Abstract
Notwithstanding the ban in 1992, asbestos exposure for workers in the construction sector in Italy remains a concern. The purpose of this study is to describe the characteristics of malignant mesothelioma (MM) cases recorded by the Italian registry (ReNaM) among construction workers. Incident mesothelioma cases with a definite asbestos exposure have been analyzed. Characteristics of cases and territorial clusters of crude rates of MM in construction workers have been described, as well as the relation between asbestos use before the ban and the historical trend of workforce in the construction sector in Italy. ReNaM has collected 31,572 incident MM cases in the period from 1993 to 2018 and asbestos exposure has been assessed for 24,864 (78.2%) cases. An occupational exposure has been reported for 17,191 MM cases (69.1% of subjects with a definite asbestos exposure). Among them, 3574 had worked in the construction sector, with an increasing trend from 15.8% in the 1993–98 period to 23.9% in 2014–2018 and a ubiquitous territorial distribution. The large use of asbestos in construction sector before the ban makes probability of exposure for workers a real concern still today, particularly for those working in maintenance and removal of old buildings. There is a clear need to assess, inform, and prevent asbestos exposure in this sector.
Highlights
Malignant mesothelioma (MM) is a rare cancer with global incidence in the general population estimated at 0.30 cases in 2020
The exposure evaluation was available for 24,864 MM cases (78.8%): among them
In the recent years the occupational trend in Italy evidenced a clear decrease in workforce, construction is still a relevant economic sector in Italy, accounting for 6.1%
Summary
Malignant mesothelioma (MM) is a rare cancer with global incidence in the general population estimated at 0.30 cases (per 100,000 inhabitants) in 2020. In Italy, that is among the countries with the highest values (Northern Europe: 1.4; Australia and New Zealand: 1.3) the incidence rate was estimated of one case per 100,000 [1]. MM is associated with occupational, environmental and in house exposures to asbestos fibers and other asbestiform fibers (vermiculite, erionite, fluoro-edenite) [2]. The average latency period, delimited from first causative exposure to malignant mesothelioma diagnosis, is approximately 40 years, with a range from 20 to 70 years [4]. Occupational exposures to asbestos have occurred in a variety of industrial contexts, including asbestos mining and milling, manufacturing of asbestos containing materials (ACMs), shipbuilding and repair, railway carriages maintenance, and construction
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