Mesothelioma: Pairon JC

Ruffié P, Lehmann M, Galateau-Sallé F, Lagrange JL, Pairon JC, Anonymous00204. · Institut Gustave Roussy, Villejuif, France. · Br J Cancer. · Pubmed #11355969 links to  free full text

This publication has no abstract.

Pairon JC, Andujar P, Matrat M, Ameille J. · Inserm, Unité 841, Créteil, France. · Rev Mal Respir. · Pubmed #18449081 No free full text.

Abstract: Lung cancer and pleural mesothelioma are the most common occupational cancers. Recent epidemiological studies have estimated that the fraction attributable to occupational factors varies from 13 to 29% for lung cancer in men and is about 85% for pleural mesothelioma in men. Previous occupational exposure to asbestos is the most common occupational exposure in these cancers. Mesothelioma immediately leads the clinician to look for past asbestos exposure. In contrast, the search for an occupational exposure that should be routine in all cases of lung cancer, is generally more difficult because of the number of occupational aetiological factors and the absence of criteria that allow distinction of an occupational cancer from a tobacco related one. Therefore attention should be paid to the identification of occupational exposure in order to set up primary prevention programmes to prevent exposure still present in the working environment and, on the other hand, to identify the subjects entitled to the acknowledgement of occupational disease and/or to obtain the compensation available to asbestos victims.

Ameille J, Brochard P, Letourneux M, Paris C, Pairon JC. · Unité de pathologie professionnelle, AP-HP, Hôpital Raymond-Poincaré, Garches, France. · Rev Mal Respir. · Pubmed #19421094 No free full text.

Abstract: INTRODUCTION: The relationships between benign asbestos-related diseases (asbestosis and pleural plaques) and thoracic cancers are still debated. The aim of this paper is to analyse epidemiological data which investigate this topic. STATE OF THE ART: Published studies show that there is a significant relationship between occupational exposure to asbestos and lung cancer risk, even in the absence of abnormalities consistent with asbestos exposure on postero-anterior chest x-ray. In subjects with occupational exposure to asbestos, an increased risk of lung cancer and pleural mesothelioma is observed in subjects with pleural plaques on chest x-ray, in comparison with the general population. In exposed subjects with similar cumulative exposure to asbestos, it is not demonstrated that pleural plaques are associated with an increased risk of lung cancer or pleural mesothelioma. PERSPECTIVES: All the analysed studies are only based on radiographic data. Their results must be confirmed by additional studies including a rigorous evaluation of the cumulative exposure to asbestos and chest CT-scans. CONCLUSION: In the present state of knowledge, isolated pleural plaques do not justify specific medical surveillance, as compared to that required by the mere estimated cumulative exposure to asbestos.

Maurel M, Stoufflet A, Thorel L, Berna V, Gislard A, Letourneux M, Pairon JC, Anonymous00220, Paris C. · EA 2304 Centre Georges Devereux, Saint-Denis Cedex, France. · Am J Ind Med. · Pubmed #19152347 No free full text.

Abstract: OBJECTIVES: CT-scan screening programs for lung cancer detection have been proposed in high-risk subjects, and more recently in former asbestos-exposed subjects. However, to date no data are available on psychological impact of such programs. The aim of this study is to examine the risk factors of psychological distress at baseline of a CT-scan screening program among asbestos-exposed subjects. METHODS: The Asbestos Post-Exposure Survey (APEXS) was carried out in France between October 2003 and December 2005 in order to screen asbestos-related diseases by CT-scan. Volunteers underwent self-administered questionnaires including an asbestos exposure assessment and, for a large sub-sample, a validated psychological distress scale. Non-exposed subjects were used as reference group. RESULTS: At baseline, a significant higher level of distress was observed in exposed subjects (n = 3,122) relative to the reference group (n = 486) after adjustment on age, sex, and tobacco status. This distress is associated independently with the self-perception of (i) intensity of asbestos exposure and (ii) the risk of current or future disease related to the asbestos exposure. The perception of the cancer risk related to asbestos seems to play a fundamental role in this psychological distress. CONCLUSION: In this study, asbestos-exposed subjects experienced a higher significant cancer distress than previously described in literature. These findings may be of potential public health importance. First, the impact of such occupational exposures on quality of life of patients who suffer from cancer related to these exposures has to be appraised. Secondly, the assessment of psychological impact of CT-scan screening programs among asbestos-exposed subjects is also required.

Pairon JC, Andujar P, Matrat M, Ameille J. · INSERM Unité 841, Créteil, France. · Rev Mal Respir. · Pubmed #18971823 No free full text.

Abstract: Lung cancer and pleural mesothelioma are the most common occupational cancers. Recent epidemiological studies have estimated that the fraction attributable to occupational factors varies from 13 to 29% for lung cancer in men and is about 85% for pleural mesothelioma in men. Previous occupational exposure to asbestos is the most common occupational exposure in these cancers. Mesothelioma immediately leads the clinician to look for past asbestos exposure. In contrast, the search for an occupational exposure that should be routine in all cases of lung cancer, is generally more difficult because of the number of occupational aetiological factors and the absence of criteria that allow distinction of an occupational cancer from a tobacco related one. Therefore attention should be paid to the identification of occupational exposure in order to set up primary prevention programmes to prevent exposure still present in the working environment and, on the other hand, to identify the subjects entitled to the acknowledgement of occupational disease and/or to obtain the compensation available to asbestos victims.

Galateau-Sallé F, Attanoos R, Gibbs AR, Burke L, Astoul P, Rolland P, Ilg AG, Pairon JC, Brochard P, Begueret H, Vignaud JM, Kerr K, Launoy G, Imbernon E, Goldberg M. · Mesopath Group, ERI 3 Inserm, CHU Caen, Caen, France. · Am J Surg Pathol. · Pubmed #17460454 No free full text.

Abstract: The lymphohistiocytoid variant of diffuse malignant mesothelioma is rare with very few cases described in the literature. It is characterized by mesothelial cells with a histiocytelike appearance and an associated dense lymphoid infiltrate. We studied clinicopathologic features and immunohistochemical patterns of a series of 22 cases. The histiocytelike cells had a mesothelial immunophenotype: AE1/AE3 (100%), calretinin (100%), CK5/6 (46%), and EMA (52%). The prominent lymphoid component showed a cytotoxic T-cell immunophenotype. Prognosis was similar to that of a large series of epithelioid diffuse malignant mesotheliomas. Formely, it was classified within the sarcomatoid type. We suggest that it should be reclassified as an epithelioid variant because of its similar behavioural characteristics. There was no evidence of Epstein-Barr virus-related infection.

Pairon JC, Fournier M, Astoul P, Galateau-Sallé F, Brochard P. · Service de pneumologie et pathologie professionnelle, CHI Créteil, et INSERM E03-37, Faculté de Médecine, Créteil, France. · Rev Mal Respir. · Pubmed #17370386 No free full text.

This publication has no abstract.

Galateau-Sallé F, Copin MC, Delajartre AY, Vignaud JM, Astoul P, Pairon JC, Le Pimpec-Barthes F, Brochard P. · Groupe Mesopath, CHU Caen. · Rev Mal Respir. · Pubmed #17370378 No free full text.

This publication has no abstract.

Pairon JC, Jaurand MC, Laurent F, Salmi R, Astoul P, Galateau-Sallé F, Brochard P. · Service de pneumologie et pathologie professionnelle, CHI Créteil, et INSERM E03-37, Faculté de médecine, Créteil, France. · Rev Mal Respir. · Pubmed #17370376 No free full text.

This publication has no abstract.

Goldberg M, Imbernon E, Rolland P, Gilg Soit Ilg A, Savès M, de Quillacq A, Frenay C, Chamming's S, Arveux P, Boutin C, Launoy G, Pairon JC, Astoul P, Galateau-Sallé F, Brochard P. · Département Santé Travail, Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94410 Saint Maurice, France. · Occup Environ Med. · Pubmed #16469823 links to  free full text

Abstract: OBJECTIVES: The French National Mesothelioma Surveillance Program (NMSP) was established in 1998 by the National Institute for Health Surveillance (InVS). Its objectives are to estimate the trends in mesothelioma incidence and the proportion attributable to occupational asbestos exposure, to help improve its pathology diagnosis, to assess its compensation as an occupational disease, and to contribute to research. METHODS: The NMSP records incident pleural tumours in 21 French districts that cover a population of approximately 16 million people (a quarter of the French population). A standardised procedure of pathological and clinical diagnosis ascertainment is used. Lifetime exposure to asbestos and to other factors (man made mineral fibres, ionising radiation, SV40 virus) is reconstructed, and a case-control study was also conducted. The proportion of mesothelioma compensated as an occupational disease was assessed. RESULTS: Depending on the hypothesis, the estimated number of incident cases in 1998 ranged from 660 to 761 (women: 127 to 146; men: 533 to 615). Among men, the industries with the highest risks of mesothelioma are construction and ship repair, asbestos industry, and manufacture of metal construction materials; the occupations at highest risk are plumbers, pipe-fitters, and sheet-metal workers. The attributable risk fraction for occupational asbestos exposure in men was 83.2% (95% CI 76.8 to 89.6). The initial pathologist's diagnosis was confirmed in 67% of cases, ruled out in 13%, and left uncertain in the others; for half of the latter, the clinical findings supported a mesothelioma diagnosis. In all, 62% applied for designation of an occupational disease, and 91% of these were receiving workers' compensation. CONCLUSIONS: The NMSP is a large scale epidemiological surveillance system with several original aspects, providing important information to improve the knowledge of malignant pleural mesothelioma, such as monitoring the evolution of its incidence, of high risk occupations and economic sectors, and improving pathology techniques.

Pairon JC, Dalphin JC, Ameille J. · Service de pneumologie et pathologie professionnelle, Centre hospitalier intercommunal de Créteil 94010. · Rev Prat. · Pubmed #15605582 No free full text.

Abstract: Different tools may be used to evaluate previous occupational exposures, either in epidemiological studies or in clinical practice: occupational questionnaire followed by an expertise or the use of a job-exposure matrix; metrology; biometrology. In routine clinical practice, the main tool is an individual questionnaire to identify if a patient has worked in one of the main jobs or tasks known to be associated with an exposure to a definite carcinogen. As individual and collective consequences are important in case of recognition as an occupational disease, looking for the previous main occupational activities entailing exposure to carcinogens should be systematic in some sites of cancer: mesothelioma, lung, ethmoid, bladder and leukemia.

Pairon JC, de Clavière C. · Service de pneumologie et pathologie professionnelle, centre hospitalier intercommunal, 94010 Créteil. · Rev Prat. · Pubmed #15605577 No free full text.

Abstract: Recent epidemiological studies estimate that the number of occupational cancers is high, as more than 3800 and up to 7000 cases occur each year in France in men. Attribuable fraction to occupational factors varies widely from one site of cancer to another. Respiratory cancers (lung and pleura) are by far the most frequent of occupational cancers with an attributable fraction of 13 to 29% for lung cancer in men according to the international literature, and an attributable fraction of 85% for pleural mesothelioma. Previous occupational exposure to asbestos is the most frequent occupational exposure for these cancers. Many occupational agents have been identified as etiological factors of cancer for different sites. Attention should be paid to these aetiologies and primary prevention programmes should be held at work in order to avoid residual occupational exposure.

Iwatsubo Y, Matrat M, Michel E, Boutin C, Galateau-Salle F, Jougla E, Bignon J, Pairon JC, Brochard P. · INSERM E99-09, Créteil, France. · Am J Ind Med. · Pubmed #12210688 No free full text.

Abstract: BACKGROUND: The number of cases of pleural mesothelioma in France has varied substantially according to methods of assessment. MATERIALS AND METHODS: We collected information from certifying physicians about 316 subjects who died between 1 July 1992 and 30 June 1993 in three regions of France with a cause of death coded as ICD-9 category 163. The ICD codes selected as the cause of death for 178 deaths between 1 January 1987 and 31 December 1992 histologically confirmed and diagnosed as pleural mesothelioma by an expert committee were examined. Finally, we used this information to estimate the number of deaths from pleural mesothelioma in France in 1992. RESULTS: In Part I, 45% (men: 54%; women: 28%) of the cases coded as ICD-9 section 163 were definitely or probably mesothelioma; 18% (men: 16%; women: 21%) possibly mesothelioma; and 37% (men: 30%; women: 51%) other tumors, primarily adenocarcinoma metastases. In Part II, 74% of the confirmed pleural mesotheliomas were coded in category 163 (men: 75%; women: 70%). Extrapolation nationwide indicated that 902 deaths were coded as ICD-9 163 in 1992: 521 cases involved definite or probable mesothelioma and 724 definite, probable, and possible cases. CONCLUSIONS: The analysis of this sample suggests that estimating the number of mesothelioma cases from the cause-of-death statistics may overestimate their incidence, but that death certificates appeared to report the diagnosis of histologically confirmed mesothelioma accurately.

Ruffié P, Lehmann M, Galateau-Sallé F, Lagrange JL, Pairon JC. · No affiliation provided · Presse Med. · Pubmed #11036521 No free full text.

This publication has no abstract.