International Archives of Occupational and Environmental Health. 2008 Sep 23. [Epub ahead of print] [Link]

Musti M, Pollice A, Cavone D, Dragonieri S, Bilancia M.

Department of Internal Medicine and Public Medicine, Section of Occupational Medicine "Ramazzini", University of Bari, National Register of Mesothelioma, Regional Operative Centre (C.O.R.), Apulia, Italy.


Objectives: To estimate the mesothelioma risk and environmental asbestos exposure (EAE) due to an asbestos-cement plant.

Methods: A spatial case–control study including 48 malignant mesothelioma (MM) cases occurred in the period 1993–2003 selected from the regional mesothelioma register (RMR) and 273 controls. The disease risk was estimated by means of a logistic-regression model, in which the probability of disease-occurrence is expressed as a function of the classes of distances. A non-parametric method was applied to estimate the full relative risk surface.

Results: Significant MM odds ratio of 5.29 (95 CI: 1.18–23.74) was found for people living within a range up to 500 m centered on the plant. The non-parametric estimation of relative risk surface unveiled a marked peak near the plant not paralleled by the spatial distribution of controls.

Conclusion: Evidence of an association between mesothelioma risk and EAE is highlighted. The role played by the RMR in increasing the public health local authorities awareness is stressed.

Keywords Asbestos-cement plant – Environmental-neighborhood exposure – Mesothelioma register – Spatial case–control study – Public health – Italy