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A spatial cluster of pleural mesothelioma cases was detected in Broni, in the Province of Pavia (northwestern Italy). Eighteen deaths due to malignant pleural neoplasms were observed in the years 1980-87 (SMR: 556; 95% confidence interval: 329-878) and the incidence of pleural mesothelioma in 1980-89 was 9.1 cases per 100,000 person-years among men and 4.3 cases among women. These findings are discussed with reference to the presence in Broni of a plant manufacturing asbestos cement products. _____________________________________________________________
Mr. Bichard finds it hard to contain his anger over his medical problems and those of colleagues who are dead or are suffering from lung cancer, brain tumours, or mesothelioma, a rare cancer of the lung lining.
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 (.
Dr. Finkelstein also cited five cases of mesothelioma among former Holmes workers. Three of the five workers died at less than fifty years of age and all were less than sixty years old!
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
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