Onder vrouwen van (ex-)werknemers en omwonenden van een voormalige Italiaanse asbestcementfabriek komt de ziekte mesothelioom vaker dan gemiddeld voor. De onderzoeksgroep bestond o.a. uit 1780 vrouwen die tussen 1988 en 2003 met een man getrouwd waren die in de Eternit Fabriek van Casale Monferrato (Piedmont, Italië.) werkte. Bij andere asbestziektes, zoals asbestgerelateerde longkanker werd geen hoger risico gevonden. De voormalige asbestfabriek was tussen 1907 en 1986 in werking in de plaats Casale Monferrate (Piedmont, Italië.). Bron: Ferrante, D. et al., (2007). Cancer mortality and incidence of mesothelioma in a cohort of wives of asbestos workers in Casale Monferrato, Italy. Environmental Health Perspectives, 115, nr. 10, oktober 07, p. 1401-05. Maule M. et al, (2007). Modeling mesothelioma risk associated with environmental asbestos exposure. Environmental Health Perspectives, 115, nr.10, p.1066-71.
Ferrante, D. et al., (2007). Cancer mortality and incidence of mesothelioma in a cohort of wives of asbestos workers in Casale Monferrato, Italy. Environmental Health Perspectives, 115, nr. 10, oktober 07, p. 1401-05.
BACKGROUND: Family members of asbestos workers are at increased risk of malignant mesothelioma (MM). Although the hazard is established, the magnitude of the risk is uncertain, and it is unclear whether risk is also increased for other cancers. Few cohort studies have been reported.
OBJECTIVE: The ".Eternit". factory of Casale Monferrato (Italy), active from 1907 to 1986, was among the most important Italian plants producing asbestos-cement (AC) goods. In this article we present updated results on mortality and MM incidence in the wives of workers at the factory.
METHODS: We studied a cohort of 1,780 women, each married to an AC worker during his employment at the factory but not personally occupationally exposed to asbestos. Cohort membership was defined starting from the marital status of each worker, which was ascertained in 1988 from the Registrar’s Office in the town where workers lived. At the end of follow-up (April 2003), 67% of women were alive, 32.3% dead, and 0.7% lost to follow-up. Duration of exposure was computed from the husband’s period of employment. Latency was the interval from first exposure to the end of follow-up.
RESULTS: The standardized mortality ratio (SMR) for pleural cancer [21 observed vs. 1.2 expected. SMR = 18.00. 95% confidence interval (CI), 11.14-27.52] was significantly increased. Mortality for lung cancer was not increased (12 observed vs. 10.3 expected. SMR = 1.17. 95% CI, 0.60-2.04). Eleven incident cases of pleural MM were observed (standardized incidence ratio = 25.19. 95% CI, 12.57-45.07).
CONCLUSIONS: Household exposure, as experienced by these AC workers’ wives, increases risk for pleural MM but not for lung cancer.
Maule M. et al, (2007). Modeling mesothelioma risk associated with environmental asbestos exposure. Environmental Health Perspectives, 115, nr.10, p.1066-71.
BACKGROUND: Environmental asbestos pollution can cause malignant mesothelioma, but few studies have involved dose-response analyses with detailed information on occupational, domestic, and environmental exposures.
OBJECTIVES: In the present study, we examined the spatial variation of mesothelioma risk in an area with high levels of asbestos pollution from an industrial plant, adjusting for occupational and domestic exposures.
METHODS: This population-based case-control study included 103 incident cases of mesothelioma and 272 controls in 1987-1993 in the area around Casale Monferrato, Italy, where an important asbestos cement plant had been active for decades. Information collected included lifelong occupational and residential histories. Mesothelioma risk was estimated through logistic regression and a mixed additive-multiplicative model in which an additive scale was assumed for the risk associated with both residential distance from the plant and occupational exposures. The adjusted excess risk gradient by residential distance was modeled as an exponential decay with a threshold.
RESULTS: Residents at the location of the asbestos cement factory had a relative risk for mesothelioma of 10.5 [95% confidence interval (CI), 3.8-50.1), adjusted for occupational and domestic exposures. Risk decreased rapidly with increasing distance from the factory, but at 10-km the risk was still 60% of its value at the source. The relative risk for occupational exposure was 6.0 (95% CI, 2.9-13.0), but this increased to 27.5 (95% CI, 7.8-153.4) when adjusted for residential distance.
CONCLUSIONS: This study provides strong evidence that asbestos pollution from an industrial source greatly increases mesothelioma risk. Furthermore, relative risks from occupational exposure were underestimated and were markedly increased when adjusted for residential distance.