Asbestos, pleural mesothelioma,and mortality in Italy

Our plain-English summary of Asbestos, pleural mesothelioma,and mortality in Italy, by R.G. Carbone, B. Terracini, A. Marinaccio, et al (Journal of Occupational and Environmental Hygiene, 2008).

The study

• Authors: R.G. Carbone, B. Terracini, A. Marinaccio, F. Montanaro, P. Shah
• Journal: Journal of Occupational and Environmental Hygiene
• Published: 2008;5(4):D55-6
• Type of article: Letter
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

In plain English

This letter to the editor responded to an international study by Lin and colleagues that left out Italy. The authors wrote that Italy's pattern of asbestos consumption was delayed by about 10 years compared with the United States, the United Kingdom and Scandinavian countries. Most asbestos produced in Italy was chrysotile, while most imported asbestos was amphiboles. They compared Italy's yearly asbestos consumption per head in 1946 to 1961 with death rates 40 years later (1986 to 2001), using separate linear regressions for each sex and disease. Mesothelioma had no specific death code before the 10th revision of the disease classification, so pleural cancer deaths stood in for pleural mesothelioma deaths. The authors reported that each extra kilogram per head went with a 1.9-fold increase in pleural mesothelioma deaths per million (adjusted R2 0.58, p less than 0.001). Among males the increase was 3.8-fold (adjusted R2 0.71, p less than 0.001). A weaker male association (0.3-fold, p 0.03) was reported for an outcome the text misprints. The authors concluded that past consumption significantly predicted pleural mesothelioma deaths in males.

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: Letter to the editor reporting a national ecological (population-level) analysis: linear regression of age-adjusted mortality rates on past per-capita asbestos consumption, assuming a fixed 40-year latency
• Who was studied: The population of Italy as a whole: national asbestos consumption per head in 1946–1961, and standardized death rates from pleural cancer (as a proxy for pleural mesothelioma) and asbestosis in 1986–2001, by sex
• Exposure: National raw asbestos consumption in kilograms per head per year, 1946–1961. Italian production was mostly chrysotile; imported asbestos was mainly amphiboles.
• Main results:
  • Italian inhabitants overall: each increase of 1 kg per head in asbestos consumption was reported as a 1.9-fold increase in pleural mesothelioma deaths per million 40 years later (adjusted R2 = 0.58, p < 0.001)
  • Males: the strongest association, a 3.8-fold increase in pleural mesothelioma deaths per 1 kg per head increase in consumption (adjusted R2 = 0.71; p < 0.001)
  • Males: a weaker association (0.3-fold, adjusted R2 = 0.3; p = 0.03) for an outcome the text prints as 'mortality from mortality'. The outcome is not clearly named; the methods list asbestosis as the other disease analysed.
• The authors' conclusion: The authors concluded that in Italy the level of past asbestos consumption is a significant predictor of pleural mesothelioma deaths in males. They called for international support for banning asbestos where it is still used, and for surveillance of mesothelioma and asbestosis cases in countries with heavy industrial asbestos use.
• Limitations the authors state:
  • There was no specific death code for mesothelioma before ICD-10, so pleural cancer deaths (ICD-9 code 163) were used as a stand-in for pleural mesothelioma deaths

Topics

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

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma.

Related studies

• Cumulative asbestos exposure and mortality from asbestos related diseases in a pooled analysis of 21 asbestos cement cohorts in Italy — F. Luberto, D. Ferrante, et al. (2019)
• Predictions of mortality from pleural mesothelioma in Italy: a model based on asbestos consumption figures supports results from age-period-cohort models — A. Marinaccio, F. Montanaro, et al. (2005)
• Cancer mortality and incidence of mesothelioma in a cohort of wives of asbestos workers in Casale Monferrato, Italy — D. Ferrante, M. Bertolotti, et al. (2007)
• A cohort study on mortality among wives of workers in the asbestos cement industry in Casale Monferrato, Italy — C. Magnani, B. Terracini, et al. (1993)
• Pleural mesothelioma mortality and asbestos exposure mapping in Italy — L. Fazzo, M. De Santis, et al. (2012)
• Predictions of Mortality from Pleural Mesothelioma in Italy After the Ban of Asbestos Use — E. Oddone, J. Bollon, et al. (2020)

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