Pleural cancer mortality and compensated cases of asbestosis in Sardinia Region municipalities (1980-2000)

Epidemiologia e Prevenzione. 2005 Sep-Dec;29(5-6 Suppl):57-62. [Link]

Marinaccio A, Altavista P, Binazzi A, Comba P, Mastrantonio M, Nesti M, Pasetto R, Scarselli A, Uccelli R, Pirastu R.

Dipartimento di medicina del lavoro, Laboratorio di epidemiologia occupazionale, Istituto superiore per la prevenzione e la sicurezza del lavoro, Roma.


Objective: To his study describes the geographical distribution of pleural cancer deaths and asbestosis cases from 1980 to 2000 in Sardinia Region (Italy). For both conditions regionwide registration systems have been available for a relatively long time and allow the identification of statistically significant clusters.

Design: For each town we have estimated Standardized Mortality Ratios (SMRs) for pleural cancer and Standardized Incidence Ratios (SIRs) for asbestosis. Expected cases were estimated from age- and gender specific rates in Sardinia. SatScan software was used to identify clusters and to verify their statistical significance.

Setting: Sardinia Region (Italy).

Main Outcome Measures: Standardized mortality and incidence rates respectively for pleural cancers and asbestosis cases and territorial clusters.

Results: The most important cluster of pleural cancer was identified in the area defined by Carloforte, Calasetta, Portoscuso and Sant’Antioco municipalities (Southwestern Sardinia) with 15 observed cases (p value= 0.003). Other clusters were detected in the municipality of La Maddalena (11 observed cases against 1.91, expected p value= 0.008) and in Southern Sardinia between Cagliari and Sarroch (p value= 0.018). The town of Marrubiu is clearly the most important cluster (p value= 0. 001) with 6 asbestosis cases in the period.

Conclusions: These results indicate the urgency of the epidemiological surveillance of asbestos related diseases in Sardinia. The active search for incident cases of malignant mesothelioma in the whole Region and the analysis of modalities of asbestos exposure (according to national guidelines) is an indispensable tool for the primary prevention of occupational, environmental and domestic exposures from unknown asbestos sources of contamination.