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A series of 421 malignant pleural mesotheliomas, diagnosed in the Trieste-Monfalcone area, northeastern Italy, were reviewed. A large majority of the patients had been employed in naval work (shipbuilding, maritime trades, and dock work). Latency periods (time intervals between first exposure to asbestos and death), showed wide variations from one occupational category to another. Such variations were attributable, but only partly, to differences in the intensity of the exposure to asbestos. Various family cases were identified, including people with and without blood relationships. The data, obtained in the studies on Trieste-Monfalcone mesothelioma, suggest that interactions between asbestos and other factors play a considerable role in the pathogenesis of asbestos-related mesothelioma. ___________________________________________________________ Med Lav 1997 Jul-Aug;88(4):310-5
We reviewed the certificates of 39,650 deaths which occurred in the period 1975-1988 in Leghorn and of 45,900 in La Spezia (Italy) in the period 1958-1988. In total 262 cases have been recorded as pleural mesothelioma. The main occupational exposures occurred in the shipbuilding industry. Regarding non-occupational exposures to asbestos, 13 cases of mesothelioma were found in women who had washed the work clothes of their relatives at home; we also found other domestic uses of asbestos which were rarely or never discussed previously in the literature: six cases might be explained by the installation of fireproof or non-conductive materials in the domestic environment. These exposures probably are more frequent than realized until now. __________________________________________________________ Am J Ind Med 1992;21(4):577-85
All cases of pleural malignant mesothelioma occurring in Tuscany were collected, backdated to 1980 (to 1970 for the provinces of Florence and Prato; to 1975 for the provinces of Pisa and Siena), in order to evaluate the incidence of occupational exposure to asbestos. The aim was to enhance primary prevention in those workplaces still at risk nowadays. To achieve information on the possible occupational, domestic or environmental exposure, an interview was conducted using a semi-structured questionnaire. An exposure classification was produced to focus preventive intervention. This surveillance system needs to be developed to contribute to epidemiological research, especially on the effects of low level exposures, and to primary prevention. _________________________________________________________ Med Lav 1997 Jul-Aug;88(4):302-9
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 stating that a threshold of effect has never been found for asbestos, Rall stands behind the outdated one fiber can kill theory of carcinogenesis. However, Rall fails to mention data supporting a threshold for chrysotile in lung cancer (11, asbestosis (12), and mesothelioma (13) as well as a panel report from the Health Effects Institute-Asbestos Research (HEI-AR) detailing animal and in vitro dose-response studies exhibiting no-observed adverse effect levels (NOAELs) for asbestos (14). Our recent work documents a dose-dependent increase in asbestos-induced proto-oncogene activation in mesothelial cells with no induction at lowest concentrations of fibers tested and an enhanced potency of crocidolite asbestos in comparison to chrysotile (15).
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