Lucia Fazzo1, Giada Minelli2, Marco De Santis3, Caterina Bruno4, Amerigo Zona5, Susanna Conti6, Pietro Comba7. 1. Dept of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 - 00161 Roma, Italy. Electronic address: lucia.fazzo@iss.it. 2. Statistical Service, Istituto Superiore di Sanità, viale Regina Elena, 299 - 00161 Roma, Italy. Electronic address: giada.minelli@iss.it. 3. Dept of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 - 00161 Roma, Italy. Electronic address: marco.desantis@iss.it. 4. Dept of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 - 00161 Roma, Italy. Electronic address: caterina.bruno@iss.it. 5. Dept of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 - 00161 Roma, Italy. Electronic address: amerigo.zona@iss.it. 6. Statistical Service, Istituto Superiore di Sanità, viale Regina Elena, 299 - 00161 Roma, Italy. Electronic address: susanna.conti@iss.it. 7. Dept of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 - 00161 Roma, Italy. Electronic address: pietro.comba@iss.it.
Abstract
BACKGROUND: Malignant mesothelioma (MM) is causally linked to asbestos exposure with an estimated etiological fraction of 80% or more. METHODS: Standardized rates of all mesothelioma (C45, ICD-10) and malignant pleural mesothelioma (C45.0, ICD-10) mortality in Italy were computed at national and regional levels, for the period 2003-2014. Standardized Mortality Ratios (SMRs, with 95% Confidence Intervals) were calculated for each of the 8047 Italian municipalities, for both diseases, with respect to Regional figures. A geographical clustering analysis at municipal level was performed, applying SatScan methods. RESULTS: In Italy, 16,086 persons (about 1,340/year) died for MM, in analysed period. National Standardized rates of MM mortality are 3.65/100,000 in men and 1.09/100,000 in women, with an increasing annual trend, among male population. The highest rates were found in men from Northern Regions. Significant clusters (p < 0.10) were found corresponding to areas that hosted major asbestos-cement plants, naval shipyards, petrochemical plants and refineries. Furthermore, excesses were found corresponding to chemical and textile industries; the latter involving, particularly, female population. Excesses were found also in areas near the chrysotile mine of Balangero, and in Biancavilla, a town with a stone quarry contaminated by fluoro-edenitic fibres; an excess of MM mortality was observed among male population living in a minor island where a Navy shipyard is located. CONCLUSIONS: Mortality for mesothelioma in Italy is still increasing, twenty-six years after the asbestos ban. Epidemiological surveillance of mesothelioma mortality allows to detect the temporal trend of the disease and highlights previously unknown or underestimated sources of asbestos exposure.
BACKGROUND:Malignant mesothelioma (MM) is causally linked to asbestos exposure with an estimated etiological fraction of 80% or more. METHODS: Standardized rates of all mesothelioma (C45, ICD-10) and malignant pleural mesothelioma (C45.0, ICD-10) mortality in Italy were computed at national and regional levels, for the period 2003-2014. Standardized Mortality Ratios (SMRs, with 95% Confidence Intervals) were calculated for each of the 8047 Italian municipalities, for both diseases, with respect to Regional figures. A geographical clustering analysis at municipal level was performed, applying SatScan methods. RESULTS: In Italy, 16,086 persons (about 1,340/year) died for MM, in analysed period. National Standardized rates of MM mortality are 3.65/100,000 in men and 1.09/100,000 in women, with an increasing annual trend, among male population. The highest rates were found in men from Northern Regions. Significant clusters (p < 0.10) were found corresponding to areas that hosted major asbestos-cement plants, naval shipyards, petrochemical plants and refineries. Furthermore, excesses were found corresponding to chemical and textile industries; the latter involving, particularly, female population. Excesses were found also in areas near the chrysotile mine of Balangero, and in Biancavilla, a town with a stone quarry contaminated by fluoro-edenitic fibres; an excess of MM mortality was observed among male population living in a minor island where a Navy shipyard is located. CONCLUSIONS: Mortality for mesothelioma in Italy is still increasing, twenty-six years after the asbestos ban. Epidemiological surveillance of mesothelioma mortality allows to detect the temporal trend of the disease and highlights previously unknown or underestimated sources of asbestos exposure.
Authors: Luigi Vimercati; Domenica Cavone; Maria Celeste Delfino; Antonio Caputi; Luigi De Maria; Stefania Sponselli; Vincenzo Corrado; Giovanni Maria Ferri; Gabriella Serio Journal: Int J Environ Res Public Health Date: 2020-04-12 Impact factor: 3.390