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Metsovo lung
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Metsovo lung
Metsovo lung was an epidemic of lung disease resulting from domestic exposure to asbestos in the village of Metsovo in northwest Greece. Most of the inhabitants had previously been exposed to a whitewash derived from local soils containing tremolite asbestos. This caused an epidemic of malignant mesothelioma (MM) that reached an incidence 300 times that expected in populations not exposed to asbestos. This was accompanied by pleural calcifications (PCs) in almost half the adult population. Both conditions have declined significantly since the whitewash ceased to be used after 1985.[citation needed]
In the early 1980s when the Medical School of Ioannina was established, a group of pneumonologists headed by S.H. Constantopoulos started encountering, almost on a daily basis, X-ray images with extensive PCs in inhabitants of Metsovo. The researchers were told that this was very common to Metsovites and was the result of old tuberculous pleurisy. However, since the picture was not even remotely similar to calcified pleurisy from previous tuberculosis, they began to investigate the precise frequency of PCs, whether their abnormal incidence was in fact confined to Metsovites, and their true cause.[citation needed]
In a field study in Metsovo and other areas around Ioannina, it was confirmed that PCs were very common among Metsovites, around 50% of adult population, increasing to more than 80% in those above 70; and that they were seen only in Metsovo and three neighbouring villages.
The relation to asbestos was identified when, a few months later, two consecutive patients appeared with massive pleural effusions that proved to be malignant mesothelioma. These were only the first of a series of mesotheliomas; seven in five years (1981–1985). This rate is roughly 300-times that expected in a non-asbestos exposed community. The combination of PCs and MM can only be attributed to asbestos exposure.
Transbronchial lung biopsies from Metsovites with extensive PCs were then obtained and sent to Mount Sinai Hospital in New York (doctors A. Langer and R. Nolan). Their analysis revealed long thin tremolite asbestos fibers in most biopsies in spite of their minuscule size.
The possibility of this exposure being occupational seemed very unlikely, as there are no asbestos mines or factories near Metsovo. The nearest such mine (active until 1990) is located near Kozani, a city 150 miles east of Metsovo. Guided by previous research by Izzettin Baris dealing with not-occupational (domestic) exposure of vast areas in Anatolia (Turkey) from erionite and tremolite, the researchers arranged a meeting with Metsovites where they were told that practically all households in Metsovo were using soil from nearby hills (white soil is louto in the local dialect) for whitewashing. The material was applied more often on walls around fireplaces, because this kept the walls white, unsoiled from the fire. This whitewash was used by everybody until 1940-1950 and gradually abandoned, so that in 1980 it was used by only 15% of the households and by 1985 it was completely abandoned.
Samples of the whitewash were sent to Mount Sinai Hospital, and proved to contain fibers of tremolite asbestos identical to the material previously obtained from the lungs of Metsovites.
Louto was obtained by digging soil from hills 5–10 km from Metsovo within the "Pindos serpentine zone". It was shaped like a ball, crushed into powder, boiled and applied to the walls. Crushing the ball released more than 200 fibers/ml of air, when the accepted limits for occupational exposure are lower than one fiber/ml. There were minuscule fiber concentrations during the rest of the process, while no fibers were detected in the ambient atmosphere of Metsovo.
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Metsovo lung AI simulator
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Metsovo lung
Metsovo lung was an epidemic of lung disease resulting from domestic exposure to asbestos in the village of Metsovo in northwest Greece. Most of the inhabitants had previously been exposed to a whitewash derived from local soils containing tremolite asbestos. This caused an epidemic of malignant mesothelioma (MM) that reached an incidence 300 times that expected in populations not exposed to asbestos. This was accompanied by pleural calcifications (PCs) in almost half the adult population. Both conditions have declined significantly since the whitewash ceased to be used after 1985.[citation needed]
In the early 1980s when the Medical School of Ioannina was established, a group of pneumonologists headed by S.H. Constantopoulos started encountering, almost on a daily basis, X-ray images with extensive PCs in inhabitants of Metsovo. The researchers were told that this was very common to Metsovites and was the result of old tuberculous pleurisy. However, since the picture was not even remotely similar to calcified pleurisy from previous tuberculosis, they began to investigate the precise frequency of PCs, whether their abnormal incidence was in fact confined to Metsovites, and their true cause.[citation needed]
In a field study in Metsovo and other areas around Ioannina, it was confirmed that PCs were very common among Metsovites, around 50% of adult population, increasing to more than 80% in those above 70; and that they were seen only in Metsovo and three neighbouring villages.
The relation to asbestos was identified when, a few months later, two consecutive patients appeared with massive pleural effusions that proved to be malignant mesothelioma. These were only the first of a series of mesotheliomas; seven in five years (1981–1985). This rate is roughly 300-times that expected in a non-asbestos exposed community. The combination of PCs and MM can only be attributed to asbestos exposure.
Transbronchial lung biopsies from Metsovites with extensive PCs were then obtained and sent to Mount Sinai Hospital in New York (doctors A. Langer and R. Nolan). Their analysis revealed long thin tremolite asbestos fibers in most biopsies in spite of their minuscule size.
The possibility of this exposure being occupational seemed very unlikely, as there are no asbestos mines or factories near Metsovo. The nearest such mine (active until 1990) is located near Kozani, a city 150 miles east of Metsovo. Guided by previous research by Izzettin Baris dealing with not-occupational (domestic) exposure of vast areas in Anatolia (Turkey) from erionite and tremolite, the researchers arranged a meeting with Metsovites where they were told that practically all households in Metsovo were using soil from nearby hills (white soil is louto in the local dialect) for whitewashing. The material was applied more often on walls around fireplaces, because this kept the walls white, unsoiled from the fire. This whitewash was used by everybody until 1940-1950 and gradually abandoned, so that in 1980 it was used by only 15% of the households and by 1985 it was completely abandoned.
Samples of the whitewash were sent to Mount Sinai Hospital, and proved to contain fibers of tremolite asbestos identical to the material previously obtained from the lungs of Metsovites.
Louto was obtained by digging soil from hills 5–10 km from Metsovo within the "Pindos serpentine zone". It was shaped like a ball, crushed into powder, boiled and applied to the walls. Crushing the ball released more than 200 fibers/ml of air, when the accepted limits for occupational exposure are lower than one fiber/ml. There were minuscule fiber concentrations during the rest of the process, while no fibers were detected in the ambient atmosphere of Metsovo.