Consensus Report of the 2015 Weinman International Conference on Mesothelioma

Consensus Report of the 2015 Weinman International Conference on Mesothelioma

Special Article in the Journal of Thoracic Oncology, August 2016

On November 9 and 10, 2015, the International Conference on Mesothelioma in Populations Exposed to Naturally Occurring Asbestiform Fibers was held at the University of Hawaii Cancer Center in Honolulu, Hawaii. The meeting was cosponsored by the International Association for the Study of Lung Cancer, and the agenda was designed with significant input from staff at the U.S. National Cancer Institute and National Institute of Environmental Health Sciences.

A multidisciplinary group of participants presented updates reflecting a range of disciplinary perspectives, including mineralogy, geology, epidemiology, toxicology, biochemistry, molecular biology, genetics, public health, and clinical oncology. The group identified knowledge gaps that are barriers to preventing and treating malignant mesothelioma (MM) and the required next steps to address barriers.

This manuscript reports the group’s efforts and focus on strategies to limit risk to the population and reduce the incidence of MM. Four main topics were explored:

  1. Genetic risk
  2. Environmental exposure
  3. Biomarkers
  4. Clinical interventions

Authors: Michele Carbone, MD, PhD, Shreya Kanodia, PhD, Ann Chao, PhD, Aubrey Miller, MD, Anil Wali, PhD, David Weissman, MD, Alex Adjei, MD, PhD, Francine Baumann, PhD, Paolo Boffetta, MD, PhD, Brenda Buck, PhD, Marc de Perrot, MD, A. Umran Dogan, PhD, Steve Gavett, PhD, Alessandro Gualtieri, PhD, Raffit Hassan, MD, Mary Hesdorffer, NP, Fred R. Hirsch, MD, PhD, David Larson, PhD, Weimin Mao, PhD, Scott Masten, PhD, Harvey I. Pass, PhD, Julian Peto, DSc, Enrico Pira, Phd, Ian Steele, MD, Anne Tsao, MD, Gavitt Alida Woodard, MD, Haining Yang, PhD, Shakun Malik, MD

Erionite exposure in North Dakota and Turkish villages with mesothelioma

Erionite exposure in North Dakota and Turkish villages with mesothelioma

PNAS Early Edition

Exposure to erionite, an asbestos-like mineral, causes unprecedented rates of malignant mesothelioma (MM) mortality in some Turkish villages. Erionite deposits are present in at least 12 US states. We investigated whether increased urban development has led to erionite exposure in the United States and after preliminary exploration, focused our studies on Dunn County, North Dakota (ND). In Dunn County, ND, we discovered that over the past three decades, more than 300 miles of roads were surfaced with erionite-containing gravel. To determine potential health implications, we compared erionite from the Turkish villages to that from ND. Our study evaluated airborne point exposure concentrations, examined the physical and chemical properties of erionite, and examined the hallmarks of mesothelial cell transformation in vitro and in vivo. Airborne erionite concentrations measured in ND along roadsides, indoors, and inside vehicles, including school buses, equaled or exceeded concentrations in Boyali, where 6.25% of all deaths are caused by MM. With the exception of outdoor samples along roadsides, ND concentrations were lower than those measured in Turkish villages with MM mortality ranging from 20 to 50%. The physical and chemical properties of erionite from Turkey and ND are very similar and they showed identical biological activities. Considering the known 30- to 60-y latency for MM development, there is reason for concern for increased risk in ND in the future. Our findings indicate that implementation of novel preventive and early detection programs in ND and other erionite-rich areas of the United States, similar to efforts currently being undertaken in Turkey, is warranted.


Michele Carbone, Y. Izzettin Baris,, Pietro Bertino, Brian Brass, Sabahattin Comertpay, A. Umran Dogan, Giovanni Gaudino, Sandro Jube,