The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case–control study in the city of Bari (Italy)

Musti, Marina; Pollice, Alessio; Cavone, Domenica; Dragonieri, Silvano; Bilancia, Massimo

doi:10.1007/s00420-008-0358-5

Cited by 54 publications

(50 citation statements)

References 41 publications

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“…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%

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: 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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“…In the South area a cluster is represented by a municipality (Bari), where a major asbestos-cement industry operated; this source of exposure was considered in studies conducted by different authors, with respect to both occupational and environmental exposures [40][41][42]28]. Graziano et al, 2009 [43], studied the area of Taranto, included in a cluster, where shipbuilding and repair facility, a foundry and a refinery are located.…”

Section: Cluster Analysismentioning

confidence: 99%

Mesothelioma mortality surveillance and asbestos exposure tracking in Italy

Fazzo

Minelli

Santis

et al. 2012

Annali Dell'Istituto Superiore Di Sanità

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Abstract.Introduction. Spatial distribution of mortality from pleural mesothelioma (which in the IcD-10 Revision has a specific code: c45.0) in Italy for the period 2003-2009 is described. Previous mortality studies at national level employed the topographic code "Malignant neoplasms of pleura", because of unavailability of a specific code in IcD-9 Revision for pleural mesothelioma. Methods. Standardized mortality ratios were computed for all municipalities, using each regional population as reference; for municipalities in Regions with rate higher than the national rate, the latter has been used as reference. SMRs were computed specifically also for each Italian Polluted Sites "of national concern for environmental remediation" (IPS) with asbestos exposure sources, composed by one or more municipalities, using regional rate as reference. Spatial Scan Statistics procedure, using SatScan software, was applied in cluster analysis: the country was divided into geographic macro-areas and the relative risks (RR) express the ratio of risk within the cluster to the risk of the macro-area outside the cluster. clusters with p-value < 0.10 were selected. Results. The national standardized annual mortality rate was 1.7 cases per 100 000. Several areas with evident burden of asbestos-related disease were detected. Significant clusters were found in correspondence to asbestos-cement industries (e.g. casale Monferrato, women: RR = 28.7), shipyards (e.g. Trieste, men: RR = 4.8), petrochemical industries (e.g. Priolo, men: RR = 6.9) and a stone quarry contaminated by fluoro-edenite fibres (Biancavilla, women: RR = 25.9). Some of the increased clusters correspond to IPS. Conclusions. The results may contribute to detect asbestos exposure and to set priorites for environmental remediation.Key words: mesothelioma, geographic mortality, asbestos, polluted sites. Riassunto (analisi della mortalità per mesotelioma ed esposizione ad amianto in Italia). Introduzione.Viene illustrata la distribuzione spaziale in Italia della mortalità per mesotelioma pleurico (che nella decima revisione IcD ha un codice specifico: c45.0) per gli anni [2003][2004][2005][2006][2007][2008][2009]. Studi precedenti a livello nazionale avevano invece utilizzato il codice topografico "Tumori maligni della pleura", in assenza di un codice specifico in Nona Revisione IcD per il mesotelioma pleurico. Metodi. I rapporti standardizzati di mortalità (SMR) sono stati calcolati per tutti i comuni, utilizzando la popolazione regionale come riferimento; per i comuni in Regioni con un tasso maggiore di quello nazionale, è stato utilizzato quest'ultimo come riferimento. SMR sono stati calcolati anche specificatamente per i siti di interesse nazionale per le bonifiche (SIN) con sorgenti di esposizione ad amianto, composti da uno o più comuni, rispetto al tasso regionale. Il software Spatial Scan Statistic SatScan è stato utilizzato per l'analisi dei cluster: il territorio nazionale è stato suddiviso in macro-aree regionali e i rischi relativi (RR) esprimono il rapporto del...

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“…In general, these studies were not able to quantify the magnitude of environmental asbestos exposure, but used proxy measures such as distance to source. This study showed that the distance of the plant to the midpoint of a postal code area was associated with number of polluted sites and exposed households, but correlation coefficients between 0.36 and 0.52 indicate that spatial risk models based on proximity measures (Magnani et al, 2000;Magnani et al, 2001;Maule et al, 2007;Kurumatani and Kumagai, 2008;Musti et al, 2009) may give rise to considerable misclassification.…”

Section: External Validitymentioning

confidence: 80%

“…In contrast to other studies we could not take into account the asbestos emission from the factory during its asbestos producing period (Magnani et al, 2000(Magnani et al, , 2001Maule et al, 2007;Kurumatani and Kumagai, 2008;Musti et al, 2009). Although some information was available on the total amount of asbestos emitted by the pipe plant permitted by legal authorities in certain years, the information was too sparse.…”

Section: Restrictions In Available Informationmentioning

confidence: 96%

“…Typically, these studies have relied on proxy estimates of exposure (Bourdes et al, 2000). Studies in the cities of Casale Monferrato and Bari in Italy and Amagasaki City in Japan showed that the distance of place of residence to an asbestos plant was associated with an increased occurrence of MM (Magnani et al, 2000;Maule et al, 2007;Kurumatani and Kumagai, 2008;Musti et al, 2009). The Japanese study modelled a relative asbestos exposure index, based on distance to plant and meteorological conditions, and could show a linear exposure-response relationship between this index and the MM risk (Kurumatani and Kumagai, 2008).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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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The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case–control study in the city of Bari (Italy)

Abstract: Evidence of an association between mesothelioma risk and EAE is highlighted. The role played by the RMR in increasing the public health local authorities awareness is stressed.

Cited by 54 publications

References 41 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

Mesothelioma mortality surveillance and asbestos exposure tracking in Italy

Assessment of cancer risks due to environmental exposure to asbestos

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