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Environmental fiber-induced pleuro-pulmonary diseases in an Anatolian village: an epidemiologic study.

This study was designed to determine the prevalence of pleural mesothelioma and other malignancies in the Anatolian village of Tuzköy, where neither asbestos nor any environmental carcinogen has been detected. Another village (Kizilköy) located 12 km from Tuzköy was selected as a control. Three hundred twelve subjects from Tuzköy who were at least 25 yr of age and 95 subjects from Kizilköy were studied. Analysis of X-rays of the Tuzköy group revealed that subjects had calcified pleural plaques (17%), pleural thickening (10.5%), obscured costophrenic angles (15%), and diffuse interstitial pulmonary fibrosis (12.1%). Sixty-seven deaths were records in Tuzköy during the previous 3 yr, 41 of which resulted from malignant diseases. There were no X-ray abnormalities or deaths resulting from malignancies in the control group. Because of the high incidence of mesothelioma and lung cancer which usually results from asbestos exposure, the presence of asbestos in Tuzköy was investigated, but none was detected in spite to Tuzköy's volcanic location. Nevertheless, zeolite, an asbestiform mineral, was detected in the stones of buildings and in the village soil, as well as in the lung and pleura of the patients during biopsy. Thus, this mineral was considered to be responsible for the fiber-induced pleuro-pulmonary diseases in Tuzköy. No zeolite was found in the soil and stones of the control village.