Pleural malignant mesothelioma epidemic: Incidence, modalities of asbestos exposure and occupations involved from the Italian National Register

Alessandro Marinaccio, Alessandra Binazzi, Davide Di Marzio, Alberto Scarselli, Marina Verardo, Dario Mirabelli, Valerio Gennaro, Carolina Mensi, Luciano Riboldi, Enzo Merler, Renata De Zotti, Antonio Romanelli, Elisabetta Chellini, Stefano Silvestri, Cristiana Pascucci, Elisa Romeo, Simona Menegozzo, Marina Musti, Domenica Cavone, Gabriella CauzilloRosario Tumino, Carmela Nicita, Massimo Melis, Sergio Iavicoli

Research output: Contribution to journalArticlepeer-review


Due to the large scale use of asbestos (more than 3.5 million tons produced or imported until its definitive banning in 1992), a specific national surveillance system of mesothelioma incident cases is active in Italy, with direct and individual anamnestic etiological investigation. In the period between 1993 and 2004, a case-list of 8,868 pleural MM was recorded by the Italian National Register (ReNaM) and the modalities of exposure to asbestos fibres have been investigated for 6,603 of them. Standardized incidence rates are 3.49 (per 100,000 inhabitants) for men and 1.25 for women, with a wide regional variability. Occupational asbestos exposure was in 69.3% of interviewed subjects (N = 4,577 cases), while 4.4% was due to cohabitation with someone (generally, the husband) occupationally exposed, 4.7% by environmental exposure from living near a contamination source and 1.6% during a leisure activity. In the male group, 81.5% of interviewed subjects exhibit an occupational exposure. In the exposed workers, the median year of first exposure was 1957, and mean latency was 43.7 years. The analysis of exposures by industrial sector focuses on a decreasing trend for those traditionally signaled as "at risk" (asbestos-cement industry, shipbuilding and repair and railway carriages maintenance) and an increasing trend for the building construction sector. The systematic mesothelioma surveillance system is relevant for the prevention of the disease and for supporting an efficient compensation system. The existing experience on all-too-predictable asbestos effects should be transferred to developing countries where asbestos use is spreading.

Original languageEnglish
Pages (from-to)2146-2154
Number of pages9
JournalInternational Journal of Cancer
Issue number9
Publication statusPublished - May 1 2012


  • asbestos
  • Italy
  • mesothelioma
  • national register
  • pleural

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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