Abstract
BackgroundMalignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases.MethodsWe set up an individual linkage between the Italian national mesothelioma register (ReNaM) and the Italian workers’ compensation authority (INAIL) archives. Logistic regression models were used to identify and test explanatory variables.ResultsWe extracted 3270 mesothelioma cases with occupational origins from the ReNaM, matching them with 1625 subjects in INAIL (49.7%); 91.2% (1,482) of the claims received compensation. The risk of not seeking compensation is significantly higher for women and the elderly. Claims have increased significantly in recent years and there is a clear geographical gradient (northern and more developed regions having higher claims rates). The highest rates of compensation claims were after work known to involve asbestos.ConclusionsOur data illustrate the importance of documentation and dissemination of all asbestos exposure modalities. Strategies focused on structural and systematic interaction between epidemiological surveillance and insurance systems are needed.
Highlights
Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos
Matching by personal tax numbers, we found 1,526 cases in the INAIL database; relaxing the criteria for linkage and searching by full name and place of birth, the number of matched subjects reached 1,625 (49.7%); 91.2% (1482) of these claims for MM received compensation from INAIL
Correct evaluation of the distribution of risk is fundamental for establishing insurance premiums, and correct premiums are fundamental to induce preventive measures for risk reduction
Summary
Malignant mesothelioma is an aggressive and lethal tumour strongly associated with exposure to asbestos (mainly occupational). In Italy a large proportion of workers are protected from occupational diseases by public insurance and an epidemiological surveillance system for incident mesothelioma cases. Malignant mesothelioma (MM) is a rare and rapidly fatal tumour closely related to inhalation of asbestos fibres. It arises from the serous membranes of the pleura and, less frequently, from the peritoneal and pericardial cavities and the tunica vaginalis testis. In 1994 mesothelioma (of every site) was recognized for the first time in Italy as an occupational disease, in addition to lung cancer (every type) occurring in asbestos exposed workers. The Italian Workers’ Compensation Authority (INAIL) allows compensation in response to individual workers’ claims, and benefits are granted to the subject or to relatives
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