Les différentes pathologies pleuropulmonaires liées à l'amiante : définitions, épidémiologie et évolution

Pleural plaques (fibrosis of the parietal pleura) are sometimes seen following light exposure. Their prevalence may reach 70% in heavily exposed populations. Fibrosis of the visceral pleura is much less common and it is not specifically related to asbestos. The incidence of asbestosis (pulmonary fibrosis induced by asbestos exposure) is diminishing in France. According to the data of the National Programme for the Surveillance of Mesothelioma, the annual number of cases of pleural mesothelioma varied from 646 to 800 for the period 1998-2003. Primary lung cancer due to asbestos does not have specific clinical, radiological or anatomical-pathological features. The number of cases attributable to asbestos has been estimated as between 2086 and 4172 for 1999. A report of the National Academy of Medicine, the Academy of Sciences and the International Centre of Cancer Research has calculated the incidence of primary lung cancer due to asbestos in 2000 as 969 for men and 133 for women. The risk of primary lung cancer is increased in populations exposed to asbestos even in the absence of radiological signs of pulmonary fibrosis. For an identical total exposure, asbestosis increases the risk of primary lung cancer. On the basis of radiological studies, pleural plaques are associated with an increased risk of lung cancer and mesothelioma. For identical levels of total asbestos exposure, it has not been established that the presence of pleural plaques increases the risk of developing thoracic cancer.