Schmolz G
Offentl Gesundheitswes. 1989 Oct;51(10):614-20.
There is a causal correlation between the inhaled dose of asbestos at the working place, the occurrence of asbestosis, and a 5-fold increased mortality rate of lung cancer. Mesothelioma, which appears to be very rare among the general population, is a specific sign of exposure to asbestos fibres. Malignant tumours of the urinary bladder, the gastro-intestinal tract, the larynx and the oesophagus in workers may also be ascribed to the specific exposure in some cases. After a brief outline of the epidemiology of these diseases the carcinogenic effects of asbestos on the cellular and subcellular level are described. It can be shown from most recent literature that asbestos fibres can also trigger epigenetic and genotoxic effects. Numeric mutation of chromosomes, damage of the plasma membrane, and a modification of the immune system are most significant. In the presence of PAH, asbestos acts as a cocarcinogen. Asbestos fibres are positive in the cellular transformation test. Due to its initiating and promoting effects, asbestos proves to be a complete carcinogen. Obviously, asbestos fulfils the criteria of the modern theory of carcinogenesis as a multicausal and multistep process.
工作场所吸入石棉的剂量、石棉沉着病的发生以及肺癌死亡率增加5倍之间存在因果关联。间皮瘤在普通人群中似乎非常罕见，是接触石棉纤维的一个特定迹象。在某些情况下，工人的膀胱癌、胃肠道癌、喉癌和食管癌等恶性肿瘤也可能归因于特定接触。在简要概述这些疾病的流行病学之后，描述了石棉在细胞和亚细胞水平上的致癌作用。从最新文献可以看出，石棉纤维还能引发表观遗传和基因毒性作用。染色体的数字突变、质膜损伤以及免疫系统的改变最为显著。在多环芳烃存在的情况下，石棉起到促癌剂的作用。石棉纤维在细胞转化试验中呈阳性。由于其启动和促进作用，石棉被证明是一种完全致癌物。显然，石棉符合现代致癌理论中多因果和多步骤过程的标准。
