Massimo Nesti - Academia.edu (original) (raw)

Papers by Massimo Nesti

European Journal of Cancer, 2003

The Italian National Mesothelioma Register (ReNaM) was set up at ISPESL (the National Institute f... more The Italian National Mesothelioma Register (ReNaM) was set up at ISPESL (the National Institute for Occupational Safety and Prevention) in 1993. Five Italian regions (Piedmont, Liguria, Emilia-Romagna, Tuscany and Puglia, with a total of approximately 17 500 000 inhabitants) agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data to ISPESL. We describe an analysis of survival of 429 mesothelioma cases-392 pleural, 34 peritoneal and 3 in the pericardium-diagnosed during 1997, with variable follow-up from June 1999 to December 2001. The Kaplan-Meier method was used to estimate survival rates, the log rank non-parametric test and Cox proportional hazard model to assess the role of prognostic factors such as age, gender, morphology, level of diagnostic certainty and modality of exposure. Median survival was 275 days (95% confidence interval (CI) 241-309) for pleural mesotheliomas and 157 days (95% CI: 118-196) for peritoneal mesotheliomas. Survival after diagnosis of malignant pleural mesothelioma showed a statistically significant linear trend for age group at diagnosis, for males and females (P=0.006 and 0.008, respectively). The Cox proportional hazard model gave an adjusted relative risk (RR adj ), for the fibrous histotype, of 2.96 (95% CI: 1.28-6.81; P=0.012) compared with cases with unspecified morphology; for epithelioid and biphasic morphologies, the risk was lower than unity. There was no significant difference in survival for cases with confirmed exposure (occupational, household or environmental) or without. #

A seguito della pubblicazione del D.Lgs. n. 257/92 sulle 'Norme relative alla cessazione dell'imp... more A seguito della pubblicazione del D.Lgs. n. 257/92 sulle 'Norme relative alla cessazione dell'impiego dell'amianto' e del DPR 8 agosto 1994:'Atto di indirizzo e coordinamento alle Regioni e Province autonome di Trento e di Bolzano per l'adozione di piani di protezione, di decontaminazione, di smaltimento e di bonifica dell'ambiente, ai fini della difesa dai pericoli derivanti dall'amianto', l'ISPESL ha realizzato e pubblicato una anagrafe delle aziende e degli esposti a rischio amianto.Tale anagrafe, ottenuta attraverso un modello statistico di linkage fra gli archivi di diverse fonti amministrative -in particolare INPS e Camere di Commercio -risulta essere articolata su due livelli: il primo relativo all'Allegato B dello stesso decreto 'Elenco dei codici ISTAT delle aziende con possibile presenza di amianto', il secondo relativo alle 'Attività maggiormente interessate da possibile presenza di amianto'. L'anno di riferimento è il 1991 in ragione dell'entrata in vigore del D.Lgs. n. 257/92 e l'unità territoriale minima di riferimento è il Comune.

International Journal of Cancer, 2005

Italy was the second main asbestos producer in Europe, after the Soviet Union, until the end of t... more Italy was the second main asbestos producer in Europe, after the Soviet Union, until the end of the 1980s, and raw asbestos was imported on a large scale until 1992. The Italian pattern of asbestos consumption lags on average about 10 years behind the United States, Australia, the United Kingdom and the Nordic countries. Measures to reduce exposure were introduced in the mid-1970s in some workplaces. In 1986, limitations were imposed on the use of crocidolite and in 1992 asbestos was definitively banned. We have used primary pleural cancer mortality figures (1970–1999) to predict mortality from mesothelioma among Italian men in the next 30 years by age-cohort-period models and by a model based on asbestos consumption figures. The pleural cancer/mesothelioma ratio and mesothelioma misdiagnosis in the past were taken into account in the analysis. Estimated risks of birth cohorts born after 1945 decrease less quickly in Italy than in other Western countries. The findings predict a peak with about 800 mesothelioma annual deaths in the period 2012–2024. Results estimated using age-period-cohort models were similar to those obtained from the asbestos consumption model. © 2004 Wiley-Liss, Inc.

Archives of Environmental Health, 2000

In a recent epidemiological study, researchers investigated mortality from malignant pleural neop... more In a recent epidemiological study, researchers investigated mortality from malignant pleural neoplasms in Italy, and they detected some geographic clusters of cases of this disease. We found a town located in a volcanic area of eastern Sicily to be of special interest. The residents, some of whom were diagnosed with pleural mesothelioma, had never had any relevant exposure to asbestos during their professional lives. The results of an environmental survey suggested that a possible cause of asbestos exposure was the stone quarries near the town. The products of the quarries contain fibrous amphiboles, which are used widely in the local building industry. These fibrous amphiboles were identified as intermediate phases between tremolite and actinolite. Samples were collected from buildings in the town, and concentrations of amphibole fibers were evaluated. Fibrous phases were detected in 71% of the samples, and fiber concentrations ranged from a few thousand to more than 4 x 10(4) fibers/mg of material. In addition, we conducted a study on the mineral fiber lung burden in a pleural mesothelioma case. Many mineral fibers that were classified as the same tremolite-actinolite fibrous amphibole found in the quarries and in the building materials were detected in the lung tissue. The results suggest that the inhabitants of the town we studied had been exposed for several decades to asbestos fibers that were present in the material extracted from the local stone quarries. The material was subsequently used in the building industry, and this has caused an increased risk of pleural mesothelioma in the area.

Esposizione ad amianto e mortalità per tumore maligno della pleura in Italia (1988)(1989)(1990)(1... more Esposizione ad amianto e mortalità per tumore maligno della pleura in Italia (1988)(1989)(1990)(1991)(1992)(1993)(1994). Comba 2000, 34 p. Rapporti ISTISAN 00/9 E' stata studiata sull'intero territorio nazionale, la mortalità per tumore maligno della pleura, utilizzando la banca dati epidemiologica dell'ENEA (dati di fonte ISTAT). Questo studio rappresenta un aggiornamento delle precedenti edizioni relative agli anni 1980-1987 e 1988-1992. La mortalità osservata in ogni comune è stata confrontata con quella attesa in base ai dati di mortalità regionali e/o nazionali. Fra le aree in cui si concentrano gli incrementi di mortalità per tumore pleurico, vanno considerati in primo luogo gli insediamenti dell'industria navalmeccanica e dell'attività portuale: la fascia costiera compresa in Liguria fra Savona e La Spezia e in Friuli-Venezia Giulia fra Trieste e Monfalcone, Venezia, Livorno, Ancona, Napoli, Taranto, Palermo, Messina e Cagliari ed i poli dell'industria del cemento-amianto, in particolare Casale Monferrato, Broni, Reggio Emilia e Bari. Vanno inoltre segnalate alcune aree industriali complesse, caratterizzate da una molteplicità di fonti di esposizione ad amianto, come Torino e Milano con le rispettive cinture industriali. Numerosi comuni sono stati segnalati per la prima volta dal presente studio, e per alcuni di essi è stato possibile formulare ipotesi sulla presenza di amianto nei cicli produttivi e/o nell'ambiente. Si ritiene che queste aree debbano essere considerate, con priorità elevata, candidate alla conduzione di studi epidemiologici sulla patologia da amianto Parole chiave: Amianto, Asbestosi, Mesotelioma pleurico Istituto Superiore di Sanità Asbestos exposure and mortality from malignant pleural neoplasms in Italy (1988)(1989)(1990)(1991)(1992)(1993)(1994).

Introduction: Commercial airline pilots and flight attendants in particular are exposed to a vari... more Introduction: Commercial airline pilots and flight attendants in particular are exposed to a variety of risk factors for cancer: electromagnetic fields, ozone, jet engine emissions, low atmospheric pressure, poor air quality, alterations of the circadian rhythm and lifestyle factors, and ionizing cosmic radiation (1, 4). Particular attention has been focused on the risk linked to cosmic radiations, whose parameters can be assessed fairly accurately, and the exposure dose calculated. Many studies suggest an increase in the risk of acute leukemia, the type of cancer currently believed to be most closely associated with exposure to ionizing radiation (3). Some recent epidemiological studies are particularly interesting as they cover a large population of aircrew, and use similar methods, casting fresh light on the whole matter. The aim of the present study was to combine the results of cohort studies that used similar methods to investigate cancer incidence in pilots.

American Journal of Industrial Medicine, 2004

BackgroundThe Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore... more BackgroundThe Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore Prevenzione e Sicurezza Lavoro (ISPESL), in Rome, in accordance with Art. 36 of Italian Legislative Decree No. 277 [1991].The Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore Prevenzione e Sicurezza Lavoro (ISPESL), in Rome, in accordance with Art. 36 of Italian Legislative Decree No. 277 [1991].MethodsFive Italian regions, Piedmont, Liguria, Emilia-Romagna, Tuscany, and Apulia, agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data systematically to ISPESL.Five Italian regions, Piedmont, Liguria, Emilia-Romagna, Tuscany, and Apulia, agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data systematically to ISPESL.ResultsFour hundred and twenty-nine mesothelioma cases, diagnosed in 1997, are recorded. The standardized annual incidence rate for definite pleural mesothelioma is 1.51 per 100,000 inhabitants (2.26 for males and 0.79 for females). Exposure was defined for 198 mesotheliomas with a histological diagnosis: 125 (63%) refer to occupational exposure, 10 (5%) to environmental exposure, and 5 (2.5%) to household exposure.Four hundred and twenty-nine mesothelioma cases, diagnosed in 1997, are recorded. The standardized annual incidence rate for definite pleural mesothelioma is 1.51 per 100,000 inhabitants (2.26 for males and 0.79 for females). Exposure was defined for 198 mesotheliomas with a histological diagnosis: 125 (63%) refer to occupational exposure, 10 (5%) to environmental exposure, and 5 (2.5%) to household exposure.ConclusionsDespite the ReNaM's work, many limitations still have to be overcome. Clear-cut information on asbestos exposure is available for a limited number of cases; and differing regional procedures in collecting and evaluating mesotheloma cases exist. At this stage the identification and evaluation of a large number of cases of mesothelioma is a worthwhile result. This epidemiological surveillance, currently being extended to other regions, will enable us to better assess the impact and diffusion of this disease in future, and to monitor more closely the effects of ceasing asbestos use in 1992, and the efficacy of preventive measures since mid '70s. Am. J. Ind. Med. 45:55–62, 2004. © 2003 Wiley-Liss, Inc.Despite the ReNaM's work, many limitations still have to be overcome. Clear-cut information on asbestos exposure is available for a limited number of cases; and differing regional procedures in collecting and evaluating mesotheloma cases exist. At this stage the identification and evaluation of a large number of cases of mesothelioma is a worthwhile result. This epidemiological surveillance, currently being extended to other regions, will enable us to better assess the impact and diffusion of this disease in future, and to monitor more closely the effects of ceasing asbestos use in 1992, and the efficacy of preventive measures since mid '70s. Am. J. Ind. Med. 45:55–62, 2004. © 2003 Wiley-Liss, Inc.

Occupational and Environmental Medicine, 2006

American Journal of Industrial Medicine, 1999

The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicti... more The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicting opinions exist for other cancer sites. The aim of the present investigation is to study cause-specific mortality of women compensated for asbestosis who had certainly been exposed to high levels of asbestos fibers. The cause-specific mortality of all Italian women compensated for asbestosis and alive December 31, 1979, was investigated through October 30, 1997. In the total cohort, which included 631 subjects, 277 deaths occurred. Cause-specific SMRs (Standardized Mortality Ratio) were computed using the national rates for comparison. A significantly increased mortality for all diseases related to asbestos exposure was observed. Mortality for all causes, all neoplasms, lung cancer, uterine cancer, ovarian cancer, and non-neoplastic respiratory diseases was significantly increased. Separate analyses for textile (n = 276) and asbestos-cement (n = 278) workers were performed. Women employed in the textile industry, mainly exposed to chrysotile, who are compensated at a younger age, showed higher SMRs for lung cancer and asbestosis. Women in the asbestos-cement industry, mainly exposed to crocidolite containing asbestos mixtures, experienced higher mortality for pleural malignancies. The role of asbestos exposure in the development of gastrointestinal and genital neoplasms is discussed.

American Journal of Industrial Medicine, 1999

The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicti... more The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicting opinions exist for other cancer sites. The aim of the present investigation is to study cause-specific mortality of women compensated for asbestosis who had certainly been exposed to high levels of asbestos fibers. The cause-specific mortality of all Italian women compensated for asbestosis and alive December 31, 1979, was investigated through October 30, 1997. In the total cohort, which included 631 subjects, 277 deaths occurred. Cause-specific SMRs (Standardized Mortality Ratio) were computed using the national rates for comparison. A significantly increased mortality for all diseases related to asbestos exposure was observed. Mortality for all causes, all neoplasms, lung cancer, uterine cancer, ovarian cancer, and non-neoplastic respiratory diseases was significantly increased. Separate analyses for textile (n = 276) and asbestos-cement (n = 278) workers were performed. Women employed in the textile industry, mainly exposed to chrysotile, who are compensated at a younger age, showed higher SMRs for lung cancer and asbestosis. Women in the asbestos-cement industry, mainly exposed to crocidolite containing asbestos mixtures, experienced higher mortality for pleural malignancies. The role of asbestos exposure in the development of gastrointestinal and genital neoplasms is discussed.

European Journal of Cancer, 2003

The Italian National Mesothelioma Register (ReNaM) was set up at ISPESL (the National Institute f... more The Italian National Mesothelioma Register (ReNaM) was set up at ISPESL (the National Institute for Occupational Safety and Prevention) in 1993. Five Italian regions (Piedmont, Liguria, Emilia-Romagna, Tuscany and Puglia, with a total of approximately 17 500 000 inhabitants) agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data to ISPESL. We describe an analysis of survival of 429 mesothelioma cases-392 pleural, 34 peritoneal and 3 in the pericardium-diagnosed during 1997, with variable follow-up from June 1999 to December 2001. The Kaplan-Meier method was used to estimate survival rates, the log rank non-parametric test and Cox proportional hazard model to assess the role of prognostic factors such as age, gender, morphology, level of diagnostic certainty and modality of exposure. Median survival was 275 days (95% confidence interval (CI) 241-309) for pleural mesotheliomas and 157 days (95% CI: 118-196) for peritoneal mesotheliomas. Survival after diagnosis of malignant pleural mesothelioma showed a statistically significant linear trend for age group at diagnosis, for males and females (P=0.006 and 0.008, respectively). The Cox proportional hazard model gave an adjusted relative risk (RR adj ), for the fibrous histotype, of 2.96 (95% CI: 1.28-6.81; P=0.012) compared with cases with unspecified morphology; for epithelioid and biphasic morphologies, the risk was lower than unity. There was no significant difference in survival for cases with confirmed exposure (occupational, household or environmental) or without. #

A seguito della pubblicazione del D.Lgs. n. 257/92 sulle 'Norme relative alla cessazione dell'imp... more A seguito della pubblicazione del D.Lgs. n. 257/92 sulle 'Norme relative alla cessazione dell'impiego dell'amianto' e del DPR 8 agosto 1994:'Atto di indirizzo e coordinamento alle Regioni e Province autonome di Trento e di Bolzano per l'adozione di piani di protezione, di decontaminazione, di smaltimento e di bonifica dell'ambiente, ai fini della difesa dai pericoli derivanti dall'amianto', l'ISPESL ha realizzato e pubblicato una anagrafe delle aziende e degli esposti a rischio amianto.Tale anagrafe, ottenuta attraverso un modello statistico di linkage fra gli archivi di diverse fonti amministrative -in particolare INPS e Camere di Commercio -risulta essere articolata su due livelli: il primo relativo all'Allegato B dello stesso decreto 'Elenco dei codici ISTAT delle aziende con possibile presenza di amianto', il secondo relativo alle 'Attività maggiormente interessate da possibile presenza di amianto'. L'anno di riferimento è il 1991 in ragione dell'entrata in vigore del D.Lgs. n. 257/92 e l'unità territoriale minima di riferimento è il Comune.

International Journal of Cancer, 2005

Italy was the second main asbestos producer in Europe, after the Soviet Union, until the end of t... more Italy was the second main asbestos producer in Europe, after the Soviet Union, until the end of the 1980s, and raw asbestos was imported on a large scale until 1992. The Italian pattern of asbestos consumption lags on average about 10 years behind the United States, Australia, the United Kingdom and the Nordic countries. Measures to reduce exposure were introduced in the mid-1970s in some workplaces. In 1986, limitations were imposed on the use of crocidolite and in 1992 asbestos was definitively banned. We have used primary pleural cancer mortality figures (1970–1999) to predict mortality from mesothelioma among Italian men in the next 30 years by age-cohort-period models and by a model based on asbestos consumption figures. The pleural cancer/mesothelioma ratio and mesothelioma misdiagnosis in the past were taken into account in the analysis. Estimated risks of birth cohorts born after 1945 decrease less quickly in Italy than in other Western countries. The findings predict a peak with about 800 mesothelioma annual deaths in the period 2012–2024. Results estimated using age-period-cohort models were similar to those obtained from the asbestos consumption model. © 2004 Wiley-Liss, Inc.

Archives of Environmental Health, 2000

In a recent epidemiological study, researchers investigated mortality from malignant pleural neop... more In a recent epidemiological study, researchers investigated mortality from malignant pleural neoplasms in Italy, and they detected some geographic clusters of cases of this disease. We found a town located in a volcanic area of eastern Sicily to be of special interest. The residents, some of whom were diagnosed with pleural mesothelioma, had never had any relevant exposure to asbestos during their professional lives. The results of an environmental survey suggested that a possible cause of asbestos exposure was the stone quarries near the town. The products of the quarries contain fibrous amphiboles, which are used widely in the local building industry. These fibrous amphiboles were identified as intermediate phases between tremolite and actinolite. Samples were collected from buildings in the town, and concentrations of amphibole fibers were evaluated. Fibrous phases were detected in 71% of the samples, and fiber concentrations ranged from a few thousand to more than 4 x 10(4) fibers/mg of material. In addition, we conducted a study on the mineral fiber lung burden in a pleural mesothelioma case. Many mineral fibers that were classified as the same tremolite-actinolite fibrous amphibole found in the quarries and in the building materials were detected in the lung tissue. The results suggest that the inhabitants of the town we studied had been exposed for several decades to asbestos fibers that were present in the material extracted from the local stone quarries. The material was subsequently used in the building industry, and this has caused an increased risk of pleural mesothelioma in the area.

Esposizione ad amianto e mortalità per tumore maligno della pleura in Italia (1988)(1989)(1990)(1... more Esposizione ad amianto e mortalità per tumore maligno della pleura in Italia (1988)(1989)(1990)(1991)(1992)(1993)(1994). Comba 2000, 34 p. Rapporti ISTISAN 00/9 E' stata studiata sull'intero territorio nazionale, la mortalità per tumore maligno della pleura, utilizzando la banca dati epidemiologica dell'ENEA (dati di fonte ISTAT). Questo studio rappresenta un aggiornamento delle precedenti edizioni relative agli anni 1980-1987 e 1988-1992. La mortalità osservata in ogni comune è stata confrontata con quella attesa in base ai dati di mortalità regionali e/o nazionali. Fra le aree in cui si concentrano gli incrementi di mortalità per tumore pleurico, vanno considerati in primo luogo gli insediamenti dell'industria navalmeccanica e dell'attività portuale: la fascia costiera compresa in Liguria fra Savona e La Spezia e in Friuli-Venezia Giulia fra Trieste e Monfalcone, Venezia, Livorno, Ancona, Napoli, Taranto, Palermo, Messina e Cagliari ed i poli dell'industria del cemento-amianto, in particolare Casale Monferrato, Broni, Reggio Emilia e Bari. Vanno inoltre segnalate alcune aree industriali complesse, caratterizzate da una molteplicità di fonti di esposizione ad amianto, come Torino e Milano con le rispettive cinture industriali. Numerosi comuni sono stati segnalati per la prima volta dal presente studio, e per alcuni di essi è stato possibile formulare ipotesi sulla presenza di amianto nei cicli produttivi e/o nell'ambiente. Si ritiene che queste aree debbano essere considerate, con priorità elevata, candidate alla conduzione di studi epidemiologici sulla patologia da amianto Parole chiave: Amianto, Asbestosi, Mesotelioma pleurico Istituto Superiore di Sanità Asbestos exposure and mortality from malignant pleural neoplasms in Italy (1988)(1989)(1990)(1991)(1992)(1993)(1994).

Introduction: Commercial airline pilots and flight attendants in particular are exposed to a vari... more Introduction: Commercial airline pilots and flight attendants in particular are exposed to a variety of risk factors for cancer: electromagnetic fields, ozone, jet engine emissions, low atmospheric pressure, poor air quality, alterations of the circadian rhythm and lifestyle factors, and ionizing cosmic radiation (1, 4). Particular attention has been focused on the risk linked to cosmic radiations, whose parameters can be assessed fairly accurately, and the exposure dose calculated. Many studies suggest an increase in the risk of acute leukemia, the type of cancer currently believed to be most closely associated with exposure to ionizing radiation (3). Some recent epidemiological studies are particularly interesting as they cover a large population of aircrew, and use similar methods, casting fresh light on the whole matter. The aim of the present study was to combine the results of cohort studies that used similar methods to investigate cancer incidence in pilots.

American Journal of Industrial Medicine, 2004

BackgroundThe Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore... more BackgroundThe Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore Prevenzione e Sicurezza Lavoro (ISPESL), in Rome, in accordance with Art. 36 of Italian Legislative Decree No. 277 [1991].The Italian National Mesothelioma Register (ReNaM) was set up at the Istituto Superiore Prevenzione e Sicurezza Lavoro (ISPESL), in Rome, in accordance with Art. 36 of Italian Legislative Decree No. 277 [1991].MethodsFive Italian regions, Piedmont, Liguria, Emilia-Romagna, Tuscany, and Apulia, agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data systematically to ISPESL.Five Italian regions, Piedmont, Liguria, Emilia-Romagna, Tuscany, and Apulia, agreed to record mesothelioma cases according to guidelines established by ISPESL, to define exposure to asbestos and transmit the data systematically to ISPESL.ResultsFour hundred and twenty-nine mesothelioma cases, diagnosed in 1997, are recorded. The standardized annual incidence rate for definite pleural mesothelioma is 1.51 per 100,000 inhabitants (2.26 for males and 0.79 for females). Exposure was defined for 198 mesotheliomas with a histological diagnosis: 125 (63%) refer to occupational exposure, 10 (5%) to environmental exposure, and 5 (2.5%) to household exposure.Four hundred and twenty-nine mesothelioma cases, diagnosed in 1997, are recorded. The standardized annual incidence rate for definite pleural mesothelioma is 1.51 per 100,000 inhabitants (2.26 for males and 0.79 for females). Exposure was defined for 198 mesotheliomas with a histological diagnosis: 125 (63%) refer to occupational exposure, 10 (5%) to environmental exposure, and 5 (2.5%) to household exposure.ConclusionsDespite the ReNaM's work, many limitations still have to be overcome. Clear-cut information on asbestos exposure is available for a limited number of cases; and differing regional procedures in collecting and evaluating mesotheloma cases exist. At this stage the identification and evaluation of a large number of cases of mesothelioma is a worthwhile result. This epidemiological surveillance, currently being extended to other regions, will enable us to better assess the impact and diffusion of this disease in future, and to monitor more closely the effects of ceasing asbestos use in 1992, and the efficacy of preventive measures since mid '70s. Am. J. Ind. Med. 45:55–62, 2004. © 2003 Wiley-Liss, Inc.Despite the ReNaM's work, many limitations still have to be overcome. Clear-cut information on asbestos exposure is available for a limited number of cases; and differing regional procedures in collecting and evaluating mesotheloma cases exist. At this stage the identification and evaluation of a large number of cases of mesothelioma is a worthwhile result. This epidemiological surveillance, currently being extended to other regions, will enable us to better assess the impact and diffusion of this disease in future, and to monitor more closely the effects of ceasing asbestos use in 1992, and the efficacy of preventive measures since mid '70s. Am. J. Ind. Med. 45:55–62, 2004. © 2003 Wiley-Liss, Inc.

Occupational and Environmental Medicine, 2006

American Journal of Industrial Medicine, 1999

The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicti... more The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicting opinions exist for other cancer sites. The aim of the present investigation is to study cause-specific mortality of women compensated for asbestosis who had certainly been exposed to high levels of asbestos fibers. The cause-specific mortality of all Italian women compensated for asbestosis and alive December 31, 1979, was investigated through October 30, 1997. In the total cohort, which included 631 subjects, 277 deaths occurred. Cause-specific SMRs (Standardized Mortality Ratio) were computed using the national rates for comparison. A significantly increased mortality for all diseases related to asbestos exposure was observed. Mortality for all causes, all neoplasms, lung cancer, uterine cancer, ovarian cancer, and non-neoplastic respiratory diseases was significantly increased. Separate analyses for textile (n = 276) and asbestos-cement (n = 278) workers were performed. Women employed in the textile industry, mainly exposed to chrysotile, who are compensated at a younger age, showed higher SMRs for lung cancer and asbestosis. Women in the asbestos-cement industry, mainly exposed to crocidolite containing asbestos mixtures, experienced higher mortality for pleural malignancies. The role of asbestos exposure in the development of gastrointestinal and genital neoplasms is discussed.

American Journal of Industrial Medicine, 1999

The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicti... more The carcinogenic effect of asbestos is accepted for lung cancer and mesothelioma, while conflicting opinions exist for other cancer sites. The aim of the present investigation is to study cause-specific mortality of women compensated for asbestosis who had certainly been exposed to high levels of asbestos fibers. The cause-specific mortality of all Italian women compensated for asbestosis and alive December 31, 1979, was investigated through October 30, 1997. In the total cohort, which included 631 subjects, 277 deaths occurred. Cause-specific SMRs (Standardized Mortality Ratio) were computed using the national rates for comparison. A significantly increased mortality for all diseases related to asbestos exposure was observed. Mortality for all causes, all neoplasms, lung cancer, uterine cancer, ovarian cancer, and non-neoplastic respiratory diseases was significantly increased. Separate analyses for textile (n = 276) and asbestos-cement (n = 278) workers were performed. Women employed in the textile industry, mainly exposed to chrysotile, who are compensated at a younger age, showed higher SMRs for lung cancer and asbestosis. Women in the asbestos-cement industry, mainly exposed to crocidolite containing asbestos mixtures, experienced higher mortality for pleural malignancies. The role of asbestos exposure in the development of gastrointestinal and genital neoplasms is discussed.