For Healthcare Professionals

Asbestos Related CME & CNE

The CDC’s Agency for Toxic Substances and Disease Registry (ATSDR) provides a no-cost web based course covering Asbestos Toxicity. The course covers the topic from the who, what, where, and how of asbestos; through U.S. regulations regarding the fiber; to clinical assessment, treatment, and management of patients.

The course offers 2.5 AMA PRA category 1 credits for physicians and 2.4 CNE credits for nurses.  To enroll for credit and take this comprehensive course, click on the link below:

ATSDR Environmental Health and Medicine Education – Asbestos Toxicity

 

Low Dose CT Screening for Lung Cancer

The National Comprehensive Cancer Network guidelines recommend lung cancer screening not only for smokers with a 30 pack-year history, but also for a second high-risk group: asymptomatic smokers with a 20 pack-year history, 50 years of age or older, with one additional risk factor.

Additional risk factors are:

  • Occupational exposure to arsenic, chromium, asbestos, nickel, cadmium, beryllium, silica, or diesel fumes
  • History of lung disease, including COPD or pulmonary fibrosis
  • Personal history of lung cancer, lymphomas, cancers of the head and neck, or smoking-related cancers; or family history of lung cancer
  • Residential exposure to radon

    American College of Chest Physicians and American Thoracic Society Policy Statement
Components Necessary for High-Quality Lung Cancer Screening Quality Lung Cancer Screening

    International Early Lung Cancer Action Program (I-ELCAP) Guidelines

  • flowchart directing treatment and monitoring decisions based on Initial Scan results
  • flowchart directing decisions based on Annual Scan results

    American College of Chest Physicians Guidelines

    Fleishner Society Guidelines

 Point/Counterpoint Editorials

Viewing the articles at the following links will require the establishment of a Free Personal Account with CHEST, the official publication of the American College of Chest Physicians

POINT: Are There Cases in Which Physicians Should Deviate From Recommendations Not to Order a Chest CT Scan?  Yes    Scott D. Halpern, MD, PhD

COUNTERPOINT: Are There Case in Which Physicians Should Deviate From Recommendations Not to Order a Chest CT Scan?  No   Tamara Simpson, MD

Rebuttal From Dr Halpern      Scott D. Halpern, MD, PhD

Rebuttal From Dr Simpson     Tamara Simpson, MD

POINT: Should Lung Cancer Screening by Chest CT be a Covered Benefit?  Yes   David Yankelevitz, MD

COUNTERPOINT: Should Lung Cancer Screening by Chest CT be a Covered Benefit?  No   Katherine Courtright, MD; Scott Manaker, MD, PhD, FCCP

Response from Dr Yankelevitz   David Yankelevitz MD

Rebuttal from Drs Courtright and Manaker   Katherine Courtright, MD; Scott Manaker, MD, PhD, FCCP

 
Low-Dose CT Screening for Lung Cancer: Computer-aided Detection of Missed Lung Cancers.  Full text article available online ahead of print 1/26/16.
Lung Cancer Deaths in the National Lung Screening Trial Attributed to Nonsolid Nodules.  Full text article available online ahead of print 7/5/16

Lung Function

Reduced lung function in smokers in a lung cancer screening cohort with asbestos exposure and pleural plaques.  American Journal of Industrial Medicine 2016 Mar; 59(3):178-85

 

Pulmonary Fibrosis

Drug therapy for treatment of idiopathic pulmonary fibrosis: Systematic review and network meta-analysis.  Abstract published online 1/2016

Association between occupational dust exposure and prognosis of idiopathic pulmonary fibrosis: A Korean national survey.  Abstract published online 10/2/14

Two new drugs approved by FDA to treat idiopathic pulmonary fibrosis, pirfenidone (Esbriet) and nintedanib (Ofev), may have application in treating asbestosis

American Thoracic Society Guidelines for Diagnosis and Treatment of Idiopathic Pulmonary Fibrosis. Condensation of 2011 evidence based guidelines

 

Mesothelioma

Extrapleural Pneumonectomy in Malignant Pleural Mesothelioma Patients: A Case-Control Study. CHEST Meeting abstract available online 10/2015

Significant preliminary response in treating malignant pleural mesothelioma with TargomiR.  Correspondence available online 6/15/15

Comparison of mesothelin and fibulin-3 in pleural fluid and serum as markers in malignant mesothelioma.  Abstract available online 5/26/15

Discovery of new biomarkers for malignant mesothelioma.  Article published online 1/31/15

 

Other Associated Cancers

Cancer Attributable to Asbestos Exposure in Shipbreaking Workers: A Matched-Cohort Study.  Published online in PLOS One 7/20/15