Malignant mesothelioma of the pleura in Trieste, Italy

Our plain-English summary of Malignant mesothelioma of the pleura in Trieste, Italy, by L. Giarelli, C. Bianchi, G. Grandi (American Journal of Industrial Medicine, 1992).

The study

• Authors: L. Giarelli, C. Bianchi, G. Grandi
• Journal: American Journal of Industrial Medicine
• Published: 1992;22(4):521-30
• Cited by: 22 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

One hundred and seventy malignant pleural mesotheliomas seen at necropsy at the Institute of Pathological Anatomy of the Trieste University during the period 1968-1987 were reviewed. The series included 153 men and 17 women, aged between 33 and 92 years (median 70 years). Lifetime work histories were obtained from the patients' relatives by personal or telephone interviews in 162 cases. A majority of the male subjects had been employed in "naval" work, 99 people having worked in the ship-building industry, 19 in the navy and merchant marine, and 7 in docks. A variety of trades appeared in the remaining histories. Work histories were indicative of occupational exposure to asbestos in 150 cases. A further 5 patients with negative or insufficient data showed asbestos bodies in routine lung sections and 5 women had a history of domestic exposure. A majority of the patients had had their first exposure before 1950. The intervals between first exposure and death ranged from 14 to 71 years (median 48 years).

In plain English

The authors reviewed 170 cases of malignant pleural mesothelioma found at autopsy at Trieste University, Italy, from 1968 to 1987: 153 men and 17 women. Lifetime work histories came from clinical records and interviews with relatives, and lung tissue was examined for asbestos bodies. Most patients had worked in shipbuilding (99), the navy and merchant marine (19) or docks (7); these "naval" workers made up 73% of all cases. Five women had cleaned the work clothes of husbands employed in shipyards. Asbestos bodies were seen in lung sections in 114 of 167 cases examined (68%). In all, 160 cases were classified as asbestos-related. Most patients were first exposed before 1950; the time from first exposure to death, calculable in 124 cases, ranged from 14 to 71 years (median 48). The authors concluded that the risk of asbestos-related mesothelioma is not confined to some workplaces but involves a variety of occupations. Pleural plaques were not studied because autopsy records often lacked this information. The study did not identify which asbestos fiber types its patients were exposed to.

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: Autopsy-based case series: review of all malignant pleural mesotheliomas seen at necropsy at one institute over 20 years, with reconstructed occupational histories and examination of lung sections for asbestos bodies
• Who was studied: 170 cases of malignant pleural mesothelioma found at autopsy in Trieste Province, Italy, from January 1968 to December 1987. There were 153 men aged 33 to 92 (mean 68.7, median 69) and 17 women aged 40 to 81 (mean 69.7, median 74). The cases came from 40,826 necropsies performed at the only institution in the province that carries out necropsies.
• Exposure: Occupational asbestos exposure, mainly in shipyards, at sea (navy and merchant marine) and in docks, and also in petrochemical work, other industries, railways, construction, textile work and other jobs. Five women had domestic exposure from cleaning their shipyard-worker husbands' work clothes. Exposure lasted between 4 months and 46 years. The fiber types the patients were exposed to were not identified.
• Main results:
  • Of the 170 patients, 99 (58.2%) had worked in the shipbuilding industry. A further 19 had worked in the navy and merchant marine and 7 in docks.
  • Shipbuilding, navy and merchant marine, and dock workers together made up 73% of all cases and 77% of the patients with complete histories.
  • Five women had domestic exposure: they had cleaned the work clothes of husbands employed in shipyards.
  • Five patients had no indication of asbestos exposure, and the data were unsatisfactory for a further 8.
  • Routine lung sections were examined in 167 cases. Asbestos bodies were found in 114 of them (68%).
  • 160 of the 170 mesotheliomas were classified as asbestos-related. This total included 5 cases with negative or incomplete histories in which asbestos bodies were present in the lung sections.
  • Most patients had their first asbestos exposure before 1950.
  • The interval from first exposure to death could be calculated in 124 cases. It ranged from 14 to 71 years (mean 47 years, median 48 years).
  • Mesothelioma had been diagnosed during life in 106 of the 170 cases.
  • The tumor types were mixed in 90 cases, purely epithelial in 60 and purely sarcomatous in 20.
• The authors' conclusion: The authors concluded that, in the Trieste area, over 90% of cases were asbestos-related. They also concluded that the risk of asbestos-related mesothelioma is not confined to some workplaces but involves a variety of occupational categories.
• Limitations the authors state:
  • Pleural plaques were not assessed, because necropsy records often lacked a clear statement on whether plaques were present.
  • Patients listed as exposed for less than 10 years had spent the rest of their working lives in a variety of workplaces. Some of them may have had additional asbestos exposures that were not counted.

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, Pleura, Pleural Mesothelioma, Autopsy, Merchant Marine, Occupational Exposure, Asbestos Bodies.

Related studies

• Asbestos and tuberculosis in Trieste, Italy — A.M. Walker, G. Stanta, et al. (1985)
• Diffuse pleural mesothelioma in Trieste. A survey based on autopsy cases — C. Bianchi, G. Grandi, et al. (1978)
• Malignant mesothelioma of the pleura in nonagenarian patients — C. Bianchi, T. Bianchi, et al. (2011)
• Asbestos exposure in malignant mesothelioma of the pleura: a survey of 557 cases — C. Bianchi, A. Brollo, et al. (2001)
• Increased risk of malignant mesothelioma of the pleura after residential or domestic exposure to asbestos: a case-control study in Casale Monferrato, Italy — C. Magnani, P. Dalmasso, et al. (2001)
• Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projections — C. Mensi, S. De Matteis, et al. (2016)

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