{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:04:26Z","timestamp":1790820266114,"version":"4.1.0"},"reference-count":12,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Malignant pleural mesothelioma (MPM) is strongly associated with occupational asbestos exposure and typically presents decades after exposure, in older men. The association of MPM with environmental exposure and genetic susceptibility is less recognised. We report a case of a 40\u2010year\u2010old man presenting in London with dyspnoea, weight loss and a persistent right\u2010sided pleural effusion following hospitalisation for pneumonia. Imaging showed circumferential nodular thickening of the right pleura with lymph node involvement, and histopathology was in keeping with epithelioid\u2010type MPM. With no known occupational exposure, childhood residences in Kabul, Afghanistan and Peshawar, Pakistan, where high levels of environmental asbestos are documented, represent plausible sources of environmental exposure. As a result of migration from regions with high environmental asbestos exposure, clinicians in high\u2010income countries may encounter increasing numbers of patients with MPM due to non\u2010occupational asbestos exposure.<\/jats:p>","DOI":"10.1002\/rcr2.70774","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:27:39Z","timestamp":1790818059000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Environmental Asbestos Exposure as a Possible Pathway to Early\u2010Onset Pleural Mesothelioma: A Case From Afghanistan and Pakistan to London"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0774-0716","authenticated-orcid":false,"given":"Sophie","family":"Mounouchos","sequence":"first","affiliation":[{"name":"Homerton NHS Healthcare Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asmita","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"University College London, Respiratory Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8174-1625","authenticated-orcid":false,"given":"Asaad Ahmed","family":"Nafees","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1940-2280","authenticated-orcid":false,"given":"Emma","family":"Johnson","sequence":"additional","affiliation":[{"name":"Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cullinan","sequence":"additional","affiliation":[{"name":"London Centre for Work and Health  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Homerton NHS Healthcare Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1056\/NEJMra1912719","article-title":"Perspectives on the Treatment of Malignant Pleural Mesothelioma","volume":"385","author":"Janes S. M.","year":"2021","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/oemed-2017-104383","article-title":"Non\u2010Occupational Exposure to Asbestos and Risk of Pleural Mesothelioma: Review and Meta\u2010Analysis","volume":"74","author":"Marsh G. M.","year":"2017","journal-title":"Occupational and Environmental Medicine"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"16766","DOI":"10.18632\/oncotarget.4414","article-title":"Distinctive Clinical Characteristics of Malignant Mesothelioma in Young Patients","volume":"6","author":"Thomas A.","year":"2015","journal-title":"Oncotarget"},{"key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"239","DOI":"10.21037\/atm.2017.04.06","article-title":"The Cappadocia Mesothelioma Epidemic: Its Influence in Turkey and Abroad","volume":"5","author":"Emri S. A.","year":"2017","journal-title":"Annals of Translational Medicine"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1038\/ng.912","article-title":"Germline BAP1 Mutations Predispose to Malignant Mesothelioma","volume":"43","author":"Testa J. R.","year":"2011","journal-title":"Nature Genetics"},{"key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"2863","DOI":"10.1200\/JCO.2018.78.5204","article-title":"Frequency of Germline Mutations in Cancer Susceptibility Genes in Malignant Mesothelioma","volume":"36","author":"Panou V.","year":"2018","journal-title":"Journal of Clinical Oncology"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1378\/chest.106.3.974","article-title":"Environmental Airborne Tremolite Asbestos Pollution and Pleural Plaques in Afghanistan","volume":"106","author":"Voisin C.","year":"1994","journal-title":"Chest"},{"key":"e_1_2_10_9_1","volume-title":"Appraisal of the Kabul Water Supply & Sanitation Project: Afghanistan","author":"World Bank","year":"1975"},{"key":"e_1_2_10_10_1","volume-title":"Report of UNIDO Programming Mission to Afghanistan, 24 April\u20106 May 1977. Document 07472, UNIDO\/ICD.84 (Restricted distribution)","author":"United Nations Industrial Development Organization","year":"1977"},{"key":"e_1_2_10_11_1","unstructured":"National Centre of Excellence in Geology (NCEG) Online \u201cNoor Jehan Thesis 2005 \u201d accessed April 27 2026 http:\/\/nceg.uop.edu.pk\/Thesis\/PhD\/Thesis12\/NoorJehanThesis\u20102005.pdf."},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"124","DOI":"10.15406\/mojcrr.2018.01.00019","article-title":"Environmental Asbestos and Pleural Mesothelioma in the North\u2010West of Pakistan; a Serious Health Hazard With Potentially Fatal Outcome","volume":"1","author":"Iqbal Z.","year":"2018","journal-title":"MOJ Current Research & Reviews"},{"issue":"1","key":"e_1_2_10_13_1","article-title":"Mesothelioma: A Misdiagnosed Entity in Pakistan","volume":"15","author":"Khalid S S.","year":"2009","journal-title":"Pakistan Journal of Chest Medicine"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70774","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.70774","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70774","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:27:42Z","timestamp":1790818062000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.70774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":12,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/rcr2.70774"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.70774","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"2026-07-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70774"}}