Mesotheliomas following exposure to asbestos used in railroads: the Italian cases

Our plain-English summary of Mesotheliomas following exposure to asbestos used in railroads: the Italian cases, by C. Maltoni, C. Pinto, A. Mobiglia (Toxicology and Industrial Health, 1991).

The study

• Authors: C. Maltoni, C. Pinto, A. Mobiglia
• Journal: Toxicology and Industrial Health
• Published: 1991;7(1-2):1-45
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The available knowledge on the oncogenic risks of asbestos, the data on the uses of asbestos in railroads, with particular regard to the Italian State Railroads (Ferrovie dello Stato = FS), and the groups at risk due to the exposure to asbestos used in railroads were briefly reviewed. The available data on the pathological effects of such exposure, and in particular on the onset of mesotheliomas among machinists and other railroad workers, were also summarized. Eighty-five cases of mesothelioma (80 pleural, 4 peritoneal, and 1 pericardial), related to the exposure to asbestos used in railroads, observed in various Italian regions, were then reported. Twenty-eight of these cases (among which 27 reported in the Emilia-Romagna Region) were submitted to a detailed study at the Bologna Institute of Oncology. Fifty cases of mesothelioma occurred among FS workers, in particular machinists; 30 cases occurred among machinists of rolling-stock workshops not belonging to the FS; 3 cases occurred among travelling workers of rolling-stock not belonging to the FS; and 2 cases were found in family members (a daughter and a wife) of FS workers. This series of cases, together with similar data from the literature, proves the existence of an actually health risk due to asbestos used in railroads, and indicates its gravity. On the basis of the available data, the following steps are considered necessary: the adoption of preventive measures, the performance of medical oncological surveillance, the promotion of systematic epidemiological investigations, and, finally, more emphasis on basic research, aimed at generating information on the biological events taking place during the incubation period of the tumors, to be used for reducing the effect of exposure, and therefore for contrasting the onset of the disease in those who, having been exposed, although healthy, are potentially at high risk.

In plain English

This article briefly reviewed asbestos in railroads and reported 85 Italian mesothelioma cases the authors related to railroad asbestos. Of these, 80 were pleural, 4 peritoneal and 1 pericardial. Fifty occurred among Italian State Railroads (FS) workers, mainly machinists, and 30 among machinists of non-FS rolling-stock workshops. Three occurred among non-FS travelling workers on rolling-stock and 2 in family members (a daughter and a wife) of FS workers. The authors studied 28 cases directly, 27 in Emilia-Romagna. They said chrysotile was the asbestos prevalently, if not exclusively, used in the FS. Cases were found in 13 regions, mostly Emilia-Romagna, which the authors said might reflect local risk and/or more accurate registration. Most occurred in the 1980s. Average latency (start of exposure to diagnosis) was 29 years for both FS and non-FS workshop workers, and 28 years for Emilia-Romagna cases. Since the cases came from occasional observations, the authors said they show but do not quantify the risk, and the true number is likely higher. The authors concluded the series confirmed a high cancer risk from this exposure.

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 of mesotheliomas collected from largely occasional observations and information, not an epidemiological study, preceded by a brief review of the literature on asbestos use and disease in railroads
• Who was studied: 85 people with mesothelioma in various Italian regions: 50 FS (Italian State Railroads) workers, in particular machinists; 30 machinists of rolling-stock workshops not belonging to the FS; 3 non-FS travelling workers on rolling-stock; 2 family members (a daughter and a wife) of FS workers. 28 cases were studied directly at the Bologna Institute of Oncology: 27 in Emilia-Romagna and 1 in Vicenza (Veneto).
• Exposure: Asbestos used in railroads. In Italy it was used to insulate boilers and mains (from the 1940s), the driving cabin of one locomotive type (1960s), and carriages (1950s to 1970s, up to 1,000 kg per carriage). The authors state chrysotile was the type prevalently, if not exclusively, used in the FS.
• Main results:
  • 85 cases of mesothelioma in total: 80 pleural, 4 peritoneal and 1 pericardial
  • 3 cases among non-FS travelling workers on rolling-stock and 2 cases in family members (a daughter and a wife) of FS workers
  • 28 cases were studied directly by the authors, including 1 case in Vicenza in the Veneto Region; the rest were in Emilia-Romagna
  • 83 of the 85 cases had been published previously
  • Cases were observed in 13 Italian regions
  • The majority of cases were observed in the Emilia-Romagna Region. The authors said this may reflect a peculiar local risk situation and/or more accurate registration of cases.
  • The great majority of reported cases occurred in the 1980s
  • The authors used 'period of latency' to mean the time between the start of exposure and diagnosis of the tumor
  • Average latency was 29 years among FS workers and also among workers of workshops not belonging to the FS. It was 28 years for the Emilia-Romagna cases. The authors said this was shorter than latencies reported in earlier US studies, and suggested heavier exposure of the Italian workers.
• The authors' conclusion: The authors concluded that the Italian series confirmed a high carcinogenic risk from exposure to asbestos used in railroads. They called for preventive measures, medical surveillance, systematic epidemiological studies and basic research.
• Limitations the authors state:
  • The cases show, but do not quantify, the risk; the series did not come from a systematic epidemiological investigation
  • The number of cases reported is probably lower than the actual number
  • The concentration of cases in Emilia-Romagna may reflect a local risk situation and/or more accurate registration of cases there

Topics

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

Medical terms in this study, explained in our Lexicon: Mesothelioma, Pericardial.

Related studies

• Mesotheliomas due to asbestos used in railroads in Italy — C. Maltoni, C. Pinto, et al. (1991)
• A retrospective cohort study of lung cancer and diesel exhaust exposure in railroad workers — E. Garshick, M.B. Schenker, et al. (1988)
• Re: Mesothelioma in railroad machinists — A. Churg, F. Green (1990)
• Relative risk of mesothelioma among railroad machinists exposed to chrysotile — I. Higgins (1989)
• A case-control study of lung cancer and diesel exhaust exposure in railroad workers — E. Garshick, M.B. Schenker, et al. (1987)
• Asbestos-related disease in railroad workers. A cross-sectional study — L.C. Oliver, E.A. Eisen, et al. (1985)

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