Epidemiology of pleural mesothelioma in North-western Italy (Piedmont)

Our plain-English summary of Epidemiology of pleural mesothelioma in North-western Italy (Piedmont), by G.F. Rubino, G. Scansetti, A. Donna, et al (British Journal of Industrial Medicine, 1972).

The study

• Authors: G.F. Rubino, G. Scansetti, A. Donna, G. Palestro
• Journal: British Journal of Industrial Medicine
• Published: 1972;29(4):436-42
• Cited by: 47 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001345).

Abstract

Rubino, G. F., Scansetti, G., Donna, A., and Palestro, G. (1972).Brit. J. industr. Med.,29, 436-442. Epidemiology of pleural mesothelioma in North-western Italy (Piedmont). Fifty-four cases of mesothelioma of the pleura admitted to the Chest Surgery Centre or to the Department of Medicine of the University of Turin from 1960 to 1970 are reported. Thoracotomy was performed in 22. In the other 32 the diagnosis was based on the clinical, radiographic, and cytological findings and on the results of biopsy. In 50 cases (18 women and 32 men), the majority of whom had always or mostly lived in Piedmont, it was possible to ascertain the family history, previous residence, and occupation, mainly with the aid of information given by the patient's relatives. A similar investigation was made by the same interviewers into 50 other patients of the same sex and age admitted to the same institutions, using an identical technique. In the group with mesothelioma (only two of whom survived more than two years after the diagnosis had been made) occupational exposure to asbestos was demonstrated unequivocally in five men. Three other patients, including one woman, had lived with persons employed in the asbestos industry (16%). Exposure for occupational reasons seemed very likely in another patient, who had been a fireman in the Turin Arsenal for 40 years. One man in the control group had worked for two years in a cement-asbestos manufacturing company (2%). A re-appraisal of the histological sections and examination of new preparations made in the 22 cases operated on was done in the Department of Pathological Anatomy of the University of Turin, also with the purpose of confirming the diagnosis. This re-appraisal revealed the presence of asbestos bodies in the mesothelioma in one case, a woman who had never been exposed to asbestos for occupational or domestic reasons but who had always lived in one of the two regions of the Province of Turin with the highest number of asbestos industries.

In plain English

This study examined pleural mesothelioma (cancer of the chest lining) patients at the University of Turin, Italy, 1960 to 1970. Of 102 cases, 54 had a confirmed or reasonably certain diagnosis; histories could be traced for 50. The authors compared these 50 with 50 other patients of the same age and sex admitted to the same institutions. A definite history of work exposure to asbestos was found in 5 (10%) of the 50 cases. Another 3 (6%) had lived with asbestos industry workers and 3 (6%) had lived near an asbestos factory, 22% in all. Among the 50 comparison patients, 1 (2%) had brief work exposure. Asbestos bodies were found in tumour tissue from 1 of 22 cases examined. She was a woman with no work or family exposure who lived where asbestos industries were most numerous. Most case histories came second-hand from relatives, whereas controls were interviewed directly. The authors concluded case exposure figures should be considered conservative. They suggested that work exposure was less common than in English-speaking series probably because crocidolite is little used in Piedmont, where chrysotile is produced.

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: Retrospective case series of pleural mesothelioma patients, compared with a control group of other hospital patients of the same age and sex
• Who was studied: 102 patients diagnosed with pleural mesothelioma at the Chest Surgery Centre or Department of Medicine of the University of Turin, 1960 to 1970. Of these, 54 had a confirmed or reasonably certain diagnosis: 22 operated on and 32 diagnosed on other criteria. Histories could be obtained for 50: 18 with histologically confirmed diagnosis (9 men, 9 women) and 32 others (23 men, 9 women), living mainly or only in Piedmont. They were compared with 50 control patients of the same age and sex from the same institutions.
• Exposure: Asbestos exposure from work (including asbestos workers, asbestos carders, a cement/asbestos pipes fitter, and a fireman in the Turin Arsenal judged probably exposed), from living with asbestos industry workers, and from living near asbestos factories. Fiber types to which individual patients were exposed are not reported.
• Main results:
  • Among the 50 mesothelioma cases, 5 (10%) had a definite history of occupational asbestos exposure.
  • Among the 50 cases, 3 (6%) had lived for a long time with asbestos industry workers and 3 (6%) had lived near an asbestos processing factory. The authors gave a total of 22% of cases with a definite history of exposure.
  • In the control group, 1 of 50 (2%) had brief occupational asbestos exposure (two years in a cement-asbestos factory), and none was a relative of an asbestos industry worker.
  • In the 18 histologically confirmed cases, 83% had no occupational exposure, 11% had occupational exposure and 6% had family exposure. None of the 18 matching controls had occupational or family exposure.
  • In the 32 cases diagnosed on clinical, radiological, cytological and biopsy findings, 9% had occupational and 6% family exposure, a total of 15%.
  • Asbestos bodies were found in the tumour tissue of 1 of 22 cases examined. This was a woman with no occupational or family exposure who had always lived in one of the two areas of the Province of Turin with the most asbestos industries.
  • Among cases without occupational or family exposure, none came from the Turin town centre, where no asbestos industries had existed. Three in northern Turin lived close to two brake and friction material factories.
  • The 10% occupational exposure figure was close to German, French and Swedish series but much lower than English-speaking series. The authors said this was probably because crocidolite is little used in Piedmont, where there is considerable chrysotile production.
• The authors' conclusion: The authors concluded that, because most case information came second-hand from relatives while controls were interviewed directly, the figures for unequivocal or probable asbestos exposure in the mesothelioma group should be considered conservative.
• Limitations the authors state:
  • For most mesothelioma cases, histories were obtained second-hand from relatives, who could give only major facts. Controls were interviewed directly.
  • The search for asbestos bodies used biopsy tissue that usually includes only the pleural tumour, not lung tissue.

Topics

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

Medical terms in this study, explained in our Lexicon: Epidemiology, Pleural Mesothelioma, Mesothelioma, Pleura, Thoracotomy, Biopsy, Occupational Exposure, Asbestos Bodies.

Related studies

• Asbestos-related lung cancer mortality in Piedmont, Italy — M. Martuzzi, P. Comba, et al. (1998)
• Gender differences in pleural mesothelioma occurrence in Lombardy and Piedmont, Italy — D. Consonni, E. Migliore, et al. (2019)
• Spatial variation of mortality for common and rare cancers in Piedmont, Italy, from 1980 to 2000: a Bayesian approach — M. Maule, F. Merletti, et al. (2006)
• Cancer morbidity of residents living near an oil refinery plant in North-West Italy — C. Salerno, P. Berchialla, et al. (2013)
• Asbestos and SV40 in malignant pleural mesothelioma from a hyperendemic area of north-eastern Italy — M. Comar, N. Zanotta, et al. (2012)
• Diffuse pleural mesothelioma and asbestos exposure in the North Western Cape Province — J.C. Wagner, C.A. Sleggs, et al. (1960)

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