Age at which the disease has developed:
DMPM usually occurs 30-40 years after first contact with occupational contact;
That is, the period of onset of the disease is 30-40 years. Since contact starts with getting into work, that is, at 20
The DMPM has generally been identified in the age range of work for 60 years (50-
These values slightly change in the environmental asbestos area in the rural area
Display. Asbestos or erionite origin starts with the birth of a rural area. In this case
The onset of the disease is the age at which the disease is detected; This is our country
50-55 years of age in the series. This figure is the number of
Longer than the workplace series, but shorter than the age at which the disease was detected. The mean age in cases with Erionite-associated DMPM is lower; 40-
It is between 50 years of age. The difference is that erionite is more
Another proof is that it is a strong carcinogen.
Male / female ratio in the DMPM case series from industrialized countries
10/1 to 3/1. On the other hand,
Because the way of life for men and women is the same, the sharing of risk is also equal,
Ie the male / female ratio in the relevant case series is around 1.
According to workplace series, in environmental contact patients,
It is natural that they show feature differences. Because the contacted dose characteristics
There is contact with various types of fibers, lifestyle of the contacted population
(A geup of worker life, the other group is the life of the wolf). For example,
Series, contact with asbestos starts with the worker starting 8 hours a day, once a week
5 days, 46-48 weeks per year. However, in the village environment
Contact starting at 24 hours a day, even at varying concentrations of dust
And the life in the village continues. In rural area, problematic asbestos fiber
Tremolite or actinolite.
On the other hand, in studies conducted up to now,
The amount of fiber in the air is higher than the amount of fiber in the rural area. In general, after the 1960s in the workplace series
The air fiber concentration did not exceed 20 f / mL. My country
In the rural area series, fiber concentrations in the air are 0.009-0.28 fiber / ml
. However, fiber concentrations in rural areas
Behavioral conditions. For example, the amount of fiber increases in windy and dry air.
After cleaning with a broom in the house, the amount of fiber may increase significantly; one
In the study, the fiber amount before broom was 014 in ml and 0.94 after broom. In other words, the difference in altitude between work place series and rural area series
Relative; Because daily contact can vary greatly in activities in rural areas,
As well as contact with the rural area as mentioned earlier. In this case
Total contact, and the amount of fiber in the lung, in a rural area born 40 years,
If the annual contact time is calculated as approximately 8,700 hours, the total of 40 years
Contact time is 340,000 hours. However, if a worker of the same age is 20 years old
20 years later, it has reached a total contact pattern of 80,000 hours.
Thus, the total amount of contacted fibers between both persons is approximately equal
; Perhaps more in rural areas. Thus
Detailed studies have yielded quantities of pulmonary asbestos fibers confirming this judgment. DMPM encounter speeds detected in environmental asbestos or erionite
These are other findings that support this judgment.
Emergence and course of the disease:
The pathogenesis of DMPM is still not fully understood. However,
We have a significant amount of knowledge about the relationship with the tissue. Asbestos fibers inhale
The aerodynamic structures of the bronchi can be easily
Progressively reaching the peripheral regions of the lung, from which the visceral
They can reach the pleura. The fibers reaching the lymphatic channels may also reach the parietal pleura.
Asbestos fibers in the pleural space, parietal
They accumulate at the entrances of the stoma-lymphatic mouths by making clusters.
The fiber separation after asbestos enters the bronchial system facilitates this process.
Where fibers are present, they are not phagocytosed to macrophage cells
But phagocytosis is not fully possible due to physical
Like phagocytosis, the course returns to the macrophage; Macrophages break down and
Lethal substances such as enzymes, cytokines and superoxide radicals
Emerges; So that the asbestos fibers are both mutagenic-carcinogenic and fibrogenic
They can initiate the activity. In addition, the fibers
Physical trauma to genetic elements, especially cell division
They may also cause chromosomal abnormalities. Mesothelial cells
Asbestos exposure is very sensitive to other system cells.
In DMPM, the tumor is small, pathologically originating from the parietal pleura
In the form of microscopic nodules, usually unilateral and from the lower half of the hemithorax
Starts. Tumor usually grows from a few places at the same time
. As the tumor grows, it creates extensions to the pleural space
Develop. Malignant cells are extruded from these structures intensively,
With the effect of attraction, these cell clusters, especially the diaphragmatic pleural surface
And new tumoral areas arise through the suture by accumulating on the lower pleural surfaces.