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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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Larese Filon F, Granzotto J, Bignotto A, Alessandrini B, Barbina P, Rui F. Recognized Occupational Diseases in Italy's Friuli-Venezia Giulia and Liguria Regions (2010-2021). LA MEDICINA DEL LAVORO 2023; 114:e2023044. [PMID: 37878256 PMCID: PMC10627103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/06/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND The study of recognized occupational diseases trend is important to understand the preventive approach needed in the future, however, while numbers of occupational diseases are available on web, data on incidence are missing. The aim of our study was to analyze the trend and the incidence rate ratio (IRR) of recognized occupational diseases in Italy, in Friuli-Venezia Giulia region (FVG) and Liguria region from 2010 to 2021. METHODS Numbers of recognized occupational diseases by the Italian National Insurance for Occupational Diseases (INAIL) were analyzed and incidence were calculated considered the total number of workforces in the area. A Poisson regression model was used to estimate incidence trends. RESULTS FVG region presented a higher incidence of all occupational diseases compared to Italy and to Liguria in the period considered. The overall incidence in 2019 was 175, 91.8 and 108 cases for 100,000 workers, for FVG, Liguria and Italy respectively. Musculoskeletal disorders (MSDs) were the majority of occupational diseases with 100, 51 and 82.8 cases per 100,000 workers, in FVG, Liguria and Italy, respectively. Incidence of occupational cancers was 16, 10 and 4.9 cases per 100,000 workers, in FVG, Liguria and Italy, respectively. The annual change of incidence from 2010 to 2019 was positive for MSDs (IRR 1.06; 95%CI 1.06 to 1.07) and decreasing for the other causes in Italy. In FVG region the trend was positive for MSDs (IRR 1.05;95%CI 1.04 to 1.06), for respiratory diseases (IRR 1.03; 95%CI 1.00 to 1.05) and pleural plaques (IRR 1.03; 95%CI 1.00 to 1.06). In Liguria the trend was positive for MSDs (IRR 1.17; 95% CI 1.15-1.19) and for pleural plaques (IRR 1.07; 95%CI 1.03-1.12). Stable trends were found for cancers. Declining trend was shown for noise induced hearing loss and skin diseases. CONCLUSIONS FVG region presented a higher incidence of recognized occupational diseases compared to Liguria region and Italian data. Results that can be explained by a higher propensity of claiming for occupational diseases in workers, mainly for MSDs disorders. For cancers and asbestos-related diseases the higher incidence can be attributable to high exposure to asbestos in FVG and Liguria workers mainly in shipyard and dock activities.
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Affiliation(s)
| | | | | | | | - Paolo Barbina
- Centro Regionale Unico Amianto, Azienda Sanitaria Universitaria Giuliano Isontina .
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Curiel-García T, Rey-Brandariz J, Varela-Lema L, Ruano-Ravina A, Candal-Pedreira C, Mourino N, Moure-Rodríguez L, Figueiras A, Pérez-Ríos M. Asbestos exposure and small cell lung cancer: Systematic review and meta-analysis. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2023; 20:427-438. [PMID: 37405865 DOI: 10.1080/15459624.2023.2232421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Asbestos is a mineral that is carcinogenic to humans. Its use has been banned in many occidental countries yet it is still produced in the United States, and materials that contain asbestos remain in many occupational settings and indoor environments. Even though asbestos carcinogenicity is well known, there is scant literature on its specific effects regarding small cell lung cancer (SCLC). We therefore conducted a systematic review and meta-analysis to determine SCLC risk among workers exposed to asbestos. A systematic search of the literature was conducted to identify studies which reported occupational exposure to asbestos and SCLC-related deaths and/or incidence. We identified seven case-control studies that included 3,231 SCLC cases; four studies reported smoking-adjusted risks. A significantly increased risk of SCLC (pooled OR 1.89; 95% CI, 1.25-2.86) was observed on pooling studies on men (six studies) that displayed moderate heterogeneity (I2 = 46.0%). Overall, our synthesis suggests that occupational exposure to asbestos significantly increases the risk of SCLC on men.
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Affiliation(s)
- Teresa Curiel-García
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Medical Oncology, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, Spain
| | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
| | - Nerea Mourino
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Lucía Moure-Rodríguez
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Spain
| | - Adolfo Figueiras
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Spain
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Stella S, Consonni D, Migliore E, Stura A, Cavone D, Vimercati L, Miligi L, Piro S, Landi MT, Caporaso NE, Curti S, Mattioli S, Brandi G, Gioscia C, Eccher S, Murano S, Casotto V, Comiati V, Negro C, D'Agostin F, Genova C, Benfatto L, Romanelli A, Grappasonni I, Madeo G, Cozzi I, Romeo E, Tommaso S, Carrozza F, Labianca M, Tallarigo F, Cascone G, Melis M, Marinaccio A, Binazzi A, Mensi C. Pleural mesothelioma risk in the construction industry: a case-control study in Italy, 2000-2018. BMJ Open 2023; 13:e073480. [PMID: 37567753 PMCID: PMC10423786 DOI: 10.1136/bmjopen-2023-073480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/07/2023] [Indexed: 08/13/2023] Open
Abstract
OBJECTIVES Workers in the construction industry have been exposed to asbestos in various occupations. In Italy, a National Mesothelioma Registry has been implemented more than 20 years ago. Using cases selected from this registry and exploiting existing control data sets, we estimated relative risks for pleural mesothelioma (PM) among construction workers. DESIGN Case-control study. SETTING Cases from the National Mesothelioma Registry (2000-2018), controls from three previous case-control studies. METHODS We selected male PM incident cases diagnosed in 2000-2018. Population controls were taken from three studies performed in six Italian regions within two periods (2002-2004 and 2012-2016). Age-adjusted and period-adjusted unconditional logistic regression models were fitted to estimate odds ratios (OR) for occupations in the construction industry. We followed two approaches, one (primary) excluding and the other (secondary) including subjects employed in other non-construction blue collar occupations for >5 years. For both approaches, we performed an overall analysis including all cases and, given the incomplete temporal and geographic overlap of cases and controls, three time or/and space restricted sensitivity analyses. RESULTS The whole data set included 15 592 cases and 2210 controls. With the primary approach (4797 cases and 1085 controls), OR was 3.64 (2181 cases) for subjects ever employed in construction. We found elevated risks for blue-collar occupations (1993 cases, OR 4.52), including bricklayers (988 cases, OR 7.05), general construction workers (320 cases, OR 4.66), plumbers and pipe fitters (305 cases, OR 9.13), painters (104 cases, OR 2.17) and several others. Sensitivity analyses yielded very similar findings. Using the secondary approach, we observed similar patterns, but ORs were remarkably lower. CONCLUSIONS We found markedly increased PM risks for most occupations in the construction industry. These findings are relevant for compensation of subjects affected with mesothelioma in the construction industry.
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Affiliation(s)
- Simona Stella
- Occupational Health Unit, Regional Operating Center of Lombardy (COR Lombardia), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Occupational Health Unit, Regional Operating Center of Lombardy (COR Lombardia), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Enrica Migliore
- COR Piemonte, Cancer Epidemiology Unit, CPO and University of Turin, Turin, Italy
| | - Antonella Stura
- COR Piemonte, Cancer Epidemiology Unit, CPO and University of Turin, Turin, Italy
| | - Domenica Cavone
- COR Puglia, Section of Occupational Medicine 'B Ramazzini', Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Luigi Vimercati
- COR Puglia, Section of Occupational Medicine 'B Ramazzini', Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Lucia Miligi
- COR Toscana, Unit of Environmental and Occupational Epidemiology, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Sara Piro
- COR Toscana, Unit of Environmental and Occupational Epidemiology, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefano Mattioli
- Department of Environmental and Prevention Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Brandi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Carmela Gioscia
- COR Valle d'Aosta, Valle d'Aosta Health Local Unit, Aosta, Italy
| | - Silvia Eccher
- COR Province of Trento, Provincial Unit of Health, Hygiene and Occupational Medicine, Trento, Italy
| | - Stefano Murano
- COR Province of Bolzano, Alto Adige Health Local Unit, Bolzano, Italy
| | - Veronica Casotto
- COR Veneto, Epidemiological Department, Azienda Zero, Padova, Italy
| | - Vera Comiati
- COR Veneto, Epidemiological Department, Azienda Zero, Padova, Italy
| | - Corrado Negro
- COR Friuli-Venezia Giulia, Clinical Unit of Occupational Medicine, University of Trieste-Trieste General Hospitals, Trieste, Italy
| | - Flavia D'Agostin
- COR Friuli-Venezia Giulia, Clinical Unit of Occupational Medicine, University of Trieste-Trieste General Hospitals, Trieste, Italy
| | - Carlo Genova
- UO Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dipartimento di Medicina Interna e Specialità Mediche, Università degli Studi di Genova, Genova, Italy
| | - Lucia Benfatto
- COR Liguria, UO Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genova, Liguria, Italy
| | - Antonio Romanelli
- COR Emilia-Romagna, Public Health Department, Health Local Unit, Reggio Emilia, Italy
| | - Iolanda Grappasonni
- COR Marche, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy
| | - Gabriella Madeo
- COR Umbria, Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimentare, Regione Umbria, Perugia, Umbria, Italy
| | - Ilaria Cozzi
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Lazio, Italy
| | - Elisa Romeo
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Lazio, Italy
| | | | | | | | | | - Giuseppe Cascone
- COR Sicilia, Cancer Registry ASP Ragusa and Sicily Regional Epidemiological Observatory, Ragusa, Italy
| | - Massimo Melis
- COR Sardegna, Regional Epidemiological Center, Cagliari, Italy
| | - Alessandro Marinaccio
- 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
| | - Carolina Mensi
- Occupational Health Unit, Regional Operating Center of Lombardy (COR Lombardia), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Paris L, Scarselli A, Marinaccio A, Massari S. Assessment of Occupational Carcinogenic Risk by Comparing Data from the Italian Register of Occupational Exposures to Carcinogens (SIREP) with the International Agency for Research on Cancer (IARC) Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105850. [PMID: 37239576 DOI: 10.3390/ijerph20105850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/09/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
In Italy, the National Register on Occupational Exposure to Carcinogens (SIREP) is established pursuant to article 243 of Legislative Decree 81/2008 and is aimed to collect information on the exposure of workers to carcinogens transmitted by employers. The aim of this study is to assess its level of implementation comparing prevailing carcinogens reported in SIREP with the monitoring of risks in the workplace evidenced by the International Agency for Research on Cancer (IARC). The data reported in the SIREP have been integrated with IARC and the database on carcinogenic risk in the workplace named MATline in order to build a matrix containing the carcinogens classified according to the IARC (Group 1 and 2A agents) and to a semi-quantitative indicator of risk level (High or Low) calculated upon the number of exposures reported in SIREP. The matrix contains the following data: carcinogens, economic sector (NACE Rev2 coding) and cancer sites. The comparison between SIREP and IARC evidence allowed us to highlight situations with a high risk of carcinogenicity and to address appropriate actions of prevention to contain the risks of exposure to carcinogenic substances.
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Affiliation(s)
- Lorena Paris
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accident at Work (INAIL), 00143 Rome, Italy
| | - Alberto Scarselli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accident at Work (INAIL), 00143 Rome, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accident at Work (INAIL), 00143 Rome, Italy
| | - Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accident at Work (INAIL), 00143 Rome, Italy
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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:ijerph20020936. [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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7
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Sneaky Diagnosis of Pleural Malignant Mesothelioma in Thoracic Surgery: All That Glitters Is Not Gold. J Clin Med 2022; 11:jcm11113225. [PMID: 35683612 PMCID: PMC9181256 DOI: 10.3390/jcm11113225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 11/17/2022] Open
Abstract
Malignant Pleural Mesothelioma (MPM) is a highly aggressive disease whose diagnosis could be challenging and confusing. It could occur with atypical presentations on every examined level. Here, we present three unconventional cases of the complex diagnostic process of MPM that we have experienced during routine practice: a patient with reactive mesothelial hyperplasia mimicking MPM, an unexpected presentation of MPM with persistent unilateral hydropneumothorax, a rare case of MPM in situ. Then, we review the relevant literature on each of these topics. Definitive biomarkers to confidently distinguish MPM from other pleural affections are still demanded. Patients presenting with persistent hydropneumothorax must always be investigated for MPM. MPM in situ is now a reality, and this raises questions about its management.
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Rhazari M, Moueqqit O, Gartini S, El morabit S, Diani S, Aharmim M, Thouil A, Kouismi H, El bourkadi JE. Unexplained Pleural Effusion Leads to the Revelation of a Malignant Mesothelioma: A Case Report. Cureus 2022; 14:e24478. [PMID: 35637829 PMCID: PMC9132562 DOI: 10.7759/cureus.24478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 11/30/2022] Open
Abstract
Malignant mesothelioma is a rare and aggressive cancer that usually affects subjects with prior asbestos exposure, a major risk factor that has been widely known as carcinogenic, and its use is now controlled if not banned in many areas of the world. Malignant mesothelioma originates from mesothelial surface cells covering the serous cavities, and the pleura is its most common site. Malignant pleural mesothelioma (MPM) typically presents with pleural effusion and chest wall pain with wide pleural thickening at radiological investigation. Although the histological examination along with immunohistochemistry helps yield the diagnosis, clinicians and experts face many challenges in diagnosing malignant mesothelioma not only due to the rarity of the disease but also due to the similarities that the disease share with other malignancies. Here, we report a case of a 55-year-old male patient with a history of chronic asbestos work exposure for 12 years who initially presented with unexplained pleural effusion and chest wall pain and was lost to follow-up but came back later with a worsening clinical state. This case is specially presented to raise awareness against cases of unexplained pleural effusion and chest pain.
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Ferrari L, Iodice S, Cantone L, Dallari B, Dioni L, Bordini L, Palleschi A, Mensi C, Pesatori AC. Identification of a new potential plasmatic biomarker panel for the diagnosis of malignant pleural mesothelioma. LA MEDICINA DEL LAVORO 2022; 113:e2022052. [PMID: 36475505 PMCID: PMC9766837 DOI: 10.23749/mdl.v113i6.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/26/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is a rare highly aggressive tumor strongly associated with asbestos exposure and characterized by poor prognosis. Currently, diagnosis is based on invasive techniques, thus there is a need of identifying non-invasive biomarkers for early detection of the disease among asbestos-exposed subjects. In the present study, we measured the plasmatic concentrations of Mesothelin, Fibulin-3, and HMGB1 protein biomarkers, and of hsa-miR-30e-3p and hsa-miR-103a-3p Extracellular-Vesicles- embedded micro RNAs (EV-miRNAs). We tested the ability of these biomarkers to discriminate between MPM and PAE subjects alone and in combination. METHODS the study was conducted on a population of 26 patients with MPM and 54 healthy subjects with previous asbestos exposure (PAE). Mesothelin, Fibulin-3, and HMGB1 protein biomarkers were measured by the enzyme-linked immunosorbent assay (ELISA) technique; the levels of hsa-miR-30e-3p and hsa-miR-103a-3p EV-miRNAs was assessed by quantitative real-time PCR (qPCR). RESULTS the most discriminating single biomarker resulted to be Fibulin-3 (AUC 0.94 CI 95% 0.88-1.0; Sensitivity 88%; Specificity 87%). After investigating the different possible combinations, the best performance was obtained by the three protein biomarkers Mesothelin, Fibulin-3, and HMGB1 (AUC 0.99 CI 95% 0.97-1.0; Sensitivity 96%; Specificity 93%). CONCLUSIONS the results obtained contribute to identifying new potential non-invasive biomarkers for the early diagnosis of MPM in high-risk asbestos-exposed subjects. Further studies are needed to validate the evidence obtained, in order to assess the reliability of the proposed biomarker panel.
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Affiliation(s)
- Luca Ferrari
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy,Occupational Health Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Simona Iodice
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Laura Cantone
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Laura Dioni
- EPIGET Lab, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Lorenzo Bordini
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Alessandro Palleschi
- Thoracic Surgery and Lung Transplantation Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Mensi
- Occupational Health Unit, 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,Occupational Health Unit, Fondazione IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, Milan, Italy
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