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Consonni D, Stella S, Denaro N, Binazzi A, Dallari B, Rugarli S, Borello F, Coviello E, Mensi C. Survival of Patients with Sinonasal Cancers in a Population-Based Registry, Lombardy, Italy, 2008-2023. Cancers (Basel) 2024; 16:896. [PMID: 38473258 DOI: 10.3390/cancers16050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/08/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
Sinonasal cancers (SNCs) are rare malignancies associated with occupational exposures. The aim of this study was to analyse the survival of SNC patients using data from the population-based SNC registry of the Lombardy region (10 million people), Italy. We included epithelial SNC cases registered in 2008-2020 and followed-up for vital status until 31 July 2023. Multivariate flexible parametric models with time-dependent covariates were fitted to calculate excess hazard ratios (EHRs) and 95% confidence intervals (CIs) of death. Based on 827 cases (553 males, 274 females) and 514 deaths (345 males, 169 females), the 5-year observed survival was 49% and the net survival was 57%. Age had a substantial impact on survival, particularly within the first year (EHR, 1.35; 95% CI, 1.12-1.51 per 10 years). Compared with the nasal cavity, the EHR for paranasal sinuses was 4.70 (95% CI, 2.96-7.47) soon after diagnosis. Compared with squamous cell carcinomas, the EHR was 0.69 (95% CI, 0.52-0.91) for adenocarcinomas, 1.68 (95% CI, 1.20-2.35) for undifferentiated and unspecified carcinomas, and 1.78 (95% CI, 1.07-2.95) for neuroendocrine carcinomas. Age and cancer site showed time-dependent effects on prognosis, especially within the first month after diagnosis. Prognosis was also markedly affected by cancer morphology. No associations were found for gender and period of diagnosis.
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Simona Stella
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Nerina Denaro
- Medical Oncology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accidents at Work (INAIL), 00143 Rome, Italy
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sabrina Rugarli
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Flavia Borello
- SC Prevenzione e Sicurezza, ATS Milano Città Metropolitana, 20122 Milan, Italy
| | - Enzo Coviello
- Formerly at Epidemiology Service, Local Health Unit, 76123 Barletta, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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Koller FJ, Consonni D, Mensi C, Nogueira LDA, Ribeiro CDO, Guimarães PRB, Kalinke LP. Sinonasal Cancer Cases in a Nationwide Hospital Cancer Registry in Brazil, 2007-2021. Med Lav 2024; 115:e2024004. [PMID: 38411978 PMCID: PMC10915678 DOI: 10.23749/mdl.v115i1.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 01/03/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Sinonasal cancers (SNC) are rare cancers with a high proportion attributable to occupational carcinogens. This study aims to describe the sociodemographic, clinical, and occupational characteristics of subjects with SNC in Brazil. METHODS Observational study conducted with secondary data from a network of Hospital Cancer Registries. We selected epithelial/unspecified SNC records with a year of diagnosis from 2007 to 2021. We performed descriptive statistics of SNC cases and calculated crude and age-standardized rates (ASR, standard: world population) by gender and Region of residence. RESULTS We identified 2,384 cases, 1,553 (65.1%) in men and 831 (34.9%) in women. The mean age at diagnosis was 59 years for both. Most SNC (50.7% in men and 53.2% in women) originated from the maxillary sinus. Most (65.5% in men and 54.5% in women) were squamous cell carcinomas. Information on occupation was missing in the years 2019-2021. Most male SNC patients (44.8%) were employed in group 6 (Agricultural, forestry, and fishing workers), while women had been mainly (34.6%) working in groups 8 (Workers in the production of industrial goods and services, machine operators) and in group 6 (27.6%). Crude SNC incidence rates were 1.0 per million person-years in men and 0.5 in women, while ASR were 1.0 and 0.4, respectively. In both genders, the highest ASR was in Minas Gerais (men: 1.9; women: 0.7). CONCLUSIONS Establishing the profile of Brazilians with sinonasal cancer can stimulate epidemiologic research for monitoring this group of cancers with a high association with occupational exposures.
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Affiliation(s)
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
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Turati F, Rossi M, Spinazzè A, Pira E, Cavallo DM, Patel L, Mensi C, La Vecchia C, Negri E. Occupational asbestos exposure and ovarian cancer: updated systematic review. Occup Med (Lond) 2023; 73:532-540. [PMID: 38072464 DOI: 10.1093/occmed/kqad122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND The association between asbestos exposure and ovarian cancer has been questioned given the possible misdiagnosis of peritoneal mesothelioma as ovarian cancer. AIMS To update a systematic review on ovarian cancer risk in women occupationally exposed to asbestos, exploring the association with the time since first exposure and the duration of exposure. METHODS We searched PubMed from 2008 onwards, screened previous systematic reviews, combined standardized mortality ratios (SMR) using random effect models and quantified heterogeneity using the I2 statistic. To assess tumour misclassification, we compared the distribution of observed excess ovarian cancers (OEOC) to that expected (EEOC) from the distribution of peritoneal cancers in strata of latency and exposure duration. RESULTS Eighteen publications (20 populations), including a pooled analysis of 21 cohorts, were included. The pooled SMR was 1.79 (95% confidence interval 1.38-2.31), with moderate heterogeneity between studies (I2 = 42%), based on 144 ovarian cancer deaths/cases. The risk was increased for women with indirect indicators of higher exposure, longer duration and latency, and lower for chrysotile than for crocidolite exposure. The effect of duration and latency could not be completely disentangled, since no multivariate analysis was available for time-related variables. The dissimilarity index between OEOC and EEOC for the time since first exposure was small suggesting a similar pattern of risk. CONCLUSIONS While some misclassification between ovarian and peritoneal cancers cannot be excluded, the observed excess risk of ovarian cancer should be added to the overall disease burden of asbestos.
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Affiliation(s)
- F Turati
- Department of Clinical Sciences and Community Health, University of Milan, 20133 Milan, Italy
| | - M Rossi
- Department of Clinical Sciences and Community Health, University of Milan, 20133 Milan, Italy
| | - A Spinazzè
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - E Pira
- Department of Sciences of Public Health and Pediatrics, University of Turin, 10126 Turin, Italy
| | - D M Cavallo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy
| | - L Patel
- Department of Clinical Sciences and Community Health, University of Milan, 20133 Milan, Italy
| | - C Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, 20133 Milan, Italy
| | - E Negri
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, 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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Vimercati L, Cavone D, Negrisolo O, Pentimone F, De Maria L, Caputi A, Sponselli S, Delvecchio G, Cafaro F, Chellini E, Binazzi A, Di Marzio D, Mensi C, Consonni D, Migliore E, Brentisci C, Martini A, Negro C, D'Agostin F, Grappasonni I, Pascucci C, Benfatto L, Malacarne D, Casotto V, Comiati V, Storchi C, Mangone L, Murano S, Rossin L, Tallarigo F, Vitale F, Verardo M, Eccher S, Madeo G, Staniscia T, Carrozza F, Cozzi I, Romeo E, Pelullo P, Labianca M, Melis M, Cascone G, Ferri GM, Serio G. Mesothelioma Risk Among Maritime Workers According to Job Title: Data From the Italian Mesothelioma Register (ReNaM). Med Lav 2023; 114:e2023038. [PMID: 37878258 PMCID: PMC10627101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 07/12/2023] [Indexed: 10/26/2023]
Abstract
The study describes the 466 cases of malignant mesotheliomas (MM) collected by the National Mesothelioma Register (ReNaM) in Italy in the period 1993-2018 relating to subjects with exclusive asbestos exposure in merchant or military navy. The cases among maritime workers represent 1.8% of the total cases with defined exposure registred in the ReNaM, of which 212 cases (45.4%) among merchant maritime workers and 254 cases (54.5%) among navy. The distribution by site of mesothelioma showed 453 (97.2%) MM cases of the pleura, 11 (2.3%) of the peritoneum and 2 (0.4%) of the tunica vaginalis of the testis. With regard to occupational exposure, it was classified as certain in 318 (68.2%) cases, probable in 69 (14.8%) cases and possible in 79 (16.9%) cases. Among the 23 classified jobs, the highest percentages of certain exposures are among naval engineers, motor mechanics, machine captains and sailors. Machine crew accounted for 49.3% of the cases, deck crew for 27.6%. All cases began exposure on board between 1926 and 1988. Seamen were exposed to asbestos while at sea by virtue of living onboard ships and from continual release of asbestos fibers due to the motion of a vessel. Epidemiological surveillance through the ReNaM has allowed us to verify among cases in the maritime, navy and merchant marine sectors, that in the past, subjects were exposed regardless of the ship's department where have provided service therefore all these cases must be considered as occupational diseases.
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Affiliation(s)
- Luigi Vimercati
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Domenica Cavone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Omero Negrisolo
- Environmental Prevention Technician former Judicial Police Officer Padua .
| | - Floriana Pentimone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Luigi De Maria
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Antonio Caputi
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Stefania Sponselli
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Giuseppe Delvecchio
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Francesco Cafaro
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | | | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Davide Di Marzio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), 00143 Rome, Italy.
| | - Carolina Mensi
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Dario Consonni
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torino, Italy.
| | - Carol Brentisci
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torino, Italy.
| | - Andrea Martini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy.
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friu-li-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy.
| | - Flavia D'Agostin
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friu-li-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy.
| | - Iolanda Grappasonni
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy.
| | - Cristiana Pascucci
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy.
| | - Lucia Benfatto
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Davide Malacarne
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Veronica Casotto
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Region, 35131 Padova, Italy.
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Region, 35131 Padova, Italy.
| | - Cinzia Storchi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.
| | - Lucia Mangone
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy .
| | - Stefano Murano
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Lucia Rossin
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Federico Tallarigo
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Filomena Vitale
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Marina Verardo
- Valle d'Aosta Health Local Unit, Regional Operating Center of Valle d'Aosta (COR Valle d'Aosta), 11100 Aosta, Italy.
| | - Silvia Eccher
- Hygiene and Occupational Medicine, Provincial Unit of Health, Regional Operating Center o Autono-mous Province of Trento (COR A.P. of Trento), 38100 Trento, Italy.
| | - Gabriella Madeo
- Center of Umbria (COR Umbria), Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimen-tare-Regione Umbria, 06126 Perugia, Italy.
| | - Tommaso Staniscia
- COR Abruzzo, Abruzzo Regional Health Agency (ASR), Pescara, Italy; 65121 Pescara, Italy.
| | - Francesco Carrozza
- Oncology Unit, Cardarelli Hospital, Regional Operating Center of Molise (COR Molise), 86100 Campo-basso, Italy.
| | - Ilaria Cozzi
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Re-gional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Elisa Romeo
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Re-gional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Paola Pelullo
- Department of Experimental Medicine, "Luigi Vanvitelli" University, Regional Operating Center of Campania (COR Campania), 80138 Napoli, Italy.
| | - Michele Labianca
- Epidemiologic Regional Center, Regional Operating Center of Basilicata (COR Basilicata), 85100 Poten-za, Italy.
| | - Massimo Melis
- Regional Epidemiological Center, Regional Operating Center of Sardegna (COR Sardegna), 09125 Ca-gliari, Italy.
| | - Giuseppe Cascone
- Regional Operating Center of Sicilia (COR Sicilia), 97100 Ragusa, Italy; ASP Ragusa Dipartimento di Prevenzione Medica .
| | | | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathological Anatomy Section, Univer-sity of Bari Aldo Moro, Bari, Italy.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Barbieri PG, Consonni D, Magnani C, Mensi C, Mirabell D, Ricci P, Terracini B. Is mesothelioma related to "initial dose" rather than to "cumulative dose"? Critical remarks on Maghin et al. Assessment protocol of mesothelioma and relevance of SEM-EDS analysis through a case studies of legal medicine of Brescia (Italy). Legal Medicine 2022;57:102076. Leg Med (Tokyo) 2023; 63:102262. [PMID: 37087784 DOI: 10.1016/j.legalmed.2023.102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 01/31/2023] [Accepted: 04/13/2023] [Indexed: 04/25/2023]
Affiliation(s)
- Pietro Gino Barbieri
- Occupational Health Unit and Mesothelioma Registry, ATS di Brescia, Brescia, Italy.
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Corrado Magnani
- Cancer Epidemiology Unit, Dept. of Translational Medicine, University of Eastern Piedmont and CPO-Piemonte, Novara, Italy
| | - Carolina Mensi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Mirabell
- Cancer Epidemiology Unit, CPO Piemonte e Università di Torino, Turin, Italy
| | - Paolo Ricci
- Epidemiology Unit, ATS della Val Padana, Mantua, Italy
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8
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Vimercati L, Cavone D, De Maria L, Caputi A, Pentimone F, Sponselli S, Delvecchio G, Chellini E, Binazzi A, Di Marzio D, Mensi C, Consonni D, Migliore E, Mirabelli D, Angelini A, Martini A, Negro C, D'Agostin F, Grappasonni I, Pascucci C, Benfatto L, Malacarne D, Casotto V, Comiati V, Storchi C, Mangone L, Murano S, Rossin L, Tallarigo F, Vitale F, Verardo M, Eccher S, Madeo G, Staniscia T, Carrozza F, Cozzi I, Romeo E, Pelullo P, Labianca M, Melis M, Cascone G, Marinaccio A, Ferri GM, Serio G. Mesothelioma Risk among Construction Workers According to Job Title: Data from the Italian Mesothelioma Register. Med Lav 2023; 114:e2023025. [PMID: 37309879 DOI: 10.23749/mdl.v114i3.14538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND An increased risk of mesothelioma has been reported in various countries for construction workers. The Italian National Mesothelioma Registry, from 1993 to 2018, reported exposure exclusively in the construction sector in 2310 cases. We describe the characteristics of these cases according to job title. METHODS We converted into 18 groups the original jobs (N=338) as reported by ISTAT codes ('ATECO 91'). The exposure level was attributed at certain, probable and possible in accordance with the qualitative classification of exposure as reported in the Registry guidelines. Descriptive analysis by jobs highlights the total number of subjects for each single job and certain exposure, in descending order, insulator, plumbing, carpenter, mechanic, bricklayer, electrician, machine operator, plasterer, building contractor, painter and labourer. RESULTS The cases grow for plumbing in the incidence periods 1993-2018, while, as expected, it decreases for insulator. Within each period considered the most numerous cases are always among bricklayers and labourers, these data confirm the prevalence of non-specialised "interchangeable" jobs in Italian construction sector in the past. CONCLUSIONS Despite the 1992 ban, the construction sector still presents an occupational health prevention challenge, circumstances of exposure to asbestos may still occur due to incomplete compliance with prevention and protection measures.
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Affiliation(s)
- Luigi Vimercati
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Op-erating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Domenica Cavone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Luigi De Maria
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Antonio Caputi
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Floriana Pentimone
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Stefania Sponselli
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | - Giuseppe Delvecchio
- Section of Occupational Medicine "B. Ramazzini", Department of Interdisciplinary Medicine, Regional Oper-ating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy.
| | | | - Alessandra Binazzi
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Com-pensation Authority (INAIL), 00143 Rome, Italy.
| | - Davide Di Marzio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Com-pensation Authority (INAIL), 00143 Rome, Italy.
| | - Carolina Mensi
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Gran-da Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Dario Consonni
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca' Gran-da Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10124 Torino, Italy.
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10124 Torino, Italy.
| | - Alessia Angelini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy.
| | - Andrea Martini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy.
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friuli-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy .
| | - Flavia D'Agostin
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friuli-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy .
| | - Iolanda Grappasonni
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, Uni-versity of Camerino, 62032 Camerino, Italy.
| | - Cristiana Pascucci
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, Uni-versity of Camerino, 62032 Camerino, Italy.
| | - Lucia Benfatto
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Davide Malacarne
- Regional Operating Center of Liguria (COR Liguria Regional Operating Center of Liguria (COR Liguria), Clinical Epidemiology Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
| | - Veronica Casotto
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Re-gion, 35131 Padova, Italy.
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Re-gion, 35131 Padova, Italy.
| | - Cinzia Storchi
- Health Local Unit, Public Health Department, Regional Operating Center of Emilia-Romagna (COR Emi-lia-Romagna), 42020 Reggio Emilia, Italy, Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Italy.
| | - Lucia Mangone
- Health Local Unit, Public Health Department, Regional Operating Center of Emilia-Romagna (COR Emi-lia-Romagna), 42020 Reggio Emilia, Italy, Epidemiology Unit, AUSL-IRCCS di Reggio Emilia, Italy.
| | - Stefano Murano
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Lucia Rossin
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy.
| | - Federico Tallarigo
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Filomena Vitale
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy.
| | - Marina Verardo
- Valle d'Aosta Health Local Unit, Regional Operating Center of Valle d'Aosta (COR Valle d'Aosta), 11100 Aosta, Italy.
| | - Silvia Eccher
- Hygiene and Occupational Medicine, Provincial Unit of Health, Regional Operating Center o Autonomous Province of Trento (COR A.P. of Trento), 38100 Trento, Italy.
| | - Gabriella Madeo
- Center of Umbria (COR Umbria), Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimentare-Regione Umbria, 06126 Perugia, Italy.
| | - Tommaso Staniscia
- Occupational Medicine Unit, Health Local Unit, Regional Operating Center of Abruzzo (COR Abruzzo), 65121 Pescara, Italy.
| | - Francesco Carrozza
- Oncology Unit, Cardarelli Hospital, Regional Operating Center of Molise (COR Molise), 86100 Campobasso, It-aly.
| | - Ilaria Cozzi
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Regional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Elisa Romeo
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Epidemiology Lazio Regional Health Service, ASL Roma 1, 00147 Roma, Italy.
| | - Paola Pelullo
- Department of Experimental Medicine, "Luigi Vanvitelli" University, Regional Operating Center of Campania (COR Campania), 80138 Napoli, Italy.
| | - Michele Labianca
- Epidemiologic Regional Center, Regional Operating Center of Basilicata (COR Basilicata), 85100 Potenza, Italy.
| | - Massimo Melis
- Regional Epidemiological Center, Regional Operating Center of Sardegna (COR Sardegna), 09125 Cagliari, Ita-ly.
| | - Giuseppe Cascone
- Cancer Registry ASP Ragusa and Sicilia Regional Epidemiological Observatory, Regional Operating Center of Sicilia (COR Sicilia), 97100 Ragusa, Italy.
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Com-pensation Authority (INAIL), 00143 Rome, Italy.
| | | | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathological Anatomy Section, University of Bari Aldo Moro, Bari, Italy.
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Mensi C, Stella S, Dallari B, Rugarli S, Pesatori AC, Ceresoli GL, Consonni D. Second Primary Cancers in a Population-Based Mesothelioma Registry. Cancers (Basel) 2023; 15:cancers15061746. [PMID: 36980631 PMCID: PMC10046097 DOI: 10.3390/cancers15061746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/17/2023] Open
Abstract
Background: The presence of a second primary cancer (SPC) in patients with pleural mesothelioma (PM) may impact overall survival and suggest a common mechanism of carcinogenesis or an underlying germline genetic alteration. Methods: We evaluated the occurrence of SPCs within PM cases collected from 2000 to 2018 by the Lombardy Mesothelioma Registry and their prognostic implications. Kaplan–Meier analysis was performed to estimate median survival times, together with univariate and multivariate Cox regression models to estimate hazard ratios (HR) and 95% confidence intervals (CI) of death. Results: The median overall survival (OS) of the entire study population (N = 6646) was 10.9 months (95% CI: 10.4–11.2); patient age and histotype were the strongest prognostic factors. No substantial survival difference was observed by the presence of an SPC (10.5 months in 1000 patients with an SPC vs. 10.9 months in 5646 patients in the non-SPC group, HR 1.03, p = 0.40). Shorter OS in the SPC group was only observed in 150 patients with the non-epithelioid subtype (median OS of 5.4 vs. 7.1 months, HR 1.21, p = 0.03). Conclusions: The diagnosis of an SPC did not influence the outcome of PM patients in the overall study population but was associated with shorter OS in non-epithelioid cases. Further studies are needed to clarify the role of SPCs as markers of genetic susceptibility in mesothelioma.
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Affiliation(s)
- Carolina Mensi
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-02-55032595
| | - Simona Stella
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Barbara Dallari
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Sabrina Rugarli
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Angela Cecilia Pesatori
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical and Community Science, Università degli Studi di Milano, 20122 Milan, Italy
| | | | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
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10
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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. Int J Environ Res Public Health 2023; 20:ijerph20020936. [PMID: 36673690 PMCID: PMC9858856 DOI: 10.3390/ijerph20020936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Guglielmucci F, Bonafede M, Azzolina D, Marinaccio A, Franzoi IG, Migliore E, Mensi C, Chellini E, Romeo E, Grosso F, Granieri A. Preliminary validation of a brief PROM assessing psychological distress in patients with malignant mesothelioma: The mesothelioma psychological distress tool-Patients. Front Psychol 2022; 13:974982. [PMID: 36506969 PMCID: PMC9732528 DOI: 10.3389/fpsyg.2022.974982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022] Open
Abstract
Objective Psychological suffering in malignant mesothelioma (MM) differs from that in other cancers because of its occupational etiology, and we aimed to develop specific patient-reported outcome measures to assess it. Methods We used a multi-method prospective observational multicentric study (N = 149), and a preliminary questionnaire validation was performed through a Bayesian approach. Results Item analysis showed a good internal consistency and reliability (Cronbach alpha = 0.79 [95% CI = 0.74-0.93]. Twenty of the 41 initial items were selected as posterior 95% highest density interval factor loading standardized effect size fell outside of the region of practical equivalence. Bayesian exploratory factor analysis showed a two-factor structure: (1) Trauma-related reactions (TR, 13 items) and (2) Claim for justice (CJ, 7 items), confirmed by the Bayesian confirmatory factor analysis. Latent factors were poorly correlated (Posterior median: 0.13; 95% CI = -0.079 to 0.323). The 90% root mean square error of approximation posterior median was 0.04 [90% CI = 0.03-0.58]; the 90% chi-square posterior median was 242 [90% CI = 209-287]. Conclusion Psychological suffering in MM patients implies negative cognitive, emotional, and somatic reactions related to the traumatic impact of the disease and the need to obtain justice through economic compensation. Our findings provide preliminary evidence that the Mesothelioma Psychological Distress Tool-Patients could be a promising and reliable instrument to assess MM patients' psychological distress.
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Affiliation(s)
- Fanny Guglielmucci
- Department of Philosophy, Communication and Performing Arts, University of Roma Tre, Rome, Italy
| | - Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy,*Correspondence: Michela Bonafede,
| | - Danila Azzolina
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | | | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, University of Turin and CPO-Piedmont, Turin, Italy
| | - Carolina Mensi
- COR Lombardy, Epidemiology Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Elisabetta Chellini
- COR Tuscany, Cancer Prevention and Research Institute, Unit of Environmental and Occupational Epidemiology, Florence, Italy
| | - Elisa Romeo
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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D'Aveni A, Stella S, Dallari B, Barile R, Rugarli S, Zellino C, Cerchiaro E, Riboldi L, Verusio C, Consonni D, Ceresoli G, Mensi C. EP07.01-005 Second Primary Cancers in a Population-Based Mesothelioma Registry. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Stoppa G, Mensi C, Fazzo L, Minelli G, Manno V, Consonni D, Biggeri A, Catelan D. Spatial Analysis of Shared Risk Factors between Pleural and Ovarian Cancer Mortality in Lombardy (Italy). Int J Environ Res Public Health 2022; 19:ijerph19063467. [PMID: 35329152 PMCID: PMC8949464 DOI: 10.3390/ijerph19063467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 01/04/2023]
Abstract
Background: Asbestos exposure is a recognized risk factor for ovarian cancer and malignant mesothelioma. There are reports in the literature of geographical ecological associations between the occurrence of these two diseases. Our aim was to further explore this association by applying advanced Bayesian techniques to a large population (10 million people). Methods: We specified a series of Bayesian hierarchical shared models to the bivariate spatial distribution of ovarian and pleural cancer mortality by municipality in the Lombardy Region (Italy) in 2000–2018. Results: Pleural cancer showed a strongly clustered spatial distribution, while ovarian cancer showed a less structured spatial pattern. The most supported Bayesian models by predictive accuracy (widely applicable or Watanabe–Akaike information criterion, WAIC) provided evidence of a shared component between the two diseases. Among five municipalities with significant high standardized mortality ratios of ovarian cancer, three also had high pleural cancer rates. Wide uncertainty was present when addressing the risk of ovarian cancer associated with pleural cancer in areas at low background risk of ovarian cancer. Conclusions: We found evidence of a shared risk factor between ovarian and pleural cancer at the small geographical level. The impact of the shared risk factor can be relevant and can go unnoticed when the prevalence of other risk factors for ovarian cancer is low. Bayesian modelling provides useful information to tailor epidemiological surveillance.
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Affiliation(s)
- Giorgia Stoppa
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, 35131 Padova, Italy; (A.B.); (D.C.)
- Correspondence: (G.S.); (C.M.)
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
- Correspondence: (G.S.); (C.M.)
| | - Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Rome, Italy;
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy; (G.M.); (V.M.)
| | - Valerio Manno
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy; (G.M.); (V.M.)
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, 35131 Padova, Italy; (A.B.); (D.C.)
| | - Dolores Catelan
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, 35131 Padova, Italy; (A.B.); (D.C.)
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15
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Spinazzè A, Consonni D, Borghi F, Rovelli S, Cattaneo A, Zellino C, Dallari B, Pesatori AC, Kromhout H, Peters S, Riboldi L, Cavallo DM, Mensi C. Asbestos Exposure in Patients with Malignant Pleural Mesothelioma included in the PRIMATE Study, Lombardy, Italy. IJERPH 2022; 19:ijerph19063390. [PMID: 35329075 PMCID: PMC8949216 DOI: 10.3390/ijerph19063390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 03/04/2022] [Accepted: 03/11/2022] [Indexed: 12/04/2022]
Abstract
The PRIMATE study is an Italian translational research project, which aims to identify personalized biomarkers associated with clinical characteristics of malignant pleural mesothelioma (MPM). For this purpose, characteristics of MPM patients with different degrees of asbestos exposure will be compared to identify somatic mutations, germline polymorphism, and blood inflammatory biomarkers. In this framework, we assessed exposure to asbestos for 562 cases of MPM extracted from the Lombardy region Mesothelioma Registry (RML), for which a complete interview based on a standardized national questionnaire and histopathological specimens were available. Exposure assessment was performed: (1) through experts' evaluation (considered as the gold standard for the purpose of this study), according to the guidelines of the Italian National Mesothelioma Registry (ReNaM) and (2) using a job-exposure matrix (SYN-JEM) to obtain qualitative (ever/never) and quantitative estimates of occupational asbestos exposure (cumulative exposure expressed in fibers per mL (f/mL)). The performance of SYN-JEM was evaluated against the experts' evaluation. According to experts' evaluation, occupational asbestos exposure was recognized in 73.6% of men and 23.6% of women; furthermore, 29 men (7.8%) and 70 women (36.9%) had non-occupational exposure to asbestos. When applying SYN-JEM, 225 men (60.5%) and 25 women (13.2%) were classified as occupationally exposed, with a median cumulative exposure higher for men (1.7 f/mL-years) than for women (1.2 f/mL-years). The concordance between the two methods (Cohen’s kappa) for occupational exposure assessment was 0.46 overall (0.41 in men, and 0.07 in women). Sensitivity was higher in men (0.73) than in women (0.18), while specificity was higher in women (0.88) than in men (0.74). Overall, both methods can be used to reconstruct past occupational exposure to asbestos, each with its own advantages and limitations.
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Affiliation(s)
- Andrea Spinazzè
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
- Correspondence:
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Francesca Borghi
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Sabrina Rovelli
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Andrea Cattaneo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Carolina Zellino
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Angela Cecilia Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands; (H.K.); (S.P.)
| | - Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, 3584 CM Utrecht, The Netherlands; (H.K.); (S.P.)
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
| | - Domenico Maria Cavallo
- Department of Science and High Technology, University of Insubria, 22100 Como, Italy; (F.B.); (S.R.); (A.C.); (D.M.C.)
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (D.C.); (C.Z.); (B.D.); (A.C.P.); (L.R.); (C.M.)
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16
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Mangone L, Mancuso P, Bisceglia I, Giorgi Rossi P, Chellini E, Negro C, Benfatto L, Migliore E, Casotto V, Mensi C, Romanelli A, Tumino R, Grappasonni I, Cavone D, Mazzoleni G, Tallarigo F, Marinaccio A. The impact of COVID-19 on new mesothelioma diagnoses in Italy. Thorac Cancer 2022; 13:702-707. [PMID: 35076994 PMCID: PMC8888152 DOI: 10.1111/1759-7714.14296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background The aim of this work was to evaluate the impact of the restrictions put in place to control the COVID‐19 pandemic on new diagnoses of malignant mesothelioma (MM) in Italy. Methods Twelve of the 21 Italian malignant mesothelioma CORs (regional operating centres) participated. The study included all cases of MM with microscopic confirmation; cases without microscopic confirmation and death certificate only (DCO) were excluded. For each case, information on sex, date of birth, tumor site, morphology, and date of diagnosis was retrieved. We compared the number of incident cases in 2020 with 2019, looking at the overall picture and for four periods: pre‐pandemic (January–February), first wave (March–May), low incidence (June–September), and second wave (October–December). Results A total of 604 cases were registered: 307 in 2019 and 297 in 2020. In the 2020 pre‐pandemic period, the incidence was higher than in the same months in 2019 (+45%); there was no significant change during the first wave (+1%) or in the low‐incidence period (−3%), while a decrease was observed during the second wave (−32%). However, the data were not homogeneous across the country: the increase in the pre‐pandemic period concerned mostly the regions of northern (+61.5%) and central Italy (+43.5%); during the first wave, MM diagnoses increased in the northern (+38.5%) and central (+11.4%) regions but decreased in the southern regions (−52.9%). All these differences are compatible with random fluctuations. Conclusion The COVID‐19 pandemic had little or no impact on new MM diagnoses, and variations were not homogeneous throughout the country.
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Affiliation(s)
- Lucia Mangone
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy.,COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Pamela Mancuso
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Isabella Bisceglia
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Reggio Emilia Cancer Registry, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Chellini
- COR Toscana, Unit of Occupational & Environmental Epidemiology, Institute for Cancer Research, Prevention and Clinical Network, Firenze, Italy
| | - Corrado Negro
- COR Friuli Venezia Giulia, Azienda Ospedaliero-Universitaria "Ospedali Riuniti di Trieste" Struttura Complessa Medicina del Lavoro, Trieste, Italy
| | - Lucia Benfatto
- COR Liguria, Epidemiologia Clinica, Istituto Nazionale per la Ricerca sul Cancro (IST-Nord), Dipartimento Terapie Oncologiche Integrate e IRCCS Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - Enrica Migliore
- COR Piemonte, Unità di Epidemiologia dei Tumori Città della salute e della scienza di Torino, Torino, Italy
| | - Veronica Casotto
- COR Veneto, Epidemiological Department, Azienda Zero, Veneto Region, Padova, Italy
| | - Carolina Mensi
- COR Lombardia, Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Romanelli
- COR Emilia-Romagna, Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Rosario Tumino
- COR Sicilia, Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy
| | - Iolanda Grappasonni
- COR Marche, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy
| | - Domenica Cavone
- COR Puglia, Interdisciplinary Department of Medicine, Section Occupational Medicine B. Ramazzini, School of Medicine, University Aldo Moro Bari, Bari, Italy
| | - Guido Mazzoleni
- COR Alto-Adige, Health Trust South Tyrol, South Tyrol, Italy
| | - Federico Tallarigo
- COR Calabria, c/o UOC Anatomia Patologica PO San Giovanni di Dio, ASP, Crotone, Italy
| | - Alessandro Marinaccio
- RENAM, INAIL (Italian Workers' Compensation Authority), Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Occupational and Environmental Epidemiology Unit, Rome, Italy
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17
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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. Med Lav 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] [What about the content of this article? (0)] [Affiliation(s)] [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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18
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Binazzi A, Di Marzio D, Verardo M, Migliore E, Benfatto L, Malacarne D, Mensi C, Consonni D, Eccher S, Mazzoleni G, Comiati V, Negro C, Romanelli A, Chellini E, Angelini A, Grappasonni I, Madeo G, Romeo E, Di Giammarco A, Carrozza F, Angelillo IF, Cavone D, Vimercati L, Labianca M, Tallarigo F, Tumino R, Melis M, Bonafede M, Scarselli A, Marinaccio A. Asbestos Exposure and Malignant Mesothelioma in Construction Workers-Epidemiological Remarks by the Italian National Mesothelioma Registry (ReNaM). Int J Environ Res Public Health 2021; 19:ijerph19010235. [PMID: 35010496 PMCID: PMC8744912 DOI: 10.3390/ijerph19010235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 12/20/2022]
Abstract
Notwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993–98 period to 23.9% in 2014–2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector.
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Affiliation(s)
- Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Marina Verardo
- Valle d’Aosta Health Local Unit, Regional Operating Center of Valle d’Aosta (COR Valle d’Aosta), 11100 Aosta, Italy;
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10124 Torino, Italy;
| | - Lucia Benfatto
- Regional Operating Center of Liguria (COR Liguria), UO Clinical Epidemiology, IRCCS AOU Policlinico San Martino, 16132 Genova, Italy; (L.B.); (D.M.)
| | - Davide Malacarne
- Regional Operating Center of Liguria (COR Liguria), UO Clinical Epidemiology, IRCCS AOU Policlinico San Martino, 16132 Genova, Italy; (L.B.); (D.M.)
| | - Carolina Mensi
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (D.C.)
| | - Dario Consonni
- Epidemiology Unit, Regional Operating Center of Lombardia (COR Lombardia), Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy; (C.M.); (D.C.)
| | - Silvia Eccher
- Hygiene and Occupational Medicine, Provincial Unit of Health, Regional Operating Center of Autonomous Province of Trento (COR A.P. of Trento), 38100 Trento, Italy;
| | - Guido Mazzoleni
- Occupational Medicine Unit, Alto Adige Health Authority, Regional Operating Center of Autonomous Province of Bolzano (COR A.P. of Bolzano), 39100 Bolzano, Italy;
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Regional Operating Center of Veneto (COR Veneto), Veneto Region, 35131 Padova, Italy;
| | - Corrado Negro
- Clinical Unit of Occupational Medicine, Regional Operating Center of Friuli-Venezia Giulia (COR Friuli-Venezia Giulia), University of Trieste-Trieste General Hospitals, 34123 Trieste, Italy;
| | - Antonio Romanelli
- Health Local Unit, Public Health Department, Regional Operating Center of Emilia-Romagna (COR Emilia-Romagna), 42020 Reggio Emilia, Italy;
| | - Elisabetta Chellini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy; (E.C.); (A.A.)
| | - Alessia Angelini
- Prevention and Clinical Network, Institute for Cancer Research, Regional Operating Center of Toscana (COR Toscana), 50139 Firenze, Italy; (E.C.); (A.A.)
| | - Iolanda Grappasonni
- Regional Operating Center of Marche (COR Marche), School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy;
| | - Gabriella Madeo
- Regional Operating Center of Umbria (COR Umbria), Servizio Prevenzione, Sanità Veterinaria e Sicurezza Alimentare-Regione Umbria, 06126 Perugia, Italy;
| | - Elisa Romeo
- Regional Operating Center of Lazio (COR Lazio), Department of Epidemiology, Lazio Region, 00143 Roma, Italy;
| | - Annamaria Di Giammarco
- Occupational Medicine Unit, Health Local Unit, Regional Operating Center of Abruzzo (COR Abruzzo), 65121 Pescara, Italy; or
| | - Francesco Carrozza
- Oncology Unit, Cardarelli Hospital, Regional Operating Center of Molise (COR Molise), 86100 Campobasso, Italy;
| | - Italo F. Angelillo
- Department of Experimental Medicine, “Luigi Vanvitelli” University, Regional Operating Center of Campania (COR Campania), 80138 Napoli, Italy; or
| | - Domenica Cavone
- Section of Occupational Medicine ‘‘B.Ramazzini’’, Department of Interdisciplinary Medicine, Regional Operating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy; (D.C.); (L.V.)
| | - Luigi Vimercati
- Section of Occupational Medicine ‘‘B.Ramazzini’’, Department of Interdisciplinary Medicine, Regional Operating Center of Puglia (COR Puglia), University of Bari, 70125 Bari, Italy; (D.C.); (L.V.)
| | - Michele Labianca
- Epidemiologic Regional Center, Regional Operating Center of Basilicata (COR Basilicata), 85100 Potenza, Italy;
| | - Federico Tallarigo
- Public Health Unit, Regional Operating Center of Calabria (COR Calabria), 88900 Crotone, Italy;
| | - Rosario Tumino
- Cancer Registry ASP Ragusa and Sicilia Regional Epidemiological Observatory, Regional Operating Center of Sicilia (COR Sicilia), 97100 Ragusa, Italy;
| | - Massimo Melis
- Regional Epidemiological Center, Regional Operating Center of Sardegna (COR Sardegna), 09125 Cagliari, Italy;
| | - Michela Bonafede
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Alberto Scarselli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00143 Roma, Italy; (A.B.); (D.D.M.); (M.B.); (A.S.)
- Correspondence: ; Tel.: +39-0654872621
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Binazzi A, Mensi C, Miligi L, Di Marzio D, Zajacova J, Galli P, Camagni A, Calisti R, Balestri A, Murano S, Piro S, d’Errico A, Bonzini M, Massacesi S, Sorasio D, Marinaccio A. Exposures to IARC Carcinogenic Agents in Work Settings Not Traditionally Associated with Sinonasal Cancer Risk: The Experience of the Italian National Sinonasal Cancer Registry. Int J Environ Res Public Health 2021; 18:ijerph182312593. [PMID: 34886319 PMCID: PMC8656996 DOI: 10.3390/ijerph182312593] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 11/16/2022]
Abstract
The aim of this study is to highlight tasks and jobs not commonly considered at high risk for sinonasal cancer (SNC) identified by Regional Operating Centers currently active in the Italian National Sinonasal Cancer Registry (ReNaTuNS), which retrieve occupational histories through a standardized questionnaire. Data on exposures to IARC carcinogenic agents in work settings unknown to be associated with SNC risk were collected and analyzed. Out of 2,208 SNC cases recorded in the ReNaTuNS database, 216 cases and their worked exposure periods were analyzed. Unsuspected jobs with exposure to wood dust include construction-related tasks, production of resins, agriculture and livestock jobs (straw and sawdust), and heel factory work (cork dust). Other examples are hairdressers, bakers (formaldehyde), dressmakers, technical assistants, wool and artificial fiber spinners, and upholsterers (textile dusts). Moreover, settings with coexposure to different agents (e.g., wood with leather dusts and chromium–nickel compounds) were recognized. The study describes jobs where the existence of carcinogenic agents associated with SNC risk is unexpected or not resulting among primary materials employed. The systematic epidemiological surveillance of all epithelial SNC cases with a detailed collection of their work history, as performed by a dedicated population registry, is essential for detecting all potential occupational cases and should be considered in the context of forensic medicine and the compensation process.
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Affiliation(s)
- Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (D.D.M.); (A.M.)
- Correspondence: ; Tel.: +39-0654872312
| | - Carolina Mensi
- Sinonasal Cancer Registry of Lombardy, Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy; (C.M.); (M.B.)
| | - Lucia Miligi
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Firenze, Italy; (L.M.); (S.P.)
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (D.D.M.); (A.M.)
| | - Jana Zajacova
- Sinonasal Cancer Registry of Piedmont, Occupational Health and Safety Department, CN1 Local Health Authority, 12037 Saluzzo, Italy; (J.Z.); (D.S.)
| | - Paolo Galli
- Sinonasal Cancer Registry of Emilia Romagna, Occupational Safety and Prevention Unit, Public Health Department, Bologna Local Health Authority, 40121 Bologna, Italy; (P.G.); (A.C.)
| | - Angela Camagni
- Sinonasal Cancer Registry of Emilia Romagna, Occupational Safety and Prevention Unit, Public Health Department, Bologna Local Health Authority, 40121 Bologna, Italy; (P.G.); (A.C.)
| | - Roberto Calisti
- Sinonasal Cancer Registry of Marche, Department of Prevention, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Regional Health Authority Marche, 62012 Civitanova Marche, Italy; (R.C.); (S.M.)
| | - Anna Balestri
- Sinonasal Cancer Registry of Lazio, Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy;
| | - Stefano Murano
- Sinonasal Cancer Registry of Autonomous Province of Bolzano, Alto Adige Health Authority, Occupational Medicine Unit, 39100 Bolzano, Italy;
| | - Sara Piro
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), 50139 Firenze, Italy; (L.M.); (S.P.)
| | - Angelo d’Errico
- Epidemiology, Local Health Unit ASL TO3, Piedmont Region, 10095 Grugliasco, Italy;
| | - Matteo Bonzini
- Sinonasal Cancer Registry of Lombardy, Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy; (C.M.); (M.B.)
- Department of Clinical Science and Community Health, University of Milano, 20100 Milano, Italy
| | - Stefania Massacesi
- Sinonasal Cancer Registry of Marche, Department of Prevention, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Regional Health Authority Marche, 62012 Civitanova Marche, Italy; (R.C.); (S.M.)
| | - Denise Sorasio
- Sinonasal Cancer Registry of Piedmont, Occupational Health and Safety Department, CN1 Local Health Authority, 12037 Saluzzo, Italy; (J.Z.); (D.S.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (D.D.M.); (A.M.)
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Binazzi A, Mensi C, Miligi L, Franchi A, Calisti R, Galli P, Romeo E, Zajacovà J, Mazzoleni G, Tonello A, Marinaccio A. [The new national guidelines for the keeping of the Italian Sinonasal Cancer Registry (ReNaTuNS)]. Epidemiol Prev 2021; 45:296-301. [PMID: 34549572 DOI: 10.19191/ep21.4.p296.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sinonasal cancers (SNC) are rare tumours with predominant occupational aetiology associated with exposures to specific carcinogens. In Italy, SNC incidence has been under compulsory surveillance since 2008, through the National Sinonasal Cancer Registry (ReNaTuNS), a nationwide cancer registry coordinated by the National Institute for Insurance Against Accidents at Work (Inail). The ReNaTuNS has a regional structure with local registries, established at Regional Operating Centres (CORs). Currently, seven Italian Regions are active in SNC search and, together with Inail, have recently released a new version of the national guidelines for keeping the Registry (available on the Inail website). The aim of this text is to present the new guidelines, an updating version, and to underline the relevance of this tool in enforcing the role of the ReNaTuNS, considering the high occupational fraction of SNC and the unicity of the Italian Registry, which collects all the information available on occupational exposures of each SNC case registered. It is recommended that the active search for SNC cases and the analysis of exposure become a systematic and well-organized activity to prevent or reduce risks of exposure and to support and improve the efficiency of the compensation and welfare system.
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Affiliation(s)
- Alessandra Binazzi
- Dipartimento di medicina, epidemiologia e igiene del lavoro e ambientale, Istituto nazionale assicurazione infortuni sul lavoro (Inail), Roma;
| | - Carolina Mensi
- Centro operativo regionale tumori naso-sinusali della Lombardia, UOC medicina del lavoro, Fondazione IRCCS Ca' Granda, Ospedale maggiore policlinico di Milano
| | - Lucia Miligi
- Centro operativo regionale tumori naso-sinusali della Toscana, SS Epidemiologia dell'ambiente e del lavoro, SC Epidemiologia dei fattori di rischio e degli stili di vita, Istituto per lo studio, la prevenzione e la rete oncologica (ISPRO), Firenze
| | - Alessandro Franchi
- Dipartimento di ricerca traslazionale e delle nuove tecnologie in medicina e chirurgia, Università degli Studi di Pisa
| | - Roberto Calisti
- Centro operativo regionale tumori naso-sinusali delle Marche, Dipartimento di prevenzione, Servizio prevenzione e sicurezza negli ambienti di lavoro ed epidemiologia occupazionale (SPreSAL Epi Occ), Azienda sanitaria unica regionale Marche, Civitanova Marche (MC)
| | - Paolo Galli
- Centro operativo regionale tumori naso-sinusali Emilia-Romagna, UOC prevenzione e sicurezza negli ambienti di lavoro Ovest, Azienda USL di Bologna
| | - Elisa Romeo
- Centro operativo regionale tumori naso-sinusali Lazio, Dipartimento di epidemiologia del Servizio sanitario regionale del Lazio, ASL Roma 1, Roma
| | - Jana Zajacovà
- Centro operativo regionale tumori naso-sinusali Piemonte, ASL CN1, Cuneo
| | - Guido Mazzoleni
- Centro operativo regionale tumori naso-sinusali della PA di Bolzano, c/o Azienda sanitaria dell'Alto Adige, Servizio aziendale di medicina del lavoro - Sezione ispettorato medico del lavoro, Bolzano
| | - Alberta Tonello
- Centro operativo regionale tumori naso-sinusali della PA di Trento, c/o Azienda provinciale per i servizi sanitari, Unità operativa prevenzione e sicurezza negli ambienti di lavoro, Servizio di medicina del lavoro, Trento
| | - Alessandro Marinaccio
- Dipartimento di medicina, epidemiologia e igiene del lavoro e ambientale, Istituto nazionale assicurazione infortuni sul lavoro (Inail), Roma
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Bonafede M, Chiorri C, Azzolina D, Marinaccio A, Migliore E, Mensi C, Chellini E, Romeo E, Grosso F, Franzoi IG, Granieri A, Guglielmucci F. Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool-Caregivers. Psychooncology 2021; 31:122-129. [PMID: 34406682 DOI: 10.1002/pon.5789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To develop a short, flexible, and comprehensive tool to measure psychological distress in caregivers of malignant mesothelioma (MM) patients: the Mesothelioma Psychological Distress Tool-Caregivers version (MPDT-C). METHODS Based on a systematic review of the relevant literature, aspects associated with caregiver distress were derived. Expert researchers/clinicians developed a pool of items for each identified aspect. Content validity was assessed through a multiple mixed-methods approach. A multicenter study was conducted to explore the factorial structure of the 47-item MPDT-C through Bayesian factor analysis. RESULTS The Bayesian exploratory factor analysis revealed an underlying three-factor structure. Factors were labeled Secondary Traumatic Stress, Engagement in Caring, and Meaningful Cognitive Restructuring. All scales showed sufficient reliability and corrected item-total correlations. Females scored higher than males for Engagement in Caring. CONCLUSIONS Taking care of malignant mesothelioma patients is a stressful process that influences the caregiver's physical, emotional, and social wellbeing. Our study offers preliminary evidence in support of the adequate psychometric properties of the MPDT-C, and these should now be replicated. Results suggest that the MPDT-C is a reliable tool with which to detect the psychological distress of this traumatized population.
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Affiliation(s)
- Michela Bonafede
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Carlo Chiorri
- Department of Educational Sciences, University of Genoa, Genova, Italy
| | - Danila Azzolina
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Enrica Migliore
- COR Piedmont, Unit of Cancer Epidemiology, CPO Piedmont, University of Turin, Turin, Italy
| | - Carolina Mensi
- COR Lombardy, Epidemiology Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and University of Milan, Milano, Italy
| | - Elisabetta Chellini
- COR Tuscany, Cancer Prevention and Research Institute, Unit of Environmental and Occupational Epidemiology, Firenze, Italy
| | - Elisa Romeo
- COR Lazio, Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
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Chellini E, Donzellini M, Ricciardi S, Kundisova L, Giovannetti L, Battisti F, Giusti M, Dallarti B, Mensi C. [BRIC-59 study: first results and considerations on the pathway on the access to health care for malignant pleural mesotheliomas]. Epidemiol Prev 2021; 45:72-81. [PMID: 33884845 DOI: 10.19191/ep21.1-2.p072.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES to define the most frequent health pathways of cases affected by malignant pleural mesothelioma according to those suggested and evaluated by the most recent specific guidelines. DESIGN epidemiological descriptive study. SETTING AND PARTICIPANTS 100 cases histologically or cytologically well defined during 2015-2017 are extracted from the archive of two Regional Mesothelioma Registries: in Tuscany Region (Central Italy) they are randomly extracted, while in Lombardy Region (Northern Italy) cases treated by a highly-specialized health centre are collected. MAIN OUTCOME MEASURES frequency of the diagnostic and therapeutic procedures; development and application of the checklist with evaluation of the duration of some phases of the predefined pathway. RESULTS all hospital medical records were collected only for 34 cases in Tuscany and 20 cases in Lombardy. The health examinations were supplied according to each case's health condition and it was not possible to define one or more structured and standardized pathways. The pre-diagnostic phase has a variable duration according to the initial health condition of the patient, also for his/her comorbidity, and to the hospital where he/she was hospitalized at first. The examinations in outpatient services (medical examinations, blood chemistry tests and radiological examinations) are several, but they are specially requested during the pre-diagnostic phase and during the period of chemotherapy. The checklist applied to a subset of Tuscan cases shows a large variation of the length of the pre-diagnostic phase (6-330 days), of the time interval between diagnosis and reporting to mesothelioma registry (1-200 days), and of the survival time (8 days - alive at 31.12.2019). CONCLUSIONS to obtain the best health pathways for malignant pleural mesotheliomas, it is necessary a strong network among the health regional services with a clinical multiprofessional coordination located in hospitals characterized by a long experience on these cases, and with an active regional monitoring on all clinical, psychological, epidemiological, and legal aspects of the pathway. The regional mesothelioma registries could give a high contribution thanks to their epidemiological skills which are necessary for the monitoring.
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Affiliation(s)
| | | | - Sara Ricciardi
- Scuola di specializzazione in chirurgia toracica, Università degli Studi di Pisa
| | - Lucia Kundisova
- Scuola di specializzazione in igiene e sanità pubblica, Università degli studi di Siena
| | - Lucia Giovannetti
- Istituto per lo studio, la prevenzione e la rete oncologica, Firenze
| | - Francesca Battisti
- SC screening e prevenzione secondaria, Istituto per lo studio, la prevenzione e la rete oncologica, Firenze
| | | | - Barbara Dallarti
- Registro mesoteliomi della Lombardia, UOC medicina del lavoro, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano
| | - Carolina Mensi
- Registro mesoteliomi della Lombardia, UOC medicina del lavoro, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico di Milano
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Mensi C, Zellino C, Polonioli M, Dallari B, Pesatori AC, Riboldi L, Consonni D. Pleural mesothelioma in a circus worker. J Occup Health 2021; 63:e12250. [PMID: 34350658 PMCID: PMC8344853 DOI: 10.1002/1348-9585.12250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/17/2021] [Accepted: 06/16/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES To describe an unusual occupational asbestos exposure in a patient with mesothelioma. METHODS Since 2000, the Lombardy Mesothelioma Registry (LMR) collects cases of malignant mesothelioma (MM) occurring among people residing in the Lombardy Region, North-West Italy, with a population of 10 million inhabitants. For each case, clinical records and asbestos exposure are collected. Each case is then classified in agreement with the guidelines of the National Mesothelioma Registry. RESULTS We identified a male (86 years old), former smoker, who had been working for 53 years as a circus truck driver and tamer of lions and tigers. The first circumstance of exposure was the use of an asbestos tape that wrapped around the hoop in the feline jumping show with a flaming hoop. The second one was the presence of insulating panels protecting the engine placed inside the trucks. CONCLUSION A new MM case with an occupational etiology has been found in the public entertainment, an occupational sector not usually considered at risk for the presence of asbestos.
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Affiliation(s)
- Carolina Mensi
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Carolina Zellino
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Marco Polonioli
- Post Graduation School of Occupational MedicineUniversità degli Studi di MilanoMilanItaly
| | - Barbara Dallari
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Angela Cecilia Pesatori
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
- Department of Clinical Sciences and Community HealthUniversità degli Studi di MilanoMilanItaly
| | - Luciano Riboldi
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
| | - Dario Consonni
- Occupational Health UnitFondazione IRCCS Ca’ Granda Ospedale Maggiore PoliclinicoMilanItaly
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Marinaccio A, Consonni D, Mensi C, Mirabelli D, Migliore E, Magnani C, Di Marzio D, Gennaro V, Mazzoleni G, Girardi P, Negro C, Romanelli A, Chellini E, Grappasonni I, Madeo G, Romeo E, Ascoli V, Carrozza F, Angelillo IF, Cavone D, Tumino R, Melis M, Curti S, Brandi G, Mattioli S, Iavicoli S. Authors' response: Mezei et al's "Comments on a recent case-control study of malignant mesothelioma of the pericardium and the tunica vaginalis testis". Scand J Work Environ Health 2021; 47:87-89. [PMID: 33388783 PMCID: PMC7801133 DOI: 10.5271/sjweh.3910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Alessandro Marinaccio
- Epidemiology Unit, Occupational and Environmental Medicine, Epidemiology and Hygiene Department, INAIL (Italian national workers compensation authority), Via Stefano Gradi 55, 00143 Rome, Italy. E-mail:
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Mensi C, Binazzi A, Miligi L, Franchi A, Calisti R, Galli P, Romeo E, Zajacovà J, Marinaccio A. [The new ReNaTuNS operating manual for nasal sinus tumor case management]. G Ital Med Lav Ergon 2020; 42:242-243. [PMID: 33600647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
No abstract available.
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Affiliation(s)
- Carolina Mensi
- Centro Operativo Regionale Tumori Naso-Sinusali Lombardia, UOC Medicina del Lavoro, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | - Alessandra Binazzi
- INAIL - Dipartimento di medicina, epidemiologia, igiene del lavoro e ambientale, Roma
| | - Lucia Miligi
- Centro Operativo Regionale Tumori Naso-Sinusali Toscana, SS Epidemiologia dell'ambiente e del lavoro - SC Epidemiologia dei fattori di rischio e degli stili di vita. Istituto per lo studio, la prevenzione e la rete oncologica (Ispro), Firenze
| | - Alessandro Franchi
- Università degli studi di Pisa, Dipartimento di ricerca traslazionale e delle nuove tecnologie in medicina e chirurgia
| | - Roberto Calisti
- Centro Operativo Regionale Tumori Naso-Sinusali Marche, ASUR Marche, Dipartimento di prevenzione, SPreSAL Epidemiologia occupazionale Civitanova Marche
| | - Paolo Galli
- Centro Operativo Regionale Tumori Naso-Sinusali Emilia-Romagna, UOC Prevenzione e sicurezza ambienti di lavoro Ovest, Dipartimento di sanità pubblica, Azienda USL di Bologna
| | - Elisa Romeo
- Centro Operativo Regionale Tumori Naso-Sinusali Lazio, Dipartimento di epidemiologia del SSR, ASL RM1 - Regione Lazio, Roma
| | - Jana Zajacovà
- Centro Operativo Regionale Tumori Naso-Sinusali Piemonte, ASL CN1, Cuneo
| | - Alessandro Marinaccio
- INAIL - Dipartimento di medicina, epidemiologia, igiene del lavoro e ambientale, Roma
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Marinaccio A, Consonni D, Mensi C, Mirabelli D, Migliore E, Magnani C, Di Marzio D, Gennaro V, Mazzoleni G, Girardi P, Negro C, Romanelli A, Chellini E, Grappasonni I, Madeo G, Romeo E, Ascoli V, Carrozza F, Angelillo IF, Cavone D, Tumino R, Melis M, Curti S, Brandi G, Mattioli S, Iavicoli S. Association between asbestos exposure and pericardial and tunica vaginalis testis malignant mesothelioma: a case-control study and epidemiological remarks. Scand J Work Environ Health 2020; 46:609-617. [PMID: 32253443 PMCID: PMC7737812 DOI: 10.5271/sjweh.3895] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Indexed: 12/11/2022] Open
Abstract
Objectives The purposes of this study are to describe the epidemiology of pericardial and tunica vaginalis testis mesothelioma and assess the role of asbestos exposure for these rare diseases. Methods Based on incident pericardial and tunica vaginalis testis mesothelioma cases collected from the Italian national mesothelioma registry (ReNaM) in the period 1993-2015, incidence rates, survival median period and prognostic factors have been evaluated. A case-control study has been performed to analyze the association with asbestos exposure (occupational and non-occupational) for these diseases. Results Between 1993 and 2015, 58 pericardial (20 women and 38 men) and 80 tunica vaginalis testis mesothelioma cases have been registered with a mean annual standardized (world standard population as reference) incidence rates of 0.049 (per million) in men and 0.023 in women for the pericardial site, and 0.095 for tunica vaginalis testis mesothelioma. Occupational exposure to asbestos was significantly associated with the risk of the diseases [odds ratio (OR) 3.68, 95% confidence interval (CI) 1.85-7.31 and OR 3.42, 95% CI 1.93-6.04 in pericardial and tunica vaginalis testis mesothelioma, respectively]. The median survival was 2.5 months for pericardial and 33.0 months for tunica vaginalis testis mesotheliomas. Age was the main predictive factor for survival for both anatomical sites. Conclusions For the first time in an analytical study, asbestos exposure was associated with pericardial and tunica vaginalis testis mesothelioma risk, supporting the causal role of asbestos for all anatomical sites. The extreme rarity of the diseases, the poor survival and the prognostic role of age have been confirmed based on population and nationwide mesothelioma registry data.
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Affiliation(s)
- Alessandro Marinaccio
- Epidemiology Unit, Occupational and Environmental Medicine, Epidemiology and Hygiene Department, INAIL, Via Stefano Gradi 55, 00143 Rome, Italy.
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Catelan D, Consonni D, Biggeri A, Dallari B, Pesatori AC, Riboldi L, Mensi C. Estimate of environmental and occupational components in the spatial distribution of malignant mesothelioma incidence in Lombardy (Italy). Environ Res 2020; 188:109691. [PMID: 32526494 DOI: 10.1016/j.envres.2020.109691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 05/15/2020] [Accepted: 05/15/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Measuring and mapping the occurrence of malignant mesothelioma (MM) is a useful means to monitor the impact of past asbestos exposure and possibly identify previously unknown sources of asbestos exposure. OBJECTIVE Our goal is to decompose the observed spatial pattern of incidence of MM in the Lombardy region (Italy) in gender-specific components linked to occupational exposure and a shared component linked to environmental exposure. MATERIALS AND METHODS We selected from the Lombardy Region Mesothelioma Registry (RML) all incident cases of MM (pleura, peritoneum, pericardium, and tunica vaginalis testis) with first diagnosis in the period 2000-2016. We mapped at municipality level crude incidence rates and smoothed rates using the Besag York and Mollié model separately for men and women. We then decomposed the spatial pattern of MM in gender-specific occupational components and a shared environmental component using a multivariate hierarchical Bayesian model. RESULTS We globally analyzed 6226 MM cases, 4048 (2897 classified as occupational asbestos exposure at interview) in men and 2178 (780 classified as occupational asbestos exposure at interview) in women. The geographical analysis showed a strong spatial pattern in the distribution of incidence rates in both genders. The multivariate hierarchical Bayesian model decomposed the spatial pattern in occupational and environmental components and consistently identified some known occupational and environmental hot spots. Other areas at high risk for MM occurrence were highlighted, contributing to better characterize environmental exposures from industrial sources and suggesting a role of natural sources in the Alpine region. CONCLUSION The spatial pattern highlights areas at higher risk which are characterized by the presence of industrial sources - asbestos-cement, metallurgic, engineering, textile industries - and of natural sources in the Alpine region. The multivariate hierarchical Bayesian model was able to disentangle the geographical distribution of MM cases in two components interpreted as occupational and environmental.
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Affiliation(s)
- Dolores Catelan
- Department of Statistics Computer Science Applications "G. Parenti", University of Florence, Florence, Italy.
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Annibale Biggeri
- Department of Statistics Computer Science Applications "G. Parenti", University of Florence, Florence, Italy
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela C Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical and Community Sciences, University of Milan, Milan, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
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Marinaccio A, Corfiati M, Binazzi A, Di Marzio D, Bonafede M, Verardo M, Migliore E, Gennaro V, Mensi C, Schallemberg G, Mazzoleni G, Fedeli U, Negro C, Romanelli A, Chellini E, Grappasonni I, Pascucci C, Madeo G, Romeo E, Trafficante L, Carrozza F, Angelillo IF, Cavone D, Cauzillo G, Tallarigo F, Tumino R, Melis M. The epidemiological surveillance of malignant mesothelioma in Italy (1993-2015): methods, findings, and research perspectives. Epidemiol Prev 2020; 44:23-30. [PMID: 32374111 DOI: 10.19191/ep20.1.p023.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND as a legacy of the large asbestos consumption until the definitive ban in 1992, Italy had to tackle a real epidemic of asbestos related diseases. The Italian National Registry of Malignant Mesotheliomas (ReNaM) is a permanent surveillance system of mesothelioma incidence, with a regional structure. Aims, assignments and territorial network of ReNaM are described, as well as data collection, recording and coding procedures. OBJECTIVES to describe the Italian epidemiological surveillance system of mesothelioma incidence, to provide updated data about occurrence of malignant mesothelioma in Italy, and to discuss goals, attainments, and expectations of registering occupational cancer. DESIGN analysis of data by malignant mesothelioma incident cases surveillance system. SETTING AND PARTICIPANTS Italy, network of regional surveillance system, all Italian regions. MAIN OUTCOME MEASURES a Regional Operating Centre (COR) is currently established in all the Italian regions, actively searching incident malignant mesothelioma cases from health care institutions. Occupational history, lifestyle habits, and residential history are obtained using a standardized questionnaire, administered to the subject or to the next of kin by a trained interviewer. The extent of dataset, epidemiological parameters, and occupations involved are reported updated at 31.12.2016, and standardized incidence rates are calculated. RESULTS at December 2016, ReNaM has collected 27,356 malignant mesothelioma cases, referring to the period of incidence 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 defined cases (14,818). CONCLUSIONS the Italian experience shows that epidemiological systematic surveillance of asbestos related diseases incidence has a key importance for assessing and monitoring the public health impact of occupational and/or environmental hazards, programming preventive interventions, including remediation plans and information campaigns, and supporting the efficiency of insurance and welfare system. Monitoring the incidence of malignant mesothelioma through a specialized cancer registry is essential to follow-up the health effects of changing modalities and extent of occupational exposures over years and of environmental contamination. Such consolidated surveillance system is recommended also for occupational cancers with low aetiological fraction.
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Affiliation(s)
- Alessandro Marinaccio
- Department of occupational and environmental medicine, epidemiology and hygiene, Italian Workers Compensation Authority (Inail), Roma (Italy);
| | - Marisa Corfiati
- Department of occupational and environmental medicine, epidemiology and hygiene, Italian Workers Compensation Authority (Inail), Roma (Italy)
| | - Alessandra Binazzi
- Department of occupational and environmental medicine, epidemiology and hygiene, Italian Workers Compensation Authority (Inail), Roma (Italy)
| | - Davide Di Marzio
- Department of occupational and environmental medicine, epidemiology and hygiene, Italian Workers Compensation Authority (Inail), Roma (Italy)
| | - Michela Bonafede
- Department of occupational and environmental medicine, epidemiology and hygiene, Italian Workers Compensation Authority (Inail), Roma (Italy)
| | - Marina Verardo
- Regional Operating Center of Valle d'Aosta, Valle d'Aosta Local Health Unit, Aosta (Italy)
| | - Enrica Migliore
- Regional Operating Center of Piedmont, Unit of Cancer Prevention, University of Turin and CPO-Piemonte, Turin (Italy)
| | - Valerio Gennaro
- Regional Operating Center of Liguria, Operative unit of Epidemiology, IRCCS University Hospital San Martino, National Cancer Research Institute (IST), Genoa (Italy)
| | - Carolina Mensi
- Regional Operating Center of Lombrady, IRCCS Ca' Granda Foundation, Ospedale Maggiore Policlinico and University of Milan, Milan (Italy)
| | - Gert Schallemberg
- Regional Operating Center of the Province of Trento, Provincial Unit of Health, hygiene and occupational medicine, Trento (Italy)
| | - Guido Mazzoleni
- Regional Operating Center of the Province of Bolzano, Alto Adige Local Health Unit, Bolzano (Italy)
| | - Ugo Fedeli
- Regional Operating Center of Veneto, Epidemiological Department, Azienda Zero, Padua (Italy)
| | - Corrado Negro
- Regional Operating Center of Friuli Venezia Giulia, University of Trieste, Clinical Unit of Occupational Medicine, Trieste General Hospitals, Trieste (Italy)
| | - Antonio Romanelli
- Regional Operating Center of Emilia-Romagna, Public Health Department, Local Health Unit, Reggio Emilia (Italy)
| | - Elisabetta Chellini
- Regional Operating Center of Tuscany, Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute, Florence (Italy)
| | - Iolanda Grappasonni
- Regional Operating Center of Marche, Hygienistic, Environmental and Health Sciences Department, School of Sciences of the drug and the products of health, University of Camerino, Camerino (Italy)
| | - Cristiana Pascucci
- Regional Operating Center of Marche, Hygienistic, Environmental and Health Sciences Department, School of Sciences of the drug and the products of health, University of Camerino, Camerino (Italy)
| | - Gabriella Madeo
- Regional Operating Center of Umbria, Department of Experimental Medicine, Public Health section, University of Perugia, Perugia (Italy)
| | - Elisa Romeo
- Regional Operating Center of Lazio, Department of Epidemiology, Lazio Region, Rome (Italy)
| | - Luana Trafficante
- Regional Operating Center of Abruzzo, Occupational Medicine Unit, Local Health Unit, Pescara (Italy)
| | - Francesco Carrozza
- Regional Operating Center of Molise, Oncology Unit, Cardarelli Hospital, Campobasso (Italy)
| | - Italo Francesco Angelillo
- Regional Operating Center of Campania, Department of Experimental Medicine, Second University of Naples, Naples (Italy)
| | - Domenica Cavone
- Regional Operating Center of Puglia, Department of Interdisciplinary Medicine, Section of Occupational Medicine "B. Ramazzini", University of Bari, Bari (Italy)
| | - Gabriella Cauzillo
- Regional Operating Center of Basilicata, Epidemiological Regional Center, Potenza (Italy)
| | - Federico Tallarigo
- Regional Operating Center of Calabria, Public Health Unit, Crotone (Italy)
| | - Rosario Tumino
- Regional Operating Center of Sicily, Cancer Registry, Provincial Health Department of Ragusa and Sicily Regional Epidemiological Observatory, Ragusa (Italy)
| | - Massimo Melis
- Regional Operating Center of Sardegna, Regional Epidemiological Center, Cagliari (Italy)
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Trama A, Proto C, Signorelli D, Garassino MC, Lo Russo G, Ganzinelli M, Prelaj A, Mensi C, Gangemi M, Gennaro V, Chellini E, Caldarella A, Angelillo IF, Ascoli V, Pascucci C, Tagliabue G, Cusimano R, Bella F, Falcini F, Merler E, Masanotti G, Ziino A, Michiara M, Gola G, Storchi C, Mangone L, Vitale MF, Cirilli C, Tumino R, Scuderi T, Fanetti AC, Piffer S, Tiseo M, Gatta G, Botta L. Treatment patterns among patients with malignant pleural mesothelioma: An Italian, population-based nationwide study. Thorac Cancer 2020; 11:1661-1669. [PMID: 32364316 PMCID: PMC7262944 DOI: 10.1111/1759-7714.13456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 02/29/2020] [Indexed: 12/01/2022] Open
Abstract
Background Malignant pleural mesothelioma (MPM) is a rare cancer with a poor prognosis. Centralization of rare cancer in dedicated centers is recommended to ensure expertise, multidisciplinarity and access to innovation. In Italy, expert centers for MPM have not been identified in all regions. We aimed to describe the treatment patterns among MPM patients across different Italian regions and to identify factors associated with the treatment patterns across the regions. Methods We performed an observational study on a random sample of 2026 MPM patients diagnosed in 2003–2008. We included 26 population‐based registries covering 70% of the Italian population. To identify factors associated with treatment patterns, across the different regions, we fitted a multinomial logistic regression model adjusted by age, sex, stage, histology and hospital with thoracic surgical department. Results MPM patients mostly received chemotherapy alone (41%) or no cancer‐directed therapy (36%) especially the older patients. The first course of treatment for MPM patients differed across regions. Patients from Piedmont, Liguria and Campania were more likely to receive no cancer‐directed therapy; those living in Tuscany and Sicily were more likely to get surgery; patients from Marche and Lazio were more likely to receive chemotherapy. These differences were not explained by age, sex, stage, histology and availability of a thoracic surgery department. Conclusions There is limited expertise available and lack of a network able to maximize the expertise available may contribute to explaining the results of our study. Our findings support the need to ensure the appropriate care of all MPM patients in reorganizing the health care services. Key points
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Affiliation(s)
- Annalisa Trama
- Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Claudia Proto
- Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Diego Signorelli
- Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Marina C Garassino
- Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Giuseppe Lo Russo
- Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Monica Ganzinelli
- Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Arsela Prelaj
- Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
| | - Carolina Mensi
- COR Lombardy, Epidemiology Unit,Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico and University of Milan, Milan, Italy
| | - Manuela Gangemi
- Unit of Cancer Epidemiology, University of Turin and CPO-Piemonte, Turin, Italy
| | - Valerio Gennaro
- COR Liguria, UO Epidemiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Elisabetta Chellini
- Unit of Occupational & Environmental Epidemiology, Tuscan Occupational Cancer Registry, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Adele Caldarella
- Tuscan Cancer Registry, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Italo F Angelillo
- Department of Experimental Medicine, COR Campania, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Valeria Ascoli
- Department of Radiological Sciences, Oncology and Anatomical Pathology, COR Lazio, University La Sapienza, Rome, Italy
| | - Cristiana Pascucci
- Mesothelioma Marche Registry - COR Marche, School of Medicinal and Health Products Sciences, University of Camerino, Camerino, Italy
| | - Giovanna Tagliabue
- Varese Cancer Registry, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Francesca Bella
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Azienda Ospedaliero-Universitaria Policlinico-Vittorio Emanuale, Catania, Italy
| | - Fabio Falcini
- Romagna Cancer Registry, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Forlì, Italy
| | - Enzo Merler
- COR Veneto, Occupational Health Unit, Department of Prevention, Padua, Italy
| | - Giuseppe Masanotti
- Sec. Public Health, Department of Experimental Medicine, COR Umbria, University of Perugia, Perugia, Italy
| | | | | | | | - Cinzia Storchi
- Servizio di Epidemiologia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Lucia Mangone
- Servizio di Epidemiologia, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria F Vitale
- U.O.S.D. Napoli 3 South Cancer Registry, Piazza San Giovanni, Naples, Italy
| | | | - Rosario Tumino
- Cancer Registry and Histopathology Deaprtment, COR Sicily, 'Civic -M.P. Arezzo' Hospital, Ragusa, Italy
| | | | | | - Silvano Piffer
- Trento Cancer Registry, Servizio Epidemiologia Clinica e Valutativa, Azienda Provinciale per i Servizi Sanitari, Trento, Italy
| | - Marcello Tiseo
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Gemma Gatta
- Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Laura Botta
- Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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- Research Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Medical Oncology, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Consonni D, De Matteis S, Dallari B, Pesatori AC, Riboldi L, Mensi C. Impact of an asbestos cement factory on mesothelioma incidence in a community in Italy. Environ Res 2020; 183:108968. [PMID: 31812249 DOI: 10.1016/j.envres.2019.108968] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Broni is a small town (9000 inhabitants) in the province of Pavia, Lombardy, north-west Italy, where the second largest Italian asbestos cement factory (Fibronit) was in operation between 1932 and 1993. Based on Lombardy Mesothelioma Registry (RML) data (2000-2011), we previously showed a high impact of asbestos exposure on malignant mesothelioma (MM) incidence among Fibronit workers, their families, and people living in Broni and in the nearby town of Stradella (11,000 residents). Given the great concern of the community, we have recently updated the data regarding 5 more years (2012-2016). METHODS From the RML database we extracted subjects who ever worked in Fibronit, their family members, ever residents in Broni, and subjects living in Stradella and nearby towns at the time of diagnosis. For each type of exposure we calculated standardized incidence ratios (SIR = observed/expected cases). RESULTS In the period 2000-2016 we registered 56 cases (2.52 expected, SIR = 22.2), 49 men (41 pleural, 8 peritoneal MM), 7 women (5 pleural, 2 peritoneal MM) with past occupational exposure in Fibronit. Among subjects never occupationally exposed and never exposed to extra-occupational sources unrelated to Fibronit, we counted 39 cases (4.24 expected, SIR = 9.2), 10 men (all pleural MM), 29 women (28 pleural, 1 peritoneal MM) in Fibronit workers' families, 91 pleural mesothelioma cases (7.43 expected, SIR = 12.2, 31 men, 60 women), ever residents in Broni, and 25 pleural mesothelioma cases (3.05 expected, SIR = 8.2, 6 men, 19 women) living in Stradella at the time of diagnosis. The overall number of excess cases was about 194 (211 against 17.24 expected). In the remaining adjacent (No. 8) and surrounding (No. 17) municipalities (32,000 people) there were 7 cases (1 men, 6 women, 8.85 expected). CONCLUSION The mesothelioma burden related to the asbestos cement factory is still high on factory workers, their families, and residents in Broni and Stradella towns.
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, UK.
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Angela C Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Consonni D, Mensi C. Comment on the paper 'Boffetta et al. Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy. Ann Oncol 2018; 29(2): 484-489'. Ann Oncol 2019; 30:340-341. [PMID: 30475941 DOI: 10.1093/annonc/mdy521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - C Mensi
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Consonni D, Migliore E, Barone-Adesi F, Dallari B, De Matteis S, Oddone E, Pesatori AC, Riboldi L, Mirabelli D, Mensi C. Gender differences in pleural mesothelioma occurrence in Lombardy and Piedmont, Italy. Environ Res 2019; 177:108636. [PMID: 31419715 DOI: 10.1016/j.envres.2019.108636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Higher mesothelioma rates in men (vs women) reflect more frequent and more intense asbestos exposure. We assessed the impact of exposure difference between genders on age-specific rates of pleural mesothelioma (PM) occurrence using data from two Italian regions. METHODS We used data from the Lombardy and Piedmont mesothelioma registries (period 2000-2016, age 45-74 years) to compare rates of PM in men and women and to estimate the rate advancement period (RAP). RESULTS Based on 3384 cases (2405 men, 979 women) in Lombardy and 2042 (1389 men, 653 women) in Piedmont, the rate ratio was 2.81 (90% confidence interval: 2.61-3.03) in Lombardy and 2.39 (2.17-2.62) in Piedmont. In both regions RAP ranged from 7 to 10 years (at age 45 and 63 in men, respectively). CONCLUSION Men showed more than twofold increased PM rates and reached the same incidence as women 7-10 years earlier. RAP can be a useful measure of exposure impact on premature disease occurrence.
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | | | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, UK and Humanitas University, Milan, Italy.
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, and ICS Maugeri IRCCS, Pavia, Italy.
| | - Angela C Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy.
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Consonni D, Calvi C, De Matteis S, Mirabelli D, Landi MT, Caporaso NE, Peters S, Vermeulen R, Kromhout H, Dallari B, Pesatori AC, Riboldi L, Mensi C. Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Lombardy, Italy. Occup Environ Med 2019; 76:545-553. [PMID: 31285358 PMCID: PMC6703122 DOI: 10.1136/oemed-2019-105826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/25/2019] [Accepted: 06/12/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Asbestos is the main risk factor for peritoneal mesothelioma (PeM). However, due to its rarity, PeM has rarely been investigated in community-based studies. We examined the association between asbestos exposure and PeM risk in a general population in Lombardy, Italy. METHODS From the regional mesothelioma registry, we selected PeM cases diagnosed in 2000-2015. Population controls (matched by area, gender and age) came from two case-control studies in Lombardy on lung cancer (2002-2004) and pleural mesothelioma (2014). Assessment of exposure to asbestos was performed through a quantitative job-exposure matrix (SYN-JEM) and expert evaluation based on a standardised questionnaire. We calculated period-specific and gender-specific OR and 90% CI using conditional logistic regression adjusted for age, province of residence and education. RESULTS We selected 68 cases and 2116 controls (2000-2007) and 159 cases and 205 controls (2008-2015). The ORs for ever asbestos exposure (expert-based, 2008-2015 only) were 5.78 (90% CI 3.03 to 11.0) in men and 8.00 (2.56 to 25.0) in women; the ORs for definite occupational exposure were 12.3 (5.62 to 26.7) in men and 14.3 (3.16 to 65.0) in women. The ORs for ever versus never occupational asbestos exposure based on SYN-JEM (both periods) were 2.05 (90% CI 1.39 to 3.01) in men and 1.62 (0.79 to 3.27) in women. In men, clear positive associations were found for duration, cumulative exposure (OR 1.33 (1.19 to 1.48) per fibres/mL-years) and latency. CONCLUSIONS Using two different methods of exposure assessment we provided evidence of a clear association between asbestos exposure and PeM risk in the general population.
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Grants
- Intramural Research Program of the National Institutes of Health, the National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
- Associazione Italiana per la Ricerca sul Cancro (AIRC), Milan, Italy
- Ministry of Health, CCM (Centro Nazionale per la Prevenzione e il Controllo delle Malattie), Rome, Italy
- Istituto Nazionale per l’Assicurazione contro gli Infortuni sul Lavoro (INAIL), Rome, Italy
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Sara De Matteis
- National Heart and Lung Institute, Imperial College, London, UK
- Medical School, Humanitas University, Milan, Italy
| | - Dario Mirabelli
- Cancer Epidemiology, CPO and University of Turin, Turin, Italy
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Susan Peters
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel 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
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela Cecilia Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
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Oddone E, Terracini B, Mirabelli D, Mensi C, Consonni D, Barone-Adesi F. Comment on: Malignant mesothelioma diagnosed at a younger age is associated with heavier asbestos exposure. Carcinogenesis 2019; 40:488-489. [PMID: 30561515 DOI: 10.1093/carcin/bgy179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/13/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy.,Hospital Occupational Medicine Unit (UOOML), ICS Maugeri SpA SB IRCCS, Institute of Pavia, Pavia, Italy
| | - Benedetto Terracini
- Unit of Cancer Epidemiology, CPO Piemonte and University of Turin, Turin, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piemonte and University of Turin, Turin, 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
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Duca P, Aurora F, Bai E, Consonni D, Decarli A, Ferrara E, Gatta G, Giardini R, Magnani C, Mensi C, Merler E, Mirabelli D, Ricci P. [Mesothelioma: in search of a shared position]. Epidemiol Prev 2019; 43:112-113. [PMID: 31293121 DOI: 10.19191/ep19.2-3.p112.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Piergiorgio Duca
- già professore di statistica medica e biometria, Università degli Studi di Milano; Direttivo di Medicina Democratica Onlus
| | | | - Edoardo Bai
- Medico del lavoro; membro del comitato scientifico di Legambiente e di ISDE
| | - Dario Consonni
- UO epidemiologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, MI
| | - Adriano Decarli
- già professore ordinario di statistica medica e biometria, Università degli Studi di Milano
| | - Enzo Ferrara
- Istituto nazionale di ricerca meteorologica, Torino; Redazione della rivista dell'associazione MD Onlus
| | - Gemma Gatta
- Dipartimento di epidemiologia valutativa, IRCCS Istituto nazionale dei tumori, Milano
| | - Roberto Giardini
- già UOC anatomia patologica, IRCCS Istituto nazionale dei tumori, Milano
| | - Corrado Magnani
- già professore di statistica medica, Università del Piemonte Orientale, Novara
| | - Carolina Mensi
- COR tumori, Clinica del lavoro, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano
| | - Enzo Merler
- Medico del lavoro; già responsabile Registro regionale veneto dei casi di mesotelioma, SPISAL, AULSS 6, Padova
| | - Dario Mirabelli
- già SC epidemiologia dei tumori, CPO Piemonte e Università di Torino
| | - Paolo Ricci
- Osservatorio epidemiologico ATS Val Padana, Mantova
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Baran FDP, Mercês NNAD, Sarquis LMM, Rosa LMD, Mensi C, Brey C. THERAPEUTIC ITINERARY REVEALED BY THE FAMILY MEMBERS OF INDIVIDUALS WITH MESOTHELIOMA: MULTIPLE CASE STUDIES. Texto contexto - enferm 2019. [DOI: 10.1590/1980-265x-tce-2017-0571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to describe the therapeutic itinerary revealed by the relatives of individuals with mesothelioma. Method: a multiple case study with a qualitative approach. Six family members of the cases occurred in the state of Paraná (Brazil). Data was collected from medical records and interviews between January and July 2016 and submitted to comparative and content analysis, supported by the Health Care System framework. Results: seven categories emerged from the data: Acknowledgment of the illness; Popular care and the attempt to escape from the illness; The popular subsystem directs to the professional subsystem; Professional subsystem: unraveling the mystery of the disease; Family: care supremacy; Religion: hope and encouragement; and Disease due to mesothelioma from the perspective of the family member. Conclusion: the therapeutic itinerary was built from early symptoms detection and common sense practices. The family was the central unit of care; the professional subsystem, with the challenge of diagnosing the disease, and religion, which represented the person’s and family members’ hope. Studying the topic can contribute to improve the planning of the health actions promoted to individuals with mesothelioma, from the diagnosis process, treatment to death.
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Affiliation(s)
| | | | | | | | - Carolina Mensi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Italy
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Kalinke LP, Kalinke MA, Sarquis LMM, Marcondes L, Halfeld T, Mensi C, Consonni D. [A proposal for the creation of a system to monitor cases of malignant mesothelioma in Curitiba, Paraná, Brazil]. CAD SAUDE PUBLICA 2018; 34:e00171917. [PMID: 30281709 DOI: 10.1590/0102-311x00171917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 05/03/2018] [Indexed: 11/22/2022] Open
Abstract
The study proposes the creation of a system to monitor cases of malignant mesothelioma in the municipality of Curitiba, Paraná State, Brazil, based on the Italian model. This diagnosis-type action-research project featured exploratory and planning phases conducted from July 2015 to May 2017. The following search tools were used: Hospital-Based Cancer Registries Integrator with specific morphologies for mesothelioma; Hospital-Based Cancer Registry with codes C38.4 and C45 of the International Classification of Diseases, 10th revision, and/or records coded by the ICD-O with topographies C38 and C48; Population-Based Cancer Registry of the Curitiba Municipal Health Department, with the same codes. The study also identified, analyzed, and adapted to the Brazilian reality the model, questionnaires, and registry software for mesothelioma from Lombardy, Italy. Fifteen cases of mesothelioma were recorded in the Hospital-Based Cancer Registries Integrator. Two cases were recorded in the University Hospital-Based Cancer Registry and 16 in the Cancer Hospital. There were 317 cases recorded in the Population-Based Cancer Registry during the same period. Although some information was complete, data were lacking on patients' occupational history, thereby preventing the determination of a causal nexus. Given a predicted increase in cases of mesothelioma in the coming decades and the response to court cases, the implementation of registries has become essential to facilitate knowledge and follow-up on the determination of the causal link and specific sources of asbestos exposure in the country.
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Affiliation(s)
| | - Marco Aurélio Kalinke
- Universidade Federal do Paraná, Curitiba, Brasil.,Universidade Tecnológica Federal do Paraná, Curitiba, Brasil
| | | | | | | | - Carolina Mensi
- Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milano, Italia
| | - Dario Consonni
- Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milano, Italia
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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 I, Cavone D, Cauzillo G, Tallarigo F, Tumino R, Melis M, Iavicoli S. Letter concerning: 'Response to: 'The epidemiology of malignant mesothelioma in women: gender differences and modalities of asbestos exposure' by Marinaccio et al'. Occup Environ Med 2018; 75:844-845. [PMID: 30209209 DOI: 10.1136/oemed-2018-105362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 08/10/2018] [Indexed: 11/03/2022]
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 Center 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
- School of Medicinal and Health Products, Center for Hygiene and Public Health Research, COR Marche, University of Camerino, Bolzano, Italy
| | - Roberto Calisti
- School of Medicinal and Health Products, Center for Hygiene and Public Health Research, COR Marche, University of Camerino, Bolzano, Italy
| | - Fabrizio Stracci
- Section of Public Health, Department of Experimental Medicine, COR Umbria, University of Perugia, Perugia, Italy
| | - Elisa Romeo
- Department of Epidemiology, COR Lazio, Lazio Region, Rome, Italy
| | - Valeria Ascoli
- Department of Radiological, Oncological and Anatomopathological Sciences, COR Lazio, La Sapienza University, Rome, Italy
| | - Luana Trafficante
- Health Local Unit, Occupational Medicine Unit, COR Abruzzo, Pescara, Italy
| | | | - Italo Angelillo
- Department of Experimental Medicine, COR Campania, Second University of Naples, Napoli, Italy
| | - Domenica Cavone
- Department of Interdisciplinary Medicine, Section of Occupational Medicine 'B Ramazzini', COR Puglia, University of Bari, Bari, Italy
| | | | | | - Rosario Tumino
- Cancer Registry ASP Ragusa and Sicily Regional Epidemiological Observatory, COR Sicily, Syracuse, Italy
| | - Massimo Melis
- Regional Epidemiological Center, COR Sardegna, Cagliari, Italy
| | - Sergio Iavicoli
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, 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: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Samant Y, Gravseth HM, Aas O, Ekle R, Strømholm T, Gigonzac V, Khireddine-Medouni I, Breuillard E, Bossard C, Guseva Canu I, Santin G, Chérié-Challine L, Bonney T, Kyeremateng-Amoah E, Forst L, Friedman L, Pesatori AC, Angelici L, Favero C, Dioni L, Mensi C, Bareggi C, Palleschi A, Cantone L, Consonni D, Bordini L, Todaro A, Bollati V. 1769 Occupational disease and morbidity modelling. Epidemiology 2018. [DOI: 10.1136/oemed-2018-icohabstracts.434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pesatori AC, Angelici L, Favero C, Dioni L, Mensi C, Bareggi C, Palleschi A, Cantone L, Consonni D, Bordini L, Todaro A, Bollati V. 1769d Combination of mirnas, mesothelin and fibulin-3 as potential biomarkers in malignant pleural mesothelioma and asbestos-exposed subjects. Epidemiology 2018. [DOI: 10.1136/oemed-2018-icohabstracts.438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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43
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Consonni D, Puchalski Kalinke LP, Kalinke MA, D’Almeida Miranda FM, Marcondes L, Hallfeld T, Brey C, Boller S, Pesatori AC, Mensi C, Sarquis LMM. 1345 Asbestos-related diseases in curitiba: the brazil-italy project. Epidemiology 2018. [DOI: 10.1136/oemed-2018-icohabstracts.396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Consonni D, Mendola M, Dallari B, Sokooti M, Tabibi R, Callegari R, Riboldi L, Mensi C. 1360 Differences between peritoneal and pleural mesothelioma in lombardy, italy. Occup Med (Lond) 2018. [DOI: 10.1136/oemed-2018-icohabstracts.1053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Binazzi A, Corfiati M, Di Marzio D, Cacciatore AM, Zajacovà J, Mensi C, Galli P, Miligi L, Calisti R, Romeo E, Franchi A, Marinaccio A. Sinonasal cancer in the Italian national surveillance system: Epidemiology, occupation, and public health implications. Am J Ind Med 2018; 61:239-250. [PMID: 29114957 DOI: 10.1002/ajim.22789] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sinonasal cancer (SNC) is a rare tumor with predominant occupational etiology associated with exposures to specific carcinogens. The aim of this study is to describe SNC cases recorded in Italy in the period 2000-2016. METHODS Clinical information, occupational history, and lifestyle habits of SNC cases collected in the Italian Sinonasal Cancer Register were examined. Age-standardized rates were estimated. RESULTS Overall, 1529 cases were recorded. The age-standardized incidence rates per 100 000 person-years were 0.65 in men and 0.26 in women. Occupational exposures were predominant among the attributed exposure settings, primarily to wood and leather dusts. Other putative causal agents included chrome, solvents, tannins, formaldehyde, textile dusts, and pesticides. Many cases had unknown exposure. CONCLUSIONS Epidemiological surveillance of SNC cases and their occupational history is fundamental for monitoring the occurrence of the disease in exposed workers in industrial sectors generally not considered at risk of SNC as well as in non-occupational settings.
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Affiliation(s)
- Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene; 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
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene; National Institute for Insurance Against Accidents at Work (INAIL); Rome Italy
| | - Anna M. Cacciatore
- Sinonasal Cancer Registry of Piedmont; Occupational Health and Safety Department; ASL CN1; Cuneo Italy
| | - Jana Zajacovà
- Sinonasal Cancer Registry of Piedmont; Occupational Health and Safety Department; ASL CN1; Cuneo Italy
| | - Carolina Mensi
- Sinonasal Cancer Registry of Lombardy; Department of Preventive Medicine; Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico; Milan Italy
| | - Paolo Galli
- Sinonasal Cancer Registry of Emilia-Romagna; Department of Public Health; Unit of Workplace Prevention and Safety; AUSL Imola Italy
| | - Lucia Miligi
- Sinonasal Cancer Registry of Tuscany; Cancer Prevention and Research Institute (ISPO); Environmental and Occupational Epidemiology Unit; Florence Italy
| | - Roberto Calisti
- Sinonasal Cancer Registry of Marche; Department of Prevention; SPreSAL; Civitanova Marche Italy
| | - Elisa Romeo
- Sinonasal Cancer Registry of Lazio; Department of Epidemiology; ASL RM1; Rome Italy
| | - Alessandro Franchi
- Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene; National Institute for Insurance Against Accidents at Work (INAIL); Rome Italy
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Cavalleri T, Angelici L, Favero C, Dioni L, Mensi C, Bareggi C, Palleschi A, Rimessi A, Consonni D, Bordini L, Todaro A, Bollati V, Pesatori AC. Plasmatic extracellular vesicle microRNAs in malignant pleural mesothelioma and asbestos-exposed subjects suggest a 2-miRNA signature as potential biomarker of disease. PLoS One 2017; 12:e0176680. [PMID: 28472171 PMCID: PMC5417506 DOI: 10.1371/journal.pone.0176680] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 04/14/2017] [Indexed: 01/29/2023] Open
Abstract
Background Malignant Pleural Mesothelioma (MPM) is an aggressive cancer mainly caused by asbestos exposure and refractory to current therapies. Specific diagnostic markers for early MPM diagnosis are needed. Changes in miRNA expression have been implicated in several diseases and cancers, including MPM. We examined if a specific miRNA signature in plasmatic extracellular vesicles (EV) may help to discriminate between malignant pleural mesothelioma patients (MPM) and subjects with Past Asbestos Exposure (PAE). Methodology/Principal findings We investigated 23 MPM patients and 19 cancer-free subjects with past asbestos exposure (PAE). We screened 754 miRNAs in plasmatic EVs by OpenArray and found 55 differential miRNAs using logistic regression models adjusted for age, sex, BMI, and smoking. Among the top-20 differential miRNAs chosen for validation by Real time PCR, 16 were confirmed. Using receiver operating characteristic (ROC) curve analysis, the most discriminating miRNA combination was given by miR-103a-3p + miR-30e-3p, which generated an AUC of 0.942 (95% CI 0.87–1.00), with a sensitivity of 95.5% and a specificity of 80.0%. Using multivariate Cox regression analysis including gender, age, BMI and smoking we found a Hazard Ratio for miR-103a-3p above the median of 0.37 (95%CI 0.13–1.13) and of 0.51 (95%CI 0.17–1.52) for miR-30e-3p. Conclusions This study suggests EV-associated miR-103a-3p and miR-30e-3p are able to discriminate MPM from PAE subjects. Larger and prospective studies are needed to confirm these two-miRNA signature alone or in combination with other biomarkers as diagnostic tools for MPM.
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Affiliation(s)
- Tommaso Cavalleri
- Department of Gastroenterology, Humanitas Clinical and Research Center, Via Manzoni 56, Rozzano (Milan), Italy
| | - Laura Angelici
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba 8, Milan, Italy
| | - Chiara Favero
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba 8, Milan, Italy
| | - Laura Dioni
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba 8, Milan, Italy
| | - Carolina Mensi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Epidemiology Unit, Via San Barnaba 8, Milan, Italy
| | - Claudia Bareggi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Medical Oncology Unit, Via F.Sforza 28, Milan, Italy
| | - Alessandro Palleschi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Thoracic Surgery and Lung Transplantation Unit, Via F. Sforza 28, Milan, Italy
| | - Arianna Rimessi
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Thoracic Surgery and Lung Transplantation Unit, Via F. Sforza 28, Milan, Italy
| | - Dario Consonni
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Epidemiology Unit, Via San Barnaba 8, Milan, Italy
| | - Lorenzo Bordini
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Occupational Health Unit, Via San Barnaba 8, Milan, Italy
| | - Aldo Todaro
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Occupational Health Unit, Via San Barnaba 8, Milan, Italy
| | - Valentina Bollati
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba 8, Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Epidemiology Unit, Via San Barnaba 8, Milan, Italy
| | - Angela Cecilia Pesatori
- EPIGET—Epidemiology, Epigenetics and Toxicology Lab—Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba 8, Milan, Italy
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Department of Preventive Medicine, Epidemiology Unit, Via San Barnaba 8, Milan, Italy
- * E-mail:
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Mensi C, Ciullo F, Barbieri GP, Riboldi L, Somigliana A, Rasperini G, Pesatori AC, Consonni D. Pleural malignant mesothelioma in dental laboratory technicians: A case series. Am J Ind Med 2017; 60:443-448. [PMID: 28409856 DOI: 10.1002/ajim.22716] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/11/2022]
Abstract
Asbestos was used in dentistry as a binder in periodontal dressings and as lining material for casting rings and crucible. However, until now, only one case of malignant mesothelioma with occupational exposure to asbestos in dental practice has been reported. We present 4 pleural mesotheliomas out of 5344 cases identified in Lombardy, Italy, in 2000-2014. Three men had been working as dental laboratory technicians, with asbestos exposure for 10, 34, and 4 years, and one woman had been helping her husband for 30 years in manufacturing dental prostheses. The men described the use of asbestos as a lining material for casting rings, while the woman was not able to confirm this use. We confirm the association of malignant mesothelioma with dental technician work. Dental technicians suffering from mesothelioma should be questioned about past occupational asbestos exposure.
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Affiliation(s)
- Carolina Mensi
- Department of Preventive Medicine; Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico; Milan Italy
| | - Francesco Ciullo
- Department of Clinical Sciences and Community Health; Università degli Studi di Milano; Milan Italy
| | - Gino Pietro Barbieri
- Formerly Mesothelioma Registry; Occupational Health Unit, Local Health Authority; Brescia Italy
| | - Luciano Riboldi
- Department of Preventive Medicine; Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico; Milan Italy
| | - Anna Somigliana
- Center of Electron Microscopy; Lombardy Environmental Protection Agency (ARPA); Milan Italy
| | - Giulio Rasperini
- Department of Biomedical, Surgical and Dental Sciences; Università degli Studi di Milano; Milan Italy
| | - Angela Cecilia Pesatori
- Department of Preventive Medicine; Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico; Milan Italy
- Department of Clinical Sciences and Community Health; Università degli Studi di Milano; Milan Italy
| | - Dario Consonni
- Department of Preventive Medicine; Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico; Milan Italy
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Mensi C, Romano A, Berti A, Dore R, Riboldi L. A second case of pericardial mesothelioma mimicking systemic lupus erythematosus in the literature in over 30 years: a case report. J Med Case Rep 2017; 11:85. [PMID: 28351431 PMCID: PMC5370430 DOI: 10.1186/s13256-017-1237-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Accepted: 02/10/2017] [Indexed: 11/24/2022] Open
Abstract
Background Mesothelioma is a rare neoplasm which commonly develops in the pleura of people exposed to asbestos. Pericardial mesothelioma accounts for only 0.7 % of all malignant mesotheliomas and it usually presents with pericardial effusion, mimicking serositis. To date, there are approximately 200 cases of pericardial mesothelioma described in the medical literature, and little knowledge exists about the systemic manifestations of this pathology. The first and only described case of pericardial mesothelioma with autoimmune features dates back to 1984 and, in our case report, we describe the second. Case presentation We report a case of a 45-year-old white woman whose pericardial mesothelioma was initially misdiagnosed as pericardial involvement of an autoimmune disease (systemic lupus erythematosus). After several relapses of pericardial effusion, a computed tomography scan and a biopsy with histological analysis were performed revealing neoplastic growth. Conclusions We describe a rare case of pericardial mesothelioma in a patient with a clinical presentation compatible with lupus serositis. Clinicians should consider malignant mesothelioma in the differential diagnosis of pericardial effusion, especially when it is recurrent and not clearly explained by other causes. Cytological samples should always be obtained and, if imaging tools are suggestive for solid processes, histological confirmation is mandatory.
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Affiliation(s)
- Carolina Mensi
- Department of Preventive Medicine, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via San Barnaba 8, 20122, Milan, Italy
| | - Alessandro Romano
- School of Occupational Medicine, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, via San Barnaba 8, 20122, Milan, Italy.
| | - Alvise Berti
- Department of Allergy and Clinical Immunology, San Raffaele Scientific Institute, via Olgettina 60, 20132, Milan, Italy
| | - Roberto Dore
- Institute of Radiology, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi, 27100, Pavia, Italy
| | - Luciano Riboldi
- Department of Preventive Medicine, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, via San Barnaba 8, 20122, Milan, Italy
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Koller FJ, Sarquis LMM, Mantovani MDF, Miranda FMD, Consonni D, Mensi C. MONITORAMENTO DO MESOTELIOMA NO SUL DO BRASIL: UMA REALIDADE AINDA A SER ESTUDADA. Cogitare Enferm 2017. [DOI: 10.5380/ce.v22i1.49192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
O Brasil é um dos maiores produtores de crisotila do mundo, mas a ocorrência de mesotelioma é aparentemente baixa. No entanto, a identificação dos casos torna-se difícil por causa de erros de diagnóstico e registro de morte. Este é um estudo epidemiológico, descritivo e retrospectivo de registros hospitalares do Instituto Nacional de Câncer do Brasil, foram selecionados registros câncer de pleura ou histologia do mesotelioma entre 2001-2014. Foram identificados 208 registros, entretanto apenas 58 casos com histologia de mesotelioma. Notavelmente, 13 (22%) tinham sido codificados incorretamente como câncer de pulmão. A última atividade laboral estava ausente em metade dos casos. Concluiu-se que os dados hospitalares existentes em relação ao mesotelioma ainda são inadequados por imprecisão e codificação errônea. Além disso, nos registros ainda não existem informações do local de trabalho, bem como da ocupação. Estes achados confirmam a necessidade de um registro de casos de mesotelioma.
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50
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Palleschi A, Bollati V, Favero C, Mensi C, Bareggi C, Rimessi A, Tosi D, Mendogni P, Nosotti M. P3.03-009 Role of microRNAs as Biomarkers of Malignant Mesothelioma in Patients with Pleural Effusion. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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