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1/8/2009
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| 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. |
| The authors briefly reviewed the literature concerning the risk
factors for primary pleural tumors in humans. The results from the
most relevant studies emphasize the fact that the large majority of
mesotheliomas are associated with exposure to asbestos or
asbestiform fibers. Exposure to asbestos is mainly through industrial
use, and mesotheliomas result from occupational,
para-occupational, or environmental exposure. Fibers of crocidolite,
amosite, and chrysotile appear to be, in descending order,
more carcinogenic for pleural tissues. The authors summarize the
available data on consumption of asbestos and
asbestos-based products in Italy. The chrysotile-asbestos mine in
Balangero (Piedmont) stimulated the industrial production of
asbestos-cement; asbestos has been largely sprayed among shipyards
and user for insulating railroad coaches and carriages.
Italy had the greatest consumption of crocidolite in Europe, whi. |
| 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%.
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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). |
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