Malignant mesothelioma in construction workers: the Apulia regional mesothelioma register, Southern Italy

Our plain-English summary of Malignant mesothelioma in construction workers: the Apulia regional mesothelioma register, Southern Italy, by L. Vimercati, D. Cavone, A. Caputi, et al (BMC Research Notes, 2019).

The study

• Authors: L. Vimercati, D. Cavone, A. Caputi, M.C. Delfino, L. De Maria, G.M. Ferri, G. Serio
• Journal: BMC Research Notes
• Published: 2019;12(1):636
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Objective: Asbestos was widely used in construction in both a friable and a compact form until the 1990s, before its use was banned. Today, many of these materials are still in situ and represent a source of risk for construction workers. The objective of the study was to analyse the cases of mesothelioma arising among construction workers registered in the Apulia regional register of mesothelioma.

Results: For the period 1993-2018, there were 178 male cases, and 10.2% of the cases were present in the regional register. The average age at diagnosis was 64.7 years. The site was pleural in 96.06% of cases, with a diagnosis of certainty in 86.5% of the total cases and 61.8% of cases with epithelial histology. The average latency is 43.9 years. In 75.2% of cases, the exposure began between 1941 and 1970, with an average duration of 24.3 years. The age at the start of exposure in 68.5% of cases is between 8 and 20 years. The ORs were 2.5 (C.I. 95% 1.01-6.17) for the epithelioid histotype and the high duration of exposure. The data underline the need for prevention and information on all activities involving construction workers in which asbestos-containing materials are still used.

In plain English

This study examined mesothelioma cases among construction workers in the regional mesothelioma register of Apulia, southern Italy. Work histories came from interviews with patients or, if they had died, their relatives. The register held 178 such cases, all men, which was 10.2% of all cases in the register. The average age at diagnosis was 64.7 years. The mesothelioma was pleural in 96.06% of cases, peritoneal in 6 and pericardial in 1. The average time from first exposure to diagnosis was 43.9 years. Exposure began between 1941 and 1970 in 75.2% of cases and lasted 24.3 years on average. In 68.5% of cases it started between ages 8 and 20. Eighty men (44.9%) had worked as masons or bricklayers. Among the cases, the epithelioid tissue type was associated with longer exposure: odds ratio 2.50 (95% confidence interval 1.01 to 6.17) for more than 32 years compared with 6 years or less. The authors concluded that prevention and information are needed where asbestos-containing materials remain. They noted they could not analyse individual trades.

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 analysis of cases recorded in a regional mesothelioma register, with exposure reconstructed by standardized questionnaire interviews and some statistical comparison of tissue types
• Who was studied: 178 male mesothelioma cases from the construction sector in the Apulia (southern Italy) regional mesothelioma register, period 1993 to 2018. These were 10.2% of all cases in the register.
• Exposure: Occupational asbestos exposure in the construction sector (Istat ATECO 91 code 45, all sub-sectors and tasks). Exposure was reconstructed by interview with the patient or family members. The article does not name fiber types.
• Main results:
  • Among the 178 cases, the mesothelioma was pleural in 96.06%. The diagnosis was classed as certain in 86.5%, and 61.8% had epithelial histology.
  • Average age at diagnosis was 64.7 years. 89.8% of cases were diagnosed at ages 51 to 80.
  • Average latency (time from first exposure to diagnosis) was 43.9 years. 83.1% of cases had a latency between 21 and 60 years.
  • In 75.2% of cases exposure began between 1941 and 1970. Average exposure duration was 24.3 years, and exposure lasted 1 to 10 years in 31.5% of cases.
  • In 68.5% of cases exposure started between ages 8 and 20. 24.1% began working between ages 8 and 15 without training or information on risks.
  • Exposure was classified as occupationally certain or probable in 61.2% of cases and as possible in 38.7%.
  • Of the cases, 80 (44.9%) worked as masons or handyman bricklayers, and 48 (26.9%) reported working with asbestos-containing products. The remaining 50 had other roles such as tiler, plasterer, carpenter, plumber and electrician.
  • For the epithelioid tissue type, exposure longer than 32 years gave an odds ratio of 2.50 (95% CI 1.01 to 6.17) compared with 6 years or less, with a trend test p of 0.04 (Table 2).
  • A positive trend was seen for the fibrous tissue type with age at diagnosis, but it was not statistically significant.
  • Eight cases first exposed in 1991 to 2000 had an average latency of 15.5 years (range 11 to 19). All had worked in maintenance and renovation of civilian homes, and none reported being aware of possible asbestos exposure.
  • None of the 6 peritoneal and 1 pericardial cases reported awareness of contact with asbestos or asbestos-containing materials.
• The authors' conclusion: The authors concluded that the data underline the need for prevention and information in all construction work where asbestos-containing materials are still in place but may be unknown or ignored by workers.
• Limitations the authors state:
  • Too few cases per specific task to analyse single sectors and risk profiles. These may have differed in intensity, duration, materials used and fiber type.

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: Malignant Mesothelioma, Mesothelioma, Friable, Histology, Latency, Epithelioid, Asbestos-Containing Material (ACM).

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