title: Asbestos fibre burden in the lungs of patients with mesothelioma who lived near asbestos-cement factories.
abstract: BACKGROUND
  Epidemics of malignant mesothelioma are occurring among inhabitants of Casale Monferrato and Bari never employed in the local asbestos-cement (AC) factories. The mesothelioma risk increased with proximity of residence to both plants.
  
  
  OBJECTIVE
  To provide information on the intensity of environmental asbestos exposure, in the general population living around these factories, through the evaluation of the lung fibre burden in mesothelioma patients.
  
  
  METHODS
  We analysed by a scanning electron microscope equipped with X-ray microanalysis wet (formalin-fixed) lung tissue samples from eight mesothelioma patients who lived in Casale Monferrato or Bari and underwent surgery. Their occupational and residential history was obtained during face-to-face interviews. Semi-quantitative and quantitative indices of cumulative environmental exposure to asbestos were computed, based on residential distance from the AC plants and duration of stay.
  
  
  RESULTS
  The lung fibre burden ranged from 110 000 to 4 300 000 fibres per gram of dry lung (f/g) and was >1 000 000 f/g in three subjects. In four cases, only amphibole fibres were detected. Environmental exposures had ceased at least 10 years before samples were taken. No patient had other definite or probable asbestos exposures. A linear relationship was observed between the lung fibre burden and all three indices of environmental cumulative exposure to asbestos.
  
  
  CONCLUSIONS
  Environmental exposure to a mixture of asbestos fibres may lead to a high lung fibre burden of amphiboles years after exposure cessation. The epidemiological evidence of an increased mesothelioma risk for the general population of Casale Monferrato and Bari, associated with asbestos contamination of the living environment, is corroborated.
authors.affiliation: Mesothelioma Registry, Occupational Health Unit, Local Health Authority, 25128 Brescia, Italy. pietro.barbieri@aslbrescia.it
authors.forename: Pietro Gino
authors.initials: PG
authors.lastname: Barbieri
authors.forename: Dario
authors.initials: D
authors.lastname: Mirabelli
authors.forename: Anna
authors.initials: A
authors.lastname: Somigliana
authors.forename: Domenica
authors.initials: D
authors.lastname: Cavone
authors.forename: Enzo
authors.initials: E
authors.lastname: Merler
mesh_terms: D000328:Adult; D017636:Asbestos, Amphibole / Q000032:analysis*; D003252:Construction Materials / Q000633:toxicity*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D007558:Italy; D008175:Lung Neoplasms; D008297:Male; D008654:Mesothelioma; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D019016:Mineral Fibers / Q000633:toxicity*; D016273:Occupational Exposure / Q000009:adverse effects; D012111:Residence Characteristics
chemical_list: D017636:Asbestos, Amphibole; D019016:Mineral Fibers