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Ramos-Bonilla JP, Giraldo M, Marsili D, Pasetto R, Terracini B, Mazzeo A, Magnani C, Comba P, Lysaniuk B, Cely-García MF, Ascoli V. An Approach to Overcome the Limitations of Surveillance of Asbestos Related Diseases in Low- and Middle-Income Countries: What We Learned from the Sibaté Study in Colombia. Ann Glob Health 2023; 89:64. [PMID: 37810608 PMCID: PMC10558025 DOI: 10.5334/aogh.4166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 09/09/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction The asbestos industry began its operations in Colombia in 1942 with the establishment of an asbestos-cement facility in Sibaté, located in the Department of Cundinamarca. Despite extensive asbestos use and production in Colombia, the country lacks a reliable epidemiological surveillance system to monitor the health effects of asbestos exposure. The Colombian health information system, known as SISPRO, did not report mesothelioma cases diagnosed in the municipality, posing a significant challenge in understanding the health impacts of asbestos exposure on the population of Sibaté. Methods To address this issue, an active surveillance strategy was implemented in Sibaté. This strategy involved conducting door-to-door health and socioeconomic structured interviews to identify Asbestos-Related Diseases (ARDs). Validation strategies included a thorough review of medical records by a panel of physicians, and the findings were communicated to local, regional, and national authorities, as well as the general population. Results The active surveillance strategy successfully identified a mesothelioma cluster in Sibaté, revealing the inadequacy of the existing health information system in monitoring asbestos-related diseases. The discovery of this cluster underscores the critical importance of implementing active surveillance strategies in Colombia, where governmental institutions and resources are often limited. Conclusion The findings of this study emphasize the urgent need for Colombia to establish a reliable epidemiological surveillance system for asbestos-related diseases (ARDs). Active surveillance strategies can play a crucial role in identifying mesothelioma clusters and enhancing our understanding of the health effects of asbestos exposure in low- and middle-income countries.
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Affiliation(s)
| | - Margarita Giraldo
- Departamento de Ingeniería Civil y Ambiental, Universidad de Los Andes, Bogotá, Colombia
| | - Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, ISS, Rome, IT
- WHO Collaborating Centre for Environmental Health in Contaminated Sites, Istituto Superiore di Sanità, Rome, IT
| | - Roberto Pasetto
- Department of Environment and Health, Istituto Superiore di Sanità, ISS, Rome, IT
- WHO Collaborating Centre for Environmental Health in Contaminated Sites, Istituto Superiore di Sanità, Rome, IT
| | - Benedetto Terracini
- Collegium Ramazzini, Bologna, IT
- Unit of Cancer Epidemiology, University of Torino and CPO-Piemonte, Torino, IT
| | - Agata Mazzeo
- Department of History and Cultures, University of Bologna, Bologna, IT
| | - Corrado Magnani
- Collegium Ramazzini, Bologna, IT
- Department of Translational Medicine, University of Eastern Piedmont, Novara, IT
| | | | | | | | - Valeria Ascoli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, IT
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Fazzo L, Minelli G, De Santis M, Ceccarelli E, Iavarone I, Zona A. The Epidemiological Surveillance of Mesothelioma Mortality in Italy as a Tool for the Prevention of Asbestos Exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5957. [PMID: 37297561 PMCID: PMC10252364 DOI: 10.3390/ijerph20115957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
As part of a surveillance plan active since the early 1990s, this study evaluates malignant mesothelioma (MM) mortality for the time-window 2010-2019 in Italy, a country that banned asbestos in 1992. National and regional mortality rates for MM, and municipal standardized mortality ratios (all mesotheliomas, pleural (MPM) and peritoneal (MPeM)), by gender and age group were calculated. A municipal clustering analysis was also performed. There were 15,446 deaths from MM (11,161 males, 3.8 × 100,000; 4285 females, 1.1 × 100,000), of which 12,496 were MPM and 661 were MPeM. In the study period, 266 people ≤50 years died from MM. A slightly decreasing rate among males since 2014 was observed. The areas at major risk hosted asbestos-cement plants, asbestos mines (chrysotile in Balangero), shipyards, petrochemical and chemical plants, and refineries. Female mortality excesses particularly were found in municipalities with a fluoro-edenite-contaminated mine (Biancavilla) and textile facilities. Excesses were also found in a region with the presence of natural asbestos fibres and in males living in two small islands. The Italian National Prevention Plan stated recommendations to eliminate asbestos exposures and to implement health surveillance and healthcare for people exposed to asbestos.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Emiliano Ceccarelli
- Statistical Service, Istituto Superiore di Sanità, 00161 Rome, Italy; (G.M.); (E.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00161 Rome, Italy; (M.D.S.); (I.I.); (A.Z.)
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Magnani C, Mensi C, Binazzi A, Marsili D, Grosso F, Ramos-Bonilla JP, Ferrante D, Migliore E, Mirabelli D, Terracini B, Consonni D, Degiovanni D, Lia M, Cely-García MF, Giraldo M, Lysaniuk B, Comba P, Marinaccio A. The Italian Experience in the Development of Mesothelioma Registries: A Pathway for Other Countries to Address the Negative Legacy of Asbestos. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20020936. [PMID: 36673690 PMCID: PMC9858856 DOI: 10.3390/ijerph20020936] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/12/2023]
Abstract
Asbestos (all forms, including chrysotile, crocidolite, amosite, tremolite, actinolite, and anthophyllite) is carcinogenic to humans and causally associated with mesothelioma and cancer of the lung, larynx, and ovary. It is one of the carcinogens most diffuse in the world, in workplaces, but also in the environment and is responsible for a very high global cancer burden. A large number of countries, mostly with high-income economies, has banned the use of asbestos which, however, is still widespread in low- and middle-income countries. It remains, thus, one of the most common occupational and environmental carcinogens worldwide. Italy issued an asbestos ban in 1992, following the dramatic observation of a large increase in mortality from mesothelioma and other asbestos-related diseases in exposed workers and also in subjects with non-occupational exposure. A mesothelioma registry was also organized and still monitors the occurrence of mesothelioma cases, conducting a case-by-case evaluation of asbestos exposure. In this report, we describe two Italian communities, Casale Monferrato and Broni, that faced an epidemic of mesothelioma resulting from the production of asbestos cement and the diffuse environmental exposure; we present the activity and results of the Italian mesothelioma registry (ReNaM), describe the risk-communication activities at the local and national level with a focus on international cooperation and also describe the interaction between mesothelioma registration and medical services specialized in mesothelioma diagnosis and treatment in an area at high risk of mesothelioma. Finally, we assess the potential application of the solutions and methods already developed in Italy in a city in Colombia with high mesothelioma incidence associated with the production of asbestos-cement materials and the presence of diffuse environmental asbestos pollution.
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Affiliation(s)
- Corrado Magnani
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority, 00143 Rome, Italy
| | - Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, ISS (Italian National Institute of Health), 00161 Rome, Italy
| | - Federica Grosso
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Juan Pablo Ramos-Bonilla
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Departamento de Ingeniería Civil y Ambiental, Universidad de Los Andes, Bogotá 111711, Colombia
| | - Daniela Ferrante
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Benedetto Terracini
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, 10126 Torin, Italy
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | | | - Michela Lia
- Mesothelioma Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | | | - Margarita Giraldo
- Departamento de Ingeniería Civil y Ambiental, Universidad de Los Andes, Bogotá 111711, Colombia
| | | | - Pietro Comba
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
| | - Alessandro Marinaccio
- Collegium Ramazzini, Bentivoglio, 40010 Modena, Italy
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority, 00143 Rome, Italy
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Stoppa G, Mensi C, Fazzo L, Minelli G, Manno V, Consonni D, Biggeri A, Catelan D. Spatial Analysis of Shared Risk Factors between Pleural and Ovarian Cancer Mortality in Lombardy (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063467. [PMID: 35329152 PMCID: PMC8949464 DOI: 10.3390/ijerph19063467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/11/2022] [Accepted: 03/12/2022] [Indexed: 01/04/2023]
Abstract
Background: Asbestos exposure is a recognized risk factor for ovarian cancer and malignant mesothelioma. There are reports in the literature of geographical ecological associations between the occurrence of these two diseases. Our aim was to further explore this association by applying advanced Bayesian techniques to a large population (10 million people). Methods: We specified a series of Bayesian hierarchical shared models to the bivariate spatial distribution of ovarian and pleural cancer mortality by municipality in the Lombardy Region (Italy) in 2000–2018. Results: Pleural cancer showed a strongly clustered spatial distribution, while ovarian cancer showed a less structured spatial pattern. The most supported Bayesian models by predictive accuracy (widely applicable or Watanabe–Akaike information criterion, WAIC) provided evidence of a shared component between the two diseases. Among five municipalities with significant high standardized mortality ratios of ovarian cancer, three also had high pleural cancer rates. Wide uncertainty was present when addressing the risk of ovarian cancer associated with pleural cancer in areas at low background risk of ovarian cancer. Conclusions: We found evidence of a shared risk factor between ovarian and pleural cancer at the small geographical level. The impact of the shared risk factor can be relevant and can go unnoticed when the prevalence of other risk factors for ovarian cancer is low. Bayesian modelling provides useful information to tailor epidemiological surveillance.
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Affiliation(s)
- Giorgia Stoppa
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, 35131 Padova, Italy; (A.B.); (D.C.)
- Correspondence: (G.S.); (C.M.)
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
- Correspondence: (G.S.); (C.M.)
| | - Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Rome, Italy;
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy; (G.M.); (V.M.)
| | - Valerio Manno
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy; (G.M.); (V.M.)
| | - Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Annibale Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, 35131 Padova, Italy; (A.B.); (D.C.)
| | - Dolores Catelan
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, 35131 Padova, Italy; (A.B.); (D.C.)
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Standardized Incidence Ratio and Standardized Mortality Ratio of Malignant Mesothelioma in a Worker Cohort Using Employment Insurance Database in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010682. [PMID: 34682428 PMCID: PMC8535247 DOI: 10.3390/ijerph182010682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/08/2021] [Accepted: 10/11/2021] [Indexed: 11/16/2022]
Abstract
Malignant mesothelioma is one of the appropriate indicators for assessing the carcinogenic effects of asbestos. This study compared the risk ratio of mesothelioma according to the industry in the worker cohort. A cohort was constructed using the Korean employment insurance system during 1995–2017, enrolling 13,285,895 men and 10,452,705 women. The standardized mortality ratio (SMR) and standardized incidence ratio (SIR) were calculated using the indirect standardization method. There were 641 malignant mesotheliomas that occurred; the SIR was significantly higher than the general population (men 1.36, 95% confidence interval (CI) 1.24–1.48, women 1.44, 95% CI: 1.23–1.7). More than half (52.8%) of malignant mesothelioma cases occurred in the manufacturing (n = 240, 38.6%, SIR: men, 1.72, 95% CI: 1.37–2.15, women, 3.31, 95% CI: 1.71–5.79) and construction industries (n = 88, 14.2%, SIR: men, 1.54 95% CI: 1.33–1.78, women, 1.62 95% CI: 1.25–2.11). The accommodation and food service (men, 2.56 95% CI: 1.28–4.58, women 1.35, 95% CI: 0.65–2.48) and real estate (men 1.34, 95% CI: 0.98–1.83, women 1.95, 95% CI: 0.78–4.02) also showed a high SIR, indicating the risk of asbestos-containing materials in old buildings. The incidence of malignant mesothelioma is likely to increase in the future, given the long latency of this disease. Moreover, long-term follow-up studies will be needed.
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Fazzo L, Binazzi A, Ferrante D, Minelli G, Consonni D, Bauleo L, Bruno C, Bugani M, De Santis M, Iavarone I, Magnani C, Romeo E, Zona A, Alessi M, Comba P, Marinaccio A. Burden of Mortality from Asbestos-Related Diseases in Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10012. [PMID: 34639316 PMCID: PMC8508095 DOI: 10.3390/ijerph181910012] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/16/2021] [Accepted: 09/20/2021] [Indexed: 11/17/2022]
Abstract
Asbestos is one of the major worldwide occupational carcinogens. The global burden of asbestos-related diseases (ARDs) was estimated around 231,000 cases/year. Italy was one of the main European asbestos producers until the 1992 ban. The WHO recommended national programs, including epidemiological surveillance, to eliminate ARDs. The present paper shows the estimate of the burden of mortality from ARDs in Italy, established for the first time. National standardized rates of mortality from mesothelioma and asbestosis and their temporal trends, based on the National Institute of Statistics database, were computed. Deaths from lung cancer attributable to asbestos exposure were estimated using population-based case-control studies. Asbestos-related lung and ovarian cancer deaths attributable to occupational exposure were estimated, considering the Italian occupational cohort studies. In the 2010-2016 period, 4400 deaths/year attributable to asbestos were estimated: 1515 from mesothelioma, 58 from asbestosis, 2830 from lung and 16 from ovarian cancers. The estimates based on occupational cohorts showed that each year 271 deaths from mesothelioma, 302 from lung cancer and 16 from ovarian cancer were attributable to occupational asbestos exposure in industrial sectors with high asbestos levels. The important health impact of asbestos in Italy, 10-25 years after the ban, was highlighted. These results suggest the need for appropriate interventions in terms of prevention, health care and social security at the local level and could contribute to the global estimate of ARDs.
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Affiliation(s)
- Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Daniela Ferrante
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Giada Minelli
- Statistical Service, Istituto Superiore di Sanità, 00100 Roma, Italy;
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy;
| | - Lisa Bauleo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Marcella Bugani
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Ivano Iavarone
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Corrado Magnani
- Department of Translational Medicine, Università del Piemonte Orientale, 28100 Novara, Italy; (D.F.); (C.M.)
| | - Elisa Romeo
- Department of Epidemiology, Servizio Sanitario Regionale del Lazio, 00100 Roma, Italy; (L.B.); (E.R.)
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Mariano Alessi
- Department of Prevention, Ministry of Health, 00100 Roma, Italy;
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, 00100 Roma, Italy; (C.B.); (M.D.S.); (I.I.); (A.Z.); (P.C.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Istituto Nazionale per l’Assicurazione Contro gli Infortuni sul Lavoro, 00100 Roma, Italy; (A.B.); (M.B.); (A.M.)
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Vimercati L, Cavone D, Delfino MC, Caputi A, De Maria L, Sponselli S, Corrado V, Ferri GM, Serio G. Asbestos Air Pollution: Description of a Mesothelioma Cluster Due to Residential Exposure from an Asbestos Cement Factory. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2636. [PMID: 32290540 PMCID: PMC7215593 DOI: 10.3390/ijerph17082636] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 12/12/2022]
Abstract
The study describes a cluster of 71 malignant mesothelioma cases among Bari residents without asbestos exposure other than residential exposure. This small cohort, as expected, was composed of a majority of females (56.34%) with a M/F ratio of 0.8, ages ≤ 65 years old (52.11%) and the epithelioid morphological type (78.87%). Sixty-four subjects (90.14%) lived between 10 m and 1000 m from the asbestos cement factory (Fibronit), and the latency length was longer than 55 years for 25 subjects (35.21%). The adjusted risk (adjusted OR) of observing the epithelial form of mesothelioma among subjects living at small distances from Fibronit was high (OR = 1.870 (0.353-9.905)) for people living 550-1000 m from the site and for those living less than 550 m from the site (OR = 1.470 (0.262-8.248)). Additionally, the subjects with a high length of exposure showed a relevant risk of epithelioid mesothelioma both for 21-40 years of exposure (OR = 2.027 (0.521-7.890)) and more than 40 years of exposure (OR = 2.879 (0.651-12.736)). All of the estimates were high but not significant because this transitional study has a typically low power. The adjustment for latency showed the same trend. Using detailed information collected by the regional mesothelioma registry, this study provided evidence of a continuing health impact of the Fibronit asbestos cement factory in Bari on the resident population.
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Affiliation(s)
- Luigi Vimercati
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Domenica Cavone
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Maria Celeste Delfino
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Antonio Caputi
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Luigi De Maria
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Stefania Sponselli
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Vincenzo Corrado
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Giovanni Maria Ferri
- Interdisciplinary Department of Medicine, Occupational Medicine “B. Ramazzini”, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy; (D.C.); (M.C.D.); (A.C.); (L.D.M.); (S.S.); (V.C.); (G.M.F.)
| | - Gabriella Serio
- Department of Emergency and Organ Transplantation (DETO), Pathology Division, University of Bari Medical School, 11 G, Cesare Square, 70124 Bari, Italy;
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8
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Ramos-Bonilla JP, Cely-García MF, Giraldo M, Comba P, Terracini B, Pasetto R, Marsili D, Ascoli V, Lysaniuk B, Rodríguez MC, Mazzeo A, Panqueva RDPL, Baldión M, Cañón D, García-Herreros LG, Pinzón B, Hernández LJ, Silva YA. An asbestos contaminated town in the vicinity of an asbestos-cement facility: The case study of Sibaté, Colombia. ENVIRONMENTAL RESEARCH 2019; 176:108464. [PMID: 31229775 DOI: 10.1016/j.envres.2019.04.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 05/16/2023]
Abstract
INTRODUCTION The asbestos industry began operations in Colombia in 1942, with an asbestos-cement facility located in the municipality of Sibaté. In recent years residents from Sibaté have been complaining about what they consider is an unusually large number of people diagnosed with asbestos-related diseases in the town. A study to analyze the situation of Sibaté started in 2015, to verify if the number of asbestos related diseases being diagnosed were higher than expected, and to identify potential asbestos exposure sources in the town. METHODS A health and socioeconomic survey was implemented door-to-door to identify potential asbestos-related diseases. Several self-reported mesothelioma cases were identified, and for confirmation purposes, copies of the medical record with the histopathology report were obtained. A panel of six physicians analyzed the medical records. Information of validated cases was used to estimate the male and female age-adjusted incidence rate for Sibaté. Based on reports of the existence of potential asbestos-contaminated landfills, topographic maps, a digital elevation model, and current satellite images were crossed using a geographic information system to identify potential landfilled areas, and soils samples were collected in some of these areas. RESULTS A total of 355 surveys were completed, and 29 self-reported mesothelioma cases were identified. Twenty-five of these cases have been persons who had lived at some moment of their lives in Sibaté. It was possible to obtain copies of the medical diagnosis for 17 cases. Of these, the panel of physicians classified 15 cases as certain pleural mesothelioma, one as probable, and one as not mesothelioma. Based on this information, the estimated age-adjusted incidence rate of mesothelioma in Sibaté was 3.1 × 105 persons-year for males and 1.6 × 105 persons-year for females. These rates are high in comparison to those reported in other cities, regions, and countries of the world. Using geographic information systems, landfilled zones in the urban area of Sibaté were identified, on top of which a school and different sports facilities were built. The analysis of four soil samples collected in landfilled zones, confirmed the existence of an underground layer of friable and non-friable asbestos. CONCLUSION The collected evidence suggests the presence of a malignant pleural mesothelioma cluster in Sibaté.
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Affiliation(s)
- Juan Pablo Ramos-Bonilla
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia.
| | - María Fernanda Cely-García
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Margarita Giraldo
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Pietro Comba
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy; WHO Collaborating Centre for Environmental Health in Contaminated Sites, Istituto Superiore di Sanità, Rome, Italy
| | | | - Roberto Pasetto
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy; WHO Collaborating Centre for Environmental Health in Contaminated Sites, Istituto Superiore di Sanità, Rome, Italy
| | - Daniela Marsili
- Department of Environment and Health, Istituto Superiore di Sanità, Rome, Italy; WHO Collaborating Centre for Environmental Health in Contaminated Sites, Istituto Superiore di Sanità, Rome, Italy
| | - Valeria Ascoli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University, Rome, Italy
| | | | - María Camila Rodríguez
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
| | - Agata Mazzeo
- Department of History and Cultures, University of Bologna, Bologna, Italy
| | - Rocio Del Pilar López Panqueva
- Department of Pathology and Laboratories, Fundación Santa Fe de Bogotá, Associate Clinical Professor, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Margarita Baldión
- Department of Pathology and Laboratories, Fundación Santa Fe de Bogotá, Associate Clinical Professor, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | - Diana Cañón
- Department of Pathology and Laboratories, Fundación Santa Fe de Bogotá, Associate Clinical Professor, School of Medicine, Universidad de Los Andes, Bogotá, Colombia
| | | | - Bibiana Pinzón
- Diagnostic Imaging Department, Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Yordi Alejandro Silva
- Department of Civil and Environmental Engineering, School of Engineering, Universidad de Los Andes, Bogotá, Colombia
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Zona A, Fazzo L, Minelli G, De Santis M, Bruno C, Conti S, Comba P. Peritoneal mesothelioma mortality in Italy: Spatial analysis and search for asbestos exposure sources. Cancer Epidemiol 2019; 60:162-167. [PMID: 31030080 DOI: 10.1016/j.canep.2019.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 03/08/2019] [Accepted: 04/02/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND This study is part of a national plan of epidemiological surveillance of malignant mesothelioma (MM) mortality in Italy. The paper shows the results of malignant peritoneal mesothelioma (MPeM) mortality study in Italian Regions and municipalities. METHODS National Bureau of Statistics data for MPeM municipal mortality (ICD-10, Code C45.1) were analyzed in the time-window 2003-2014: mortality standardized rates (reference Italian population, census 2011), temporal trends of the annual national rates, Standardized Mortality Ratios and a municipal clustering analysis were performed. RESULTS 747 deaths for MPeM were recorded (0.10/100,000): 464 in men (0.14/100,000) and in 283 women (0.07/100,000). No significant MPeM mortality temporal trend was found. Seventeen municipalities showed excesses of mortality for MPeM in at least one gender and/or overall population. Four clusters in male population, and one in women were identified. CONCLUSIONS The study identifies some areas where remediation activities and/or health care actions may be warranted.
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Affiliation(s)
- A Zona
- Department of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 I-00161 Rome, Italy.
| | - L Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 I-00161 Rome, Italy.
| | - G Minelli
- Statistical Service, Istituto Superiore di Sanità, viale Regina Elena, 299 I-00161 Rome, Italy.
| | - M De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 I-00161 Rome, Italy.
| | - C Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 I-00161 Rome, Italy.
| | - S Conti
- Statistical Service, Istituto Superiore di Sanità, viale Regina Elena, 299 I-00161 Rome, Italy.
| | - P Comba
- Department of Environment and Health, Istituto Superiore di Sanità, viale Regina Elena, 299 I-00161 Rome, Italy.
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