Background Despite the available information on cancer risk, asbestos is used in large areas in the world, mostly in the production of asbestos cement. Moreover, questions are raised regarding the shape of the dose response relation, the relation with time since exposure and the association with neoplasms in various organs. We conducted a study on the relationship between cumulative asbestos exposure and mortality from asbestos related diseases in a large Italian pool of 21 cohorts of asbestos-cement workers with protracted exposure to both chrysotile and amphibole asbestos. Methods The cohort included 13,076 workers, 81.9% men and 18.1% women, working in 21 Italian asbestos-cement factories, with over 40 years of observation. Exposure was estimated by plant and period, and weighted for the type of asbestos used. Data were analysed with consideration of cause of death, cumulative exposure and time since first exposure (TSFE), and by gender. SMRs were computed using reference rates by region, gender and calendar time. Poisson regression models including cubic splines were used to analyse the effect of cumulative exposure to asbestos and TSFE on mortality for asbestos-related diseases. 95% Confidence Intervals (CI) were computed according to the Poisson distribution. Results Mortality was significantly increased for ‘All Causes’ and ‘All Malignant Neoplasm (MN)’, in both genders. Considering asbestos related diseases (ARDs), statistically significant excesses were observed for MN of peritoneum (SMR: men 14.19; women 15.14), pleura (SMR: 22.35 and 48.10), lung (SMR: 1.67 and 1.67), ovary (in the highest exposure class SMR 2.45), and asbestosis (SMR: 507 and 1023). Mortality for ARDs, in particular pleural and peritoneal malignancies, lung cancer, ovarian cancer and asbestosis increased monotonically with cumulative exposure. Pleural MN mortality increased progressively in the first 40 years of TSFE, then reached a plateau, while peritoneal MN showed a continuous increase. The trend of lung cancer SMRs also showed a flattening after 40 years of TSFE. Attributable proportions for pleural, peritoneal, and lung MN were respectively 96, 93 and 40%. Conclusions Mortality for ARDs was associated with cumulative exposure to asbestos. Risk of death from pleural MN did not increase indefinitely with TSFE but eventually reached a plateau, consistently with reports from other recent studies. Electronic supplementary material The online version of this article (10.1186/s12940-019-0510-6) contains supplementary material, which is available to authorized users.

The study confirmed the increased risk for cancer of the lung, ovary, pleura and peritoneum but not of the larynx and the digestive tract. Pleural cancer mortality reached a plateau at long TSFE, coherently with recent reports.

One of the open questions regarding the asbestos problem is the fate of the mineral fibres in the body once inhaled and deposited in the deep respiratory system. In this context, the present paper reports the results of an electron microscopy study of both mineral fibres and asbestos bodies found in the lung tissue of a patient who died of malignant mesothelioma due to past occupational exposure. In concert with previous in vivo animal studies, our data provide evidence that amphibole asbestos fibres are durable in the lungs, whereas chrysotile fibres are transformed into a silica‐rich product, which can be easily cleared. Amphibole fibres recovered from samples of tissue of the deceased display a high degree of crystallinity but also show a very thin amorphous layer on their surface; 31% of the fibres are coated with asbestos bodies consisting of a mixture of ferroproteins (mainly ferritin). Here, we propose an improved model for the coating process. Formation of a coating on the fibres is a defence mechanism against fibres that are longer than 10 µm and thinner than 0.5 µm, which macrophages cannot engulf. The mature asbestos bodies show signs of degradation, and the iron stored in ferritin may be released and potentially increase oxidative stress in the lung tissue.

Feed mill workers may handle or process maize contaminated with aflatoxins (AFs). This condition may lead to an unacceptable intake of toxins deriving from occupational exposure. This study assessed the serological and urinary levels of AFs in workers exposed to potentially contaminated dusts in two mills. From March to April 2014, blood and urine samples were collected, on Monday and Friday morning of the same working week from 29 exposed workers and 30 non-exposed controls. AFs (M1, G2, G1, B1, B2) and aflatoxicol (AFOH) A were analyzed. Each subject filled in a questionnaire to evaluate potential food-borne exposures to mycotoxins. AFs contamination in environmental dust was measured in both plants. No serum sample was found to be positive. Seventy four percent of urine samples (73.7%) revealed AFM1 presence. AFM1 mean concentration was 0.035 and 0.027 ng/mL in exposed and non-exposed workers, respectively (p = 0.432); the concentration was slightly higher in Friday’s than in Monday’s samples, in exposed workers, 0.040 versus (vs.) 0.031 and non-exposed controls (0.030 vs. 0.024, p = 0.437). Environmental AFs contamination ranged from 7.2 to 125.4 µg/kg. The findings of this study reveal the presence of higher AFs concentration in exposed workers than in non-exposed controls, although these differences are to be considered consistent with random fluctuations.

Today, cancer is one of the main health issues faced in the workplace, with asbestos an important carcinogen in the occupational environment. Among the asbestos minerals, chrysotile is the main species of socio-economic and industrial relevance. Although chrysotile asbestos is classified as a “carcinogenic substance” by the International Agency for Research on Cancer (IARC), this fiber is still mined and used in Russia. The effective health hazard posed by the Russian commercial chrysotile has not been quantitatively assessed to date. In this work, the potential toxicity/pathogenicity of Russian chrysotile was quantitatively determined using the fiber potential toxicity index (FPTI) model. This model was applied to a representative commercial chrysotile from the Orenburg region, Russia, whose morphometric, crystal-chemical, surface activity, and biodurability related parameters were determined. We have quantitatively assessed that the toxicity/pathogenicity potential of Russian chrysotile (FPTI = 2.4) is lower than that of amphibole asbestos species but higher than the threshold limit set for “safe” mineral fibers (FPTI = 2.0), although it does not contain impurities of amphibole asbestos. Differences with other chrysotile samples were discussed, and it was found that the investigated Russian commercial chrysotile shares several features with the Italian Balangero chrysotile, indicating that widespread concern on commercial Russian chrysotile is justified.