Asbestos exposure in a shipyard area, northeastern Italy

Our plain-English summary of Asbestos exposure in a shipyard area, northeastern Italy, by C. Bianchi, A. Brollo, L. Ramani (Industrial Health, 2000).

The study

• Authors: C. Bianchi, A. Brollo, L. Ramani
• Journal: Industrial Health
• Published: 2000;38(3):301-8
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The Monfalcone area, northeastern Italy, is a small industrial district (population 60,000), with a large shipyard. In order to monitor asbestos exposure in this area, a series of 3,640 necropsies, carried out at the Monfalcone Hospital between October 1979 and September 1998, were investigated. The thoracic cavities were examined for pleural plaques; these were classified into three classes (small, moderate, large). Routine histological sections of lung tissue were examined for asbestos bodies. Isolation and counting of asbestos bodies were performed in 1,075 cases. Lifetime occupational data were collected in 1,277 cases. Pleural plaques were observed in 70.5% among men and in 23.8% among women. The prevalences of pleural plaques did not show significant variations during the study period. Asbestos bodies were found on routine lung sections in 23.7% of men and 3.0% of women. The shipyard workers, the most numerous category in the series, were characterized by high prevalence of pleural plaques (total 86.7%, large 32.4%), high prevalence of asbestos bodies on routine lung sections (35.3%), and high amounts of lung asbestos bodies after isolation. The present data indicate that asbestos exposure may reach alarming levels in the shipyard areas.

In plain English

The authors studied 3,640 autopsies of people aged 15 or older at the Hospital of Monfalcone, a shipyard town in northeastern Italy, from October 1979 to September 1998. They checked for pleural plaques, graded small, moderate or large, and looked for asbestos bodies in routine lung sections. Asbestos bodies were extracted and counted in 1,075 cases; relatives gave work histories in 1,277. Plaques were found in 70.5% of 2,260 men and 23.8% of 1,380 women. Asbestos bodies were seen on routine sections in 23.7% of men and 3.0% of women. Plaque rates showed no relevant change over the study period. Among the 646 shipbuilding workers with work histories, 86.7% had plaques (32.4% large) and 35.3% had asbestos bodies on routine sections. Compared with other occupational groups, they had significantly higher rates of moderate-to-large plaques and of asbestos bodies on routine sections, and higher lung asbestos body counts. Women classed as domestically exposed had cleaned relatives' work clothes. The authors concluded that the area's high asbestos exposure was mainly due to shipbuilding and also reached family members through dusty work clothes.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Autopsy (necropsy) series examining three markers of asbestos exposure: occupational history, pleural plaques, and lung asbestos bodies
• Who was studied: 3,640 autopsies of persons aged 15 or older (2,260 men, 1,380 women) at the Hospital of Monfalcone, northeastern Italy, October 1979 to September 1998. Autopsies covered 30 to 45% of hospital deaths among men and 20 to 30% among women.
• Exposure: Asbestos exposure in shipbuilding and other occupations, plus domestic exposure from cleaning work clothes. Fiber types were not identified in this series, apart from a very limited sample published earlier.
• Main results:
  • Pleural plaques were found in 70.5% of men (2,260 cases) and 23.8% of women (1,380 cases).
  • Asbestos bodies were found on routine lung sections in 23.7% of men and 3.0% of women.
  • Men resident in the Monfalcone area had higher prevalences of total plaques (73.7% of 1,940) and of large plaques than men resident elsewhere (51.3% of 320 total plaques), p less than 0.0001.
  • Plaque prevalence showed no relevant variation when cases were divided by age group and calendar period.
  • The prevalence of asbestos bodies on routine lung sections rose progressively from people without plaques through plaque classes 1, 2 and 3. Among men it rose from 4.8% to 14.1%, 32.6% and 50.8% (p less than 0.0001).
  • Shipbuilding workers (646 cases with occupational data) had 86.7% total plaques, 32.4% large plaques and 35.3% asbestos bodies on routine sections. Their moderate-large plaques and asbestos bodies were significantly higher than in other groups (p less than 0.0001).
  • In digested lung tissue, shipyard workers (430 cases) differed significantly from other categories in the share of cases with more than 10,000 asbestos bodies per gram (p less than 0.0001).
  • Women very rarely had more than 10,000 asbestos bodies per gram of dried lung tissue.
  • Women classed as domestically exposed (141 cases, 51.0% with plaques) had cleaned the work clothes of relatives employed in the shipyard or other industries.
• The authors' conclusion: The authors concluded that the high degree of asbestos exposure in the Monfalcone area was mainly attributable to shipbuilding, and that family members of shipyard workers were also exposed through asbestos-polluted work clothes.
• Limitations the authors state:
  • The authors described examining routine lung sections for asbestos bodies as a rough method with reduced sensitivity.
  • The people from the surrounding area are only a partial comparison group, because some shipyard workers came from there.
  • Asbestos fiber type was identified in only a very limited sample of the series.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Pleural Plaques, Asbestos Bodies.

Related studies

• Pleural plaques as risk indicators for malignant pleural mesothelioma: a necropsy-based study — C. Bianchi, A. Brollo, et al. (1997)
• A historical cohort mortality study among shipyard workers in Genoa, Italy — R. Puntoni, F. Merlo, et al. (2001)
• Asbestos and SV40 in malignant pleural mesothelioma from a hyperendemic area of north-eastern Italy — M. Comar, N. Zanotta, et al. (2012)
• Asbestos-related mesothelioma in Monfalcone, Italy — C. Bianchi, A. Brollo, et al. (1993)
• Mortality among shipyard workers in Genoa, Italy — R. Puntoni, M. Vercelli, et al. (1979)
• Mortality among workers exposed to asbestos at the shipyard of Genoa, Italy: a 55 years follow-up — D.F. Merlo, M. Bruzzone, et al. (2018)

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