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Stoppa G, Mensi C, Fazzo L, Minelli G, Manno V, Marinaccio A, Consonni D, Biggeri A, Catelan D. Ovarian cancer deaths attributable to asbestos exposure in Lombardy (Italy) in 2000-2018. Occup Environ Med 2024; 81:359-365. [PMID: 38981677 DOI: 10.1136/oemed-2023-109342] [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: 11/27/2023] [Accepted: 06/17/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES We aimed to estimate the fraction of deaths from ovarian cancer attributable to asbestos exposure in Lombardy Region, Italy, using a novel approach that exploits the fact that ovarian cancer asbestos exposure is associated with pleural cancer and other risk factors for breast cancer. METHODS This ecological study is based on the Italian National Institute of Statistics mortality data. We formulate a trivariate Bayesian joint disease model to estimate the attributable fraction (AF) and the number of ovarian cancer deaths attributable to asbestos exposure from the geographic distribution of ovarian, pleural and breast cancer mortality at the municipality level from 2000 to 2018. Expected deaths and standardised mortality ratios were calculated using regional rates. RESULTS We found shared dependencies between ovarian and pleural cancer, which capture risk factors common to the two diseases (asbestos exposure), and a spatially structured clustering component shared between ovarian and breast cancer, capturing other risk factors. Based on 10 462 ovarian cancer deaths, we estimated that 574 (95% credibility interval 388-819) were attributable to asbestos (AF 5.5%; 95% credibility interval 3.7-7.8). AF reaches 34%-47% in some municipalities with known heavy asbestos pollution. CONCLUSIONS The impact of asbestos on ovarian cancer occurrence can be relevant, particularly in areas with high asbestos exposure. Estimating attributable cases was possible only by using advanced Bayesian modelling to consider other risk factors for ovarian cancer. These findings are instrumental in tailoring public health surveillance programmes and implementing compensation and prevention policies.
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Affiliation(s)
- Giorgia Stoppa
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padua, Padova, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucia Fazzo
- Department of Environment and Health, Italian National Institute of Health, Rome, Italy
| | - Giada Minelli
- Statistical Service, Italian National Institute of Health, Rome, Italy
| | - Valerio Manno
- Statistical Service, Italian National Institute of Health, Rome, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padua, Padova, Italy
| | - Dolores Catelan
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padua, Padova, Italy
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Leung L, Lavoué J, Siemiatycki J, Guénel P, Koushik A. Occupational environment and ovarian cancer risk. Occup Environ Med 2023; 80:489-497. [PMID: 37429725 DOI: 10.1136/oemed-2022-108557] [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: 07/04/2022] [Accepted: 03/30/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVES To investigate employment in an occupation or industry and specific occupational exposures in relation to ovarian cancer risk. METHODS In a population-based case-control study conducted in Montreal, Canada (2011-2016), lifetime occupational histories were collected for 491 cases of ovarian cancer and 897 controls. An industrial hygienist coded the occupation and industry of each participant's job. Associations with ovarian cancer risk were estimated for each of several occupations and industries. Job codes were linked to the Canadian job-exposure matrix, thereby generating exposure histories to many agents. The relationship between exposure to each of the 29 most prevalent agents and ovarian cancer risk was assessed. Odds ratios and 95% confidence intervals (OR (95% CI)) for associations with ovarian cancer risk were estimated using logistic regression and controlling for multiple covariates. RESULTS Elevated ORs (95% CI) were observed for employment ≥10 years as Accountants (2.05 (1.10 to 3.79)); Hairdressers, Barbers, Beauticians and Related Workers (3.22 (1.25 to 8.27)); Sewers and Embroiderers (1.85 (0.77 to 4.45)); and Salespeople, Shop Assistants and Demonstrators (1.45 (0.71 to 2.96)); and in the industries of Retail Trade (1.59 (1.05 to 2.39)) and Construction (2.79 (0.52 to 4.83)). Positive associations with ORs above 1.42 were seen for high cumulative exposure versus never exposure to 18 agents: cosmetic talc, ammonia, hydrogen peroxide, hair dust, synthetic fibres, polyester fibres, organic dyes and pigments, cellulose, formaldehyde, propellant gases, aliphatic alcohols, ethanol, isopropanol, fluorocarbons, alkanes (C5-C17), mononuclear aromatic hydrocarbons, polycyclic aromatic hydrocarbons from petroleum and bleaches. CONCLUSIONS Certain occupations, industries and specific occupational exposures may be associated with ovarian cancer risk. Further research is needed to provide a more solid grounding for any inferences in this regard.
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Affiliation(s)
- Lisa Leung
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Inserm U1018, CESP, Team Exposome and Heredity, Université Paris-Saclay, Villejuif, France
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
| | - Jérôme Lavoué
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
- Department of Environmental and Occupational Health, Université de Montréal, Montreal, Quebec, Canada
| | - Jack Siemiatycki
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
| | - Pascal Guénel
- Inserm U1018, CESP, Team Exposome and Heredity, Université Paris-Saclay, Villejuif, France
| | - Anita Koushik
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
- Université de Montréal Hospital Research Centre, CRCHUM, Montreal, Quebec, Canada
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Nowak D, Schmalfeldt B, Tannapfel A, Mahner S. Asbestos Exposure and Ovarian Cancer - a Gynaecological Occupational Disease. Background, Mandatory Notification, Practical Approach. Geburtshilfe Frauenheilkd 2021; 81:555-561. [PMID: 34035550 PMCID: PMC8137273 DOI: 10.1055/a-1361-1715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 01/18/2021] [Indexed: 12/01/2022] Open
Abstract
In 2017, ovarian cancer due to asbestos exposure was designated a new, and thereby the first, gynaecological occupational disease in Germany. Asbestos is a naturally occurring mineral fibre with an annual usage in Germany of 160 000 – 180 000 metric tonnes in the 1960s and 1970s. The carcinogenicity of asbestos for the target organs lungs, larynx, pleura including pericardium, and peritoneum including tunica vaginalis testis has been clearly established for many years. Recent meta-analyses of data from cohort studies have demonstrated that the risk of ovarian cancer roughly doubles in women with occupational exposure to asbestos. Since the group of people with double the risk of developing lung cancer due to work-related asbestos exposure has a 2.25-fold increased risk of mortality from ovarian cancer on average, work-related ovarian cancer has been assigned the same recognition requirements as in occupational lung (and laryngeal) cancer. Thus, gynaecologists must obtain
a thorough history of occupational exposure to asbestos, even if it may have taken place long in the past. The law mandates that suspected such cases must be reported to the Statutory Accident Insurance carrier or the State Occupational Safety and Health Agency.
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Affiliation(s)
- Dennis Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU Klinikum, München, Germany
| | - Barbara Schmalfeldt
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Tannapfel
- Institut für Pathologie der Ruhr-Universität Bochum, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Germany
| | - Sven Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, LMU Klinikum, München, Germany
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Vimercati L, Cavone D, Delfino MC, Bruni B, De Maria L, Caputi A, Sponselli S, Rossi R, Resta L, Fortarezza F, Pezzuto F, Serio G. Primary Ovarian Mesothelioma: A Case Series with Electron Microscopy Examination and Review of the Literature. Cancers (Basel) 2021; 13:2278. [PMID: 34068638 PMCID: PMC8126134 DOI: 10.3390/cancers13092278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 01/12/2023] Open
Abstract
Primary ovarian mesothelioma is a rare, aggressive neoplastic disease with a poor prognosis. At onset, the tumor is only rarely limited to the ovaries and usually already widespread in the peritoneum. The rarity of this entity and the difficulties differentiating it from either ovarian carcinoma or peritoneal mesothelioma may lead to frequent misdiagnoses and may raise some concerns about its histogenesis. Thus, reporting such rare cases is fundamental to gain greater awareness of this neoplasm and try to answer unsolved questions. Herein, we described four cases of histological diagnoses of ovarian mesothelioma extrapolated by the regional mesothelioma register of Apulia (southern Italy). In all cases, a detailed medical history was collected according to national mesothelioma register guidelines. A broad panel of antibodies was used for immunohistochemistry to confirm the diagnoses. Moreover, ovarian tissue samples were also examined by transmission and scanning electron microscopy, detecting asbestos fibers and talc crystals in two cases. Because of the few cases described, we reviewed the English literature in the Medline database, focusing on articles about ovarian mesothelioma "misclassification", "misdiagnosis", "diagnostic challenge" or "diagnostic pitfall" and on unsolved questions about its histogenesis and possible risk factors.
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Affiliation(s)
- Luigi Vimercati
- Interdisciplinary Department of Medicine, Occupational Medicine-Section Ramazzini, University of Bari Aldo Moro, 70124 Bari, Italy; (L.V.); (D.C.); (M.C.D.); (L.D.M.); (A.C.); (S.S.)
| | - Domenica Cavone
- Interdisciplinary Department of Medicine, Occupational Medicine-Section Ramazzini, University of Bari Aldo Moro, 70124 Bari, Italy; (L.V.); (D.C.); (M.C.D.); (L.D.M.); (A.C.); (S.S.)
| | - Maria Celeste Delfino
- Interdisciplinary Department of Medicine, Occupational Medicine-Section Ramazzini, University of Bari Aldo Moro, 70124 Bari, Italy; (L.V.); (D.C.); (M.C.D.); (L.D.M.); (A.C.); (S.S.)
| | - Biagio Bruni
- Ultrastructure Laboratory, Istituto Superiore di Sanità, 00161 Rome, Italy;
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Occupational Medicine-Section Ramazzini, University of Bari Aldo Moro, 70124 Bari, Italy; (L.V.); (D.C.); (M.C.D.); (L.D.M.); (A.C.); (S.S.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, Occupational Medicine-Section Ramazzini, University of Bari Aldo Moro, 70124 Bari, Italy; (L.V.); (D.C.); (M.C.D.); (L.D.M.); (A.C.); (S.S.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, Occupational Medicine-Section Ramazzini, University of Bari Aldo Moro, 70124 Bari, Italy; (L.V.); (D.C.); (M.C.D.); (L.D.M.); (A.C.); (S.S.)
| | - Roberta Rossi
- Department of Emergency and Organ Transplantation (DETO), Pathological Anatomy Section, University of Bari Aldo Moro, 70124 Bari, Italy; (R.R.); (L.R.)
| | - Leonardo Resta
- Department of Emergency and Organ Transplantation (DETO), Pathological Anatomy Section, University of Bari Aldo Moro, 70124 Bari, Italy; (R.R.); (L.R.)
| | - Francesco Fortarezza
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35121 Padova, Italy;
| | - Federica Pezzuto
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova Medical School, 35121 Padova, Italy;
| | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathological Anatomy Section, University of Bari Aldo Moro, 70124 Bari, Italy; (R.R.); (L.R.)
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van Zandwijk N, Reid G, Frank AL. Asbestos-related cancers: the 'Hidden Killer' remains a global threat. Expert Rev Anticancer Ther 2020; 20:271-278. [PMID: 32223452 DOI: 10.1080/14737140.2020.1745067] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Asbestos, the most frequent cause of occupational cancer, continues to be consumed on a massive scale, with millions of people exposed on a daily basis. This review explains why we have failed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestos victims are likely to remain high. Emerging and developed countries have to be reminded that asbestos exposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by the surge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking and stimulated by manufacturers.Areas covered: Underreporting of malignant mesothelioma and asbestos-induced lung cancer, frequently-used arguments in the amphibole/chrysotile debate and the conclusion from bona-fide research organizations, that all forms of asbestos are carcinogenic, are reviewed. Special attention is paid to the consequences of ubiquitous environmental asbestos and the 'changing face' of malignant mesothelioma in countries with heavy asbestos use in the past.Expert opinion: Experts in oncology, respiratory medicine, occupational and public health, and basic researchers must take responsibility and acknowledge the ongoing silent epidemic of asbestos-related diseases. The call for a world-wide asbestos ban is more urgent than ever.
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Affiliation(s)
- Nico van Zandwijk
- Concord (Sydney) Medical School, University of Sydney, Concord Repatriation General Hospital, Concord, Australia
| | - Glen Reid
- Department of Pathology, University of Otago, Dunedin, New Zealand
| | - Arthur L Frank
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Approaching a Unified Theory for Particle-Induced Inflammation. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2016. [DOI: 10.1007/978-4-431-55732-6_3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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