Pleural and peritoneal mesotheliomas in the Friuli Venezia Giulia register: data analysis from 1995 to 2015 in Northeastern Italy

Our plain-English summary of Pleural and peritoneal mesotheliomas in the Friuli Venezia Giulia register: data analysis from 1995 to 2015 in Northeastern Italy, by F. D'Agostin, P. De Michieli, C. Chermaz, et al (Journal of Thoracic Disease, 2017).

The study

• Authors: F. D'Agostin, P. De Michieli, C. Chermaz, C. Negro
• Journal: Journal of Thoracic Disease
• Published: 2017;9(4):1032-1045
• Cited by: 10 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: The Friuli Venezia Giulia Mesothelioma Register contains a case-list of 1,109 mesotheliomas (1,034 pleural, 75 peritoneal) during 1995-2015. Exposure data are available for almost all cases. The aim was to assess mesothelioma incidence in the Region, an area with several shipyards, and to investigate determinants of mesothelioma latency among occupational cases.

Methods: Incidence rates were calculated. Univariate and multivariate analyses were performed to estimate latency time by anatomical site, gender, diagnostic period and industry sector.

Results: Mesothelioma incidence rates among men were higher than among women during the overall period. The incidence of pleural mesothelioma in men leveled off until 2009 (6.50 per 100,000) with a slight decrease thereafter. For women, the rate increased until 2006 (1.31 per 100,000) and then remained relatively stable. The incidence of peritoneal mesothelioma in men was constant whereas rate among women increased during 2010-2015. The number of cases diagnosed during three-year periods remained level. In multivariate model, site and gender were not relevant for latency period whereas construction workers had a shorter latency than shipyard workers.

Conclusions: Despite the asbestos ban since 1992, occupational exposure is still at risk. This highlights the need to assess exposure levels and to find a reliable health surveillance tool.

In plain English

This study analyzed the Friuli Venezia Giulia Mesothelioma Register in northeastern Italy, a region with several shipyards. Between 1995 and 2015 the register recorded 1,109 mesotheliomas (931 men, 178 women). Of these, 1,034 were pleural and 75 peritoneal. The authors calculated incidence rates for 3-year periods. For people exposed to asbestos at work, they studied latency, the time from first exposure to diagnosis. In men, pleural mesothelioma rose from 6.33 per 100,000 to 7.90 per 100,000 between 1995 and 2009, then showed a slight falling trend. Pleural rates were higher in men than in women in all years. A history of occupational asbestos exposure was found in 80% of men and 18% of women. Among occupational cases, latency did not differ significantly between women and men or between pleural and peritoneal cases. Construction workers had a shorter average latency than shipyard workers (46.3 vs. 51 years). The authors concluded that pleural mesothelioma trends were strongly influenced by occupational asbestos exposure. They noted that exposure histories came from patients or relatives, and that data collection for 2014 to 2015 was still ongoing.

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: Retrospective analysis of a regional mesothelioma register, combining incidence rates by 3-year period with an analysis of latency among occupationally exposed cases
• Who was studied: 1,109 mesothelioma patients (931 males, 178 females) recorded by the Friuli Venezia Giulia Mesothelioma Register, northeastern Italy, 1995 to 2015. Of these, 1,034 were pleural and 75 peritoneal.
• Exposure: Asbestos exposure was classified from questionnaires and interviews as occupational (certain, probable, possible), household, environmental, hobbies, unlikely or unknown. The most common occupational settings were shipbuilding, construction and transportation/ports. No workplace air measurements were available.
• Main results:
  • Among men, pleural mesothelioma incidence increased from 107 cases (6.33 per 100,000) to 139 cases (7.90 per 100,000) between 1995 and 2009, with a slight falling trend thereafter.
  • Among women, pleural mesothelioma incidence remained rather stable from 1995 to 2015, with the highest rates from 1998 to 2006.
  • Pleural mesothelioma rates were higher in men than in women in all years.
  • In men, the peritoneal mesothelioma incidence rate varied from 0.30 to 0.67 per 100,000.
  • Occupational asbestos exposure was found in 80% (741) of the 931 men, compared with 18% (32) of women (P<0.01).
  • 3% of all cases (33 females and 2 males) had exposure from living with someone occupationally exposed, generally a husband or father.
  • Autopsies were performed in 397 men. More than 60% (246) of these men had pleural plaques, and 50 also had asbestosis.
  • Among occupational cases, women had a shorter latency than men, but the difference was not statistically significant. Latency did not differ significantly between pleural and peritoneal cases.
  • Latency did not differ significantly between occupational cases with and without asbestosis (51 vs. 50 years).
  • Construction workers had a shorter average latency than shipyard workers (46.3 vs. 51 years, P<0.01).
  • Latency increased significantly with year of diagnosis, from 44.9 years to 52 years. The text gives these as diagnoses in 1995 and 2015; the article's table gives them as the periods 1995 to 1999 and 2010 to 2015.
  • In the multivariate model, the associations of latency with year of first exposure, year of diagnosis and industry sector were confirmed.
• The authors' conclusion: The authors concluded that pleural mesothelioma incidence trends in both men and women in Friuli Venezia Giulia were strongly influenced by occupational asbestos exposure and, potentially, by workplace safety regulations introduced since 1975.
• Limitations the authors state:
  • Exposure histories came from patients, who may have given inaccurate histories, or from relatives, with a loss of information quality.
  • Start of exposure was taken as the start of the first exposure-related job, which might not match actual first exposure and could overestimate latency.
  • The case series was incomplete: cases with past exposure and short latency could be missing.
  • Collection of incidence data for 2014 to 2015 was still ongoing.
  • No quantitative workplace exposure measurements were available.

Topics

Medical terms in this study, explained in our Lexicon: Peritoneal Mesothelioma, Mesothelioma, Latency, Incidence, Pleural Mesothelioma, Occupational Exposure.

Related studies

• Recognized Occupational Diseases in Italy's Friuli-Venezia Giulia and Liguria Regions (2010-2021) — F. Larese Filon, J. Granzotto, et al. (2023)
• Mesothelioma Risk among Construction Workers According to Job Title: Data from the Italian Mesothelioma Register — L. Vimercati, D. Cavone, et al. (2023)
• Mesothelioma Risk Among Maritime Workers According to Job Title: Data From the Italian Mesothelioma Register (ReNaM) — L. Vimercati, D. Cavone, et al. (2023)
• Asbestos exposure in a shipyard area, northeastern Italy — C. Bianchi, A. Brollo, et al. (2000)
• Italian National Register of Occupational Cancers: data system and findings — A. Scarselli, S. Massari, et al. (2010)
• Asbestos exposure and malignant mesothelioma of the tunica vaginalis testis: a systematic review and the experience of the Apulia (southern Italy) mesothelioma register — L. Vimercati, D. Cavone, et al. (2019)

Browse more research in Journal of Thoracic Disease, or return to medical research.