Urban mesothelioma: is there an emerging risk of asbestos in place?

Our plain-English summary of Urban mesothelioma: is there an emerging risk of asbestos in place?, by V. Ascoli, P. Comba, R. Pasetto (International Journal of Cancer, 2004).

The study

• Authors: V. Ascoli, P. Comba, R. Pasetto
• Journal: International Journal of Cancer
• Published: 2004;111(6):975-6
• Type of article: Letter
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Summary of the article

In this letter, the authors asked whether asbestos remaining in buildings ("asbestos in place") poses a mesothelioma risk in cities without asbestos industries. They drew on their survey of 167 cytologically or histologically confirmed malignant mesothelioma cases diagnosed in 1993–2001 in Rome, a nonindustrial city, and surrounding municipalities of the Latium region. Exposure history came from a standard questionnaire or medical records. Compared with cases resident outside Rome, cases resident in Rome had a lower percentage of occupational exposure (33.0% vs. 63.0%), a higher proportion of unknown exposure (43.6% vs. 15.1%), and a lower male-to-female ratio for pleural mesothelioma (1.4, 95% CI 1.07–1.91 vs. 3.8, 95% CI 2.79–4.98). Mortality data also showed this lower ratio (1.4 vs. 2.1). In Rome, unknown-exposure cases included almost equal numbers of men and women in non-asbestos-related jobs. The authors noted that sprayed amosite and chrysotile were used extensively in Rome buildings between the 1960s and early 1970s, especially public administration buildings and offices. They also noted that standardized mortality rates from malignant pleural neoplasm in 1980–1997 were higher in Rome than in pooled Latium municipalities (men 0.95 vs. 0.79; women 0.59 vs. 0.39 per 100,000). They inferred that there might be an urban hazard linked to asbestos in place. They recommended revising exposure questionnaires, combining them with lung fibre measurements, and promoting collaborative studies of adequate sample size.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This letter to the editor reported findings from the authors' survey of malignant mesothelioma in Rome, which they described as a nonindustrial city, and in the surrounding municipalities of Italy's Latium region. For 167 cases confirmed by cell or tissue examination between 1993 and 2001, the authors compared people living in Rome with people living outside the city. Among Rome residents, occupational asbestos exposure was less common (33.0% versus 63.0% outside Rome) and unknown exposure was more common (43.6% versus 15.1%). The male-to-female ratio for pleural mesothelioma was 1.4 (95% CI 1.07–1.91) in Rome and 3.8 (95% CI 2.79–4.98) outside. Among Rome residents, the authors observed an apparent excess of women with no appreciable occupational exposure. From 1980 to 1997, death rates from malignant pleural cancer were higher in Rome than in the pooled Latium municipalities. The authors inferred that there might be an urban hazard from asbestos in place in buildings. They said exposure histories from questionnaires alone are not sensitive enough and should be combined with measurement of fibers in lung samples. They also called for larger collaborative studies.

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: Letter to the editor reporting descriptive results from the authors' survey (case series) of malignant mesothelioma cases, comparing cases living inside versus outside Rome
• Who was studied: 167 cases of malignant mesothelioma confirmed by cytology or histology, diagnosed 1993–2001, living in Rome or in surrounding municipalities of the Latium region, Italy
• Exposure: Asbestos exposure history from a standard questionnaire or medical records, classified as occupational (certain, probable or possible), domestic, environmental, hobby-related, unknown or unclassifiable. The hypothesis examined was exposure to asbestos 'in place' in buildings. The authors noted that sprayed amosite and chrysotile (spelled 'crysotile' in the letter) were used in Rome buildings between the 1960s and early 1970s, especially public administration buildings and offices, citing another source.
• Main results:
  • Occupational asbestos exposure: 33.0% of cases living in Rome (27 males, 4 females) versus 63.0% of cases living outside Rome (43 males, 3 females)
  • Unknown asbestos exposure: 43.6% of cases living in Rome (21 males, 20 females) versus 15.1% of cases living outside Rome (8 males, 3 females)
  • Male-to-female ratio for pleural mesothelioma: 1.4 (95% CI 1.07–1.91) in Rome versus 3.8 (95% CI 2.79–4.98) outside Rome. Mortality data gave 1.4 (95% CI 1.19–1.72) versus 2.1 (95% CI 1.70–2.62).
  • Among cases living in Rome, the authors observed an apparent excess of women with no appreciable occupational asbestos exposure
  • Standardized mortality rates from malignant pleural neoplasm, 1980–1997, Rome versus pooled Latium municipalities: men 0.95 versus 0.79 per 100,000; women 0.59 versus 0.39 per 100,000
  • Among Rome cases with occupational exposure, one-third involved construction work
• The authors' conclusion: The authors inferred that there might be an urban asbestos hazard linked to asbestos in place. They recommended revising exposure questionnaires, combining questionnaire data with measurement of fiber content in lung samples, and carrying out collaborative studies of adequate sample size.
• Limitations the authors state:
  • The authors stated that estimating exposure from history alone is not sensitive enough to assess the proportion of cases without exposure, so questionnaire data cannot accurately exclude asbestos exposure

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, Exposure History, Occupational Exposure, Pleural Mesothelioma, Amosite, Chrysotile, Neoplasm.

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