title: Impact of an asbestos cement factory on mesothelioma incidence: global assessment of effects of occupational, familial, and environmental exposure.
abstract: Few studies have examined the incidence of malignant mesothelioma (MM) associated with distinct sources of asbestos exposure (occupational, familial, or environmental). We assessed the impact of asbestos exposure-global and by source-on the incidence of MM in Broni, an Italian town in which an asbestos cement factory once operated (1932-1993). Based on data collected by the Lombardy Mesothelioma Registry, we calculated the number of observed and expected MM cases among workers, their cohabitants, and people living in the area in 2000-2011. We identified 147 MM cases (17.45 expected), 138 pleural and nine peritoneal, attributable to exposure to asbestos from the factory. Thirty-eight cases had past occupational exposure at the factory (2.33 expected), numbering 32 men (26 pleural, six peritoneal) and six women (four pleural, two peritoneal). In the families of the workers, there were 37 MM cases (4.23 expected), numbering five men (all pleural) and 32 women (31 pleural, one peritoneal). Among residents in Broni or in the adjacent/surrounding towns, there were 72 cases of pleural MM (10.89 expected), numbering 23 men and 49 women. The largest MM excess was found in the towns of Broni (48 observed, 3.68 expected) and Stradella (16 observed, 1.85 expected). This study documents the large impact of the asbestos cement factory, with about 130 excess MM cases in a 12-year period. The largest MM burden was among women, from non-occupational exposure. Almost half of the MM cases were attributable to environmental exposure.
authors.affiliation: Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: carolina.mensi@unimi.it.
authors.forename: Carolina
authors.initials: C
authors.lastname: Mensi
authors.affiliation: Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: luciano.riboldi@unimi.it.
authors.forename: Luciano
authors.initials: L
authors.lastname: Riboldi
authors.affiliation: National Heart & Lung Institute, Respiratory Epidemiology, Occupational Medicine and Public Health, Imperial College London, London, UK. Electronic address: s.de-matteis@imperial.ac.uk.
authors.forename: Sara
authors.initials: S
authors.lastname: De Matteis
authors.affiliation: 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. Electronic address: pieralberto.bertazzi@unimi.it.
authors.forename: Pier Alberto
authors.initials: PA
authors.lastname: Bertazzi
authors.affiliation: Department of Preventive Medicine, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. Electronic address: dario.consonni@unimi.it.
authors.forename: Dario
authors.initials: D
authors.lastname: Consonni
mesh_terms: D000368:Aged; D001194:Asbestos / Q000633:toxicity*; D002273:Carcinogens / Q000633:toxicity*; D004781:Environmental Exposure; D005192:Family Health; D005260:Female; D006801:Humans; D015994:Incidence; D007221:Industry; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology*; D000086002:Mesothelioma, Malignant; D016273:Occupational Exposure
chemical_list: D002273:Carcinogens; D001194:Asbestos
keywords: Asbestos; Cancer incidence; Environmental exposure; Familial exposure; Mesothelioma; Occupational exposure