Incidence of extrapleural malignant mesothelioma and asbestos exposure, from the Italian national register

Abstract

The rarity of the disease, the low specificity of diagnosis and difficulties in identifying the modalities of asbestos exposure call for caution in discussing aetiological factors other than asbestos.

Pleural mesothelioma in household members of asbestos-exposed workers in Friuli Venezia Giulia, Italy

“…The severity of asbestos exposure in the shipbuilding and maintenance industry as well as the high incidence of pleural mesotheliomas in the shipyard areas has been well documented [9]. The prolonged latency period (59 years) found in the current study is consistent with other studies [16,27]. Marinaccio et al [16] reported the mean latency of 48 years among household exposed mesothelioma cases which was significantly longer than that of 43 years observed among the occupationally exposed ones.…”

“…Their exposure was only through residential inhalation of asbestos from husband's or father's contaminated work clothes that were not removed in the workplace for cleaning but or unknown (e.g., questionnaires reported an incomplete job and/or residential and familial history) following the National Guidelines [15,16]. Certain occupational exposure is attributed to the subjects whose work has involved the use of asbestos or materials containing asbestos; probable occupational exposure to the subjects who have worked in a firm where asbestos has been certainly used but whose exposure cannot be documented; possible occupational exposure to the subjects who have worked in a firm referring to an economic sector where asbestos has been used [15,16]. Exposure information and medical data were reviewed (by occupational physicians) in all cases included for the analysis.…”

“…428 the 1st year of cohabitation (or the year of 1st exposure beginning for the cohabitant) was considered as the onset of asbestos exposure [16]. For example, for each wife, the time of 1st exposure to asbestos was considered to have coincided with the date of marriage or the date the husband was hired, whichever was later.…”

“…For example, for each wife, the time of 1st exposure to asbestos was considered to have coincided with the date of marriage or the date the husband was hired, whichever was later. As a matter of fact, the beginning of a work period could not exactly correspond to the beginning of exposure to asbestos and it could lead to an overestimation of latency time [16].…”

“…As stated in the epidemiological literature [16], the retrospective analysis of collected cases -as usual for an incidence surveillance system -could "miss" the cases with the shorter latency thereby overestimating the mean latency period. In addition, the possible presence of competitive causes of death (e.g., asbestos related lung cancer and asbestosis) and the incomplete cohort analysis (our study population comprised cases collected in recent years and, hence, cases with relevant past exposure and short latency could be missing) induce a possible bias in the statistical inference about differences in latency.…”