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Mukhopadhyay D, Cocco P, Orrù S, Cherchi R, De Matteis S. The role of MicroRNAs as early biomarkers of asbestos-related lung cancer: A systematic review and meta-analysis. Pulmonology 2024:S2531-0437(24)00015-1. [PMID: 38402124 DOI: 10.1016/j.pulmoe.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Asbestos is still the leading cause of occupational cancer mortality worldwide. Asbestos-related lung cancer (LC) and malignant pleural mesothelioma (MPM) prognosis is still poor especially at advanced stage, so early diagnosis biomarkers are needed. MicroRNAs (miRNAs) have been proposed as potential early diagnostic biomarkers of asbestos-related LC and MPM. AIM To evaluate the role of miRNAs as diagnostic and prognostic biomarkers of asbestos-related LC and MPM by performing a literature systematic review and meta-analysis. METHODS MEDLINE, EMBASE via Ovid, PUBMED and Cochrane library databases were systematically searched up to April 2023 to identify relevant articles. A grey literature search was also conducted using the Google Scholar platform. MeSH and free text terms for 'asbestos', 'occupational exposure', 'lung cancer', 'mesothelioma' and 'miRNAs' were used to search the literature. Our systematic review protocol was registered in the PROSPERO database. Study quality was assessed via the Newcastle-Ottawa Scale. RESULTS From the search, 331 articles were retrieved, and, after applying our selection criteria, and exclusion of one study for poor quality, 27 studies were included in the review. Most of the studies were hospital-based case-control, conducted in Europe, and evaluated MPM among men only. MiRNAs expression was measured mainly in plasma or serum. MiR-126, miR-132-3p, and miR-103a-3p were the most promising diagnostic biomarkers for MPM, and we estimated a pooled area under the curve (AUC) of 85 %, 73 %, and 50 %, respectively. In relation to MPM prognosis, miR-197‑3p resulted associated with increased survival time. MiR-126, alone and combined with miR-222, was confirmed associated also to LC diagnosis, together with miR-1254 and miR-574-5p; no miRNA was found associated to LC prognosis. CONCLUSION Based on our systematic literature review there is suggestive evidence that the expression of specific miRNAs in the blood serum or plasma are associated with asbestos-related LC and MPM diagnosis and prognosis. Further large longitudinal studies are urgently needed to validate these findings and elucidate the underlying mechanisms given the potential important implications for patients' survival.
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Affiliation(s)
- D Mukhopadhyay
- Molecular and Translational Medicine, Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Cagliari, Italy
| | - P Cocco
- Centre for Occupational and Environmental Health, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Oxford Road, Manchester, United Kingdom
| | - S Orrù
- Operative Unit of Medical Genetics, Health Agency of Sardinia, Hospital Binaghi, Cagliari, Italy; Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Cagliari, Italy
| | - R Cherchi
- Operative Unit of Thoracic Surgery, Hospital G. Brotzu, Cagliari, Italy
| | - S De Matteis
- Department of Health Sciences, University of Milan, Milan, Italy; NHLI, Imperial College London, United Knigdom.
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Ferrante D, Angelini A, Barbiero F, Barbone F, Bauleo L, Binazzi A, Bovenzi M, Bruno C, Casotto V, Cernigliaro A, Ceppi M, Cervino D, Chellini E, Curti S, De Santis M, Fazzo L, Fedeli U, Fiorillo G, Franchi A, Gangemi M, Giangreco M, Rossi PG, Girardi P, Luberto F, Massari S, Mattioli S, Menegozzo S, Merlo DF, Michelozzi P, Migliore E, Miligi L, Oddone E, Pernetti R, Perticaroli P, Piro S, Addario SP, Romeo E, Roncaglia F, Silvestri S, Storchi C, Zona A, Magnani C, Marinaccio A. Cause specific mortality in an Italian pool of asbestos workers cohorts. Am J Ind Med 2024; 67:31-43. [PMID: 37855384 DOI: 10.1002/ajim.23546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Asbestos is a known human carcinogen and is causally associated with malignant mesothelioma, lung, larynx and ovarian cancers. METHODS Cancer risk was studied among a pool of formerly asbestos-exposed workers in Italy. Fifty-two Italian asbestos cohorts (asbestos-cement, rolling-stock, shipbuilding, and other) were pooled and their mortality follow-up was updated to 2018. Standardized mortality ratios (SMRs) were computed for major causes of death considering duration of exposure and time since first exposure (TSFE), using reference rates by region, age and calendar period. RESULTS The study included 63,502 subjects (57,156 men and 6346 women): 40% who were alive, 58% who died (cause known for 92%), and 2% lost to follow-up. Mortality was increased for all causes (SMR: men = 1.04, 95% confidence interval [CI] 1.03-1.05; women = 1.15, 95% CI 1.11-1.18), all malignancies (SMR: men = 1.21, 95% CI 1.18-1.23; women = 1.29, 95% CI 1.22-1.37), pleural and peritoneal malignancies (men: SMR = 10.46, 95% CI 9.86-11.09 and 4.29, 95% CI 3.66-5.00; women: SMR = 27.13, 95% CI 23.29-31.42 and 7.51, 95% CI 5.52-9.98), lung (SMR: men = 1.28, 95% CI 1.24-1.32; women = 1.26, 95% CI 1.02-1.53), and ovarian cancer (SMR = 1.42, 95% CI 1.08-1.84). Pleural cancer mortality increased during the first 40 years of TSFE (latency), reaching a plateau thereafter. CONCLUSIONS Analyses by time-dependent variables showed that the risk for pleural neoplasms increased with latency and no longer increases at long TSFE, consistent with with asbestos clearance from the lungs. Peritoneal neoplasm risk increased over all observation time.
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Affiliation(s)
- Daniela Ferrante
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Alessia Angelini
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Fabiano Barbiero
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Fabio Barbone
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Lisa Bauleo
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
| | - Massimo Bovenzi
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Veronica Casotto
- Epidemiological Department, Azienda Zero, Padova, Veneto Region, Italy
| | | | - Marcello Ceppi
- Clinical Epidemiology Unit, IRCCS-Ospedale Policlinico San Martino, Genoa, Italy
| | - Daniela Cervino
- Department of Public Health, Azienda USL di Bologna, Bologna, Italy
| | | | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Padova, Veneto Region, Italy
| | - Germano Fiorillo
- Unit of Occupational Medicine-Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | - Alberto Franchi
- Department of Public Health, Azienda USL di Bologna, Bologna, Italy
| | - Manuela Gangemi
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, Torino, Italy
| | - Manuela Giangreco
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venice, Italy
| | - Ferdinando Luberto
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
| | - Stefano Mattioli
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Simona Menegozzo
- Unit of Occupational Medicine-Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | | | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, Torino, Italy
| | - Lucia Miligi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine-University of Pavia, Pavia, Italy
| | - Roberta Pernetti
- Department of Public Health, Experimental and Forensic Medicine-University of Pavia, Pavia, Italy
| | | | - Sara Piro
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Elisa Romeo
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Stefano Silvestri
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Cinzia Storchi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
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Marinaccio A, Di Marzio D, Mensi C, Consonni D, Gioscia C, Migliore E, Genova C, Rossetto Giaccherino R, Eccher S, Murano S, Comiati V, Casotto V, Negro C, Mangone L, Miligi L, Piro S, Angelini A, Grappasonni I, Madeo G, Cozzi I, Ancona L, Staniscia T, Carrozza F, Cavone D, Vimercati L, Labianca M, Tallarigo F, Cascone G, Melis M, Bonafede M, Scarselli A, Binazzi A. Incidence of mesothelioma in young people and causal exposure to asbestos in the Italian national mesothelioma registry (ReNaM). Occup Environ Med 2023; 80:603-609. [PMID: 37813485 DOI: 10.1136/oemed-2023-108983] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/29/2023] [Indexed: 10/17/2023]
Abstract
INTRODUCTION The epidemiological surveillance of mesothelioma incidence is a crucial key for investigating the occupational and environmental sources of asbestos exposure. The median age at diagnosis is generally high, according to the long latency of the disease. The purposes of this study are to analyse the incidence of mesothelioma in young people and to evaluate the modalities of asbestos exposure. METHODS Incident malignant mesothelioma (MM) cases in the period 1993-2018 were retrieved from Italian national mesothelioma registry and analysed for gender, incidence period, morphology and exposure. Age-standardised rates have been calculated and the multiple correspondence analysis has been performed. The association between age and asbestos exposure has been tested by χ2 test. RESULTS From 1993 to 2018, 30 828 incident MM cases have been collected and 1278 (4.1%) presented diagnosis at early age (≤50 years). There is a substantial association between age at diagnosis and the type of asbestos exposure and a significantly lower frequency of cases with occupational exposure to asbestos (497 cases vs 701 expected) in young people has been documented. Paraoccupational and environmental exposure to asbestos have been found more frequent in young MM cases (85 and 93 observed cases vs 52 and 44 expected cases, respectively). CONCLUSIONS Mesothelioma incidence surveillance at population level and the anamnestic individual research of asbestos exposure is a fundamental tool for monitoring asbestos exposure health effects, supporting the exposure risks prevention policies. Clusters of mesothelioma incident cases in young people are a significant signal of a potential non-occupational exposure to asbestos.
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Affiliation(s)
- Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Davide Di Marzio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Carolina Mensi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carmela Gioscia
- Valle d'Aosta Health Local Unit, Valle d'Aosta Region, Aosta, Italy
| | - Enrica Migliore
- COR Piemonte, Unit of Cancer Epidemiology, University of Turin and CPO-Piemonte, Torino, Italy
| | - Carlo Genova
- Internal Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Silvia Eccher
- Provincial Unit of Health Hygiene and Occupational Medicine, COR Province of Trento- APSS, Trento, Italy
| | - Stefano Murano
- Occupational Medicine Unit, COR PA Bolzano, Bolzano, Italy
| | - Vera Comiati
- COR Veneto, Azienda Zero, Veneto Region, Padova, Italy
| | | | - Corrado Negro
- COR Friuli Venezia Giulia, Unit of Occupational Medicine, University of Trieste, Trieste Hospital, Trieste, Italy
| | | | | | | | | | | | | | - Ilaria Cozzi
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, ASL Roma1, Rome, Italy
| | - Laura Ancona
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, ASL Roma1, Rome, Italy
| | | | | | - Domenica Cavone
- Section Occupational Medicine, Interdisciplinary Department of Medicine, COR Puglia, University of Bari Aldo Moro, Bari, Italy
| | - Luigi Vimercati
- Section Occupational Medicine, Interdisciplinary Department of Medicine, COR Puglia, University of Bari Aldo Moro, Bari, Italy
| | - Michele Labianca
- COR Basilicata, Epidemiologic Regional Center, Basilicata Region, Potenza, Italy
| | | | - Giuseppe Cascone
- Public Health Agency Ragusa (ASP), COR Mesoteliomi della Sicilia, Ragusa, Italy
| | | | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alberto Scarselli
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
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Janosikova M, Nakladalova M, Stepanek L. Current causes of mesothelioma: how has the asbestos ban changed the perspective? Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2023. [PMID: 36883200 DOI: 10.5507/bp.2023.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
The association of mesothelioma, a lethal lung disease, with asbestos has led to an absolute ban on asbestos in at least 55 countries worldwide. The purpose of this paper is to review residual exposure to asbestos as well as other emerging causes of mesothelioma outside asbestos. The review provides detailed description of asbestos minerals, their geographical locations, mesothelioma in these areas, as well as contemporary possible sources of asbestos exposure. Second, we examine other emerging causes of mesothelioma including: ionizing radiation as the second most important risk factor after asbestos, particularly relevant to patients undergoing radiotherapy, third, carbon nanotubes which are under investigation and fourth, Simian virus 40. In the case of asbestos per se, the greatest risk is from occupational exposure during mining and subsequent processing. Of the non-occupational exposures, environmental exposure is most serious, followed by exposure from indoor asbestos minerals and secondary familial exposure. Overall, asbestos is still a major risk factor, but alternative causes should not be neglected, especially in young people, in women and those with a history of radiotherapy or living in high-risk locations.
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Affiliation(s)
- Magdalena Janosikova
- Department of Occupational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
| | - Marie Nakladalova
- Department of Occupational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
| | - Ladislav Stepanek
- Department of Occupational Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc, I. P. Pavlova 185/6, 779 00 Olomouc, Czech Republic
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Magnani C, Mensi C, Binazzi A, Marsili D, Grosso F, Ramos-Bonilla JP, Ferrante D, Migliore E, Mirabelli D, Terracini B, Consonni D, Degiovanni D, Lia M, Cely-García MF, Giraldo M, Lysaniuk B, Comba P, Marinaccio A. The Italian Experience in the Development of Mesothelioma Registries: A Pathway for Other Countries to Address the Negative Legacy of Asbestos. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:936. [PMID: 36673690 PMCID: PMC9858856 DOI: 10.3390/ijerph20020936] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/12/2023]
Abstract
Asbestos (all forms, including chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite) is carcinogenic to humans and causally associated with mesothelioma and cancer of the lung, larynx, and ovary. It is one of the carcinogens most diffuse in the world, in workplaces, but also in the environment and is responsible for a very high global cancer burden. A large number of countries, mostly with high-income economies, has banned the use of asbestos which, however, is still widespread in low- and middle-income countries. It remains, thus, one of the most common occupational and environmental carcinogens worldwide. Italy issued an asbestos ban in 1992, following the dramatic observation of a large increase in mortality from mesothelioma and other asbestos-related diseases in exposed workers and also in subjects with non-occupational exposure. A mesothelioma registry was also organized and still monitors the occurrence of mesothelioma cases, conducting a case-by-case evaluation of asbestos exposure. In this report, we describe two Italian communities, Casale Monferrato and Broni, that faced an epidemic of mesothelioma resulting from the production of asbestos cement and the diffuse environmental exposure; we present the activity and results of the Italian mesothelioma registry (ReNaM), describe the risk-communication activities at the local and national level with a focus on international cooperation and also describe the interaction between mesothelioma registration and medical services specialized in mesothelioma diagnosis and treatment in an area at high risk of mesothelioma. Finally, we assess the potential application of the solutions and methods already developed in Italy in a city in Colombia with high mesothelioma incidence associated with the production of asbestos-cement materials and the presence of diffuse environmental asbestos pollution.
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Affiliation(s)
- Corrado Magnani
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority, 00143 Rome, Italy
| | - Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, ISS (Italian National Institute of Health), 00161 Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Juan Pablo Ramos-Bonilla
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Departamento de Ingeniería Civil y Ambiental, Universidad de Los Andes, Bogotá 111711, Colombia
| | - Daniela Ferrante
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Benedetto Terracini
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | | - Michela Lia
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | | | - Margarita Giraldo
- Departamento de Ingeniería Civil y Ambiental, Universidad de Los Andes, Bogotá 111711, Colombia
| | | | - Pietro Comba
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
| | - Alessandro Marinaccio
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority, 00143 Rome, Italy
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Migliore E, Consonni D, Peters S, Vermeulen RCH, Kromhout H, Baldassarre A, Cavone D, Chellini E, Magnani C, Mensi C, Merler E, Musti M, Marinaccio A, Mirabelli D. Pleural mesothelioma risk by industry and occupation: results from the Multicentre Italian Study on the Etiology of Mesothelioma (MISEM). Environ Health 2022; 21:60. [PMID: 35717324 PMCID: PMC9206310 DOI: 10.1186/s12940-022-00869-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The Italian mesothelioma registry (ReNaM) estimates mesothelioma incidence and addresses its etiology by assessing cases' exposures but cannot provide relative risk estimates. OBJECTIVES i) To estimate pleural mesothelioma relative risk by industry and occupation and by ReNaM categories of asbestos exposure; and ii) to provide quantitative estimates of the exposure-response relationship. METHODS A population-based mesothelioma case-control study was conducted in 2012-2014 in five Italian regions. Cases and age and gender frequency-matched controls were interviewed using a standard ReNaM questionnaire. Experts coded work histories according to international standard classifications of industries/occupations and assigned asbestos exposure according to ReNaM categories. Job codes were further linked to SYN-JEM, a quantitative job-exposure matrix. Cumulative exposure (CE, f/mL-years) was computed by summing individual exposures over lifetime work history. Unconditional logistic regression analyses adjusted by gender, centre and age were fitted to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS Among men we observed increased risks of mesothelioma in many industries and associated occupations, including: asbestos-cement (OR = 3.43), manufacture of railroad equipment (OR = 8.07), shipbuilding and repairing (OR = 2.34), iron and steel mills (OR = 2.15), and construction (OR = 1.94). ORs by ReNaM exposure categories were as follows: definite/probable occupational exposure (OR = 15.8, men; OR = 8.80, women), possible occupational (OR = 2.82, men; OR = 3.70, women), sharing home with an exposed worker (OR = 2.55, men; OR = 10.3, women), residential (OR = 2.14, men; OR = 3.24, women). Based on SYN-JEM, mesothelioma risk increased by almost 30% per f/mL-year (OR = 1.28, CI 1.16-1.42). CONCLUSIONS Out study involved five regions with historically different types and levels of industrial development, encompassing one third of the Italian population and half of Italian mesothelioma cases. As expected, we found increased pleural mesothelioma risk in the asbestos industry and in trades with large consumption of asbestos materials. Clear associations were found using both qualitative (ReNaM classifications) and quantitative estimates (using SYN-JEM) of past asbestos exposure, with clear evidence of an exposure-response relationship.
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Affiliation(s)
- Enrica Migliore
- Cancer Epidemiology Unit, CPO Piemonte and University of Turin, Turin, Italy.
- Interdepartmental Centre G. Scansetti for Studies On Asbestos and Other Toxic Particulates, University of Turin, Turin, Italy.
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Susan Peters
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel C H Vermeulen
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hans Kromhout
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Domenica Cavone
- Interdisciplinary Department of Medicine, Section of Occupational Medicine "B. Ramazzini", University of Bari, Bari, Italy
| | - Elisabetta Chellini
- Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute, Florence, Italy
| | - Corrado Magnani
- Interdepartmental Centre G. Scansetti for Studies On Asbestos and Other Toxic Particulates, University of Turin, Turin, Italy
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont and CPO Piemonte, Novara, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Enzo Merler
- Occupational Health Unit, Department of Prevention, Padua, Italy
| | - Marina Musti
- Interdisciplinary Department of Medicine, Section of Occupational Medicine "B. Ramazzini", University of Bari, Bari, Italy
| | - Alessandro Marinaccio
- Unit of Occupational and Environmental Epidemiology - Italian Mesothelioma Register, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Dario Mirabelli
- Cancer Epidemiology Unit, CPO Piemonte and University of Turin, Turin, Italy
- Interdepartmental Centre G. Scansetti for Studies On Asbestos and Other Toxic Particulates, University of Turin, Turin, Italy
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7
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Saito CA, Bussacos MA, Salvi L, Mensi C, Consonni D, Fernandes FT, Campos F, Cavalcante F, Algranti E. Sex-Specific Mortality from Asbestos-Related Diseases, Lung and Ovarian Cancer in Municipalities with High Asbestos Consumption, Brazil, 2000-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3656. [PMID: 35329341 PMCID: PMC8949971 DOI: 10.3390/ijerph19063656] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 01/09/2023]
Abstract
The aim of this study is to compare the mortality rates for typical asbestos-related diseases (ARD-T: mesothelioma, asbestosis, and pleural plaques) and for lung and ovarian cancer in Brazilian municipalities where asbestos mines and asbestos-cement plants had been operating (areas with high asbestos consumption, H-ASB) compared with in other municipalities. The death records for adults aged 30+ years were retrieved from multiple health information systems. In the 2000-2017 time period, age-standardized mortality rates (standard: Brazil 2010) and standardized rate ratios (SRR; H-ASB vs. others) were estimated. The SRRs for ARD-T were 2.56 for men (257 deaths in H-ASB municipalities) and 1.19 for women (136 deaths). For lung cancer, the SRRs were 1.33 for men (32,604 deaths) and 1.19 for women (20,735 deaths). The SRR for ovarian cancer was 1.34 (8446 deaths). Except for ARD-T and lung cancer in women, the SRRs were higher in municipalities that began using asbestos before 1970 than in municipalities that began utilizing asbestos from 1970 onwards. In conclusion, the mortality rates for ARD-T, and lung and ovarian cancer in municipalities with a history of asbestos mining and asbestos-cement production exceed those of the whole country. Caution is needed when interpreting the results of this ecological study. Analytical studies are necessary to document the impact of asbestos exposure on health, particularly in the future given the long latency of asbestos-related cancers.
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Affiliation(s)
- Cézar Akiyoshi Saito
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
| | - Marco Antonio Bussacos
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
| | - Leonardo Salvi
- Programa de Saúde Ambiental e de Saúde do Trabalhador, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, Brazil; (L.S.); (F.C.); (F.C.)
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Fernando Timoteo Fernandes
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
| | - Felipe Campos
- Programa de Saúde Ambiental e de Saúde do Trabalhador, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, Brazil; (L.S.); (F.C.); (F.C.)
| | - Franciana Cavalcante
- Programa de Saúde Ambiental e de Saúde do Trabalhador, Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador 40110-040, Brazil; (L.S.); (F.C.); (F.C.)
| | - Eduardo Algranti
- Fundacentro, Ministério do Trabalho e Previdência, São Paulo 05409-002, Brazil; (C.A.S.); (M.A.B.); (F.T.F.)
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8
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Fazzo L, Binazzi A, Ferrante D, Minelli G, Consonni D, Bauleo L, Bruno C, Bugani M, De Santis M, Iavarone I, Magnani C, Romeo E, Zona A, Alessi M, Comba P, Marinaccio A. Burden of Mortality from Asbestos-Related Diseases in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10012. [PMID: 34639316 PMCID: PMC8508095 DOI: 10.3390/ijerph181910012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
Asbestos is one of the major worldwide occupational carcinogens. The global burden of asbestos-related diseases (ARDs) was estimated around 231,000 cases/year. Italy was one of the main European asbestos producers until the 1992 ban. The WHO recommended national programs, including epidemiological surveillance, to eliminate ARDs. The present paper shows the estimate of the burden of mortality from ARDs in Italy, established for the first time. National standardized rates of mortality from mesothelioma and asbestosis and their temporal trends, based on the National Institute of Statistics database, were computed. Deaths from lung cancer attributable to asbestos exposure were estimated using population-based case-control studies. Asbestos-related lung and ovarian cancer deaths attributable to occupational exposure were estimated, considering the Italian occupational cohort studies. In the 2010-2016 period, 4400 deaths/year attributable to asbestos were estimated: 1515 from mesothelioma, 58 from asbestosis, 2830 from lung and 16 from ovarian cancers. The estimates based on occupational cohorts showed that each year 271 deaths from mesothelioma, 302 from lung cancer and 16 from ovarian cancer were attributable to occupational asbestos exposure in industrial sectors with high asbestos levels. The important health impact of asbestos in Italy, 10-25 years after the ban, was highlighted. These results suggest the need for appropriate interventions in terms of prevention, health care and social security at the local level and could contribute to the global estimate of ARDs.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Daniela Ferrante
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy;
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy;
| | - Lisa Bauleo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Marcella Bugani
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Corrado Magnani
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Elisa Romeo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Mariano Alessi
- Department of Prevention, Ministry of Health, 00100 Roma, Italy;
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
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9
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Visonà SD, Capella S, Bodini S, Borrelli P, Villani S, Crespi E, Colosio C, Previderè C, Belluso E. Evaluation of Deposition and Clearance of Asbestos (Detected by SEM-EDS) in Lungs of Deceased Subjects Environmentally and/or Occupationally Exposed in Broni (Pavia, Northern Italy). Front Public Health 2021; 9:678040. [PMID: 34354974 PMCID: PMC8329042 DOI: 10.3389/fpubh.2021.678040] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/21/2021] [Indexed: 11/19/2022] Open
Abstract
Biodurability is one of the main determinants of asbestos hazardousness for human health. Very little is known about the actual persistence of asbestos in lungs and its clearance, nor about differences in this regard between the different mineralogical types of asbestos. The aim of the present study was to evaluate the amount, the dimensional characteristics and the mineralogic kinds of asbestos in lungs (measured using SEM-EDS) of a series of 72 deceased subjects who were certainly exposed to asbestos (mainly crocidolite and chrysotile) during their life. Moreover, we investigated possible correlations between the lung burden of asbestos (in general and considering each asbestos type), as well as their dimension (length, width, and l/w ratio) and the duration of exposure, the latency- in case of malignant mesothelioma (MM), the survival and the time since the end of exposure. In 62.5% of subjects, asbestos burden in lungs was lower that the threshold considered demonstrative for occupational exposure. In 29.1% of cases no asbestos was found. Chrysotile was practically not detected. The mean length of asbestos fibers and the length to width ratio were significantly related to the duration of exposure to asbestos. No other statistically significant correlations were found between the amount and dimensional characteristics of asbestos (nor with the relative amount of each asbestos type) and the other chronological variables considered. In conclusion, it was pointed out that chrysotile can be completely removed from human lungs in <8 years and, instead, amphiboles persist much more time. The present results suggest, as well, that the finding of no asbestos in lungs cannot rule out the attribution of MM to asbestos (in particular, chrysotile) inhaled in an occupational setting. This point is of crucial importance from a legal point of view.
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Affiliation(s)
- Silvia D. Visonà
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Silvana Capella
- Department of Earth Sciences, University of Torino, Turin, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates “G. Scansetti”, University of Torino, Turin, Italy
| | - Sofia Bodini
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Paola Borrelli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, Pavia University, Pavia, Italy
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University “G. d'Annunzio”, Chieti, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, Pavia University, Pavia, Italy
| | - Eleonora Crespi
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
| | - Claudio Colosio
- Occupational Health Unit, Santi Paolo e Carlo Hospital, Milan, Italy
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Carlo Previderè
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Elena Belluso
- Department of Earth Sciences, University of Torino, Turin, Italy
- Interdepartmental Center for Studies on Asbestos and other Toxic Particulates “G. Scansetti”, University of Torino, Turin, Italy
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10
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Opitz I, Scherpereel A, Berghmans T, Psallidas I, Glatzer M, Rigau D, Astoul P, Bölükbas S, Boyd J, Coolen J, De Bondt C, De Ruysscher D, Durieux V, Faivre-Finn C, Fennell DA, Galateau-Salle F, Greillier L, Hoda MA, Klepetko W, Lacourt A, McElnay P, Maskell NA, Mutti L, Pairon JC, Van Schil P, van Meerbeeck JP, Waller D, Weder W, Putora PM, Cardillo G. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur J Cardiothorac Surg 2021; 58:1-24. [PMID: 32448904 DOI: 10.1093/ejcts/ezaa158] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force brought together experts to update previous 2009 ERS/ESTS guidelines on management of malignant pleural mesothelioma (MPM), a rare cancer with globally poor outcome, after a systematic review of the 2009-2018 literature. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach. The evidence syntheses were discussed and recommendations formulated by this multidisciplinary group of experts. Diagnosis: pleural biopsies remain the gold standard to confirm the diagnosis, usually obtained by thoracoscopy but occasionally via image-guided percutaneous needle biopsy in cases of pleural symphysis or poor performance status. Pathology: standard staining procedures are insufficient in ∼10% of cases, justifying the use of specific markers, including BAP-1 and CDKN2A (p16) for the separation of atypical mesothelial proliferation from MPM. Staging: in the absence of a uniform, robust and validated staging system, we advise using the most recent 2016 8th TNM (tumour, node, metastasis) classification, with an algorithm for pretherapeutic assessment. Monitoring: patient's performance status, histological subtype and tumour volume are the main prognostic factors of clinical importance in routine MPM management. Other potential parameters should be recorded at baseline and reported in clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM patients and only selected patients are candidates for radical surgery. New promising targeted therapies, immunotherapies and strategies have been reviewed. Because of limited data on the best combination treatment, we emphasize that patients who are considered candidates for a multimodal approach, including radical surgery, should be treated as part of clinical trials in MPM-dedicated centres.
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Affiliation(s)
- Isabelle Opitz
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Arnaud Scherpereel
- Department of Pulmonary and Thoracic Oncology, French National Network of Clinical Expert Centers for Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France.,Department of Pulmonary and Thoracic Oncology, University Lille, CHU Lille, INSERM U1189, OncoThAI, Lille, France
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Markus Glatzer
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Philippe Astoul
- Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Servet Bölükbas
- Department of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen, Germany
| | | | - Johan Coolen
- Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte De Bondt
- Department of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Dirk De Ruysscher
- Department of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center+, GROW Research Institute, Maastricht, Netherlands
| | - Valerie Durieux
- Bibliothèque des Sciences de la Santé, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Corinne Faivre-Finn
- The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Dean A Fennell
- Leicester Cancer Research Centre, University of Leicester and University of Leicester Hospitals NHS Trust, Leicester, UK
| | - Francoise Galateau-Salle
- Department of Biopathology, National Reference Center for Pleural Malignant Mesothelioma and Rare Peritoneal Tumors MESOPATH, Centre Leon Berard, Lyon, France
| | - Laurent Greillier
- Department of Multidisciplinary Oncology and Therapeutic Innovations, Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Inserm UMR1068, CNRS UMR7258, Marseille, France
| | - Mir Ali Hoda
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Walter Klepetko
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Aude Lacourt
- University Bordeaux, INSERM, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Bordeaux, France
| | | | - Nick A Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luciano Mutti
- Teaching Hospital Vercelli/Gruppo Italiano, Vercelli, Italy
| | - Jean-Claude Pairon
- INSERM U955, GEIC2O, Université Paris-Est Créteil, Service de Pathologies professionnelles et de l'Environnement, Institut Santé -Travail Paris-Est, CHI Créteil, Créteil, France
| | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Jan P van Meerbeeck
- Department of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - David Waller
- Barts Thorax Centre, St Bartholomew's Hospital, London, UK
| | - Walter Weder
- Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Paul Martin Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, St. Gallen, Switzerland.,Department of Radiation Oncology, University of Bern, Bern, Switzerland
| | - Giuseppe Cardillo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
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11
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A novel BH3-mimetic, AZD0466, targeting BCL-XL and BCL-2 is effective in pre-clinical models of malignant pleural mesothelioma. Cell Death Discov 2021; 7:122. [PMID: 34050131 PMCID: PMC8163735 DOI: 10.1038/s41420-021-00505-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/15/2021] [Accepted: 05/01/2021] [Indexed: 12/29/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive cancer with treatment limited to Cisplatin and Pemetrexed chemotherapy. Recently, we showed that drugs targeting the BCL-2-regulated apoptosis pathway could kill MPM cell lines in vitro, and control tumor growth in vivo. These studies showed BCL-XL was the dominant pro-survival BCL-2 family member correlating with its high-level expression in cells and patient tumor samples. In this study we show another inhibitor, AZD4320 that targets BCL-XL (and BCL-2), can also potently kill MPM tumor cells in vitro (EC50 values in the 200 nM range) and this effect is enhanced by co-inhibition of MCL-1 using AZD5991. Moreover, we show that a novel nanoparticle, AZD0466, where AZD4320 is chemically conjugated to a PEGylated poly-lysine dendrimer, was as effective as standard-of-care chemotherapy, Cisplatin, at inhibiting tumor growth in mouse xenograft studies, and this effect was enhanced when both drugs were combined. Critically, the degree of thrombocytopenia, an on-target toxicity associated with BCL-XL inhibition, was significantly reduced throughout the treatment period compared to other BCL-XL-targeting BH3-mimetics. These pre-clinical findings provide a rationale for the future clinical evaluation for novel BH3-mimetic formulations in MPM, and indeed, other solid tumor types dependent on BCL-XL.
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12
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Visonà SD, Capella S, Bodini S, Borrelli P, Villani S, Crespi E, Frontini A, Colosio C, Belluso E. Inorganic Fiber Lung Burden in Subjects with Occupational and/or Anthropogenic Environmental Asbestos Exposure in Broni (Pavia, Northern Italy): An SEM-EDS Study on Autoptic Samples. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2053. [PMID: 33669843 PMCID: PMC7923219 DOI: 10.3390/ijerph18042053] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 11/25/2022]
Abstract
Increased mortality due to malignant mesothelioma has been demonstrated by several epidemiologic studies in the area around Broni (a small town in Lombardy, northern Italy), where a factory producing asbestos cement was active between 1932 and 1993. Until now, the inorganic fiber burden in lungs has not been investigated in this population. The aim of this study is to assess the lung fiber burden in 72 individuals with previous occupational and/or anthropogenic environmental exposure to asbestos during the activity of an important asbestos cement factory. Inorganic fiber lung burden was assessed in autoptic samples taken from individuals deceased from asbestos-related diseases using a scanning electron microscope equipped with an energy-dispersive spectrometer. Significant differences in the detected amount of asbestos were pointed out among the three types of exposure. In most lung samples taken from patients who died of mesothelioma, very little asbestos (or, in some cases, no fibers) was found. Such subjects showed a significantly lower median amount of asbestos as compared to asbestosis. Almost no chrysotile was detected in the examined samples. Overall, crocidolite was the most represented asbestos, followed by amosite, tremolite/actinolite asbestos, and anthophyllite asbestos. There were significant differences in the amount of crocidolite and amosite fibers according to the kind of exposure. Overall, these findings provide novel insights into the link between asbestos exposure and mesothelioma, as well as the different impacts of the various types of asbestos on human health in relation to their different biopersistences in the lung microenvironment.
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Affiliation(s)
- Silvia Damiana Visonà
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Silvana Capella
- Department of Earth Sciences, University of Torino, 10125 Torino, Italy; (S.C.); (E.B.)
- Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates “G. Scansetti”, University of Torino, 10121 Torino, Italy
| | - Sofia Bodini
- Unit of Legal Medicine and Forensic Sciences, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy;
| | - Paola Borrelli
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (P.B.); (S.V.)
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, University “G. d’Annunzio” Chieti-Pescara, 66100 Chieti, Italy
| | - Simona Villani
- Unit of Biostatistics and Clinical Epidemiology, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (P.B.); (S.V.)
| | - Eleonora Crespi
- Occupational Health Unit, Santi Paolo e Carlo Hospital, 20142 Milano, Italy; (E.C.); (C.C.)
| | - Andrea Frontini
- Department of Life and Environmental Science, Polytechnic University of Marche, 60131 Ancona, Italy;
| | - Claudio Colosio
- Occupational Health Unit, Santi Paolo e Carlo Hospital, 20142 Milano, Italy; (E.C.); (C.C.)
- Department of Health Sciences, University of Milan, 20122 Milano, Italy
| | - Elena Belluso
- Department of Earth Sciences, University of Torino, 10125 Torino, Italy; (S.C.); (E.B.)
- Interdepartmental Center for Studies on Asbestos and Other Toxic Particulates “G. Scansetti”, University of Torino, 10121 Torino, Italy
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13
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Emmett EA. Asbestos in High-Risk Communities: Public Health Implications. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1579. [PMID: 33562413 PMCID: PMC7915393 DOI: 10.3390/ijerph18041579] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/19/2021] [Accepted: 01/31/2021] [Indexed: 02/07/2023]
Abstract
Asbestos-related diseases (ARDs)-mesothelioma, lung cancer, and asbestosis-are well known as occupational diseases. As industrial asbestos use is eliminated, ARDs within the general community from para-occupational, environmental, and natural exposures are more prominent. ARD clusters have been studied in communities including Broni, Italy; Libby, Montana; Wittenoom, Western Australia; Karain, Turkey; Ambler, Pennsylvania; and elsewhere. Community ARDs pose specific public health issues and challenges. Community exposure results in higher proportions of mesothelioma in women and a younger age distribution than occupational exposures. Exposure amount, age at exposure, fiber type, and genetic predisposition influence ARD expression; vulnerable groups include those with social and behavioral risk, exposure to extreme events, and genetic predispositions. To address community exposure, regulations should address all carcinogenic elongated mineral fibers. Banning asbestos mining, use, and importation will not reduce risks from asbestos already in place. Residents of high-risk communities are characteristically exposed through several pathways differing among communities. Administrative responsibility for controlling environmental exposures is more diffuse than for workplaces, complicated by diverse community attitudes to risk and prevention and legal complexity. The National Mesothelioma Registries help track the identification of communities at risk. High-risk communities need enhanced services for screening, diagnosis, treatment, and social and psychological support, including for retired asbestos workers. Legal settlements could help fund community programs. A focus on prevention, public health programs, particularization to specific community needs, and participation is recommended.
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Affiliation(s)
- Edward A Emmett
- Occupational and Environmental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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14
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Barbieri PG, Somigliana A, Chen Y, Consonni D, Vignola R, Finotto L. Lung Asbestos Fibre Burden and Pleural Mesothelioma in Women with Non-occupational Exposure. Ann Work Expo Health 2021; 64:297-310. [PMID: 32065212 DOI: 10.1093/annweh/wxaa009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 11/16/2019] [Accepted: 01/23/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) due to environmental and familial (domestic) asbestos exposure is well recognized. However, information on cumulative asbestos dose in subjects affected by MPM is limited. OBJECTIVES To evaluate the residual lung asbestos fibre and asbestos body burden in women with MPM with past environmental and/or familial asbestos exposure. METHODS We collected lung samples from autopsies regarding 15 non-occupationally asbestos-exposed MPM cases, divided in three groups: (i) familial exposure from the Fincantieri shipyards in Monfalcone (No. 7), (ii) environmental and familial asbestos exposure from the asbestos-cement plant Fibronit in Broni (No. 6), and (iii) environmental exposure from the Fibronit plant (No. 2). Asbestos body (AB) and fibres (AF) per gram of dry lung tissue were counted by optical and scanning electron microscopy, respectively, and expressed as geometric means and standard deviations (GM, GSD). RESULTS GM/GSD of AB counts were 6123/9.6 (Group 1), 13 800/10.4 (Group 2), and 8400/1.1 (Group 3); GM/GSD of AF were 0.6/2.1 (Group 1), 7.9/2.1 (Group 2), and 6.0/2.3 (Group 3) million. Pleural plaques were observed in 12 cases. CONCLUSIONS Exclusive familial exposure to asbestos determined cumulative doses close to those observed in moderate occupational exposure circumstances. Our results also suggest that combined environmental and familial exposures may cause unexpectedly high cumulative fibre doses.
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Affiliation(s)
- Pietro Gino Barbieri
- Formerly Mesothelioma Registry, Occupational Health Unit, Local Health Authority, Brescia, Italy
| | - Anna Somigliana
- Centre of Electronic Microscopy, Lombardy Environmental Protection Agency (ARPA), Milan, Italy
| | - Yao Chen
- Public Health Department, Forensic Medical Unit, University of Pavia, Pavia, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Vignola
- Occupational Health Unit, Local Health Authority, Broni (PV), Italy
| | - Luigi Finotto
- Occupational Health Unit, Local Health Authority, Monfalcone (GO), Italy
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15
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Fontana L, Massari S, Maisonneuve P, Persechino B, Marinaccio A, Rampinelli C, Spaggiari L, Veronesi G, Iavicoli S. An innovative approach to identify past exposure to asbestos integrating questionnaire information and administrative data. Health Policy 2020; 125:246-253. [PMID: 33358598 DOI: 10.1016/j.healthpol.2020.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 11/06/2020] [Accepted: 11/24/2020] [Indexed: 11/18/2022]
Abstract
Reconstruction of work history of subjects exposed to occupational carcinogens might be extremely challenging and provide unreliable results. This study, carried out in Italy from February to November 2014, aimed to explore the validity of an innovative approach to reconstruct the occupational history of workers who have previously been exposed to asbestos combining the administration of structured questionnaire with the use of administrative data. Subjects recruited in this study were enrolled in the cohorts of COSMOS 1 and 2 studies. Participants indicating an exposure to asbestos were contacted and a structured questionnaire was administered to them to verify the validity of the self-reported asbestos exposure. Subsequently, work histories of respondents were investigated using administrative information. The record linkage with social security archives allowed the reassembling of the complete work history of 487 participants. In detail, administrative files allow the retrieval of 98 % of workers declaring not to be exposed, versus 77 % using the questionnaire. Furthermore, the percentage of retrieved cases is not relevant for high risk sectors but it is almost double for industries with probable presence of asbestos. The combined and integrated use of structured questionnaire with administrative data proved effective in accurately identifying subjects who actually had an asbestos exposure. This innovative strategy, being cost-effective and easily adaptable to other carcinogens, could be particularly useful in selecting subjects to recruit in specific screening and control programs for the early diagnosis of occupational cancers.
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Affiliation(s)
- Luca Fontana
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy; Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
| | - Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, via Ripamonti 435, 20141, Milan, Italy.
| | - Benedetta Persechino
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
| | - Cristiano Rampinelli
- Department of Medical Imaging and Radiation Sciences, IEO European Institute of Oncology IRCSS, via Ripamonti 435, 20141, Milan, Italy.
| | - Lorenzo Spaggiari
- Division of Thoracic Surgery, IEO European Institute of Oncology IRCSS, via Ripamonti 435, 20141, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Via Festa Del Perdono 7, 20122, Milan, Italy.
| | - Giulia Veronesi
- Division of Thoracic and General Surgery, Humanitas Clinical and Research Center, Via Alessandro Manzoni 56, 20089, Rozzano (Milan), Italy.
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Via Fontana Candida 1, 00078, Monte Porzio Catone, Rome, Italy.
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16
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Capella S, Bellis D, Fioretti E, Marinelli R, Belluso E. Respirable inorganic fibers dispersed in air and settled in human lung samples: Assessment of their nature, source, and concentration in a NW Italy large city. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 263:114384. [PMID: 32234644 DOI: 10.1016/j.envpol.2020.114384] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/04/2020] [Accepted: 03/14/2020] [Indexed: 06/11/2023]
Abstract
The present investigation represents a new approach useful to evaluate the general population risk correlated with environmental exposure to air dispersed inorganic fibers. The used method is based on the evaluation of the respirable inorganic fibers both air dispersed in a big city and contained in lungs of the general population following their respiration. Moreover, these data allow to identify the sources of dispersion (anthropogenic or natural) in air of the inorganic fibers and therefore to apply strategies to improve air quality. To describe this approach, we investigated air samples from a big city in NW Italy and lung inorganic burden of people here lived. This paper reports the data of the airborne inorganic fibers detected in two sampling campaign (2014 and 2016), in 24 districts of Torino (Piemonte - NW Italy), and in some autoptic lungs of general population lived here. The airborne fibers (collected on mixed-cellulose esters membrane) were characterized by SEMEDS. The identified inorganic fiber species were assigned to 5 classes, one of these including 2 types of asbestos. These last are grouped as tremolite/actinolite asbestos. They are dispersed from natural sources (i.e. certain kinds of rocks outcropping in the city surrounding areas). In no-one of the 24 districts of Torino their concentration highlighted a situation of asbestos pollution in place. A correlation with inorganic fibers (collected on mixed-cellulose esters membrane and characterized by SEM-EDS) detected in lung tissue samples of 10 subjects lived in Torino all their life and without professional exposure to asbestos were attempted. The only types of fibers identified as asbestos are tremolite/actinolite asbestos, and they match those detected in air sampling. The number of fibers per 1 g of tissue dry weight is lower than the quantities reported as indicative of significant asbestos exposure. We observed interesting gender differences.
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Affiliation(s)
- Silvana Capella
- Department of Earth Sciences, University of Torino, Torino, Italy; Interdepartmental Centre for Studies on Asbestos and Other Toxic Particulates "G. Scansetti", University of Torino, Torino, Italy.
| | - Donata Bellis
- Interdepartmental Centre for Studies on Asbestos and Other Toxic Particulates "G. Scansetti", University of Torino, Torino, Italy; Department of Surgery, Pathological Anatomy, Ospedale degli Infermi, Ponderano, Biella, Italy
| | | | | | - Elena Belluso
- Department of Earth Sciences, University of Torino, Torino, Italy; Interdepartmental Centre for Studies on Asbestos and Other Toxic Particulates "G. Scansetti", University of Torino, Torino, Italy; Institute of Geosciences and Earth Resources, CNR, Unit of Torino, Italy
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17
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Neitzel RL, Sayler SK, Demond AH, d'Arcy H, Garabrant DH, Franzblau A. Measurement of asbestos emissions associated with demolition of abandoned residential dwellings. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 722:137891. [PMID: 32208261 PMCID: PMC7261207 DOI: 10.1016/j.scitotenv.2020.137891] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/10/2020] [Accepted: 03/11/2020] [Indexed: 06/10/2023]
Abstract
Many cities are revitalizing their urban cores through the demolition of abandoned residential dwellings (ARDs). However, data regarding the emissions of asbestos during such an operation are sparse. We measured airborne asbestos emissions from emergency demolitions (demolitions on structures deemed too dangerous to enter and remove asbestos) of ARDs in Detroit. High-flow air sampling was conducted during ARD demolitions. Air samples were analyzed using Phased Contrast Microscopy (PCM), and a subset using Transmission Electron Microscopy (TEM). One hundred and one air samples were collected on 25 emergency demolitions. Fifty-four of the 101 PCM samples (53%) exceeded the limit of detection (LOD). However, only 2 of 46 TEM samples (4%) exceeded the LOD for asbestos; these latter samples were from two different demolitions and each contained a single chrysotile asbestos fiber. Using conservative exposure assumptions and commonly-accepted risk estimation formulae, we estimated the lifetime risk of mesothelioma and lung cancer combined to be less than one case per one million people. Emissions of airborne asbestos during emergency (unabated) ARD demolition operations appear to be negligible. As a result, the associated health risk for asbestos-related disease is also negligible. Reconsideration of current regulatory mandates for asbestos abatement in ARDs may be warranted.
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Affiliation(s)
- Richard L Neitzel
- University of Michigan, Department of Environmental Health Sciences, Ann Arbor, MI, USA.
| | - Stephanie K Sayler
- University of Michigan, Department of Environmental Health Sciences, Ann Arbor, MI, USA
| | - Avery H Demond
- University of Michigan, Department of Civil and Environmental Engineering, Ann Arbor, MI, USA
| | - Hannah d'Arcy
- University of Michigan, Department of Environmental Health Sciences, Ann Arbor, MI, USA
| | - David H Garabrant
- University of Michigan, Department of Environmental Health Sciences, Ann Arbor, MI, USA
| | - Alfred Franzblau
- University of Michigan, Department of Environmental Health Sciences, Ann Arbor, MI, USA
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18
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Scherpereel A, Opitz I, Berghmans T, Psallidas I, Glatzer M, Rigau D, Astoul P, Bölükbas S, Boyd J, Coolen J, De Bondt C, De Ruysscher D, Durieux V, Faivre-Finn C, Fennell D, Galateau-Salle F, Greillier L, Hoda MA, Klepetko W, Lacourt A, McElnay P, Maskell NA, Mutti L, Pairon JC, Van Schil P, van Meerbeeck JP, Waller D, Weder W, Cardillo G, Putora PM. ERS/ESTS/EACTS/ESTRO guidelines for the management of malignant pleural mesothelioma. Eur Respir J 2020; 55:13993003.00953-2019. [PMID: 32451346 DOI: 10.1183/13993003.00953-2019] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/17/2019] [Indexed: 12/23/2022]
Abstract
The European Respiratory Society (ERS)/European Society of Thoracic Surgeons (ESTS)/European Association for Cardio-Thoracic Surgery (EACTS)/European Society for Radiotherapy and Oncology (ESTRO) task force brought together experts to update previous 2009 ERS/ESTS guidelines on management of malignant pleural mesothelioma (MPM), a rare cancer with globally poor outcome, after a systematic review of the 2009-2018 literature. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach. The evidence syntheses were discussed and recommendations formulated by this multidisciplinary group of experts. Diagnosis: pleural biopsies remain the gold standard to confirm the diagnosis, usually obtained by thoracoscopy but occasionally via image-guided percutaneous needle biopsy in cases of pleural symphysis or poor performance status. Pathology: standard staining procedures are insufficient in ∼10% of cases, justifying the use of specific markers, including BAP-1 and CDKN2A (p16) for the separation of atypical mesothelial proliferation from MPM. Staging: in the absence of a uniform, robust and validated staging system, we advise using the most recent 2016 8th TNM (tumour, node, metastasis) classification, with an algorithm for pre-therapeutic assessment. Monitoring: patient's performance status, histological subtype and tumour volume are the main prognostic factors of clinical importance in routine MPM management. Other potential parameters should be recorded at baseline and reported in clinical trials. Treatment: (chemo)therapy has limited efficacy in MPM patients and only selected patients are candidates for radical surgery. New promising targeted therapies, immunotherapies and strategies have been reviewed. Because of limited data on the best combination treatment, we emphasise that patients who are considered candidates for a multimodal approach, including radical surgery, should be treated as part of clinical trials in MPM-dedicated centres.
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Affiliation(s)
- Arnaud Scherpereel
- Pulmonary and Thoracic Oncology, Univ. Lille, CHU Lille, INSERM U1189, OncoThAI, Lille, France .,French National Network of Clinical Expert Centers for Malignant Pleural Mesothelioma Management (Mesoclin), Lille, France
| | - Isabelle Opitz
- Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | | | - Ioannis Psallidas
- Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Markus Glatzer
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland
| | - David Rigau
- Iberoamerican Cochrane Center, Barcelona, Spain
| | - Philippe Astoul
- Dept of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Aix-Marseille University, Marseille, France
| | - Servet Bölükbas
- Dept of Thoracic Surgery, Evang, Kliniken Essen-Mitte, Essen, Germany
| | | | - Johan Coolen
- Dept of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Charlotte De Bondt
- Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Dirk De Ruysscher
- Dept of Radiation Oncology (Maastro Clinic), Maastricht University Medical Center+, GROW Research Institute, Maastricht, The Netherlands
| | - Valerie Durieux
- Bibliothèque des Sciences de la Santé, Université libre de Bruxelles (ULB), Brussels, Belgium
| | - Corinne Faivre-Finn
- The Christie NHS Foundation Trust, The University of Manchester, Manchester, UK
| | - Dean Fennell
- Leicester Cancer Research Centre, University of Leicester and University of Leicester Hospitals NHS Trust, Leicester, UK
| | - Francoise Galateau-Salle
- National Reference Center for Pleural Malignant Mesothelioma and Rare Peritoneal Tumors MESOPATH, Dept of Biopathology, Centre Leon Berard, Lyon, France
| | - Laurent Greillier
- Aix Marseille University, Assistance Publique Hôpitaux de Marseille, Inserm UMR1068, CNRS UMR7258, Dept of Multidisciplinary Oncology and Therapeutic Innovations, Marseille, France
| | - Mir Ali Hoda
- Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Walter Klepetko
- Dept of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Aude Lacourt
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, team EPICENE, UMR 1219, Bordeaux, France
| | | | - Nick A Maskell
- Academic Respiratory Unit, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luciano Mutti
- Teaching Hosp. Vercelli/Gruppo Italiano Mesotelioma, Italy
| | - Jean-Claude Pairon
- INSERM U955, Equipe 4, Université Paris-Est Créteil, and Service de Pathologies professionnelles et de l'Environnement, Institut Santé-Travail Paris-Est, CHI Créteil, Créteil, France
| | - Paul Van Schil
- Dept Thoracic and Vascular Surgery, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - Jan P van Meerbeeck
- Dept of Pulmonology and Thoracic Oncology, Antwerp University and Antwerp University Hospital, Antwerp, Belgium
| | - David Waller
- Barts Thorax Centre, St Bartholomew's Hospital, London, UK
| | - Walter Weder
- Dept of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Giuseppe Cardillo
- Unit of Thoracic Surgery, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Paul Martin Putora
- Dept of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland.,Dept of Radiation Oncology, University of Bern, Bern, Switzerland
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19
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Vimercati L, Cavone D, Delfino MC, Caputi A, De Maria L, Sponselli S, Corrado V, Ferri GM, Serio G. Asbestos Air Pollution: Description of a Mesothelioma Cluster Due to Residential Exposure from an Asbestos Cement Factory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2636. [PMID: 32290540 PMCID: PMC7215593 DOI: 10.3390/ijerph17082636] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/12/2022]
Abstract
The study describes a cluster of 71 malignant mesothelioma cases among Bari residents without asbestos exposure other than residential exposure. This small cohort, as expected, was composed of a majority of females (56.34%) with a M/F ratio of 0.8, ages ≤ 65 years old (52.11%) and the epithelioid morphological type (78.87%). Sixty-four subjects (90.14%) lived between 10 m and 1000 m from the asbestos cement factory (Fibronit), and the latency length was longer than 55 years for 25 subjects (35.21%). The adjusted risk (adjusted OR) of observing the epithelial form of mesothelioma among subjects living at small distances from Fibronit was high (OR = 1.870 (0.353-9.905)) for people living 550-1000 m from the site and for those living less than 550 m from the site (OR = 1.470 (0.262-8.248)). Additionally, the subjects with a high length of exposure showed a relevant risk of epithelioid mesothelioma both for 21-40 years of exposure (OR = 2.027 (0.521-7.890)) and more than 40 years of exposure (OR = 2.879 (0.651-12.736)). All of the estimates were high but not significant because this transitional study has a typically low power. The adjustment for latency showed the same trend. Using detailed information collected by the regional mesothelioma registry, this study provided evidence of a continuing health impact of the Fibronit asbestos cement factory in Bari on the resident population.
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Affiliation(s)
- Luigi Vimercati
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Domenica Cavone
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Maria Celeste Delfino
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Vincenzo Corrado
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Giovanni Maria Ferri
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathology Division, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy;
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20
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Ferrari L, Carugno M, Mensi C, Pesatori AC. Circulating Epigenetic Biomarkers in Malignant Pleural Mesothelioma: State of the Art and critical Evaluation. Front Oncol 2020; 10:445. [PMID: 32318342 PMCID: PMC7146237 DOI: 10.3389/fonc.2020.00445] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/13/2020] [Indexed: 12/18/2022] Open
Abstract
Malignant pleural mesothelioma (MPM) is a rare and aggressive cancer, which originates from the mesothelial cells of the pleura and is associated with asbestos exposure. In light of its aggressive nature, late diagnosis and dismal prognosis, there is an urgent need for identification of biomarkers in easily accessible samples (such as blood) for early diagnosis of MPM. In the last 10 years, epigenetic markers, such as DNA methylation and microRNAs (miRNAs), have gained popularity as possible early diagnostic and prognostic biomarkers in cancer research. The aim of this review is to provide a critical analysis of the current evidences on circulating epigenetic biomarkers for MPM and on their translational potential to the clinical practice for early diagnosis and for prognosis.
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Affiliation(s)
- Luca Ferrari
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Michele Carugno
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Mensi
- Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela Cecilia Pesatori
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.,Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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21
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Marsh GM, Ierardi AM, Benson SM, Finley BL. Response to letters regarding "Occupational exposures to cosmetic talc and risk of mesothelioma: an updated pooled cohort and statistical power analysis with consideration of latency period". Inhal Toxicol 2019; 31:387-391. [PMID: 31851545 DOI: 10.1080/08958378.2019.1702744] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - A Michael Ierardi
- Cardno ChemRisk, Brooklyn, NY, USA.,Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
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22
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VIMERCATI L, CAVONE D, MANSI F, CANNONE E, DE MARIA L, CAPUTI A, DELFINO M, SERIO G. Health impact of exposure to asbestos in polluted area of Southern Italy. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2019; 60:E407-E418. [PMID: 31967100 PMCID: PMC6953442 DOI: 10.15167/2421-4248/jpmh2019.60.4.1330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 11/07/2019] [Indexed: 12/02/2022]
Abstract
The three main sources of asbestos pollution in the city of Bari, Puglia, the former Fibronit asbestos factory, the Torre Quetta beach, the former Rossani barracks and the history of their reclamation are described. The results of cohort studies on factory workers and case-control studies on asbestos exposure to the resident population and the onset of mesothelioma are also reported. Finally, the data of the regional register of mesothelioma related to residents in the city of Bari and four new cases with environmental exposure due to the former Rossani barracks are presented.
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Affiliation(s)
- L. VIMERCATI
- Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari Medical School, Bari, Italy
| | - D. CAVONE
- Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari Medical School, Bari, Italy
| | - F. MANSI
- Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari Medical School, Bari, Italy
| | - E.S.S. CANNONE
- Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari Medical School, Bari, Italy
| | - L. DE MARIA
- Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari Medical School, Bari, Italy
| | - A. CAPUTI
- Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari Medical School, Bari, Italy
| | - M.C. DELFINO
- Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari Medical School, Bari, Italy
| | - G. SERIO
- Department of Biomedical Science and Human Oncology, University of Bari Medical School, Bari, Italy
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23
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Pyana Kitenge J, Kapinga Kayembe D, Tshibangu Muamba M, Kachil Rubing H, De Vos B, Van Bouwel J, Nemery B. Malignant mesothelioma in Sub-Saharan Africa: A case report from Lubumbashi, DR Congo. ENVIRONMENTAL RESEARCH 2019; 176:108556. [PMID: 31260913 DOI: 10.1016/j.envres.2019.108556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 06/21/2019] [Accepted: 06/23/2019] [Indexed: 06/09/2023]
Abstract
Although asbestos has been used throughout Africa in the past decades, no reports of asbestos-related malignant mesothelioma are available from sub-Saharan Africa, except from South Africa and Zimbabwe. We present a case of a 39-year-old man who died from a histologically proven malignant mesothelioma of the peritoneum in Lubumbashi, DR Congo. No occupational exposure to asbestos could be found in his history. In view of his young age, we speculated that he had been exposed to asbestos as a child, which was highly plausible because he had grown up in one of the numerous mining estates of the region. The houses of these estates were often built with asbestos-containing materials, notably roofs made of corrugated asbestos-cement. The possibility of past domestic or environmental exposure to asbestos was substantiated by the identification of chrysotile and crocidolite fibres in samples of asbestos-cement collected from the home where the patient had lived as a child. To our knowledge, this is the first report of malignant mesothelioma from a country in the Central African region. We expect that heightened awareness and improved diagnosis will lead to the detection of more asbestos-related diseases in Africa.
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Affiliation(s)
- Joseph Pyana Kitenge
- University of Lubumbashi, Occupational Health, Lubumbashi, DR Congo; Centre Médical du Centre Ville (CMDC), Lubumbashi, DR Congo
| | | | | | | | | | | | - Benoit Nemery
- KU Leuven, Department of Public Health and Primary Care, Leuven, Belgium.
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Marsh GM, Ierardi AM, Benson SM, Finley BL. Occupational exposures to cosmetic talc and risk of mesothelioma: an updated pooled cohort and statistical power analysis with consideration of latency period. Inhal Toxicol 2019; 31:213-223. [DOI: 10.1080/08958378.2019.1645768] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - A. Michael Ierardi
- Cardno ChemRisk, Brooklyn, NY, USA
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, NY, USA
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Abstract
Since 1973 the International Agency for Research on Cancer has classified asbestos as a certain carcinogen, but today it is still used in several countries. To date, mesothelioma risk is certainly linked not only to occupational exposures but also to environmental exposures. The incidence and mortality are increasing worldwide, especially in developing countries where asbestos is still often used without adequate measures for worker safety. The epidemiological surveillance systems of related asbestos diseases are instruments of public health adopted internationally. The experience and the operating methodology of the Italian mesothelioma registry and the data produced from 1996 to 2015 highlight how in countries where the asbestos ban has been active for over 20 years the risk of asbestos remains present, especially in the construction sector as well as for the environmental exposures of the resident population near companies that used asbestos in their production cycle. Worldwide, it is necessary to introduce the ban on the extraction, processing, and marketing of asbestos as claimed by the international scientific community.
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Algranti E, Ramos-Bonilla JP, Terracini B, Santana VS, Comba P, Pasetto R, Mazzeo A, Cavariani F, Trotta A, Marsili D. Prevention of Asbestos Exposure in Latin America within a Global Public Health Perspective. Ann Glob Health 2019; 85:49. [PMID: 30924615 PMCID: PMC6634328 DOI: 10.5334/aogh.2341] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Asbestos consumption in Latin America (LA) amounts to 10% of yearly global production. Little is known about the impact of asbestos exposure in the region. OBJECTIVE To discuss scientific and socio-economic issues and conflicts of interest and to summarize epidemiological data of asbestos health effects in LA. DISCUSSION Recent data on chrysotile strengthened the evidence of its carcinogenicity and showed an excessive risk of lung cancer at cumulative exposure levels as low as 1.5 fibre-years/ml. Technology for substitution is available for all asbestos-containing products and ceasing asbestos production and manufacturing will not result in unemployment and loss of income, except for the mining industry. The flawed arguments used by the industry to maintain its market, both to the public and in courtrooms, strongly relies on the lack of local evidence of the ill effects and on the invisibility of asbestos-related diseases in LA, due to the limited number of studies and the exposed workers' difficulty accessing health services. The few epidemiological studies available show clear evidence of clusters of mesothelioma in municipalities with a history of asbestos consumption and a forecasted rise in its incidence in Argentina and Brazil for the next decade. In Brazil, non-governmental organizations of asbestos workers were pivotal to counterbalance misinformation and inequities, ending recently in a Supreme Court decision backing an asbestos ban. In parallel, continuous efforts should be made to stimulate the growth of competent and ethical researchers to convey adequate information to the scientific community and to the general public.
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Affiliation(s)
| | | | | | - Vilma S. Santana
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, BR
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, IT
| | - Roberto Pasetto
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, IT
| | - Agata Mazzeo
- School of Arts, Humanities, and Cultural Heritage, University of Bologna, Bologna, IT
| | - Fulvio Cavariani
- Centro Regionale Amianto Lazio Dipartimento di Prevenzione, Unità Sanitaria Locale, Viterbo, IT
| | - Andrés Trotta
- Instituto de Salud Colectiva (ISCo)/Institute of Collective Health, Universidad Nacional de Lanús (UNLa)/National University of Lanús, Buenos Aires, AR
| | - Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, IT
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Dalsgaard SB, Würtz ET, Hansen J, Røe OD, Omland Ø. Environmental asbestos exposure in childhood and risk of mesothelioma later in life: a long-term follow-up register-based cohort study. Occup Environ Med 2019; 76:407-413. [PMID: 30804166 DOI: 10.1136/oemed-2018-105392] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/07/2018] [Accepted: 12/10/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To examine the risk of malignant mesothelioma (MM) in former pupils who attended primary school near an asbestos cement plant. METHODS A cohort of 12 111 former pupils, born 1940-1970, was established from individual historical records from four primary schools located at a distance of 100-750 m in the prevailing wind direction from an asbestos cement plant operating from 1928 to 1984 in Aalborg, Denmark. The school cohort and a comparison cohort consisting of 108 987 gender and 5-year frequency-matched subjects were followed up (2015) for MM in the Danish Cancer Registry. Using Cox regression, HRs were estimated for the incidence of MM. Adjustments for occupational and familial asbestos exposure were made with a job exposure matrix. An SIR analysis including latency periods testing the cancer incidence rate was performed with the comparison cohort as the reference rate. RESULTS The median person-years of follow-up were 62.5 years in the school cohort and 62.2 years in the comparison cohort. There were 32 males and 6 females of the former pupils who developed MM during the follow-up: HRmale 7.01 (95% CI 4.24 to 11.57), HRfemale 7.43 (95% CI 2.50 to 22.13). Those who attended school 250 m north of the plant had the highest HR for MM, 10.65 (95% Cl 5.82 to 19.48). No significant trend between school distance and risk of MM was established (p=0.35). CONCLUSION Our results suggest that boys and girls who attended schools and lived in the neighbourhood of an asbestos cement plant later in life have a significantly increased risk of MM.
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Affiliation(s)
- Sofie Bünemann Dalsgaard
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Occupational and Environmental Medicine, Danish Ramazzini Center, Aalborg University Hospital, Aalborg, Denmark
| | - Else Toft Würtz
- Department of Occupational and Environmental Medicine, Danish Ramazzini Center, Aalborg University Hospital, Aalborg, Denmark
| | - Johnni Hansen
- Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark
| | - Oluf Dimitri Røe
- Department of Oncology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øyvind Omland
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Occupational and Environmental Medicine, Danish Ramazzini Center, Aalborg University Hospital, Aalborg, Denmark
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Ippoliti R, Falavigna G, Grosso F, Maconi A, Randi L, Numico G. The Economic Impact of Clinical Research in an Italian Public Hospital: The Malignant Pleural Mesothelioma Case Study. Int J Health Policy Manag 2018; 7:728-737. [PMID: 30078293 PMCID: PMC6077275 DOI: 10.15171/ijhpm.2018.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 02/05/2018] [Indexed: 11/30/2022] Open
Abstract
Background: The current economic constraints cause hospital management to use the available public resources as rationally as possible. At the same time, there is the necessity to improve current scientific knowledge. This is even more relevant in the case of patients with malignant pleural mesothelioma (MPM), given the severity of the disease, its dismal prognosis, and the cost of chemotherapy drugs. This work aims to evaluate the standard cost of patients with MPM, supporting physicians in their decision-making process in relation to budget constraints, as well as policy-makers with respect research policy.
Methods: The authors conducted a retrospective cost analysis on all the patients with MPM who were first admitted to a reference hospital specialized in MPM care between 2014 and 2015, collecting data on their diagnostic pathways and active treatments, as well as on the related official fees for each procedure. Then, using a multiple regression model, we estimated the overall expected cost of a patient with MPM treated in our hospital, to be born by the Regional Healthcare System based on the chosen clinical pathway.
Results: According to results, the economic impact of caring for a patient with MPM is mostly related to the selected active treatments, with drug and hospitalization costs as main drivers. Our analysis suggests that the expected reimbursed fee to care for a patient with MPM is equal to € 18 214.99, with chemotherapy and monitoring costs equal to € 12 861.43 and hospitalization cost equal to € 5353.55. This cost decreases to € 320.18 in the case of enrollment in an experimental trial of first-line treatment. In the other cases (second-line or third-line trials), the expected cost borne by the healthcare system for treating patients grows exponentially (€ 40,124.18 and € 59 839.94, respectively).
Conclusion: Experimental trials might be a solution to decrease the economic burden for the public healthcare system only in the case of first-line treatments, where the cost of chemotherapy is relevant. Nevertheless, policy-makers have to accept the sharing of this economic burden between society and the pharmaceutical industry to broaden the current scientific knowledge.
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Affiliation(s)
- Roberto Ippoliti
- Scientific Promotion, General Hospital of Alessandria, Alessandria, Italy.,Department of Management, University of Turin, Turin, Italy
| | - Greta Falavigna
- Research Institute on Sustainable Economic Growth, National Research Council of Italy, Moncalieri, Italy
| | - Federica Grosso
- Oncology Unit, General Hospital of Alessandria, Alessandria, Italy
| | - Antonio Maconi
- Scientific Promotion, General Hospital of Alessandria, Alessandria, Italy
| | - Lorenza Randi
- Scientific Promotion, General Hospital of Alessandria, Alessandria, Italy
| | - Gianmauro Numico
- Oncology Unit, General Hospital of Alessandria, Alessandria, Italy
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Marinaccio A, Binazzi A, Bonafede M, Altimari A, Boscioni R, Corfiati M, Clemente M, Brusco A. Occupational diseases in Italian national priority contaminated sites. Am J Ind Med 2018; 61:582-591. [PMID: 29888799 DOI: 10.1002/ajim.22866] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 05/16/2018] [Indexed: 11/11/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the occupational health risks in the Italian National Priority Contaminated Sites (NPCSs). METHODS Established cases of occupational diseases in 2010-2014 were extracted from the Italian National Institute for Insurance against Accidents at Work (INAIL) archives. Standardized incidence ratios with 95% confidence intervals were estimated by site and by disease group separately for genders. RESULTS In the 44 NPCSs evaluated, 11 015 cases of occupational diseases (8877 in men and 2138 in women) were ascertained. Overall, an excess of occupational diseases with respect to expected cases of 24.2% was found in men residing in NPCSs. An increased occurrence was detected in 21 NPCSs for men and in eight for women. CONCLUSIONS The findings suggest a role of occupational diseases in the health profile of NPCSs, reinforcing the need for a permanent surveillance system.
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Affiliation(s)
- Alessandro Marinaccio
- Department of Occupational and Environmental Medicine; Epidemiology; Hygiene, National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine; Epidemiology; Hygiene, National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
| | - Michela Bonafede
- Department of Occupational and Environmental Medicine; Epidemiology; Hygiene, National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
| | - Antonella Altimari
- Statistical and Actuarial Department; National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
| | - Roberto Boscioni
- Statistical and Actuarial Department; National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
| | - Marisa Corfiati
- Department of Occupational and Environmental Medicine; Epidemiology; Hygiene, National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
| | - Marta Clemente
- General Medical Department; National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
| | - Adelina Brusco
- Statistical and Actuarial Department; National Institute for Insurance against Accidents at Work (INAIL); Rome Italy
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Vimercati L, Cavone D, Lovreglio P, De Maria L, Caputi A, Ferri GM, Serio G. Environmental asbestos exposure and mesothelioma cases in Bari, Apulia region, southern Italy: a national interest site for land reclamation. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:15692-15701. [PMID: 29574645 PMCID: PMC5984633 DOI: 10.1007/s11356-018-1618-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/25/2018] [Indexed: 05/07/2023]
Abstract
Asbestos is an environmental carcinogen, and asbestos-related diseases are a global-scale public health issue. We report three cases (one male and two females) of pleural malignant mesothelioma (PMM) caused by environmental asbestos exposure reported by the Apulia Regional Operating Centre (COR) to the National Mesothelioma Registry (ReNaM). The patients revealed no history of asbestos exposure even after detailed assessment. The environmental (neighborhood) asbestos exposure for each of the three cases was due to both the residential history of the subjects and their workplace, close to a military barracks, at a distance of between 45 and 100 m. Moreover, in addition to this new source of pollution, an asbestos cement factory was located in the urban area of Bari municipality, in the Apulia region, southern Italy. Environmental-residential/neighborhood asbestos exposure in the city of Bari, a contaminated area classified as a site of national concern for land reclamation, is discussed also with reference to the military barracks.
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Affiliation(s)
- Luigi Vimercati
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University Aldo Moro of Bari Medical School, 11 G. Cesare Square, 70124, Bari, Italy.
| | - Domenica Cavone
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University Aldo Moro of Bari Medical School, 11 G. Cesare Square, 70124, Bari, Italy
| | - Piero Lovreglio
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University Aldo Moro of Bari Medical School, 11 G. Cesare Square, 70124, Bari, Italy
| | - Luigi De Maria
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University Aldo Moro of Bari Medical School, 11 G. Cesare Square, 70124, Bari, Italy
| | - Antonio Caputi
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University Aldo Moro of Bari Medical School, 11 G. Cesare Square, 70124, Bari, Italy
| | - Giovanni Maria Ferri
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University Aldo Moro of Bari Medical School, 11 G. Cesare Square, 70124, Bari, Italy
| | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathology Division, University Aldo Moro of Bari Medical School, 11 G. Cesare Square, 70124, Bari, Italy
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Bonafede M, Ghelli M, Corfiati M, Rosa V, Guglielmucci F, Granieri A, Branchi C, Iavicoli S, Marinaccio A. The psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects: A systematic review of published studies. Am J Ind Med 2018; 61:400-412. [PMID: 29575036 DOI: 10.1002/ajim.22831] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND The purpose of this study is to present the results of a systematic review of published research that focuses on psychological aspects of malignant mesothelioma patients and asbestos-exposed people. METHODS Our research includes primary studies published between 1980 and 2016, using information from the Cochrane Library, the Psychology Behavioral Sciences Collection, PsychINFO, PubMed, PubGet, PubPsych, and Scopus, in compliance with PRISMA guidelines. RESULTS We identified 12 papers that investigated the psychological distress and care needs of mesothelioma patients, and nine papers for asbestos-exposed subjects. CONCLUSIONS This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects. It confirms that malignant mesothelioma is associated with the physical, emotional, and social functioning of patients, while also suggesting that the risk of developing asbestos-related diseases among asbestos-exposed subjects is associated with high levels of psychological distress, despair, and mental health difficulties.
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Affiliation(s)
- Michela Bonafede
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Monica Ghelli
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Marisa Corfiati
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Valentina Rosa
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | | | | | - Claudia Branchi
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine; Epidemiology and Hygiene; Italian Workers’ Compensation Authority (INAIL); Rome Italy
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Marinaccio A, Corfiati M, Binazzi A, Di Marzio D, Scarselli A, Ferrante P, Bonafede M, Verardo M, Mirabelli D, Gennaro V, Mensi C, Schallemberg G, Mazzoleni G, Merler E, Girardi P, Negro C, D’Agostin F, Romanelli A, Chellini E, Silvestri S, Pascucci C, Calisti R, Stracci F, Romeo E, Ascoli V, Trafficante L, Carrozza F, Angelillo IF, Cavone D, Cauzillo G, Tallarigo F, Tumino R, Melis M, Iavicoli S. The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure. Occup Environ Med 2018; 75:254-262. [PMID: 29269563 PMCID: PMC5878657 DOI: 10.1136/oemed-2016-104119] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 09/04/2017] [Accepted: 10/05/2017] [Indexed: 12/04/2022]
Abstract
INTRODUCTION The epidemiology of gender differences for mesothelioma incidence has been rarely discussed in national case lists. In Italy an epidemiological surveillance system (ReNaM) is working by the means of a national register. METHODS Incident malignant mesothelioma (MM) cases in the period 1993 to 2012 were retrieved from ReNaM. Gender ratio by age class, period of diagnosis, diagnostic certainty, morphology and modalities of asbestos exposure has been analysed using exact tests for proportion. Economic activity sectors, jobs and territorial distribution of mesothelioma cases in women have been described and discussed. To perform international comparative analyses, the gender ratio of mesothelioma deaths was calculated by country from the WHO database and the correlation with the mortality rates estimated. RESULTS In the period of study a case list of 21 463 MMs has been registered and the modalities of asbestos exposure have been investigated for 16 458 (76.7%) of them. The gender ratio (F/M) was 0.38 and 0.70 (0.14 and 0.30 for occupationally exposed subjects only) for pleural and peritoneal cases respectively. Occupational exposures for female MM cases occurred in the chemical and plastic industry, and mainly in the non-asbestos textile sector. Gender ratio proved to be inversely correlated with mortality rate among countries. CONCLUSIONS The consistent proportion of mesothelioma cases in women in Italy is mainly due to the relevant role of non-occupational asbestos exposures and the historical presence of the female workforce in several industrial settings. Enhancing the awareness of mesothelioma aetiology in women could support the effectiveness of welfare system and prevention policies.
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Affiliation(s)
- Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Marisa Corfiati
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Davide Di Marzio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Alberto Scarselli
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Pierpaolo Ferrante
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Marina Verardo
- Valle d’Aosta Health Local Unit, Regional Operating Centre of Valle d’Aosta (COR Valle d’Aosta), Aosta, Italy
| | - Dario Mirabelli
- COR Piedmont, Unit of Cancer Prevention, University of Turin and CPO-Piemonte, Torino, Italy
| | - Valerio Gennaro
- COR Liguria, UO Epidemiology, IRCCS Az, Ospedaliera Universitaria San Martino, National Cancer Research Institute (IST), Genova, Italy
| | - Carolina Mensi
- COR Lombardy, Department of Preventive Medicine, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico and University of Milan, Milano, Italy
| | - Gert Schallemberg
- Provincial Unit of Health, Hygiene and Occupational Medicine, COR Province of Trento, Trento, Italy
| | - Guido Mazzoleni
- Alto Adige Health Local Unit, COR Province of Bolzano, Bolzano, Italy
| | - Enzo Merler
- Occupational Health Unit, Department of Prevention, COR Veneto, Padua, Italy
| | - Paolo Girardi
- Occupational Health Unit, Department of Prevention, COR Veneto, Padua, Italy
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, COR Friuli-Venezia Giulia, University of Trieste – Trieste General Hospitals, Trieste, Italy
| | - Flavia D’Agostin
- Clinical Unit of Occupational Medicine, COR Friuli-Venezia Giulia, University of Trieste – Trieste General Hospitals, Trieste, Italy
| | - Antonio Romanelli
- Health Local Unit, Public Health Department, COR Emilia-Romagna, Reggio Emilia, Italy
| | - Elisabetta Chellini
- Unit of Environmental and Occupational Epidemiology, COR Tuscany, Cancer Prevention and Research Institute, Firenze, Italy
| | | | - Cristiana Pascucci
- Hygienistic, Environmental and Health Sciences Department, School of Sciences of the drug and the products of health, COR Marche, University of Camerino, Camerino, Italy
| | - Roberto Calisti
- Hygienistic, Environmental and Health Sciences Department, School of Sciences of the drug and the products of health, COR Marche, University of Camerino, Camerino, Italy
| | - Fabrizio Stracci
- Department of Hygiene and Public Health, COR Umbria, University of Perugia, Perugia, Italy
| | - Elisa Romeo
- Department of Epidemiology, COR Lazio, Lazio Region, Rome, Italy
| | - Valeria Ascoli
- Department of Experimental Medicine, COR Lazio, University La Sapienza, Rome, Italy
| | - Luana Trafficante
- Health Local Unit, Occupational Medicine Unit, COR Abruzzo, Pescara, Italy
| | | | | | - Domenica Cavone
- Department of Interdisciplinary Medicine, Section of Occupational Medicine ’B.Ramazzini', COR Puglia, University of Bari, Firenze, Italy
| | | | | | - Rosario Tumino
- Cancer Registry ASP Ragusa and Sicily Regional Epidemiological Observatory, COR Sicily, Policlinico, Italy
| | - Massimo Melis
- COR Sardegna, Regional Epidemiological Centre, Cagliari, Italy
| | - Sergio Iavicoli
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
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Micolucci L, Akhtar MM, Olivieri F, Rippo MR, Procopio AD. Diagnostic value of microRNAs in asbestos exposure and malignant mesothelioma: systematic review and qualitative meta-analysis. Oncotarget 2018; 7:58606-58637. [PMID: 27259231 PMCID: PMC5295457 DOI: 10.18632/oncotarget.9686] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/28/2016] [Indexed: 12/13/2022] Open
Abstract
Background Asbestos is a harmful and exceptionally persistent natural material. Malignant mesothelioma (MM), an asbestos-related disease, is an insidious, lethal cancer that is poorly responsive to current treatments. Minimally invasive, specific, and sensitive biomarkers providing early and effective diagnosis in high-risk patients are urgently needed. MicroRNAs (miRNAs, miRs) are endogenous, non-coding, small RNAs with established diagnostic value in cancer and pollution exposure. A systematic review and a qualitative meta-analysis were conducted to identify high-confidence miRNAs that can serve as biomarkers of asbestos exposure and MM. Methods The major biomedical databases were systematically searched for miRNA expression signatures related to asbestos exposure and MM. The qualitative meta-analysis applied a novel vote-counting method that takes into account multiple parameters. The most significant miRNAs thus identified were then subjected to functional and bioinformatic analysis to assess their biomarker potential. Results A pool of deregulated circulating and tissue miRNAs with biomarker potential for MM was identified and designated as “mesomiRs” (MM-associated miRNAs). Comparison of data from asbestos-exposed and MM subjects found that the most promising candidates for a multimarker signature were circulating miR-126-3p, miR-103a-3p, and miR-625-3p in combination with mesothelin. The most consistently described tissue miRNAs, miR-16-5p, miR-126-3p, miR-143-3p, miR-145-5p, miR-192-5p, miR-193a-3p, miR-200b-3p, miR-203a-3p, and miR-652-3p, were also found to provide a diagnostic signature and should be further investigated as possible therapeutic targets. Conclusion The qualitative meta-analysis and functional investigation confirmed the early diagnostic value of two miRNA signatures for MM. Large-scale, standardized validation studies are needed to assess their clinical relevance, so as to move from the workbench to the clinic.
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Affiliation(s)
- Luigina Micolucci
- Computational Pathology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.,Laboratory of Experimental Pathology, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Most Mauluda Akhtar
- Computational Pathology Unit, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.,Laboratory of Experimental Pathology, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Fabiola Olivieri
- Laboratory of Experimental Pathology, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.,Center of Clinical Pathology and Innovative Therapy, Italian National Research Center on Aging (INRCA-IRCCS), Ancona, Italy
| | - Maria Rita Rippo
- Laboratory of Experimental Pathology, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Antonio Domenico Procopio
- Laboratory of Experimental Pathology, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.,Center of Clinical Pathology and Innovative Therapy, Italian National Research Center on Aging (INRCA-IRCCS), Ancona, Italy
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Finley BL, Benson SM, Marsh GM. Response to letters regarding “Cosmetic talc as a risk factor for pleural mesothelioma: a weight of evidence evaluation of the epidemiology”. Inhal Toxicol 2018; 30:1-4. [DOI: 10.1080/08958378.2018.1438540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Gary M. Marsh
- Cardno ChemRisk, Pittsburgh, PA, USA
- University of Pittsburgh Center for Occupational Biostatistics & Epidemiology, Pittsburgh, PA, USA
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Marinaccio A, Binazzi A, Bonafede M, Di Marzio D, Scarselli A. Epidemiology of malignant mesothelioma in Italy: surveillance systems, territorial clusters and occupations involved. J Thorac Dis 2018; 10:S221-S227. [PMID: 29507789 DOI: 10.21037/jtd.2017.12.146] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background As a legacy of the large asbestos consumption until the definitive ban in 1992, Italy is currently suffering a severe epidemic of asbestos related diseases. The aim of this paper is to describe the surveillance system for mesothelioma incidence and to provide evidences regarding the occurrence of the disease in Italy and the circumstances of asbestos exposure. Methods Italian National Register of Malignant Mesotheliomas (ReNaM) is a permanent surveillance system of mesothelioma incidence, with Regional Operating Centres (CORs) active in each Italian region, identifying incident malignant mesothelioma (MM) cases from health care structures. Occupational history, lifestyle habits and residential history are obtained using a standardised questionnaire, administered by a trained interviewer, to the subject or to the next of kin. Descriptive epidemiological figures, occupations involved in exposures and territorial maps of MM cases have been produced. Results At December 2016, ReNaM has collected 27,356 MM cases for the incidence period between 1993 and 2015. The modalities of exposure to asbestos have been investigated for 21,387 (78%) and an occupational exposure has been defined for around 70% of interviewed cases (14,818). Non-occupational exposure is still relevant with 4.9% and 4.4% of cases for which respectively a familial exposure (due to the cohabitation with an occupational exposed subject) and an environmental exposure (due to the residence near a contaminated site) has been detected. Discussion The epidemiological surveillance of MM incident cases, by the means of a national register for estimating the occurrence of the disease and identifying the circumstances of asbestos exposure, is a relevant tool for preventing asbestos exposure, for supporting the effectiveness of insurance system and for estimating reliable epidemiological figures.
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Affiliation(s)
- Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Davide Di Marzio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alberto Scarselli
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Italian Workers' Compensation Authority (INAIL), Rome, Italy
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Marsili D, Angelini A, Bruno C, Corfiati M, Marinaccio A, Silvestri S, Zona A, Comba P. Asbestos Ban in Italy: A Major Milestone, Not the Final Cut. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1379. [PMID: 29137208 PMCID: PMC5708018 DOI: 10.3390/ijerph14111379] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 11/03/2017] [Accepted: 11/06/2017] [Indexed: 11/17/2022]
Abstract
Background and history: Italy was the main asbestos producer and one of the greatest consumers in 20th century Europe until the asbestos ban was introduced in 1992. Asbestos exposure affected the population in a wide range of working environments, namely mining and marketing of asbestos, asbestos cement production, shipyards and textile industries. This also determined a widespread environmental asbestos exposure affecting the surrounding communities. Methods: To investigate the drivers and difficulties of the process leading to the asbestos ban and its subsequent implementation, we focused on stakeholder involvement, environmental health policies, capacity building and communication. Results: In the past three decades, stakeholder involvement has been instrumental in advancing the industrial asbestos replacement process, prevention and remediation interventions. Furthermore, involvement also contributed to the integration of environmental and health policies at national, regional and local levels, including capacity building and communication. In a global public health perspective, international scientific cooperation has been established with countries using and producing asbestos. Discussion and Conclusions: Key factors and lessons learnt in Italy from both successful and ineffective asbestos policies are described to support the relevant stakeholders in countries still using asbestos contributing to the termination of its use.
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Affiliation(s)
- Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Alessia Angelini
- Institute for Study and Prevention of Cancer, 50139 Florence, Italy.
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Marisa Corfiati
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Stefano Silvestri
- Institute for Study and Prevention of Cancer, 50139 Florence, Italy.
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy.
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Liu B, van Gerwen M, Bonassi S, Taioli E. Epidemiology of Environmental Exposure and Malignant Mesothelioma. J Thorac Oncol 2017; 12:1031-1045. [DOI: 10.1016/j.jtho.2017.04.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 03/21/2017] [Accepted: 04/01/2017] [Indexed: 01/11/2023]
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Lapa C, Kircher S, Schirbel A, Rosenwald A, Kropf S, Pelzer T, Walles T, Buck AK, Weber WA, Wester HJ, Herrmann K, Lückerath K. Targeting CXCR4 with [ 68Ga]Pentixafor: a suitable theranostic approach in pleural mesothelioma? Oncotarget 2017; 8:96732-96737. [PMID: 29228566 PMCID: PMC5722518 DOI: 10.18632/oncotarget.18235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 05/15/2017] [Indexed: 11/25/2022] Open
Abstract
C-X-C motif chemokine receptor 4 (CXCR4) is a key factor for tumor growth and metastasis in several types of human cancer. This study investigated the feasibility of CXCR4-directed imaging with positron emission tomography/computed tomography (PET/CT) using [68Ga]Pentixafor in malignant pleural mesothelioma. Six patients with pleural mesothelioma underwent [68Ga]Pentixafor-PET/CT. 2′-[18F]fluoro-2′-deoxy-D-glucose ([18F]FDG)-PET/CT (4/6 patients) and immunohistochemistry obtained from biopsy or surgery (all) served as standards of reference. Additionally, 9 surgical mesothelioma samples were available for histological work-up. Whereas [18F]FDG-PET depicted active lesions in all patients, [68Ga]Pentixafor-PET/CT recorded physiologic tracer distribution and none of the 6 patients presented [68Ga]Pentixafor-positive lesions. This finding paralleled results of immunohistochemistry which also could not identify relevant CXCR4 surface expression in the samples analyzed. In contrast to past reports, our data suggest widely absence of CXCR4 expression in pleural mesothelioma. Hence, robust cell surface expression should be confirmed prior to targeting this chemokine receptor for diagnosis and/or therapy.
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Affiliation(s)
- Constantin Lapa
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Stefan Kircher
- Institute of Pathology, University of Würzburg, Comprehensive Cancer Center Mainfranken (CCCMF), Würzburg, Germany
| | - Andreas Schirbel
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Rosenwald
- Institute of Pathology, University of Würzburg, Comprehensive Cancer Center Mainfranken (CCCMF), Würzburg, Germany
| | | | - Theo Pelzer
- Department of Internal Medicine I, Division of Pulmonology, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Thorsten Walles
- Department of Thoracic Surgery, University Hospital Magdeburg, Magdeburg, Germany
| | - Andreas K Buck
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Wolfgang A Weber
- Molecular Imaging and Therapy Service, Memorial Sloan-Kettering Cancer Center and Weill-Cornell Medical College, New York, New York, USA
| | - Hans-Juergen Wester
- Pharmaceutical Radiochemistry, Technische Universität München, Munich, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.,Department of Nuclear Medicine, University Hospital Essen, Essen, Germany
| | - Katharina Lückerath
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
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Mezei G, Chang ET, Mowat FS, Moolgavkar SH. Epidemiology of mesothelioma of the pericardium and tunica vaginalis testis. Ann Epidemiol 2017; 27:348-359.e11. [PMID: 28527639 DOI: 10.1016/j.annepidem.2017.04.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 01/10/2017] [Accepted: 04/06/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Malignant mesothelioma most commonly arises in the pleura and peritoneum but also occurs rarely at other anatomical sites with mesothelial tissue, namely, the pericardium and tunica vaginalis testis (TVT). This review provides a better understanding of the epidemiology of mesothelioma of these extrapleural sites. METHODS We conducted a systematic review of the epidemiologic and clinical literature on pericardial mesothelioma and mesothelioma of the TVT. We also analyzed U.S. Surveillance, Epidemiology, and End Results cancer registry data to describe incidence patterns of these malignancies. RESULTS An etiologic role of asbestos exposure has been hypothesized for pericardial and TVT mesotheliomas, but no analytical case-control epidemiologic studies exist to test this relationship. A substantial proportion of cases with these malignancies report no known asbestos exposure. In large occupational cohorts with heavy asbestos exposures, no cases of pericardial or TVT mesothelioma have been reported. Trends in the incidence of these malignancies do not match those of pleural mesothelioma, which correspond to historical trends of commercial asbestos use. A male preponderance of pericardial mesothelioma is not evident. CONCLUSIONS In the absence of analytic epidemiologic studies, the etiologic role of environmental risk factors for mesothelioma of the pericardium and TVT remains elusive.
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Affiliation(s)
- Gabor Mezei
- Health Sciences Center, Exponent, Inc., Menlo Park, CA.
| | - Ellen T Chang
- Health Sciences Center, Exponent, Inc., Menlo Park, CA
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Cullinan P, Muñoz X, Suojalehto H, Agius R, Jindal S, Sigsgaard T, Blomberg A, Charpin D, Annesi-Maesano I, Gulati M, Kim Y, Frank AL, Akgün M, Fishwick D, de la Hoz RE, Moitra S. Occupational lung diseases: from old and novel exposures to effective preventive strategies. THE LANCET RESPIRATORY MEDICINE 2017; 5:445-455. [PMID: 28089118 DOI: 10.1016/s2213-2600(16)30424-6] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/22/2016] [Accepted: 11/02/2016] [Indexed: 02/06/2023]
Abstract
Occupational exposure is an important, global cause of respiratory disease. Unlike many other non-communicable lung diseases, the proximal causes of many occupational lung diseases are well understood and they should be amenable to control with use of established and effective approaches. Therefore, the risks arising from exposure to silica and asbestos are well known, as are the means of their prevention. Although the incidence of occupational lung disease has decreased in many countries, in parts of the world undergoing rapid economic transition and population growth-often with large informal and unregulated workforces-occupational exposures continue to impose a heavy burden of disease. The incidence of interstitial and malignant lung diseases remains unacceptably high because control measures are not implemented or exposures arise in novel ways. With the advent of innovative technologies, new threats are continually introduced to the workplace (eg, indium compounds and vicinal diketones). In developed countries, work-related asthma is the commonest occupational lung disease of short latency. Although generic control measures to reduce the risk of developing or exacerbating asthma are well recognised, there is still uncertainty, for example, with regards to the management of workers who develop asthma but remain in the same job. In this Review, we provide recommendations for research, surveillance, and other action for reducing the burden of occupational lung diseases.
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Affiliation(s)
- Paul Cullinan
- Department of Occupational and Environmental Medicine, Imperial College, London, UK; MRC-PHE Centre for Environment and Health, London, UK
| | - Xavier Muñoz
- Servei de Pneumologia, Hospital Universitari Vall d'Hebron (CIBER de Enfermedades Respiratorias), Barcelona, Spain; CIBER de Enfermedades Respiratorias, Barcelona, Spain
| | - Hille Suojalehto
- Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Raymond Agius
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Surinder Jindal
- Department of Respiratory Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Anders Blomberg
- Department of Public Health and Clinical Medicine, Division of Medicine, and Division of Respiratory Medicine, Umeå University, Umeå, Sweden
| | - Denis Charpin
- Clinique des Bronches, Allergie et Sommeil, Hôpital Nord, Marseille, France; INSERM, Aix-Marseille Université, Marseille, France
| | - Isabella Annesi-Maesano
- Epidémiologie des Maladies Respiratoires et Allergiques, iPLESP INSERM et UPMC, Paris, France
| | - Mridu Gulati
- Section of Pulmonary, Critical Care, and Sleep Medicine, and Yale Occupational and Environmental Medicine Program, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Yangho Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Arthur L Frank
- Division of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Metin Akgün
- Department of Chest Diseases, Ataturk University School of Medicine, Erzurum, Turkey
| | - David Fishwick
- Centre for Workplace Health, University of Sheffield, Sheffield, UK
| | - Rafael E de la Hoz
- Department of Preventive Medicine, Division of Occupational and Environmental Medicine, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Subhabrata Moitra
- Department of Respiratory Medicine and Allergology, Faculty of Clinical Sciences, Lund University Lund, Sweden; Department of Pneumology, Allergy and Asthma Research Centre, Kolkata, India.
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Gray C, Carey RN, Reid A. Current and future risks of asbestos exposure in the Australian community. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2016; 22:292-299. [PMID: 27611196 DOI: 10.1080/10773525.2016.1227037] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Australia mined asbestos for more than 100 years and manufactured and imported asbestos products. There is a legacy of in situ asbestos throughout the built environment. METHODS The aim of this study was to identify the possible sources of current and future asbestos exposure from the built environment. Telephone interviews with environmental health officers, asbestos removalists, and asbestos assessors in Australia sought information about common asbestos scenarios encountered. RESULTS There is a considerable amount of asbestos remaining in situ in the Australian built environment. Potential current and future sources of asbestos exposure to the public are from asbestos-containing roofs and fences, unsafe asbestos removal practices, do-it-yourself home renovations and illegal dumping. CONCLUSION This research has highlighted a need for consistent approaches in the regulation and enforcement of safe practices for the management and removal of asbestos to ensure that in situ asbestos in the built environment is managed appropriately.
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Affiliation(s)
- Corie Gray
- a School of Public Health , Curtin University , Bentley , Australia
| | - Renee N Carey
- a School of Public Health , Curtin University , Bentley , Australia
| | - Alison Reid
- a School of Public Health , Curtin University , Bentley , Australia
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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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The resistance related to targeted therapy in malignant pleural mesothelioma: Why has not the target been hit yet? Crit Rev Oncol Hematol 2016; 107:20-32. [PMID: 27823648 DOI: 10.1016/j.critrevonc.2016.08.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 08/23/2016] [Accepted: 08/30/2016] [Indexed: 01/06/2023] Open
Abstract
Malignant pleural mesothelioma (MPM) is an aggressive tumor of the pleura with a poor prognosis. The most active first-line regimens are platinum compounds and pemetrexed. There is no standard second-line treatment in MPM. Advances in the understanding of tumor molecular biology have led to the development of several targeted treatments, which have been evaluated in clinical trials. Unfortunately none of the explored targeted treatments can currently be recommended as routine treatment in MPM. We reviewed the biological pathways involved in MPM, the clinical trials about targeted therapy, and possible related mechanisms of resistance. We suggest that specific genetic markers are needed as targets of selective therapy. By this way the selection of patients based on the molecular profile may facilitate a therapeutic strategy that allows the use of the most appropriate drug for each patient.
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Lemen RA. Mesothelioma from asbestos exposures: Epidemiologic patterns and impact in the United States. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2016; 19:250-265. [PMID: 27705549 DOI: 10.1080/10937404.2016.1195323] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Mesothelioma, a rare tumor, is highly correlated with asbestos exposure. Mesothelioma, similar to all asbestos-related diseases, is dose/intensity dependent to some degree, and studies showed the risk of mesothelioma rises with cumulative exposures. Multiple processes occur in an individual before mesothelioma occurs. The impact of mesothelioma in the United States has been continuous over the last half century, claiming between 2,000 and 3,000 lives each year. Mesothelioma is a preventable tumor that is more frequently reported as associated with asbestos exposure among men than women. However, the rate of asbestos-associated mesothelioma is on the rise among women due to better investigation into their histories of asbestos exposure. It is of interest that investigators detected asbestos-associated cases of mesothelioma in women from nonoccupational sources-that is, bystander, incidental, or take-home exposures. It is postulated that asbestos-associated mesotheliomas, in both men and women, are likely underreported. However, with the implementation of the most recent ICD-10 coding system, the correlation of mesothelioma with asbestos exposure is expected to rise to approximately 80% in the United States. This study examined the demographic and etiological nature of asbestos-related mesothelioma.
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Affiliation(s)
- Richard A Lemen
- a Department of Environmental Health , Emory University , Atlanta , Georgia , USA
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