Environmental asbestos exposure and mesothelioma cases in Bari, Apulia region, southern Italy: a national interest site for land reclamation

Our plain-English summary of Environmental asbestos exposure and mesothelioma cases in Bari, Apulia region, southern Italy: a national interest site for land reclamation, by L. Vimercati, D. Cavone, P. Lovreglio, et al (Environmental Science and Pollution Research International, 2018).

The study

• Authors: L. Vimercati, D. Cavone, P. Lovreglio, L. De Maria, A. Caputi, G.M. Ferri, G. Serio
• Journal: Environmental Science and Pollution Research International
• Published: 2018;25(16):15692-15701
• Type of article: Case report
• Cited by: 24 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Asbestos is an environmental carcinogen, and asbestos-related diseases are a global-scale public health issue. We report three cases (one male and two females) of pleural malignant mesothelioma (PMM) caused by environmental asbestos exposure reported by the Apulia Regional Operating Centre (COR) to the National Mesothelioma Registry (ReNaM). The patients revealed no history of asbestos exposure even after detailed assessment. The environmental (neighborhood) asbestos exposure for each of the three cases was due to both the residential history of the subjects and their workplace, close to a military barracks, at a distance of between 45 and 100 m. Moreover, in addition to this new source of pollution, an asbestos cement factory was located in the urban area of Bari municipality, in the Apulia region, southern Italy. Environmental-residential/neighborhood asbestos exposure in the city of Bari, a contaminated area classified as a site of national concern for land reclamation, is discussed also with reference to the military barracks.

In plain English

This case series described three people with pleural malignant mesothelioma (one man, two women) from the Apulia regional register of Italy's National Mesothelioma Registry. Through standardized interviews, the authors traced each patient's exposure to living or working near Bari's Rossani military barracks, whose roofs and chimneys contained asbestos cement. Their homes were 200 to 1200 m from the former Fibronit asbestos cement factory. A 74-year-old man diagnosed in 2015 had lived less than 45 m from the barracks for 17 years. A 56-year-old woman diagnosed in 2009 had worked 50 m and lived 50 to 500 m from the barracks; she died 28 months later. A 54-year-old woman diagnosed in 2013 had worked 100 to 250 m from the barracks and had lived 200 m from Fibronit since birth. Exposure lasted 17 to 54 years, with latency of 30 to 54 years. The authors concluded that the cases emphasize an association between mesothelioma and asbestos pollution in Bari. They noted that concentration data from inside the barracks and Fibronit sites were unavailable and that air near the factory was poorly monitored while it operated.

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: Case series (case reports) of three mesothelioma cases from a regional mesothelioma register, with exposure reconstruction based on interviews and residential and work histories
• Who was studied: Three patients with pleural malignant mesothelioma (one man, two women) listed in the Apulia regional mesothelioma register in Bari, southern Italy. They were diagnosed in 2009, 2013 and 2015, at ages 54 to 74.
• Exposure: Environmental (neighborhood) asbestos exposure. The patients lived or worked 45 to 100 m from the Rossani military barracks, whose roofs and chimneys contained asbestos cement (Eternit). Their homes were 200 to 1200 m from the Fibronit asbestos cement factory; the article describes that plant as having used chrysotile (80%), crocidolite (15%) and amosite (5%). Exposure was assessed by interview and by residential distance and duration.
• Main results:
  • Case 1: a 74-year-old man diagnosed in 2015. He had lived less than 45 m from the barracks for 17 years, starting at age 28 (1969 to 1986). He was alive at follow-up in October 2017, more than 2 years after diagnosis.
  • Case 2: a 56-year-old woman diagnosed in 2009. She had worked as a bank employee 50 m from the barracks (1986 to 1996) and had lived 50 to 500 m from the barracks (1979 to 2009). She died after 28 months, in 2011.
  • Case 3: a 54-year-old woman diagnosed in 2013. She had worked 100 to 250 m from the barracks (1980 to 2000) and had lived 200 m from the Fibronit site for 54 years since birth. She was alive and disease-free 55 months after treatment.
  • Across the three cases, exposure lasted 17 to 54 years, and the latency (time from first exposure to diagnosis) was 30 to 54 years.
• The authors' conclusion: The authors concluded that these cases emphasize the association between mesothelioma and environmental asbestos pollution in Bari, from both the asbestos cement factory and the military barracks.
• Limitations the authors state:
  • No data were available on environmental asbestos concentrations inside the barracks area or the Fibronit site.
  • Weather data from the exposure period of interest were not available, so wind data from 1961 to 1990 from the authors' earlier study were used.
  • Airborne asbestos near the Bari asbestos cement factory was poorly monitored in the past, while the factory was operating; only limited measurements were available.

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, Malignant Mesothelioma, Asbestos-Cement.

Related studies

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• Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: a systematic review and the experience of the Apulia (southern Italy) mesothelioma register — L. Vimercati, D. Cavone, et al. (2019)
• Response to the "Letter to the Editor" by Gabor Mezei et al., Comments on Vimercati et al., 2019, "Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: a systematic review and the experience of the Apulia (Southern Italy) mesothelioma register" — L. Vimercati, D. Cavone, et al. (2019)
• Health impact of exposure to asbestos in polluted area of Southern Italy — L. Vimercati, D. Cavone, et al. (2019)
• The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case-control study in the city of Bari (Italy) — M. Musti, A. Pollice, et al. (2009)
• 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)

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