Mesothelioma in Agriculture in Lombardy, Italy: An Unrecognized Risk

Our plain-English summary of Mesothelioma in Agriculture in Lombardy, Italy: An Unrecognized Risk, by C. Mensi, B. Dallari, M. Polonioli, et al (International Journal of Environmental Research and Public Health, 2021).

The study

• Authors: C. Mensi, B. Dallari, M. Polonioli, L. Riboldi, D. Consonni, A.C. Pesatori
• Journal: International Journal of Environmental Research and Public Health
• Published: 2021;18(1)
• Cited by: 5 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Cohort studies showed consistently low risks for malignant mesothelioma (MM) among agricultural workers, however the investigated exposures did not include asbestos. Our aim is to describe sources of asbestos exposure of MM in agriculture. Twenty-six MM cases in agricultural or seed trades workers were identified through the MM registry of the Lombardy region, Italy in 2000-2016. Asbestos exposures were investigated through a standardized questionnaire. The most frequent exposure circumstances were recycled jute bags previously containing asbestos (11 cases) and maintenance and repair of asbestos roofs (12 subjects). Three subjects performed maintenance and repair of tractor asbestos brakes and two used asbestos filters for wine production. Our data suggest asbestos exposure opportunities in the agricultural setting, underlining the need to look for this exposure in subjects affected with mesothelioma.

In plain English

This brief report described people with malignant mesothelioma in Lombardy, Italy, whose only recognized asbestos exposure came from work in agriculture or the seed trade. The regional mesothelioma registry recorded 6237 mesothelioma cases from 2000 to 2016. From these, the authors selected 26 people (21 men, 5 women) exposed to asbestos only in these sectors. Twenty-five had pleural mesothelioma and one had peritoneal mesothelioma. Exposure was assessed through a standardized questionnaire given to patients or their next of kin. The circumstances reported most often were maintenance and repair of asbestos roofs on farm buildings (12 people) and use of recycled jute bags that had previously held asbestos (11 people). Three people repaired tractors with asbestos brakes, and two used asbestos filters in wine production. Seven men also had pleural plaques. All 26 died. Median survival was 12.3 months for men and 10.6 months for women. Nineteen filed compensation claims and only five were compensated. The authors concluded that agriculture holds multiple sources of asbestos exposure that should be looked for in people with mesothelioma. The authors noted that exposure was assessed only qualitatively and that the type of asbestos fiber was unknown.

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: Brief report: a descriptive case series drawn from a population-based mesothelioma registry
• Who was studied: 26 malignant mesothelioma cases (21 men, 5 women) diagnosed in 2000 to 2016 among residents of the Lombardy region, Italy, who were exposed to asbestos only through work in agriculture or seed trades. They were selected from 6237 cases in the regional registry; 36 cases had at least one agricultural or seed-trade work period with recognized asbestos exposure.
• Exposure: Asbestos exposure in farm work, assessed by a standardized questionnaire: recycled jute bags that had previously held asbestos, asbestos roofs on agricultural buildings, tractor brakes and clutches, and asbestos filters for wine. Fiber type was not known, and exposure was assessed only qualitatively.
• Main results:
  • Among the 26 cases, the most frequent exposure circumstances were use of recycled jute bags that had previously contained asbestos (11 cases) and maintenance and repair of asbestos roofs in agricultural buildings (12 subjects).
  • Three subjects maintained and repaired tractors with asbestos brakes or frictions and gaskets; two subjects used asbestos filters for wine production.
  • 25 of the 26 cases had pleural mesothelioma (one man had peritoneal mesothelioma). Age at diagnosis ranged from 56.8 to 85.7 years.
  • Seven men also had pleural plaques in addition to mesothelioma.
  • For 19 cases (73%), asbestos exposure began in 1970 or earlier.
  • All subjects died. Median survival was 12.3 months for men and 10.6 months for women.
  • Nineteen cases filed compensation claims with the Italian workers' compensation authority (INAIL); only five were compensated, and most of the claimants were informal workers.
• The authors' conclusion: The authors concluded that there are multiple sources of asbestos exposure in the agricultural setting. They said these sources need to be thoroughly looked for in people with mesothelioma, particularly those who worked before the 1980s.
• Limitations the authors state:
  • Some interviews were given to next of kin, who may not have been fully aware of the exposure circumstances.
  • Although interviewers were trained, optimal interview quality could not be guaranteed in all cases.
  • Asbestos exposure was assessed only qualitatively.
  • No information was available on the type of asbestos fibers.

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, Malignant Mesothelioma, Asbestos Exposure, Brake Lining.

Related studies

• Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Lombardy, Italy — D. Consonni, C. Calvi, et al. (2019)
• Estimate of environmental and occupational components in the spatial distribution of malignant mesothelioma incidence in Lombardy (Italy) — D. Catelan, D. Consonni, et al. (2020)
• Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy — A. Spinazzè, D. Consonni, et al. (2022)
• Gender differences in pleural mesothelioma occurrence in Lombardy and Piedmont, Italy — D. Consonni, E. Migliore, et al. (2019)
• Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projections — C. Mensi, S. De Matteis, et al. (2016)
• Differences between peritoneal and pleural mesothelioma in Lombardy, Italy — C. Mensi, M. Mendola, et al. (2017)

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