Gudmundsson Gunnar, Tomasson Kristinn
Department of Respiratory Medicine, Landspitali University Hospital, Laboratory of Toxicology, Faculty of Medicine, University of Iceland.
Laekning Health Care Centre, Lagmula, Reykjavik.
Laeknabladid. 2019;105(7):327-334. doi: 10.17992/lbl.2019.0708.241.
Asbestos are crystallized silicate minerals that form fibers with different structures and characteristics. Asbestos fibers are very durable and can tolerate very high temperatures. Therefore it was common to use asbestos as a fire retardants, heat insulation and where high temperature is used. Asbestos has been banned in Iceland from 1983 but can still be found in large amounts in buildings, ships and hot water pipes. Large amounts of asbestos were imported in the years before the ban but diminished soon to almost nothing today. Needle or filamentous shaped dust is released when working with asbestos. It is this dust that is dangerous for health. The latent time from exposure to disease can be up to forty years. Asbestos reaches the lungs via inhalation and can cause asbestosis that is a form of lung fibrosis with slow progression. Asbestos can also cause benign pleural effusions, pleural plaques and diffuse pleural thickening. Asbestos is a carcinogen. Lung cancer is most common but asbestos is also a risk factor for cancers of other organs. Mesothelioma is most common in the pleura but can be seen in other membranes. The incidence of these tumors is high in Iceland and is still increasing among males. Of all the European countries mortality is highest in Iceland. It is important for physicians to include asbestos exposure in the differential diagnosis of lung diseases and when lung cancer is diagnosed.
石棉是结晶硅酸盐矿物，可形成具有不同结构和特性的纤维。石棉纤维非常耐用，能耐受很高的温度。因此，过去常将石棉用作阻燃剂、隔热材料以及用于高温环境。冰岛自1983年起已禁止使用石棉，但在建筑物、船舶和热水管道中仍能大量发现。在禁令实施前的几年里，大量石棉被进口，但如今已几乎消失殆尽。处理石棉时会释放出针状或丝状粉尘。正是这种粉尘对健康有害。从接触石棉到发病的潜伏期可达40年。石棉通过吸入进入肺部，可导致石棉肺，这是一种进展缓慢的肺纤维化形式。石棉还可引起良性胸腔积液、胸膜斑和弥漫性胸膜增厚。石棉是一种致癌物。肺癌最为常见，但石棉也是其他器官癌症的危险因素。间皮瘤最常见于胸膜，但也可见于其他膜。这些肿瘤在冰岛的发病率很高，且在男性中仍在上升。在所有欧洲国家中，冰岛的死亡率最高。对于医生来说，在肺部疾病的鉴别诊断以及诊断肺癌时，将石棉暴露纳入考虑非常重要。
