Further evidence of an excess of risk of pleural malignant mesothelioma in textile workers in Prato (Italy)

Our plain-English summary of Further evidence of an excess of risk of pleural malignant mesothelioma in textile workers in Prato (Italy), by E. Paci, M. Zappa, L. Paoletti, et al (British Journal of Cancer, 1991).

The study

• Authors: E. Paci, M. Zappa, L. Paoletti, E. Buiatti, E. Chellini, E. Merler, A. Seniori Costantini
• Journal: British Journal of Cancer
• Published: 1991;64(2):377-8
• Cited by: 11 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. 004168).

Summary of the article

An earlier study found that six of 13 pleural malignant mesothelioma (PMM) cases in the Province of Florence, Italy, in 1979-1984 had worked in the Prato textile industry, five of them as rag sorters. A later hygiene survey showed that Prato textile workers were exposed to asbestos through recycled bags that had contained asbestos fibres. In this follow-up, the authors re-examined already diagnosed PMM and all cases of pleural cancerous infiltration from 1970-1988 held in the archives of the Department of Pathology of the University of Florence. Trained nurses interviewed cases or their nearest living relatives using a structured questionnaire on smoking, work history and asbestos exposure. Of 61 PMM cases (44 males, 17 females) among provincial residents, 22 (16 males, six females) had ever worked in textiles, 16 of them as rag sorters. One interview was refused, and relatives of another case could not be traced. Among the textile cases, mean age at first exposure was 31.6 years, mean duration of textile work 24.4 years and mean latency 29.8 years. Electron microscopy of the only two adequate lung samples showed 2,387 and 10,146 asbestos fibres per mg (crocidolite; crocidolite and chrysotile). Both were above the 1,000 f/mg value taken as indicating occupational exposure. Six textile cases had worked only in later production phases. The authors concluded that the results confirmed a high incidence of mesothelioma among Prato textile workers, especially rag sorters. They warned that asbestos-related tumours could arise from unknown and unexpected sources.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This short report from Florence, Italy, followed up an earlier study by the same research group that had linked pleural malignant mesothelioma (a cancer of the lining around the lungs) to textile work in the Prato area. The authors re-examined mesothelioma and pleural cancer cases from 1970 to 1988 in the University of Florence pathology archives. Trained nurses interviewed the patients or their relatives about smoking, work history and contact with asbestos. Of 61 pleural mesothelioma cases (44 males, 17 females) among residents of the Province of Florence, 22 had ever worked in textiles, and 16 of these had sorted rags. Lung tissue from only two cases could be tested. One contained 2,387 crocidolite fibres per milligram, the other 10,146 crocidolite and chrysotile fibres per milligram. The authors assumed that 1,000 fibres per milligram of lung tissue indicated occupational exposure. An earlier hygiene survey had traced asbestos in this industry to reused bags that had held asbestos, torn-up army uniforms, and chrysotile added to wool yarn. The authors concluded that their results confirm a previously reported high incidence among Prato textile workers, especially rag sorters.

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: pleural malignant mesothelioma cases from a pathology archive were re-examined, and patients or relatives were interviewed about work history, smoking and asbestos exposure. Lung tissue fibre analysis was done where material allowed. Published as a short report.
• Who was studied: 61 cases of pleural malignant mesothelioma (44 males, 17 females) among residents of the Province of Florence, Italy, 1970 to 1988. For one case the interview was refused, and for another no living relatives could be traced.
• Exposure: Work in the Prato textile industry, especially rag sorting. An earlier industrial hygiene survey (Quinn et al., 1987) identified three asbestos sources: jute and polypropylene bags that had once held asbestos being reused to wrap rags; fibres released when army uniforms and other war materials were torn up; and asbestos-chrysotile added to woollen yarn during spinning.
• Main results:
  • Of the 61 pleural mesothelioma cases, 22 (16 males, six females) had ever worked as textile workers, and 16 of these (14 males, two females) had worked as rag sorters.
  • Rag sorting was the longest-held job for 12 of the textile cases (10 males, 2 females) and had ever been worked by 16.
  • Among the textile cases, the mean age at first exposure was 31.6 years (standard deviation 11.0; range 18 to 55). The mean duration of textile work was 24.4 years (standard deviation 9.8; range 9 to 38). The average latency (time from first exposure to year of diagnosis) was 29.8 (standard deviation 8.1; range 10 to 40).
  • The first textile case occurred in 1973, and textile cases appeared regularly from then until 1988.
  • Only two lung tissue samples could be analysed by electron microscope. One had 2,387 crocidolite fibres per milligram, and the other had 10,146 fibres per milligram (crocidolite and chrysotile). A value of 1,000 fibres per milligram in lung tissue was assumed to indicate occupational exposure.
  • Six of the 22 textile cases worked only in the last phases of production (spinning, weaving and dyeing). The authors said this supports possible asbestos exposure in other phases of textile production.
• The authors' conclusion: The authors concluded that the results confirm the previously reported high incidence of malignant mesothelioma among Prato textile workers, particularly rag sorters. They said this unexpected risk should alert people to possible asbestos-related tumour epidemics from unknown and unexpected sources.
• Limitations the authors state:
  • Enough tissue for fibre analysis was available in only two cases.

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pathology, Occupational History, Asbestos Exposure, Latency, Crocidolite, Chrysotile, Occupational Exposure.

Related studies

• Malignant mesothelioma in non-asbestos textile workers in Florence — E. Paci, S. Dini, et al. (1987)
• Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy — P. Boffetta, L. Righi, et al. (2018)
• Temporal Patterns of Exposure to Asbestos and Risk of Asbestosis: An Analysis of a Cohort of Asbestos Textile Workers — A. Farioli, F.S. Violante, et al. (2018)
• A case-referent study of lung tumors in non-asbestos textile workers — E. Paci, E. Buiatti, et al. (1987)
• Comment on the paper 'Boffetta et al. Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy. Ann Oncol 2018; 29(2): 484-489' — D. Consonni, C. Mensi (2019)
• Comment on 'Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy' — C. Brentisci, M. Gangemi, et al. (2018)

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