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1/8/2009
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| AIM AND BACKGROUND: To evaluate the characteristics of a case-series
of 79 malignant mesothelioma patients collected
from the main teaching hospital of Rome, Italy, and other local
clinics of Latium Region and to assess the role of asbestos
exposure, since previous studies on the occurrence of the disease in
this area were lacking. METHODS: The study included
cytohistologically diagnosed malignant mesothelioma (71 pleural, 7
peritoneal, and 1 testicular tunica lis) detected or
referred for consultation during the period 1980-1995. Information
regarding occupational and/or nonoccupational exposures
was derived from clinical records and interviews, when available.
RESULTS: Patients were resident in Rome and other towns
of Latium; a few were from other parts of central and southern Italy.
Exposure to asbestos was assessed for 45.5% of patients,
another 45.5% had unknown exposure, and for the remaining 9% such
info. |
| 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. |
| A case-control study on pleural malignant mesothelioma (MM) was
conducted in Casale Monferrato, where the largest Italian
asbestos cement (AC) factory had been operating from 1907 to 1985. In
a previous study we observed a five to seven-fold
increase in the incidence of MM among people living in that city and
never employed in the factory mentioned. The present
study includes cases of MM with histological diagnosis over the
period 1.1.1987-30.6.1993 among residents in the Local
Health Unit (LHU) of Casale Monferrato. Population controls were
randomly extracted from the list of the residents in the
LHU, matched to cases on , date of birth, vital status and date of
death. Cases and controls (or their closest relative) were
interviewed with a standardised questionnaire focusing on asbestos
exposure in the (life-long) residential and occupational
histories and in leisure time activities as well as on occupational
a. |
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