Occupational cancer in Italy: evaluating the extent of compensated cases in the period 1994-2006

Our plain-English summary of Occupational cancer in Italy: evaluating the extent of compensated cases in the period 1994-2006, by A. Scarselli, P. Scano, A. Marinaccio, et al (American Journal of Industrial Medicine, 2009).

The study

• Authors: A. Scarselli, P. Scano, A. Marinaccio, S. Iavicoli
• Journal: American Journal of Industrial Medicine
• Published: 2009;52(11):859-67
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objective: The aim of this study is to analyze occupational cancer claims compensated in the industrial sector in Italy between 1994 and 2006.

Methods: A descriptive analysis of compensated occupational cancers based on the Italian Workers' Compensation Authority (INAIL) data was performed. Summary statistics were compiled by sex and age of worker, cancer type, workplace agent and economic sector. The temporal trend in the period 1994-2006 was investigated for the most frequently compensated cancers (mesothelioma and lung cancer from asbestos; nasal cavities cancer from wood and leather dust).

Results: Between 1994 and 2006, 6,243 cancer claims were compensated by INAIL due to occupational exposure in the industrial sector. Most (5,288, or 85%) of these compensated claims occurred in the period 2000-2006, when the annual mean of the most compensated cancers increased approximately four times compared to the period 1994-1999.

Conclusions: There is an increasing trend in compensation for work-related cancers in Italy in recent years, even if occupational cancers are still widely underreported.

(c) 2009 Wiley-Liss, Inc.

In plain English

This study described occupational cancer claims that Italy's Workers' Compensation Authority (INAIL) compensated in the industrial sector between 1994 and 2006. Over that period 6,243 cancer claims were compensated. For 1994 to 1999, the data covered only asbestos-related mesothelioma and lung cancer and nasal cancers from wood and leather dust. In those years 955 claims were compensated, 857 of them for asbestos exposure. For 2000 to 2006, 5,288 claims were analyzed in detail, and about 95% of claimants were men. In that period asbestos was the most frequent workplace agent, making up 71% of compensated cancers, mainly pleural cancer (66%) and lung cancer (30%). Compensated asbestos-related cancers rose from 246 in 2000 to 933 in 2006. The yearly average of compensated asbestos, wood-dust and leather-dust cancers was about four times higher in 2000 to 2006 than in 1994 to 1999. The authors concluded that compensation for work-related cancers was rising but that occupational cancers were still widely underreported. They noted that the earlier data were incomplete and that the industry sector was missing for 52% of claims.

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: Descriptive analysis of workers' compensation claims data (INAIL claims held in the MaPro occupational disease database), with a multivariate analysis of variance for age, period and birth-cohort effects
• Who was studied: 6,243 cancer claims compensated by INAIL for occupational exposure in the industrial sector in Italy, 1994 to 2006. A detailed analysis covered 5,288 compensated claims (5,280 workers) from 2000 to 2006. Claims from agriculture and State administration were excluded.
• Exposure: Workplace carcinogens recorded as the primary exposure agent on claims. For 1994 to 1999 these were only asbestos (pleural, pericardial and peritoneal mesothelioma, and lung cancer), wood dust and leather dust (nasal and paranasal cancers). For 2000 to 2006 other agents were also included, such as aromatic amines, polycyclic aromatic hydrocarbons, ionizing radiation, chromium VI compounds and vinyl chloride. Asbestos fiber types were not specified.
• Main results:
  • From 1994 to 1999, 955 cancer claims were compensated in the industrial sector: 857 for asbestos exposure, 68 for wood dust and 30 for leather dust.
  • Among the 1994 to 1999 asbestos claims, 73% were pleural mesothelioma, 3% peritoneal mesothelioma, 1% pericardial mesothelioma and 23% lung cancer.
  • Among the 2000 to 2006 claimants, about 95% were male.
  • The annual mean of compensated cancers due to asbestos, wood dust and leather dust in 2000 to 2006 was about four times that of 1994 to 1999.
  • Compensated asbestos-related cancers numbered 246 in 2000 and 933 in 2006.
  • In 2000 to 2006, asbestos was the most frequent workplace exposure agent, accounting for 71% of all compensated cancers.
  • The asbestos-related compensated cancers in 2000 to 2006 were pleural cancer (66%), lung cancer (30%) and peritoneal cancer (3%).
  • Compensated occupational mesothelioma cases rose from 17 in 1994 to 672 in 2006.
  • Compensated asbestos-related lung cancer cases rose from 3 in 1994 to 261 in 2006.
  • The percentage of cancer claims rejected fell from 48% in 2000 to 40% in 2006.
  • The calendar period 2003 to 2006 differed significantly from the two earlier periods (1999 to 2002 and 1994 to 1998).
  • The mean age at diagnosis was 66 years for pleural cancers.
• The authors' conclusion: The authors concluded that compensation for work-related cancers in Italy had been increasing in recent years, although occupational cancers were still widely underreported.
• Limitations the authors state:
  • The data for the full 1994 to 2006 period were incomplete. Data from 1994 to 1999 covered only asbestos-related mesothelioma and lung cancer, and nasal cancers from wood and leather dust.
  • Information on the industry sector was missing for 52% of the 2000 to 2006 claims.
  • The location of the work site was missing for 58% of the 2000 to 2006 claims.
  • Only the primary exposure agent was recorded on each claim.
  • The workplace exposure agent was undefined for about 15% of compensated claims.

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Lung Cancer, Occupational Exposure.

Related studies

• Cohort mortality study of women compensated for asbestosis in Italy — D. Germani, S. Belli, et al. (1999)
• Asbestos-related occupational cancers compensated under the Industrial Accident Compensation Insurance in Korea — Y.S. Ahn, S.K. Kang (2009)
• Occupational cancer in Italy — E. Merler, P. Vineis, et al. (1999)
• Italian National Register of Occupational Cancers: data system and findings — A. Scarselli, S. Massari, et al. (2010)
• Patterns of care for malignant pleural mesothelioma patients compensated by the Dust Diseases Board in New South Wales, Australia — S.C. Kao, S. Clarke, et al. (2013)
• Predictions of mortality from pleural mesothelioma in Italy: a model based on asbestos consumption figures supports results from age-period-cohort models — A. Marinaccio, F. Montanaro, et al. (2005)

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