Background: Inhabitants of the southeast of Turkey (ST) have been exposed since childhood to inhalation of asbestos, from a material containing tremolite, used for whitewashing. This has resulted in an increased incidence of malignant pleural mesothelioma (MPM). Objectives: To review the epidemiological features of MPM cases in ST; to calculate and compare the incidence with the previously reported ones. Subjects and Methods: The study included 176 MPM cases from different places in ST. The incidence of MPM was calculated for those places according to the distribution of the cases. Results: In the previously identified regions of asbestos (region 1) where the population had been informed of the danger with the soil some decades ago, the MPM incidence was decreased, as compared to the previous reports. The annual incidence of MPM in these places was found to be 42.9 per million in this study while it had been reported to be 105.5 per million in the previous studies. In contrast, the incidence that was reported previously to be 2.75 per million in the regions where asbestos exposure had not been identified before (region 2) was found to be 8.6 per million in this study. In region 2 the incidence of MPM increased even in the second half of the last decade (5.9 versus 11.9 per million). Conclusions: Use of asbestos-containing soil continues in different places in ST. Even if the use of this soil is abandoned today, MPM will be an important health problem in this region till the third or fourth decades of this century. Informing the villagers of the danger and preventing the use of this soil may result in a considerable decrease in the incidence of MPM.

Albelda SM, Sterman DH, Litzky LA: Malignant mesothelioma and other primary pleural tumors, in Fishman AP (ed): Fishman’s Pulmonary Diseases and Disorders. New York, McGraw-Hill, 1998, pp 1453–1466.
Hillerdal G: Mesothelioma: Cases associated with non-occupational and low dose exposures. Occup Environ Med 1999;56:505–513.
Selçuk ZT, Çöplü L, Emri S, Kalyoncu AF, Şahin AA, Barış Yİ: Malignant pleural mesothelioma due to environmental mineral fiber exposure in Turkey: Analysis of 135 cases. Chest 1992;102:790–796.
Yılmaz UM, Utkaner G, Yalnız E, Kumcuoğlu Z: Computed tomographic findings of environmental asbestos-related malignant pleural mesothelioma. Respirology 1998;3:33–38.
Şahin AA, Çöplü L, Selçuk ZT, Eryılmaz M, Emri S, Akhan O, Barış Yİ: Malignant pleural mesothelioma caused by environmental exposure to asbestos or erionite in rural Turkey: CT findings in 84 patients. AJR 1993;161:533–537.
Yazıcıoğlu S, İlçayto R, Balcı K, Saylı BS, Yorulmaz B: Pleural calcification, pleural mesotheliomas, and bronchial cancers caused by tremolite dust. Thorax 1980;35:564–569.
Yazıcıoğlu S: Pleural calcification associated with exposure to chrysotile asbestos in southeast Turkey. Chest 1976;70:43–47.
Cöplü L, Dumortier P, Demir AU, Selçuk ZT, Kalyoncu F, Kisacik G, DeVuyst P, Sahin AA, Baris YI: An epidemiological study in an Anatolian village in Turkey environmentally exposed to tremolite asbestos. J Environ Pathol Toxicol Oncol 1996;15:177–182.
Artvinli M, Baris YI: Malignant mesothelioma in a small village in the Anatolian region of Turkey: An epidemiologic study. J Natl Cancer Inst 1979;63:17–22.
Baris YI, Saracci R, Simonato L, Skidmore JW, Artvinli M: Malignant mesothelioma and radiological chest abnormalities in two villages in Central Turkey. An epidemiological and environmental investigation. Lancet 1981;i:984–987.
Artvinli M, Baris YI: Environmental fiber-induced pleuro-pulmonary diseases in an Anatolian village: An epidemiologic study. Arch Environ Health 1982;37:177–181.
Baris I, Simonato L, Artvinli M, Pooley F, Saracci R, Skidmore J, Wagner C: Epidemiological and environmental evidence of the health effects of exposure to erionite fibres: A four-year study in the Cappadocian region of Turkey. Int J Cancer 1987;39:10–17.
Baris YI, Bilir N, Artvinli M, Sahin AA, Kalyoncu F, Sebastien P: An epidemiological study in an Anatolian village environmentally exposed to tremolite asbestos. Br J Ind Med 1988;45:838–840.
Baris I, Artvinli M, Sahin A, Savas T, Erkan ML: Occurrence of pleural mesothelioma: Chronic fibrosing pleurisy and calcified pleural plaques in Turkey in relation with environmental pollution by mineral fibers (in French). Rev Fr Mal Respir 1979;7:687–694.
Baris YI, Artvinli M, Sahin AA: Environmental mesothelioma in Turkey. Ann N Y Acad Sci 1979;330:423–432.
Metintas M, Hillerdal G, Metintas S: Malignant mesothelioma due to environmental exposure to erionite: Follow-up of a Turkish emigrant cohort. Eur Respir J 1999;13:523–526.
Yazıcıoğlu S, Öktem K, İlçayto R, Balcı K, Şaylı BS: Association between malignant tumors of the lung and pleurae and asbestosis. A retrospective study. Chest 1978;73:52–56.
Schwartz DA: New developments in asbestos-induced pleural disease. Chest 1991;99:191–198.
Adams VI, Unnı KK, Muhm JR, Jett JR, Ilstrup DM, Bernatz PE: Diffuse malignant mesothelioma of pleura: Diagnosis and survival in 92 cases. Cancer 1986;58:1540–1551.
Brenner J, Sordillo PP, Magill GB, Goldey RB: Malignant mesothelioma of the pleura: Review of 123 patients. Cancer 1982;49:2431–2435.
Boutin C, Schlesser M, Frenay C, Astoul Ph. Malignant pleural mesothelioma. Eur Respir J 1998;12:972–981.
Hasleton PS: Pleural disease; in Hasleton PS (ed): Spencer’s Pathology of the Lung. New York, McGraw-Hill, 1996, pp 1131–1210.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.