Mesothelioma of the pleura in the Province of Trieste

La Medicina Del Lavoro.. 2007 Sep-Oct;98(5):374-80 [Link]

Bianchi C, Bianchi T, Tommasi M.

Centro di Studio e Documentazione sui Tumori Ambientali, Lega Italiana per la Lotta contro i Tumori, Ospedale di Monfalcone, Monfalcone.


Background: The Province of Trieste, north-eastern Italy (population about 240,000), has been identified as an area with a high incidence of pleural mesothelioma.

Objectives: (i) To obtain preliminary data on the trend of the mesothelioma epidemic in the Province of Trieste during the last six years; (ii) to define the cases in terms of asbestos exposure.

Methods: Pleural mesotheliomas diagnosed at the Department of Surgery, Thoracic Surgery Unit, Trieste University, in the period January 2001-May 2006 were reviewed. The histological diagnosis was generally based on material obtained at thoracoscopy, pleurectomy, or pleuropneumonectomy. In three cases the pathological diagnosis was made by biopsy of the thoracic wall, and in a further three cases by cytological examination of pleural fluid. Detailed occupational histories were obtained from the patients themselves at the time of first admission.

Results: The group included 99 people resident in the Province of Trieste (89 men and 10 women, aged between 43 and 89 years). On the basis of the occupational history, 95 cases were defined as asbestos-related. A majority of patients had been employed in marine work, including shipbuilding (46 cases), port activity (13 cases), and maritime trades (8 cases). Thirteen patients had worked in other industries (iron industry, petrochemical, etc.). Fourteen people had been employed in a variety of occupations (fire-fighter, lift mechanic, cinema projectionist, pastry worker, telephone technician, etc.). Five women had histories of exposure to asbestos at home. About 70% of the patients had their first exposure to asbestos before 1960. Two-thirds of the cases were exposed to asbestos for 20 years or more. Latency periods (time intervals elapsed between first exposure to asbestos and diagnosis of mesothelioma) ranged from 25 to 71 years (mean 49.3, median 49.0). One patient had a history of prior thoracic irradiation for Hodgkin’s disease.

Conclusions: In the Province of Trieste the mesothelioma epidemic does not show any signs of abatement. Besides marine work, a variety of other occupations appear to be associated with the tumour in this area.