a team of investigators from four institutions, are now launching three investigations into disease pathology in the town and to determine recommended cleanup efforts.

The Principal Investigator of the project is Stephen Levin, MD, Associate Professor of Preventive Medicine at Mount Sinai School of Medicine and a nationally known expert in occupational medicine and asbestos-related diseases who has also served as PI of the nationwide World Trade Center Medical Monitoring & Treatment Program, coordinated by Mount Sinai since 2002.

"The asbestos-related disease in Libby is far more aggressive and rapidly progressive than what's seen in most asbestos-exposed workers, with high rates of cancers and severe effects on respiratory function," said Dr. Levin. "For that reason alone, the health problems in Libby are important to study and understand."

The first of the three programs will focus on particular risks of exposure to Libby asbestos during childhood, when lungs are still developing and maturing. This research may determine the level of environmental cleanup necessary in Libby to protect children, who are a particularly sensitive target population.

A second study will compare lung scarring among Libby residents who were exposed to asbestos only in their environment (and not at their place of employment) with lung scarring seen in workers with historically long-term, heavy exposure to common commercial forms of asbestos. Researchers hope to discover why Libby residents have advanced rates of lung scarring. They will also investigate the mechanism for asbestos-related scar formation and approaches to preventing scar formation after exposure has already occurred.

The third investigation will examine the relationships between autoimmune disorders, autoimmune antibody abnormalities, and CT-scan evidence of scarring lung disease in the context of exposure to Libby asbestos. Auto-immune disorders such as rheumatoid arthritis and lupus have been found to occur more frequently in Libby, and antibody levels to the body's own tissues are found in Libby residents more frequently and at higher concentrations.

Mount Sinai researchers will collaborate on the research effort, to be known as the Libby Epidemiology Research Program, with Libby's Center for Asbestos Related Disease (CARD), investigators from the University of Montana and Idaho State University, and a national scientific advisory group. The research will be supported by a grant of over $4.8 million from the Agency for Toxic Substances and Disease Registry (ATSDR) of the federal Center for Disease Control and Prevention.

The crisis in Libby, a mining town whose history has been shaped by vermiculite-producing corporations since the 1920s, is the result of community-wide occupational and environmental exposure to Libby's naturally occurring vermiculite, contaminated with asbestos and asbestos-like silicate fibers up to 26% by weight.

Health effects have been detected not just in mine and processing plant workers, area lumber mill workers and loggers (from asbestos dusting of forests) and their families, but also among other Libby residents and their children. Many were exposed through ambient air or to mine tailings and other contaminated materials provided to the town by mining companies for the construction of ball fields, school running tracks, playgrounds, public buildings and facilities, as well as for private gardens and house and business insulation.

There is evidence that even relatively low-level exposures to Libby asbestos can cause serious scarring lung diseases, which markedly impair respiratory function, as well as asbestos-related cancers like lung cancer and mesothelioma, which occur at higher rates among the Libby population than elsewhere in the United States.

The health crisis potentially extends far beyond the borders of Libby, since millions of homes and businesses in North America have used vermiculite from Libby as attic insulation, fireproofing and soil conditioner. The ore from Libby was shipped by rail to 49 plant locations throughout North America and the Caribbean for processing, exposing many more workers and communities to the hazardous dust.

CARD Director Brad Black, MD, said, "The pattern of asbestos disease caused by exposure to Libby amphibole asbestos has led to excessive morbidity and mortality for the Libby population, and has been exceedingly challenging for the medical community. The severity of nonmalignant pulmonary disease in non-occupational exposure has been very unusual, raising question as to the potency of the unique amphibole mixture. We look forward to working with Dr. Levin and Mount Sinai to find some of these answers."

Mesothelioma Treatment Options - Patient Medical Research & Pain Management

1) Keep up an open dialogue with your doctor

It is natural to want to understand as much as possible about a disease and its treatments, particularly when the disease is as rare as malignant mesothelioma. The Internet has opened up a wealth of information on mesothelioma, however, it is still important to keep in mind that your doctor is your FIRST and (hopefully) BEST resource for understanding and dealing with this disease.

This does not mean that you shouldn't explore resources and treatments on your own; a good doctor wants informed patients who are interested in discussing every available option. Only a trained physician, however, can help you understand each treatment and evaluate how it fits in with your particular circumstances, including the stage of your disease.

There are valuable research and support resources available via the Internet which can assist you in your efforts to gain medical knowlege as you begin your interaction with your doctor. To begin, there is an online resource that tutors on how to use the Internet to research a lung cancer diagnosis. This tutorial also cautions you as a researcher to be mindful of the limitations of Internet-based research and to learn how to evaluate the information that you do find. Another useful tool to assist in being an informed patient is The Cancer Patient's Workbook: Everything You Need to Stay Organized and Informed, (DK Books, 2001). This workbook hopes to help the patient better understand their situation so they may deal with and fight their disease from an informed position. This interactive guide helps patients cope and also explains how to receive the best treatment possible.

2) Explore the American Cancer Society's Cancer Resource Center

This community-based organization claims its mission is "eliminating cancer as a major health problem...through research, education, advocacy, and service." As a non-governmental organization, the American Cancer Society is the largest source of private funds earmarked for cancer research. The ACS website is a very good place for you to investigate ongoing research and treatment options, as well as find extensive links to help further direct your medical research.

The American Cancer Society provides a useful fact sheet that describes the asbestos - mesothelioma link. If you suspect that you might have mesothelioma, there are several methods which can help to detect the presence of this disease.

While you may find some answers on this particular site, the ACS advises you to remember that as you cope with cancer and cancer treatment, you need to have honest, open discussions with your doctor. You should feel free to ask any question that's on your mind, no matter how small it might seem.

3) Explore the National Cancer Institute's PDQ

The National Cancer Institute provides a computer service called PDQ to give up-to-date information on cancer issues for patients, their families, doctors, and other healthcare professionals. Detailed information on detection, diagnosis, treatment, support groups, clinical trials and treatments is reviewed and updated each month by oncology experts. Each topic is discussed in two tracks, one for patients and one for healthcare professionals.

You might want to visit the information written for patients first, in order to get a clear understanding of the issues discussed in layman's terms. For more detailed information, you can then explore the physician's track.

By going to NCI's CancerNet, you can research the PDQ informational summaries for malignant mesothelioma; these summaries are written for both patient or professional readers. You will also find a useful overview on researching, treating, and coping with malignant mesothelioma.

You will find links to other treatment specific PDQ pages throughout this website.

4) Explore MEDLINE

Published by the National Library of Medicine, MEDLINE is a comprehensive index of medical citations and abstracts dating back to 1966. In the past, this database was available only to students, doctors or by subscription. However, there are now several Internet resources which offer free MEDLINE access, including PubMed and MedlinePlus. Use of both services is free, although you must initially fill out a member registration form.

An additional benefit of these services is access to full-text versions of many of the articles. PubMed publishes a list of MEDLINE journals with links to publisher web sites at: Access to these articles may require user registration or a small fee, but recent issues are often available free of charge.

These publications and abstracts are not written for the layperson, so make sure you discuss any literature you read with your doctor before making any decisions about them.

Although MEDLINE is the most comprehensive database of medical literatere, the National Cancer Institute also has a free database of cancer-specific abstracts and literature.

5) Contact the Cancer Information Service

The National Cancer Institute offers an informational and educational service known as the Cancer Information Toll-Free Telephone Service (CIS). Information is available in Spanish and English, and is up-to-date and easy to understand. You can get information about recent scientific advances, cancer programs, prevention, early detection, and other topics.

Contact the CIS, toll-free in the United States and Puerto Rico, at 1-800-4-CANCER (1-800-422-6237), Monday through Friday, 9:00 a.m. to 4:30 p.m., your time.

6) Explore OncoLink

The University of Pennsylvania maintains OncoLink, an outstanding resource on the web for information about all types of cancer and related topics. The homepage is and has information about clinical trials, symptom management, cancer support services, financial issues, book reviews, and many other topics. OncoLink has mesothelioma patient information found under Patient Statement: Malignant Mesothelioma. For a more personal perspective, there is also an article entitled "Thoughts from a Mesothelioma Patient".

Lastly, for a broad resource on the cancer topic and links to specific web sites, consult the Lung Cancer Resources Directory.

If you have questions, need more information, or experience difficulty accessing these sites, please feel free to contact us and we will do our best to help.