title: Respiratory health in Turkish asbestos cement workers: the role of environmental exposure.
abstract: OBJECTIVE
  Benign and malignant pleural and lung diseases due to environmental asbestos exposure constitute an important health problem in Turkey. The country has widespread natural deposits of asbestos in rural parts of central and eastern regions. Few data exists about the respiratory health effects of occupational asbestos exposure in Turkey. A cross-sectional study was conducted to investigate respiratory health effects of occupational asbestos exposure and the contribution of environmental asbestos exposure.
  
  
  METHODS
  Investigations included asbestos dust measurements in the workplace and application of an interviewer-administered questionnaire, a standard posteroanterior chest X-ray and spirometry. Information on birthplace of the workers was obtained in 406 workers and used to identify environmental exposure to asbestos, through a map of geographic locations with known asbestos exposure.
  
  
  RESULTS
  Asbestos dust concentration in the ambient air of the work sites (fiber/ml) ranged between 0.2 and 0.76 (mean: 0.25, median: 0.22). Environmental exposure to asbestos was determined in 24.4% of the workers. After the adjustment for age, smoking, occupational asbestos exposure, and potential risk factors environmental asbestos exposure was associated with small irregular opacities grade > or = 1/0 (44.2% vs. 26.6%, P < 0.01), FVC% (97.8 vs. 104.5, P < 0.0001), and FEV1% (92.4 vs. 99.9, P < .0001). Occupational exposure to asbestos was associated with small irregular opacities grade > or = 1/0 (OR: 2.0, 95% CI: 1.3-3.1, per 1 unit increase in the natural logarithm of fiber/ml) and FEV1/FVC% (beta: 1.1, SEM: 0.54; P < 0.05, per 1 unit increase in the natural logarithm of fiber/ml).
  
  
  CONCLUSIONS
  Environmental exposure to asbestos could increase the risk of asbestosis and lung function impairment in workers occupationally exposed to asbestos, independent from occupational exposure and smoking.
authors.affiliation: Department of Chest Disease, Cumhuriyet University Medical School, Sivas, Turkey.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akkurt
authors.forename: Buhara
authors.initials: B
authors.lastname: Onal
authors.forename: Ahmet Uğur
authors.initials: AU
authors.lastname: Demir
authors.forename: Dilek
authors.initials: D
authors.lastname: Tüzün
authors.forename: Handan
authors.initials: H
authors.lastname: Sabir
authors.forename: Lütfi
authors.initials: L
authors.lastname: Ulusoy
authors.forename: Kaan O
authors.initials: KO
authors.lastname: Karadağ
authors.forename: Nihat
authors.initials: N
authors.lastname: Ersoy
authors.forename: Lütfi
authors.initials: L
authors.lastname: Cöplü
mesh_terms: D000328:Adult; D001194:Asbestos / Q000633:toxicity*; D001195:Asbestosis / Q000453:epidemiology / Q000209:etiology*; D003252:Construction Materials / Q000633:toxicity*; D003430:Cross-Sectional Studies; D004391:Dust; D006801:Humans; D007407:Interviews as Topic; D016273:Occupational Exposure / Q000009:adverse effects*; D012137:Respiratory System; D018570:Risk Assessment; D012307:Risk Factors; D013147:Spirometry; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology
chemical_list: D004391:Dust; D001194:Asbestos