End of domestic asbestos exposure epidemic in Metsovo; N.W. Greece

INTRODUCTION: Metsovites had been exposed to tremolite asbestos from a whitewash ("luto"), used by all until 1940. This exposure has resulted in frequent pleural calcifications (PCs) and a mesothelioma epidemic, fading due to abandonment of luto. We have reported that most older Metsovites have PCs in chest CT and asbestos bodies (ABs) in BAL. These parameters are used now in younger Metsovites to evaluate if those not exposed are free from signs of exposure. MATERIALS & METHODS: 22 Metsovites age 30-49 had chest CTs and 8 of them BAL. Age was chosen because it takes 30 yrs for PCs to appear and because they were born between 1960-80 when luto use had declined considerably giving us the possibility to evaluate Metsovites who have lived all their life free of luto. Previous BAL studies of 7 age matched Metsovites were used as control. There were no similar control chest CTs. Therefore we studied all available (86) chest CTs of Metsovites over 30. RESULTS: Only 3/22 had used luto (35,47,48 yo). All 8 BAL studies were negative, in contrast to the exposed control group, where 6/7 (85,7%) BAL studies showed ABs. Only one chest CT was positive for PCs (48yo: luto until 13yo). From the 86 chest CTs, 5 belonged in the 30-39 and 9 in 40-49 yo group. None of the 30-39yo group had PCs and none had used luto. There was one CT positive in the 40-49yo group (11%). He had used luto in childhood as was the case with 2/6 others of this group in which luto history was obtained. CONCLUSION: There is no evidence of asbestos exposure in younger Metsovites who have not used luto. The domestic use of this tremolite-whitewash has been the only source of asbestos in Metsovo. Its abandonment has resulted in the end of this epidemic.