Pleural mesothelioma mortality and asbestos exposure mapping in Italy.
BACKGROUND
An epidemic of asbestos-related diseases is ongoing worldwide. Mortality from malignant pleural neoplasms in Italy was analyzed, to estimate the health impact of asbestos at national and local level.


METHODS
Mortality from ICD-9 code 163 was considered, in the time-window 1995-2002, using National Bureau of Statistics data. National and regional standardized rates and municipal Standardized Mortality Ratios (SMR) were calculated. Municipal clusters were identified by applying Spatial Scan Statistics procedure. Relative risks (RR) express the ratio of risk within the cluster to the risk outside the cluster.


RESULTS
The national standardized annual mortality rate was 1.9 per 100,000. Significant clusters corresponded to asbestos-cement industries (Casale Monferrato: RR = 11.63), shipyards (Monfalcone, RR = 7.43), oil refineries (Falconara, RR = 2.52), petrochemical industries (Priolo, RR = 3.81).


CONCLUSIONS
The present study confirms malignant pleural neoplasms mortality as a suitable indicator of asbestos exposure at geographic level. In addition to asbestos-cement industries and shipyards, other industrial settings are associated with pleural neoplasm mortality.
Environmental Epidemiology Unit, Department of Environment and Primary Prevention, Istituto Superiore di Sanità, Rome, Italy. lucia.fazzo@iss.it
Lucia
L
Fazzo
Marco
M
De Santis
Giada
G
Minelli
Caterina
C
Bruno
Amerigo
A
Zona
Alessandro
A
Marinaccio
Susanna
S
Conti
Pietro
P
Comba
D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D008654:Mesothelioma / Q000401:mortality*; D008875:Middle Aged; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D010997:Pleural Neoplasms / Q000401:mortality*; D016012:Poisson Distribution; D012306:Risk
D001194:Asbestos