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1. 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

2. The Clinical and Translational Research Activities at the INT – IRCCS 'Fondazione Pascale' Cancer Center (Naples, Italy) during the COVID-19 Pandemic

Author

Buonaguro F. M., Botti G., Ascierto P. A., Pignata S., Ionna F., Delrio P., Petrillo A., Cavalcanti E., Di Bonito M., Perdona S., De Laurentiis M., Fiore F., Palaia R., Izzo F., D'Auria S., Rossi V., Menegozzo S., Piccirillo M., Celentano E., Cuomo A., Normanno N., Tornesello M. L., Saviano R., Barberio D., Buonaguro L., Giannoni G., Muto P., Miscio L., Bianchi A. A. M., Cascella M., Ciavolino P., Correra M., Di Franco R., Di Pietro G., Franco P., Grizzuti G., Labonia F., Russo S., Salzano G., Buonaguro, F. M., Botti, G., Ascierto, P. A., Pignata, S., Ionna, F., Delrio, P., Petrillo, A., Cavalcanti, E., Di Bonito, M., Perdona, S., De Laurentiis, M., Fiore, F., Palaia, R., Izzo, F., D'Auria, S., Rossi, V., Menegozzo, S., Piccirillo, M., Celentano, E., Cuomo, A., Normanno, N., Tornesello, M. L., Saviano, R., Barberio, D., Buonaguro, L., Giannoni, G., Muto, P., Miscio, L., Bianchi, A. A. M., Cascella, M., Ciavolino, P., Correra, M., Di Franco, R., Di Pietro, G., Franco, P., Grizzuti, G., Labonia, F., Russo, S., and Salzano, G.

Subjects
Cancer Research, ARDS, medicine.medical_specialty, COVID-19, Cancer center, IL-6, Italy, Pascale, SARS-CoV-2, Tocilizumab, Epidemiology, Translational research, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Quarantine, Pandemic, medicine, 030212 general & internal medicine, Respiratory distress, business.industry, Methodology, Cancer, medicine.disease, Triage, Distress, Infectious Diseases, Oncology, 030220 oncology & carcinogenesis, Emergency medicine, business
Abstract

COVID-19 pandemic following the outbreak in China and Western Europe, where it finally lost the momentum, is now devastating North and South America. It has not been identified the reason and the molecular mechanisms of the two different patterns of the pulmonary host responses to the virus from a minimal disease in young subjects to a severe distress syndrome (ARDS) in older subjects, particularly those with previous chronic diseases (including diabetes) and cancer. The Management of the Istituto Nazionale Tumori - IRCCS “Fondazione Pascale” in Naples (INT-Pascale), along with all Health professionals decided not to interrupt the treatment of those hospitalized and to continue, even if after a careful triage in order not to allow SARS-CoV-2 positive subjects to access, to take care of cancer patients with serious conditions. Although very few (n = 3) patients developed a symptomatic COVID-19 and required the transfer to a COVID-19 area of the Institute, no patients died during the hospitalization and completed their oncology treatment. Besides monitoring of the patients, all employees of the Institute (physicians, nurses, researchers, lawyers, accountants, gatekeepers, guardians, janitors) have been tested for a possible exposure. Personnel identified as positive, has been promptly subjected to home quarantine and subdued to health surveillance. One severe case of respiratory distress has been reported in a positive employees and one death of a family member. Further steps to home monitoring of COVID-19 clinical course have been taken with the development of remote Wi-Fi connected digital devices for the detection of early signs of respiratory distress, including heart rate and oxygen saturation.In conclusion cancer care has been performed and continued safely also during COVID-19 pandemic and further remote home strategies are in progress to ensure the appropriate monitoring of cancer patients.

Published
2020

3. Italian pool of asbestos workers cohorts: asbestos related mortality by industrial sector and cumulative exposure

Author

Magnani C., Silvestri S., Angelini A., Ranucci A., Azzolina D., Cena T., Chellini E., Merler E., Pavone V., Miligi L., Gorini G., Bressan V., Girardi P., Bauleo L., Romeo E., Luberto F., Sala O., Scarnato C., Menegozzo S., Oddone E., Tunesi S., Perticaroli P., Pettinari A., Cuccaro F., Mattioli S., Baldassarre A., Barone-Adesi F., Musti M., Mirabelli D., Pirastu R., Marinaccio A., Massari S., Ferrante D, Working Group, Ballarin MN, Brentisci C, Cortini B, Curti S, Gangemi M, Gioffrè F, Legittimo P, Mangone L, Marinelli F, Marinilli P, Panato C, Roncaglia F, Storchi C, Stura A, Vicentini M, Verdi S, Nannavecchia AM, Bisceglia L, Magnani C., Silvestri S., Angelini A., Ranucci A., Azzolina D., Cena T., Chellini E., Merler E., Pavone V., Miligi L., Gorini G., Bressan V., Girardi P., Bauleo L., Romeo E., Luberto F., Sala O., Scarnato C., Menegozzo S., Oddone E., Tunesi S., Perticaroli P., Pettinari A., Cuccaro F., Mattioli S., Baldassarre A., Barone-Adesi F., Musti M., Mirabelli D., Pirastu R., Marinaccio A., Massari S., Ferrante D, Working Group, Ballarin MN, Brentisci C, Cortini B, Curti S, Gangemi M, Gioffrè F, Legittimo P, Mangone L, Marinelli F, Marinilli P, Panato C, Roncaglia F, Storchi C, Stura A, Vicentini M, Verdi S, Nannavecchia AM, and Bisceglia L

Subjects
Risk, Mesothelioma, Lung Neoplasms, Pleural Neoplasms, Socio-culturale, Asbesto, Cohort Studies, Cause of Death, Occupational Exposure, Asbestos, Glassworks, Rolling stock, Shipyards, Humans, Industry, Peritoneal Neoplasms, Retrospective Studies, Mineral Fibers, Ovarian Neoplasms, Construction Materials, Ambientale, Italy, Urinary Bladder Neoplasms, Asbestosis, Glasswork, Female
Abstract

Italy has been a large user of asbestos and asbestos containing materials until the 1992 ban. We present a pooled cohort study on long-term mortality in exposed workers.Pool of 43 Italian asbestos cohorts (asbestos cement, rolling stock, shipbuilding, glasswork, harbors, insulation and other industries). SMRs were computed by industrial sector for the 1970-2010 period, for the major causes, using reference rates by age, sex, region and calendar period.The study included 51 801 subjects (5741 women): 55.9% alive, 42.6% died (cause known for 95%) and 1.5% lost to follow-up. Asbestos exposure was estimated at the plant and period levels. Asbestos related mortality was significantly increased. All industrial sectors showed increased mortality from pleural malignancies, and most also from peritoneal and lung cancer and asbestosis, with exposure related trend. Increased mortality was also observed for ovarian cancer and for bladder cancer.The study confirmed the increased risk for cancer of the lung, ovary, pleura and peritoneum but not of the larynx and the digestive tract. A large increase in mortality from asbestosis was observed.

Published
2020

4. Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy

Author

Girardi P., Merler E., Ferrante D., Silvestri S., Chellini E., Angelini A., Luberto F., Fedeli U., Oddone E., Vicentini M., Barone-Adesi F., Cena T., Mirabelli D., Mangone L., Roncaglia F., Sala O., Menegozzo S., Pirastu R., Azzolina D., Tunesi S., Miligi L., Perticaroli P., Pettinari A., Cuccaro F., Nannavecchia A. M., Bisceglia L., Marinaccio A., Pavone V. L. M., Magnani C., Working Group, Ancona L., Baldassarre A., Brentisci C., Cortini B., Curti S., Gangemi M., Gorini G., Legittimo P., Marinelli F., Marinilli P., Bressan V., Mattioli S., Ranucci A., Romeo E., Scarnato C., Storchi C., Stura A., Verdi S., Girardi P., Merler E., Ferrante D., Silvestri S., Chellini E., Angelini A., Luberto F., Fedeli U., Oddone E., Vicentini M., Barone-Adesi F., Cena T., Mirabelli D., Mangone L., Roncaglia F., Sala O., Menegozzo S., Pirastu R., Azzolina D., Tunesi S., Miligi L., Perticaroli P., Pettinari A., Cuccaro F., Nannavecchia A.M., Bisceglia L., Marinaccio A., Pavone V.L.M., Magnani C., Working Group, Ancona L., Baldassarre A., Brentisci C., Cortini B., Curti S., Gangemi M., Gorini G., Legittimo P., Marinelli F., Marinilli P., Bressan V., Mattioli S., Ranucci A., Romeo E., Scarnato C., Storchi C., Stura A., and Verdi S.

Subjects
Male, Asbestos, Serpentine, Asbestosis, Cumulative Exposure, Asbesto, cohort mortality study, medicine.disease_cause, Asbestos, Settore MED/01 - Statistica Medica, NO, 03 medical and health sciences, asbestos exposure, 0302 clinical medicine, Occupational Exposure, Chrysotile, Medicine, Humans, 030212 general & internal medicine, Asbestos-related diseases, Asbestos-related disease, business.industry, Asbestos exposure, Cohort mortality study, Retrospective assessment, asbestos-related diseases, asbestosis, retrospective assessment, Public Health, Environmental and Occupational Health, Asbestosi, Middle Aged, medicine.disease, 030210 environmental & occupational health, Asbestos cement, Cohort effect, Italy, Cohort, Female, business, Settore SECS-S/01 - Statistica, Demography, Human
Abstract

Objectives This study was performed with the aim of investigating the temporal patterns and determinants associated with mortality from asbestosis among 21 cohorts of Asbestos-Cement (AC) workers who were heavily exposed to asbestos fibres. Methods Mortality for asbestosis was analysed for a cohort of 13 076 Italian AC workers (18.1% women). Individual cumulative asbestos exposure index was calculated by factory and period of work weighting by the different composition of asbestos used (crocidolite, amosite, and chrysotile). Two different approaches to analysis, based on Standardized Mortality Ratios (SMRs) and Age-Period-Cohort (APC) models were applied. Results Among the considered AC facilities, asbestos exposure was extremely high until the end of the 1970s and, due to the long latency, a peak of asbestosis mortality was observed after the 1990s. Mortality for asbestosis reached extremely high SMR values [SMR: males 508, 95% confidence interval (CI): 446–563; females 1027, 95% CI: 771–1336]. SMR increased steeply with the increasing values of cumulative asbestos exposure and with Time Since the First Exposure. APC analysis reported a clear age effect with a mortality peak at 75–80 years; the mortality for asbestosis increased in the last three quintiles of the cumulative exposure; calendar period did not have a significant temporal component while the cohort effect disappeared if we included in the model the cumulative exposure to asbestos. Conclusions Among heaviest exposed workers, mortality risk for asbestosis began to increase before 50 years of age. Mortality for asbestosis was mainly determined by cumulative exposure to asbestos.

Published
2019

5. 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, 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, Detragiache, E, Merletti, F, Gangemi, M, Stura, A, Brentisci, C, Cammarieri, Diglio G, Macerata, V, Gilardetti, M, Benfatto, L, Bianchelli, M, Mazzucco, G, Consonni, D, Pesatori, AC, Riboldi, L, Bressan, V, Gioffrè, F, Ballarin, MN, Chermaz, C, De Michieli, P, Mangone, L, Storchi, C, Sala, O, Badiali, AM, Cacciarini, V, Giovannetti, L, Martini, A, Calisti, R, La, Rosa F, DʼAlo’, D, Petrucci, MS, Davoli, M, Forastiere, F, Cavariani, F, Romeo, E, Ancona, L, Di Giammarco, A, Menegozzo, S, Canfora, ML, Santoro, M, Viscardi, F, Brangi, A, Cozza, V, Baldassarre, A, Lio, S, Nicita, C, Dardanoni, G, Scondotto, S, Nieddu, V, Pergola, M, and Stecchi, S

Published
2015
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6. Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy

Author

Luberto F., Ferrante D., Silvestri S., Angelini A., Cuccaro F., Nannavecchia A. M., Oddone E., Vicentini M., Barone-Adesi F., Cena T., Mirabelli D., Mangone L., Roncaglia F., Sala O., Menegozzo S., Pirastu R., Azzolina D., Tunesi S., Chellini E., Miligi L., Perticaroli P., Pettinari A., Bressan V., Merler E., Girardi P., Bisceglia L., Marinaccio A., Massari S., Magnani C., Working group, Curti S., Mattioli S., Luberto F., Ferrante D., Silvestri S., Angelini A., Cuccaro F., Nannavecchia A.M., Oddone E., Vicentini M., Barone-Adesi F., Cena T., Mirabelli D., Mangone L., Roncaglia F., Sala O., Menegozzo S., Pirastu R., Azzolina D., Tunesi S., Chellini E., Miligi L., Perticaroli P., Pettinari A., Bressan V., Merler E., Girardi P., Bisceglia L., Marinaccio A., Massari S., Magnani C., Working group, Curti S., and Mattioli S.

Subjects
Male, Mesothelioma, Asbestos, Asbestos-cement, Dose response relationship, Mesothelioma, Lung cancer, Ovarian Cancer, Epidemiology, Time Factors, Epidemiology, Health, Toxicology and Mutagenesis, Asbestosis, Physiology, Cumulative Exposure, medicine.disease_cause, Cohort Studies, Neoplasms, Chrysotile, Asbestos-related diseases, 0303 health sciences, lcsh:Public aspects of medicine, Middle Aged, Asbestos-cement, Asbestos cement, Ovarian Cancer, Italy, Dose response relationship, lcsh:Industrial medicine. Industrial hygiene, Female, Lung cancer, Settore SECS-S/01 - Statistica, Adult, Asbesto, Asbestos, Settore MED/01 - Statistica Medica, NO, 03 medical and health sciences, lcsh:RC963-969, Young Adult, Sex Factors, Occupational Exposure, medicine, Humans, business.industry, Research, Public Health, Environmental and Occupational Health, 030311 toxicology, lcsh:RA1-1270, medicine.disease, business
Abstract

Background Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos. Methods The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution. Results Mortality was significantly increased for ‘All Causes’ and ‘All Malignant Neoplasm (MN)’, in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%. Conclusions Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studies. Electronic supplementary material The online version of this article (10.1186/s12940-019-0510-6) contains supplementary material, which is available to authorized users.

Published
2019

7. Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies

Author

Barone-Adesi F., Ferrante D., Chellini E., Merler E., Pavone V., Silvestri S., Miligi L., Gorini G., Bressan V., Girardi P., Ancona L., Romeo E., Luberto F., Sala O., Scarnato C., Menegozzo S., Oddone E., Tunesi S., Perticaroli P., Pettinari A., Cuccaro F., Curti S., Baldassarre A., Cena T., Angelini A., Marinaccio A., Mirabelli D., Musti M., Pirastu R., Ranucci A., Magnani C., Working Group, Mattioli S., Barone-Adesi F., Ferrante D., Chellini E., Merler E., Pavone V., Silvestri S., Miligi L., Gorini G., Bressan V., Girardi P., Ancona L., Romeo E., Luberto F., Sala O., Scarnato C., Menegozzo S., Oddone E., Tunesi S., Perticaroli P., Pettinari A., Cuccaro F., Curti S., Baldassarre A., Cena T., Angelini A., Marinaccio A., Mirabelli D., Musti M., Pirastu R., Ranucci A., Magnani C., Working Group, and Mattioli S.

Subjects
Oncology, Adult, Male, medicine.medical_specialty, Time Factors, Time Factor, Adolescent, Pleural Neoplasms, asbestos, epidemiology, mesothelioma, Asbesto, medicine.disease_cause, Asbestos, Settore MED/01 - Statistica Medica, NO, 03 medical and health sciences, Peritoneal Neoplasm, Young Adult, 0302 clinical medicine, Internal medicine, Occupational Exposure, Epidemiology, medicine, Humans, Pleural Neoplasm, Mesothelioma, Young adult, Peritoneal Neoplasms, business.industry, Public Health, Environmental and Occupational Health, Cancer, asbestos, epidemiology, mesothelioma, Adolescent, Adult, Italy, Middle Aged, Models, Theoretical, medicine.disease, 030210 environmental & occupational health, Occupational Disease, Occupational Diseases, asbestos, epidemiology, mesothelioma, Italy, 030220 oncology & carcinogenesis, Female, business, Human, Cohort study
Abstract

ObjectivesModels based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis.MethodsWe used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time.ResultsRates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer.ConclusionsRates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations.

Published
2019

9. AMIANTO

Author

Comba, Pietro, Minoia, C, Carnevale, F, Marsili, Daniela, Ferrante, D., Chellini, E., Merler, E., Pavone, V., Silvestri, S., Miligi, L., Gorini, G., Bressan, V., Girardi, P., Ancona, L., Romeo, E., Luberto, F., Sala, O., Scarnato, C., Menegozzo, S., Oddone, E., Tunesi, S., Perticaroli, P., Pettinari, A., Cuccaro, F., Mattioli, S., Baldassarre, A., Angelini, A., Barone Adesi, F., Cena, T., Legittimo, P., Marinaccio, A., Mirabelli, D., Musti, M., Pirastu, R., and Ranucci, A. e Magnani C.

Published
2019

10. AMIANTO

Author

Comba, P, Minoia, C, Carnevale, F, Marsili, D, Ferrante, D., Chellini, E., Merler, E., Pavone, V., Silvestri, S., Miligi, L., Gorini, G., Bressan, V., Girardi, P., Ancona, L., Romeo, E., Luberto, F., Sala, O., Scarnato, C., Menegozzo, S., Oddone, E., Tunesi, S., Perticaroli, P., Pettinari, A., Cuccaro, F., Mattioli, S., Baldassarre, A., Angelini, A., Barone Adesi, F., Cena, T., Legittimo, P., Marinaccio, A., Mirabelli, D., Musti, M., Pirastu, R., and Ranucci, A. e Magnani C.

Subjects
Settore MED/01 - Statistica Medica
Published
2019

11. 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

12. [SENTIERI - Epidemiological study of residents in national priority contaminated sites: incidence of mesothelioma]

Author

Binazzi, A, Bruno, C, Comba, P, Conti, S, Corfiati, M, Fazzo, L, Manno, V, Marinaccio, A, Menegozzo, S, Minelli, G, Pasetto, R, Pirastu, R, Zona, A, ANGELILLO, Italo Francesco, Canessa, Pa, Cauzillo, G, Cavone, D, Chellini, E, Cocchioni, M, De Michieli, P, Forastiere, F, Davoli, M, Di Giammarco, A, Gennaro, V, Giaimo, M, Gioffrè, F, Mangone, L, Mazzoleni, G, Mensi, C, Merler, E, Merletti, F, Merseburger, A, Miligi, L, Mirabelli, D, Musti, M, Negro, C, Nicita, C, Pascucci, C, Riboldi, L, Romanelli, A, Schallemberg, G, Stracci, F, Trafficante, L, Tumino, R., Binazzi, A, Bruno, C, Comba, P, Conti, S, Corfiati, M, Fazzo, L, Manno, V, Marinaccio, A, Menegozzo, S, Minelli, G, Pasetto, R, Pirastu, R, Zona, A, Angelillo, Italo Francesco, Canessa, Pa, Cauzillo, G, Cavone, D, Chellini, E, Cocchioni, M, De Michieli, P, Forastiere, F, Davoli, M, Di Giammarco, A, Gennaro, V, Giaimo, M, Gioffrè, F, Mangone, L, Mazzoleni, G, Mensi, C, Merler, E, Merletti, F, Merseburger, A, Miligi, L, Mirabelli, D, Musti, M, Negro, C, Nicita, C, Pascucci, C, Riboldi, L, Romanelli, A, Schallemberg, G, Stracci, F, Trafficante, L, and Tumino, R.

Abstract

The purpose of SENTIERI-ReNaM Project is to describe mesothelioma incidence in the Italian National Priority Contaminated Sites (NPCSs). The present report deals with 39 NPCSs (20 in Northern Italy, 8 in Central Italy and 11 in Southern Italy). Asbestos is specifically mentioned in the regulatory acts of recognition for 10 NPCSs and it is the only agent that has determined environmental contamination in 3 of them (Casale Monferrato, Broni, and Bari). The timeframe of the study is 2000-2011 for 34 out of 39 sites. The corresponding reference periods for the sites of Latium, Campania, Umbria, and Bolzano Province are, respectively, 2001-2011, 2005-2011, and 2006-2011. Standardized Incidence Ratios (SIRs) for mesothelioma, with their corresponding 90% Confidence Intervals, have been estimated for all sites. The interpretation of the study findings has been based on anamnestic information made available by the Italian National Mesothelioma Registry (ReNaM), and completed thanks to knowledge derived from the international scientific literature. In men, mesothelioma incidence has shown excesses in 27/39 sites and defects in the remaining 12; in women, excesses have been reported in 20 sites, defects in 15, and no cases have been detected in the remaining 4 sites. The highest annual incidence rates have been observed in the sites characterized only by the presence of asbestos- cement factories (Broni and Casale Monferrato): respectively, 98.0 and 68.6 per 100,000 per year in men, 72.1 and 45.8 in women. Besides these two sites, the highest rates have been observed in the sites with naval shipyards: 13.2 in men and 2.5 in women. Excesses of mesothelioma incidence have been confirmed (with respect to previous observations) in the sites of Broni, Casale Monferrato, Balangero, and in the coastal areas of Trieste, La Spezia, Venice, and Leghorn. Balangero has been the major European chrysotile quarry, while the other sites are characterized by the presence of naval shipyards with demonstrated use of asbestos before it was banned in 1992. An excess of mesothelioma incidence has also been confirmed in the site of Biancavilla, characterized by the presence of the fluoro-edenite fibrous amphibole, classified as carcinogenic to humans by the International Agency for Research on Cancer (IARC). An increased incidence of mesothelioma was also observed in the areas where no direct use of asbestos had previously been documented, like Cengio and Saliceto (chemical industry), Falconara on Sea (oil refinery), and Litorale Domizio Flegreo and Agro Aversano (a large area including multiple hazardous waste dumping sites). These findings show that a relevant proportion of Italian mesothelioma cases is concentrated in NPCSs. About 1,500 extra cases of mesothelioma have been estimated in the overall series of 39 sites (2000-2011), corresponding to 125 extra cases per year. The excess has concerned the sites with manufacture of asbestos-cement products, but also the areas with asbestos quarries, naval shipyards, illegal hazardous waste dumping sites with asbestos-containing materials, petrochemical industries, refineries and steel plants. In some sites, particularly Casale Monferrato and Broni, analytical epidemiological studies have shown the causal role of not only occupational, but also environmental exposures, with special reference to paving of gardens and courtyards with asbestos-cement industry by-products. The main novelty generated by the collaborative SENTIERI-ReNaM Project concerns the detection of significant mesothelioma excesses not only in sites where asbestos is explicitly reported as a source of contamination, but also in a number of areas defined "of national interest" for environmental cleanup due to other sources of pollution. This confirms that the range of economic activities and working and living environments affected by asbestos exposure is very wide and it is not restricted to the industrial sectors characterized by the direct use of this material.

Published
2016

13. SENTIERI-ReNaM: Valutazione globale del carico di mesotelioma

Author

Binazzi A, GdL SENTIERI-ReNaM., Bruno, C, Comba, PAOLO GIOVANNI, Conti, S, Corfiati, M, Fazzo, L, Manno, V, Marinaccio, A, Menegozzo, S, Minelli, Giuditta, Pasetto, R, Pirastu, R, Zona, A, Angelillo, I, Canessa, Pa, Cauzillo, G, Cavone, D, Chellini, E, Cocchioni, M, De Michieli, P, Forastiere, F, Davoli, M, Di Giammarco, A, Gennaro, V, Giaimo, M, Gioffrè, F, Mangone, L, Mazzoleni, G, Mensi, C, Merler, E, Merletti, F, Merseburger, A, Miligi, L, Mirabelli, D, Musti, M, Negro, C, Nicita, C, Pascucci, C, Riboldi, Lorenzo, Romanelli, A, Schallemberg, G, Stracci, F, Trafficante, Luigi Alberto, and Tumino, R.

Subjects
Mesothelioma, Male, Risk, Epidemiology, Incidence, Asbestos, Burden of illness, Italy, National Priority Contaminated Sites - NPCSs, Carcinogens, Environmental, Confidence Intervals, Female, Health Surveys, Humans, Industry, Occupational Exposure, Registries, Environmental Exposure, Environmental Pollution, Hazardous Waste Sites, Public Health, Environmental and Occupational Health, Environmental and Occupational Health, Environmental, Carcinogens, Public Health
Published
2017

14. [SENTIERI-ReNaM: Discussion and concluding remarks]

Author

Zona, Amerigo, Fazzo, Lucia, Binazzi, Alessandra, Bruno, Caterina, Corfiati, Marisa, Comba, Pietro, Conti, Susanna, Menegozzo, Simona, Nicita, Carmela, Pasetto, Roberto, Pirastu, Roberta, Marinaccio, Alessandro, Binazzi A, GdL SENTIERI-ReNaM., Bruno, C, Comba, P, Conti, S, Corfiati, M, Fazzo, L, Manno, V, Marinaccio, A, Menegozzo, S, Minelli, G, Pasetto, R, Pirastu, R, Zona, A, Angelillo, I, Canessa, Pa, Cauzillo, G, Cavone, D, Chellini, E, Cocchioni, M, De Michieli, P, Forastiere, F, Davoli, M, Di Giammarco, A, Gennaro, V, Giaimo, M, Gioffrè, F, Mangone, L, Mazzoleni, G, Mensi, C, Merler, E, Merletti, F, Merseburger, A, Miligi, L, Mirabelli, D, Musti, M, Negro, C, Nicita, C, Pascucci, C, Riboldi, L, Romanelli, A, Schallemberg, G, Stracci, F, Trafficante, L, and Tumino, R.

Subjects
Male, Mesothelioma, Risk, Incidence, Asbestos, Environmental Exposure, Health Surveys, Carcinogens, Environmental, Environmental, Italy, Occupational Exposure, Hazardous Waste Sites, Carcinogens, Confidence Intervals, Humans, Industry, Female, Registries, Environmental Pollution
Abstract

SENTIERI-ReNaM Project analysed the incidence of malignant mesothelioma (MM) for the period 2000-2011 in 39 National Priority Contaminated Sites (NPCSs), and assessed the overall impact of mesothelioma in different types of NPCSs. In the study period, 2,683 incident cases of malignant mesothelioma were recorded: 1,998 males (74.5%), 685 females (25.5%). Excluding cases with non attributable exposure and those non interviewed, exposure was identified in 1,926 cases (70% of all cases): 1,541 males (occupational exposure: 1,414; environmental exposure: 82), 385 females (occupational exposure: 103; environmental exposure: 141). Women experienced mainly environmental and domestic exposures to asbestos. Standard Incidence Ratio (SIR) excesses were observed in men in 27 out of 39 NPCSs and defects in the remaining 12; in women, 20 NPCSs showed SIR excesses, defects in 15; in 4 NPCSs no MM cases occurred among female population. The highest rates were found in NPCSs with asbestos-cement plants (Broni and Casale Monferrato), respectively, 98 per 100,000 per year and 68.6 in men, 72.1 and 45.8 in women. Excluding these two sites, the highest incidence rates were found in the group with harbours and shipyards, where the rates were, respectively, 13.2 among men and 2.5 among women. The results of this report will be communicated to national and local institutions, as well as to NPCSs resident populations.

Published
2016

15. [SENTIERI-ReNaM: Results]

Author

Binazzi, Alessandra, Zona, Amerigo, Marinaccio, Alessandro, Bruno, Caterina, Corfiati, Marisa, Fazzo, Lucia, Menegozzo, Simona, Nicita, Carmela, Pasetto, Roberto, Pirastu, Roberta, De Santisi, Marco, Comba, Pietro, Binazzi A, GdL SENTIERI-ReNaM., Bruno, C, Comba, PAOLO GIOVANNI, Conti, S, Corfiati, M, Fazzo, L, Manno, V, Marinaccio, A, Menegozzo, S, Minelli, G, Pasetto, R, Pirastu, R, Zona, A, Angelillo, I, Canessa, Pa, Cauzillo, G, Cavone, D, Chellini, E, Cocchioni, M, De Michieli, P, Forastiere, F, Davoli, M, Di Giammarco, A, Gennaro, V, Giaimo, M, Gioffrè, F, Mangone, L, Mazzoleni, G, Mensi, C, Merler, E, Merletti, F, Merseburger, A, Miligi, L, Mirabelli, D, Musti, M16, 17 Negro, C, Nicita, C, Pascucci, C, Riboldi, L, Romanelli, A, Schallemberg, G, Stracci, F, Trafficante, L, and Tumino, R.

Subjects
Male, Mesothelioma, Risk, Incidence, Asbestos, Environmental Exposure, Health Surveys, Carcinogens, Environmental, Environmental, Italy, Occupational Exposure, Hazardous Waste Sites, Carcinogens, Confidence Intervals, Humans, Industry, Female, Registries, Environmental Pollution
Abstract

Mesothelioma incidence has been analyzed in National Priority Contaminated Sites (NPCSs) to estimate the health impact of asbestos exposure on resident people. The burden of professional and environmental exposures has been identified through data of the Regional Operational Centres (CORs), made available by the Italian National Mesothelioma Registry (ReNaM). An excess of mesothelioma incidence is confirmed in sites with a known past history of direct use of asbestos, such as Balangero, Casale Monferrato, Broni, Bari-Fibronit, and in coastal areas, where shipyards, harbours and other industries that involved a wide use of asbestos are represented (e.g., Trieste, La Spezia, Venice, and Leghorn). An excess of mesothelioma has been observed in settings where the asbestos is not mentioned as contaminant in the decree that included these sites among NPCSs, such as Cengio and Saliceto in Northern Italy; Falconara Marittima and the Bacino Idrografico Fiume Sacco in the Central Italy; the Litorale Domizio Flegreo and Agro Aversano, Milazzo, and Gela in the Southern Italy. Observed excess in the various NPCSs confirms the large-scale occurrence in contaminated Italian sites of a significant amount of total mesothelioma cases observed at national level. The analysis of occupational risk in epidemiological studies with an ecological design helps in defining the contribution of different factors to the overall risk.

Published
2016

16. Early biomarkers of pleural malignant mesothelioma in workers past exposed to asbestos: Proposal of a survey

Author

Menegozzo m., BALDI, Alfonso, Costigliola A., Crispi?, FASANO, Silvia, Menegozzo S., SANTINI, Mario, Menegozzo, M., Baldi, Alfonso, Costigliola, A., Crispi?, Fasano, Silvia, Menegozzo, S., and Santini, Mario

Subjects
Mesothelioma, Biological monitoring, Asbesto
Abstract

At present biological monitoring of the asbestos formerly exposed workers does not have early biomarkers to assure effective sanitary surveillance for pleural malignant mesothelioma. The research project coordinated by Campania Mesothelioma Registry plans to identify and validate two early biomarkers at gene level (gene expression profiling) and at serum level (SMRP = serum mesothelin-related protein).

Published
2004

17. [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

18. [A new risk in the occupational medicine setting: mobbing]

Author

GILIOLI R, ADINOLFI M, BAGAGLIO A, BOCCALETTI D, CASSITTO MG, FANELLI C, FATTORINI E, GILIOLI D, GRIECO A, GUIZZARO A, LABELLA A, MATTEI O, MENEGOZZO M, MENEGOZZO S, MOLININI R, MUSTO D, PAOLETTI A, PAPALIA F, QUAGLIUOLO R, VINCI F., DELLA PIETRA, Bruno, Gilioli, R, Adinolfi, M, Bagaglio, A, Boccaletti, D, Cassitto, Mg, DELLA PIETRA, Bruno, Fanelli, C, Fattorini, E, Gilioli, D, Grieco, A, Guizzaro, A, Labella, A, Mattei, O, Menegozzo, M, Menegozzo, S, Molinini, R, Musto, D, Paoletti, A, Papalia, F, Quagliuolo, R, and Vinci, F.

Subjects
Occupational Diseases, Stress Disorders, Post-Traumatic, Italy, Risk Factors, Occupational Exposure, Humans, Physician's Role, Social Behavior
Published
2001

20. Mortality study in an asbestos cement factory in Naples, Italy

Author

Menegozzo, S, Comba, P, Ferrante, D, De Santis, M, Gorini, G, Izzo, F, Magnani, C, Pirastu, Roberta, Simonetti, A, Tùnesi, S, and Menegozzo, M.

Subjects
Adult, Male, Mesothelioma, Lung Neoplasms, Pleural Neoplasms, Population, lavoratori del cemento amianto, Cohort Studies, Young Adult, Occupational Exposure, Humans, Registries, Peritoneal Neoplasms, lung cancer, mortality study, peritoneal cancer, pleural cancer, asbestos-cement workers, Aged, tumore della pleura, Construction Materials, lcsh:Public aspects of medicine, technology, industry, and agriculture, tumore del peritoneo, lcsh:RA1-1270, Asbestos, Middle Aged, tumore del polmone, respiratory tract diseases, Occupational Diseases, Italy, Cardiovascular Diseases, Asbestosis, Carcinogens, Female, Pneumoconiosis, studio di mortalità
Abstract

The objective of this paper is to investigate mortality among 1247 male asbestos-cement workers employed in an asbestos-cement plant located in Naples. The cohort included 1247 men hired between 1950 and 1986. The follow-up began on January 1st 1965. The vital status and causes of death were ascertained up to December 31 2005. Cause-specific mortality rates of the Campania Region population were used as reference. Relative risks were estimated using Standardized Mortality Ratios (SMRs), and the confidence intervals were calculated at a 95% level (95% CI). A significant increase in mortality was observed for respiratory disease (81 deaths; SMR = 187; 95% CI = 149- 233), particularly for pneumoconiosis (42 deaths; SMR = 13 313; 95% CI = 9595-17 996) of which 41 deaths for asbestosis (SMR = 43 385; 95% CI = 31 134-58 857), for pleural cancer (24 deaths; SMR = 2617; 95% CI = 1677-3893), for lung cancer (84 deaths; SMR=153; 95% CI = 122-189) and for peritoneal cancer (9 deaths; SMR = 1985; 95% CI = 908-3769). Non-significant increases were also observed for rectum cancer (6 deaths; SMR = 157; 95% CI = 58-342). In conclusion, consistently with other mortality studies on asbestos-cement workers performed in different countries, an increased mortality from asbestosis, lung cancer, pleural and peritoneal mesothelioma was detected in the present cohort.

Published
2011

21. Pleural malignant mesothelioma epidemic: incidence, modalities of asbestos exposure and occupations involved from the Italian National Register

Author

Marinaccio, A, Binazzi, A, Marzio, Dd, Scarselli, A, Verardo, M, Mirabelli, D, Gennaro, V, Mensi, C, Riboldi, L, Merler, E, Zotti, Rd, Romanelli, A, Chellini, E, Silvestri, S, Pascucci, C, Romeo, E, Menegozzo, S, Musti, M, Cavone, D, Cauzillo, G, Tumino, R, Nicita, C, Melis, M, Iavicoli, S, ReNaM Working Group, Massari, S, Branchi, C, Detragiache, E, Merletti, Franco, Gangemi, M, Stura, A, Brentisci, C, Cammarieri Diglio, G, Macerata, V, Gilardetti, M, Lazzarotto, A, Benfatto, L, Bianchelli, M, Mazzucco, G, Sieno, C, Pesatori, Ac, Gioffrè, F, Bressan, V, De Michieli, P, Mangone, L, Storchi, C, Seniori Costantini, A, Badiali, Am, Cacciarini, V, Giovannetti, L, Martini, A, Calisti, R, La Rosa, F, Stracci, F, D'Alò, D, Perucci, Ca, Forastiere, F, Cavariani, F, Ascoli, V, Sangalli, M, Trafficante, L, Gatta, S, Menegozzo, M, Izzo, F, Canfora, Ml, Santoro, M, Viscardi, F, Massaro, T, Convertini, L, Leotta, A, Lio, Sg, Dardanoni, G, Scondotto, S, Corrias, Ga, Angius, Mr, and Nieddu, V.

Subjects
Adult, Male, Mesothelioma, Cancer Research, medicine.medical_specialty, Pathology, Pleural Neoplasms, asbestos, italy, mesothelioma, national register, pleural, Developing country, medicine.disease_cause, Asbestos, Occupational safety and health, Environmental health, Occupational Exposure, Epidemiology, medicine, Humans, Epidemics, Pleural mesothelioma, Aged, business.industry, Incidence (epidemiology), Age Factors, Environmental exposure, Middle Aged, medicine.disease, Occupational Diseases, Oncology, Italy, Population Surveillance, Etiology, Female, business
Abstract

Due to the large scale use of asbestos (more than 3.5 million tons produced or imported until its definitive banning in 1992), a specific national surveillance system of mesothelioma incident cases is active in Italy, with direct and individual anamnestic etiological investigation. In the period between 1993 and 2004, a case-list of 8,868 pleural MM was recorded by the Italian National Register (ReNaM) and the modalities of exposure to asbestos fibres have been investigated for 6,603 of them. Standardized incidence rates are 3.49 (per 100,000 inhabitants) for men and 1.25 for women, with a wide regional variability. Occupational asbestos exposure was in 69.3% of interviewed subjects (N = 4,577 cases), while 4.4% was due to cohabitation with someone (generally, the husband) occupationally exposed, 4.7% by environmental exposure from living near a contamination source and 1.6% during a leisure activity. In the male group, 81.5% of interviewed subjects exhibit an occupational exposure. In the exposed workers, the median year of first exposure was 1957, and mean latency was 43.7 years. The analysis of exposures by industrial sector focuses on a decreasing trend for those traditionally signaled as "at risk" (asbestos-cement industry, shipbuilding and repair and railway carriages maintenance) and an increasing trend for the building construction sector. The systematic mesothelioma surveillance system is relevant for the prevention of the disease and for supporting an efficient compensation system. The existing experience on all-too-predictable asbestos effects should be transferred to developing countries where asbestos use is spreading.

Published
2011

22. 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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25. Il registro nazionale dei casi di neoplasia a bassa frazione eziologica con sospetta origine professionale istituito dall'art. 244 del D.Lgs. n. 81/2008.

Author

Massari, S., Ippoliti, M., Menegozzo, S., Forastiere, F., and Crosignani, P.

Abstract

Copyright of Giornale Italiano di Medicina del Lavoro ed Ergonomia is the property of Giornale Italiano di Medicina del Lavoro ed Ergonomia Editorial Board 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
2011

27. [Italian national register of low etiological fraction occupational cancer pursuant to art. 244 of legislative decree n. 81/2008]

Author

Massari S, Ippoliti M, Menegozzo S, Francesco Forastiere, and Crosignani P

Subjects
Occupational Diseases, Italy, Neoplasms, Humans, Registries, Occupational Health
Abstract

Legislative decree No. 81/2008 in the article n. 244 states that ISPESL, now INAIL, realizes a register of occupational cancers with low etiological fraction by means of a data collection method based exclusively on voluntary reports by GPs, healthcare and social security agencies (ReNaLOC) and a surveillance cancer monitoring system (OCCAM) based on linkage of routinely available data (cancer registries, hospital discharge records, Italian Social Security archives). ReNaLOC has produced a partial picture of the situation, it includes 1.584 cases as of June 2011. With OCCAM many situations of known risks were identified and others are worthy to be deepen.

28. [SENTIERI-ReNaM: Results]

Author

Binazzi, A., Zona, A., Marinaccio, A., Bruno, C., Corfiati, M., Fazzo, L., Menegozzo, S., Nicita, C., Roberto Pasetto, Pirastu, R., Santisi, M., Comba, P., and GdL SENTIERI-ReNaM

30. Time trend in mesothelioma and lung cancer risk in asbestos workers in Italy,Valutazione della variazione temporale del rischio di mesotelioma e di tumore del polmone nelle coorti di esposti ad amianto per lavoro in Italia

Author

Magnani, C., Ancona, L., Baldassarre, A., Bressan, V., Cena, T., Chellini, E., Cuccaro, F., Ferrante, D., Legittimo, P., Luberto, F., Marinaccio, A., Mattioli, S., Menegozzo, S., Merler, E., Lucia Miligi, Mirabelli, D., Musti, M., Oddone, E., Pavone, V., Perticaroli, P., Pettinari, A., Pirastu, R., Ranucci, A., Romeo, E., Sala, O., Scarnato, C., and Silvestri, S.

31. 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.

33. CASI DI MESOTELIOMA MALIGNO NEL COMPARTO DEI TRASPORTI AEREI IN ITALIA.

Author

Menegozzo, S., Viscardi, F., Izzo, F., Ascoli, V., Barbieri, G., Cavone, D., De Zotti, R., Cavariani, F., Gennaro, V., Marinaccio, A., Mensi, C., Merler, E., Mirabelli, D., Musti, M., Pascucci, C., Romanelli, A., Silvestri, S., and Menegozzo, M.

Abstract

I dati relativi alla esposizione professionale ad amianto nel trasporto aereo non risultano finora particolarmente approfonditi: obiettivo del presente lavoro è quello di descrivere la casistica dei mesoteliomi maligni appartenenti al settore dei trasporti aerei individuati dal Registro Nazionale dei Mesoteliomi (ReNaM). I casi di mesotelioma maligno individuati sono classificati in base a criteri diagnostici e di esposizione stabiliti dalle linee guida ReNaM ISPESL del 2003: sono stati presi in considerazione i casi di mesotelioma maligno certi, probabili e possibili per i quali è disponibile il questionario sulle abitudini di vita e di lavoro che dimostra almeno la presenza di un periodo lavorativo nel settore dei trasporti aerei. Il maggior numero di casi rilevato è dislocato nelle aree geografiche dove insistono attività collegate alla costruzione di aeromobili; invece l'attività di gran lunga più rappresentata è quella della costruzione degli aeromobili, seguita dalla Aeronautica Militare. L'indagine condotta sul settore del trasporto aereo in Italia evidenzia una casistica dei mesoteliomi maligni che denota un diffuso utilizzo -- per il passato -- di materiali contenenti amianto, in linea con quanto già emerso per altri settori del trasporto maggiormente indagati (navale e ferroviario). Per il settore in esame risulta di particolare interesse l'esposizione professionale attribuibile al settore dell'Aeronautica Militare. Un ulteriore approfondimento viene fornito mettendo in evidenza mansioni e profili professionali particolarmente interessati dall'esposizione a fibre d'asbesto. [ABSTRACT FROM AUTHOR]

Published
2011

34. ATTIVITÀ DEL REGISTRO MESOTELIOMI DELLA CAMPANIA DAL LUGLIO 2003 AL GIUGNO 2011.

Author

Menegozzo, M., Izzo, F., Menegozzo, S., and Viscardi, F.

Abstract

Copyright of Giornale Italiano di Medicina del Lavoro ed Ergonomia is the property of Giornale Italiano di Medicina del Lavoro ed Ergonomia Editorial Board 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
2011

35. Molecular analysis of the effects of Piroxicam and Cisplatin on mesothelioma cells growth and viability.

Author

Verdina A, Cardillo I, Nebbioso A, Galati R, Menegozzo S, Altucci L, Sacchi A, Baldi A, Verdina, Alessandra, Cardillo, Irene, Nebbioso, Angela, Galati, Rossella, Menegozzo, Simona, Altucci, Lucia, Sacchi, Ada, and Baldi, Alfonso

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been proposed for prevention and treatment of a variety of human cancers. Piroxicam, in particular, has been recently shown to exert significant anti-tumoral activity in combination with cisplatin (CDDP) on mesothelioma cells. However, the mechanisms through which NSAIDs regulate the cell cycle as well as the signal pathways involved in the growth inhibition, remain unclear. In the present study, using two mesothelioma cell lines, MSTO-211H and NCI-H2452, we have investigated the influence of piroxicam alone and in association with CDDP on proliferation, cell cycle regulation and apoptosis. In both cell lines a significant effect on cell growth inhibition, respect to the control, was observed with all the drugs tested. Moreover, treatment with piroxicam or CDDP alone altered the cell cycle phase distribution as well as the expression of some cell cycle regulatory proteins in both cell lines. These effects were increased, even if in a not completely overlapping manner, after treatment with the association of piroxicam and CDDP. In particular, the two drugs in NCI cell line had a synergistic effect on apoptosis, probably through activation of caspase 8 and caspase 9, while the most evident targets among the cell cycle regulators were cyclin D1 and p21waf1. These results suggest that the association of piroxicam and CDDP specifically triggers cell cycle regulation and apoptosis in different mesothelioma cell lines and may hold promise in the treatment of mesothelioma. [ABSTRACT FROM AUTHOR]

Published
2008
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36. Expression of the embryonic lethal abnormal vision-like protein HuR in human mesothelioma

Author

Ada Sacchi, Alessandra Verdina, Bruno Vincenzi, Daniela Stoppoloni, Irene Cardillo, Mario Santini, Simona Menegozzo, Alfonso Baldi, Rossella Galati, Stoppoloni, D, Cardillo, I, Verdina, A, Vincenzi, B, Menegozzo, S, Santini, Mario, Sacchi, A, Baldi, Alfonso, and Galati, R.

Subjects
Mesothelioma, Cancer Research, Pathology, medicine.medical_specialty, Prognosi, Blotting, Western, Kaplan-Meier Estimate, Biology, ELAV-Like Protein 1, Cell Line, Tumor, Biomarkers, Tumor, medicine, Humans, RNA, Messenger, Cyclooxygenase-2, Messenger RNA, Human embryonic lethal abnormal vision-like protein, Reverse Transcriptase Polymerase Chain Reaction, RNA-Binding Proteins, Cancer, Prognosis, medicine.disease, Immunohistochemistry, Embryonic stem cell, ELAV Proteins, Oncology, Cyclooxygenase 2, Cell culture, Cytoplasm, Tumor progression, Antigens, Surface, Cancer research, Cytokines
Abstract

BACKGROUND. The human embryonic lethal abnormal vision (ELAV)-like protein HuR is a messenger RNA (mRNA)-binding protein that controls the stability of certain transcripts, including cyclooxygenase2 (COX-2). METHODS. To investigate a possible contribution of dysregulation of mRNA stability to the progression of cancer and to COX-2 over expression in mesothelioma, the authors studied expression of COX-2 and HuR in 5 mesothelioma cell lines (MSTO, NCI, Ist-Mes1, Ist-Mes2, and MPP89) and in a group of 29 human mesothelioma specimens that were characterized previously for COX-2 expression. RESULTS. All 5 cell lines expressed HuR, whereas COX-2 was not detectable in MSTO or NCI cells. Treatment with cytokines induced a shift in systolic HuR protein levels in MPP89 and Ist-Mes2 cells that was accompanied by an increase in the expression of COX-2 mRNA and protein. In Ist-Mes1 cells, cytokine stimulation did not cause the passage of HuR from nucleus to cytoplasm, and the synthesis of COX-2 did not increase. In tumor tissues, immunohistochemistry revealed a positive, statistically significant correlation between high COX-2 expression and cytoplasmic localization of HuR (P = .016). Moreover, on univariate analysis, overall survival was found to be influenced strongly by cytoplasmic HuR localization (P = .004). CONCLUSIONS. The current results suggested that HuR plays a role in tumor progression in mesothelioma and that COX-2 may be a target of its activity in neoplastic cells. Together, these observations indicate that strategies aiming toward the modulation of HuR may have a potential clinical benefit in mesothelioma. Cancer 2008. © 2008 American Cancer Society.

Published
2008

37. Cell-growth and migration inhibition of human mesothelioma cells induced by 3-O-Methylfunicone from Penicillium pinophilum and cisplatin

Author

BUOMMINO, Elisabetta, RIZZO, Antonietta, DONNARUMMA, Giovanna, A. DE FILIPPIS, R. NICOLETTI, M. MENEGOZZO, S. MENEGOZZO, M. L. CIAVATTA, V. BRANCATO, M. A. TUFANO, DE FILIPPIS, Anna, Buommino, Elisabetta, A, DE FILIPPIS, R, Nicoletti, M, Menegozzo, S, Menegozzo, M, L, A, Rizzo, V, Brancato, M, A, Donnarumma, G., A., DE FILIPPIS, R., Nicoletti, M., Menegozzo, S., Menegozzo, M. L., Ciavatta, Rizzo, Antonietta, V., Brancato, M. A., Tufano, Donnarumma, Giovanna, DE FILIPPIS, Anna, Buommino, E, De Filippis, A, Nicoletti, R, Menegozzo, M, Menegozzo, S, Ciavatta, M, Rizzo, A, Brancato, V, Tufano, M, and Donnarumma, G

Subjects
inorganic chemicals, Oncology, Mesothelioma, Vascular Endothelial Growth Factor A, medicine.medical_specialty, Angiogenesis, Motility, Integrin, Drug resistance, Biology, Cell Movement, Internal medicine, Cell Line, Tumor, Antineoplastic Combined Chemotherapy Protocols, medicine, 3-O-methylfunicone, Humans, Pharmacology (medical), Receptors, Vitronectin, RNA, Messenger, neoplasms, Cell Shape, Metalloproteinase, Migration, Cell Proliferation, Pharmacology, Cisplatin, Cell growth, Chemotaxis, Penicillium, medicine.disease, In vitro, respiratory tract diseases, Gene Expression Regulation, Neoplastic, Cell culture, Pyrones, Cancer research, Matrix Metalloproteinase 2, Human, medicine.drug
Abstract

Malignant pleural mesothelioma is a fatal malignancy linked to asbestos exposure. The main challenge for mesothelioma treatment is to go beyond the drug resistance, in particular against cisplatin (CDDP), one of the most used chemotherapeutic drug. 3-O-methylfunicone (OMF) is a metabolite produced by the fungus Penicillium pinophilum; its antiproliferative properties have been previously studied in vitro. Particularly, OMF is able to inhibit mesothelioma cell motility. To improve the effects of CDDP by-passing the resistance of mesothelioma cells to this drug, in the present study we investigated the combined treatment of OMF with CDDP respectively in an established mesothelioma cell line (NCI) and primary mesothelioma cells (Mest). As compared to the effect of single treatments, the combination of OMF and CDDP resulted in a stronger inhibition of NCI and Mest cell proliferation. OMF combination with CDDP was also able to affect the migratory ability of NCI and Mest cells by down-regulating αv and β5 expression and reducing metalloproteinase 2 (MMP-2) production. In addition, this association was effective in modulating VEGF gene expression. This finding highlights the possibility to use OMF and CDDP together to regulate angiogenesis and tumour progression in mesothelioma.

Published
2012

38. Global Gene Expression Profiling Of Human Pleural Mesotheliomas: Identification of Matrix Metalloproteinase 14 (MMP-14) as Potential Tumour Target

Author

Gilda Cobellis, Pasquale Mellone, Riccardo Pierantoni, Stefania Crispi, Bruno Vincenzi, Silvia Fasano, Raffaele A. Calogero, Rosaria Meccariello, Gennaro Citro, Simona Menegozzo, M Menegozzo, Alfonso Baldi, Giovanni Vicidomini, Francesco Facciolo, Mario Santini, Crispi, S, Calogero, Ra, Santini, Mario, Mellone, P, Vincenzi, B, Citro, G, Vicidomini, Giovanni, Fasano, Silvia, Meccariello, R, Cobellis, Gilda, Menegozzo, S, Pierantoni, Riccardo, Facciolo, F, Baldi, Alfonso, and Menegozzo, M.

Subjects
Male, Mesothelioma, Risk, Mesothelioma/genetic, Microarray, Respiratory Medicine/Pleural Diseases, including Mesothelioma, Pleural Neoplasms, lcsh:Medicine, Computational Biology/Transcriptional Regulation, Biology, Bioinformatics, Gene expression, medicine, Biomarkers, Tumor, Matrix Metalloproteinase 14, Humans, Pleural Neoplasm, lcsh:Science, Genetics and Genomics/Cancer Genetics, Aged, Oligonucleotide Array Sequence Analysis, Proportional Hazards Models, Multidisciplinary, Microarray analysis techniques, Reverse Transcriptase Polymerase Chain Reaction, Gene Expression Profiling, lcsh:R, Cell Cycle, Genetics and Genomics/Gene Expression, Middle Aged, medicine.disease, Matrix Metalloproteinase 14/genetic, Gene expression profiling, Cancer research, Disease Progression, MMP14, lcsh:Q, Female, DNA microarray, Research Article, Computational Biology/Genomics
Abstract

BACKGROUND: The goal of our study was to molecularly dissect mesothelioma tumour pathways by mean of microarray technologies in order to identify new tumour biomarkers that could be used as early diagnostic markers and possibly as specific molecular therapeutic targets. METHODOLOGY: We performed Affymetrix HGU133A plus 2.0 microarray analysis, containing probes for about 39,000 human transcripts, comparing 9 human pleural mesotheliomas with 4 normal pleural specimens. Stringent statistical feature selection detected a set of differentially expressed genes that have been further evaluated to identify potential biomarkers to be used in early diagnostics. Selected genes were confirmed by RT-PCR. As reported by other mesothelioma profiling studies, most of genes are involved in G2/M transition. Our list contains several genes previously described as prognostic classifier. Furthermore, we found novel genes, never associated before to mesotheliom that could be involved in tumour progression. Notable is the identification of MMP-14, a member of matrix metalloproteinase family. In a cohort of 70 mesothelioma patients, we found by a multivariate Cox regression analysis, that the only parameter influencing overall survival was expression of MMP14. The calculated relative risk of death in MM patients with low MMP14 expression was significantly lower than patients with high MMp14 expression (P = 0.002). CONCLUSIONS: Based on the results provided, this molecule could be viewed as a new and effective therapeutic target to test for the cure of mesothelioma. Background: The goal of our study was to molecularly dissect mesothelioma tumour pathways by mean of microarray technologies in order to identify new tumour biomarkers that could be used as early diagnostic markers and possibly as specific molecular therapeutic targets.Methodology: We performed Affymetrix HGU133A plus 2.0 microarray analysis, containing probes for about 39,000 human transcripts, comparing 9 human pleural mesotheliomas with 4 normal pleural specimens. Stringent statistical feature selection detected a set of differentially expressed genes that have been further evaluated to identify potential biomarkers to be used in early diagnostics. Selected genes were confirmed by RT-PCR. As reported by other mesothelioma profiling studies, most of genes are involved in G2/M transition. Our list contains several genes previously described as prognostic classifier. Furthermore, we found novel genes, never associated before to mesotheliom that could be involved in tumour progression. Notable is the identification of MMP-14, a member of matrix metalloproteinase family. In a cohort of 70 mesothelioma patients, we found by a multivariate Cox regression analysis, that the only parameter influencing overall survival was expression of MMP14. The calculated relative risk of death in MM patients with low MMP14 expression was significantly lower than patients with high MMp14 expression (P = 0.002).Conclusions: Based on the results provided, this molecule could be viewed as a new and effective therapeutic target to test for the cure of mesothelioma.

Published
2009

39. Biological agents involved in malignant mesothelioma: relevance as biomarkers or therapeutic targets

Author

Stefania Crispi, Simona Menegozzo, Gennaro Citro, Irene Cardillo, Alfonso Baldi, Enrico P. Spugnini, Crispi, S, Cardillo, I, Spugnini, Ep, Citro, G, Menegozzo, S, and Baldi, Alfonso

Subjects
Mesothelioma, Cancer Research, Pathology, medicine.medical_specialty, Lung Neoplasms, Pleural Neoplasms, medicine.disease_cause, Asbestos, Pathogenesis, Mice, Pathogenesi, Drug Discovery, medicine, Biomarkers, Tumor, Animals, Humans, Peritoneal Neoplasms, Pharmacology, business.industry, Mechanism (biology), Molecular pathogenesis, Biomarker, medicine.disease, Disease control, Gene Expression Regulation, Neoplastic, Oncology, Mutation, Cancer research, Carcinogens, business, cDNA array
Abstract

Malignant mesothelioma (MM) is a rare, highly aggressive tumor that arises from the surface serosal cells (pleural, peritoneal and pericardial cavities). Epidemiological and clinical data show that there is an association between asbestos exposure and MM development, even if the exact mechanism whereby asbestos induces MM is unknown. The continuing identification and elucidation of the molecular defects involved in mesothelioma pathogenesis and progression should lead to better disease control and greater therapeutic options in the near future. Goal of this article is to summarize the most recent advances in molecular pathogenesis of mesothelioma with particular emphasis on genes that could be considered as biomarkers or therapeutic targets and discuss possible clinical implications of these findings. © 2010 Bentham Science Publishers Ltd.

Published
2009

40. Molecular analysis of the effects of Piroxicam and Cisplatin on mesothelioma cells growth and viability

Author

Alessandra, Verdina, Irene, Cardillo, Angela, Nebbioso, Rossella, Galati, Simona, Menegozzo, Lucia, Altucci, Ada, Sacchi, Alfonso, Baldi, Verdina, A, Cardillo, I, Nebbioso, Angela, Galati, R, Menegozzo, S, Altucci, A, Sacchi, A, Baldi, Alfonso, and Altucci, Lucia

Subjects
Mesothelioma, Cell Survival, Research, Anti-Inflammatory Agents, Non-Steroidal, Cell Cycle, lcsh:R, lcsh:Medicine, Antineoplastic Agents, Apoptosis, Cell Line, Enzyme Activation, Piroxicam, Cyclooxygenase 2, Cell Line, Tumor, Humans, Cyclooxygenase Inhibitors, Cisplatin, neoplasms, Cell Proliferation
Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) have been proposed for prevention and treatment of a variety of human cancers. Piroxicam, in particular, has been recently shown to exert significant anti-tumoral activity in combination with cisplatin (CDDP) on mesothelioma cells. However, the mechanisms through which NSAIDs regulate the cell cycle as well as the signal pathways involved in the growth inhibition, remain unclear. In the present study, using two mesothelioma cell lines, MSTO-211H and NCI-H2452, we have investigated the influence of piroxicam alone and in association with CDDP on proliferation, cell cycle regulation and apoptosis. In both cell lines a significant effect on cell growth inhibition, respect to the control, was observed with all the drugs tested. Moreover, treatment with piroxicam or CDDP alone altered the cell cycle phase distribution as well as the expression of some cell cycle regulatory proteins in both cell lines. These effects were increased, even if in a not completely overlapping manner, after treatment with the association of piroxicam and CDDP. In particular, the two drugs in NCI cell line had a synergistic effect on apoptosis, probably through activation of caspase 8 and caspase 9, while the most evident targets among the cell cycle regulators were cyclin D1 and p21waf1. These results suggest that the association of piroxicam and CDDP specifically triggers cell cycle regulation and apoptosis in different mesothelioma cell lines and may hold promise in the treatment of mesothelioma. © 2008 Verdina et al; licensee BioMed Central Ltd.

Published
2008

41. The serine protease HtrA1 is a novel prognostic factor for human mesothelioma

Author

Pasquale Mellone, Alfonso Baldi, Simona Menegozzo, Mario Santini, Gennaro Citro, M. Marino, Alessandra Mirri, Bruno Vincenzi, Marcella Mottolese, Anna Ceribelli, Mara Campioni, Jeremy Chien, Francesco Facciolo, Viji Shridhar, P. Visca, Enrico P. Spugnini, Vincenzo Giuseppe Di Crescenzo, Michael Ehrmann, Baldi, Alfonso, Mottolese, M, Vincenzi, B, Campioni, M, Mellone, P, DI MARINO, Mp, DI CRESCENZO, V, Visca, P, Menegozzo, S, Citro, G, Cerebelli, A, Mirri, A, Chien, J, Shridhar, V, Ehrmann, M, Santini, Mario, and Facciolo, F.

Subjects
Male, Mesothelioma, Oncology, medicine.medical_specialty, Multivariate analysis, Survival, Prognosi, EGFR, Biology, Bioinformatics, Cell Line, Tumor, Internal medicine, Biomarkers, Tumor, Genetics, medicine, Humans, Aged, Retrospective Studies, Aged, 80 and over, Pharmacology, Serine protease, Proportional hazards model, Serine Endopeptidases, Serine Protease HTRA1, High-Temperature Requirement A Serine Peptidase 1, Middle Aged, Prognosis, medicine.disease, Immunohistochemistry, eye diseases, ErbB Receptors, HtrA1, HTRA1, biology.protein, Molecular Medicine, Female, Lymph, Follow-Up Studies
Abstract

Aims: The objective of our study was to analyze the potential prognostic value of the expression of the serine protease HtrA1 and of EGFR in 70 malignant mesotheliomas. Materials & methods: Immunohistochemistry was used to determine the expression of HtrA1 and EGFR. Univariate and multivariate analyses were used to correlate expression of these molecular factors in combination with available clinicopathologic data to patient survival. Results: A positive, statistically significant relationship has been recorded between HtrA1 expression level and survival (p

Published
2008

42. Cause specific mortality in an Italian pool of asbestos workers cohorts.

Author

Ferrante D, Angelini A, Barbiero F, Barbone F, Bauleo L, Binazzi A, Bovenzi M, Bruno C, Casotto V, Cernigliaro A, Ceppi M, Cervino D, Chellini E, Curti S, De Santis M, Fazzo L, Fedeli U, Fiorillo G, Franchi A, Gangemi M, Giangreco M, Rossi PG, Girardi P, Luberto F, Massari S, Mattioli S, Menegozzo S, Merlo DF, Michelozzi P, Migliore E, Miligi L, Oddone E, Pernetti R, Perticaroli P, Piro S, Addario SP, Romeo E, Roncaglia F, Silvestri S, Storchi C, Zona A, Magnani C, and Marinaccio A

Subjects
Male, Humans, Female, Cause of Death, Cohort Studies, Construction Materials, Italy epidemiology, Mesothelioma etiology, Occupational Exposure adverse effects, Occupational Diseases etiology, Asbestos adverse effects, Pleural Neoplasms, Peritoneal Neoplasms, Ovarian Neoplasms, Lung Neoplasms etiology
Abstract

Background: Asbestos is a known human carcinogen and is causally associated with malignant mesothelioma, lung, larynx and ovarian cancers., Methods: Cancer risk was studied among a pool of formerly asbestos-exposed workers in Italy. Fifty-two Italian asbestos cohorts (asbestos-cement, rolling-stock, shipbuilding, and other) were pooled and their mortality follow-up was updated to 2018. Standardized mortality ratios (SMRs) were computed for major causes of death considering duration of exposure and time since first exposure (TSFE), using reference rates by region, age and calendar period., Results: The study included 63,502 subjects (57,156 men and 6346 women): 40% who were alive, 58% who died (cause known for 92%), and 2% lost to follow-up. Mortality was increased for all causes (SMR: men = 1.04, 95% confidence interval [CI] 1.03-1.05; women = 1.15, 95% CI 1.11-1.18), all malignancies (SMR: men = 1.21, 95% CI 1.18-1.23; women = 1.29, 95% CI 1.22-1.37), pleural and peritoneal malignancies (men: SMR = 10.46, 95% CI 9.86-11.09 and 4.29, 95% CI 3.66-5.00; women: SMR = 27.13, 95% CI 23.29-31.42 and 7.51, 95% CI 5.52-9.98), lung (SMR: men = 1.28, 95% CI 1.24-1.32; women = 1.26, 95% CI 1.02-1.53), and ovarian cancer (SMR = 1.42, 95% CI 1.08-1.84). Pleural cancer mortality increased during the first 40 years of TSFE (latency), reaching a plateau thereafter., Conclusions: Analyses by time-dependent variables showed that the risk for pleural neoplasms increased with latency and no longer increases at long TSFE, consistent with with asbestos clearance from the lungs. Peritoneal neoplasm risk increased over all observation time., (© 2023 The Authors. American Journal of Industrial Medicine published by Wiley Periodicals LLC.)

Published
2024
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43. Rate advancement measurement for lung cancer and pleural mesothelioma in asbestos-exposed workers.

Author

Azzolina D, Consonni D, Ferrante D, Mirabelli D, Silvestri S, Luberto F, Angelini A, Cuccaro F, Nannavecchia AM, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Tunesi S, Chellini E, Miligi L, Perticaroli P, Pettinari A, Bressan V, Merler E, Girardi P, Bisceglia L, Marinaccio A, Massari S, and Magnani C

Subjects
Humans, Cohort Studies, Italy epidemiology, Mortality trends, Risk Assessment, Male, Female, Construction Industry, Adult, Middle Aged, Aged, Asbestos toxicity, Lung Neoplasms epidemiology, Lung Neoplasms mortality, Mesothelioma epidemiology, Mesothelioma mortality, Occupational Diseases epidemiology, Occupational Diseases mortality, Occupational Exposure adverse effects, Pleural Neoplasms epidemiology, Pleural Neoplasms mortality
Abstract

Introduction: Exposure to asbestos increases the risk of lung cancer and mesothelioma. Few studies quantified the premature occurrence of these diseases in asbestos-exposed workers. Focus on premature disease onset (rate advancement or acceleration) can be useful in risk communication and for the evaluation of exposure impact. We estimated rate advancement for total mortality, lung cancer and pleural mesothelioma deaths, by classes of cumulative asbestos exposure in a pooled cohort of asbestos cement (AC) workers in Italy., Method: The cohort study included 12 578 workers from 21 cohorts, with 6626 deaths in total, 858 deaths from lung cancer and 394 from pleural malignant neoplasm (MN). Rate advancement was estimated by fitting a competitive mortality Weibull model to the hazard of death over time since first exposure (TSFE)., Result: Acceleration time (AT) was estimated at different TSFE values. The highest level of cumulative exposure compared with the lowest, for pleural MN AT was 16.9 (95% CI 14.9 to 19.2) and 33.8 (95% CI 29.8 to 38.4) years at TSFE of 20 and 40 years, respectively. For lung cancer, it was 13.3 (95% CI 12.0 to 14.7) and 26.6 (95% CI 23.9 to 29.4) years, respectively. As for total mortality, AT was 3.35 (95% CI 2.98 to 3.71) years at 20 years TSFE, and 6.70 (95% CI 5.95 to 7.41) at 40 years TSFE., Conclusion: The current study observed marked rate advancement after asbestos exposure for lung cancer and pleural mesothelioma, as well as for total mortality., Competing Interests: Competing interests: The authors declare that they have no competing interests. The following authors or working group components reported that they served as expert witness in court trials on asbestos related diseases: AA, AB, CM, DM, EM, EO, FB-A, LBi, LMa, LMi, MM, SMe, SS, VP., (© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2023
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45. A SARS-CoV-2 Infection High-Uptake Program on Healthcare Workers and Cancer Patients of the National Cancer Institute of Naples, Italy.

Author

Crispo A, Di Gennaro P, Coluccia S, Gandini S, Montagnese C, Porciello G, Nocerino F, Grimaldi M, Tafuri M, Luongo A, Rotondo E, Amore A, Labonia F, Meola S, Marone S, Pierro G, Menegozzo S, Miscio L, Perri F, Rainisio M, Bianchi AAM, Cavalcanti E, Cascella M, and Celentano E

Abstract

Background: From the beginning of 2020, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) quickly spread worldwide, becoming the main problem for the healthcare systems. Healthcare workers (HCWs) are at higher risk of infection and can be a dangerous vehicle for the spread of the virus. Furthermore, cancer patients (CPs) are a vulnerable population, with an increased risk of developing severe and lethal forms of Coronavirus Disease 19 (COVID-19). Therefore, at the National Cancer Institute of Naples, where only cancer patients are treated, a surveillance program aimed to prevent the hospital access of SARS-CoV-2 positive subjects (HCWs and CPs) was implemented. The study aims to describe the results of the monitoring activity for the SARS-CoV-2 spread among HCWs and CPs, from March 2020 to March 2021., Methods: This surveillance program included a periodic sampling through nasopharyngeal molecular swabs for SARS-CoV-2 (Real-Time Polymerase Chain Reaction, RT-PCR). CPs were submitted to the molecular test at least 48 h before hospital admission. Survival analysis and multiple logistic regression models were performed among HCWs and CPs to assess the main SARS-CoV-2 risk factors., Results: The percentages of HCWs tested with RT-PCR for the detection of SARS-CoV-2, according to the first and the second wave, were 79.7% and 91.7%, respectively, while the percentages for the CPs were 24.6% and 39.6%. SARS-CoV-2 was detected in 20 (1.7%) HCWs of the 1204 subjects tested during the first wave, and in 127 (9.2%) of 1385 subjects tested in the second wave ( p < 0.001); among CPs, the prevalence of patients tested varied from 100 (4.6%) during the first wave to 168 (4.9%) during the second wave ( p = 0.8). The multivariate logistic analysis provided a significant OR for nurses (OR = 2.24, 95% CI 1.23-4.08, p < 0.001) compared to research, administrative staff, and other job titles., Conclusions: Our findings show that the positivity rate between the two waves in the HCWs increased over time but not in the CPs; therefore, the importance of adopting stringent measures to contain the shock wave of SARS-CoV-2 infection in the hospital setting was essential. Among HCWs, nurses are more exposed to contagion and patients who needed continuity in oncological care for diseases other than COVID-19, such as suspected cancer.

Published
2022
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46. The clinical and translational research activities at the INT - IRCCS "Fondazione Pascale" cancer center (Naples, Italy) during the COVID-19 pandemic.

Author

Buonaguro FM, Botti G, Ascierto PA, Pignata S, Ionna F, Delrio P, Petrillo A, Cavalcanti E, Di Bonito M, Perdonà S, De Laurentiis M, Fiore F, Palaia R, Izzo F, D'Auria S, Rossi V, Menegozzo S, Piccirillo M, Celentano E, Cuomo A, Normanno N, Tornesello ML, Saviano R, Barberio D, Buonaguro L, Giannoni G, Muto P, Miscio L, and Bianchi AAM

Abstract

COVID-19 pandemic following the outbreak in China and Western Europe, where it finally lost the momentum, is now devastating North and South America. It has not been identified the reason and the molecular mechanisms of the two different patterns of the pulmonary host responses to the virus from a minimal disease in young subjects to a severe distress syndrome (ARDS) in older subjects, particularly those with previous chronic diseases (including diabetes) and cancer. The Management of the Istituto Nazionale Tumori - IRCCS "Fondazione Pascale" in Naples (INT-Pascale), along with all Health professionals decided not to interrupt the treatment of those hospitalized and to continue, even if after a careful triage in order not to allow SARS-CoV-2 positive subjects to access, to take care of cancer patients with serious conditions. Although very few (n = 3) patients developed a symptomatic COVID-19 and required the transfer to a COVID-19 area of the Institute, no patients died during the hospitalization and completed their oncology treatment. Besides monitoring of the patients, all employees of the Institute (physicians, nurses, researchers, lawyers, accountants, gatekeepers, guardians, janitors) have been tested for a possible exposure. Personnel identified as positive, has been promptly subjected to home quarantine and subdued to health surveillance. One severe case of respiratory distress has been reported in a positive employees and one death of a family member. Further steps to home monitoring of COVID-19 clinical course have been taken with the development of remote Wi-Fi connected digital devices for the detection of early signs of respiratory distress, including heart rate and oxygen saturation.In conclusion cancer care has been performed and continued safely also during COVID-19 pandemic and further remote home strategies are in progress to ensure the appropriate monitoring of cancer patients.

Published
2020
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47. Italian pool of asbestos workers cohorts: asbestos related mortality by industrial sector and cumulative exposure.

Author

Magnani C, Silvestri S, Angelini A, Ranucci A, Azzolina D, Cena T, Chellini E, Merler E, Pavone V, Miligi L, Gorini G, Bressan V, Girardi P, Bauleo L, Romeo E, Luberto F, Sala O, Scarnato C, Menegozzo S, Oddone E, Tunesi S, Perticaroli P, Pettinari A, Cuccaro F, Mattioli S, Baldassarre A, Barone-Adesi F, Musti M, Mirabelli D, Pirastu R, Marinaccio A, Massari S, and Ferrante D

Subjects
Cause of Death, Cohort Studies, Female, Humans, Italy epidemiology, Lung Neoplasms etiology, Lung Neoplasms mortality, Mineral Fibers toxicity, Ovarian Neoplasms etiology, Ovarian Neoplasms mortality, Peritoneal Neoplasms etiology, Peritoneal Neoplasms mortality, Pleural Neoplasms etiology, Pleural Neoplasms mortality, Retrospective Studies, Risk, Urinary Bladder Neoplasms etiology, Urinary Bladder Neoplasms mortality, Asbestos toxicity, Asbestosis mortality, Construction Materials toxicity, Industry, Occupational Exposure adverse effects
Abstract

Objective: Italy has been a large user of asbestos and asbestos containing materials until the 1992 ban. We present a pooled cohort study on long-term mortality in exposed workers., Methods: Pool of 43 Italian asbestos cohorts (asbestos cement, rolling stock, shipbuilding, glasswork, harbors, insulation and other industries). SMRs were computed by industrial sector for the 1970-2010 period, for the major causes, using reference rates by age, sex, region and calendar period., Results: The study included 51 801 subjects (5741 women): 55.9% alive, 42.6% died (cause known for 95%) and 1.5% lost to follow-up. Asbestos exposure was estimated at the plant and period levels. Asbestos related mortality was significantly increased. All industrial sectors showed increased mortality from pleural malignancies, and most also from peritoneal and lung cancer and asbestosis, with exposure related trend. Increased mortality was also observed for ovarian cancer and for bladder cancer., Discussion: The study confirmed the increased risk for cancer of the lung, ovary, pleura and peritoneum but not of the larynx and the digestive tract. A large increase in mortality from asbestosis was observed.

Published
2020
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48. Factors Affecting Asbestosis Mortality Among Asbestos-Cement Workers in Italy.

Author

Girardi P, Merler E, Ferrante D, Silvestri S, Chellini E, Angelini A, Luberto F, Fedeli U, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mirabelli D, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Azzolina D, Tunesi S, Miligi L, Perticaroli P, Pettinari A, Cuccaro F, Nannavecchia AM, Bisceglia L, Marinaccio A, Pavone VLM, and Magnani C

Subjects
Asbestos, Serpentine, Female, Humans, Italy epidemiology, Male, Middle Aged, Asbestos adverse effects, Asbestosis, Occupational Exposure adverse effects
Abstract

Objectives: This study was performed with the aim of investigating the temporal patterns and determinants associated with mortality from asbestosis among 21 cohorts of Asbestos-Cement (AC) workers who were heavily exposed to asbestos fibres., Methods: Mortality for asbestosis was analysed for a cohort of 13 076 Italian AC workers (18.1% women). Individual cumulative asbestos exposure index was calculated by factory and period of work weighting by the different composition of asbestos used (crocidolite, amosite, and chrysotile). Two different approaches to analysis, based on Standardized Mortality Ratios (SMRs) and Age-Period-Cohort (APC) models were applied., Results: Among the considered AC facilities, asbestos exposure was extremely high until the end of the 1970s and, due to the long latency, a peak of asbestosis mortality was observed after the 1990s. Mortality for asbestosis reached extremely high SMR values [SMR: males 508, 95% confidence interval (CI): 446-563; females 1027, 95% CI: 771-1336]. SMR increased steeply with the increasing values of cumulative asbestos exposure and with Time Since the First Exposure. APC analysis reported a clear age effect with a mortality peak at 75-80 years; the mortality for asbestosis increased in the last three quintiles of the cumulative exposure; calendar period did not have a significant temporal component while the cohort effect disappeared if we included in the model the cumulative exposure to asbestos., Conclusions: Among heaviest exposed workers, mortality risk for asbestosis began to increase before 50 years of age. Mortality for asbestosis was mainly determined by cumulative exposure to asbestos., (© The Author(s) 2020. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Published
2020
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49. Role of asbestos clearance in explaining long-term risk of pleural and peritoneal cancer: a pooled analysis of cohort studies.

Author

Barone-Adesi F, Ferrante D, Chellini E, Merler E, Pavone V, Silvestri S, Miligi L, Gorini G, Bressan V, Girardi P, Ancona L, Romeo E, Luberto F, Sala O, Scarnato C, Menegozzo S, Oddone E, Tunesi S, Perticaroli P, Pettinari A, Cuccaro F, Curti S, Baldassarre A, Cena T, Angelini A, Marinaccio A, Mirabelli D, Musti M, Pirastu R, Ranucci A, and Magnani C

Subjects
Adolescent, Adult, Female, Humans, Italy epidemiology, Male, Middle Aged, Models, Theoretical, Time Factors, Young Adult, Asbestos adverse effects, Occupational Diseases mortality, Occupational Exposure adverse effects, Peritoneal Neoplasms mortality, Pleural Neoplasms mortality
Abstract

Objectives: Models based on the multistage theory of cancer predict that rates of malignant mesothelioma continuously increase with time since first exposure (TSFE) to asbestos, even after the end of external exposure. However, recent epidemiological studies suggest that mesothelioma rates level off many years after first exposure to asbestos. A gradual clearance of asbestos from the lungs has been suggested as a possible explanation for this phenomenon. We analysed long-term trends of pleural and peritoneal cancer mortality in subjects exposed to asbestos to evaluate whether such trends were consistent with the clearance hypothesis., Methods: We used data from a pool of 43 Italian asbestos cohorts (51 801 subjects). The role of asbestos clearance was explored using the traditional mesothelioma multistage model, generalised to include a term representing elimination of fibres over time., Results: Rates of pleural cancer increased until 40 years of TSFE, but remained stable thereafter. On the other hand, we observed a monotonic increase of peritoneal cancer with TSFE. The model taking into account asbestos clearance fitted the data better than the traditional one for pleural (p=0.004) but not for peritoneal (p=0.09) cancer., Conclusions: Rates of pleural cancer do not increase indefinitely after the exposure to asbestos, but eventually reach a plateau. This trend is well described by a model accounting for a gradual elimination of the asbestos fibres. These results are relevant for the prediction of future rates of mesothelioma and in asbestos litigations., Competing Interests: Competing interests: SM served as expert witness for the judge, the public prosecutor and the defendant’s attorneys in court trials regarding asbestos-related diseases. CM and SS served as expert witnesses for the judge and the public prosecutor in court trials regarding asbestos-related diseases. AA, FB-A, PL, EM, LMi, DM and EO served as expert witnesses for the public prosecutor in court trials regarding asbestos-related diseases. LMa conducted negotiations and stipulated contracts representing the Italian Association of Cancer Registries (AIRTUM) for the preparation and publication of specific reports on the epidemiology of tumour pathologies with MSD, Lilly and Sanofi. All other authors declare they have no actual or potential competing financial interests., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2019
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50. Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy.

Author

Luberto F, Ferrante D, Silvestri S, Angelini A, Cuccaro F, Nannavecchia AM, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mirabelli D, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Azzolina D, Tunesi S, Chellini E, Miligi L, Perticaroli P, Pettinari A, Bressan V, Merler E, Girardi P, Bisceglia L, Marinaccio A, Massari S, and Magnani C

Subjects
Adult, Asbestosis etiology, Cohort Studies, Female, Humans, Italy epidemiology, Male, Middle Aged, Neoplasms chemically induced, Sex Factors, Time Factors, Young Adult, Asbestos adverse effects, Asbestosis epidemiology, Neoplasms epidemiology, Occupational Exposure adverse effects
Abstract

Background: Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos., Methods: The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution., Results: Mortality was significantly increased for 'All Causes' and 'All Malignant Neoplasm (MN)', in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%., Conclusions: Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studies.

Published
2019
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