Asbestos exposure in malignant mesothelioma of the pleura: a survey of 557 cases

Our plain-English summary of Asbestos exposure in malignant mesothelioma of the pleura: a survey of 557 cases, by C. Bianchi, A. Brollo, L. Ramani, et al (Industrial Health, 2001).

The study

• Authors: C. Bianchi, A. Brollo, L. Ramani, T. Bianchi, L. Giarelli
• Journal: Industrial Health
• Published: 2001;39(2):161-7
• Cited by: 50 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A series of 557 malignant mesotheliomas of the pleura diagnosed in the Trieste-Monfalcone area, Italy, in the period 1968-2000 were reviewed. The series included 492 men and 65 women, aged between 32 and 93 years (median age 69 years). Necropsy findings were available in 456 cases (82%). Occupational histories were obtained from the patients themselves or from their relatives by personal or telephone interviews. Routine lung sections were examined for asbestos bodies in 442 cases. In 109 cases isolation and counting of asbestos bodies were performed. A majority of people had histories of working in the shipyards. Asbestos bodies were observed in lung sections in 67% of the cases. Lung asbestos body burdens after isolation ranged between 20 bodies and about 10 millions of bodies/g dried tissue. Latency periods (time intervals between first exposure to asbestos and death) ranged between 14 and 75 years (mean 48.8 years, median 51.0). Latency periods among insulators and dock workers were shorter than among the other categories. High asbestos consumption occurred in many countries in the 1960s and in the 1970s. The data on latency periods obtained in the present study suggest that a world mesothelioma epidemic has to be expected in the coming decades.

In plain English

This study reviewed 557 cases of malignant mesothelioma of the pleura (the lining around the lungs) diagnosed in the Trieste-Monfalcone area of northeastern Italy, a shipyard district, between 1968 and 2000. The cases were 492 men and 65 women. In 456 cases the diagnosis was based on or confirmed by autopsy. Work histories came from patients or relatives, and lung tissue was examined for asbestos bodies. A large majority of the men had worked in shipbuilding. Twenty-one women had been exposed at home by cleaning relatives' work clothes. The authors reported that over 90% of the tumors were asbestos-related. Of 394 patients with a known first-exposure date, about 80% were first exposed before 1950. In 380 cases, the time from first exposure to death ranged from 14 to 75 years (median 51.0), exceeding 40 years in about 75%. Insulators and dock workers had shorter times. Asbestos bodies appeared in routine lung sections in 67% of the 442 cases examined. The authors concluded that these long latency periods suggest a world mesothelioma epidemic is to be expected in the coming decades.

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: Review of a case series of malignant pleural mesotheliomas, with occupational interviews, lung asbestos body examination and autopsy findings
• Who was studied: 557 people with malignant pleural mesothelioma (492 men aged 32 to 93, 65 women aged 40 to 89) diagnosed in the Trieste-Monfalcone area, northeastern Italy, 1968 to 2000; diagnosis based on or confirmed by necropsy in 456 cases
• Exposure: Occupational and domestic asbestos exposure, mainly in shipbuilding. Other groups were other industries, navy and merchant marine, dock work and insulation. Women were exposed at home through cleaning work clothes. Fiber types were not generally specified; one patient was listed as a Wittenoom (Australia) crocidolite mine worker.
• Main results:
  • Among the 65 women, 21 had histories of asbestos exposure at home from cleaning the work clothes of family members
  • Among men with available occupational data, about 85% were classifiable as having done 'naval' work (shipbuilding and ship repair, maritime trades, dock work)
  • The proportion of asbestos-related tumors in the series was higher than 90%
  • About 80% of patients with first-exposure data (394 cases) were first exposed before 1950
  • Latency periods (first exposure to death), calculated in 380 cases, ranged from 14 to 75 years (mean 48.8, median 51.0). They were longer than 40 years in about 75% of cases.
  • Latency periods among insulators (5 cases, mean 29.6 years) and dock workers (14 cases, mean 36.3 years) were shorter than among the other categories. Shipbuilding cases (263) had a mean of 49.3 years.
  • Asbestos bodies were found in routine lung sections in 67% of the 442 cases examined
  • In the 109 cases with asbestos body counts, amounts ranged from 20 bodies to about 10 million bodies per gram of dried lung tissue
  • Pleural plaques were observed in a majority of the 133 necropsy cases specifically examined for them; they were absent in 19 (14.3%)
  • Environmental (non-occupational, non-domestic) asbestos exposure was not documented in these cases
• The authors' conclusion: The authors concluded that the long latency periods found, together with high asbestos use in the 1960s and 1970s, suggest that a world mesothelioma epidemic has to be expected in the coming decades
• Limitations the authors state:
  • Sufficient occupational and social data could not be obtained for a relevant portion of the female patients
  • It was sometimes very difficult to obtain complete occupational data and to establish whether a given job involved contact with asbestos

Mines named here

Asbestos mines this study is about. Each mine's page says who ran it, when it worked, and what it produced.

• Wittenoom, Western Australia

All asbestos mines

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Mesothelioma, Pleura, Autopsy, Asbestos Bodies, Latency, Insulator.

Related studies

• Familial mesothelioma of the pleura--a report of 40 cases — C. Bianchi, A. Brollo, et al. (2004)
• Malignant mesothelioma of the pleura in Trieste, Italy — L. Giarelli, C. Bianchi, et al. (1992)
• Malignant mesothelioma of the pleura in nonagenarian patients — C. Bianchi, T. Bianchi, et al. (2011)
• Asbestos exposure in lung carcinoma: a necropsy-based study of 414 cases — C. Bianchi, A. Brollo, et al. (1999)
• Malignant mesothelioma of the pleura and other malignancies in the same patient — C. Bianchi, T. Bianchi, et al. (2007)
• Diffuse pleural mesothelioma in Trieste. A survey based on autopsy cases — C. Bianchi, G. Grandi, et al. (1978)

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