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Padova, Italy

Mirabelli D.,University of Turin | Cavone D.,University of Bari | Merler E.,Occupational Health Unit | Gennaro V.,Italian National Cancer Institute | And 7 more authors.
Occupational and Environmental Medicine

Background: Malignant mesotheliomas are strictly related to asbestos, but in a proportion of cases no exposure can be recalled. Published estimates of this proportion have important variations. Historical and geographical differences in the fraction of cancer due to any given exposure are to be expected, but incomplete identification of non-occupational exposures may have played a role Methods: To assess the role of non-occupational exposures in causing malignant mesotheliomas in Italy, the exposures of cases registered by the national mesothelioma registry (ReNaM) were examined. ReNaM started in 1993 in five regions and currently covers 98% of the Italian population. Information on occupational and non-occupational exposures of cases is collected whenever possible. Results: From 1993 to 2001 ReNaM registered 5173 malignant mesothelioma cases, and exposures were assessed in 3552 of them. 144 and 150 cases with exposures limited to environmental (living in the neighbourhood of an industrial or natural source of asbestos) or familial (living with a person occupationally exposed to asbestos) circumstances, respectively, were identified, accounting for 8.3% of all cases. Conclusions: Geographical variations in the proportion of cases due to non-occupational exposures may be explained by the past distribution of asbestos-using industries. Source

Cattaneo A.,University of Milan | Peruzzo C.,Occupational Health Unit | Garramone G.,International Center for Pesticides and Health Risk Prevention | Urso P.,University of Milan | And 3 more authors.
Indoor Air

The province of Lodi is located in northern Italy on the Po River plain, where high background levels of air pollutants are prevalent. Lodi province is characterized by intensive agriculture, notably animal husbandry. This paper assesses indoor levels of selected airborne pollutants in 60 homes in the province, with special attention to size-fractionated particulate matter (PM). Indoor PM2.5 concentrations are frequently higher than current guidelines. PM10 and nitrogen dioxide also exceed the respective guideline recommendations in some cases, noting that 24-h nitrogen dioxide levels were compared with an annual limit value. All other studied pollutant levels are below current international guidelines. Among indoor PM size fractions, PM0.5 is predominant in terms of mass concentrations corresponding to 57% of PM10 in summer and 71% in winter. A strong seasonal trend is observed for all studied pollutants, with higher levels in winter corresponding to changes in ambient concentrations. The seasonal variation in PM10 is largely due to PM0.5 increase from summer to winter. Summer indoor PM levels are mainly from indoor-generated particles, while particles of outdoor origin represent the main contribution to winter indoor PM levels. On average, indoor concentrations of coarse PM are mostly constituted by indoor-generated particles. © 2011 John Wiley & Sons A/S. Source

Barbieri P.G.,Occupational Health Unit | Marinaccio A.,Epidemiology Unit | Ferrante P.,Epidemiology Unit | Scarselli A.,Epidemiology Unit | And 2 more authors.

Aims and background. During the 1990's, the traditional unimodal treatments (surgery, radiotherapy, chemotherapy, immunotherapy) for malignant pleural mesothelioma started to be combined in bimodal or multimodal strategies. However, recent population-based analyses of the survival of patients with malignant pleural mesothelioma indicate that even these treatments have not led to significant improvements in prognosis, which remains very poor. The present study assessed the survival of patients given combined treatments and multimodal therapies in a specialized hospital department. Methods. The study population comprised 530 patients diagnosed with malignant pleural mesothelioma from 1982 to 2006: 343 of them were residents in the province of Brescia (Lombardy, Northern Italy) and 187 were residents outside the province, with a follow-up to 31 December 2009. Kaplan-Meier survival analyses and Cox proportional risks model were used to test sex, age at diagnosis, histological type and treatments, as prognostic factors. Results. The estimated median survival for the whole group of patients was 317 days (257 for residents and 398 for non-residents), and respectively 310 and 340 days in the groups diagnosed in the periods 1982-2000 and 2001-2006. Multivariate analysis confirmed that the prognosis was better for younger patients and cases of epithelioid type malignant pleural mesothelioma, whereas for patients receiving any single treatment the prognosis was not significantly better than for those given palliative care alone. However, patients receiving combined treatments or the multimodality approach had significantly longer median survival and the relative risk of death was respectively 0.57 and 0.61 compared to untreated patients (or those only given symptomatic therapy). Conclusions. This is the first study in Italy to assess the effectiveness of different treatment approaches in a significant number of patients treated in one hospital. Further studies are needed to confirm the improvement in prognosis - even if modest - on larger numbers of patients and taking into account the different stages of the disease. © Il Pensiero Scientifico Editore. Source

Cattaneo A.,University of Milan | Somigliana A.,Environmental Protection Agency of Lombardy Region ARPA | Gemmi M.,University of Milan | Bernabeo F.,Occupational Health Unit | And 3 more authors.
Annals of Occupational Hygiene

Asbestos may be naturally present in rocks and soils. In some cases, there is the possibility of releasing asbestos fibres into the atmosphere from the rock or soil, subsequently exposing workers and the general population, which can lead to an increased risk of developing asbestos-related diseases. In the present study, air contaminated with asbestos fibres released from serpentinites was investigated in occupational settings (quarries and processing factories) and in the environment close to working facilities and at urban sites. The only naturally occurrence of asbestos found in Valmalenco area was chrysotile; amphibole fibres were never detected. An experimental cut-off diameter of 0.25 mm was established for distinguishing between Valmalenco chrysotile and antigorite single fibres using selected area electron diffraction analyses. Air contamination from chrysotile fibres in the examined occupational settings was site-dependent as the degree of asbestos contamination of Valmalenco serpentinites is highly variable from place to place. Block cutting of massive serpentinites with multiple blades or discs and drilling at the quarry sites that had the highest levels of asbestos contamination generated the highest exposures to (i.e. over the occupational exposure limits) asbestos. Conversely, working activities on foliated serpentinites produced airborne chrysotile concentrations comparable with ambient levels. Environmental chrysotile concentrations were always below the Italian limit for life environments (0.002 f ml -1), except for one sample collected at a quarry property boundary. The present exposure assessment study should encourage the development of an effective and concordant policy for proper use of asbestos-bearing rocks and soils as well as for the protection of public health. © The Author 2012. Source

Cattaneo A.,University of Milan | Taronna M.,University of Insubria | Garramone G.,International Center for Pesticides and Health Risk Prevention | Peruzzo C.,Occupational Health Unit | And 3 more authors.
Aerosol Science and Technology

This study tested the reliability of a novel method developed for assessing the individual exposure to size-fractionated particulate matter (PM) and gaseous urban pollutants. Individual exposure was defined as the exposure constantly measured in proximity to the subject, even during transfers. Individual exposure was measured using a mobile monitoring unit (MMU), developed to sample simultaneously some urban pollutants of interest for public health purposes. The obtained concentrations were compared with those simultaneously collected in the breathing zone, considered as the gold standard for estimating human exposure to air pollutants. Short-time number concentrations of ultrafine, fine, and coarse particles collected by MMU were characterized by a high predictivity of personal exposures (R2 0.89; slope 0.94-1.17 for PM 10 m), far superior to fixed-site measurements. 5-h time-weighted averages fully explained the variability of ultrafine and fine particles (R2 0.99). The concentrations of gaseous pollutants measured by MMU were less correlated with those collected in the breathing zone (R2 = 0.34-0.65). Nevertheless, the capability of the MMU to detect the variations of personal exposures to O3 and CO was better than that normally observed using fixed measurements, likely due to the placement of the MMU in the different microenvironments where subjects spent their time. Individual exposures measured by the MMU could be of importance in toxicological and epidemiological studies on PM, with the advantage of accounting for exposure to several gaseous co-pollutants. Source

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