Malignant Mesothelioma Rates Rising in Lombardy Region of Italy
Lombardy, Italy is the most populated and most industrial region of Italy. Correspondingly, it has suffered the burden of asbestos-related disease incidence. In a recent study by Carolina Mensi, et al., “Incidence of mesothelioma in Lombardy, Italy: exposure to asbestos, time patterns and future projects”, the authors discuss how the scientific community can use this unfortunate regional epidemic to “increase awareness of dangers of exposure to asbestos in countries that still use it, but where its health effects are still overlooked.”
Between the years 1945 and 1992 when it was finally banned, asbestos was widely used in ironing-boards, thermal insulation, asbestos gloves, asbestos-cement tiles, water tanks, and in the petrochemical, railroad and shipbuilding industries. Since 2000, the Lombardy Region has maintained a register of mesothelioma diagnoses called “Registro Mesoteliomi Lombardia”, or “RML”. Diagnoses were obtained via immunohistochemical confirmation and imaging (for a “certain MM”), cytology plus imaging (for a “probable MM”), or positive imaging (for a “possible MM”). Patients were not only asked about employment history, but also on each cohabitant. This includes the cohabitant’s occupation, years living with them and brushing off or washing dirty work clothes at home.
Risk for Malignant Mesothelioma was highest among building construction (for men), textile (for women), asbestos cement and railroad production/maintenance industries. Previously using a Poisson age-cohort, an earlier study was able to digest the information contained in the RML to determine that the peak of malignant mesothelioma cases was likely to occur between 2012 and 2024. It now appears in this study that the peak will occur in 2019. It was noted that the peak may have already occurred in other Italian regions. One puzzling note is that a large proportion of women (39.2%) with malignant mesothelioma were unable to identify asbestos exposure. This suggests that all sources of exposure to asbestos are still not known.