Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry

Marisa Corfiati, Alberto Scarselli, Alessandra Binazzi, Davide Di Marzio, Marina Verardo, Dario Mirabelli, Valerio Gennaro, Carolina Mensi, Gert Schallemberg, Enzo Merler, Corrado Negro, Antonio Romanelli, Elisabetta Chellini, Stefano Silvestri, Mario Cocchioni, Cristiana Pascucci, Fabrizio Stracci, Elisa Romeo, Luana Trafficante, Italo AngelilloSimona Menegozzo, Marina Musti, Domenica Cavone, Gabriella Cauzillo, Federico Tallarigo, Rosario Tumino, Massimo Melis, Sergio Iavicoli, Alessandro Marinaccio, E. Detragiache, F. Merletti, M. Gangemi, A. Stura, C. Brentisci, G. Cammarieri Diglio, V. Macerata, M. Gilardetti, L. Benfatto, M. Bianchelli, G. Mazzucco, D. Consonni, A. C. Pesatori, L. Riboldi, V. Bressan, F. Gioffrè, M. N. Ballarin, C. Chermaz, P. De Michieli, L. Mangone, C. Storchi, O. Sala, S. Silvestri, A. M. Badiali, V. Cacciarini, L. Giovannetti, A. Martini, R. Calisti, F. La Rosa, D. D'Alo', M. S. Petrucci, M. Davoli, F. Forastiere, F. Cavariani, V. Ascoli, L. Ancona, A. Di Giammarco, M. L. Canfora, M. Santoro, F. Viscardi, A. Brangi, V. Cozza, A. Baldassarre, L. Convertini, S. G. Lio, C. Nicita, G. Dardanoni, S. Scondotto, V. Nieddu, M. Pergola, S. Stecchi

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Background: Previous ecological spatial studies of malignant mesothelioma cases, mostly based on mortality data, lack reliable data on individual exposure to asbestos, thus failing to assess the contribution of different occupational and environmental sources in the determination of risk excess in specific areas. This study aims to identify territorial clusters of malignant mesothelioma through a Bayesian spatial analysis and to characterize them by the integrated use of asbestos exposure information retrieved from the Italian national mesothelioma registry (ReNaM). Methods: In the period 1993 to 2008, 15,322 incident cases of all-site malignant mesothelioma were recorded and 11,852 occupational, residential and familial histories were obtained by individual interviews. Observed cases were assigned to the municipality of residence at the time of diagnosis and compared to those expected based on the age-specific rates of the respective geographical area. A spatial cluster analysis was performed for each area applying a Bayesian hierarchical model. Information about modalities and economic sectors of asbestos exposure was analyzed for each cluster. Results: Thirty-two clusters of malignant mesothelioma were identified and characterized using the exposure data. Asbestos cement manufacturing industries and shipbuilding and repair facilities represented the main sources of asbestos exposure, but a major contribution to asbestos exposure was also provided by sectors with no direct use of asbestos, such as non-asbestos textile industries, metal engineering and construction. A high proportion of cases with environmental exposure was found in clusters where asbestos cement plants were located or a natural source of asbestos (or asbestos-like) fibers was identifiable. Differences in type and sources of exposure can also explain the varying percentage of cases occurring in women among clusters. Conclusions: Our study demonstrates shared exposure patterns in territorial clusters of malignant mesothelioma due to single or multiple industrial sources, with major implications for public health policies, health surveillance, compensation procedures and site remediation programs.

Original languageEnglish
Article number286
JournalBMC Cancer
Volume15
Issue number1
DOIs
Publication statusPublished - Apr 15 2015

Fingerprint

Asbestos
Registries
Spatial Analysis
Malignant Mesothelioma
Textile Industry
Bayes Theorem
Mesothelioma
Environmental Exposure
Public Policy
Health Policy
Compensation and Redress
Cluster Analysis
Public Health
Metals
Economics
Interviews
Mortality

Keywords

  • Asbestos
  • Clusters
  • Italy
  • Mesothelioma
  • National registry

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Genetics

Cite this

Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry. / Corfiati, Marisa; Scarselli, Alberto; Binazzi, Alessandra; Di Marzio, Davide; Verardo, Marina; Mirabelli, Dario; Gennaro, Valerio; Mensi, Carolina; Schallemberg, Gert; Merler, Enzo; Negro, Corrado; Romanelli, Antonio; Chellini, Elisabetta; Silvestri, Stefano; Cocchioni, Mario; Pascucci, Cristiana; Stracci, Fabrizio; Romeo, Elisa; Trafficante, Luana; Angelillo, Italo; Menegozzo, Simona; Musti, Marina; Cavone, Domenica; Cauzillo, Gabriella; Tallarigo, Federico; Tumino, Rosario; Melis, Massimo; Iavicoli, Sergio; Marinaccio, Alessandro; Detragiache, E.; Merletti, F.; Gangemi, M.; Stura, A.; Brentisci, C.; Cammarieri Diglio, G.; Macerata, V.; Gilardetti, M.; Benfatto, L.; Bianchelli, M.; Mazzucco, G.; Consonni, D.; Pesatori, A. C.; Riboldi, L.; Bressan, V.; Gioffrè, F.; Ballarin, M. N.; Chermaz, C.; De Michieli, P.; Mangone, L.; Storchi, C.; Sala, O.; Silvestri, S.; Badiali, A. M.; Cacciarini, V.; Giovannetti, L.; Martini, A.; Calisti, R.; La Rosa, F.; D'Alo', D.; Petrucci, M. S.; Davoli, M.; Forastiere, F.; Cavariani, F.; Ascoli, V.; Ancona, L.; Di Giammarco, A.; Canfora, M. L.; Santoro, M.; Viscardi, F.; Brangi, A.; Cozza, V.; Baldassarre, A.; Convertini, L.; Lio, S. G.; Nicita, C.; Dardanoni, G.; Scondotto, S.; Nieddu, V.; Pergola, M.; Stecchi, S.

In: BMC Cancer, Vol. 15, No. 1, 286, 15.04.2015.

Research output: Contribution to journalArticle

Corfiati, M, Scarselli, A, Binazzi, A, Di Marzio, D, Verardo, M, Mirabelli, D, Gennaro, V, Mensi, C, Schallemberg, G, Merler, E, Negro, C, Romanelli, A, Chellini, E, Silvestri, S, Cocchioni, M, Pascucci, C, Stracci, F, Romeo, E, Trafficante, L, Angelillo, I, Menegozzo, S, Musti, M, Cavone, D, Cauzillo, G, Tallarigo, F, Tumino, R, Melis, M, Iavicoli, S, Marinaccio, A, Detragiache, E, Merletti, F, Gangemi, M, Stura, A, Brentisci, C, Cammarieri Diglio, G, Macerata, V, Gilardetti, M, Benfatto, L, Bianchelli, M, Mazzucco, G, Consonni, D, Pesatori, AC, Riboldi, L, Bressan, V, Gioffrè, F, Ballarin, MN, Chermaz, C, De Michieli, P, Mangone, L, Storchi, C, Sala, O, Silvestri, S, Badiali, AM, Cacciarini, V, Giovannetti, L, Martini, A, Calisti, R, La Rosa, F, D'Alo', D, Petrucci, MS, Davoli, M, Forastiere, F, Cavariani, F, Ascoli, V, Ancona, L, Di Giammarco, A, Canfora, ML, Santoro, M, Viscardi, F, Brangi, A, Cozza, V, Baldassarre, A, Convertini, L, Lio, SG, Nicita, C, Dardanoni, G, Scondotto, S, Nieddu, V, Pergola, M & Stecchi, S 2015, 'Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry', BMC Cancer, vol. 15, no. 1, 286. https://doi.org/10.1186/s12885-015-1301-2
Corfiati, Marisa ; Scarselli, Alberto ; Binazzi, Alessandra ; Di Marzio, Davide ; Verardo, Marina ; Mirabelli, Dario ; Gennaro, Valerio ; Mensi, Carolina ; Schallemberg, Gert ; Merler, Enzo ; Negro, Corrado ; Romanelli, Antonio ; Chellini, Elisabetta ; Silvestri, Stefano ; Cocchioni, Mario ; Pascucci, Cristiana ; Stracci, Fabrizio ; Romeo, Elisa ; Trafficante, Luana ; Angelillo, Italo ; Menegozzo, Simona ; Musti, Marina ; Cavone, Domenica ; Cauzillo, Gabriella ; Tallarigo, Federico ; Tumino, Rosario ; Melis, Massimo ; Iavicoli, Sergio ; Marinaccio, Alessandro ; Detragiache, E. ; Merletti, F. ; Gangemi, M. ; Stura, A. ; Brentisci, C. ; Cammarieri Diglio, G. ; Macerata, V. ; Gilardetti, M. ; Benfatto, L. ; Bianchelli, M. ; Mazzucco, G. ; Consonni, D. ; Pesatori, A. C. ; Riboldi, L. ; Bressan, V. ; Gioffrè, F. ; Ballarin, M. N. ; Chermaz, C. ; De Michieli, P. ; Mangone, L. ; Storchi, C. ; Sala, O. ; Silvestri, S. ; Badiali, A. M. ; Cacciarini, V. ; Giovannetti, L. ; Martini, A. ; Calisti, R. ; La Rosa, F. ; D'Alo', D. ; Petrucci, M. S. ; Davoli, M. ; Forastiere, F. ; Cavariani, F. ; Ascoli, V. ; Ancona, L. ; Di Giammarco, A. ; Canfora, M. L. ; Santoro, M. ; Viscardi, F. ; Brangi, A. ; Cozza, V. ; Baldassarre, A. ; Convertini, L. ; Lio, S. G. ; Nicita, C. ; Dardanoni, G. ; Scondotto, S. ; Nieddu, V. ; Pergola, M. ; Stecchi, S. / Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry. In: BMC Cancer. 2015 ; Vol. 15, No. 1.
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title = "Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry",
abstract = "Background: Previous ecological spatial studies of malignant mesothelioma cases, mostly based on mortality data, lack reliable data on individual exposure to asbestos, thus failing to assess the contribution of different occupational and environmental sources in the determination of risk excess in specific areas. This study aims to identify territorial clusters of malignant mesothelioma through a Bayesian spatial analysis and to characterize them by the integrated use of asbestos exposure information retrieved from the Italian national mesothelioma registry (ReNaM). Methods: In the period 1993 to 2008, 15,322 incident cases of all-site malignant mesothelioma were recorded and 11,852 occupational, residential and familial histories were obtained by individual interviews. Observed cases were assigned to the municipality of residence at the time of diagnosis and compared to those expected based on the age-specific rates of the respective geographical area. A spatial cluster analysis was performed for each area applying a Bayesian hierarchical model. Information about modalities and economic sectors of asbestos exposure was analyzed for each cluster. Results: Thirty-two clusters of malignant mesothelioma were identified and characterized using the exposure data. Asbestos cement manufacturing industries and shipbuilding and repair facilities represented the main sources of asbestos exposure, but a major contribution to asbestos exposure was also provided by sectors with no direct use of asbestos, such as non-asbestos textile industries, metal engineering and construction. A high proportion of cases with environmental exposure was found in clusters where asbestos cement plants were located or a natural source of asbestos (or asbestos-like) fibers was identifiable. Differences in type and sources of exposure can also explain the varying percentage of cases occurring in women among clusters. Conclusions: Our study demonstrates shared exposure patterns in territorial clusters of malignant mesothelioma due to single or multiple industrial sources, with major implications for public health policies, health surveillance, compensation procedures and site remediation programs.",
keywords = "Asbestos, Clusters, Italy, Mesothelioma, National registry",
author = "Marisa Corfiati and Alberto Scarselli and Alessandra Binazzi and {Di Marzio}, Davide and Marina Verardo and Dario Mirabelli and Valerio Gennaro and Carolina Mensi and Gert Schallemberg and Enzo Merler and Corrado Negro and Antonio Romanelli and Elisabetta Chellini and Stefano Silvestri and Mario Cocchioni and Cristiana Pascucci and Fabrizio Stracci and Elisa Romeo and Luana Trafficante and Italo Angelillo and Simona Menegozzo and Marina Musti and Domenica Cavone and Gabriella Cauzillo and Federico Tallarigo and Rosario Tumino and Massimo Melis and Sergio Iavicoli and Alessandro Marinaccio and E. Detragiache and F. Merletti and M. Gangemi and A. Stura and C. Brentisci and {Cammarieri Diglio}, G. and V. Macerata and M. Gilardetti and L. Benfatto and M. Bianchelli and G. Mazzucco and D. Consonni and Pesatori, {A. C.} and L. Riboldi and V. Bressan and F. Gioffr{\`e} and Ballarin, {M. N.} and C. Chermaz and {De Michieli}, P. and L. Mangone and C. Storchi and O. Sala and S. Silvestri and Badiali, {A. M.} and V. Cacciarini and L. Giovannetti and A. Martini and R. Calisti and {La Rosa}, F. and D. D'Alo' and Petrucci, {M. S.} and M. Davoli and F. Forastiere and F. Cavariani and V. Ascoli and L. Ancona and {Di Giammarco}, A. and Canfora, {M. L.} and M. Santoro and F. Viscardi and A. Brangi and V. Cozza and A. Baldassarre and L. Convertini and Lio, {S. G.} and C. Nicita and G. Dardanoni and S. Scondotto and V. Nieddu and M. Pergola and S. Stecchi",
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month = "4",
day = "15",
doi = "10.1186/s12885-015-1301-2",
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TY - JOUR

T1 - Epidemiological patterns of asbestos exposure and spatial clusters of incident cases of malignant mesothelioma from the Italian national registry

AU - Corfiati, Marisa

AU - Scarselli, Alberto

AU - Binazzi, Alessandra

AU - Di Marzio, Davide

AU - Verardo, Marina

AU - Mirabelli, Dario

AU - Gennaro, Valerio

AU - Mensi, Carolina

AU - Schallemberg, Gert

AU - Merler, Enzo

AU - Negro, Corrado

AU - Romanelli, Antonio

AU - Chellini, Elisabetta

AU - Silvestri, Stefano

AU - Cocchioni, Mario

AU - Pascucci, Cristiana

AU - Stracci, Fabrizio

AU - Romeo, Elisa

AU - Trafficante, Luana

AU - Angelillo, Italo

AU - Menegozzo, Simona

AU - Musti, Marina

AU - Cavone, Domenica

AU - Cauzillo, Gabriella

AU - Tallarigo, Federico

AU - Tumino, Rosario

AU - Melis, Massimo

AU - Iavicoli, Sergio

AU - Marinaccio, Alessandro

AU - Detragiache, E.

AU - Merletti, F.

AU - Gangemi, M.

AU - Stura, A.

AU - Brentisci, C.

AU - Cammarieri Diglio, G.

AU - Macerata, V.

AU - Gilardetti, M.

AU - Benfatto, L.

AU - Bianchelli, M.

AU - Mazzucco, G.

AU - Consonni, D.

AU - Pesatori, A. C.

AU - Riboldi, L.

AU - Bressan, V.

AU - Gioffrè, F.

AU - Ballarin, M. N.

AU - Chermaz, C.

AU - De Michieli, P.

AU - Mangone, L.

AU - Storchi, C.

AU - Sala, O.

AU - Silvestri, S.

AU - Badiali, A. M.

AU - Cacciarini, V.

AU - Giovannetti, L.

AU - Martini, A.

AU - Calisti, R.

AU - La Rosa, F.

AU - D'Alo', D.

AU - Petrucci, M. S.

AU - Davoli, M.

AU - Forastiere, F.

AU - Cavariani, F.

AU - Ascoli, V.

AU - Ancona, L.

AU - Di Giammarco, A.

AU - Canfora, M. L.

AU - Santoro, M.

AU - Viscardi, F.

AU - Brangi, A.

AU - Cozza, V.

AU - Baldassarre, A.

AU - Convertini, L.

AU - Lio, S. G.

AU - Nicita, C.

AU - Dardanoni, G.

AU - Scondotto, S.

AU - Nieddu, V.

AU - Pergola, M.

AU - Stecchi, S.

PY - 2015/4/15

Y1 - 2015/4/15

N2 - Background: Previous ecological spatial studies of malignant mesothelioma cases, mostly based on mortality data, lack reliable data on individual exposure to asbestos, thus failing to assess the contribution of different occupational and environmental sources in the determination of risk excess in specific areas. This study aims to identify territorial clusters of malignant mesothelioma through a Bayesian spatial analysis and to characterize them by the integrated use of asbestos exposure information retrieved from the Italian national mesothelioma registry (ReNaM). Methods: In the period 1993 to 2008, 15,322 incident cases of all-site malignant mesothelioma were recorded and 11,852 occupational, residential and familial histories were obtained by individual interviews. Observed cases were assigned to the municipality of residence at the time of diagnosis and compared to those expected based on the age-specific rates of the respective geographical area. A spatial cluster analysis was performed for each area applying a Bayesian hierarchical model. Information about modalities and economic sectors of asbestos exposure was analyzed for each cluster. Results: Thirty-two clusters of malignant mesothelioma were identified and characterized using the exposure data. Asbestos cement manufacturing industries and shipbuilding and repair facilities represented the main sources of asbestos exposure, but a major contribution to asbestos exposure was also provided by sectors with no direct use of asbestos, such as non-asbestos textile industries, metal engineering and construction. A high proportion of cases with environmental exposure was found in clusters where asbestos cement plants were located or a natural source of asbestos (or asbestos-like) fibers was identifiable. Differences in type and sources of exposure can also explain the varying percentage of cases occurring in women among clusters. Conclusions: Our study demonstrates shared exposure patterns in territorial clusters of malignant mesothelioma due to single or multiple industrial sources, with major implications for public health policies, health surveillance, compensation procedures and site remediation programs.

AB - Background: Previous ecological spatial studies of malignant mesothelioma cases, mostly based on mortality data, lack reliable data on individual exposure to asbestos, thus failing to assess the contribution of different occupational and environmental sources in the determination of risk excess in specific areas. This study aims to identify territorial clusters of malignant mesothelioma through a Bayesian spatial analysis and to characterize them by the integrated use of asbestos exposure information retrieved from the Italian national mesothelioma registry (ReNaM). Methods: In the period 1993 to 2008, 15,322 incident cases of all-site malignant mesothelioma were recorded and 11,852 occupational, residential and familial histories were obtained by individual interviews. Observed cases were assigned to the municipality of residence at the time of diagnosis and compared to those expected based on the age-specific rates of the respective geographical area. A spatial cluster analysis was performed for each area applying a Bayesian hierarchical model. Information about modalities and economic sectors of asbestos exposure was analyzed for each cluster. Results: Thirty-two clusters of malignant mesothelioma were identified and characterized using the exposure data. Asbestos cement manufacturing industries and shipbuilding and repair facilities represented the main sources of asbestos exposure, but a major contribution to asbestos exposure was also provided by sectors with no direct use of asbestos, such as non-asbestos textile industries, metal engineering and construction. A high proportion of cases with environmental exposure was found in clusters where asbestos cement plants were located or a natural source of asbestos (or asbestos-like) fibers was identifiable. Differences in type and sources of exposure can also explain the varying percentage of cases occurring in women among clusters. Conclusions: Our study demonstrates shared exposure patterns in territorial clusters of malignant mesothelioma due to single or multiple industrial sources, with major implications for public health policies, health surveillance, compensation procedures and site remediation programs.

KW - Asbestos

KW - Clusters

KW - Italy

KW - Mesothelioma

KW - National registry

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U2 - 10.1186/s12885-015-1301-2

DO - 10.1186/s12885-015-1301-2

M3 - Article

AN - SCOPUS:84928035226

VL - 15

JO - BMC Cancer

JF - BMC Cancer

SN - 1471-2407

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ER -