Although the association between exposure to asbestos and malignant mesothelioma (particularly malignant pleural mesothelioma) has been well established, the health impact of environmental exposure (EE) to asbestos has been less studied. This review summarizes the most recent studies on the association between malignant mesothelioma and EE with asbestos to identify features associated with EE and quantify the association with malignant mesothelioma. There were 44 studies from 18 countries that met our selection criteria, with a considerable amount of heterogeneity in their study design, measures of exposure, and health outcomes. The male-to-female ratio was close to or less than 1 and generally lower than the ratio reported when both occupational and environmental exposures were considered. Although recent studies have continued to improve our understanding of environmental exposure to asbestos, challenges remain. We have highlighted a few new research directions, such as a need for reliable matrices to identify common and less recognized types of EE, asbestos biomarker studies specifically focusing on EE, and research on populations and geographic areas that have not been previously studied.

Original languageEnglish
Pages (from-to)1031-1045
Number of pages15
JournalJournal of Thoracic Oncology
Issue number7
StatePublished - Jul 2017


  • Asbestos
  • Cancer
  • Fibers
  • Non-occupational exposure


Dive into the research topics of 'Epidemiology of Environmental Exposure and Malignant Mesothelioma'. Together they form a unique fingerprint.

Cite this