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2. Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: a case–control study and epidemiological remarks

Author

Marinaccio, A., Consonni, D., Mensi, C., Mirabelli, D., Migliore, E., Magnani, C., Di Marzio, D., Gennaro, V., Mazzoleni, G., Girardi, P., Negro, C., Romanelli, A., Chellini, E., Grappasonni, I., Madeo, G., Romeo, E., Ascoli, V., Carrozza, F., Angelillo, I. F., Cavone, D., Tumino, R., Melis, M., Curti, S., Brandi, G., Mattioli, S., Iavicoli, S., Dallari, B., Pesatori, A. C., Riboldi, L., Merletti, F., Gangemi, M., Stura, A., Brentisci, C., Gilardetti, M., Benfatto, L., Canessa, P. A., Malacarne, D., Mazzucco, G., Campi, M. G., Fedeli, U., Bressan, V., Gioffre, F., Ballarin, M. N., Chermaz, C., D'Agostin, F., De Michieli, P., Mangone, L., Storchi, C., Sala, O., Badiali, A. M., Cacciarini, V., Giovannetti, L., Martini, A., Calisti, R., Pascucci, C., Stracci, F., Masanotti, G., Davoli, M., Cavariani, F., Ancona, L., Annunziata, A., Menegozzo, S., Napolitano, F., Pelullo, C. P., Vimercati, L., Cascone, G., Frasca, G., Giurdanella, M. C., Martorana, C., Nicita, C., Rollo, C. P., Spata, E., Dardanoni, G., Scondotto, S., Nieddu, V., Pergola, M., Stecchi, S., Marinaccio, A., Consonni, D., Mensi, C., Mirabelli, D., Migliore, E., Magnani, C., Di Marzio, D., Gennaro, V., Mazzoleni, G., Girardi, P., Negro, C., Romanelli, A., Chellini, E., Grappasonni, I., Madeo, G., Romeo, E., Ascoli, V., Carrozza, F., Angelillo, I. F., Cavone, D., Tumino, R., Melis, M., Curti, S., Brandi, G., Mattioli, S., Iavicoli, S., Dallari, B., Pesatori, A. C., Riboldi, L., Merletti, F., Gangemi, M., Stura, A., Brentisci, C., Gilardetti, M., Benfatto, L., Canessa, P. A., Malacarne, D., Mazzucco, G., Campi, M. G., Fedeli, U., Bressan, V., Gioffre, F., Ballarin, M. N., Chermaz, C., D'Agostin, F., De Michieli, P., Mangone, L., Storchi, C., Sala, O., Badiali, A. M., Cacciarini, V., Giovannetti, L., Martini, A., Calisti, R., Pascucci, C., Stracci, F., Masanotti, G., Davoli, M., Cavariani, F., Ancona, L., Annunziata, A., Menegozzo, S., Napolitano, F., Pelullo, C. P., Vimercati, L., Cascone, G., Frasca, G., Giurdanella, M. C., Martorana, C., Nicita, C., Rollo, C. P., Spata, E., Dardanoni, G., Scondotto, S., Nieddu, V., Pergola, M., Stecchi, S., Marinaccio A., Consonni D., Mensi C., Mirabelli D., Migliore E., Magnani C., Di Marzio D., Gennaro V., Mazzoleni G., Girardi P., Negro C., Romanelli A., Chellini E., Grappasonni I., Madeo G., Romeo E., Ascoli V., Carrozza F., Angelillo I.F., Cavone D., Tumino R., Melis M., Curti S., Brandi G., Mattioli S., Iavicoli S., Dallari B., Pesatori A.C., Riboldi L., Merletti F., Gangemi M., Stura A., Brentisci C., Gilardetti M., Benfatto L., Canessa P.A., Malacarne D., Mazzucco G., Campi M.G., Fedeli U., Bressan V., Gioffre F., Ballarin M.N., Chermaz C., D'agostin F., De Michieli P., Mangone L., Storchi C., Sala O., Badiali A.M., Cacciarini V., Giovannetti L., Martini A., Calisti R., Pascucci C., Stracci F., Masanotti G., Davoli M., Cavariani F., Ancona L., Annunziata A., Menegozzo S., Napolitano F., Pelullo C.P., Vimercati L., Cascone G., Frasca G., Giurdanella M.C., Martorana C., Nicita C., Rollo C.P., Spata E., Dardanoni G., Scondotto S., Nieddu V., Pergola M., Stecchi S., Marinaccio, Alessandro, Consonni, Dario, Mensi, Carolina, Mirabelli, Dario, Migliore, Enrica, Magnani, Corrado, Di Marzio, Davide, Gennaro, Valerio, Mazzoleni, Guido, Girardi, Paolo, Negro, Corrado, Romanelli, Antonio, Chellini, Elisabetta, Grappasonni, Iolanda, Madeo, Gabriella, Romeo, Elisa, Ascoli, Valeria, Carrozza, Francesco, Angelillo, Italo Francesco, Cavone, Domenica, Tumino, Rosario, Melis, Massimo, Curti, Stefania, Brandi, Giovanni, Mattioli, Stefano, and Iavicoli, Sergio

Subjects
medicine.medical_specialty, pericardial and tunica vaginalis testis, Epidemiology, Population, rare disease, national registry, medicine.disease_cause, Epidemiology, Italy, National registry, Rare disease, Asbestos, epidemiology, Italy, national registry, rare disease, NO, 03 medical and health sciences, 0302 clinical medicine, italy, medicine, epidemiology, Italy, Mesothelioma, education, Gynecology, education.field_of_study, business.industry, Public Health, Environmental and Occupational Health, Tunica vaginalis testis, Case-control study, case–control study, Odds ratio, medicine.disease, asbestos, 030210 environmental & occupational health, National registry, exposure, mesothelioma, malignant mesothelioma, Original Article, Public aspects of medicine, RA1-1270, business, Rare disease
Abstract

Objectives: The purposes of this study are to describe the epidemiology of pericardial and tunica vaginalis testis mesothelioma and assess the role of asbestos exposure for these rare diseases. Methods: Based on incident pericardial and tunica vaginalis testis mesothelioma cases collected from the Italian national mesothelioma registry (ReNaM) in the period 1993–2015, incidence rates, survival median period and prognostic factors have been evaluated. A case–control study has been performed to analyze the association with asbestos exposure (occupational and non-occupational) for these diseases. Results: Between 1993 and 2015, 58 pericardial (20 women and 38 men) and 80 tunica vaginalis testis mesothelioma cases have been registered with a mean annual standardized (world standard population as reference) incidence rates of 0.049 (per million) in men and 0.023 in women for the pericardial site, and 0.095 for tunica vaginalis testis mesothelioma. Occupational exposure to asbestos was significantly associated with the risk of the diseases [odds ratio (OR) 3.68, 95% confidence interval (CI) 1.85–7.31 and OR 3.42, 95% CI 1.93–6.04 in pericardial and tunica vaginalis testis mesothelioma, respectively]. The median survival was 2.5 months for pericardial and 33.0 months for tunica vaginalis testis mesotheliomas. Age was the main predictive factor for survival for both anatomical sites. Conclusions: For the first time in an analytical study, asbestos exposure was associated with pericardial and tunica vaginalis testis mesothelioma risk, supporting the causal role of asbestos for all anatomical sites. The extreme rarity of the diseases, the poor survival and the prognostic role of age have been confirmed based on population and nationwide mesothelioma registry data.

Published
2020

3. Authors’ response: Mezei et al's 'comments on a recent case-control study of malignant mesothelioma of the pericardium and the tunica vaginalis testis'

Author

Marinaccio A., Consonni D., Mensi C., Mirabelli D., Migliore E., Magnani C., Di Marzio D., Gennaro V., Mazzoleni G., Girardi P., Negro C., Romanelli A., Chellini E., Grappasonni I., Madeo G., Romeo E., Ascoli V., Carrozza F., Angelillo I. F., Cavone D., Tumino R., Melis M., Curti S., Brandi G., Mattioli S., Iavicoli S., Marinaccio, A., Consonni, D., Mensi, C., Mirabelli, D., Migliore, E., Magnani, C., Di Marzio, D., Gennaro, V., Mazzoleni, G., Girardi, P., Negro, C., Romanelli, A., Chellini, E., Grappasonni, I., Madeo, G., Romeo, E., Ascoli, V., Carrozza, F., Angelillo, I. F., Cavone, D., Tumino, R., Melis, M., Curti, S., Brandi, G., Mattioli, S., Iavicoli, S., Marinaccio A., Consonni D., Mensi C., Mirabelli D., Migliore E., Magnani C., Di Marzio D., Gennaro V., Mazzoleni G., Girardi P., Negro C., Romanelli A., Chellini E., Grappasonni I., Madeo G., Romeo E., Ascoli V., Carrozza F., Angelillo I.F., Cavone D., Tumino R., Melis M., Curti S., Brandi G., Mattioli S., and Iavicoli S.

Subjects
Mesothelioma, Tunica vaginalis testis, Economica, Letter, pericardial and tunica vaginalis testis (TVT), Socio-culturale, Ambientale, mesothelioma, ReNaM, Key terms: asbestos, Key terms: asbesto, Pericardium, Malignant mesothelioma
Abstract

Mezei et al's letter (1) is an opportunity to provide more details about our study on pericardial and tunica vaginalis testis (TVT) mesothelioma (2), which is based on the Italian national mesothelioma registry (ReNaM): a surveillance system on mesothelioma, with individual asbestos exposure assessment. Incidence of pericardial mesothelioma has been estimated around 0.5 and 0.2 cases per 10 million person-years in men and women, respectively, and around 1 case for TVT mesothelioma. ReNaM collected 138 cases thanks to its long period of observation (1993-2015) and national coverage. Conducting a population-based case-control study with incidence-density sampling of controls across Italy and over a 23 year time-span should have been planned in 1993 and would have been beyond feasibility and ReNaM scope. We rather exploited two existing series of controls (3). The resulting incomplete time- and spatial matching of cases and controls is a limitation of our study and has been acknowledged in our article. The analysis of case-control studies can nevertheless be accomplished in logistic models accounting for the variables of interest, in both individually and frequency matched studies (4). Furthermore, analyses restricted to (i) regions with enrolled controls, (ii) cases with definite diagnosis, (iii) incidence period 2000-2015, and (iv) subjects born before 1950 have been provided in the manuscript, confirming the strength of the association with asbestos exposure (supplemental material tables S4-7). Following Mezei et al's suggestion, we performed further sensitivity analyses by restriction to regions with controls and fitting conditional regression models using risk-sets made of combinations of age and year of birth categories (5-year classes for both). We confirmed positive associations with occupational exposure to asbestos of pericardial mesothelioma, with odds ratios (OR) (adjusted for region) of 9.16 among women [95% confidence interval (CI) 0.56-150] and 5.63 (95% CI 1.02-31.0) among men; for TVT mesothelioma the OR was 7.70 (95% CI 2.89-20.5). Using risk sets of age categories and introducing year of birth (5-year categories) as a covariate (dummy variables) the OR were similar: OR (adjusted for region) of 9.17 among women (95% CI 0.56-150) and 5.76 (95% CI 1.07-31.0) among men; for TVT the OR was 9.86 (95% CI 3.46-28.1). Possible bias from incomplete geographical overlap between cases and controls has been addressed in the paper (table S4) and above. In spatially restricted analyses, OR were larger than in those including cases from the whole country, indicating that bias was towards the null. Mezei et al further noted that "the regional distribution of controls is different from that of person-time observed". This objection is not relevant because the above analyses were adjusted by region. Our controls were provided by a population-based study on pleural mesothelioma (called MISEM) and a hospital-based study on cholangiocarcinoma (called CARA). In MISEM, the response rate was 48.4%, a low but not unexpected rate as participation among population controls is usually lower and has been declining over time (5). It is important to underline that ReNaM applied the same questionnaire that was used for interviews and carried out the same exposure assessment as both MISEM and CARA. As repeatedly stated in ReNaM papers (6-7), each regional operating center assesses asbestos exposure based on the individual questionnaire, other available information, and knowledge of local industries. Occupational exposure to asbestos is classified as definite, probable or possible. Occupational exposure is (i) definite when the subject`s work was reported or otherwise known to have involved the use of asbestos or asbestos-containing materials (MCA); (ii) probable when subjects worked in factories where asbestos or MCA were used, but their personal exposure could not be documented; and (iii) possible when they were employed in industrial activities known to entail the use of asbestos or MCA. Hence, the definite and probable categories are closer to one another and were combined in our analyses. In any case, restricting analyses to subjects with definite occupational exposure and using each set of controls separately, as suggested by Mezei et al, yielded elevated OR for TVT and pericardial mesothelioma among men using both the above described modelling strategies; the OR could not be calculated for women. There were 70 (25 pericardial and 45 TVT) occupationally exposed mesothelioma cases. In population-based studies, analyses by occupation are limited by the low prevalence of most specific jobs. As briefly reported in our paper, for purely descriptive purposes, the industrial activity of exposure (cases may have multiple exposures), were construction (22 exposures, 7 and 15 for pericardial and TVT mesotheliomas, respectively), steel mills and other metal working industries (4 and 11), textile industries (2 and 3), and agriculture (2 and 5); other sectors had lower exposure frequencies. The absence of industries like asbestos-cement production, shipbuilding and railway carriages production/repair should not be surprising and had already been observed (7). In the Italian multicenter cohort study of asbestos workers (8), given the person-years of observation accrued by workers employed in these industries and gender- and site-specific crude incidence rates, approximately 0.1 case of pericardial and 0.2 of TVT mesothelioma would have been expected from 1970 to 2010. Even increasing ten-fold such figures to account for higher occupational risks among these workers would not change much. Asbestos exposure in agriculture has been repeatedly discussed in ReNaM reports (9: pages 70, 73, 128, 164 and 205). Exposure opportunities included the presence of asbestos in wine production, reuse of hessian bags previously containing asbestos, or construction and maintenance of rural buildings. Similarly, mesothelioma cases and agricultural workers exposed to asbestos have been noted in France (10). In conclusion, the additional analyses we performed according to Mezei et al's suggestions confirm the association between asbestos exposure and pericardial and TVT mesothelioma, supporting the causal role of asbestos for all mesotheliomas. ReNaM`s continuing surveillance system with national coverage is a precious platform for launching analytical studies on pleural and extra pleural mesothelioma. References 1. Mezei G, Chang ET, Mowat FS, Moolgavkar SH. Comments on a recent case-control study of malignant mesothelioma of the pericardium and the tunica vaginalis testis Scand J Work Environ Health. 2021;47(1):85-86. https://doi.org/10.5271/3909 2. Marinaccio A, Consonni D, Mensi C, Mirabelli D, Migliore E, Magnani C et al.; ReNaM Working Group. Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: a case-control study and epidemiological remarks. Scand J Work Environ Health. 2020;46(6):609-617. https://doi.org/10.5271/sjweh.3895. 3. Greenland S. Control-initiated case-control studies. Int J Epidemiol 1985 Mar;14(1):130-4. https://doi.org/10.1093/ije/14.1.130. 4. Pearce N. Analysis of matched case-control studies. BMJ 2016 Feb;352:i969. https://doi.org/10.1136/bmj.i969. 5. Bigert C, Gustavsson P, Straif K, Pesch B, Brüning T, Kendzia B et al. Lung cancer risk among cooks when accounting for tobacco smoking: a pooled analysis of case-control studies from Europe, Canada, New Zealand, and China. J Occup Environ Med 2015 Feb;57(2):202-9. https://doi.org/10.1097/JOM.0000000000000337. 6. Marinaccio A, Binazzi A, Marzio DD, Scarselli A, Verardo M, Mirabelli D et al.; ReNaM Working Group. Pleural malignant mesothelioma epidemic: incidence, modalities of asbestos exposure and occupations involved from the Italian National Register. Int J Cancer 2012 May;130(9):2146-54. https://doi.org/10.1002/ijc.26229. 7. Marinaccio A, Binazzi A, Di Marzio D, Scarselli A, Verardo M, Mirabelli D et al. Incidence of extrapleural malignant mesothelioma and asbestos exposure, from the Italian national register. Occup Environ Med 2010 Nov;67(11):760-5. https://doi.org/10.1136/oem.2009.051466. 8. Ferrante D, Chellini E, Merler E, Pavone V, Silvestri S, Miligi L et al.; the working group. Italian pool of asbestos workers cohorts: mortality trends of asbestos-related neoplasms after long time since first exposure. Occup Environ Med 2017 Dec;74(12):887-98. https://doi.org/10.1136/oemed-2016-104100. 9. ReNaM VI Report. Available from: https://www.inail.it/cs/internet/docs/alg-pubbl-registro-nazionale-mesoteliomi-6-rapporto.pdf. Italian 10. Marant Micallef C, Shield KD, Vignat J, Baldi I, Charbotel B, Fervers B et al. Cancers in France in 2015 attributable to occupational exposures. Int J Hyg Environ Health 2019 Jan;222(1):22-9. https://doi.org/10.1016/j.ijheh.2018.07.015.

Published
2021

7. Wireless Shelf Life Monitoring and Real Time Prediction in a Supply-Chain of Perishables Goods

Author

Annese, V.F., Cipriani, S., Biccario, G., Di Marzio, D., De Venuto, D., Elattar, Ehab E., and Tsai, Sang-Bing

Abstract

This paper discusses the huge potential of a Wireless Sensor Network (WSN) as a tool for real-time monitoring in a perishable goods supply chain according to the pressing need of security and food certification. The combination of an appropriate monitoring system and further data processing create a tool that can provide the most useful information for each application. In this paper we propose a case study.

Published
2015

8. [Epidemiologic surveillance of mesothelioma for the prevention of asbestos exposure also in non-traditional settings]

Author

Binazzi, A., Scarselli, A., Corfiati, M., Di Marzio, D., Branchi, C., Verardo, M., Mirabelli, D., Gennaro, V., Mensi, C., Schallenberg, G., Merler, E., De Zotti, R., Romanelli, A., Chellini, E., Pascucci, C., D'Alo, D., Forastiere, F., Trafficante, L., Menegozzo, S., Musti, M., Cauzillo, G., Leotta, A., Tumino, R., Melis, M., Marinaccio, A., Gruppo Di, Lavoro Renam Detragiache E., Merletti, F., Gangemi, M., Stura, A., Brentisci, C., Diglio, Cammarieri G., Macerata, V., Gilardetti, M., Benfatto, L., Bianchelli, M., Mazzucco, G., Sieno, C., Pesatori, A., Riboldi, L., Gioffre, F., Bressan, V., De Michieli, P., Chermaz, C., Negro, C., Mangone, L., Storchi, C., Silvestri, S., Badiali, A., Cacciarini, V., Giovannetti, L., Martini, A., Calisti, R., La Rosa, F., Stracci, F., Cavariani, F., Ascoli, Valeria, Romeo, E., Sangalli, M., Gatta, S., Izzo, F., Canfora, M., Santoro, M., Viscardi, F., Cavone, D., Massaro, T., Convertini, L., Giovanni, L., Nicita, C., Nieddu, V., Pergola, M., Stecchi, S., Dardanoni, G., and Scondotto, S.

Subjects
Male, Mesothelioma, Lung Neoplasms, asbestos, epidemiologic surveillance, prevention, mesothelioma, Pleural Neoplasms, Mesothelioma, Malignant, Asbestos, Middle Aged, Occupational Diseases, Italy, Occupational Exposure, Population Surveillance, Epidemiological Monitoring, Humans, Female, Registries
Abstract

To show how malignant mesothelioma (MM) surveillance not only identifies settings of exposure representing past industrial history, but it may also detect conditions of current exposure relevant for the prevention, if the wide spectrum of asbestos uses is considered.Active search of MM cases and exposure assessment at individual level through a questionnaire; identification of exposure circumstances relevant for prevention.Italy, all the Regions where a Regional Operating Centre (COR) is established to identify all MM cases diagnosed in the population and analyze their occupational, residential, household and environmental histories. Period of diagnosis: 1993-2008.Descriptive analysis of MM cases and of asbestos exposures.ReNaM includes 15,845 cases of MM diagnosed between 1993 and 2008.The male/female ratio is 2.5. Mean age at diagnosis is 69 years. Pleural MMs represent 93% of all cases. Exposures have been investigated in 12,065 cases (76%). The median latency time is 46 years. In addition to clusters of MM cases in activities well known to entail asbestos use, different current exposure circumstances requiring intervention have been evidenced.On the basis of this experience, epidemiological surveillance of all occupational cancers should be implemented to foster synergies with the compensation system and the Local Health Authorities' occupational safety and health services, as required by the Italian Legislative Decree N. 81/2008.

Published
2013

9. Platelet gel: assays of three growth factors

Author

Rughetti, A., Gallo, R., Caloprisco, G., Boretan, A., Necozione, S., Dellorso, L., Leocata, Pietro, Pivellini, C., DI MARZIO, D., DI NATALE, D., Lepore, L., Lupo, A., and Alesse, E.

Published
2006

10. Platelet gel: assay of three growth factors

Author

Rughetti, A, Gallo, R, Caloprisco, G, Borean, A, Necozione, Stefano, Dell'Orso, L. L., Leocata, Pietro, Rivellini, C, Di Marzio, D, Di Natale, D, Lepore, L, Lupo, A, and Alesse, Edoardo

Published
2006

17. Incidence of extrapleural malignant mesothelioma and asbestos exposure, from the Italian national register

Author

Marinaccio, A., primary, Binazzi, A., additional, Di Marzio, D., additional, Scarselli, A., additional, Verardo, M., additional, Mirabelli, D., additional, Gennaro, V., additional, Mensi, C., additional, Merler, E., additional, De Zotti, R., additional, Mangone, L., additional, Chellini, E., additional, Pascucci, C., additional, Ascoli, V., additional, Menegozzo, S., additional, Cavone, D., additional, Cauzillo, G., additional, Nicita, C., additional, Melis, M., additional, and Iavicoli, S., additional

Published
2010
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21. Spectral nondestructive evaluation—SNDE.

Author

Di Marzio, D., McLaughlin, J. S., Chu, S., Fonneland, N., and Weir, J.

Subjects
*SPECTRAL reflectance, *PAINT
Abstract

Programmed paint stripping and repainting for commercial and military aircraft inspection consumes a large amount time and money and generates considerable amounts of toxic waste. A technique is required that detects surface cracks and corrosion of metallic aerostructures while leaving the paint coating intact. We have investigated the use of infrared spectral reflectance techniques for seeing through paint coatings to the underlying substrate. Many commercial and milspec primers and topcoats exhibit an optically transparent window in the mid-IR range which permits the extraction of spectral reflectance signatures from as well as allowing imaging of the substrate. Both diffuse reflectance and multispectral IR focal plane imaging is used to successfully detect corrosion and surface morphology of painted metal surfaces. © 2001 American Institute of Physics. [ABSTRACT FROM AUTHOR]

Published
2001

22. Estimating number of workers potentially at risk of exposure to hardwood dust in certain industrial sectors in Italy using a national register.

Author

SCARSELLI, A. and DI MARZIO, D.

Subjects
HARDWOODS, CARCINOGENS, FURNITURE, EPIDEMIOLOGY, INDUSTRIAL safety
Abstract

Copyright of La Medicina del Lavoro is the property of Mattioli 1885 SpA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2014

37. Epidemiologic surveillance of mesothelioma for the prevention of asbestos exposure also in non-traditional settings,Sorveglianza epidemiologica dei mesoteliomi per la prevenzione dell'esposizione ad amianto anche in attività non tradizionalmente coinvolte

Author

Binazzi, A., Scarselli, A., Corfiati, M., Di Marzio, D., Branchi, C., Verardo, M., Mirabelli, D., Gennaro, V., Mensi, C., Schallenberg, G., Merler, E., Zotti, R., Romanelli, A., Chellini, E., Pascucci, C., D Alò, D., Francesco Forastiere, Trafficante, L., Menegozzo, S., Musti, M., Cauzillo, G., Leotta, A., Tumino, R., Melis, M., and Marinaccio, A.

42. Asbestos Exposure and Malignant Mesothelioma in Construction Workers—Epidemiological Remarks by the Italian National Mesothelioma Registry (ReNaM)

Author

Alessandra Binazzi, Davide Di Marzio, Marina Verardo, Enrica Migliore, Lucia Benfatto, Davide Malacarne, Carolina Mensi, Dario Consonni, Silvia Eccher, Guido Mazzoleni, Vera Comiati, Corrado Negro, Antonio Romanelli, Elisabetta Chellini, Alessia Angelini, Iolanda Grappasonni, Gabriella Madeo, Elisa Romeo, Annamaria Di Giammarco, Francesco Carrozza, Italo F. Angelillo, Domenica Cavone, Luigi Vimercati, Michele Labianca, Federico Tallarigo, Rosario Tumino, Massimo Melis, Michela Bonafede, Alberto Scarselli, Alessandro Marinaccio, on behalf of the ReNaM Working Group, Binazzi, A., Di Marzio, D., Verardo, M., Migliore, E., Benfatto, L., Malacarne, D., Mensi, C., Consonni, D., Eccher, S., Mazzoleni, G., Comiati, V., Negro, C., Romanelli, A., Chellini, E., Angelini, A., Grappasonni, I., Madeo, G., Romeo, E., Di Giammarco, A., Carrozza, F., Angelillo, I. F., Cavone, D., Vimercati, L., Labianca, M., Tallarigo, F., Tumino, R., Melis, M., Bonafede, M., Scarselli, A., and Marinaccio, A.

Subjects
Mesothelioma, Registrie, Malignant, national mesothelioma registry, Health, Toxicology and Mutagenesis, Mesothelioma, Malignant, mesothelioma, asbestos, construction workers, Italy, Construction Industry, Public Health, Environmental and Occupational Health, Asbesto, Asbestos, Construction workers, National mesothelioma registry, Humans, Registries, Occupational Exposure, Article, Medicine, Construction worker, Human
Abstract

Notwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993–98 period to 23.9% in 2014–2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector.

Published
2022

43. Predictors of filing claims and receiving compensation in malignant mesothelioma patients

Author

Domenica Cavone, Gert Schallemberg, Elisa Romeo, Francesco Carrozza, Ugo Fedeli, Italo F. Angelillo, Gabriella Cauzillo, Valerio Gennaro, Corrado Negro, Federico Tallarigo, Enrica Migliore, Luana Trafficante, Alessandro Marinaccio, Claudio Gariazzo, Antonio Romanelli, Iolanda Grappasonni, Gabriella Madeo, Carolina Mensi, Davide Di Marzio, Elisabetta Chellini, Guido Mazzoleni, Sergio Iavicoli, Rosario Tumino, Marina Verardo, Massimo Melis, Marinaccio, A., Gariazzo, C., Di Marzio, D., Iavicoli, S., Verardo, M., Migliore, E., Gennaro, V., Mensi, C., Mazzoleni, G., Schallemberg, G., Fedeli, U., Negro, C., Romanelli, A., Chellini, E., Grappasonni, I., Madeo, G., Romeo, E., Trafficante, L., Carrozza, F., Angelillo, I. F., Cavone, D., Cauzillo, G., Tallarigo, F., Tumino, R., and Melis, M.

Subjects
Mesothelioma, medicine.medical_specialty, media_common.quotation_subject, Asbesto, Logistic regression, medicine.disease_cause, Occupational safety and health, Asbestos, 03 medical and health sciences, 0302 clinical medicine, Occupational Exposure, medicine, Humans, 030212 general & internal medicine, media_common, National Insurance, Insurance system, business.industry, 030503 health policy & services, Health Policy, Public health, Filing, Mesothelioma, Malignant, medicine.disease, Italy, Occupational diseases, Relative risk, Family medicine, 0305 other medical science, business, Welfare
Abstract

Although the predominant occupation origin of mesothelioma is well known, determinant factors involved in filing compensation are scarcely investigated. A linkage between incident mesothelioma cases collected by Italian mesothelioma register (ReNaM) and compensation claims and assignment by Italian national insurance Institute (INAIL) has been conducted for cases diagnosed in the period 2010-2015 and occupational exposure to asbestos. Logistic regression models and decision tree models have been used to identify demographic, diagnostic and anamnestic factors significant for filing and receiving compensation. We have included in the analyses 5019 mesothelioma cases, and among them, 3321 (66.2 %) were found in INAIL archives as mesothelioma cases who fil claims for compensation. The modalities of asbestos exposure, sector of working activities and job type are crucial factors. Furthermore, gender, age at diagnosis, area of residence have been found to be significant predictors of probability to fil claims. Relative risks to fil claims were obtained for the above determinants and conditions to maximize the probability to obtain compensation identified. Our findings demonstrate that there is a need to enforce policies for improving awareness of the occupational origin for mesothelioma cases. Stakeholders, occupational health and safety institutions can play an important role for improving the sensitization regarding the rights of compensation benefits, ensuring the equity and the effectiveness of insurance, welfare and public health systems.

Published
2020
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44. The epidemiological surveillance of malignant mesothelioma in Italy (1993-2015): methods, findings, and research perspectives

Author

Alessandro, Marinaccio, Marisa, Corfiati, Alessandra, Binazzi, Davide, Di Marzio, Michela, Bonafede, Marina, Verardo, Enrica, Migliore, Valerio, Gennaro, Carolina, Mensi, Gert, Schallemberg, Guido, Mazzoleni, Ugo, Fedeli, Corrado, Negro, Antonio, Romanelli, Elisabetta, Chellini, Iolanda, Grappasonni, Cristiana, Pascucci, Gabriella, Madeo, Elisa, Romeo, Luana, Trafficante, Francesco, Carrozza, Italo Francesco, Angelillo, Domenica, Cavone, Gabriella, Cauzillo, Federico, Tallarigo, Rosario, Tumino, Massimo, Melis, Sergio, Stecchi, Marinaccio, A., Corfiati, M., Binazzi, A., Di Marzio, D., Bonafede, M., Verardo, M., Migliore, E., Gennaro, V., Mensi, C., Schallemberg, G., Mazzoleni, G., Fedeli, U., Negro, C., Romanelli, A., Chellini, E., Grappasonni, I., Pascucci, C., Madeo, G., Romeo, E., Trafficante, L., Carrozza, F., Angelillo, I. F., Cavone, D., Cauzillo, G., Tallarigo, F., Tumino, R., and Melis, M.

Subjects
Mesothelioma, Adult, Male, Malignant, Incidence, Mesothelioma, Malignant, Asbestos, Asbesto, Middle Aged, Occupational Disease, Occupational Diseases, asbesto, Epidemiological surveillance system, Italy, Female, Humans, Occupational Exposure, Population Surveillance, Registries, epidemiological surveillance system, mesothelioma, Human
Abstract

BACKGROUND: As a legacy of the large asbestos consumption until the definitive ban in 1992, Italy had to tackle a real epidemic of asbestos related diseases. The Italian National Registry of Malignant Mesotheliomas (ReNaM) is a permanent surveillance system of mesothelioma incidence, with a regional structure. Aims, assignments and territorial network of ReNaM are described, as well as data collection, recording and coding procedures. OBJECTIVES: To describe the Italian epidemiological surveillance system of mesothelioma incidence, to provide updated data about occurrence of malignant mesothelioma in Italy, and to discuss goals, attainments, and expectations of registering occupational cancer. DESIGN: Analysis of data by malignant mesothelioma incident cases surveillance system. SETTING AND PARTICIPANTS: Italy, network of regional sur-veillance system, all Italian regions. MAIN OUTCOME MEASURES: A Regional Operating Centre (COR) is currently established in all the Italian regions, actively searching incident malignant mesothelioma cases from health care institutions. Occupational history, lifestyle habits, and residential history are obtained using a standardized questionnaire, administered to the subject or to the next of kin by a trained interviewer. The extent of dataset, epide-miological parameters, and occupations involved are reported updated at 31.12.2016, and standardized incidence rates are calculated. RESULTS: At December 2016, ReNaM has collected 27,356 malignant mesothelioma cases, referring to the period of incidence between 1993 and 2015. The modalities of exposure to asbestos have been investigated for 21,387 (78%) and an occupational exposure has been defined for around 70% of defined cases (14,818). CONCLUSIONS: The Italian experience shows that epidemiological systematic surveillance of asbestos related diseases incidence has a key importance for assessing and monitoring the public health impact of occupational and/or environmental hazards, programming preventive interventions, including remediation plans and information campaigns, and supporting the efficiency of insurance and welfare system. Monitor-ing the incidence of malignant mesothelioma through a specialized cancer registry is essential to follow-up the health effects of changing modalities and extent of occupational exposures over years and of environmental contamination. Such consolidated surveillance system is recommended also for occupational cancers with low aetiological fraction.

Published
2020

45. The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure

Author

Marinaccio, Alessandro, Corfiati, Marisa, Binazzi, Alessandra, Di Marzio, Davide, Scarselli, Alberto, Ferrante, Pierpaolo, Bonafede, Michela, Verardo, Marina, Mirabelli, Dario, Gennaro, Valerio, Mensi, Carolina, Schallemberg, Gert, Mazzoleni, Guido, Merler, Enzo, Girardi, Paolo, Negro, Corrado, D'Agostin, Flavia, Romanelli, Antonio, Chellini, Elisabetta, Silvestri, Stefano, Pascucci, Cristiana, Calisti, Roberto, Stracci, Fabrizio, Romeo, Elisa, Ascoli, Valeria, Trafficante, Luana, Carrozza, Francesco, Angelillo, Italo Francesco, Cavone, Domenica, Cauzillo, Gabriella, Tallarigo, Federico, Tumino, Rosario, Melis, Massimo, Iavicoli, Sergio, Detragiache, E, Merletti, F, Gangemi, M, Stura, A, Brentisci, C, Diglio, Gc, Macerata, V, Gilardetti, M, Lazzarotto, A, Benfatto, L, Bianchelli, M, Mazzucco, G, Campi, M, Malacarne, D, Camposeragno, D, Giorgio, Fd, Canessa, P, Consonni, D, Pesatori, A, Riboldi, L, Bressan, V, Gioffrè, F, Ballarinl, M, Chermaz, C, Michieli, P, Mangone, L, Storchi, C, Sala, O, Badiali, A, Cacciarini, V, Giovannetti, L, Martini, A, Grappasonni, I, Masanotti, G, D'Alo', D, Petrucci, M, Davoli, M, Forastiere, F, Cavariani, F, Ancona, L, Giammarco, Ad, Menegozzo, S, Canfora, M, Santoro, M, Viscardi, F, Brangi, A, Cozza, V, Vimercati, L, Lio, S, Cascone, G, Frasca, G, Giurdanella, M, Martorana, C, Nicita, C, Rollo, P, Spata, E, Dardanoni, G, Scondotto, S, Nieddu, V, Pergola, M, Stecchi, S., Marinaccio, A, Corfiati, M, Binazzi, A, Di Marzio, D, Scarselli, A, Ferrante, P, Bonafede, M, Verardo, M, Mirabelli, D, Gennaro, V, Mensi, C, Schallemberg, G, Mazzoleni, G, Merler, E, Girardi, P, Negro, C, D'Agostin, F, Romanelli, A, Chellini, E, Silvestri, S, Pascucci, C, Calisti, R, Stracci, F, Romeo, E, Ascoli, V, Trafficante, L, Carrozza, F, Angelillo, If, Cavone, D, Cauzillo, G, Tallarigo, F, Tumino, R, Melis, M, Iavicoli, S., Marinaccio, Alessandro, Corfiati, Marisa, Binazzi, Alessandra, Di Marzio, Davide, Scarselli, Alberto, Ferrante, Pierpaolo, Bonafede, Michela, Verardo, Marina, Mirabelli, Dario, Gennaro, Valerio, Mensi, Carolina, Schallemberg, Gert, Mazzoleni, Guido, Merler, Enzo, Girardi, Paolo, Negro, Corrado, D'Agostin, Flavia, Romanelli, Antonio, Chellini, Elisabetta, Silvestri, Stefano, Pascucci, Cristiana, Calisti, Roberto, Stracci, Fabrizio, Romeo, Elisa, Ascoli, Valeria, Trafficante, Luana, Carrozza, Francesco, Angelillo, Italo Francesco, Cavone, Domenica, Cauzillo, Gabriella, Tallarigo, Federico, Tumino, Rosario, Melis, Massimo, and Iavicoli, Sergio

Subjects
medicine.medical_specialty, asbestos, gender, mesothelioma, asbestos, gender, mesothelioma, medicine.disease_cause, Asbestos, asbesto, 03 medical and health sciences, 0302 clinical medicine, Epidemiology, Medicine, 030212 general & internal medicine, Mesothelioma, Workplace, Modalities, business.industry, Incidence (epidemiology), Mortality rate, Environmental and Occupational Health, Public Health, Environmental and Occupational Health, medicine.disease, 030220 oncology & carcinogenesis, Workforce, Etiology, Public Health, Settore SECS-S/01 - Statistica, business, Demography
Abstract

IntroductionThe epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register.MethodsIncident malignant mesothelioma (MM) cases in the period 1993 to 2012 were retrieved from ReNaM. Gender ratio by age class, period of diagnosis, diagnostic certainty, morphology and modalities of asbestos exposure has been analysed using exact tests for proportion. Economic activity sectors, jobs and territorial distribution of mesothelioma cases in women have been described and discussed. To perform international comparative analyses, the gender ratio of mesothelioma deaths was calculated by country from the WHO database and the correlation with the mortality rates estimated.ResultsIn the period of study a case list of 21 463 MMs has been registered and the modalities of asbestos exposure have been investigated for 16 458 (76.7%) of them. The gender ratio (F/M) was 0.38 and 0.70 (0.14 and 0.30 for occupationally exposed subjects only) for pleural and peritoneal cases respectively. Occupational exposures for female MM cases occurred in the chemical and plastic industry, and mainly in the non-asbestos textile sector. Gender ratio proved to be inversely correlated with mortality rate among countries.ConclusionsThe consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies.

Published
2018

46. Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues

Author

Marinaccio, Alessandro, Binazzi, Alessandra, Bonafede, Michela, Corfiati, Marisa, Marzio, Davide Di, Scarselli, Alberto, Verardo, Marina, Mirabelli, Dario, Gennaro, Valerio, Mensi, Carolina, Schallemberg, Gert, Merler, Enzo, Negro, Corrado, Romanelli, Antonio, Chellini, Elisabetta, Silvestri, Stefano, Cocchioni, Mario, Pascucci, Cristiana, Stracci, Fabrizio, Ascoli, Valeria, Trafficante, Luana, Angelillo, Italo, Musti, Marina, Cavone, Domenica, Cauzillo, Gabriella, Tallarigo, Federico, Tumino, Rosario, Melis, Massimo, ReNaM Working Group, Marinaccio, Alessandro, Binazzi, Alessandra, Bonafede, Michela, Corfiati, Marisa, Di Marzio, Davide, Scarselli, Alberto, Verardo, Marina, Mirabelli, Dario, Gennaro, Valerio, Mensi, Carolina, Schallemberg, Gert, Merler, Enzo, Negro, Corrado, Romanelli, Antonio, Chellini, Elisabetta, Silvestri, Stefano, Cocchioni, Mario, Pascucci, Cristiana, Stracci, Fabrizio, Ascoli, Valeria, Trafficante, Luana, Angelillo, Italo, Musti, Marina, Cavone, Domenica, Cauzillo, Gabriella, Tallarigo, Federico, Tumino, Rosario, Melis, Massimo, Marinaccio, A, Binazzi, A, Bonafede, M, Corfiati, M, Di Marzio, D, Scarselli, A, Verardo, M, Mirabelli, D, Gennaro, V, Mensi, C, Schallemberg, G, Merler, E, Negro, C, Romanelli, A, Chellini, E, Silvestri, S, Cocchioni, M, Pascucci, C, Stracci, F, Ascoli, V, Trafficante, L, Angelillo, Italo Francesco, Musti, M, Cavone, D, Cauzillo, G, Tallarigo, F, Tumino, R, Melis, M, and ReNaM Working, Group

Subjects
Male, Mesothelioma, Pathology, Lung Neoplasms, Non occupational, environmental exposure, Malignant Mesothelioma, medicine.disease_cause, Epidemiology, Medicine, Child, new-caledonia, risk, Aged, 80 and over, Incidence (epidemiology), Incidence, Environmental exposure, cohort, Middle Aged, tremolite, Italy, Child, Preschool, Population Surveillance, national surveillance, Environmental Pollutants, Female, Public Health, western-australia, Adult, medicine.medical_specialty, Adolescent, Pleural Neoplasms, Asbestos, Young Adult, Sex Factors, Environmental health, Occupational Exposure, Humans, Aged, business.industry, Pleural mesothelioma, Public health, Mesothelioma, Malignant, Public Health, Environmental and Occupational Health, Infant, Newborn, Infant, Malignant Mesothelioma, asbestos, national surveillance, medicine.disease, mortality, pleural mesothelioma, workers, wittenoom, business
Abstract

Introduction Italy produced and imported a large amount of raw asbestos, up to the ban in 1992, with a peak in the period between 1976 and 1980 at about 160 000 tons/year. The National Register of Mesotheliomas (ReNaM, “Registro Nazionale dei Mesoteliomi” in Italian), a surveillance system of mesothelioma incidence, has been active since 2002, operating through a regional structure. Methods The Operating Regional Center (COR) actively researches cases and defines asbestos exposure on the basis of national guidelines. Diagnostic, demographic and exposure characteristics of non-occupationally exposed cases are analysed and described with respect to occupationally exposed cases. Results Standardised incidence rates for pleural mesothelioma in 2008 were 3.84 (per 100 000) for men and 1.45 for women, respectively. Among the 15 845 mesothelioma cases registered between 1993 and 2008, exposure to asbestos fibres was investigated for 12 065 individuals (76.1%), identifying 530 (4.4%) with familial exposure (they lived with an occupationally exposed cohabitant), 514 (4.3%) with environmental exposure to asbestos (they lived near sources of asbestos pollution and were never occupationally exposed) and 188 (1.6%) exposed through hobby-related or other leisure activities. Clusters of cases due to environmental exposure are mainly related to the presence of asbestos-cement industry plants (Casale Monferrato, Broni, Bari), to shipbuilding and repair activities (Monfalcone, Trieste, La Spezia, Genova) and soil contamination (Biancavilla in Sicily). Conclusions Asbestos pollution outside the workplace contributes significantly to the burden of asbestos-related diseases, suggesting the need to prevent exposures and to discuss how to deal with compensation rights for malignant mesothelioma cases induced by non-occupational exposure to asbestos.

Published
2015

47. Occupational carcinogens in Italy: an overview on exposure to cadmium and its compounds.

Author

Scarselli A, Corfiati M, DI Marzio D, and Marinaccio A

Subjects
Italy epidemiology, Humans, Male, Female, Industry, Cadmium Compounds analysis, Occupational Exposure analysis, Carcinogens analysis, Cadmium analysis, Cadmium toxicity
Abstract

Given the recognized carcinogenicity of cadmium, several regulatory interventions have been carried out over the years to protect exposed workers. The aim of the study is to investigate the prevalence and extent of exposure to cadmium among Italian workers. Data was collected from a nation-wide occupational exposure registry (SIREP, 1996-2022). Gender-specific statistical analysis was carried out for some exposure-related variables (cadmium compound, activity sector, occupational group, firm size). Potentially exposed workers were estimated for some industrial sectors. Concurrent exposures were investigated using cluster analysis. Overall 4,264 measurements were analyzed. Four industrial sectors were found to be most involved by cadmium exposure: base metal manufacturing, fabricated metal products, machinery and equipment, and other transport equipment (55% of measurements). Jewellery/precious-metal workers, and glass/ceramic plant operators were found to be most at exposure risk. A total of 26,470 workers potentially exposed was estimated (69% men). Concurrent exposures to other occupational carcinogens were detected quite frequently (52% of workers). Several situations of exposure and co-exposure to cadmium deserve attention and awareness in order to minimize the risks associated with workers' health. Recognition of potentially hazardous exposure conditions is an important step in prevention strategies to better protect workers against cancer-causing agents.

Published
2024
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48. Gender Differences in Sinonasal Cancer Incidence: Data from the Italian Registry.

Author

Binazzi A, di Marzio D, Mensi C, Consonni D, Miligi L, Piro S, Zajacovà J, Sorasio D, Galli P, Camagni A, Calisti R, Massacesi S, Cozzi I, Balestri A, Murano S, Fedeli U, Comiati V, Eccher S, Lattanzio S, Marinaccio A, and ReNaTuNS Working Group

Abstract

Background: Although rare, sinonasal cancers (SNCs) have a high occupational attributable fraction., Methods: We applied gender-based approaches to descriptive analyses, incidence, and patterns of exposures using the Italian National Sinonasal Cancer Registry (ReNaTuNS: Registro Nazionale Tumori Naso-Sinusali)., Results: The study included 2851 SNC patients. SNC was diagnosed more often in men (73%) than in women (27%). The most frequent morphology in men was intestinal-type adenocarcinoma (33%), whereas in women, it was squamous cell carcinoma (49%). Nasal cavities were predominant in both genders (50%), ethmoidal sinus in men (24%), and maxillary in women (24%). Incidence rates were 0.76 (per 100,000 person-years) in men and 0.24 in women and increased by age, more evidently in men, peaking over 75 years in both. Occupational exposures to wood and leather dusts were the most frequent (41% for men, 33% for women). Few exposures were extra-occupational or domestic. Unlikely exposure was relevant in women (57%)., Conclusions: The surveillance of SNC cases through a registry that allows for the identification of and compensation for this occupational disease is important in Italy, where numerous workers are exposed to carcinogens for SNC, without even being aware. Considering the rarity of the disease, particularly among women, the ReNaTuNS can provide a method to analyze gender differences.

Published
2024
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49. Incidence of mesothelioma in young people and causal exposure to asbestos in the Italian national mesothelioma registry (ReNaM).

Author

Marinaccio A, Di Marzio D, Mensi C, Consonni D, Gioscia C, Migliore E, Genova C, Rossetto Giaccherino R, Eccher S, Murano S, Comiati V, Casotto V, Negro C, Mangone L, Miligi L, Piro S, Angelini A, Grappasonni I, Madeo G, Cozzi I, Ancona L, Staniscia T, Carrozza F, Cavone D, Vimercati L, Labianca M, Tallarigo F, Cascone G, Melis M, Bonafede M, Scarselli A, and Binazzi A

Subjects
Humans, Adolescent, Middle Aged, Incidence, Italy epidemiology, Registries, Mesothelioma, Malignant complications, Mesothelioma epidemiology, Mesothelioma etiology, Asbestos adverse effects, Occupational Exposure adverse effects, Pleural Neoplasms epidemiology, Pleural Neoplasms etiology
Abstract

Introduction: The epidemiological surveillance of mesothelioma incidence is a crucial key for investigating the occupational and environmental sources of asbestos exposure. The median age at diagnosis is generally high, according to the long latency of the disease. The purposes of this study are to analyse the incidence of mesothelioma in young people and to evaluate the modalities of asbestos exposure., Methods: Incident malignant mesothelioma (MM) cases in the period 1993-2018 were retrieved from Italian national mesothelioma registry and analysed for gender, incidence period, morphology and exposure. Age-standardised rates have been calculated and the multiple correspondence analysis has been performed. The association between age and asbestos exposure has been tested by χ 2 test., Results: From 1993 to 2018, 30 828 incident MM cases have been collected and 1278 (4.1%) presented diagnosis at early age (≤50 years). There is a substantial association between age at diagnosis and the type of asbestos exposure and a significantly lower frequency of cases with occupational exposure to asbestos (497 cases vs 701 expected) in young people has been documented. Paraoccupational and environmental exposure to asbestos have been found more frequent in young MM cases (85 and 93 observed cases vs 52 and 44 expected cases, respectively)., Conclusions: Mesothelioma incidence surveillance at population level and the anamnestic individual research of asbestos exposure is a fundamental tool for monitoring asbestos exposure health effects, supporting the exposure risks prevention policies. Clusters of mesothelioma incident cases in young people are a significant signal of a potential non-occupational exposure to asbestos., Competing Interests: Competing interests: CM and DCo reported that they have served as expert witnesses in court trials on asbestos-related diseases., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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50. Mesothelioma Risk Among Maritime Workers According to Job Title: Data From the Italian Mesothelioma Register (ReNaM).

Author

Vimercati L, Cavone D, Negrisolo O, Pentimone F, De Maria L, Caputi A, Sponselli S, Delvecchio G, Cafaro F, Chellini E, Binazzi A, Di Marzio D, Mensi C, Consonni D, Migliore E, Brentisci C, Martini A, Negro C, D'Agostin F, Grappasonni I, Pascucci C, Benfatto L, Malacarne D, Casotto V, Comiati V, Storchi C, Mangone L, Murano S, Rossin L, Tallarigo F, Vitale F, Verardo M, Eccher S, Madeo G, Staniscia T, Carrozza F, Cozzi I, Romeo E, Pelullo P, Labianca M, Melis M, Cascone G, Ferri GM, and Serio G

Subjects
Male, Humans, Italy epidemiology, Mesothelioma, Malignant, Mesothelioma epidemiology, Mesothelioma etiology, Military Personnel, Asbestos adverse effects
Abstract

The study describes the 466 cases of malignant mesotheliomas (MM) collected by the National Mesothelioma Register (ReNaM) in Italy in the period 1993-2018 relating to subjects with exclusive asbestos exposure in merchant or military navy. The cases among maritime workers represent 1.8% of the total cases with defined exposure registred in the ReNaM, of which 212 cases (45.4%) among merchant maritime workers and 254 cases (54.5%) among navy. The distribution by site of mesothelioma showed 453 (97.2%) MM cases of the pleura, 11 (2.3%) of the peritoneum and 2 (0.4%) of the tunica vaginalis of the testis. With regard to occupational exposure, it was classified as certain in 318 (68.2%) cases, probable in 69 (14.8%) cases and possible in 79 (16.9%) cases. Among the 23 classified jobs, the highest percentages of certain exposures are among naval engineers, motor mechanics, machine captains and sailors. Machine crew accounted for 49.3% of the cases, deck crew for 27.6%. All cases began exposure on board between 1926 and 1988. Seamen were exposed to asbestos while at sea by virtue of living onboard ships and from continual release of asbestos fibers due to the motion of a vessel. Epidemiological surveillance through the ReNaM has allowed us to verify among cases in the maritime, navy and merchant marine sectors, that in the past, subjects were exposed regardless of the ship's department where have provided service therefore all these cases must be considered as occupational diseases.

Published
2023

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