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In order to provide estimates of the accuracy of death certification of malignant pleural mesothelioma in Italy, the causes of death of a series of ascertained cases were investigated. The study included 523 cases of pleural mesothelioma diagnosed in 1984-1988 by 88 hospital departments and clinics. Vital status at 7 May 1990 was ascertained for 92.7% of subjects. The overall concordance between pathological diagnosis and death certification was about 75%. ___________________________________________________________ Med Lav 1994 Mar-Apr;85(2):157-60
Latency periods (time intervals elapsing between first exposure to asbestos and death) were examined in 421 cases of malignant pleural mesothelioma, diagnosed in the Trieste-Monfalcone area, Italy. Occupational data were collected from the patients or from their relatives by personal or telephone interviews. Routine lung sections were examined for asbestos bodies in 370 cases. Latency periods, calculated in 312 cases, ranged from 14 to 72 years (mean 48.7, median 51). Latency periods differed significantly from one occupational group to another. Mean latency periods were 29.6 among insulators, 35.4 among dock workers, 43.7 in a heterogeneous group defined as various, 46.4 in non-shipbuilding industry workers, 49.4 in shipyard workers, 51.7 among women with a history of domestic exposure to asbestos, and 56.2 in people employed in maritime trades. The ANOVA test indicated a correlation between latency periods an.
Our 1990 article reported on recent papers in the peer-reviewed literature and two international symposia, one at the International Agency for Research on Cancer (2) and the other at Harvard University (3), all concluding that chrysotile fibers are less active than amphibole types (crocidolite, amosite, tremolite) of asbestos in the causation of mesothelioma in man. In his summary of the IARC meeting, Sir Richard Doll, an eminent epidemiologist, concluded there is the difference between the effects of chrysotile and amphiboles, which is so great in relation to mesothelioma that it is possible to argue that chrysotile does not cause mesothelioma at all (2). This observation has been supported by numerous peer-reviewed papers and working groups subsequently (4-6).
Mesothelioma, a fatal cancer usually found on the lining of the lung, is specifically recognized in Ontario—as is asbestosis—as arising from exposure to asbestos. Mesothelioma is written into the Compensation Act as a Schedule 4 Disease.
Ralls statement that countervailing human data on the carcinogenic effects of chrysotile asbestos (including large numbers of mesotheliomas among Canadians) exist is reminiscent of a similar claim by Nicholson et al. (7) in which his exaggerated numbers were correctly put into perspective by the epidemiologists studying the Canadian workers (8). His unreferenced conclusion that mesotheliomas are largely from chrysotile exposure in insulation workers and family members who were exposed to low doses ignores the fact that these individuals encountered mixed exposures to chrysotile and amphiboles at much higher concentrations than levels of asbestos (predominantly chrysotile) occurring in homes and public buildings today. Moreover, Rall does not acknowledge the significant content of amphibole fibers in the lungs of these workers (9) as well as recent studies showing a correlation between the lung burden of tremolite, but not chrysotile, in the lungs of Canadian miners with mesothelioma (.
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