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The presence of asbestos in cosmetic talc has been reported in the United States since the 1970s. The present article first retraces the Italian case, then focuses on technical features as well as the relevant laws, rules, and regulations, ending with a precautionary evidence-based approach. Research was mainly aimed at retrieving official Italian Health Authority papers on the tests carried out several decades ago, to identify the presence of any asbestos in talc of products for sale. Results show that, in Italy, National Institute of Health (the technical agency of the Ministry of Health) and the Italian Pharmacopoeia (1985) used scanning electron microscopy (SEM) to ascertain the absence of asbestos fibres, following positive identification in several samples they had analysed. In 2008, Italy adopted the EU Pharmacopoeia according to which light microscopy (LM) was sufficient for analysis. Such a technical downgrading clearly went - and goes - against the standard principle of precaution to prevent harm to users' health.Unfortunately, documents on the above-mentioned SEM research that would have contextualized observations were not recovered from the Italian State Archive. Observations and results indicate that in practice levels of attention on the issue underwent a considerable (negative) decline, so much that effective planning of the necessary controls was not possible, which is unfortunately true to this day. Final comments deal with the principle of precaution and possible practical operational solutions.

Objective: The aim of this study was to update the analysis of mortality of a cohort of talc miners and millers in Northern Italy. Methods: We analyzed the mortality during 1946 to 2013 of 1722 male workers in an asbestos-free talc mine (1166 miners and 556 millers) employed during 1946 to 1995. Results: The overall standardized mortality ratio (SMR) was 1.24 [95% confidence interval (95% CI) 1.17 to 1.32]; no deaths were observed from pleural cancer; mortality from lung cancer was not increased. Mortality from pneumoconiosis was increased (SMR 26.62; 95% CI 20.71 to 33.69), in particular among miners, and was associated with duration of employment and time since first employment. Conclusions: We confirmed the lack of association between exposure to asbestos-free talc, lung cancer, and mesothelioma. Increased mortality from pneumoconiosis among miners is attributable to past exposure to silica. [ABSTRACT FROM AUTHOR]

Background: Pleural disease (PD), particularly malignant pleural effusion (MPE), is a common cause of hospital admission and its prevalence is rising worldwide. Recent advances in diagnostic and therapeutic options, such as Indwelling Pleural Catheters (IPCs), have simplified PD treatment, allowing an effective outpatients management. Therefore, dedicated pleural services can improve PD care, guaranteeing specialized management and optimizing time and cost. We aimed to provide an overview on MPE management in Italy, mainly focused on distribution and characteristics of pleural services and IPCs use., Methods: A nationwide survey, endorsed by the Italian Thoracic Society, was distributed by email to members of selected subgroups in 2021., Results: Ninety (23%) members replied, most of whom being pulmonologists (91%). MPE resulted the most common cause of pleural effusion and was managed with heterogenous approaches, including talc pleurodesis via slurry (43%), talc poudrage (31%), repeated thoracentesis (22%) and IPCs insertion (2%). The setting of IPC insertion was inpatient care in 48% of cases, with a predominance of draining frequency every other day. IPC management mainly relied on caregivers (42%). The presence of a pleural service was reported by 37% of respondents., Conclusions: The present study provides an extensive overview of MPE management in Italy, showing a highly heterogeneous approach, a scarce prevalence of out-patient pleural services, and a still limited adoption of IPCs, mainly due to lack of dedicated community care systems. This survey emphasizes the need of promoting a higher spreading of pleural services and an innovative healthcare delivery with more favourable cost-benefit ratio., (© 2023. The Author(s).)

The present study analysed the asbestos lung burden in necroscopic samples from 55 subjects free from asbestos-related diseases, collected between 2009 and 2011 in Milan, Italy. Multiple lung samples were analysed by light microscopy (asbestos bodies, AB) and EDXA-scanning electron microscopy (asbestos fibres and other inorganic fibres). Asbestos fibres were detected in 35 (63.6%) subjects, with a higher frequency for amphiboles than for chrysotile. Commercial (CA) and non-commercial amphiboles (NCA) were found in roughly similar frequencies. The estimated median value was 0.11 million fibres per gram of dry lung tissue (mf g-1) for all asbestos, 0.09 mf g-1 for amphiboles. In 44 (80.0%) subjects no chrysotile fibres were detected. A negative relationship between asbestos mass-weighted fibre count and year of birth (and a corresponding positive increase with age) was observed for amphiboles [-4.15%, 95% confidence interval (CI) = -5.89 to -2.37], talc (-2.12%, 95% CI = -3.94 to -0.28), and Ti-rich fibres (-3.10%, 95% CI = -5.54 to -0.60), but not for chrysotile (-2.84%, 95% CI = -7.69 to 2.27). Residential district, birthplace, and smoking habit did not affect the lung burden of asbestos or inorganic fibres. Females showed higher burden only for amphiboles (0.12 versus 0.03 mf g-1 in males, P = 0.07) and talc fibres (0.14 versus 0 mf g-1 in males, P = 0.03). Chrysotile fibres were shorter and thinner than amphibole fibres and NCA fibres were thicker than CA ones. The AB prevalence was 16.4% (nine subjects) with concentrations ranging from 10 to 110 AB g-1 dry, well below the 1000 AB g-1 threshold for establishing occupational exposure. No AB were found in subjects younger than 30 years. Our study demonstrated detectable levels of asbestos fibres in a sample taken from the general population. The significant increase with age confirmed that amphibole fibres are the most representative of cumulative exposure. [ABSTRACT FROM AUTHOR]

In central Sardinia, several talc-chlorite-feldspar bodies have long been mined by open-pit operations. The mining activity has deeply modified the original landscape of the Lasasai-Bonucoro area in the district of Orani. Thus, the rehabilitation of this area, in particular the open-pit works that are now occupied by pools filled with ground water from aquifers, should be considered as an overall project of landscape restoration. Particular conditions, such as the constant outflow of good-quality water and the scenic nature of the surrounding countryside, are favourable to the accomplishment of the recovery plan. On the basis of the naturalistic and geographical contexts of the mining area and its surroundings, a few proposals concerning the re-utilisation of these excavations are presented in this article. The preparatory work included the characterisation of the study area with a topographic survey, the establishment of a geodetic control network with global positioning system to describe the morphologic features of the landscape and the representation of the study area using three dimensional analysis and geoprocessing by commercial geographical information system GIS/CAD software. The final step involved the use of a digital scenery generator, capable of integrating graphical data layers with geological and morphological maps, to create virtual 3D environments thereby giving a rendering of a present, past and future landscape development. [ABSTRACT FROM AUTHOR]

Sustainable development of coastal zones must balance economic development that encourages human visitation from a larger population with desires that differ from the local residents with the need to maintain opportunities for the local resident society and conserve ecological capital, which may serve as the basis for residents. We present a case study in which the sustainability level of a coastal zone (Riviera del Beigua), located along the Ligurian coast of north-western Italy, was assessed through the lens of systems ecology using emergy synthesis to integrate across economic, social and environmental sub-systems. Our purposes were (1) to quantify the environmental sustainability level of this coastal zone, (2) to evaluate the role of tourism in affecting the economy, society and environment, and (3) to compare emergy synthesis to Butler's Tourism Area Life Cycle model (TALC). Results showed that 81% of the total emergy consumption in the coastal zone was derived from external sources, indicating that this tourist-heavy community was not sustainable. Tourism, as the dominant economic sub-system, consumed 42% of the total emergy budget, while local residents used the remaining 58%. The progressive stages of the TALC model were found to parallel the dynamic changes in the ratio of external emergy inputs to local emergy inputs, suggesting that emergy synthesis could be a useful tool for detecting a tourist region's TALC stage. Use of such a quantitative tool could expedite sustainability assessment to allow administrative managers to understand the complex relationship between a region's economy, environment and resident society so sound policies can be developed to improve overall sustainability. [Copyright &y& Elsevier]

Objective: To update the analysis of mortality of a cohort of talc miners and millers in Northern Italy., Methods: We analyzed overall mortality and mortality from specific causes of death during 1946-2020 of 1749 male workers in a talc mine where asbestos was not detected (1184 miners and 565 millers) employed during 1946-1995., Results: The overall standardized mortality ratio (SMR) was 1.21 (95 % confidence interval [CI] 1.14-1.28); no deaths were observed from pleural cancer. Mortality from lung cancer was not increased (SMR = 1.02 95 % CI 0.82-1.27), while mortality from pneumoconiosis was (SMR 9.55; 95 % CI 7.43-12.08), especially among miners (SMR 12.74; 95 % CI 9.79-16.31). There was a trend in risk of pneumoconiosis with increasing duration of employment in the overall cohort, and the SMR for 25+ years of employment was 15.12 (95 % CI 10.89-20.43)., Conclusions: This uniquely long-term follow up confirms the results of previous analyses, namely the lack of association between exposure to talc with no detectable level of asbestos and lung cancer and mesothelioma. Increased mortality from pneumoconiosis among miners is related to past exposure to silica., (Copyright © 2021. Published by Elsevier Inc.)

Simple Summary: Primary ovarian mesothelioma is a rare and aggressive neoplastic disease with a poor prognosis. The rarity of this entity and the challenging differential diagnosis with other ovarian and peritoneal neoplasms may lead to frequent misdiagnosis and some concerns about its histogenesis. This case series describes four histologically and ultrastructurally documented primary ovarian mesotheliomas in exposed patients, as reported in the medical history. Because of the few cases described, we reviewed the English literature on ovarian mesothelioma and on its possible risk factors, already known and recognized for pleural, pericardial, peritoneal, tunica vaginalis mesothelioma. Describing such rare cases and summarizing the knowledge so far is fundamental to gain greater awareness of this neoplasm and try to answer unsolved questions on its origin. Primary ovarian mesothelioma is a rare, aggressive neoplastic disease with a poor prognosis. At onset, the tumor is only rarely limited to the ovaries and usually already widespread in the peritoneum. The rarity of this entity and the difficulties differentiating it from either ovarian carcinoma or peritoneal mesothelioma may lead to frequent misdiagnoses and may raise some concerns about its histogenesis. Thus, reporting such rare cases is fundamental to gain greater awareness of this neoplasm and try to answer unsolved questions. Herein, we described four cases of histological diagnoses of ovarian mesothelioma extrapolated by the regional mesothelioma register of Apulia (southern Italy). In all cases, a detailed medical history was collected according to national mesothelioma register guidelines. A broad panel of antibodies was used for immunohistochemistry to confirm the diagnoses. Moreover, ovarian tissue samples were also examined by transmission and scanning electron microscopy, detecting asbestos fibers and talc crystals in two cases. Because of the few cases described, we reviewed the English literature in the Medline database, focusing on articles about ovarian mesothelioma "misclassification", "misdiagnosis", "diagnostic challenge" or "diagnostic pitfall" and on unsolved questions about its histogenesis and possible risk factors. [ABSTRACT FROM AUTHOR]