Epidemiologic surveillance for primary prevention of malignant mesothelioma: the Italian experience
Wednesday, February 8th, 2006.
La Medicina del Lavoro. 2005 Jul-Aug;96(4):338-46. [Link]
Nesti M, Marinaccio A, Gennaro V, Gorini G, Mirabelli D, Mensi C, Merler E, Montanaro F, Musti M, Pannelli F, Romanelli A, Tumino R; ReNaM Working Group.
ISPESL - National Institute for occupational safety and prevention, Occupational Medicine Department, Epidemiology Unit Rome, Italy.
Abstract
Background: The Italian National Mesothelioma Registry (ReNaM) was set up at the National Institute for Occupational Safety and Health (ISPESL) to estimate Italian incidence of malignant mesothelioma (MM), define modalities of asbestos exposures, assess impact and diffusion of MM, identify underestimated sources of environmental contamination.
Objectives: To describe ReNaM activity, database dimension and epidemiological characteristics of the caselist.
Methods: Regional Operating Centers (COR) in 16 Italian regions were set up to identify and investigate all cases of MM diagnosed in each region, applying national guidelines. COR collect cases in health care institutions. Occupational history, lifestyle and residence are obtained by direct interview using a standard questionnaire. Exposure modalities are classified by industrial hygienists, evaluating whether work, private life or any particular environmental condition could have involved asbestos exposure.
Results: Data refer to 3,446 cases collected in 9 Italian regions during 1993-2001. Pleural mesothelioma affected 94% cases, pleural/peritoneal ratio was 16:1. Gender ratio (M/F) was 2.7:1 (1.3:1 for peritoneum). There was a variety of occupational exposures, some already known as high risk sectors and others unexpected. The most common exposures occurred in building and construction, metallurgy and steel, shipbuilding, and railway stock. High risk categories were encountered such as bricklayers, plumbers, carpenters, electricians, welders, installers and maintenance workers in metallurgy and the steel industry, general labourers, tool makers and painters in shipbuilding/repair/demolition.
Conclusions: Despite some ReNam’s limitations, identification of MM cases and analysis of modality of exposure, with standardized criteria, are a fundamental tool for primary prevention of asbestos related diseases.
Glossary
- high risk
- when the chance of developing cancer is greater than that normally seen in the general population. People may be at high risk from many factors, including heredity (such as a family history of breast cancer), personal habits (such as smoking), or the environment (such as overexposure to sunlight).
- epidemiology
- (ep-uh-deem-ee-AHL-uh-gee) the study of diseases in populations by collecting and analyzing statistical data. In the field of cancer, epidemiologists look at how many people have cancer; who gets specific types of cancer; and what factors (such as environment, job hazards, family patterns, and personal habits, such as smoking and diet) play a part in the development of cancer.
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
- peritoneal
- (pair-uh-tuh-nee-al) the serous membrane that lines the cavity of the abdomen. (More on Peritoneal Mesothelioma.)
