Pleural mesothelioma risk by industry and occupation: results from the Multicentre Italian Study on the Etiology of Mesothelioma (MISEM)

Environmental Health

Dario Mirabelli¹  Enrica Migliore¹  Susan Peters²  Roel C. H. Vermeulen²  Hans Kromhout²  Corrado Magnani³  Marina Musti⁴  Domenica Cavone⁴  Enzo Merler⁵  Dario Consonni⁶  Carolina Mensi⁶  Antonio Baldassarre⁷  Elisabetta Chellini⁸  Alessandro Marinaccio⁹ 

[1] Cancer Epidemiology Unit, CPO Piemonte and University of Turin;Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University;Interdepartmental Centre G. Scansetti for Studies On Asbestos and Other Toxic Particulates, University of Turin;Interdisciplinary Department of Medicine, Section of Occupational Medicine “B. Ramazzini”, University of Bari;Occupational Health Unit, Department of Prevention;Occupational Health Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico;Occupational Medicine Unit, Careggi University Hospital;Unit of Environmental and Occupational Epidemiology, Cancer Prevention and Research Institute;Unit of Occupational and Environmental Epidemiology - Italian Mesothelioma Register, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL);

关键词: Pleural mesothelioma;    Asbestos;    Occupational exposure;    Exposure assessment;    Case–control study;   

DOI  :  10.1186/s12940-022-00869-5

来源: DOAJ

【 摘 要 】

Abstract Background The Italian mesothelioma registry (ReNaM) estimates mesothelioma incidence and addresses its etiology by assessing cases’ exposures but cannot provide relative risk estimates. Objectives i) To estimate pleural mesothelioma relative risk by industry and occupation and by ReNaM categories of asbestos exposure; and ii) to provide quantitative estimates of the exposure–response relationship. Methods A population-based mesothelioma case–control study was conducted in 2012–2014 in five Italian regions. Cases and age and gender frequency-matched controls were interviewed using a standard ReNaM questionnaire. Experts coded work histories according to international standard classifications of industries/occupations and assigned asbestos exposure according to ReNaM categories. Job codes were further linked to SYN-JEM, a quantitative job-exposure matrix. Cumulative exposure (CE, f/mL-years) was computed by summing individual exposures over lifetime work history. Unconditional logistic regression analyses adjusted by gender, centre and age were fitted to calculate odds ratios (OR) and 95% confidence intervals (CI). Results Among men we observed increased risks of mesothelioma in many industries and associated occupations, including: asbestos-cement (OR = 3.43), manufacture of railroad equipment (OR = 8.07), shipbuilding and repairing (OR = 2.34), iron and steel mills (OR = 2.15), and construction (OR = 1.94). ORs by ReNaM exposure categories were as follows: definite/probable occupational exposure (OR = 15.8, men; OR = 8.80, women), possible occupational (OR = 2.82, men; OR = 3.70, women), sharing home with an exposed worker (OR = 2.55, men; OR = 10.3, women), residential (OR = 2.14, men; OR = 3.24, women). Based on SYN-JEM, mesothelioma risk increased by almost 30% per f/mL-year (OR = 1.28, CI 1.16–1.42). Conclusions Out study involved five regions with historically different types and levels of industrial development, encompassing one third of the Italian population and half of Italian mesothelioma cases. As expected, we found increased pleural mesothelioma risk in the asbestos industry and in trades with large consumption of asbestos materials. Clear associations were found using both qualitative (ReNaM classifications) and quantitative estimates (using SYN-JEM) of past asbestos exposure, with clear evidence of an exposure–response relationship.

【 授权许可】

Unknown