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Binazzi A, Di Marzio D, Verardo M, Migliore E, Benfatto L, Malacarne D, Mensi C, Consonni D, Eccher S, Mazzoleni G, Comiati V, Negro C, Romanelli A, Chellini E, Angelini A, Grappasonni I, Madeo G, Romeo E, Di Giammarco A, Carrozza F, Angelillo IF, Cavone D, Vimercati L, Labianca M, Tallarigo F, Tumino R, Melis M, Bonafede M, Scarselli A, Marinaccio A. Asbestos Exposure and Malignant Mesothelioma in Construction Workers-Epidemiological Remarks by the Italian National Mesothelioma Registry (ReNaM). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010235. [PMID: 35010496 PMCID: PMC8744912 DOI: 10.3390/ijerph19010235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 12/20/2022]
Abstract
Notwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993–98 period to 23.9% in 2014–2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector.
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Affiliation(s)
- Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Marina Verardo
- Valle d’Aosta Health Local Unit, Regional Operating Center of Valle d’Aosta (COR Valle d’Aosta), 11100 Aosta, Italy;
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10124 Torino, Italy;
| | - Lucia Benfatto
- Regional Operating Center of Liguria (COR Liguria), UO Clinical Epidemiology, IRCCS AOU Policlinico San Martino, 16132 Genova, Italy; (L.B.); (D.M.)
| | - Davide Malacarne
- Regional Operating Center of Liguria (COR Liguria), UO Clinical Epidemiology, IRCCS AOU Policlinico San Martino, 16132 Genova, Italy; (L.B.); (D.M.)
| | - Carolina Mensi
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (D.C.)
| | - Dario Consonni
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (D.C.)
| | - Silvia Eccher
- Hygiene and Occupational Medicine, Provincial Unit of Health, Regional Operating Center of Autonomous Province of Trento (COR A.P. of Trento), 38100 Trento, Italy;
| | - Guido Mazzoleni
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy;
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Region, 35131 Padova, Italy;
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friuli-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy;
| | - Antonio Romanelli
- Health Local Unit, Public Health Department, Regional Operating Center of Emilia-Romagna (COR Emilia-Romagna), 42020 Reggio Emilia, Italy;
| | - Elisabetta Chellini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy; (E.C.); (A.A.)
| | - Alessia Angelini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy; (E.C.); (A.A.)
| | - Iolanda Grappasonni
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy;
| | - Gabriella Madeo
- Regional Operating Center of Umbria (COR Umbria), Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimentare-Regione Umbria, 06126 Perugia, Italy;
| | - Elisa Romeo
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Lazio Region, 00143 Roma, Italy;
| | - Annamaria Di Giammarco
- Occupational Medicine Unit, Health Local Unit, Regional Operating Center of Abruzzo (COR Abruzzo), 65121 Pescara, Italy; or
| | - Francesco Carrozza
- Oncology Unit, Cardarelli Hospital, Regional Operating Center of Molise (COR Molise), 86100 Campobasso, Italy;
| | - Italo F. Angelillo
- Department of Experimental Medicine, “Luigi Vanvitelli” University, Regional Operating Center of Campania (COR Campania), 80138 Napoli, Italy; or
| | - Domenica Cavone
- Section of Occupational Medicine ‘‘B.Ramazzini’’, Department of Interdisciplinary Medicine, Regional Operating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy; (D.C.); (L.V.)
| | - Luigi Vimercati
- Section of Occupational Medicine ‘‘B.Ramazzini’’, Department of Interdisciplinary Medicine, Regional Operating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy; (D.C.); (L.V.)
| | - Michele Labianca
- Epidemiologic Regional Center, Regional Operating Center of Basilicata (COR Basilicata), 85100 Potenza, Italy;
| | - Federico Tallarigo
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy;
| | - Rosario Tumino
- Cancer Registry ASP Ragusa and Sicilia Regional Epidemiological Observatory, Regional Operating Center of Sicilia (COR Sicilia), 97100 Ragusa, Italy;
| | - Massimo Melis
- Regional Epidemiological Center, Regional Operating Center of Sardegna (COR Sardegna), 09125 Cagliari, Italy;
| | - Michela Bonafede
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Alberto Scarselli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
- Correspondence: ; Tel.: +39-0654872621
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DeBono NL, Warden H, Logar‐Henderson C, Shakik S, Dakouo M, MacLeod J, Demers PA. Incidence of mesothelioma and asbestosis by occupation in a diverse workforce. Am J Ind Med 2021; 64:476-487. [PMID: 33834530 DOI: 10.1002/ajim.23245] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/09/2021] [Accepted: 03/02/2021] [Indexed: 11/09/2022]
Abstract
OBJECTIVE We sought to characterize detailed patterns of mesothelioma and asbestosis incidence in the workforce as part of an occupational disease surveillance program in Ontario, Canada. METHODS The Occupational Disease Surveillance System (ODSS) cohort was established using workers' compensation claims data and includes 2.18 million workers employed from 1983 to 2014. Workers were followed for mesothelioma and asbestosis diagnoses in Ontario Cancer Registry, physician, hospital, and ambulatory care records through 2016. Trends in incidence rates were estimated over the study period. Cox proportional hazard models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS A total of 854 mesothelioma and 737 asbestosis cases were diagnosed during follow-up. Compared with all other workers in the ODSS, those employed in construction trades occupations had the greatest adjusted incidence rate of both mesothelioma (223 cases; HR, 2.38; 95% CI: 2.03-2.78) and asbestosis (261 cases; HR, 3.64; 95% CI: 3.11-4.25). Rates were particularly elevated for insulators, pipefitters and plumbers, and carpenters. Workers in welding and flame cutting, boiler making, and mechanic and machinery repair occupations, as well as those in industrial chemical and primary metal manufacturing industries, had strongly elevated rates of both diseases. Rates were greater than anticipated for workers in electrical utility occupations and education and related services. CONCLUSIONS Results substantiate the risk of mesothelioma and asbestosis in occupation and industry groups in the Ontario workforce with known or suspected asbestos exposure. Sustained efforts to prevent the occurrence of additional cases of disease in high-risk groups are warranted.
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Affiliation(s)
- Nathan L. DeBono
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Hunter Warden
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
- Faculty of Medicine University of Toronto Toronto Ontario Canada
| | | | - Sharara Shakik
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Jill MacLeod
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
| | - Paul A. Demers
- Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada
- Occupational Cancer Research Centre Ontario Health Toronto Ontario Canada
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Marinaccio A, Consonni D, Mensi C, Mirabelli D, Migliore E, Magnani C, Di Marzio D, Gennaro V, Mazzoleni G, Girardi P, Negro C, Romanelli A, Chellini E, Grappasonni I, Madeo G, Romeo E, Ascoli V, Carrozza F, Angelillo IF, Cavone D, Tumino R, Melis M, Curti S, Brandi G, Mattioli S, Iavicoli S. Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: a case-control study and epidemiological remarks. Scand J Work Environ Health 2020; 46:609-617. [PMID: 32253443 PMCID: PMC7737812 DOI: 10.5271/sjweh.3895] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives The purposes of this study are to describe the epidemiology of pericardial and tunica vaginalis testis mesothelioma and assess the role of asbestos exposure for these rare diseases. Methods Based on incident pericardial and tunica vaginalis testis mesothelioma cases collected from the Italian national mesothelioma registry (ReNaM) in the period 1993-2015, incidence rates, survival median period and prognostic factors have been evaluated. A case-control study has been performed to analyze the association with asbestos exposure (occupational and non-occupational) for these diseases. Results Between 1993 and 2015, 58 pericardial (20 women and 38 men) and 80 tunica vaginalis testis mesothelioma cases have been registered with a mean annual standardized (world standard population as reference) incidence rates of 0.049 (per million) in men and 0.023 in women for the pericardial site, and 0.095 for tunica vaginalis testis mesothelioma. Occupational exposure to asbestos was significantly associated with the risk of the diseases [odds ratio (OR) 3.68, 95% confidence interval (CI) 1.85-7.31 and OR 3.42, 95% CI 1.93-6.04 in pericardial and tunica vaginalis testis mesothelioma, respectively]. The median survival was 2.5 months for pericardial and 33.0 months for tunica vaginalis testis mesotheliomas. Age was the main predictive factor for survival for both anatomical sites. Conclusions For the first time in an analytical study, asbestos exposure was associated with pericardial and tunica vaginalis testis mesothelioma risk, supporting the causal role of asbestos for all anatomical sites. The extreme rarity of the diseases, the poor survival and the prognostic role of age have been confirmed based on population and nationwide mesothelioma registry data.
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Affiliation(s)
- Alessandro Marinaccio
- Epidemiology Unit, Occupational and Environmental Medicine, Epidemiology and Hygiene Department, INAIL, Via Stefano Gradi 55, 00143 Rome, Italy.
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Torres-Roman JS, Gomez-Rubio V, Sanchez-Trujillo L, Delgado-Rosas E, Puche-Vergara F, Sanz-Anquela JM, Ortega MA. Geographic study of mortality due to mesothelioma in Peru and its evolution. Cancer Epidemiol 2020; 68:101791. [PMID: 32823056 DOI: 10.1016/j.canep.2020.101791] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Peru has a public health problem because of asbestos imports. We analyzed the mortality trends for mesothelioma in Peru and its provinces from 2005 to 2014 and estimated their relationship with the amount of asbestos imported previously. METHODS We computed age-standardized mortality rates (ASMRs) per 100,000 population (direct method and SEGI world standard population reference), and the standardized mortality ratio (SMR). The relationship between the amount of asbestos imported annually along the period 1965-2010 and the number of mesothelioma deaths per year from 2005 to 2014 was estimated by log-linear Poisson regression models and Pearson correlation calculations. RESULTS After correcting the number of deaths, Peru registered 428 cases (or 430 when corrected cases are rounded by sex) between 2005 and 2014. The highest ASMRs were in Arequipa and Callao (range: 0.40-0.41/100,000 population), followed by Huancavelica (0.36/100,000 population). This translates into approximately one death per each 68-111 of asbestos tons imported. The latency period for the higher level of positive correlation found was 8 years (r = 0.8). Male female sex ratio was lower in provinces such as Junin and Hunacavelica with geological asbestos risk. CONCLUSIONS Two patterns of mesothelioma risk have been detected, occupational and environmental. During the 2002-2006 years, Peru increased the asbestos use. If crocidolite imports were also increased, this could be behind the 8 years latency period detected. Peru should boost strategies towards the total ban of all forms of asbestos.
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Affiliation(s)
- J Smith Torres-Roman
- Universidad Católica Los Ángeles de Chimbote, Instituto de Investigación, Chimbote, Peru; Maestria en Epidemiología y Bioestadistica, Universidad Cientifica del Sur, Lima, Peru
| | | | - Lara Sanchez-Trujillo
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Alcalá de Henares, Madrid, Spain
| | | | | | - Jose Miguel Sanz-Anquela
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Alcalá de Henares, Madrid, Spain
| | - Miguel Angel Ortega
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, Alcalá de Henares, Madrid, Spain; Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, Alcalá de Henares, Madrid, Spain; Ramón y Cajal Institute of Healthcare Research (IRYCIS), Networking Biomedical Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Alcalá de Henares, Madrid, Spain.
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Mensi C, De Matteis S, Dallari B, Riboldi L, Bertazzi PA, Consonni D. Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projections. Occup Environ Med 2016; 73:607-13. [PMID: 27312399 PMCID: PMC5013098 DOI: 10.1136/oemed-2016-103652] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/23/2016] [Accepted: 05/31/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In Italy, asbestos has been extensively used from 1945 to 1992. We evaluated the impact of exposure to asbestos on occurrence of malignant mesothelioma (MM) in the Lombardy Region, Northwest Italy, the most populated and industrialised Italian region. METHODS From the Lombardy Mesothelioma Registry, we selected all incident cases of MM diagnosed between 2000 and 2012. We described sources of exposure to asbestos and examined time trends of MM rates. Using Poisson age-cohort models, we derived projections of burden of MM in the Lombardy population for the period 2013-2029. RESULTS In 2000-2012, we recorded 4442 cases of MM (2850 men, 1592 women). Occupational exposure to asbestos was more frequent in men (73.6%) than in women (38.2%). Non-occupational exposure was found for 13.6% of women and 3.6% of men. The average number of cases of MM per year was still increasing (+3.6% in men, +3.3% in women). Incidence rates were still increasing in individuals aged 65+ years and declining in younger people. A maximum of 417 cases of MM (267 men, 150 women) are expected in 2019. We forecast there will be 6832 more cases (4397 in men, 2435 in women) in the period 2013-2029, for a total of 11 274 cases of MM (7247 in men, 4027 in women) in 30 years. CONCLUSIONS This study documented a high burden of MM in both genders in the Lombardy Region, reflecting extensive occupational (mainly in men) and non-occupational (mainly in women) exposure to asbestos in the past. Incidence rates are still increasing; a downturn in occurrence of MM is expected to occur after 2019.
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Affiliation(s)
- Carolina Mensi
- Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sara De Matteis
- National Heart and Lung Institute, Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK
| | - Barbara Dallari
- Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Luciano Riboldi
- Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Pier Alberto Bertazzi
- Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Marinaccio A, Binazzi A, Bonafede M, Corfiati M, Di Marzio D, Scarselli A, Verardo M, Mirabelli D, Gennaro V, Mensi C, Schallemberg G, Merler E, Negro C, Romanelli A, Chellini E, Silvestri S, Cocchioni M, Pascucci C, Stracci F, Ascoli V, Trafficante L, Angelillo I, Musti M, Cavone D, Cauzillo G, Tallarigo F, Tumino R, Melis M. Malignant mesothelioma due to non-occupational asbestos exposure from the Italian national surveillance system (ReNaM): epidemiology and public health issues. Occup Environ Med 2015; 72:648-55. [DOI: 10.1136/oemed-2014-102297] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 11/25/2014] [Indexed: 11/04/2022]
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Greim H, Utell MJ, Maxim LD, Niebo R. Perspectives on refractory ceramic fiber (RCF) carcinogenicity: comparisons with other fibers. Inhal Toxicol 2014; 26:789-810. [PMID: 25264933 PMCID: PMC4245174 DOI: 10.3109/08958378.2014.953276] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
In 2011, SCOEL classified RCF as a secondary genotoxic carcinogen and supported a practical threshold. Inflammation was considered the predominant manifestation of RCF toxicity. Intrapleural and intraperitoneal implantation induced mesotheliomas and sarcomas in laboratory animals. Chronic nose-only inhalation bioassays indicated that RCF exposure in rats increased the incidence of lung cancer and similar exposures resulted in mesothelioma in hamsters, but these studies may have been compromised by overload. Epidemiological studies in the US and Europe showed an association between exposure and prevalence of respiratory symptoms and pleural plaques, but no interstitial fibrosis, mesotheliomas, or increased numbers of lung tumors were observed. As the latency of asbestos induced mesotheliomas can be up to 50 years, the relationship between RCF exposure and respiratory malignances has not been fully determined. Nonetheless, it is possible to offer useful perspectives. RCF and rock wool have similar airborne fiber dimensions and biopersistence. Therefore, it is likely that these fibers have similar toxicology. Traditional rock wool has been the subject of numerous cohort and case control studies. For rock wool, IARC (2002) concluded that the epidemiological studies did not provide evidence of carcinogenicity. Based on analogies with rock wool (read across), it is reasonable to believe that increases in lung cancer or any mesotheliomas are unlikely to be found in the RCF-exposed cohort. RCF producers have developed a product stewardship program to measure and control fiber concentrations and to further understand the health status of their workers.
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Affiliation(s)
- Helmut Greim
- Institute of Molecular Pharmacology and Toxicology, Technical University , Munich , Germany
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Comment on 'The latency period of mesothelioma among a cohort of British asbestos workers (1978-2005)': methodological problems with case-only survival analysis. Br J Cancer 2014; 111:1674. [PMID: 24781281 PMCID: PMC4200077 DOI: 10.1038/bjc.2013.823] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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The latency period of mesothelioma among a cohort of British asbestos workers (1978-2005). Br J Cancer 2013; 109:1965-73. [PMID: 23989951 PMCID: PMC3790169 DOI: 10.1038/bjc.2013.514] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 07/21/2013] [Accepted: 08/08/2013] [Indexed: 11/18/2022] Open
Abstract
Background: The Great Britain (GB) Asbestos Survey is a prospective cohort of asbestos workers in GB. The objective of this study was to investigate determinants of mesothelioma latency, paying particular attention to indicators of intensity of asbestos exposure such as occupation, sex, and presence of asbestosis. Methods: The analysis included members of the cohort who died with mesothelioma between 1978 and 2005. The primary outcome was the latency period defined as the time from first occupational exposure to asbestos to death with mesothelioma. Generalised gamma accelerated failure-time models were used to estimate time ratios (TRs). Results: After excluding missing data, there were 614 workers who died with mesothelioma between 1978 and 2005. Total follow-up time was 9280 person-years, with a median latency of 22.8 years (95% confidence interval (CI) 16.0–27.2 years). In the fully adjusted model, latency was around 29% longer for females compared with males (TR=1.29, 95% CI=1.18–1.42), and 5% shorter for those who died with asbestosis compared with those who did not (TR=0.95, 95% CI=0.91–0.99). There was no evidence of an association between latency and occupation. Conclusion: This study did not find sufficient evidence that greater intensity asbestos exposures would lead to shorter mesothelioma latencies.
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OccIDEAS: An Innovative Tool to Assess Past Asbestos Exposure in the Australian Mesothelioma Registry. Saf Health Work 2012; 3:71-6. [PMID: 22953234 PMCID: PMC3430919 DOI: 10.5491/shaw.2012.3.1.71] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 10/11/2011] [Accepted: 10/13/2011] [Indexed: 11/08/2022] Open
Abstract
Malignant mesothelioma is an uncommon but rapidly fatal disease for which the principal aetiological agent is exposure to asbestos. Mesothelioma is of particular significance in Australia where asbestos use was very widespread from the 1950s until the 1980s. Exposure to asbestos includes occupational exposure associated with working with asbestos or in workplaces where asbestos is used and also 'take-home' exposure of family members of asbestos exposed workers. Asbestos exposure may also be non-occupational, occurring as a consequence of using asbestos products in non-occupational contexts and passive exposure is also possible, such as exposure to asbestos products in the built environment or proximity to an environmental source of exposure, for example an asbestos production plant. The extremely long latency period for this disease makes exposure assessment problematic in the context of a mesothelioma registry. OccIDEAS, a recently developed online tool for retrospective exposure assessment, has been adapted for use in the Australian Mesothelioma Registry (AMR) to enable systematic retrospective exposure assessment of consenting cases. Twelve occupational questionnaire modules and one non-occupational module have been developed for the AMR, which form the basis of structured interviews using OccIDEAS, which also stores collected data and provides a framework for generating metrics of exposure.
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Rake C, Gilham C, Hatch J, Darnton A, Hodgson J, Peto J. Occupational, domestic and environmental mesothelioma risks in the British population: a case-control study. Br J Cancer 2009; 100:1175-83. [PMID: 19259084 PMCID: PMC2669989 DOI: 10.1038/sj.bjc.6604879] [Citation(s) in RCA: 176] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We obtained lifetime occupational and residential histories by telephone interview with 622 mesothelioma patients (512 men, 110 women) and 1420 population controls. Odds ratios (ORs) were converted to lifetime risk (LR) estimates for Britons born in the 1940s. Male ORs (95% confidence interval (CI)) relative to low-risk occupations for >10 years of exposure before the age of 30 years were 50.0 (25.8–96.8) for carpenters (LR 1 in 17), 17.1 (10.3–28.3) for plumbers, electricians and painters, 7.0 (3.2–15.2) for other construction workers, 15.3 (9.0–26.2) for other recognised high-risk occupations and 5.2 (3.1–8.5) in other industries where asbestos may be encountered. The LR was similar in apparently unexposed men and women (∼1 in 1000), and this was approximately doubled in exposed workers’ relatives (OR 2.0, 95% CI 1.3–3.2). No other environmental hazards were identified. In all, 14% of male and 62% of female cases were not attributable to occupational or domestic asbestos exposure. Approximately half of the male cases were construction workers, and only four had worked for more than 5 years in asbestos product manufacture.
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Affiliation(s)
- C Rake
- Institute of Cancer Research, Sutton, Surrey, UK
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Analysis of latency time and its determinants in asbestos related malignant mesothelioma cases of the Italian register. Eur J Cancer 2007; 43:2722-8. [DOI: 10.1016/j.ejca.2007.09.018] [Citation(s) in RCA: 105] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2007] [Revised: 09/13/2007] [Accepted: 09/24/2007] [Indexed: 11/22/2022]
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Imbernon E, Marchand JL, Garras L, Goldberg M. Évaluation quantitative du risque de cancer du poumon et de mésothéliome pleural chez les mécaniciens de véhicules automobiles. Rev Epidemiol Sante Publique 2005; 53:491-500. [PMID: 16434923 DOI: 10.1016/s0398-7620(05)84726-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND A quantitative assessment of the risk of lung cancer and pleural mesothelioma among mechanics exposed to dust released from automobile asbestos-containing parts was performed. METHODS The population of automobile mechanics in France, according to profession and industrial sectors codes, was estimated from the data of the 1999 census. Risks were computed for a total male population of 242,360 automobile mechanics aged 16 to 60 years. Exposure to asbestos among these workers comes from maintenance tasks involving asbestos-containing parts produced before 1997 (date of the asbestos ban in France). Airborne asbestos concentration data available from the literature were highly variable. No data reporting the distribution of time spent for such tasks over a typical week of work were available. Therefore, different weekly exposure profiles were simulated, based on data from the 1994 SUMER survey. Risk models were those used for assessing asbestos health effects by all national and international agencies. Exposure scenarios mixed different levels of exposure, periods of time, proportions of exposed workers and dates of the "natural" disappearance of the automobile fleet built before asbestos was banned in brakes and other parts. The most realistic scenario hypothesizes that all automobile mechanics were exposed to asbestos, that the exposure levels ranged from 0.06 and 0.25 fibers/liter per week for the period before 1997, and between 0.01 and 0.06 fibers/liter per week afterwards until 2010. RESULTS According to this scenario, the number of lifelong cancer deaths (lung and pleura) induced by asbestos exposure in this population is estimated at 602 "unavoidable" cases, due to exposure experienced before 2003; 43 other cases will occur if asbestos is not removed from existing automobiles.
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Affiliation(s)
- E Imbernon
- Département Santé Travail-Institut de Veille Sanitaire, 12, rue du Val d'Osne, 94415 Saint-Maurice Cedex.
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Pan XL, Day HW, Wang W, Beckett LA, Schenker MB. Residential proximity to naturally occurring asbestos and mesothelioma risk in California. Am J Respir Crit Care Med 2005; 172:1019-25. [PMID: 15976368 PMCID: PMC2718408 DOI: 10.1164/rccm.200412-1731oc] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Little is known about environmental exposure to low levels of naturally occurring asbestos (NOA) and malignant mesothelioma (MM) risk. OBJECTIVES To conduct a cancer registry-based case control study of residential proximity to NOA with MM in California. METHODS Incident MM cases (n = 2,908) aged 35 yr or more, diagnosed between 1988 and 1997, were selected from the California Cancer Registry and frequency matched to control subjects with pancreatic cancer (n = 2,908) by 5-yr age group and sex. Control subjects were selected by stratified random sampling from 28,123 incident pancreatic cancers in the same time period. We located 93.7% of subjects at the house or street level at initial diagnosis. Individual occupational exposure to asbestos was derived from the longest held occupation, available for 74% of MM cases and 63% of pancreatic cancers. Occupational exposure to asbestos was determined by a priori classification and confirmed by association with mesothelioma. MAIN RESULTS The adjusted odds ratios and 95% confidence interval for low, medium, and high probabilities of occupational exposures to asbestos were 1.71 (1.32-2.21), 2.51 (1.91-3.30), and 14.94 (8.37-26.67), respectively. Logistic regression analysis from a subset of 1,133 mesothelioma cases and 890 control subjects with pancreatic cancer showed that the odds of mesothelioma decreased approximately 6.3% for every 10 km farther from the nearest asbestos source, an odds ratio of 0.937 (95% confidence interval = 0.895-0.982), adjusted for age, sex, and occupational exposure to asbestos. CONCLUSIONS These data support the hypothesis that residential proximity to NOA is significantly associated with increased risk of MM in California.
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Affiliation(s)
- Xue-lei Pan
- Department of Public Health Sciences, University of California at Davis, Davis, CA 95616-8638, USA
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Marinaccio A, Montanaro F, Mastrantonio M, Uccelli R, Altavista P, Nesti M, Costantini AS, Gorini G. Predictions of mortality from pleural mesothelioma in Italy: a model based on asbestos consumption figures supports results from age-period-cohort models. Int J Cancer 2005; 115:142-7. [PMID: 15645436 DOI: 10.1002/ijc.20820] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Italy was the second main asbestos producer in Europe, after the Soviet Union, until the end of the 1980s, and raw asbestos was imported on a large scale until 1992. The Italian pattern of asbestos consumption lags on average about 10 years behind the United States, Australia, the United Kingdom and the Nordic countries. Measures to reduce exposure were introduced in the mid-1970s in some workplaces. In 1986, limitations were imposed on the use of crocidolite and in 1992 asbestos was definitively banned. We have used primary pleural cancer mortality figures (1970-1999) to predict mortality from mesothelioma among Italian men in the next 30 years by age-cohort-period models and by a model based on asbestos consumption figures. The pleural cancer/mesothelioma ratio and mesothelioma misdiagnosis in the past were taken into account in the analysis. Estimated risks of birth cohorts born after 1945 decrease less quickly in Italy than in other Western countries. The findings predict a peak with about 800 mesothelioma annual deaths in the period 2012-2024. Results estimated using age-period-cohort models were similar to those obtained from the asbestos consumption model.
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Affiliation(s)
- Alessandro Marinaccio
- Epidemiology Unit, Occupational Medicine Department, National Institute for Occupational Safety and Prevention, Rome, Italy.
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Swuste P, Burdorf A, Ruers B. Asbestos, asbestos-related diseases, and compensation claims in The Netherlands. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2004; 10:159-65. [PMID: 15281374 DOI: 10.1179/oeh.2004.10.2.159] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
In The Netherlands the number of asbestos-related diseases is increasing. An age-cohort model predicts a steep rise in pleural mesothelioma deaths up to 490 cases per year among men, with a total death toll close over 12,000 cases during 2000-2028. In the past decade the number of compensation claims for asbestos-related diseases has more than doubled, with increasingly verdicts in favor of claimants. In addition to the medical information, information about the state of the art of preventive measures in different periods of time plays a decisive role in these claims. The use of asbestos in The Netherlands, the occurrence of asbestos-related diseases, the national asbestos regulations, and the position of the claimants in asbestos lawsuits in The Netherlands are reviewed.
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Affiliation(s)
- Paul Swuste
- Safety Science Group, Delft University of Technology, Delft, The Netherlands.
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Abstract
BACKGROUND The Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore Prevenzione e Sicurezza Lavoro (ISPESL), in Rome, in accordance with Art. 36 of Italian Legislative Decree No. 277 [1991]. METHODS Five Italian regions, Piedmont, Liguria, Emilia-Romagna, Tuscany, and Apulia, agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data systematically to ISPESL. RESULTS Four hundred and twenty-nine mesothelioma cases, diagnosed in 1997, are recorded. The standardized annual incidence rate for definite pleural mesothelioma is 1.51 per 100,000 inhabitants (2.26 for males and 0.79 for females). Exposure was defined for 198 mesotheliomas with a histological diagnosis: 125 (63%) refer to occupational exposure, 10 (5%) to environmental exposure, and 5 (2.5%) to household exposure. CONCLUSIONS Despite the ReNaM's work, many limitations still have to be overcome. Clear-cut information on asbestos exposure is available for a limited number of cases; and differing regional procedures in collecting and evaluating mesotheloma cases exist. At this stage the identification and evaluation of a large number of cases of mesothelioma is a worthwhile result. This epidemiological surveillance, currently being extended to other regions, will enable us to better assess the impact and diffusion of this disease in future, and to monitor more closely the effects of ceasing asbestos use in 1992, and the efficacy of preventive measures since mid '70s. Am. J. Ind. Med. 45:55-62, 2004.
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Affiliation(s)
- Massimo Nesti
- Department of Occupational Medicine, Epidemiology unit, ISPESL-National Institute for Occupational Safety and Prevention, Via Alessandria, Rome, Italy.
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