Departments of Medicine (Pulmonary/Critical Care), Massachusetts General Hospital, Boston, Massachusetts.
Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts.
Am J Ind Med. 2017 Nov;60(11):963-967. doi: 10.1002/ajim.22768. Epub 2017 Sep 22.
Diffuse peritoneal malignant mesothelioma (DPM) is caused by exposure to asbestos. The medical literature has linked DPM primarily to high levels of asbestos exposure, in particular amosite. Controversy persists as to whether chrysotile is capable of causing DPM, especially when exposures are paraoccupational.
Sixty-two subjects (51 men, 11 women) with DPM were reviewed in medical-legal consultation with deposition and product identification evidence.
All had pathologically confirmed DPM. Most were exposed to both amphibole and chrysotile, but chrysotile alone was documented in 14/62 (26%) cases. A total of 7/14 (50%) cases of the paraoccupational exposures were to chrysotile alone. Women were younger than men as were those with paraoccupational versus those with occupational exposure. The mean duration of exposure for all cases was 17.9 ± 10 years and latency from time of first exposure was 45.9 + 11.6 years.
DPM occurs with both occupational and paraoccupational exposures to asbestos and may be seen in paraoccupational exposures to chrysotile asbestos.
弥漫性腹膜恶性间皮瘤（DPM）是由接触石棉引起的。医学文献主要将 DPM 与高水平的石棉暴露联系起来，特别是铁石棉。关于温石棉是否能够引起 DPM，尤其是在职业性以外的暴露情况下，仍存在争议。
对 62 名患有 DPM 的患者进行了医疗法律咨询，咨询过程中进行了证词和产品鉴定。
所有患者均经病理证实患有 DPM。大多数患者同时接触到了角闪石和温石棉，但在 62 例患者中（26%）仅记录到温石棉暴露。职业性以外的接触中，有 7 例（50%）仅接触温石棉。女性比男性年轻，职业性接触组比职业性接触组的潜伏期短。所有病例的平均暴露时间为 17.9±10 年，首次暴露后的潜伏期为 45.9+11.6 年。
DPM 可发生于职业性和职业性以外接触石棉的情况下，也可能发生于职业性以外接触温石棉的情况下。
