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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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Fazzo L, Minelli G, De Santis M, Ceccarelli E, Iavarone I, Zona A. The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5957. [PMID: 37297561 PMCID: PMC10252364 DOI: 10.3390/ijerph20115957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
As part of a surveillance plan active since the early 1990s, this study evaluates malignant mesothelioma (MM) mortality for the time-window 2010-2019 in Italy, a country that banned asbestos in 1992. National and regional mortality rates for MM, and municipal standardized mortality ratios (all mesotheliomas, pleural (MPM) and peritoneal (MPeM)), by gender and age group were calculated. A municipal clustering analysis was also performed. There were 15,446 deaths from MM (11,161 males, 3.8 × 100,000; 4285 females, 1.1 × 100,000), of which 12,496 were MPM and 661 were MPeM. In the study period, 266 people ≤50 years died from MM. A slightly decreasing rate among males since 2014 was observed. The areas at major risk hosted asbestos-cement plants, asbestos mines (chrysotile in Balangero), shipyards, petrochemical and chemical plants, and refineries. Female mortality excesses particularly were found in municipalities with a fluoro-edenite-contaminated mine (Biancavilla) and textile facilities. Excesses were also found in a region with the presence of natural asbestos fibres and in males living in two small islands. The Italian National Prevention Plan stated recommendations to eliminate asbestos exposures and to implement health surveillance and healthcare for people exposed to asbestos.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Emiliano Ceccarelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
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Asbestos Consumption and Malignant Mesothelioma Mortality Trends in the Major User Countries. Ann Glob Health 2023; 89:11. [PMID: 36819965 PMCID: PMC9936915 DOI: 10.5334/aogh.4012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/25/2023] [Indexed: 02/15/2023] Open
Abstract
Background The causal association between mesothelioma and asbestos exposure is conclusive, and many studies have proved that the trend in asbestos use is a strong predictor of the pattern in mesothelioma cases with an adequate latency time (generally around 30-40 years or more). Recently, a novel approach for predicting malignant pleural mesothelioma, based on asbestos consumption trend and using distributed non-linear models, has been applied. Objectives The purpose of this study is to analyse trends in asbestos consumption and malignant mesothelioma mortality in the major asbestos-user countries. Furthermore, we applied distributed non-linear models to estimate and compare epidemiological relationships between asbestos consumption and mesothelioma mortality across these countries. Methods The study involves major asbestos-user countries in which historical asbestos consumption and mesothelioma mortality data are available. Data on asbestos consumption were derived from worldwide asbestos supply and mesothelioma mortality data from World Health Organization (WHO) mortality archives. A quasi-Poisson generalized linear model was used to model past asbestos exposure and male mesothelioma mortality rates in each country. Exposure-response associations have been modelled using distributed lag non-linear models. Findings and conclusions According to the criteria defined above, we selected 18 countries with raw asbestos cumulative consumptions higher than two million tons in the period 1933-2012. Overall, a clear linear relationship can be observed between total consumption and total deaths for mesothelioma. Country-specific exposure, lag and age-response relationships were identified and common functions extracted by a meta-analysis procedure. Non-linear models appear suitable and flexible tools for investigating the association between mesothelioma mortality and asbestos consumption. There is a need to improve the global epidemiological surveillance of asbestos-related diseases, particularly mesothelioma mortality, and the absence of reliable data for some major asbestos-user countries is a real concern. A reliable assessment of mesothelioma mortality is a fundamental step towards increasing the awareness of related risks and the need of an international ban on asbestos.
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Kimpo MS, Francisco KL, Chong QT, Lian DWQ, Lin NY, Mali V, Loh DL, Prabhakharan K. Mesothelioma with ALK gene mutations in two pediatric patients: Clinical course and outcome. Pediatr Blood Cancer 2022; 69:e29544. [PMID: 34957683 DOI: 10.1002/pbc.29544] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Miriam Santiago Kimpo
- Division of Paediatric Hematology and Oncology, KTP University Children's Medical Institute, National University Hospital, Kent Ridge, Singapore
| | - Krista Lea Francisco
- Division of Paediatric Hematology and Oncology, KTP University Children's Medical Institute, National University Hospital, Kent Ridge, Singapore
| | - Quah Thuan Chong
- Division of Paediatric Hematology and Oncology, KTP University Children's Medical Institute, National University Hospital, Kent Ridge, Singapore
| | | | - Nyo Yoke Lin
- Department of Paediatric Surgery, KTP University Children's Medical Institute, National University Hospital, Kent Ridge, Singapore
| | - Vidyadhar Mali
- Department of Paediatric Surgery, KTP University Children's Medical Institute, National University Hospital, Kent Ridge, Singapore
| | - Dale Lincoln Loh
- Department of Paediatric Surgery, KTP University Children's Medical Institute, National University Hospital, Kent Ridge, Singapore
| | - Krishnan Prabhakharan
- Department of Paediatric Surgery, KTP University Children's Medical Institute, National University Hospital, Kent Ridge, Singapore
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Musk AWB, Reid A, Olsen N, Hobbs M, Armstrong B, Franklin P, Hui J, Layman L, Merler E, Brims F, Alfonso H, Shilkin K, Sodhi-Berry N, de Klerk N. The Wittenoom legacy. Int J Epidemiol 2021; 49:467-476. [PMID: 31670764 DOI: 10.1093/ije/dyz204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 10/17/2019] [Indexed: 01/05/2023] Open
Abstract
The Wittenoom crocidolite (blue asbestos) mine and mill ceased operating in 1966. The impact of this industry on asbestos-related disease in Western Australia has been immense. Use of the employment records of the Australian Blue Asbestos Company and records of the Wittenoom township residents has permitted two cohorts of people with virtually exclusive exposure to crocidolite to be assembled and studied. Follow-up of these two cohorts has been conducted through data linkage with available hospital, mortality and cancer records. The evolution of asbestos-related disease has been recorded and, with the establishment of exposure measurements, quantitative exposure-response relationships have been estimated. There has been an ongoing epidemic of mortality from lung cancer and malignant mesothelioma and, less so, from asbestosis. Wittenoom crocidolite was used extensively in asbestos-cement products in Western Australia. As a result, the state has recorded a higher malignant-mesothelioma mortality rate than in any other Australian state and in any defined general population in the world. Thus, the legacy of Wittenoom has extended beyond the mine and the town, and is still evident more than 50 years after the closure of the mine.
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Affiliation(s)
- Arthur W Bill Musk
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Alison Reid
- School of Public Health, Curtin University, Bentley, WA, Australia
| | - Nola Olsen
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Michael Hobbs
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Bruce Armstrong
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Peter Franklin
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Jennie Hui
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.,PathWest Laboratories Medicine of WA, Nedlands, WA, Australia
| | - Lenore Layman
- School of Arts, Murdoch University, Perth, WA, Australia
| | - Enzo Merler
- Previously, Venetian Mesothelioma Registry, National Health Service, Padua, Italy
| | - Fraser Brims
- Curtin Medical School, Curtin University, Bentley, WA, Australia
| | - Helman Alfonso
- School of Public Health, Curtin University, Bentley, WA, Australia
| | - Keith Shilkin
- PathWest Laboratories Medicine of WA, Nedlands, WA, Australia
| | - Nita Sodhi-Berry
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia
| | - Nicholas de Klerk
- School of Population and Global Health, University of Western Australia, Crawley, WA, Australia.,Telethon Kids Institute, University of Western Australia, Crawley, WA, Australia
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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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Mesothelioma in children and adolescents: the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) contribution. Eur J Cancer 2020; 140:63-70. [DOI: 10.1016/j.ejca.2020.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/08/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023]
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Reid A, Franklin P, Berry G, Peters S, Sodhi-Berry N, Brims F, Musk AW, de Klerk NH. Response to letter by Farioli et al. Occup Environ Med 2019; 76:356. [PMID: 30928905 DOI: 10.1136/oemed-2019-105740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 02/06/2019] [Indexed: 11/04/2022]
Affiliation(s)
- Alison Reid
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Peter Franklin
- School of Population Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Geoffrey Berry
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Susan Peters
- Institute for risk asessment sciences, Utrecht University, Utrecht, The Netherlands
| | - Nita Sodhi-Berry
- School of Population Health, University of Western Australia, Crawley, Western Australia, Australia
| | - Fraser Brims
- Curtin Medical School, Curtin University-Perth City Campus, Perth, Western Australia, Australia.,Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Arthur W Musk
- School of Population Health, University of Western Australia, Crawley, Western Australia, Australia.,Respiratory Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Nicholas H de Klerk
- Centre for Child Health Research, University of Western Australia, Crawley, Western Australia, Australia
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Farioli A, Boffetta P, Curti S, Garzaro G, La Vecchia C, Mattioli S, Spatari G, Violante FS. Response to: 'Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom' by Reid et al. Occup Environ Med 2019; 76:355. [PMID: 30804167 DOI: 10.1136/oemed-2018-105637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 02/06/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Andrea Farioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.,Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
| | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giacomo Garzaro
- Department of Public Health Sciences and Pediatrics, Universita degli Studi di Torino, Torino, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Milan University, Milan, Italy
| | - Stefano Mattioli
- Department of Internal Medicine, Geriatrics, University of Bologna, Section of Occupational Medicine, Bologna, Italy
| | - Giovanna Spatari
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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