Malignant mesothelioma in non-asbestos textile workers in Florence

Our plain-English summary of Malignant mesothelioma in non-asbestos textile workers in Florence, by E. Paci, S. Dini, E. Buiatti, et al (American Journal of Industrial Medicine, 1987).

The study

• Authors: E. Paci, S. Dini, E. Buiatti, A. Seniori Costantini, S. Lenzi, M. Zappa
• Journal: American Journal of Industrial Medicine
• Published: 1987;11(3):249-54
• Cited by: 21 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 000341).

Abstract

By means of a review of histological diagnosis in the Pathology Department of the University of Florence, suspected cases of malignant mesothelioma, diagnosed in the period 1979-1984, were identified. Study of histological specimens permitted the selection of 13 cases of malignant mesothelioma resident in the Province of Florence. To these cases, referents were matched for age, sex, and year of hospital admission, with residence weighted for the general population of the Province. Both cases and referents (or their next of kin) completed an occupational questionnaire detailing possible occupational exposures. Out of the 13 cases of mesothelioma, 6 were textile workers and 5 of these were "rag-sorters". There were only 5 textile workers among the 52 controls. No asbestos cloth production plants have been in operation in the area from which the cases and referents are derived. Possible sources of exposure to asbestos in the textile industry of this area are discussed.

In plain English

This study from Florence, Italy, looked for jobs linked to malignant mesothelioma. Using records of the University of Florence Pathology Department, the authors identified 13 confirmed cases diagnosed from 1979 to 1984 in residents of the Province of Florence. Each case was matched with four hospital patients (52 referents in all) of the same sex, similar age and the same year of admission. Cases, referents or their next of kin answered a standardized occupational questionnaire. Six of the 13 cases were textile workers, and five of these were "rag-sorters", who sorted and ripped imported second-hand fabric by hand in dusty conditions. Five of the 52 referents were textile workers. Having clothing and textile work as the main occupation was linked to an odds ratio of 28 (95% confidence interval 4.78 to 164.70). No case or referent recalled direct asbestos exposure. To the authors' knowledge, no asbestos fabric was ever made in the area. The authors suggested that asbestos might have come from asbestos cloth mixed into imported rags or from their containers, and said an industrial hygiene survey would be required.

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 with a matched case-referent (case-control) analysis, matching ratio 1:4
• Who was studied: 13 histologically confirmed malignant mesothelioma cases (12 pleural per Table I) diagnosed 1979-1984 among residents of the Province of Florence, Italy, plus 52 hospital referents matched by sex, age (within 2 years) and year of admission, with no discharge diagnosis of mesothelioma or primary lung cancer
• Exposure: Work in the clothing and textile industry as main occupation, chiefly rag-sorting of imported second-hand fabrics for wool recovery. Asbestos exposure was not measured. No subject recalled it, and the authors knew of no asbestos fabric production in the area.
• Main results:
  • Among the 13 cases, 6 were textile workers and 5 of these 6 were rag-sorters; all six textile-worker cases were pleural mesotheliomas (three epithelial, two biphasic, one mesenchymal)
  • 5 of the 52 referents were textile workers
  • Odds ratio for clothing and textile industry as main occupation, cases versus referents: 28 (95% confidence interval 4.78 to 164.70)
  • No case or referent (or next of kin) recalled any direct exposure to asbestos
  • Among the textile-worker cases, average age at diagnosis was 57.70 years (plus or minus 5.86 years) and average latency was 35.11 years (plus or minus 9.12 years)
  • Rag-sorting, done by hand on imported second-hand fabric, produced a great deal of dust
• The authors' conclusion: The authors suggested that asbestos exposure could possibly have come from asbestos cloths mixed with imported rags, or from the rags' containers. They said an industrial hygiene survey would be required to determine whether there is asbestos exposure in the Prato textile industry today.
• Limitations the authors state:
  • Few cases were identified in 1981-1982 because of reduced activity of the thoracic surgery department. The authors saw no reason to think cases were lost selectively by occupation.
  • Asbestos exposure may have occurred in circumstances that subjects did not recognize
  • No industrial hygiene measurements were available; a survey would be required to determine whether asbestos exposure exists

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Pathology, Occupational Exposure, Mesothelioma.

Related studies

• A case-referent study of lung tumors in non-asbestos textile workers — E. Paci, E. Buiatti, et al. (1987)
• An asbestos hazard in the reprocessed textile industry — M.M. Quinn, D. Kriebel, et al. (1987)
• Further evidence of an excess of risk of pleural malignant mesothelioma in textile workers in Prato (Italy) — E. Paci, M. Zappa, et al. (1991)
• Follow-up study of chrysotile asbestos textile workers: cohort mortality and case-control analyses — J.M. Dement, D.P. Brown, et al. (1994)
• Cause-specific mortality in a Chinese chrysotile textile worker cohort — X. Wang, S. Lin, et al. (2013)
• Increased lung cancer mortality among chrysotile asbestos textile workers is more strongly associated with exposure to long thin fibres — D. Loomis, J.M. Dement, et al. (2012)

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