title: Pleural malignant mesothelioma epidemic: incidence, modalities of asbestos exposure and occupations involved from the Italian National Register.
abstract: Due to the large scale use of asbestos (more than 3.5 million tons produced or imported until its definitive banning in 1992), a specific national surveillance system of mesothelioma incident cases is active in Italy, with direct and individual anamnestic etiological investigation. In the period between 1993 and 2004, a case-list of 8,868 pleural MM was recorded by the Italian National Register (ReNaM) and the modalities of exposure to asbestos fibres have been investigated for 6,603 of them. Standardized incidence rates are 3.49 (per 100,000 inhabitants) for men and 1.25 for women, with a wide regional variability. Occupational asbestos exposure was in 69.3% of interviewed subjects (N = 4,577 cases), while 4.4% was due to cohabitation with someone (generally, the husband) occupationally exposed, 4.7% by environmental exposure from living near a contamination source and 1.6% during a leisure activity. In the male group, 81.5% of interviewed subjects exhibit an occupational exposure. In the exposed workers, the median year of first exposure was 1957, and mean latency was 43.7 years. The analysis of exposures by industrial sector focuses on a decreasing trend for those traditionally signaled as "at risk" (asbestos-cement industry, shipbuilding and repair and railway carriages maintenance) and an increasing trend for the building construction sector. The systematic mesothelioma surveillance system is relevant for the prevention of the disease and for supporting an efficient compensation system. The existing experience on all-too-predictable asbestos effects should be transferred to developing countries where asbestos use is spreading.
authors.affiliation: Workers Compensation Authority (INAIL), Research Area ex ISPESL, Occupational Medicine Department, Epidemiology Unit, Rome, Italy. alessandro.marinaccio@ispesl.it
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marinaccio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Binazzi
authors.forename: Davide Di
authors.initials: DD
authors.lastname: Marzio
authors.forename: Alberto
authors.initials: A
authors.lastname: Scarselli
authors.forename: Marina
authors.initials: M
authors.lastname: Verardo
authors.forename: Dario
authors.initials: D
authors.lastname: Mirabelli
authors.forename: Valerio
authors.initials: V
authors.lastname: Gennaro
authors.forename: Carolina
authors.initials: C
authors.lastname: Mensi
authors.forename: Luciano
authors.initials: L
authors.lastname: Riboldi
authors.forename: Enzo
authors.initials: E
authors.lastname: Merler
authors.forename: Renata De
authors.initials: RD
authors.lastname: Zotti
authors.forename: Antonio
authors.initials: A
authors.lastname: Romanelli
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Chellini
authors.forename: Stefano
authors.initials: S
authors.lastname: Silvestri
authors.forename: Cristiana
authors.initials: C
authors.lastname: Pascucci
authors.forename: Elisa
authors.initials: E
authors.lastname: Romeo
authors.forename: Simona
authors.initials: S
authors.lastname: Menegozzo
authors.forename: Marina
authors.initials: M
authors.lastname: Musti
authors.forename: Domenica
authors.initials: D
authors.lastname: Cavone
authors.forename: Gabriella
authors.initials: G
authors.lastname: Cauzillo
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Carmela
authors.initials: C
authors.lastname: Nicita
authors.forename: Massimo
authors.initials: M
authors.lastname: Melis
authors.forename: Sergio
authors.initials: S
authors.lastname: Iavicoli
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001194:Asbestos / Q000009:adverse effects / Q000737:chemistry; D058872:Epidemics; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008654:Mesothelioma / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology*; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced; D016273:Occupational Exposure / Q000009:adverse effects; D010997:Pleural Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology*; D011159:Population Surveillance
chemical_list: D001194:Asbestos