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The relationship between malignant mesothelioma and an asbestos cement plant environmental risk: a spatial case–control study in the city of Bari (Italy)

  • Marina Musti
  • Alessio Pollice
  • Domenica CavoneEmail author
  • Silvano Dragonieri
  • Massimo Bilancia
Original Article

Abstract

Objectives

To estimate the mesothelioma risk and environmental asbestos exposure (EAE) due to an asbestos-cement plant.

Methods

A spatial case–control study including 48 malignant mesothelioma (MM) cases occurred in the period 1993–2003 selected from the regional mesothelioma register (RMR) and 273 controls. The disease risk was estimated by means of a logistic-regression model, in which the probability of disease-occurrence is expressed as a function of the classes of distances. A non-parametric method was applied to estimate the full relative risk surface.

Results

Significant MM odds ratio of 5.29 (95 CI: 1.18–23.74) was found for people living within a range up to 500 m centered on the plant. The non-parametric estimation of relative risk surface unveiled a marked peak near the plant not paralleled by the spatial distribution of controls.

Conclusion

Evidence of an association between mesothelioma risk and EAE is highlighted. The role played by the RMR in increasing the public health local authorities awareness is stressed.

Keywords

Asbestos-cement plant Environmental-neighborhood exposure Mesothelioma register Spatial case–control study Public health Italy 

Notes

Acknowledgments

We thank Professor Annibale Biggeri for his comments to the manuscript. The authors would like to thank Professor Benedetto Terracini for the ideas on which this paper is based. Conflict of interest statement: None declared by any author.

References

  1. Albin M, Magnani C, Krstev S, Rapiti E, Shefer I (1999) Asbestos and cancer: an overview of current trends in Europe. Environ Health Perspect 107(Suppl 2):289–298. doi: 10.2307/3434419 PubMedCrossRefGoogle Scholar
  2. Amendola P, Belli S, Binazzi A, Cavalleri A, Comba P, Mastrantonio M et al (2003) Mortality from malignant pleural neoplasms in Broni (Pavia), 1980–1997. Epidemiol Prev 27(2):86–90PubMedGoogle Scholar
  3. Berman M, Diggle PJ (1989) Estimated weighted integrals of the second-order intensity of a spatial point process. JRSS B 51:81–92Google Scholar
  4. Bianchi C, Bianchi T (2007) Malignant mesothelioma: global incidence and relationship with asbestos. Ind Health 45(3):379–387. doi: 10.2486/indhealth.45.379 PubMedCrossRefGoogle Scholar
  5. Bianchi F, Biggeri A, Cadum E, Comba P, Forastiere F, Martuzzi M et al (2006) Environmental epidemiology and polluted areas in Italy. Epidemiol Prev 30(3):146–152PubMedGoogle Scholar
  6. Biggeri A, Barbone F, Lagazio C, Bovensi M, Stanta G (1996) Air pollution and lung cancer in Trieste, Italy: spatial analysis of risk as a function of distance from sources. Environ Health Perspect 104:750–754. doi: 10.2307/3433221 PubMedCrossRefGoogle Scholar
  7. Bilancia M, Cavone D, Pollice A, Musti M (2003) Valutazione del rischio di mesotelioma: il caso di una fabbrica per la produzione di cemento-amianto nella città di Bari. Epidemiol Prev 27(5):277–282PubMedGoogle Scholar
  8. Boffetta P (2006) Human cancer from environmental pollutants: the epidemiological evidence. Mutat Res 608(2):157–162PubMedGoogle Scholar
  9. Bourdes V, Boffetta P, Pisani P (2000) Environmental exposure to asbestos and risk of pleural mesothelioma: review and meta-analysis. Eur J Epidemiol 16(5):411–417. doi: 10.1023/A:1007691003600 PubMedCrossRefGoogle Scholar
  10. Burdorf A, Järvholm B, Englund A (2005) Explaining differences in incidence rates of pleural mesothelioma between Sweden and the Netherlands. Int J Cancer 113(2):298–301. doi: 10.1002/ijc.20552 PubMedCrossRefGoogle Scholar
  11. Comba P, Ascoli V, Belli S, Benedetti M, Gatti L, Ricci P et al (2003) Risk of soft tissue sarcomas and residence in the neighbourhood of an incinerator of industrial wastes. Occup Environ Med 60(9):680–683. doi: 10.1136/oem.60.9.680 PubMedCrossRefGoogle Scholar
  12. Comba P, Merler E, Pasetto R (2005) Asbestos-related diseases in Italy: epidemiologic evidences and public health issues. Int J Occup Environ Health 11(1):36–44PubMedGoogle Scholar
  13. Coviello V, Carbonara M, Bisceglia L, Di Pierri C, Ferri GM, Lo Izzo A et al (2002) Mortality in a cohort of asbestos cement workers in Bari. Epidemiol Prev 26(2):65–70PubMedGoogle Scholar
  14. Cuzick J, Edwards R (1990) Spatial clustering for inhmogeneous population (with discussion). JRSS B 52:73:104Google Scholar
  15. DeGiovanni D, Pesce B, Pondrano N (2004) Asbestos in Italy. Int J Occup Environ Health 10(2):193–197PubMedGoogle Scholar
  16. Diggle P (2003) Statistical analysis of spatial point patterns, 2n edn. Hodder ArnoldGoogle Scholar
  17. Diggle PJ, Rowlingson BS (1994) A conditional approach to point process modelling of elevated risk. JRSS A 157:433–440Google Scholar
  18. Dreassi E, Lagazio C, Maule MM, Magnani C, Biggeri A (2007) Sensitivity analysis of the relationship between disease occurrence and distance from a putative source of pollution (submitted)Google Scholar
  19. Elliott P, Wartenberg D (2004) Spatial epidemiology: current approaches and future challenges. Environ Health Perspect 112(9):998–1006PubMedGoogle Scholar
  20. Gatrell AC, Bailey TC, Diggle PJ, Rowlingson BS (1996) Spatial point pattern analysis and its application in geographical epidemiology. Trans Inst Engl Geogr 21:256–274. doi: 10.2307/622936 CrossRefGoogle Scholar
  21. Goldberg M, Luce D (2005) Can exposure to very low levels of asbestos induce pleural mesothelioma? Am J Respir Crit Care Med 172:939–940. doi: 10.1164/rccm.2507003 PubMedCrossRefGoogle Scholar
  22. Han D, Rogerson PA, Bonner MR, Nie J, Vena JE, Muti P, et al (2005) Assessing spatio-temporal variability of risk surfaces using residential history data in a case control study of breast cancer. Int J Health Geogr 12:4(1)Google Scholar
  23. Hillerdal G (1999) Mesothelioma cases associated with non-occupational and low dose exposures. Occup Environ Med 56(8):505–513PubMedCrossRefGoogle Scholar
  24. Jacquez GM, Meliker JR, Avruskin GA, Goovaerts P, Kaufmann A, Wilson ML et al (2006) Case control geographic clustering for residential histories accounting for risk factors and covariates. Int J Health Geogr 5:32. doi: 10.1186/1476-072X-5-32 PubMedCrossRefGoogle Scholar
  25. La Vecchia C, Decarli A, Peto J, Levi F, Tomei F, Negri E (2000) An age, period and cohort analysis of pleural cancer mortality in Europe. Eur J Cancer Prev 9(3):179–184. doi: 10.1097/00008469-200006000-00006 PubMedCrossRefGoogle Scholar
  26. Magnani C, Agudo A, Gonzalez CA, Andrion A, Calleja A, Chellini E et al (2000) Multicentric study on malignant mesothelioma and non-occupational exposure to asbestos. Br J Cancer 83(1):104–111. doi: 10.1054/bjoc.2000.1161 PubMedCrossRefGoogle Scholar
  27. Magnani C, Dalmasso P, Biggeri A, Ivaldi C, Mirabelli D, Terracini B (2001) Increased risk of malignant mesothelioma of the pleura after residential or domestic exposure to asbestos: a case–control study in Casale Monferrato, Italy. Environ Health Perspect 109(9):915–919. doi: 10.2307/3454992 PubMedCrossRefGoogle Scholar
  28. Marinaccio A, Montanaro F, Mastrantonio M, Mastrantonio M, Uccelli R, Altavista P et al (2005) Predictions of mortality from pleural mesothelioma in Italy: a model based on asbestos consumption figures supports results from age-period-cohort models. Int J Cancer 115(1):142–147. doi: 10.1002/ijc.20820 PubMedCrossRefGoogle Scholar
  29. Mather FJ, White LE, Langlois EC, Shorter CF, Swalm CM, Shaffer JG et al (2004) Statistical methods for linking health, exposure, and hazards. Environ Health Perspect 112(14):1440–1445PubMedGoogle Scholar
  30. Maule MM, Magnani C, Dalmasso P, Mirabelli D, Merletti F, Biggeri A (2007) Modeling mesothelioma risk associated with environmental asbestos exposure. Environ Health Perspect 115(7):1066–1071PubMedCrossRefGoogle Scholar
  31. Mirabelli D, Calisti R, Barone Adesi F, Fornero E, Merletti F, Magnani C (2008) Excess of mesotheliomas after exposure to chrysotile in Balangero, Italy. Occup Environ Med. 2008 Jun 4 Epub ahead of printGoogle Scholar
  32. Morris SE, Wakefield JC (2000) Assessment of disease risk in relation to a pre-specified source. In: Elliot P, Wakefield JC, Best NG, Briggs DJ (eds) Spatial epidemiology—methods and applications. Oxford University Press, Oxford, pp 153–184Google Scholar
  33. Musti M, Cavone D, Aalto Y, Scattone A, Serio G, Knuutila S (2002) A cluster of familial malignant mesothelioma with del (9p) as the sole chromosomal anomaly. Cancer Genet Cytogenet 138(1):73–76PubMedCrossRefGoogle Scholar
  34. Napoli S (1975) Inquinamento da amianto: rilievi critici sulle metodiche ed esperienze nella città di Bari. Lavoro Umano XXVII, 148–55Google Scholar
  35. Newhouse ML, Thompson H (1993) Mesothelioma of pleura, peritoneum following exposure to asbestos in the London area. 1965. Br J Ind Med 50(9):769–778PubMedGoogle Scholar
  36. Nuckols JR, Ward MH, Jarup L (2004) Using geographic information systems for exposure assessment in environmental epidemiology studies. Environ Health Perspect 112(9):1007–1015PubMedGoogle Scholar
  37. Osman E, Hasan B, Meral U, Ercan A, Mehmet T, Nazan B et al (2007) Recent discovery of an old disease: malignant pleural mesothelioma in a village in south-east Turkey. Respirology 12(3):448–451PubMedCrossRefGoogle Scholar
  38. Pan XL, Day HW, Wang W, Beckett LA, Schenker MB (2005) Residential proximity to naturally occurring asbestos and mesothelioma risk in California. Am J Respir Crit Care Med 172(8):1019–1025PubMedCrossRefGoogle Scholar
  39. Pannelli F, Montanaro F, Pascucci C, Mirabelli D, Gennaro V (2006) Mesothelioma incidence and time trend in the worlds. Med Lav 97(5):682–693PubMedGoogle Scholar
  40. Pasetto R, Comba P, Marconi A (2005) Mesothelioma associated with environmental exposure. Med Lav 96(4):330–337PubMedGoogle Scholar
  41. Reid A, Berry G, de Klerk N, Hansen J, Heyworth J, Ambrosini G et al (2007) Age and sex differences in malignant mesothelioma after residential exposure to blue asbestos (crocidolite). Chest 131(2):376–382PubMedCrossRefGoogle Scholar
  42. Rogerson PA (2006) Statistical methods for the detection of spatial clustering in case–control data. Stat Med 25(5):811–823PubMedCrossRefGoogle Scholar
  43. Schneider J, Rödelsperger K, Pohlabeln H, Woitowitz HJ (1996) Environmental and indoor air exposure to asbestos fiber dust as a risk and causal factor of diffuse malignant pleural mesothelioma. Zentralbl Hyg Umweltmed 199(1):1–23PubMedGoogle Scholar
  44. Szeszenia-Dabrowska N, Wilczynska U, Szymczak W, Laskowicz K (1998) Environmental exposure to asbestos in asbestos cement workers: a case of additional exposure from indiscriminate use of industrial wastes. Int J Occup Med Environ Health 11(2):171–177PubMedGoogle Scholar
  45. Vieira V, Webster T, Aschengrau A, Ozonoff D (2002) A method for spatial analysis of risk in a population-based case–control study. Int J Hyg Environ Health 205(1–2):115–120PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Marina Musti
    • 1
  • Alessio Pollice
    • 2
  • Domenica Cavone
    • 1
    • 4
    Email author
  • Silvano Dragonieri
    • 3
  • Massimo Bilancia
    • 2
  1. 1.Department of Internal Medicine and Public Medicine, Section of Occupational Medicine “Ramazzini”University of Bari, National Register of Mesothelioma, Regional Operative Centre (C.O.R.)ApuliaItaly
  2. 2.Department of Statistical Sciences “Carlo Cecchi”University of BariBariItaly
  3. 3.Respiratory Diseases, Department of Clinical Methodology and Medical-Surgical TechnologiesUniversity of BariBariItaly
  4. 4.Università degli Studi di BariBari (BA)Italy

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