Chen Grace, Mannetje Andrea 't, Salmond Jennifer A, Douwes Jeroen
Centre for Public Health Research, Massey University, Wellington, New Zealand.
School of Environment, University of Auckland, Auckland, New Zealand.
Ann Work Expo Health. 2025 Aug 1;69(7):677-692. doi: 10.1093/annweh/wxaf034.
Erionite, a naturally occurring fibrous zeolite classified as a human carcinogen, is believed to be more potent than asbestos in causing mesothelioma. However, unlike asbestos, erionite has rarely been used for commercial purposes and, as a result, knowledge about exposure pathways is limited. This paper provides a narrative review of the current knowledge regarding the associations between erionite exposure, health effects and exposure circumstances.
Medline/PubMed and Scopus were systematically searched up to the end of 2024 using keywords related to erionite exposure and health outcomes.
We identified 26 peer-reviewed journal articles reporting on the health effects of erionite exposure, specifically mesothelioma and lung cancer, with mesothelioma being the most extensively studied outcome. Of these, 12 studies focussed on erionite-exposed populations in Turkey, 8 examined health effects among Turkish migrants in northern Europe, and 6 investigated erionite-related health risks in North America (3 in the United States and 3 in Mexico). These studies showed a very high incidence of mesothelioma, often in relatively young individuals, from the Cappadocia region of Turkey, with well-documented environmental exposures to erionite, contributing to a high proportion of all deaths (21% to 51%) in affected villages. Evidence of lung cancer associated with erionite exposure was also found. There is also evidence of erionite exposure-associated mesothelioma in Guanajuato, central Mexico. In the United States, erionite exposure-associated health effects (not mesothelioma) have been reported among people occupationally exposed to erionite. Studies on environmental exposures have shown outdoor concentrations ranging from 0.001 f/ml to 0.3 f/ml, while indoor concentrations have ranged from 0.005 to 1.38 f/ml. Occupational exposure to erionite has been less studied, with only one study in forestry workers showing elevated exposures to erionite ranging from non-detectable to 0.36 f/cc. Erionite deposits have also been identified in other countries such as Italy and New Zealand, but exposures and associated health effects have not yet been studied in these regions.
There is clear evidence that environmental exposure to erionite in the Cappadocia region of Turkey, and Guanajuato in central Mexico are causally associated with the high mesothelioma rates observed in these areas. Evidence for other parts of the world where there is naturally occurring erionite is limited. This review has highlighted significant knowledge gaps, and advocates for further research on occupational exposure to erionite fibres and associated health effects.
毛沸石是一种天然存在的纤维状沸石，被归类为人类致癌物，据信在引发间皮瘤方面比石棉更具致癌性。然而，与石棉不同的是，毛沸石很少用于商业用途，因此，关于接触途径的了解有限。本文对目前有关毛沸石接触、健康影响和接触情况之间关联的知识进行了叙述性综述。
截至2024年底，使用与毛沸石接触和健康结果相关的关键词，对Medline/PubMed和Scopus进行了系统检索。
我们识别出26篇经同行评审的期刊文章，报道了毛沸石接触的健康影响，特别是间皮瘤和肺癌，其中间皮瘤是研究最为广泛的结果。其中，12项研究聚焦于土耳其接触毛沸石的人群，8项研究考察了北欧土耳其移民的健康影响，6项研究调查了北美（美国3项，墨西哥3项）与毛沸石相关的健康风险。这些研究表明，来自土耳其卡帕多西亚地区的间皮瘤发病率非常高，患者往往相对年轻，有充分记录的环境中毛沸石接触情况，在受影响村庄的所有死亡病例中占比很高（21%至51%）。还发现了与毛沸石接触相关的肺癌证据。在墨西哥中部的瓜纳华托也有与毛沸石接触相关的间皮瘤证据。在美国，职业接触毛沸石的人群中报告了与毛沸石接触相关的健康影响（非间皮瘤）。环境接触研究表明，室外浓度范围为0.001纤维/毫升至0.3纤维/毫升，而室内浓度范围为0.005至1.38纤维/毫升。对职业接触毛沸石的研究较少，仅有一项针对林业工人的研究显示，毛沸石接触量升高，范围从检测不到到0.36纤维/立方厘米。在意大利和新西兰等其他国家也发现了毛沸石矿床，但这些地区尚未对接触情况及相关健康影响进行研究。
有明确证据表明，土耳其卡帕多西亚地区以及墨西哥中部瓜纳华托的环境中毛沸石接触与这些地区观察到的高间皮瘤发病率存在因果关系。世界上其他存在天然毛沸石的地区的证据有限。本综述突出了显著的知识空白，并主张对职业接触毛沸石纤维及其相关健康影响进行进一步研究。
