Cancer Mortality and Incidence of Mesothelioma in a Cohort of Wives of Asbestos Workers in Casale Monferrato, Italy

Ferrante, Daniela; Bertolotti, Marinella; Todesco, Annalisa; Mirabelli, Dario; Terracini, Benedetto; Magnani, Corrado

doi:10.1289/ehp.10195

Cited by 114 publications

(109 citation statements)

References 15 publications

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“…Similar findings have been observed among wives of asbestos workers in Casale Monferrato, Piedmont, northern Italy (Ferrante et al, 2007;Magnani et al, 2001), and in other countries (Rake et al, 2009;Reid et al, 2008).…”

Section: Discussionsupporting

confidence: 85%

“…Although many studies have investigated the effects of occupational exposure to asbestos among cohorts of workers, there have been few studies on the impact of asbestos exposure on their families (familial, household, or domestic exposure) or among people who live near asbestos mines or factories (environmental exposure), and very few studies have examined those sources of exposure comprehensively (Barbieri et al, 2012;Boffetta and Stayner, 2006;Bourdes et al, 2000;Ferrante et al, 2007;IARC, 2012;Joubert et al, 1991;Magnani et al, 2001;Magnani et al, 2013;Magnani et al, 1993;Musti et al, 2009;Rake et al, 2009;Vianna and Polan, 1978).…”

Section: Introductionmentioning

confidence: 99%

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Impact of an asbestos cement factory on mesothelioma incidence: Global assessment of effects of occupational, familial, and environmental exposure

Mensi

Riboldi

Matteis

et al. 2015

Environment International

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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 . Based on data collected by the Regional 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 146 MM cases (12.57 expected), 138 pleural and eight peritoneal, attributable to exposure to asbestos from the factory. Thirty-six cases had past occupational exposure at the factory (0.64 expected), numbering 30 men (25 pleural, five peritoneal) and six women (four pleural, two peritoneal). In the families of the workers, there were 37 MM cases (3.03 expected), numbering five men (all pleural) and 32 women (31 pleural, one peritoneal). Among residents in Broni or the surrounding towns, there were 73 cases of pleural MM (8.90 expected), numbering 24 men and 49 women. The largest MM excess was found in the towns of Broni (47 observed, 3.02 expected) and Stradella (16 observed, 1.51 expected). This study documents the large impact of the asbestos cement factory, with about 133 excess MM cases. The largest MM burden was among women, from non-occupational exposure. Almost half of the MM cases were attributable to environmental exposure. Dear Editor of Environment International, we are submitting a manuscript on the impact of asbestos exposure, related to an asbestoscement factory, on mesothelioma incidence in a community in northern Italy. Differently from previous works, we were able (thanks to a mesothelioma registry operating in the region), to evaluate the global impact on workers, their family members, and the rest of the population. We found a large overall impact of asbestos exposure, with over 130 excess cases in 12 years. Moreover, the largest burden was in women, and environmental exposure accounted for half of the cases.Continuous documentation of the effects of asbestos exposure also outside the occupational context is important not only for local communities, but also to increase awareness of the health effects of asbestos in countries that still use it and in which the perception of the real entity of health effects attributable to asbestos is still poor.We assure that the manuscript is an original work, has not been previously published whole or in part, and is not under consideration for publication elsewhere.None of the authors have any actual or potential competing financial interests regarding the submitted article.All authors have read the manuscript, agree the work is ready for submission to a journal, and accept responsibility for the manuscript's contents.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Impact of an asbestos cement factory on mesothelioma incidence: Global assessment of effects of occupational, familial, and environmental exposure

Mensi

Riboldi

Matteis

et al. 2015

Environment International

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“…17 One study found, however, a higher SMR of rectal cancer versus intestine and rectal cancer together. 24 Our study found significantly increased HRs for colon (both total and distal) and rectal cancer. The association with rectal cancer and, given the location, with distal colon cancer could be explained by asbestos' relation to smoking carcinogenesis and the fact that associations with smoking have been appreciably stronger for rectal cancer than (proximal) colon cancer.…”

Section: Colorectal Cancermentioning

confidence: 46%

Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study

et al. 2014

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The evidence for an association between occupational asbestos exposure and esophageal, gastric and colorectal cancer is limited. We studied this association specifically addressing risk differences between relatively low and high exposure, risk associated with cancer subtypes, the influence of potential confounders and the interaction between asbestos and smoking in relation to cancer risk. Using the Netherlands Cohort Study (n 5 58,279 men, aged 55-69 years at baseline), asbestos exposure was estimated by linkage to a job-exposure matrix. After 17.3 years of follow-up, 187 esophageal, 486 gastric and 1,724 colorectal cancer cases were available for analysis. The models adjusted for age and family history of cancer showed that mainly (prolonged) exposure to high levels of asbestos was statistically significantly associated with risk of esophageal adenocarcinoma (EAC), total and distal colon cancer and rectal cancer. For overall gastric cancer and gastric non-cardia adenocarcinoma (GNCA), also exposure to lower levels of asbestos was associated. Additional adjustment for lifestyle confounders, especially smoking status, yielded non-significant associations with overall gastric cancer and GNCA in the multivariableadjusted model, except for the prolonged highly exposed subjects (tertile 3 vs. never: HR 2.67, 95% CI: 1.11-6.44 and HR 3.35, 95% CI: 1.33-8.44, respectively). No statistically significant additive or multiplicative interaction between asbestos and smoking was observed for any of the studied cancers. This prospective population-based study showed that (prolonged) high asbestos exposure was associated with overall gastric cancer, EAC, GNCA, total and distal colon cancer and rectal cancer.The International Agency for Research on Cancer evaluated the evidence for an association between asbestos exposure and gastric and colorectal cancer as limited, though for colorectal cancer they were evenly divided as to whether the evidence was strong enough to justify classification as sufficient. 1 For esophageal cancer, a relatively rare cancer, results of epidemiological studies on associations with asbestos are mixed and together with the fact that animal experiments do not support biological activity of asbestos at this site, the evidence was considered to be inadequate. 2 Therefore, the question remains whether asbestos entails an increased risk of developing gastrointestinal tumors, and if so, whether risk differs for relatively low and high exposure levels. As there are numerous other risk factors for gastrointestinal cancers, an additional question relates to the influence of potential confounders. Furthermore, cancer subtypes may have different etiologies and should be studied separately if possible. Finally, as for lung cancer, the question arises if interaction between asbestos and smoking is present in relation to gastrointestinal cancers. 1,2

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“…Such outdoor behaviour may increase exposure substantially. Fourth, asbestos waste on roads and yards may be transported into a house by clothes and footwear, similar to the well-known route whereby asbestos workers give rise to asbestos exposure of their next of kin through their work clothes (Magnani et al, 1993;Magnani et al, 1995;Ferrante et al, 2007;Rake et al, 2009;Reid et al, 2008a, b). An investigation in nine houses with erosion of asbestos roof plates on their yards showed indoor concentrations with a maximum of 27,000 fibres/m 3 that were substantially higher than outdoor concentrations well below 1000 fibres/m 3 (Tromp and Tempelman, 1994).…”

Section: Internal Validitymentioning

confidence: 99%

Assessment of cancer risks due to environmental exposure to asbestos

Driece

Siesling

Swuste

et al. 2009

J Expo Sci Environ Epidemiol

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In a rural area widespread pollution of friable and non-friable waste products was present, used to harden dirt tracks, yards, and driveways during . Exposure to environmental asbestos was assessed by a site approach, based on number of polluted sites within postal code areas, and by a household approach, based on number of households in the close vicinity to polluted sites within postal code areas. Based on asbestos soil investigations, 293 sites were identified with asbestos waste material at the surface, of which 77% contained crocidolite fibres as well as chrysotile fibres. The 293 sitesat-risk varied from 5 m 2 to 2722 m 2 and were surrounded by 347 households within 100 m of these sites. Distance to the plant was associated with the number of sites (r ¼ 0.36), and with the number of households (r ¼ 0.52). However, categorization of postal code areas into low, intermediate or high likelihood of exposure to asbestos showed a modest agreement between the site and household approach. In the site approach a total of 2.3 million person-years at risk were estimated with an average exposure of 1674 fibres/m 3 and an expected 1.8 cases of malignant mesothelioma each year. The household approach resulted in estimates of 1.2 million person-years at risk, and 0.9 cases of malignant mesothelioma per year, respectively. This study illustrates that asbestos waste on the surface of roads and yards in an area with over 130,000 inhabitants may result in long-term exposure to asbestos that will cause several cases of malignant mesothelioma each year. Although distance to plant, number of polluted sites and number of exposed household were associated, the modest agreement among these measures of exposure indicate that the exposure assessment strategy chosen in a particular study may result in considerable misclassification. Without detailed information on individual behaviour within the polluted area, it is difficult to show that a more individually oriented approach will perform better than an ecological approach.

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Cancer Mortality and Incidence of Mesothelioma in a Cohort of Wives of Asbestos Workers in Casale Monferrato, Italy

Cited by 114 publications

References 15 publications

Impact of an asbestos cement factory on mesothelioma incidence: Global assessment of effects of occupational, familial, and environmental exposure

Impact of an asbestos cement factory on mesothelioma incidence: Global assessment of effects of occupational, familial, and environmental exposure

Occupational asbestos exposure and risk of esophageal, gastric and colorectal cancer in the prospective Netherlands Cohort Study

Assessment of cancer risks due to environmental exposure to asbestos

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