Mesothelioma among shipyard workers in Monfalcone, Italy

Our plain-English summary of Mesothelioma among shipyard workers in Monfalcone, Italy, by C. Bianchi, T. Bianchi (Indian Journal of Occupational and Environmental Medicine, 2012).

The study

• Authors: C. Bianchi, T. Bianchi
• Journal: Indian Journal of Occupational and Environmental Medicine
• Published: 2012;16(3):119-23
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The high mesothelioma incidence in Monfalcone, Italy, is mainly attributable to shipbuilding activity. Mesothelioma risk among shipyard workers in Monfalcone is poorly defined.

Materials And Methods: Workers hired at the Monfalcone shipyards in the period 1950-1959 were identified by surveying shipyard roll. The list of the workers was coupled with the archive data of Monfalcone and Trieste Hospitals. Mesotheliomas diagnosed in the above people were reexamined.

Results: Of 1,403 workers hired in 1950-1959, 35 were diagnosed with mesothelioma (34 pleural, one peritoneal) between 1978 and 2012. Latency periods exceeded 40 years in 31 cases. The highest percentage of mesotheliomas was observed among people aged 14-19 years at hiring time (3.4%). Four mesothelioma patients had a blood relative with the same tumor.

Conclusions: The present findings show high mesothelioma percentage among shipyard workers hired at young ages. The effects of asbestos exposure begun in 1950-1959 cannot be considered as exhausted.

In plain English

This study examined the 1,403 people (1,375 men and 28 women, aged 14 to 59) hired at the shipyards of Monfalcone, Italy, in 1950 to 1959. The authors matched the hiring roll with hospital pathology archives in Monfalcone and Trieste and re-examined the mesothelioma cases. Thirty-five workers were diagnosed with malignant mesothelioma between 1978 and 2012: 34 pleural and one peritoneal. Among men hired at ages 14 to 19, 23 of 667 (3.4%) were diagnosed with mesothelioma. The figures were 8 of 382 (2.0%) at ages 20 to 29 and 3 of 179 (1.6%) at 30 to 39. No men hired at 40 to 49 (112) or 50 to 59 (34) were diagnosed. These differences did not reach statistical significance. In 34 cases, time from hiring to diagnosis ranged from 25 to 68 years (mean 48.3). Four men with pleural mesothelioma had a blood relative with the same tumor. The authors noted that cases before 1979, and among people who moved away, may have been missed. They concluded that the results indicate a high mesothelioma risk among workers hired in that decade, and that further observation is needed.

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: Study of a group of workers identified from the shipyard hiring roll and linked to hospital pathology archives, with re-examination of the mesothelioma cases found
• Who was studied: 1,403 workers (1,375 men and 28 women, aged 14 to 59) hired at the Monfalcone shipyards, Northeastern Italy, in 1950 to 1959; 21 of the 28 women were hired as canteen employees
• Exposure: Shipyard work at Monfalcone beginning in 1950 to 1959. No specific fiber type is given for these workers. The most frequent trades among the mesothelioma patients were plumber (11 cases), carpenter-shipwright (10 cases) and welder (6 cases). Two men had asbestos exposure before their 1950s employment. The one woman with mesothelioma was a canteen employee who also cleaned the work clothes of her occupationally exposed husband and son.
• Main results:
  • 35 cases of malignant mesothelioma (34 pleural, one peritoneal) were diagnosed among the 1,403 workers hired in 1950 to 1959. The patients were 34 men aged 47 to 82 and one woman aged 88.
  • The tumors were diagnosed between 1978 and 2012. Diagnosis was based on or confirmed by necropsy in 27 cases, by biopsy or surgical material in 7, and by cytology in 1.
  • Among male workers, by age at hiring: 14 to 19 years, 23 cases among 667 men (3.4%); 20 to 29 years, 8 among 382 (2.0%); 30 to 39 years, 3 among 179 (1.6%); 40 to 49 years, 0 among 112; 50 to 59 years, 0 among 34. This table covers men only.
  • The differences in mesothelioma percentages between the age-at-hiring groups did not reach statistical significance
  • Latency periods (time from hiring year to diagnosis), calculated in 34 cases, ranged from 25 to 68 years, with a mean of 48.3 years
  • Latency exceeded 40 years in 31 cases (stated in the abstract printed with the article)
  • Of 29 mesothelioma patients with data on employment duration, 28 had worked in the shipyards for more than 10 years and 25 for more than 20 years
  • Lung asbestos bodies counted in 22 cases ranged from 1,000 to 886,000 bodies per gram of dried tissue; 14 of these had more than 10,000 per gram. In six further cases, asbestos bodies were reported on routine lung sections.
  • Four men with pleural mesothelioma had a blood relative with the same tumor (one father and son, one pair of brothers, two brother and sister pairs). Three of the relatives had occupational asbestos exposure and one had domestic exposure.
• The authors' conclusion: The authors concluded that the results indicate a high mesothelioma risk among workers hired at the Monfalcone shipyards in 1950 to 1959, and that a further observation period is needed to evaluate the full impact of exposure begun in that decade. They also stated that the four familial cases agree with the view that genetic susceptibility has a relevant role.
• Limitations the authors state:
  • Mesothelioma studies in the district began in 1979, so earlier cases may have gone undetected or unregistered, and the findings may be underestimated
  • The Monfalcone and Trieste hospital archives do not cover all cases, especially people who moved to other areas
  • Cases were still being diagnosed in 2012, so further cases are expected
  • Asbestos is cleared from the lung over time, so lung asbestos body counts only partly reflect past exposure. Lung burdens may also differ from those in the pleura.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Latency, Asbestos Exposure.

Related studies

• Asbestos-related mesothelioma in Monfalcone, Italy — C. Bianchi, A. Brollo, et al. (1993)
• Mortality among shipyard workers in Genoa, Italy — R. Puntoni, M. Vercelli, et al. (1979)
• A historical cohort mortality study among shipyard workers in Genoa, Italy — R. Puntoni, F. Merlo, et al. (2001)
• Mortality among workers exposed to asbestos at the shipyard of Genoa, Italy: a 55 years follow-up — D.F. Merlo, M. Bruzzone, et al. (2018)
• Asbestos exposure in a shipyard area, northeastern Italy — C. Bianchi, A. Brollo, et al. (2000)
• Asbestos exposure in the Monfalcone area. A social and pathological study of 100 autopsy cases — C. Bianchi, A. Brollo, et al. (1981)

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