Incidence of malignant mesothelioma and asbestos exposure in the Emilia-Romagna region, Italy

Our plain-English summary of Incidence of malignant mesothelioma and asbestos exposure in the Emilia-Romagna region, Italy, by L. Mangone, C. Storchi, C. Pinto, et al (La Medicina del Lavoro, 2022).

The study

• Authors: L. Mangone, C. Storchi, C. Pinto, P. Giorgi Rossi, I. Bisceglia, A. Romanelli
• Journal: La Medicina del Lavoro
• Published: 2022;113(5):e2022047
• Type of article: Review
• Cited by: 9 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The aim of this study is to describe the incidence of malignant mesothelioma (MM) and asbestos exposure in an Italian region in the period 1996-June 2021.

Methods: The study included cases with microscopic confirmation and those with instrumental confirmation. For each case, information on sex, age, tumour site, morphology and date of diagnosis was collected, along with details of exposure to asbestos.

Results: 3,097 cases of MM (2,233 males and 864 females) were registered: 90.8% with microscopic confirmation. A total of 2,840 cases involved the pleura (92%), 230 cases the peritoneum (7%), and a small number of cases the pericardium and testis (9 and 18, respectively). Most cases (78.0%) occurred after 65 years of age, while only 1.5% concerned individuals with age < 45 years. The standardized incidence rate for the entire period (adjusted to the 2000 Italian standard population and calculated per 100,000 person-years) was equal to 3.9 in males and 1.4 in females, and the trend showed an increase with age in both sexes. Concerning asbestos exposure, 79.7% of cases were exposed (86.7% males and 60.1% females). In 70.3%, exposure was occupational (83.4% males and 33.2% females), while 20.7% of females and 0.8% of males had familial exposure. Building construction, rolling stock manufacture/repair and metalworking were the most prevalent economic activities associated with occupational exposure.

Conclusions: This study offers an overview of MM in an Italian region characterized by high incidence and high exposure due to its particular production activities.

In plain English

This study described malignant mesothelioma cases recorded in Emilia-Romagna, northern Italy, from January 1996 to June 2021, and their reported asbestos exposure. The registry recorded 3,097 cases (2,233 males and 864 females). Of these, 2,840 involved the pleura, 230 the peritoneum, 9 the pericardium and 18 the testis. Most cases (78.0%) were diagnosed at age 65 or older. Standardized incidence per 100,000 person-years rose in males from 2.4 (1996) to 4.4 (2016) and in females from 0.8 (1996) to 1.4 (2018). Exposure information was collected for 2,683 cases, mainly by questionnaire, though for 394 it was insufficient to reconstruct exposure. Among these 2,683, occupational exposure was reported for 83.4% of males and 33.2% of females, and familial exposure for 0.8% of males and 20.7% of females. Among occupationally exposed men, construction and railway rolling stock repair led. Among occupationally exposed women, sugar refineries and other food industries led, followed by asbestos-cement production. The authors concluded that the region has high incidence and high exposure due to its particular production activities. They noted the lack of information on disease stage and treatment.

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: Descriptive, population-based study of cases recorded by a regional mesothelioma registry, with asbestos exposure assessed by questionnaire
• Who was studied: 3,097 residents of the Emilia-Romagna region (northern Italy) diagnosed with malignant mesothelioma between 1 January 1996 and 30 June 2021: 2,233 males and 864 females. 90.8% of cases had microscopic confirmation.
• Exposure: Asbestos exposure was classified as occupational, familial, environmental, non-occupational, improbable or unknown. Information came from a questionnaire given to the patient or a next-of-kin. Occupational exposure was broken down by economic activity. No fiber types were assessed for the cases.
• Main results:
  • Tumour site, all 3,097 cases: 2,840 pleura (92%), 230 peritoneum (7%), 9 pericardium and 18 testis.
  • 78.0% of patients were at least 65 years of age at diagnosis; 1.5% (47 cases) were under 45.
  • Standardized incidence rate for the entire period, per 100,000 person-years (2000 Italian standard population): 3.9 in males and 1.4 in females.
  • Trend in standardized incidence rate: males rose from 2.4 in 1996 to 4.4 in 2016; females rose from 0.8 in 1996 to 1.4 in 2018.
  • Rate in the last completed year (2019): 3.6 in males and 1.0 in females.
  • The exposure distribution was reported for 2,683 cases (87% of the total): 1,979 males and 704 females.
  • Of these 2,683 cases, 394 (14.7%) had exposure classed as unknown, meaning the data were insufficient to reconstruct exposure history. A further 150 (5.6%) had exposure classed as improbable.
  • Among these 2,683 cases, occupational exposure was found in 83.4% of males and 33.2% of females (70.3% overall).
  • Among these 2,683 cases, familial exposure was found in 20.7% of females and 0.8% of males (6.0% overall).
  • Building construction, rolling stock manufacture or repair, and metalworking were the most prevalent economic activities associated with occupational exposure.
  • Among the 234 occupationally exposed women, sugar refineries and other food industries accounted for 17.5% and production of asbestos-cement products for 13.7%.
• The authors' conclusion: The authors concluded that the study offers an overview of malignant mesothelioma in an Italian region characterized by high incidence and high exposure due to its particular production activities.
• Limitations the authors state:
  • No information on disease stage or treatment.
  • Because of small numbers, rates could not be reported separately by sex and by site.
  • Incidence data were complete only to 2019. The authors noted that the 125 cases in 2020 could reflect fewer diagnoses during the COVID-19 pandemic.

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, Asbestos Exposure, Pleura, Peritoneum, Pericardium, Incidence, Occupational Exposure.

Related studies

• Trends in Asbestos Exposure and Malignant Mesothelioma Incidence in Emilia-Romagna Italy: A Retrospective Study 1996-2023 — F. Giacomino, F. Marinelli, et al. (2024)
• 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)
• Past trends and future prediction of mesothelioma incidence in an industrialized area of Italy, the Veneto Region — P. Girardi, V. Bressan, et al. (2014)
• Incidence of pleural mesothelioma in Liguria Region, Italy (1996-2002) — V. Gennaro, D. Ugolini, et al. (2005)
• Asbestos Exposures, Mesothelioma Incidence and Mortality, and Awareness by General Practitioners in the Molise Region, Central Italy — G. Ripabelli, M. Tamburro, et al. (2018)
• 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)

Browse more research in La Medicina del Lavoro, or return to medical research.