Asbestos-related diseases in Italy: epidemiologic evidences and public health issues

Our plain-English summary of Asbestos-related diseases in Italy: epidemiologic evidences and public health issues, by P. Comba, E. Merler, R. Pasetto (International Journal of Occupational and Environmental Health, 2005).

The study

• Authors: P. Comba, E. Merler, R. Pasetto
• Journal: International Journal of Occupational and Environmental Health
• Published: 2005;11(1):36-44
• Type of article: Review
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Epidemiologic information about asbestos-related diseases in Italy, derived from mortality data, epidemiologic surveillance, and analytical studies, is presented. These systems evidence exposures to asbestos and relative risks for populations exposed in work environments and also in the general environment, and provide objective data to identify sources of exposure and for risk management. Limitations and perspectives of Italian studies are considered, and public health issues evaluated: the risk for migrants, social security aspects, and asbestos-related disease in the courts. Although asbestos use was banned in 1992, information and risk communication efforts should be implemented to empower affected individuals and communities and to pursue equitable allocation of resources for primary prevention and health surveillance.

In plain English

This article was a review of epidemiologic information on asbestos-related diseases in Italy. It drew on national mortality data, regional mesothelioma registries and earlier studies, and also discussed migrants, social security and court cases. It reported that in the most recent national mortality survey, annual death rates from malignant pleural neoplasms were 2.17 per 100,000 for men and 1.09 per 100,000 for women. Increases were found mainly in shipyard areas and near asbestos-cement plants. The national mesothelioma registry had received information on 3,675 cases, and estimated survival after diagnosis was close to a year. The review described cohort studies of railway rolling-stock workers, studies of residents near asbestos-cement factories, and a mesothelioma cluster in Biancavilla, Sicily, where local stone quarries were suggested as a possible source of fiber exposure. It also covered mesothelioma among Italians who had worked abroad. The authors noted that exposure measurements and lung-tissue fiber analyses were largely lacking in Italy. They concluded that major information and risk communication efforts are needed to empower affected individuals and communities.

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 Italian epidemiologic evidence (mortality data, mesothelioma surveillance, analytical studies) and public health issues; updates an earlier European review
• Who was studied: Populations in Italy: the national population (over 8,000 municipalities) in mortality surveillance, mesothelioma cases in regional registries, worker cohorts, residents of contaminated areas, and Italian migrant workers who worked abroad
• Exposure: Occupational, domestic and environmental asbestos exposure: shipyards, asbestos-cement plants, railway rolling-stock work (where crocidolite was used as insulation), in-place asbestos, naturally occurring fibers including tremolite and the fibrous amphibole fluoro-edenite, and the Balangero chrysotile mine
• Main results:
  • In the most recent national mortality report, annual mortality rates for malignant pleural neoplasms were 2.17 per 100,000 for men and 1.09 per 100,000 for women
  • Increased mortality from malignant pleural neoplasms was found mainly in shipyard areas (Genoa, Venice, Trieste, Naples) and near asbestos-cement industries such as Casale Monferrato
  • The National Register of Mesothelioma Cases had received information on 3,675 mesothelioma cases (personal communication); estimated survival after diagnosis was close to a year
  • For cases registered in 1997, the occupational sectors with the greater risks were building and construction, the metal and steel industry, shipyards, and railway stock operations
  • Italian cohort studies of railway and rolling-stock workers showed a high risk of mortality from mesothelioma; the excess was directly related to length of follow-up
  • In Biancavilla, Sicily, where industrial asbestos use had never occurred, an environmental survey suggested local stone quarries as a possible source of asbestiform fiber exposure; the amphibole was identified as fluoro-edenite, and fibrous phases were detected in 71% of building material samples
  • Fifteen cases of pleural or peritoneal malignant mesothelioma were documented among people in Italy who had previously worked at the Eternit AG asbestos-cement factory in Niederurnen, Switzerland. Of more than 1,200 Italians in the Wittenoom crocidolite mine workforce, about 30% had returned to Italy by 1997
  • Of about 217,000 requests for asbestos-related retirement benefits, 42,000 of those evaluated were accepted and 78,000 rejected
  • Mesothelioma deaths were predicted to plateau in 2015-2020 at approximately 1,000 per year (cited as a personal communication)
  • Lung tissue fiber concentration analyses had been published for only about a dozen Italian mesothelioma victims
• The authors' conclusion: The authors concluded that the continuing rise in mesothelioma partly reflects long latency and partly exposure sources not yet adequately considered (in-place, dwellings, polluted sites). They concluded that major information and risk communication efforts are needed to empower affected individuals and communities and to pursue equitable allocation of resources for primary prevention and health surveillance
• Limitations the authors state:
  • Death certificate coding of pleural mesothelioma is imperfect: about 75% of deaths are correctly coded, and false negative and false positive estimates of 18% and 40% have been reported
  • Only six of the 16 active regional mesothelioma registers are complete enough for reliable incidence estimation
  • Exposure data and biological marker studies are largely lacking in Italy, so Italian researchers cannot contribute to evaluating exposure-response relationships

Topics

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

Medical terms in this study, explained in our Lexicon: Relative Risk.

Related studies

• Adverse health effects of fluoro-edenitic fibers: epidemiological evidence and public health priorities — C. Bruno, P. Comba, et al. (2006)
• Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues — A. Marinaccio, A. Binazzi, et al. (2015)
• The Public Health Value of Opioid Litigation — R.L. Haffajee (2020)
• The third wave of asbestos disease: exposure to asbestos in place. Public health control. Introduction — P.J. Landrigan (1991)
• The contribution of environmental monitoring in the epidemiological assessment of exogenous risk. The experience of ARPA in the Emilia-Romagna Region of Italy — A. Zavatti, P. Lauriola (1999)
• Public Health and Independent Risk Assessment — P. Vineis (2019)

Browse more research in International Journal of Occupational and Environmental Health, or return to medical research.