1
|
Berge LAM, Shala NK, Barone-Adesi F, Hosgood HD, Samuelsen SO, Bråtveit M, Kirkeleit J, Silverman D, Friesen MC, Babigumira R, Grimsrud TK, Veierød MB, Stenehjem JS. Exposure to fibres and risk of pleural mesothelioma in the Norwegian Offshore Petroleum Workers cohort. Occup Environ Med 2024; 81:331-338. [PMID: 38955483 DOI: 10.1136/oemed-2024-109424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/21/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES Pleural mesothelioma is a rare respiratory cancer, mainly caused by inhalation of asbestos fibres. Other inorganic fibres are also suggested risk factors. We aimed to investigate the association between exposure to asbestos or refractory ceramic fibres (RCFs) and pleural mesothelioma among male Norwegian offshore petroleum workers. METHODS Among 25 347 men in the Norwegian Offshore Petroleum Workers (NOPW) cohort (1965-1998), 43 pleural mesothelioma cases were identified through the Cancer Registry of Norway (1999-2022). A case-cohort study was conducted with 2095 randomly drawn non-cases from the cohort. Asbestos and RCF exposures were assessed with expert-made job-exposure matrices (JEMs). Weighted Cox regression was used to estimate HRs and 95% CIs, adjusted for age at baseline and pre-offshore employment with likely asbestos exposure. RESULTS An increased risk of pleural mesothelioma was indicated for the highest versus lowest tertile of average intensity of asbestos (HR=1.21, 95% CI: 0.57 to 2.54). Pre-offshore asbestos exposure (vs no such exposure) was associated with increased risk of pleural mesothelioma (HR=2.06, 95% CI: 1.11 to 3.81). For offshore workers with no pre-offshore asbestos exposure, an increased risk of pleural mesothelioma was found for the highest tertile of average intensity of asbestos (HR=4.13, 95% CI: 0.93 to 18), versus the lowest tertile. No associations were found between RCF and pleural mesothelioma. CONCLUSIONS Associations between JEM-based offshore asbestos exposure and pleural mesothelioma were confirmed in the NOPW cohort. Pleural mesothelioma risk was also associated with asbestos exposure before work in the offshore petroleum industry.
Collapse
Affiliation(s)
- Leon Alexander Mclaren Berge
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Research, Cancer Registry of Norway, National Institute of Public Health, Oslo, Norway
| | - Nita Kaupang Shala
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Research, Cancer Registry of Norway, National Institute of Public Health, Oslo, Norway
| | | | - H Dean Hosgood
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Magne Bråtveit
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Jorunn Kirkeleit
- Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway
| | - Debra Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Ronnie Babigumira
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
- Department of Research, Cancer Registry of Norway, National Institute of Public Health, Oslo, Norway
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, National Institute of Public Health, Oslo, Norway
| | - Marit B Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Jo S Stenehjem
- Department of Research, Cancer Registry of Norway, National Institute of Public Health, Oslo, Norway
| |
Collapse
|
2
|
De Maria L, Pentimone F, Cavone D, Caputi A, Sponselli S, Fragassi F, Dicataldo F, Luisi V, Delvecchio G, Giannelli G, Cafaro F, Sole S, Ronghi C, Zagaria S, Loiacono G, Sifanno G, Ferri GM, Vimercati L. Clinical investigation of former workers exposed to asbestos: the health surveillance experience of an Italian University Hospital. Front Public Health 2024; 12:1411910. [PMID: 38952736 PMCID: PMC11215018 DOI: 10.3389/fpubh.2024.1411910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 05/28/2024] [Indexed: 07/03/2024] Open
Abstract
Background The need for health surveillance of former workers exposed to asbestos was provided by law in Italy after the asbestos ban in 1992. Objectives We describe the results of the health surveillance of former workers exposed to asbestos, conducted over 27 years, from 1994 to 2020, at the Operative Unit of Occupational Medicine of the University Hospital of Bari. Materials and methods We adopted the health surveillance protocol, which was validated at the national level in 2018. Results A total of 1,405 former workers exposed to asbestos were examined. We proceeded with diagnosing pathologies in 339 cases (24% of the cohort subjected to surveillance), with diagnoses of some cases involving multiple pathologies. Specifically, pleural plaques were diagnosed in 49.2% of the 339 cases, asbestosis in 35.9%, malignant pleural mesothelioma (MPM) in 20.3%, mesothelioma of the vaginal tunic of the testis (MTVT) in 9.1%, lung cancer in 5.8%, and laryngeal cancer in 0.8%. Conclusion Despite the 1992 asbestos ban, asbestos-related diseases remain a serious public health issue. It is important to establish criteria that ensure the health surveillance of formerly exposed workers minimizes costs, reduces the number of invasive examinations, and optimizes achievable results.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Luigi Vimercati
- University of Bari, Interdisciplinary Department of Medicine, Occupational Medicine Unit, Bari, Italy
| |
Collapse
|
3
|
Miao X, Yao T, Dong C, Chen Z, Wei W, Shi Z, Xu T, Shao J, Niu Q, Rui D, Hu Y, Yan Y. Global, regional, and national burden of non-communicable diseases attributable to occupational asbestos exposure 1990-2019 and prediction to 2035: worsening or improving? BMC Public Health 2024; 24:832. [PMID: 38500093 PMCID: PMC10946175 DOI: 10.1186/s12889-024-18099-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/14/2024] [Indexed: 03/20/2024] Open
Abstract
Understanding the burden associated with occupational asbestos exposure on a global and regional scale is necessary to implement coordinated prevention and control strategies. By the GBD Study 2019, we conducted a comprehensive assessment of the non-communicable diseases burden attributable to occupational asbestos exposure. In 2019, 239,330 deaths and 4,189,000 disability-adjusted life years (DALYs) worldwide due to occupational asbestos exposure occurred. 1990-2019, deaths and DALYs attributed to occupational asbestos exposure increased by 65.65% and 43.66%, respectively. Age-standardized mortality rate (ASMR) and age-standardized DALYs rate (ASDR) decreased, with the most rapid declines in high Socio-Demographic Index (SDI) regions, with average annual percent change (AAPC) of - 1.05(95%CI: -1.2, -0.89) and -1.53(95%CI: -1.71, -1.36), respectively. Lung cancer, mesothelioma and ovarian cancer were the top three contributors to the increase in deaths and DALYs, accounting for more than 96%. AAPCs of ASMR and ASDR were positively associated with SDI. Global deaths from occupational asbestos exposure were predicted to increase and ASMR to decrease by 2035, mostly in males. Due consideration should be given to the susceptibility of the elderly, the lag of asbestos onset, and the regional differences, and constantly improve the prevention and control measures of occupational asbestos exposure and related diseases.
Collapse
Affiliation(s)
- Xinlu Miao
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Teng Yao
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Chenxian Dong
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Zuhai Chen
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Wanting Wei
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Zhengyang Shi
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Tongtong Xu
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Jianjiang Shao
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
| | - Qiang Niu
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Dongsheng Rui
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China
| | - Yunhua Hu
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China.
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China.
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China.
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
| | - Yizhong Yan
- Department of Preventive Medicine, School of Medicine, Shihezi University, No. 59, North 2nd Rd, Hong-Shan District, Shihezi, Xinjiang, 832003, China.
- Key Laboratory for Prevention and Control of Crucial Emerging Infectious Diseases and Public Health Security of The Xinjiang Production and Construction Corps, Shihezi, Xinjiang, China.
- Key Laboratory of Preventive Medicine, Shihezi University, Shihezi, Xinjiang, China.
- Key Laboratory of Xinjiang Endemic and Ethnic Diseases (Ministry of Education), School of Medicine, Shihezi University, Shihezi, Xinjiang, China.
| |
Collapse
|
4
|
Ferrante D, Angelini A, Barbiero F, Barbone F, Bauleo L, Binazzi A, Bovenzi M, Bruno C, Casotto V, Cernigliaro A, Ceppi M, Cervino D, Chellini E, Curti S, De Santis M, Fazzo L, Fedeli U, Fiorillo G, Franchi A, Gangemi M, Giangreco M, Rossi PG, Girardi P, Luberto F, Massari S, Mattioli S, Menegozzo S, Merlo DF, Michelozzi P, Migliore E, Miligi L, Oddone E, Pernetti R, Perticaroli P, Piro S, Addario SP, Romeo E, Roncaglia F, Silvestri S, Storchi C, Zona A, Magnani C, Marinaccio A. Cause specific mortality in an Italian pool of asbestos workers cohorts. Am J Ind Med 2024; 67:31-43. [PMID: 37855384 DOI: 10.1002/ajim.23546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 10/03/2023] [Accepted: 10/06/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Asbestos is a known human carcinogen and is causally associated with malignant mesothelioma, lung, larynx and ovarian cancers. METHODS Cancer risk was studied among a pool of formerly asbestos-exposed workers in Italy. Fifty-two Italian asbestos cohorts (asbestos-cement, rolling-stock, shipbuilding, and other) were pooled and their mortality follow-up was updated to 2018. Standardized mortality ratios (SMRs) were computed for major causes of death considering duration of exposure and time since first exposure (TSFE), using reference rates by region, age and calendar period. RESULTS The study included 63,502 subjects (57,156 men and 6346 women): 40% who were alive, 58% who died (cause known for 92%), and 2% lost to follow-up. Mortality was increased for all causes (SMR: men = 1.04, 95% confidence interval [CI] 1.03-1.05; women = 1.15, 95% CI 1.11-1.18), all malignancies (SMR: men = 1.21, 95% CI 1.18-1.23; women = 1.29, 95% CI 1.22-1.37), pleural and peritoneal malignancies (men: SMR = 10.46, 95% CI 9.86-11.09 and 4.29, 95% CI 3.66-5.00; women: SMR = 27.13, 95% CI 23.29-31.42 and 7.51, 95% CI 5.52-9.98), lung (SMR: men = 1.28, 95% CI 1.24-1.32; women = 1.26, 95% CI 1.02-1.53), and ovarian cancer (SMR = 1.42, 95% CI 1.08-1.84). Pleural cancer mortality increased during the first 40 years of TSFE (latency), reaching a plateau thereafter. CONCLUSIONS Analyses by time-dependent variables showed that the risk for pleural neoplasms increased with latency and no longer increases at long TSFE, consistent with with asbestos clearance from the lungs. Peritoneal neoplasm risk increased over all observation time.
Collapse
Affiliation(s)
- Daniela Ferrante
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Alessia Angelini
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Fabiano Barbiero
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Fabio Barbone
- Department of Medical Sciences, University of Trieste, Trieste, Italy
| | - Lisa Bauleo
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
| | - Massimo Bovenzi
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | - Caterina Bruno
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Veronica Casotto
- Epidemiological Department, Azienda Zero, Padova, Veneto Region, Italy
| | | | - Marcello Ceppi
- Clinical Epidemiology Unit, IRCCS-Ospedale Policlinico San Martino, Genoa, Italy
| | - Daniela Cervino
- Department of Public Health, Azienda USL di Bologna, Bologna, Italy
| | | | - Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Marco De Santis
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Lucia Fazzo
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Padova, Veneto Region, Italy
| | - Germano Fiorillo
- Unit of Occupational Medicine-Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | - Alberto Franchi
- Department of Public Health, Azienda USL di Bologna, Bologna, Italy
| | - Manuela Gangemi
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, Torino, Italy
| | - Manuela Giangreco
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venice, Italy
| | - Ferdinando Luberto
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Stefania Massari
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
| | - Stefano Mattioli
- Department of Environmental and Preventive Sciences, University of Ferrara, Ferrara, Italy
| | - Simona Menegozzo
- Unit of Occupational Medicine-Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Napoli, Italy
| | | | - Paola Michelozzi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Regional Operating Center of Piemonte (COR Piemonte), University of Torino and CPO-Piemonte, Torino, Italy
| | - Lucia Miligi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine-University of Pavia, Pavia, Italy
| | - Roberta Pernetti
- Department of Public Health, Experimental and Forensic Medicine-University of Pavia, Pavia, Italy
| | | | - Sara Piro
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | | | - Elisa Romeo
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | | | - Stefano Silvestri
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Cinzia Storchi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Amerigo Zona
- Department of Environment and Health, Istituto Superiore di Sanità, Roma, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Università del Piemonte Orientale and CPO Piemonte, Novara, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority, Rome, Italy
| |
Collapse
|
5
|
Azzolina D, Consonni D, Ferrante D, Mirabelli D, Silvestri S, Luberto F, Angelini A, Cuccaro F, Nannavecchia AM, Oddone E, Vicentini M, Barone-Adesi F, Cena T, Mangone L, Roncaglia F, Sala O, Menegozzo S, Pirastu R, Tunesi S, Chellini E, Miligi L, Perticaroli P, Pettinari A, Bressan V, Merler E, Girardi P, Bisceglia L, Marinaccio A, Massari S, Magnani C. Rate advancement measurement for lung cancer and pleural mesothelioma in asbestos-exposed workers. Thorax 2023; 78:808-815. [PMID: 36357176 DOI: 10.1136/thorax-2021-217862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 10/13/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Exposure to asbestos increases the risk of lung cancer and mesothelioma. Few studies quantified the premature occurrence of these diseases in asbestos-exposed workers. Focus on premature disease onset (rate advancement or acceleration) can be useful in risk communication and for the evaluation of exposure impact. We estimated rate advancement for total mortality, lung cancer and pleural mesothelioma deaths, by classes of cumulative asbestos exposure in a pooled cohort of asbestos cement (AC) workers in Italy. METHOD The cohort study included 12 578 workers from 21 cohorts, with 6626 deaths in total, 858 deaths from lung cancer and 394 from pleural malignant neoplasm (MN). Rate advancement was estimated by fitting a competitive mortality Weibull model to the hazard of death over time since first exposure (TSFE). RESULT Acceleration time (AT) was estimated at different TSFE values. The highest level of cumulative exposure compared with the lowest, for pleural MN AT was 16.9 (95% CI 14.9 to 19.2) and 33.8 (95% CI 29.8 to 38.4) years at TSFE of 20 and 40 years, respectively. For lung cancer, it was 13.3 (95% CI 12.0 to 14.7) and 26.6 (95% CI 23.9 to 29.4) years, respectively. As for total mortality, AT was 3.35 (95% CI 2.98 to 3.71) years at 20 years TSFE, and 6.70 (95% CI 5.95 to 7.41) at 40 years TSFE. CONCLUSION The current study observed marked rate advancement after asbestos exposure for lung cancer and pleural mesothelioma, as well as for total mortality.
Collapse
Affiliation(s)
| | - Dario Consonni
- Unit of Epidemiology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Ferrante
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Dario Mirabelli
- Unit of Cancer Epidemiology, CPO Piedmont and University of Turin, Turin, Italy
| | - Stefano Silvestri
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Ferdinando Luberto
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Alessia Angelini
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Francesco Cuccaro
- Unit of Epidemiology and Statistics, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Anna Maria Nannavecchia
- Unit of Epidemiology and Statistics, Local Health Unit of Barletta-Andria-Trani, Barletta, Italy
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, and ICS Maugeri IRCCS, Pavia, Italy
| | - Massimo Vicentini
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesco Barone-Adesi
- Unit of Public Health, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Tiziana Cena
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Lucia Mangone
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Francesca Roncaglia
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Orietta Sala
- Regional Agency for Protection, Environment and Energy Emilia-Romagna, Reggio Emilia, Italy
| | - Simona Menegozzo
- National Cancer Institute IRCCS Fondazione Pascale, Napoli, Italy
| | - Roberta Pirastu
- Department of Biology and Biotechnologies 'Charles Darwin', Sapienza University, Rome, Italy
| | - Sara Tunesi
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| | - Elisabetta Chellini
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | - Lucia Miligi
- Occupational & Environmental Epidemiology Unit-Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Firenze, Italy
| | | | | | | | - Enzo Merler
- Mesothelioma Register of the Veneto Region, Regional Epidemiologic System, Local Health Unit 6, Padua, Italy
| | - Paolo Girardi
- Mesothelioma Register of the Veneto Region, Regional Epidemiologic System, Local Health Unit 6, Padua, Italy
- Department of Developmental and Social Psychology Department of Statistical Sciences University of Padova, Padua, Italy
| | - Lucia Bisceglia
- Apulia Regional Agency for Health and Social Policies-ARESS Puglia, Bari, Italy
| | - Alessandro Marinaccio
- Italian Workers' Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Roma, Italy
| | - Stefania Massari
- Italian Workers' Compensation Authority (INAIL), Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Unit of Occupational and Environmental Epidemiology, Italian Mesothelioma Register, Roma, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, Università degli Studi del Piemonte Orientale Amedeo Avogadro, Novara, Italy
| |
Collapse
|
6
|
Cangemi M, Montico M, Trovo M, Minatel E, Di Gregorio E, Corona G, Giordari F, Comaro E, Colizzi F, Baboçi L, Steffan A, Revelant A, Muraro E. Emerging Role of Immunomonitoring to Predict the Clinical Outcome of Patients With Malignant Pleural Mesothelioma Treated With Radical Radiation Therapy. Int J Radiat Oncol Biol Phys 2023; 115:608-621. [PMID: 36202181 DOI: 10.1016/j.ijrobp.2022.09.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE The present study aimed at evaluating the baseline immune profile and the immunomodulating effects of radical hemithoracic radiation therapy (RT) in patients affected by malignant pleural mesothelioma (MPM) to identify potential predictive biomarkers of therapy response, toxicity development, and eligibility for further immunotherapeutic treatments. METHODS AND MATERIALS Blood samples were collected from 55 patients with MPM, enrolled in a phase 3 trial comparing radical hemithoracic RT (interventional arm, n = 28) with local palliative RT (control arm, n = 27). Immunomonitoring was performed before RT, at the end of treatment, and 1 month after therapy, characterizing natural killer cells, B and T lymphocytes, activated CD4 and CD8 T cells, interferon-γ- and tumor necrosis factor-α-producing T helper (Th) 1 cells, regulatory T cells, and Th17 and Th22 lymphocytes, through flow cytometry. Serum levels of interleukin (IL)-6, -8, -10 and mesothelin were quantified through Enzyme-Linked Immunosorbent Assay (ELISA) assays at the same time points. Variations in the immune parameters were investigated by Friedman test and Wilcoxon signed rank post hoc test with Bonferroni correction for multiple testing, while the prognostic effect of immune biomarkers was evaluated through Kaplan-Meier method and Spearman's correlation analysis. RESULTS Major immune variations were noticed after radical RT compared with palliative treatment, in particular an improvement in activated T cells and in interferon-γ-producing Th1 cells after RT. In the interventional arm, baseline high levels of Th22 and IL-10 and an increase in T cells were associated with an improved survival, whereas a fold increase in serum mesothelin correlated with the development of severe toxicity. An improvement of immunosuppressive regulatory T cells was observed in both arms of treatment. CONCLUSIONS The immunomonitoring performed in patients with MPM revealed potential prognostic biomarkers for radical hemithoracic RT treatment and identified specific immune signatures induced by RT immunomodulation, which could suggest a synergistic effect with an immunotherapeutic treatment.
Collapse
Affiliation(s)
- Michela Cangemi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Marcella Montico
- Clinical Trial Office, Scientific Direction, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Marco Trovo
- Department of Radiation Oncology, Udine General Hospital, Udine, Italy
| | - Emilio Minatel
- Division of Radiation Oncology, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Emanuela Di Gregorio
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Giuseppe Corona
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Fabiana Giordari
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Elisa Comaro
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Francesca Colizzi
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Lorena Baboçi
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Agostino Steffan
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Alberto Revelant
- Division of Radiation Oncology, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy
| | - Elena Muraro
- Immunopathology and Cancer Biomarkers, CRO Aviano, National Cancer Institute, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Aviano, Italy.
| |
Collapse
|
7
|
Global magnitude and temporal trend of mesothelioma burden along with the contribution of occupational asbestos exposure in 204 countries and territories from 1990 to 2019: Results from the Global Burden of Disease Study 2019. Crit Rev Oncol Hematol 2022; 179:103821. [PMID: 36165817 DOI: 10.1016/j.critrevonc.2022.103821] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/15/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Understanding the burden of mesothelioma with the contribution of occupational asbestos exposure globally provides essential foundations for cancer control, policy decisions and resource allocation. Globally, 34,511 incident cases, 29,251 deaths and 668,104 disability-adjusted life years (DALYs) of mesothelioma were estimated in 2019. The age-standardized rates of incidence, mortality and DALYs all showed a slightly declining trend over the past 30 years, but the latest absolute number of mesothelioma burden almost doubled since 1990. The burden rate decreased among the population aged under 70 years, but increased among the population aged over 80 years, especially in the High socio-demographic index (SDI) region. The burden rate of mesothelioma attributable to asbestos exposure was positively associated with SDI at the national level. This study depicted a continuous increase in mesothelioma burden globally over the past 30 years. Controlling occupational asbestos exposure will reduce the mesothelioma burden, especially for higher SDI regions.
Collapse
|
8
|
Prognostic Bone Metastasis-Associated Immune-Related Genes Regulated by Transcription Factors in Mesothelioma. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9940566. [PMID: 35127947 PMCID: PMC8813231 DOI: 10.1155/2022/9940566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 09/30/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022]
Abstract
Mesothelioma (MESO) is a mesothelial originate neoplasm with high morbidity and mortality. Despite advancement in technology, early diagnosis still lacks effectivity and is full of pitfalls. Approaches of cancer diagnosis and therapy utilizing immune biomarkers and transcription factors (TFs) have attracted more and more attention. But the molecular mechanism of these features in MESO bone metastasis has not been thoroughly studied. Utilizing high-throughput genome sequencing data and lists of specific gene subsets, we performed several data mining algorithm. Single-sample Gene Set Enrichment Analysis (ssGSEA) was applied to identify downstream immune cells. Potential pathways involved in MESO bone metastasis were identified using Gene Oncology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, Gene Set Variation Analysis (GSVA), Gene Set Enrichment Analysis (GSEA), and Cox regression analysis. Ultimately, a model to help early diagnosis and to predict prognosis was constructed based on differentially expressed immune-related genes between bone metastatic and nonmetastatic MESO groups. In conclusion, immune-related gene SDC2, regulated by TFs TCF7L1 and POLR3D, had an important role on immune cell function and infiltration, providing novel biomarkers and therapeutic targets for metastatic MESO.
Collapse
|
9
|
Oddone E, Bollon J, Nava CR, Consonni D, Marinaccio A, Magnani C, Gasparrini A, Barone-Adesi F. Effect of Asbestos Consumption on Malignant Pleural Mesothelioma in Italy: Forecasts of Mortality up to 2040. Cancers (Basel) 2021; 13:3338. [PMID: 34283067 PMCID: PMC8267929 DOI: 10.3390/cancers13133338] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 06/30/2021] [Indexed: 12/31/2022] Open
Abstract
Statistical models used to forecast malignant pleural mesothelioma (MPM) trends often do not take into account historical asbestos consumption, possibly resulting in less accurate predictions of the future MPM death toll. We used the distributed lag non-linear model (DLNM) approach to predict future MPM cases in Italy until 2040, based on past asbestos consumption figures. Analyses were conducted using data on male MPM deaths (1970-2014) and annual asbestos consumption using data on domestic production, importation, and exportation. According to our model, the peak of MPM deaths is expected to occur in 2021 (1122 expected cases), with a subsequent decrease in mortality (344 MPM deaths in 2039). The exposure-response curve shows that relative risk (RR) of MPM increased almost linearly for lower levels of exposure but flattened at higher levels. The lag-specific RR grew until 30 years since exposure and decreased thereafter, suggesting that the most relevant contributions to the risk come from exposures which occurred 20-40 years before death. Our results show that the Italian MPM epidemic is approaching its peak and underline that the association between temporal trends of MPM and time since exposure to asbestos is not monotonic, suggesting a lesser role of remote exposures in the development of MPM than previously assumed.
Collapse
Affiliation(s)
- Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Severino Boezio 24, 27100 Pavia, Italy
- Occupational Medicine Unit (UOOML), ICS Maugeri IRCCS, 27100 Pavia, Italy
| | - Jordy Bollon
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy; (J.B.); (C.M.); (F.B.-A.)
| | - Consuelo Rubina Nava
- Department of Economics and Statistics ‘Cognetti de Martiis’, University of Turin, 10124 Turin, Italy;
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Alessandro Marinaccio
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers’ Compensation Authority (INAIL), 00187 Rome, Italy;
| | - Corrado Magnani
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy; (J.B.); (C.M.); (F.B.-A.)
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK;
- Centre for Statistical Methodology, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
| | - Francesco Barone-Adesi
- Department of Translational Medicine, University of Eastern Piedmont, 28100 Novara, Italy; (J.B.); (C.M.); (F.B.-A.)
| |
Collapse
|