Asbestos exposure in the Monfalcone area. A social and pathological study of 100 autopsy cases

Our plain-English summary of Asbestos exposure in the Monfalcone area. A social and pathological study of 100 autopsy cases, by C. Bianchi, A. Brollo, C. Miniussi, et al (Tumori, 1981).

The study

• Authors: C. Bianchi, A. Brollo, C. Miniussi, L. Bittesini
• Journal: Tumori
• Published: 1981;67(4):279-82
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Monfalcone is a coastal town with important shipyards. In the present investigation hyalin pleural plaques, lung asbestos bodies, and occupational history were studied in 100 consecutive autopsy cases, collected at the hospital of Monfalcone. Pleural plaques were observed in 72% of males and in 33% of females. Asbestos bodies were found after chemical digestion of pulmonary tissue in 94 cases, and an approximate estimation of their amount showed high or very high numbers in 39 cases. Occupational history, obtained from patients' relatives, was suggestive of occupational asbestos exposure in 60 cases, with 37 subjects having worked in the shipyards. Thirteen other patients had had a probable domestic exposure to asbestos. The severity of asbestos exposure in the Monfalcone area is emphasized.

In plain English

This study examined 100 consecutive autopsies (73 males and 27 females, aged 39 to 91) performed between October 1979 and June 1980 at the general hospital of Monfalcone, an Italian town with large shipyards. The authors looked for hyalin pleural plaques, counted asbestos bodies in a chemically digested sample of right lung tissue, and obtained lifetime work histories from relatives. Plaques were found in 62 people (53 males and 9 females), which the authors give as 72% of males and 33% of females. Asbestos bodies were found in 94 cases, with high or very high numbers in 39. By work history, 37 had worked in the shipyards, 23 had other work suggestive of asbestos exposure, 13 women had probable domestic exposure, and 27 had no history indicating exposure. Both patients with pleural mesothelioma had severe plaques and high asbestos body counts. Of 13 lung cancer patients, all smokers, 12 had plaques. The authors concluded that asbestos exposure in the area was an alarming phenomenon. They noted that work histories came from relatives and might be inadequate.

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 series: 100 consecutive necropsies at one hospital, combining pathology findings (pleural plaques, lung asbestos bodies) with occupational histories obtained by interviewing relatives
• Who was studied: 100 consecutive autopsy cases (73 males, 27 females, ages 39 to 91; mean age 71 in females and 66 in males) at the Ospedale Generale Provinciale of Monfalcone, Italy, October 1979 to June 1980. Ninety-four had lived most of their lives in Monfalcone and/or a small neighboring area.
• Exposure: Asbestos exposure judged from lifetime work history, with shipyard and construction work counted as suggestive of occupational exposure, plus probable domestic exposure (for example, wives of shipyard workers). Exposure was also indicated by pleural plaques and asbestos bodies in lung tissue. Fiber types were not identified.
• Main results:
  • Hyalin pleural plaques were found in 62 of the 100 subjects (53 males and 9 females), which the authors give as 72% of males and 33% of females.
  • Among the 62 with plaques, the extent was slight in 21, moderate in 16 and severe in 25.
  • Asbestos bodies were found in 94 cases: scarce (1-10) in 24, discrete (11-100) in 31, high (101-1000) in 20 and very high (over 1000) in 19, including 4 over 10,000. High or very high counts were present in 39% of cases.
  • By work history, 37 patients had worked in the Monfalcone shipyards (group I), 23 had other histories suggestive of occupational exposure (group II; 8 in construction), 13 women had a history suggestive of domestic exposure (group III; 10 were housewives married to shipyard workers), and 27 had no history indicating exposure (group IV).
  • Of the 37 shipyard workers, 32 had moderate or severe plaques and/or a high number of asbestos bodies. Of the 27 patients with no history of exposure, 26 had fewer than 100 asbestos bodies and slight or no plaques.
  • The degree of pleural plaques and the number of asbestos bodies ran in parallel in 78% of cases.
  • Both patients with malignant pleural mesothelioma had severe pleural hyalinosis and high asbestos body counts. One, with over 10,000 asbestos bodies, was a shipyard worker (group I). The other, with more than 1000, was in the domestic exposure group (group III).
  • Of the 13 patients with lung cancer (all males), 12 had pleural plaques (8 moderate or severe) and 5 had more than 100 asbestos bodies. All had been smokers, and 10 were heavy smokers.
• The authors' conclusion: The authors concluded that asbestos exposure in the Monfalcone area is an alarming phenomenon. They predicted a high incidence of lung cancer in some categories of workers and described pleural mesothelioma as a high risk in the area.
• Limitations the authors state:
  • Discrepancies between work history and the pathology findings may reflect inadequate history data, because histories were obtained from relatives.
  • Some occupations, such as construction work, were classified as suggestive of asbestos exposure, but exposure may or may not have actually occurred.

Topics

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

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

Related studies

• Asbestos-related mesothelioma in Monfalcone, Italy — C. Bianchi, A. Brollo, et al. (1993)
• Asbestos bodies in routine necropsies on Tyneside: a pathological and social study — T. Ashcroft (1968)
• Asbestos exposure in a shipyard area, northeastern Italy — C. Bianchi, A. Brollo, et al. (2000)
• Coated and uncoated lung mineral fibres in subjects with and without pleural plaques at autopsy — A. Andrion, D. Bellis, et al. (1984)
• Iron signature in asbestos-induced malignant pleural mesothelioma: A population-based autopsy study — S. Crovella, A.M. Bianco, et al. (2016)
• Mesothelioma among shipyard workers in Monfalcone, Italy — C. Bianchi, T. Bianchi (2012)

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