Occupational Groups At Risk Asbestosis and Mesothelioma Health Problems

Thousands of people die annually from diseases caused by exposure to asbestos in their workplace. Mesothelioma is a serious and debilitative form of lung or abdominal cancer that is always connected to exposure to the environmental toxin called asbestos dust or fibre. Before it was banned in most industrialized countries, asbestos was widely used for a number of industrial and construction applications, even long after its was discovered as a dangerous environmental toxin to human health. For this reason therefore, understanding how and when an individual may have been exposed to asbestos is essential in preventing it as well as fight for compensation claim. Mesothelioma may be a relatively rare disease but for those affected by it, it can alter the victim’s life and the lives of his/her loved ones drastically for life. For us not to digress from the major theme of this write up, those that are at a high risk of developing mesothelioma are: workers at shipyard, asbestos mine and mill, producers of asbestos products, workers in the heating and construction industries, trades people, friends and family of the workers in the fields listed above. If you work in the following professional occupations or anyone close to you have worked in any of these occupations they are most likely to have been exposed to asbestos toxins and you can file compensation claim. These professionals groups include:

-    Aeronautical Engineers            -  Carpenters
-    Aircraft Mechanics and Repairmen        -  Cement Workers
-    Asbestos and Insulation Workers        -  Chemical Technicians
-    Asbestos Removal Workers            -  Civil Engineers
-    Asbestos Miners                -  Clothing Ironers and Pressers
-    Automobile Repair Workers            -  College and University Professors
-    Automobile Mechanics            -  Construction Labourers
-    Blacksmiths                    -  Drill Press Operatives
-    Boilersmakers                    -  Drywall Installers and Lathers
-    Brick and Stone Masons            -  Drywall Removers
-    Building Managers and Sperintendents    -  Electricians
-    Electrical Power Linemen and Cable Men    -  Elementary School Teachers
-    Electrical and Electronics Engineers        -  Engineers
-    Evacuating, Grading and Road Machine Operators
-    Filers, Polishers, Sanders and Buffers   
-    Furnace, Men, Smelter Men and Pourers    -  Foremen
-    Garage Workers and Gas Station Attendants   
-    Grinding Machine Operatives            -  Firemen
-    Hairdressers and Cosmetologists        -  Forge Men and Hammer Men
-    Heat Treaters, Annealers and Temperers    - Freight and Materials Handlers
-    Heavy Equipment Mechanics, Including Diesel
-    Household Appliance and Accessory Installers and Mechanics
-    Crane Men, Derrick Men, Hoist Men        -  Industrial Engineers
-    Insulation and Floor Installers
-    Insurance Adjusters, Examiners and Investigators
-    Job and Die Setters, Metal            -  Locomotive Engineers
-    Longshoremen and Stevedores        -  Machine Operators
-    Machinists                    -  Mechanical Engineers
-    Mechanical and Repairmen           
-    Carding, Lapping and Combing Operatives
-    Manufacturing Checkers, Examiners and Inspectors
-    Millwrights                    -  Miscellaneous Operatives
-    Metal Molders                   
-    Motormen in mines, factory, logging camps etc
-    Other Industrial and Ship Workers        -  Painters and Sculptors
-    Painters, Construction and Maintenance    -  Pipe Fitters
-    Pattern and Model Makers            -  Plumbers and Pipe Fitters
-    Personnel and Labour Relations Workers    -  Power Station Operators
-    Railroad Workers                -  Metal Rollers and Finishers
-    9/11 World Trade Centre Recovery Workers
-    Roofers and Slaters                -  Sailors and Deckhands
-    Sales Engineers                -  Sawyers
-    Sheet Metal Workers and Tinsmiths        -  Shipbuilders
-    Sheet Metal Workers and Winders        -  Spinners, Twisters and Winders
-    Stationary Engineers                -  Structural Metal Craftmen
-    Technicians                    -  Textiles Operatives
-    Telephone Installers and Repairmen        -  Weavers
-    Welders and Flamecutters

Mesothelioma Surgery Treatment Option for Mesothelioma Victims

As the name implies mesothelioma surgery is the idea of using surgical operation to take out the cancer from the body of the mesothelioma sufferers. This is necessary because a diagnosis of mesothelioma from fluid sample is many times inconclusive and this makes diagnostic surgery necessary and the next step in confirming and staging mesothelioma. Towards mesothelioma surgery, the first thing to do is called thoracoscopy. This enables a physician to evaluate the pleural cavity and to conduct multiple tissue biopsies under direct vision.

Through thorascopy up to 98% of cases of definitive diagnosis can be gotten and in most cases, chemical pleurodesis aimed at relieving the accumulation and segregation of fluid in the intrapleural space is often accomplished during the same procedure. Through thoracoscopy, it is also possible to gauge the intensity of the tumor, and make known the possibility of surgical resectability. Though less invasive than an open biopsy, thorascopy is better performed only on patients whose tumor that has not taken over the pleural space.

Video-Assisted Thoracic Surgery (VATS). VATS is alternative option to thoracoscopy. But due to its being more invasive nature, concerns of tumor seeding is usually increases. By utilizing small incisions however, physicians can view the pleural space with the assistance of a camera, and obtain sufficient tissue samples for analysis needed by a pathologist. The extent of the tumor (i.e., pleural involvement, chest wall invasion and others) can also be determined through VATS and the right recommendation made as to the type of debulking procedure that can be made at this time.

Mediastinoscopy, on the other hand, is sometimes used as an aid in staging extent of the disease when enlarged nodes are seen using imaging techniques. In cases where imaging techniques suggest possible invasion of the tumor through the diaphragm, laproscopy is used in mesothelioma patients. The information obtained here can be very useful and important in evaluating a patient for potential pleurectomy or extrapleural pneumonectomy.

Once the oncologists carried out the procedures above and determined what surgery option to use, certain palliative surgical procedures can be effected in the patient. Palliative surgical procedures are meant to treat a symptom of mesothelioma, without aggressively treating the disease itself. The most common of palliative treatments are Chest Tube Drainage and Pleurodesis. This palliative treatment is useful in treating the first symptoms of mesothelioma which often prompts mesothelioma patients to seek medical attention is fluid build-up, or pleural effusion. Once this effusion has occurred, it is many times persistent, returning rapidly after initial draining of the fluid, this condition is medically referred to as thoracentesis.

Thus in order to eliminate this problem, the pleural space must be closed and to accomplish this, mesothelioma doctors make use of talc slurry or other sclerosing agent which helps produce an adhesion i.e. the joining of body tissues to close the space that fluid accumulates. For better mesothelioma treatment however, thoracoscopy and Pleurodesis done in conjunction with VATS using a powdered form of talc versus talc slurry. On the other hand patients should know that both chest tube drainage and pleurodesis will only be effective if there is no tumor encasing the lung which restricts its expansion.

Pleuroperitoneal Shunt is another palliative option often used for mesothelioma patients. Though it plays a limited role in palliation for several reasons among which are, one because it involves placement of a catheter run under the skin from the pleural to the peritoneal cavity and two, obstruction of the catheter and possible seeding of the tumor into the abdominal cavity may be other concerns. One option that is however considered the most effective means of controlling pleural effusion in cases where the lung's expansion is restricted by disease is pleurectomy. Pleurectomy when used as palliative may be performed where more extensive surgery is not a better option and in these cases, it is understood that all visible or gross tumor will not be removed.

For pleural mesothelioma cases, pleurectomy or decortication is usually performed on patients with early stage disease (Stage I and selected Stage II), in an attempts to remove all gross tumor. But, if it is found that all tumours cannot be removed without removing the lung, this may be done at the same time and is called pneumonectomy.

Recent medical evidence however have shown that extrapleural pneumonectomy is considerably more radical than other surgical approaches, and should be carried out by surgeons with great expertise by thoroughly evaluating patients before performing the procedure itself. This is because past experience has shown that, surgery alone has failed to effect a cure or even to help prolong life for any extended period of time and for this reason it is currently being combined with traditional chemotherapy, radiation and other new approaches such as gene therapy, immunotherapy or photodynamic therapy. As said above extrapleural pneumonectomy is a serious operation which must be handled with great caution, and doctors that experienced in this procedure choose their patients carefully.

Therefore, when it comes to the issues of surgery option for mesothelioma, it is up to each individual surgeon to advise the patient on its feasibility and to conduct whatever tests s/he feels are necessary to optimize the patient's chances of survival and recovery. Surgery of this nature should always be done with a complete understanding of the possible benefits and risks involved. If you are considering surgery as a treatment option, speak openly with your doctor about your concerns, and be sure that all your questions are answered to your satisfaction. Though this list may not be all inclusive, and may vary according to the preference of the surgeon, the following is a general list of patient selection criteria used by most surgeons.

1. Karnofsky Performance Status score (KPSs) of >70 must be established. This score relates to what symptoms of the disease the patient may be experiencing and how well they are able to conduct their daily activities. Some surgeons may require a higher performance status than others.

2. Adequate renal (kidney) and liver function tests. There must be no significant kidney or liver disease.
3. Normal cardiac function per electrocardiogram and echocardiography.
4.Adequate pulmonary function to tolerate the surgery.
5. Disease is limited to the same side of the chest (the ipsilateral hemithorax) with no penetration of the diaphragm or extension to the heart or extensive involvement of the chest wall.
6. Age of the patient must also be taken into consideration, but may not be as important as their overall status above.

Furthermore, in peritoneal mesothelioma, cytoreductive surgery can also be used and is usually aimed at removing all or nearly the entire gross visible tumor in the peritoneal cavity in order to treat any remaining cancer cells, Intra-Peritoneal Hyperthermic (heated) Chemotherapy (IPHC) is then delivered to the abdominal cavity to help the patient fight cancer cells. The type of chemotherapy drug used for this may also vary according to the physician’s preference.