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Magnani C.,University of Eastern Piedmont and Piemonte | Magnani C.,University of Turin | Bianchi C.,Center for the Study of Environmental Cancer | Chellini E.,Unit of Environmental and Occupational Epidemiology. ISPO | And 18 more authors.
Medicina del Lavoro | Year: 2015

The III Italian Consensus Conference on Pleural Mesothelioma (MM) convened on January 29th 2015. This report presents the conclusions of the 'Epidemiology, Public Health and Occupational Medicine' section. MM incidence in 2011 in Italy was 3.64 per 100,000 person/years in men and 1.32 in women. Incidence trends are starting to level off. Ten percent of cases are due to non-occupational exposure. Incidence among women is very high in Italy, because of both non-occupational and occupational exposure. The removal of asbestos in place is proceeding slowly, with remaining exposure. Recent literature confirms the causal role of chrysotile. Fibrous fluoro-edenite was classified as carcinogenic by IARC (Group 1) on the basis of MM data. A specific type (MWCNT-7) of Carbon Nanotubes was classified 2B. For pleural MM, after about 45 years since first exposure, the incidence trend slowed down; with more studies needed. Cumulative exposure is a proxy of the relevant exposure, but does not allow to distinguish if duration or intensity may possibly play a prominent role, neither to evaluate the temporal sequence of exposures. Studies showed that duration and intensity are independent determinants of MM. Blood related MM are less than 2.5%. The role of BAP1 germline mutations is limited to the BAP1 cancer syndrome, but negligible for sporadic cases. Correct MM diagnosis is baseline; guidelines agree on the importance of the tumor gross appearance and of the hematoxylin-eosin-based histology. Immunohistochemical markers contribute to diagnostic confirmation: the selection depends on morphology, location, and differential diagnosis. The WG suggested that 1) General Cancer Registries and ReNaM Regional Operational Centres (COR) interact and systematically compare MM cases; 2) ReNaM should report results presenting the diagnostic certainty codes and the diagnostic basis, separately; 3) General Cancer Registries and COR should interact with pathologists to assure the up-To-date methodology; 4) Necroscopy should be practiced for validation. Expert referral centres could contribute to the definition of uncertain cases. Health surveillance should aim to all asbestos effects. No diagnostic test is recommended for MM screening. Health surveillance should provide information on risks, medical perspective, and smoking cessation. The economic burden associated to MM was estimated in 250,000 Euro per case. Source

Bianchi C.,Center for the Study of Environmental Cancer | Bianchi T.,Center for the Study of Environmental Cancer | Bucconi S.,University of Trieste
European Journal of Oncology | Year: 2011

A 73-year-old man with a history of occupational exposure to asbestos in shipbuilding industry underwent right orchiectomy for non-Hodgkin, diffuse, large B cell lymphoma. Nine months later a right pleural mesothelioma was diagnosed. At autopsy, metastatic mesothelioma of the right pleura was observed. Markers of asbestos exposure (pleural plaques and lung asbestos bodies) were detected. The co-existence of lymphoma and asbestos-related mesothelioma has repeatedly been reported. The possibility of common etiological factors (immune impairment induced by asbestos) has to be considered. Eur. J. Oncol., 15 (3-4), 167-171, 2010. Source

Bianchi C.,Center for the Study of Environmental Cancer | Bianchi T.,Center for the Study of Environmental Cancer | Bucconi S.,University of Trieste
Tumori | Year: 2011

Aims and background. Malignant mesothelioma developing at very old ages is a rare event. The reasons for such late development were investigated. Methods. A series of 811 malignant mesothelioma of the pleura, diagnosed at the Trieste and Monfalcone Hospitals, in northeastern Italy, in the period 1968-2008 were reviewed. Eight cases regarding patients aged 90 years or more were selected. In such cases, occupational histories were re-examined, and additional data could be obtained from the patients' relatives. Routine lung sections obtained at necropsy were examined for asbestos bodies. In 2 cases, asbestos bodies had been isolated after chemical digestion of lung tissue. Results. The group included 7 men and one woman, aged between 90 and 93 years. All 8 patients had long-term histories of occupational exposure to asbestos, mostly in shipyards. Latency periods, elapsed between first exposure to asbestos and tumor manifestation, ranged between 64 and 75 years. Asbestos bodies were found on routine lung sections in 6 cases. Isolation of lung asbestos bodies showed 72,000 bodies per gram of dried tissue in a 90-year-old man, who had worked in the shipyards for 34 years, and 150 bodies per gram in a 93-year-old woman, who had worked in the shipyards for 23 years. Conclusions. In this group of cases, the late development of mesothelioma can not be attributed to mild exposure to asbestos or to unusually late exposures. Very long latency periods even in people heavily exposed suggest an individual resistance to the oncogenic effects of asbestos. Source

Bianchi C.,Center for the Study of Environmental Cancer | Bianchi T.,Center for the Study of Environmental Cancer
Indian Journal of Occupational and Environmental Medicine | Year: 2012

The Monfalcone area, northeastern Italy, a small industrial district with large shipyards, shows a high incidence of asbestos-related mesothelioma. In order to reconstruct some features of the Monfalcone shipbuilding activity during World War II and its health effects, the shipyard roll were examined, and people hired in 1942 were identified. The list of 2,776 persons hired in 1942 was coupled with the Pathological Anatomy Units archives of the Monfalcone and the Trieste Hospitals. Eighteen of the above persons had been diagnosed with pleural mesothelioma in the period 1981-2005. Eight patients had their first exposure in 1942, and the others had histories of previous exposures. Of 557 persons aged 14-15 years in 1942, six had a diagnosis of pleural mesothelioma. Necropsy findings were available in 14 cases. The burdens of lung asbestos bodies, isolated in 11 cases, showed wide variation (from 150 to 600,000 bodies per gram of dried tissue). While probably underestimated, the present data indicate a high incidence of mesothelioma among the shipyard workers of Monfalcone. Source

Bianchi C.,Center for the Study of Environmental Cancer | Bianchi T.,Center for the Study of Environmental Cancer
European Journal of Oncology | Year: 2010

Recent studies indicate that mesothelioma incidence remains high or is rising in various areas of the eastern Adriatic coast. Both Italy (Trieste Province) as well as Croatia (Rijeka and Split) are involved. In these areas pleural mesothelioma shows strict similarities, with a large prevalence of shipyard workers. Source

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